Endpoint strategy for repurposing programs in indications without validated biomarkers: lessons from the ReMEdi study in ME/CFS
Repurposing offers a compressed path to Phase 2, but endpoint strategy is often the gating factor. Many indications that attract repurposing interest are those without validated biomarkers, where subjective patient-reported outcomes alone can leave programs vulnerable to noise and regulatory scrutiny. Layering digital measures introduces validation, integration, and presentation challenges most teams haven't built playbooks for. ReMEdi paired ePROs with continuous wearable monitoring and remote functional testing in a fully decentralized Phase 2 repurposing study. This panel discussion covers the framework for selecting and validating digital measures, when continuous monitoring earns its place, and how the composite-endpoint angle is taking shape with regulators.
In this panel, Meri Beckwith, Co-CEO of Lindus, Dr. Simon Bock, Clinical and Market Access, Portfolio & Innovation Manager at Tiefenbacher Group and Dr. Beata Godlewska, Principal Investigator for the ReMEdi trial, sit down to discuss how modern trial design is expanding what's feasible. Drawing on their experience running the ReMEdi study in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), they'll discuss how innovative trial design strategies enabled them to capture regulatory-grade data in a population historically excluded from research, how digital endpoints and wearables are providing more granular, remote, and patient-centric data, and how these methodological choices help sponsors work through the operational hurdles that commonly cause programs to stall.
The conversation will also cover the regulatory challenges and economic considerations that shape drug repurposing strategies, including how feasibility and commercial attractiveness factor into development decisions.
What you'll learn
- A framework for selecting and validating digital endpoints in indications without validated biomarkers, with detail on how the ReMEdi team approached validation and regulator presentation
- The composite-endpoint approach, combining subjective PROs with objective digital/wearable-derived measures, as a forward-looking model for regulatory submissions in biomarker-poor indications
- Practical design principles for remote and hybrid study designs that maintain regulatory-grade rigor across repurposing programs in underserved conditions
- Operational proof points on enrollment timelines, retention, and data completeness in a decentralized repurposing study, with ReMEdi-specific benchmarks shared where available
Register here
Meet the panel
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