The NIH defines a clinical trial as a research study in which one or more human subjects are prospectively assigned to one or more interventions (which may include placebo or other control) to evaluate the effects of those interventions on health-related biomedical or behavioral outcomes. Clinical trials range from small first-in-human, tolerability or exploratory studies, to larger trials of efficacy or effectiveness.

Learn about NIAMS policies and procedures for investigators conducting clinical research, including short-term and long-term clinical studies.

Types of Clinical Research Grants

Exploratory Clinical Trial Grants (R21)

This Exploratory Clinical Trials Grants Program is designed to facilitate the execution of short-term, interventional studies. Such studies must meet the NIH definition of a clinical trial and be feasible within the time and budget constraints of this Funding Opportunity Announcement (FOA). A high priority is the use of such studies to stimulate the translation of promising research developments from laboratory, preclinical, and early human testing into clinical practice.

Clinical Observational (CO) Studies in Musculoskeletal, Rheumatic, and Skin Diseases (R01)

Applicants are encouraged to propose studies that address significant obstacles or questions in the design of a clinical trial, such as determining appropriate outcome measures, or identifying when patients are most likely to respond to an intervention.

NIAMS Clinical Trial Planning Grants (R34)

The R34 planning grants will give investigators the time and funds necessary to complete detailed clinical trial planning to meet NIAMS and NIH standards and regulatory requirements.

NIAMS Clinical Trial Implementation Cooperative Agreement (U01)

The U01 implementation cooperative agreement is for applicants that have completed the necessary pre-trial planning activities and are ready to launch the clinical trial.

NIAMS Consultation

Investigators should contact the appropriate NIAMS Program Director prior to submitting applications for a NIAMS Exploratory Clinical Trial (R21) grant, a NIAMS Clinical Observational (R01) grant, a NIAMS R34 clinical trial planning grant or a U01 implementation grant application. Applicants should refer to our Consultation with NIAMS Staff for details on additional information they might wish to share with the Program Director in a pre-submission consultation.

Letter of Intent/Letter of Request

Letter of Intent: Applications with Direct Costs Less Than $500,000

All investigators considering applying for a R34 or a U01 with budgets less than $500,000 in any given year are strongly encouraged to submit a Letter of Intent (LOI) to the NIAMS before submission of the application, including new and resubmission applications. Applicants are encouraged to allow enough time before the planned receipt date to give the Institute sufficient time to discuss the LOI with the investigators, particularly if there has been no prior consultation with the NIAMS about the application. Please see instructions about deadlines and what to include in the LOI. The LOI should be submitted to the Scientific/Research contacts listed in the Program Announcement, who will share the request with the appropriate Program Director.

Letter of Request: Applications with Direct Costs $500,000 or More

Per NIH policy, pre-approval is required prior to submission of an application that will have direct costs of $500,000 or more in any given year. Applicants should refer to NIAMS specific guidelines for information about deadlines and what to include in their Letter of Request (LOR) seeking permission to submit an application. Potential applicants must submit the LOR at least 10 weeks prior to the application due date to determine whether the Institute will approve the written request to submit a U01. The NIAMS will not evaluate the technical and scientific merit of the proposed trial at this stage. Technical and scientific merit will be determined during peer review. Applicants whose projects do meet NIAMS’ programmatic needs or are not considered to be appropriate as investigator-initiated clinical trials will not be granted permission to submit an application. Pre-approval by NIAMS, on the basis of an LOR submitted prior to the application, indicates that NIAMS has determined that the proposed project is of high priority. The NIAMS will inform the applicant of the decision.

Peer Review by AMS Clinical (AMSC) Trials Review Committee

Peer review of properly completed applications submitted in response to the Program Announcements listed on this page will be conducted by the NIAMS AMS Clinical Trials Review Committee. This review committee will provide expertise in NIAMS disease areas and in clinical trial methodology.

The NIAMS will make funding decisions on investigator-initiated clinical trials applications with meritorious scores based on programmatic priority. Those judged to have low program priority, or that fail to meet the criteria outlined above, will not receive funding, even if found to be scientifically sound in peer review.

Other Clinical Trial Funding Opportunity Announcements (FOAs)

NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Required) PA-18-344

NIH Research Project Grant (Parent R01 Clinical Trial Required) PA-18-345

The NIAMS will only accept clinical trial applications proposing mechanistic studies in response to these funding opportunities. A mechanistic study is defined as one designed to understand a behavioral or biological process, the pathophysiology of a disease, or the mechanism of action of an intervention. If a clinical trial application proposes to test a clinical outcome as its primary objective, it should be submitted to a NIAMS-specific clinical trial funding opportunity found in the section above. For more information about mechanistic studies, refer to NOT-AR-18-008.

Career Development Award Applications Involving Clinical Trials

Mentored Research Scientist Development Award (Parent K01 & Independent Clinical Trial Required) PA-18-363

Mentored Patient-Oriented Research Career Development Award (Parent K23 - Independent Clinical Trial Required) PA-18-374

NIH Pathway to Independence Award (Parent K99/R00 - Independent Clinical Trial Required) PA-18-397

Midcareer Investigator Award in Patient-Oriented Research (Parent K24 & Independent Clinical Trial Required) PA-18-393

Additional Review Criteria for Career Development Award Applications Involving Clinical Trials NOT-OD-18-109

NOTE: Applicants who propose clinical trials submitted in response to other CT Required or CT Optional funding opportunity announcements not listed on this page will follow the guidelines and instructions in those announcements.

Other Clinical Trial Opportunities

Investigators seeking support only for drug development and who do not have access to medicinal chemistry and drug development expertise are encouraged to consider other programs for those areas which are available through individual NIH Institutes.

Bridging Interventional Development Gaps (BrIDGs)

Previously known as the NIH Rapid Access to Interventional Development (NIH-RAID) Program, this program offers investigators access to IND-directed services on a competitive basis. Investigators who are seeking support for such studies are encouraged to apply there.

Therapeutics for Rare and Neglected Diseases (TRND)

This program is designed to support pre-clinical development of therapeutic candidates intended to treat rare or neglected disorders, with the goal of enabling an Investigational New Drug (IND) application. TRND stimulates drug discovery and development research collaborations among NIH and academic scientists, nonprofit organizations, and pharmaceutical and biotechnology companies working on rare and neglected illnesses. Investigators are encouraged to refer to NCATS TRND to determine if there are opportunities offered through this program that suits their needs.

Trial Innovation Network

This program is designed to address critical roadblocks in clinical trials and to accelerate the translation of novel interventions into life-saving therapies. The network will focus on operational innovation, operational excellence and collaboration while leveraging the expertise, diversity and broad reach of the NCATS CTSA Program.

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