Phase III

Musculoskeletal

pain 69#20volume 737#34

Pain rank 20 of 76, volume rank 34 of 76 by industry trials. Trials here amend about 1.3x and fail enrollment about 1.0x 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 55 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 $25M at stake per 100 trials. Across the roughly 737 industry trials here, the floor is $183M.

If amendments fell by10%$18M30%$55M50%$91M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors69pain index
Eligibility amendments
55%vs map 41%proxyn = 49sampled
Enrollment failure
13%vs map 13%n = 657concluded
Startup lag
59 dvs map 45.5 dn = 263with dates
Median duration
18.1 mon = 665completed
All sponsors56pain index
Eligibility amendments
38%proxyn = 97sampled
Enrollment failure
14%n = 1,163concluded
Startup lag
73 dn = 626with dates
Median duration
21.0 mon = 1,402completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (23 of 88 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 decision23 (26%)
Low accrual15 (17%)
Not reported10 (11%)
Safety or tolerability10 (11%)
Other stated reason9 (10%)
No enrollment recorded (inferred)inferred8 (9%)
External or regulatory4 (5%)
Superseded by another study3 (3%)
Efficacy or futility2 (2%)
Logistics or operations1 (1%)
Technical or device issue1 (1%)
Business or funding1 (1%)
Feasibility or operational failure1 (1%)
n = 88terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06504966Xentria, Inc.withdrawnSponsor decision
NCT06260748Leadiant Biosciences, Inc.withdrawnFeasibility or operational failure
NCT06115512Angitia BiopharmaceuticalsterminatedSafety or tolerability
NCT05758415Novartis PharmaceuticalsterminatedSponsor decision
NCT05722522Novartis PharmaceuticalsterminatedSponsor decision
NCT05632783IBSA Institut Biochimique SAwithdrawnSponsor decision
NCT05335486Redo-NeurosystemswithdrawnLow accrual
NCT04931667Biosplice Therapeutics, Inc.terminatedSafety or tolerability
NCT04577820Regeneron PharmaceuticalswithdrawnSponsor decision
NCT04520607Biosplice Therapeutics, Inc.terminatedSafety or tolerability
NCT04386980Sorrento Therapeutics, Inc.withdrawnSuperseded by another study
NCT04044742Sorrento Therapeutics, Inc.withdrawnSuperseded by another study

Musculoskeletal at other phases