Phase II

Neurology

pain 80#12volume 1,968#11

Pain rank 12 of 76, volume rank 11 of 76 by industry trials. Trials here amend about 1.1x and fail enrollment about 1.8x 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 46 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 $21M at stake per 100 trials. Across the roughly 1,968 industry trials here, the floor is $405M.

If amendments fell by10%$41M30%$122M50%$203M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors80pain index
Eligibility amendments
46%vs map 40%proxyn = 225sampled
Enrollment failure
24%vs map 13%n = 1,572concluded
Startup lag
67 dvs map 45.5 dn = 1,127with dates
Median duration
19.8 mon = 1,890completed
All sponsors86pain index
Eligibility amendments
42%proxyn = 312sampled
Enrollment failure
22%n = 3,338concluded
Startup lag
92 dn = 2,646with dates
Median duration
24.0 mon = 4,530completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (98 of 380 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 decision98 (26%)
Low accrual66 (17%)
Safety or tolerability50 (13%)
Efficacy or futility50 (13%)
Not reported50 (13%)
No enrollment recorded (inferred)inferred17 (4%)
Logistics or operations12 (3%)
Business or funding11 (3%)
Other stated reason6 (2%)
Never initiated5 (1%)
External or regulatory4 (1%)
Feasibility or operational failure4 (1%)
Superseded by another study3 (1%)
Completed or objective met3 (1%)
Technical or device issue1 (0%)
n = 380terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT07116499Kallyope Inc.terminatedEfficacy or futility
NCT07011771Capsida Biotherapeutics, Inc.withdrawnSafety or tolerability
NCT07006805Cabaletta BiowithdrawnLow accrual
NCT06983158Capsida Biotherapeutics, Inc.terminatedCompleted or objective met
NCT06910384New England Cell Therapeutics, Inc.terminatedSponsor decision
NCT06903286SpinogenixterminatedSponsor decision
NCT06833281SpinogenixterminatedSponsor decision
NCT06822517Ventus Therapeutics U.S., Inc.terminatedSponsor decision
NCT06721156Merck Sharp & Dohme LLCterminatedSponsor decision
NCT06677203Asceneuron S.A.terminatedSponsor decision
NCT06637527Okyo Pharma LtdterminatedSafety or tolerability
NCT06199037Shanghai Hengrui Pharmaceutical Co., Ltd.terminatedSponsor decision

Neurology at other phases