Phase I

Endocrine & Metabolic

pain 8#71volume 1,910#13

Pain rank 71 of 76, volume rank 13 of 76 by industry trials. Trials here amend about 0.7x and fail enrollment about 0.4x 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 27 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 $12M at stake per 100 trials. Across the roughly 1,910 industry trials here, the floor is $230M.

If amendments fell by10%$23M30%$69M50%$115M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors8pain index
Eligibility amendments
27%vs map 40%proxyn = 41sampled
Enrollment failure
6%vs map 13%n = 1,611concluded
Startup lag
20 dvs map 45.5 dn = 973with dates
Median duration
5.9 mon = 1,860completed
All sponsors9pain index
Eligibility amendments
29%proxyn = 83sampled
Enrollment failure
9%n = 2,258concluded
Startup lag
28 dn = 1,388with dates
Median duration
8.1 mon = 2,725completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (32 of 97 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 decision32 (33%)
Low accrual14 (14%)
Safety or tolerability13 (13%)
Not reported13 (13%)
No enrollment recorded (inferred)inferred6 (6%)
Efficacy or futility4 (4%)
Technical or device issue3 (3%)
Other stated reason3 (3%)
External or regulatory2 (2%)
Business or funding2 (2%)
Logistics or operations1 (1%)
Completed or objective met1 (1%)
Change in standard of care1 (1%)
Superseded by another study1 (1%)
Never initiated1 (1%)
n = 97terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT07228559BioCryst PharmaceuticalsterminatedSponsor decision
NCT06970405Regeneron PharmaceuticalswithdrawnSponsor decision
NCT06939946OPTOSURGICAL, LLCterminatedSponsor decision
NCT06910839PfizerterminatedSponsor decision
NCT06417697Xeno BiosciencesterminatedSafety or tolerability
NCT06143423Chia Tai Tianqing Pharmaceutical Group Nanjing Shunxin Pharmaceutical Co., Ltd.terminatedSponsor decision
NCT06138327BioMarin PharmaceuticalwithdrawnSafety or tolerability
NCT06007651Eli Lilly and CompanyterminatedLow accrual
NCT05694741AstraZenecaterminatedChange in standard of care
NCT05694169ProkidneyterminatedSponsor decision
NCT05671653PfizerterminatedSponsor decision
NCT05595681Cell to Cure ApSterminatedLow accrual

Endocrine & Metabolic at other phases