Lupus crowds Phase 1. Psoriasis crowds Phase 3. What crowding by phase tells R&D and BD.

Counting trials per disease answers the wrong question. Lupus and psoriasis carry a similar number of active industry trials. Read by phase, they are opposite markets: one is front-loaded with first-in-human studies, the other is crowded at the finish line. That difference should change what R&D starts and what BD buys.

Heatmap · active industry trials by phaseReal data

Lupus crowds Phase 1; psoriasis crowds Phase 3

Two shapes of market

Divide Phase 1 trials by Phase 3 trials and the six diseases split cleanly. Rheumatoid arthritis runs 60 Phase 1 trials against 19 in Phase 3, a ratio of 3.2. Lupus runs 99 against 34 (2.9). Psoriasis is the mirror image: 24 Phase 1 trials against 63 in Phase 3 (0.38), with Crohn's disease close behind.

Dumbbell · Phase 1 vs Phase 3Real data

Two diseases are front-loaded, four are back-loaded

What a front-loaded market means

In rheumatoid arthritis and lupus, many new shots on goal sit early and few sit late. For R&D, entering at Phase 1 means joining a crowd where differentiation has to come from mechanism, not timing. The late stage is comparatively open, so an asset that is ready for Phase 2 or 3 faces fewer direct late-stage competitors today than the headline trial count suggests. For BD, these fields will generate a wave of Phase 2 data over the next few years. That is the in-licensing window, before the data prices the assets.

What a back-loaded market means

In psoriasis and Crohn's disease the late stage is full of programmes that will reach the label, or fail, in the next few years. For R&D, a new entrant arrives in a crowded label and needs a clear edge: route, dosing, a sub-population or a new endpoint. For BD, late-stage assets are de-risked and expensive; the scarce resource is the thin early pipeline, where next-generation mechanisms sit.

Ulcerative colitis and atopic dermatitis sit between the two, heaviest in Phase 2 (53 and 63 trials). The next two to three years of Phase 2 data will decide which mechanisms move forward there.

What the registry cannot tell you

Trials are not assets: one programme can run several trials, and one trial can list several conditions. The count says nothing about mechanism, which is where crowding really bites. The next step is to group these trials by mechanism of action, which needs enrichment from reference sources beyond the registry, recorded as a reviewed rule rather than a guess.

Run it yourself

Every number above came from a query you can repeat. Ask the registry the same question for your own indication; the answer is drawn live, with its source and query time.

Method and queries

ClinicalTrials.gov API v2, pulled 17 Oct 2026. For each disease and phase: overall status recruiting, not yet recruiting, active not recruiting or enrolling by invitation; StudyType INTERVENTIONAL; LeadSponsorClass INDUSTRY; Phase = PHASE1, PHASE2 or PHASE3. Condition terms: ulcerative colitis, Crohn disease, psoriasis, atopic dermatitis, rheumatoid arthritis, systemic lupus erythematosus (ClinicalTrials.gov condition search, which includes its synonym mapping).