Depression is now one of the top five most studied disease areas in clinical development, according to new global analysis by Phesi.

The mid-year analysis of all this year’s trials to date reveals that Covid-19 is no longer one of the top five most studied disease areas, and trial activity for depression has increased – becoming the fourth most studied disease globally.

Three of the top five most-studied diseases fall within oncology, with solid tumours the most studied disease indication, and breast cancer falling to the second-most studied, stroke third, and prostate cancer fifth.

“Awareness of the global mental health crisis has been growing in the wake of the Covid-19 pandemic. An estimated 5% of adults are affected by depression globally.

“New therapies to tackle this disease are desperately needed, with SSRIs – the last major class of antidepressants – launched over forty years ago,” says Phesi president Dr Gen Li.

“As clinical development investment into Covid-19 continues to wane – a trend Phesi saw begin to emerge at the end of 2022 – the industry is allocating resources to other disease areas.

“Increased investment into depression therapies is likely due to greater awareness, improved understanding of the underlying causes of the disease, and growing investment in new avenues, such as psychedelics.

“There will be particular challenges in clinical trials in this area. Companies will need to design protocols carefully to ensure newly approved treatments reach patients as soon as possible.”

Perhaps of greater concern is that the analysis also found that the rise in Phase II study attrition identified in Phesi’s end-of-year 2022 analysis has increased further. So far in 2023, 31% of trials at Phase II have been cancelled – this is a 55% increase on pre-Covid levels.

High levels of cancellations at Phase II increase the overall costs of clinical development considerably. More worryingly, such delays will have a knock-on effect on the rate at which new therapies reach market and may even prevent viable new therapies from ever reaching patients.

“The clinical development industry is still feeling the effects of disruption caused by the pandemic. The fallout will be with us for some time longer, and we predict that we will see around two more years of high levels of Phase II attrition.

“The strain of these trial cancellations on the global drug development pipeline will be severe, and to ease the pain, productivity and trial efficiency needs to improve,” explained Dr Li. “Unnecessary protocol amendments and trial cancellations are a symptom of inadequate protocol design. We must go back to the fundamentals and use data to improve the design of clinical trial protocols.

“By applying predictive analytics in protocol design, the industry can overcome enrolment difficulties, accelerate clinical trials and avoid amendments, overall improving productivity.”

The analysis also explored trends in age-related trial amendments from the current year, highlighting the disease indications that are most prone to age-related amendments – including Crohn’s Disease, Sickle Cell Disease and ALS. 

The full report can be downloaded here.

Phesi is a global provider of patient-centric data analytics, using the industry’s largest clinical trial database to simulate clinical development and improve decision making. It implements AI-driven solutions for trial simulation, patient profiling, program and protocol design, trial execution and digital control arms to support life sciences companies to accelerate drug development and commercialisation.