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Study of Sex Differences in the Clinical Evaluation of Medical Products

DraftCenter for Biologics Evaluation and Research Center for Devices and Radiological Health Center for Drug Evaluation and Research Office of the Commissioner,Office of Women's Health Office of the Commissioner,Office of Clinical Policy and Programs12/15/2025

Description

This guidance provides recommendations for (1) increasing enrollment of female participants in clinical trials and non-interventional studies to help ensure the generalizability of results, (2) analyzing and interpreting sex-specific data, and (3) including sex-specific information in regulatory submissions of medical products. In areas where male participants may be underrepresented in clinical trials, the general principles outlined in this guidance also apply to increasing enrollment of male participants in clinical trials.

Scope & Applicability

Product Classes

2
Combination Product

Products combining drug, device, or biological constituents; Generally recommended for Enhanced Documentation; Requires 14971-based framework incorporating ICH Q9; A drug-device combination where the device constituent part detects ingestion.

Cardiovascular Drugs

Clinical Trials Supporting FDA Approval of Cardiovascular Drugs

Stakeholders

2
Sponsor

Entity responsible for submitting applications under section 524B

applicant

entity submitting marketing applications

Regulatory Context

Attributes

2
Sex

Data element D.5 capturing the sex of the patient.

recommended dosages

different recommended dosages in females and males

Identified Hazards

Hazards

2
Reproductive or Developmental Toxicity

excluded from eligibility because of a risk or potential risk of reproductive or developmental toxicity

Serious risk

Specific risks associated with a drug that may necessitate ETASU

Related CFR Sections (5)

Related Warning Letters (10)

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    Maria A. Carballosa, M.D.

    2025-12-23
  • Unapproved New Drug/Unlicensed Biological Product/Biologics License Application (BLA)

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    2025-12-09
  • Sponsor/Investigator

    Verdure Sciences, Inc.

    2025-11-18
  • Clinical Investigator (Sponsor)

    Pamela K. Den Besten, DDS, MS

    2025-09-30
  • Clinical Investigator/Sponsor

    Ralph A. DeFronzo, M.D.

    2025-09-23
  • Clinical Investigator

    Shirish M. Gadgeel, M.D.

    2025-09-09
  • Clinical Investigator

    Mark J. Savant, M.D

    2025-07-15
  • Clinical Investigator

    Peter Michael, M.D.

    2025-07-01
  • Clinical Investigator (Sponsor)

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  • Bioresearch Monitoring Program

    Amy Lightner, MD

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See Also (8)