Phase I

Cardiovascular

pain 22#62volume 1,008#24

Pain rank 62 of 76, volume rank 24 of 76 by industry trials. Trials here amend about 0.8x and fail enrollment about 0.7x the map median.

What this is worth

The amendment proxy, priced. Order of magnitude, anchor cited, assumptions on the table.

Per 100 industry trials in this cell, about 30 rewrite their eligibility criteria at least once. At the industry average of $450k direct cost per amendment, with the 6+ weeks of delay each not even counted, that is at least $14M at stake per 100 trials. Across the roughly 1,008 industry trials here, the floor is $138M.

If amendments fell by10%$14M30%$41M50%$69M

Assumes $450k direct cost per amendment (industry average; Phase II median runs lower, Phase III higher, and delay cost is excluded), applied to the proxy rate. The proxy counts only trials with at least one eligibility change, so this understates the true exposure. How this is derived.

The signals

Industry sponsors first, since that is the commercial buyer, each figure shown against the map median. All-sponsor figures follow. A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.

Industry sponsors22pain index
Eligibility amendments
30%vs map 40%proxyn = 46sampled
Enrollment failure
10%vs map 13%n = 832concluded
Startup lag
33 dvs map 45.5 dn = 499with dates
Median duration
5.7 mon = 979completed
All sponsors23pain index
Eligibility amendments
28%proxyn = 88sampled
Enrollment failure
14%n = 1,462concluded
Startup lag
51 dn = 955with dates
Median duration
12.0 mon = 1,840completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (25 of 82 stopped). A keyword pass runs first; free text it could not place was sorted once by a frozen AI classification into these same categories, auditable rather than a live model. "No enrollment recorded (inferred)" is not a stated reason: it is read from a zero enrollment count, meaning the trial never enrolled anyone. "Not reported" means the sponsor left the field blank, shown rather than hidden.

Sponsor decision25 (30%)
Low accrual14 (17%)
Not reported13 (16%)
Safety or tolerability7 (9%)
No enrollment recorded (inferred)inferred6 (7%)
Efficacy or futility6 (7%)
Business or funding3 (4%)
Never initiated2 (2%)
Technical or device issue1 (1%)
Logistics or operations1 (1%)
Superseded by another study1 (1%)
Feasibility or operational failure1 (1%)
Completed or objective met1 (1%)
External or regulatory1 (1%)
n = 82terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell. Each links to its ClinicalTrials.gov record.

TrialSponsorStatusStated reason
NCT06780033Arnatar Therapeutics, Inc.terminatedSponsor decision
NCT06639087AstraZenecaterminatedSponsor decision
NCT06611423AstraZenecaterminatedLow accrual
NCT0658115935Pharma IncterminatedSponsor decision
NCT0649346135Pharma IncterminatedSponsor decision
NCT06483802Astellas Gene TherapieswithdrawnSponsor decision
NCT06381466AstraZenecaterminatedSafety or tolerability
NCT05758818Rain Oncology IncterminatedSponsor decision
NCT05731492ActelionwithdrawnSponsor decision
NCT05609825Eli Lilly and CompanyterminatedEfficacy or futility
NCT05532046BayerterminatedSafety or tolerability
NCT05323136Shaanxi Micot Pharmaceutical Technology Co., Ltd.terminatedSponsor decision

Cardiovascular at other phases