Phase II

Musculoskeletal

pain 57#32volume 583#44

Pain rank 32 of 76, volume rank 44 of 76 by industry trials. Trials here amend about 0.9x and fail enrollment about 1.4x 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 36 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 $16M at stake per 100 trials. Across the roughly 583 industry trials here, the floor is $93M.

If amendments fell by10%$9M30%$28M50%$47M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors57pain index
Eligibility amendments
36%vs map 40%proxyn = 45sampled
Enrollment failure
19%vs map 13%n = 484concluded
Startup lag
52 dvs map 45.5 dn = 285with dates
Median duration
16.1 mon = 552completed
All sponsors70pain index
Eligibility amendments
35%proxyn = 88sampled
Enrollment failure
17%n = 1,064concluded
Startup lag
83 dn = 693with dates
Median duration
20.1 mon = 1,344completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (25 of 91 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.

Low accrual25 (27%)
Sponsor decision20 (22%)
Not reported12 (13%)
Efficacy or futility10 (11%)
Safety or tolerability8 (9%)
Logistics or operations4 (4%)
No enrollment recorded (inferred)inferred4 (4%)
Other stated reason3 (3%)
Never initiated2 (2%)
Business or funding1 (1%)
Superseded by another study1 (1%)
Technical or device issue1 (1%)
n = 91terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06977568Pacira Pharmaceuticals, IncterminatedLow accrual
NCT06788236Aventi Biotechnology Inc.terminatedLow accrual
NCT06258499Carmell Therapeutics CorporationwithdrawnNever initiated
NCT05838742GlaxoSmithKlineterminatedEfficacy or futility
NCT05796765MiMedx Group, Inc.terminatedSponsor decision
NCT05742763QC Kinetix LLCwithdrawnLow accrual
NCT05462990Novartis PharmaceuticalsterminatedSponsor decision
NCT05092646Axolotl BiologixterminatedLow accrual
NCT05008835ACADIA Pharmaceuticals Inc.terminatedSponsor decision
NCT04864392Novartis PharmaceuticalsterminatedSafety or tolerability
NCT04841512Xalud Therapeutics, Inc.withdrawnLow accrual
NCT04814368Novartis PharmaceuticalsterminatedSponsor decision

Musculoskeletal at other phases