Real-time & continuous trials

Continuous by design.

Regulators are moving from periodic data batches toward continuous visibility and pre-reviewed INDs. Here is what has actually changed, what hasn't, and how to be ready without betting your program on a pilot.

What has changed

A dated timeline, reviewed monthly

Editorially owned. Each entry needs a primary-source link and a date before it's added — this is a status tracker, not a marketing claim.

Sep 2025

ICH E6(R3) finalized

The revised Good Clinical Practice guideline puts sponsor oversight of delegated activities squarely back on the sponsor — the basis for the CRO/vendor oversight decision on our Biotech & Pharma page.

Jan 2026

FDA–EMA AI principles

Joint FDA–EMA principles on AI in the drug development lifecycle set shared expectations for context-of-use and human oversight — the frame our Technology & AI Vendors work is built on.

Apr 2026

FDA launches Real-Time Clinical Trials (RTCT)

Proof-of-concept trials and a Request for Information move the industry from periodic data batches toward continuous signal flow. The initiative's two most visible champions have since left FDA — RTCT is an accelerant for the direction of travel, not a settled program.

May 2026

ICH M11 finalized

The harmonized protocol template and technical specification standardizes protocol structure — the basis for the structured-protocol option on our Protocol & Trial Design work.

Jun–Jul 2026

Operation TrialBlazer & the Expedited IND proposal

HHS launches Operation TrialBlazer, including a proposed Expedited IND pilot in which CROs and medical centers could pre-review Phase 1 protocols, alongside a draft master-protocols framework.

Last reviewed: September 2026. This tracker never implies AyurDatta is a pilot participant or a Qualified Research Institution.

What it means for you

Three seats, three sets of stakes

Sponsors

Data flows and signal definitions need to be agreed before continuous review is possible — and a named physician still has to make the call on what a real-time signal means.

See Biotech & Pharma →

CROs

A Qualified Research Institution role under Expedited IND would need on-demand physician-level protocol and IND review — capability most CROs don't carry in-house today.

See CRO & FSP enablement →

Technology & AI vendors

Continuous data flow raises the bar on validated, human-overseen AI — the FDA–EMA principles are the standard your buyers will hold you to.

See Technology & AI Vendors →
Readiness checklist

Six questions to answer before you need to

  • Do you know where every safety-relevant data flow originates and where it lands?
  • Are your signal definitions (CRS, ICANS, DLTs, or equivalent) agreed and documented before the first patient is dosed?
  • Is a named, credentialed physician assigned to review flagged signals — not just a team?
  • Does every material decision generate an audit trail as it happens, not reconstructed later?
  • Are your eClinical decisions being made at IND, not bolted on after protocol lock?
  • Is your protocol structured to ICH M11, or will it need retrofitting for the next submission?

Answer honestly and want a graded view? Take the Readiness Check →

Briefing and speaking

Read the briefing, and where we've gone on the record

Free download

Continuous by Design

FDA's Real-Time Clinical Trials initiative: the history, the industry response, and AyurDatta's four-pillar readiness framework with a 90-day action plan.

Download the briefing →
Public filing

Our comment to FDA

Submitted June 25, 2026 in response to Docket FDA-2026-N-4390 — why every AI-assisted safety output needs a matching, documented human decision.

Read our comment to FDA →
What hasn't changed

The obligation was never the pilot's to carry.

Sponsor accountability and documented physician judgment remain your obligation regardless of which pilots run, which proposals advance, or which champions move on. That is the constant this entire hub is built around.

Start where the risk is lowest

A Readiness Assessment, or twenty minutes to talk it through.