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. 2025 Apr 7;14(7):2519.
doi: 10.3390/jcm14072519.

The Current Landscape of Clinical Trials

Geeta Joshi  1 , Tara K Bhandari  2 , Pushkar Joshi  3 , Smriti Bhandari  4 , Shalini Reddy Araveeti  5 , Aditi Jain  6 , Subash Khadka  7 , Shaun Trecarten  8 , Ahmad Abdelaziz  9 , Harshit Garg  10 , Mukund Bhandari  11
Affiliations

The Current Landscape of Clinical Trials

Geeta Joshi et al. J Clin Med. .

Abstract

Background/Objectives: Clinical trials are essential in the development of new medical treatments, offering crucial data on their safety and effectiveness. Methods: This study provides a comprehensive analysis of clinical trials registered on ClinicalTrials.gov, examining the current landscape, challenges, and innovations that have shaped the field over the past century. Data were extracted on 7 March 2025 and analyzed to identify patterns in trial design, sponsorship, participant demographics, and geographical distribution. Results: The analysis reveals a continuous increase in clinical trial registrations, peaking in 2021, driven by the COVID-19 pandemic. Most trials focus on cancer, reflecting its global burden, with randomized controlled trials (RCTs) being the most common study design. However, challenges persist, including underrepresentation of certain demographics, limited global distribution, and insufficient reporting of trial results. Additionally, the underrepresentation of pediatric, elderly, and minority populations in trials limits the generalizability of findings. Conclusions: The analysis underscores the need for more inclusive and globally distributed research to address disparities in health outcomes.

Keywords: clinical trial report; clinical trials; clinicaltrials.gov; randomized controlled trials.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Total number of clinical trials started in each year from 2005 to 2025 (current as of 7 March 2025); (B) study status of clinical trials; (C) number of clinical trials by disease/condition; (D) types of intervention/treatment.
Figure 2
Figure 2
(A) Distribution of clinical trials by their primary purpose; (B) interventional clinical trials by allocation; (C) distribution of interventional study model; (D) distribution of clinical trials by collaboration status; (E) top 20 sponsors of interventional clinical trials; (F) distribution of funder type for the clinical trials conducted in last two decades.
Figure 3
Figure 3
(A) Overall distribution of clinical trials phases; (B) distribution of enrollment number by trial phase; (C) distribution of days to completion; (D) clinical trials with and without study results.
Figure 4
Figure 4
(A) Overall distribution of clinical trial participants by sex; (B) overall distribution of clinical trial participants by age group; (C) clinical trials with multiple locations; (D) distribution of clinical trials conducted in a single country.
Figure 5
Figure 5
Distribution of clinical trials by continents and disease for the last two decades.
Figure 6
Figure 6
Landscape of clinical trials in the last two decades by disease/condition.
See this image and copyright information in PMC

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