Where the evidence has to hold

Phase II and III are where the strength of your development programme is tested. We build the biometrics around the claim you need to make, so your design, your data and your submission outputs all point the same way.

Statistical design for Phase II and III trials

Build the design around the claim

In Phase II and III, scale leaves less room for weak assumptions. We define what the trial needs to demonstrate, then shape the design and analysis around that objective so the evidence stands up to regulatory review.

Keep complexity under control

More patients, sites and countries bring greater complexity, variability and pressure on the data. We keep design, data management and analysis closely connected so issues are identified early and evidence quality is protected as the study scales.

Keep every workstream aligned

Late-phase delivery depends on every biometrics workstream working towards the same outcome. With more than a third of our portfolio in Phase II and III, we know how to keep those elements connected from protocol to final evidence.

Phase II and III clinical trial services

Study design & strategy

  • Confirmatory trial design We shape Phase II and III designs around the evidence the study needs to produce. From estimands and endpoints to multiplicity, randomisation and margins, each decision is made with the final claim and regulatory review in mind.
  • Sample size and adaptive designs We use sample size calculations, simulation and adaptive methods to test how the design performs under realistic scenarios. This gives sponsors a clearer view of uncertainty, risk and where flexibility can genuinely strengthen the study.

Planning & analysis

  • Statistical analysis plans We write SAPs so the analysis is clear before the data are seen. Primary, secondary and sensitivity analyses are defined upfront, with transparent handling of missing data and intercurrent events.
  • Statistical analysis and interpretation We go beyond producing results. Across primary, secondary, interim and exploratory analyses, we help teams understand what the evidence supports, where uncertainty remains and what that means for the next decision.

Data & programming

  • Clinical data management We manage complex Phase II and III data with consistency from EDC build through to database lock. CDISC-aligned processes, external data integration and active query management keep the data clean, current and ready for analysis.
  • Statistical programming We build validated SDTM and ADaM datasets, tables, listings and figures with traceability at the centre. Submission deliverables are prepared so reviewers can follow the evidence clearly from dataset to output.

Reporting & safety

  • Medical writing Our medical writers work closely with the statistical team from protocol through to clinical study report and CTD contributions. This keeps the scientific rationale, analysis and final conclusions consistent throughout.
  • Safety and pharmacovigilance We keep safety data and reporting closely connected to the wider study. Our teams support timely review, clear documentation and reliable safety oversight throughout the trial lifecycle.

Late-phase studies we support

Phase II dose-finding and dose-ranging

Studies focused on identifying the dose, regimen and response profile to carry forward into confirmatory development.

Phase II and seamless Phase II/III designs

Programmes that combine learning and confirmation within one design, with pre-defined criteria for progressing between stages.

Pivotal Phase III trials

Large confirmatory studies designed to establish efficacy and safety for regulatory submission, including superiority, non-inferiority and equivalence trials.

Adaptive and group-sequential trials

Studies that use planned interim analyses to allow pre-specified changes or early decisions while preserving statistical validity.

Multi-regional clinical trials (MRCTs)

Global studies spanning multiple countries or regions, where consistency of treatment effect and regional differences need to be properly assessed.

Rare disease and small-population trials

Studies where limited patient numbers require more tailored design choices and careful use of the available evidence.

Medical device pivotal investigations

Confirmatory clinical investigations designed to generate the evidence required for regulatory approval and CE marking.

Trials requiring an IDMC or DSMB

Studies that need independent review of accumulating safety or efficacy data while the trial remains ongoing.

How we approach Phase II and III studies

  1. Start with what the study needs to prove

    We define the claim first, then shape the design around what the study needs to demonstrate. Limitations are identified before they become embedded in the protocol.

  2. Make the assumptions clear

    We ground assumptions around variability, effect size and attrition in the available evidence and test their impact, so you can see where uncertainty remains.

  3. Pre-specify and stay disciplined

    Primary analyses are clearly defined in the SAP and kept separate from exploratory work, protecting the integrity of the evidence and making results easier to defend.

  4. Build for review from the start

    Data, analyses and documentation are structured so the path from protocol to conclusion stays clear, traceable and ready for regulatory review.

Why sponsors choose Metronomia for Phase II and III

Biometrics is our core

Biometrics is not one department within a wider model, it is the focus of our business. Sponsors work directly with experienced specialists who understand the study, the data and the decisions behind both.

Deep expertise, made clear

Complex statistical methods should lead to clearer decisions, not harder conversations. We bring expertise across estimands, multiplicity, adaptive designs and sensitivity analyses, and explain what they mean in practical terms for study teams, leadership and regulators.

Independence where it matters

Our statistical work is separate from trial operations, giving sponsors an independent view when objectivity matters most. This is particularly valuable for interim analyses, IDMC support and second opinions on late-phase study design.

Ready for regulatory review

We structure data, analyses and documentation with submission requirements in mind from the outset. CDISC expertise and integrated medical writing help keep the evidence consistent, traceable and ready for review without unnecessary rework later.

Flexible around your programme

We can lead full biometrics delivery, work alongside your existing CRO or support a defined workstream. Our model fits around the programme you already have, giving you the expertise you need without adding unnecessary complexity.

A clear way forward when studies get difficult

When a study is already under pressure, we bring an experienced, objective view. From inherited datasets and delayed analyses to statistical approaches that need reassessing, we help establish what can be resolved and what needs to change next.

Not sure where to start?

Sometimes the hardest part is knowing where to begin. Our senior consultants help you clarify priorities, weigh development challenges, and find the right path forward across study design, statistics, regulatory strategy and data.

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