Legal Framework
The new EU Regulation No 536/2014 (Clinical Trials Regulation, CTR) came into force on 31 January 2022. It concerns the new way in which clinical drug research is conducted in the European Union (EU). The Regulation harmonises the procedures for the submission, assessment and monitoring of clinical drug trials in the EU through the Clinical Trials Information System (CTIS).
The legal framework at national level for the processing of applications for clinical trials submitted in accordance with Regulation (EU) No 536/2014 is described in the legal texts below.
• Law of 7 May 2017 on clinical trials of medicines for human use (FR-version)
• Royal Decree of 9 October 2017 implementing the Law of 7 May 2017 on clinical trials of medicines for human use (FR-version)
To determine whether a clinical study falls under the European Regulation as a clinical trial, the decision tree (Annex I in Q&A document) can be consulted.
Contents of a CTR dossier for a clinical trial
European requirements
The contents of a CTR dossier for a clinical trial are described in Annex I to the Clinical Trials Regulation.
The templates of the application documents in Part II were developed by the European Commission and can be found in Chapter I of EudraLex, Volume 10.
• Recruitment and Informed consent procedure template
• Compensation for trial participants
• Template for declaration of interest by the principal investigator
Information specific to Belgium
In Belgium, there are some specific requirements regarding the content of the CTR dossier for clinical trials. These are described in the link of requested documents for Belgium, which is updated twice a year.
Timelines
The European Clinical Trials Regulation (CTR) establishes the binding maximum timelines for the approval of clinical trial applications. These timelines are implemented and monitored through the Clinical Trials Information System (CTIS).
For a Phase I clinical trial initially submitted exclusively in Belgium, the FAMHP already applies shorter timelines, which are laid down in the Law of 7 May 2017. The trial is assessed within twenty days, provided that no requests for additional information are issued.
From 1 January 2026, the FAMHP will introduce additional expedited timelines for the evaluation of initial mononational clinical trial applications concerning medicinal products for human use. The timelines are defined for Part 1 of the application. However, in the case of a full application, Part 2 will not be completed later than Part 1. This means that the expedited timelines will also be respected by the Ethics Committees, enabling faster decision-making.
Special attention is given to the initial submission of early-phase clinical trials. The timelines currently applied to mononational Phase I clinical trials will be extended to mononational Phases I, I–II and Phase II clinical trials.
Belgium will implement additional measures for the initial submissions of all other mononational trials (Phases II-III, III, III-IV, IV).
A detailed overview of the resulting timelines by category of initial mononational clinical trials submitted in Belgium, applicable as of 1 January 2026, is provided in the Annex.
These new shortened timelines constitute an official national target; however, unlike the timelines for mononational Phase I trials, they are not legally defined. These timelines may be adjusted in the future based on evolving knowledge. In such cases, we will communicate transparently.
With these expedited timelines, the Belgium positions itself among the fastest regulators for clinical trials in Europe, without compromising the strict requirements applicable to clinical trials. This is an incentive to strengthen Belgium’s position as a hub for clinical research.
Should European pilot phases be launched in the future in which Belgium can participate, and if these significantly expedite the assessment of multinational clinical trial submissions, the FAMHP will join these initiatives, subject to capacity. The FAMHP, together with the College and the Ethics Committees, strives for harmonisation in Europe. By promoting cooperation between Member States and harmonisation, better and more sustainable outcomes can be achieved.
Central information system (CTIS)
CTIS is the central access point for submitting applications for clinical trials within the EU and the European Economic Area (EEA) and it consists of several components.
• A workspace for clinical trial sponsors and the organisations that work in collaboration with them. The secure sponsor workspace assists clinical trial sponsors in preparing their application and compiling the supporting documentation to be submitted for assessment.
• A workspace for the competent authorities of the EU Member States and EEA countries, and for the European Commission. This secure workspace for authorities supports the activities of EU Member States, EEA countries, and the European Commission in the assessment and supervision of clinical drug trials.
• The public will have access to detailed information on all clinical trials conducted in the EU and EEA through the public website once applications are submitted and approved through CTIS.
The EU Member States and EEA countries will assess and monitor clinical trials in CTIS. The European Medicines Agency (EMA) builds and maintains CTIS. The European Commission will ensure the correct interpretation and implementation of the Clinical Trials Regulation.
Processing of clinical drug trials in CTIS
Clinical trial sponsors seeking approval for a clinical trial in one or more EU/EEA Member States will be required to submit only one application form and the supporting dossier through CTIS. The submission of the clinical trial application form and supporting dossier also includes the public registration of the clinical trial.
CTIS will support the day-to-day business processes of EU Member States, EEA countries and sponsors throughout the duration of a clinical trial. The system will provide regulatory oversight of clinical trials and tools for supervision and monitoring.
Registration for the use of CTIS
Parties wishing to use CTIS must have an EMA account. Users who already have an EMA account, for example to use EudraVigilance or the Substance, Product, Organisation and Referentials Database (SPOR), do not need to create a new account. Users who do not have an EMA account can register through the EMA account management facility.
Organisations may need to go through additional registration steps based on the user management approach that was used for CTIS. The organisation-centred approach enables user management by an administrator at organisation level, rather than at the level of an individual trial. This is intended for organisations that run various trials through CTIS. To make use of this organisation-based approach, organisations must ensure that they are registered in the EMA organisation management system and must register a CTIS High Level Administrator through the EMA account management facility.
More information about CTIS
• General information about the Clinical Trials Regulation and CTIS
• CTIS handbook for clinical trial sponsors
• EMA also offers training sessions for additional learning opportunities. Video recordings of these 'walk in clinics' or 'bitesize talks' and supporting materials are available on this page
• Clinical Trial Highlights Newsletter
• Clinical Trials Regulation – EudraLex, Volume 10, Clinical trials guidelines
• A Q&A document from the European Commission provides answers to frequently asked questions about the CTR.
Information sessions on the Clinical Trials Regulation
Presentations from the information sessions on 10 March 2023 and on 15 September 2023
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