Yes. Could be Neutral: If the Phase 3 trial is to be conducted after EMA approval as part of a conditional requirement for a confirmatory study. Slightly Negative: If Phase 3 represents a second trial required by the FDA or other regulators (e.g., China or TGA). Highly Negative (but less likely): If the EMA has requested an additional Phase 3 before granting approval as Investor pointed out. What would you assign probability to each scenario?
On a positive note, the OLE N is higher than 74 (Autrialian only). So using 30% sites in AUS, the OLE completers could be as high as 246 out of 300. Do we know why the company is not willing to disclose the absolute disease improvement?
Here is ChapGPT Key Differences
Aspect | Confirmatory Phase 3 (Post-MAA) | Phase 4 Purpose |To confirm efficacy/safety for full approval. |To monitor long-term safety and explore new indications. Timing |After conditional approval but before full approval. |After full, unconditional approval. Mandatory? |Yes, required to maintain conditional approval. |No, unless required as part of post-marketing conditions. Endpoints |Primary endpoints to validate efficacy and safety. |Secondary/exploratory endpoints and long-term outcomes. Design Rigor |Rigorously designed (e.g., randomized controlled trials). |May include observational or less rigorous studies. Focus |Core evidence to confirm approval criteria. |Real-world use, safety, and broader patient outcomes. Regulatory Impact |Can lead to approval withdrawal if not completed. |Generally no impact on approval status.