MCA-F-501/15, version 1 – 24 February 2025 — Notification of the End of a Clinical Trial
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Contents
MEDICINES CONTROL AGENCY
MCA
THE GAMBIA
NOTIFICATION OF THE END
MCA-F-501/15
OF A CLINICAL TRIAL
MEDICINES CONTROL AGENCY
Off Bertil Harding Highway, Kotu East, Kanifing Municipality, P.O. Box 3162, Serekunda, The Gambia
Website: www.mca.gm; E-mail: info@mca.gm; Tel. No.: +2204380632
A TRIAL IDENTIFICATION
PACTR Number:
Protocol Number:
Full Title of Clinical Trial:
B APPLICANT IDENTIFICATION (please tick the appropriate box)
Sponsor ☐
Legal representative of the sponsor ☐
Person or organisation authorised by the
sponsor to make the application
☐
Complete below:
Organisation
Name of person to contact
Address
Telephone number
Email
C END OF TRIAL
Is this the end of the trial in The Gambia ☐ Yes ☐ No
only1
If yes, give date (DD/MM/YYYY):
Is this the end of the complete trial in all
countries concerned by the trial1
☐ Yes ☐ No
If yes, give date (DD/MM/YYYY):
Is it an early termination? ☐ Yes ☐ No
If yes, give date (DD/MM/YYYY):
Briefly describe in an annex (free text):
• The justification for early termination of the trial
MCA-F-501/15, version 1 – 24 February 2025 Page 1 of 2
Original PDF page 1 — retained source fields, tables and layout.
Clinical Trial Progress Report MCA The Gambia
• Number of participant still receiving treatment at time of early termination
in The Gambia and their proposed management;
• The consequences of early termination for the evaluation of the results and
for overall risk benefit assessment of the investigational medicinal product
1
In case of a multi-country trial, if the national and global end of trial dates are different
submit this form two times:
1) At the end of the trial in The Gambia
2) At the global end of the trial
Declaration by the Applicant
I hereby confirm that/confirm on behalf of the sponsor that (delete which is not
applicable):
• The above information given on this declaration is correct; and
• That the clinical trial summary report will be submitted within the
applicable deadlines in accordance with the MCA Guideline for Clinical
Trials in Humans
Name:
Signature Date
For official use
Date of receipt
MCA registration number
Ethics committee
registration number
MCA-F-501/15, version 1 – 24 February 2025 Page 2 of 2
Original PDF page 2 — retained source fields, tables and layout.