A Sponsor's Best Practice and Operating Principles to Manage Data Monitoring Committees

The use of data monitoring committees (DMC) to safeguard patients' safety in clinical trials has evolved over the last decades and has become increasingly common. To ensure well-operating and high-performing DMCs, pharmaceutical companies need to establish clearly defined operational processes while continuously seeking to optimize these and adapt to the needs of drug development. Although there are health authority guidelines on establishing and managing a DMC, the perspectives and experiences of sponsors are often underrepresented. This publication shares insights on a sponsor, Novo Nordisk (NN), regarding principles and practices for DMC establishment and management across varying trial types and therapeutic areas, including challenges and solutions. Highlighting NN's structured and successful approach to DMCs, it details clearly defined roles and responsibilities that ensure productive DMC meetings and high-quality data for the DMC. Additionally, NN's practices for clear, transparent, and trustful communication between the sponsor, the DMC, and the independent external statistical vendor are described. Processes for quality control, internal audits, and learnings from inspections and how these are incorporated for continuous improvement of the DMC process are discussed. While the processes and practices described are primarily designed for medium and large pharmaceutical companies, certain aspects may also be relevant and beneficial for smaller companies.