Back to Explorer

Enhancing Participation in Clinical Trials — Eligibility Criteria, Enrollment Practices, and Trial Designs: Guidance for Industry

FinalCenter for Drug Evaluation and Research Center for Biologics Evaluation and Research12/15/2025

Description

This guidance recommends approaches that sponsors of clinical trials intended to support a new drug application or a biologics license application can take to increase enrollment of a representative population in their clinical trials. This guidance considers both demographic characteristics of study populations (e.g., sex, race, ethnicity, age, location of residency) and non-demographic characteristics of populations (e.g., patients with organ dysfunction, comorbid conditions, disabilities, those at the extremes of the weight range, and populations with diseases or conditions with low prevalence). Enrolling participants with a wide range of baseline characteristics may create a study population that more accurately reflects the patients likely to take the drug if it is approved and allow assessment of the impact of those characteristics on the safety and effectiveness of the study drug.

Scope & Applicability

Product Classes

2
investigational drug

The drug being tested in clinical trials for MDS.

Rare Diseases

A higher degree of uncertainty is common in drug development programs for rare diseases.

Stakeholders

7
sponsors

Target audience for recommendations on assessment of overall survival

Office for Human Research Protections

HHS office providing resources for the public

Office of Women’s Health

FDA office providing resources on women in clinical trials

Task Force on Research Specific to Pregnant Women and Lactating Women

Established to identify gaps in knowledge for safe therapies

Clinical Investigator

Veterinarian responsible for selecting anesthetic regimens and conducting field studies

sponsor

responsible for justifying omission of studies

Institutional Review Board

Governs top dose in clinical studies

Regulatory Context

Attributes

3
demographic characteristics

sex, race, ethnicity, age, location of residency

benefit-risk profile

Evaluation of product safety and effectiveness

NYHA stage III and IV

Specific classification used to define heart failure exclusion

Related CFR Sections (3)

Related Warning Letters (10)

  • In Vivo Bioavailability-Bioequivalence Studies – Clinical

    Maria A. Carballosa, M.D.

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

    Celularity, Inc

    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)

    American Behavioral Research Institute, LLC

    2025-06-10
  • Bioresearch Monitoring Program

    Amy Lightner, MD

    2025-06-03

See Also (8)