ArticleNeuroepidemiology2026
Understanding Late-Stage Clinical Trial Failure in Multiple Sclerosis: Insights from ClinicalTrials.gov.
Article in Neuroepidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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6 authors.
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Abstract
introductionClinical trial failure - when a study is withdrawn or terminated for reasons unrelated to safety or efficacy - wastes resources and exposes patients to unnecessary risks. We examined such failures in the field of multiple sclerosis (MS).
methodsWe searched <ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link> for phase III and IV MS drug trials conducted in 2008-2024. Trials were classified as normally ended or failed based on recruitment status and reported reasons. When information was missing, we reviewed publications and contacted principal investigators (PIs). Kaplan-Meier method was used to assess time to trial end and multivariate logistic regression was used to identify factors associated with failure.
resultsThe 282 clinical trials included in our analysis involved 62 experimental drugs, primarily disease-modifying therapies (n = 213 trials). Most studies aimed to evaluate drug efficacy (n = 197 trials). Overall, 74.8% of trials ended normally while 25.2% failed. On average, failed trials ended 10 months earlier than the rest of studies (trial actual duration: 17.8 vs. 28.2 months, p < 0.001). Main reasons for failure were low recruitment (28.2%), unspecified business decisions (26.8%), and logistical problems (12.7%). In 28.2% of occasions, it remained undisclosed. Trials evaluating drug safety (OR 0.35, 95% CI: 0.13-0.94) and those with ≥50 participating centres (OR 0.10, 95% CI: 0.02-0.38) seemed to have a lower risk of failure. Failure was not significantly associated with other factors such as study start date, PI location, or industry involvement.
conclusionOne out of four late-stage MS clinical trials fails. Increasing the number of study sites and improving recruitment strategies could enhance their success rates.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.