New analysis from the clinical data science company Phesi has revealed that around 6.7% of all active clinical trials have been impacted by disruption in the Middle East.
It found that out of 65,061 globally recruiting clinical trials across 186 countries, 4361 studies (equivalent to 6.7%) were impacted by the disruption.
Across a total of 356,699 recruiting investigator sites, 7958 (2.2%) are in the affected region, with Phase III trials accounting for the highest number of impacted sites (2732).
The majority of affected sites are located in Turkey, Israel and Egypt.
A significant number of oncology trials are impacted, with non-small cell lung cancer being the most affected indication, followed by breast cancer.
Additionally, there are noticeable effects on other conditions, including heart failure, multiple myeloma and Crohn's disease.
"Clinical development has become deeply interconnected, said Dr Gen Li, founder and CEO, Phesi.
"When disruption occurs, the impact extends beyond individual sites, particularly in high-priority disease areas such as oncology."
The impact on Phase III trials is particularly significant, as these later-stage studies involve larger, committed patient populations and represent years of investment.
"Patient safety and the safety of investigators and clinical staff must remain the primary consideration, alongside the need to keep existing trials going."
Phesi’s analysis also found that large pharmaceutical companies have a significant presence in the region. All of the top ten global pharma companies have a considerable number of investigator sites in the affected countries, with some organisations having between 400 and 500 sites.
This level of exposure indicates that regional disruptions could have significant implications for global trial delivery, underscoring the importance of maintaining continuity amid rapidly changing conditions.
"Disruption and uncertainty are becoming a structural feature of clinical development," continued Dr Li.
"The priority is not only to respond, but to proactively use data to understand exposure and mitigate risk."
Such periods of disruption reinforce the need for a precise, data-driven approach to development. Sponsors need to quickly understand their exposure, identify alternatives and adapt trial strategies in real time, while maintaining high standards of patient safety and data integrity.
"There is also an opportunity to explore approaches such as external control arms and modelling techniques, including digital twins, particularly in well-characterised disease areas."