Effect of Dietary Nitrate Ingestion in Heart Failure

1. Is the biology right?

• Somatic driver evidence: not published · No target found for the interventions.

  Rule: Open Targets has somatic-mutation evidence for the target in this cancer. Source: Open Targets Platform, 2026-11-11
• Human genetic evidence: not published · No target found for the interventions.

  Rule: Any germline or somatic human genetic evidence for the target in this cancer. Source: Open Targets Platform, 2026-11-11
• Pediatric target: not published · No target found for the interventions.

  Rule: Target is on FDA's Pediatric Molecular Target List (relevant targets); membership alone neither requires nor waives a study. Source: FDA Pediatric Molecular Target List (Listed as February 2026 on the FDA Pediatric Oncology page; the file served is 9.7.22_the_relevant_molecular_target_list.xlsx, whose Summary of Changes sheet is headed 'SEPTEMBER 2022 UPDATE' (footnote date 2022-09-01)), 2026-11-11
• Haematologic cancer: no · Solid tumour

  Rule: From the indication, or the registry conditions when no indication matches. Source: ClinicalTrials.gov NCT03511248, 2026-11-11

  Published context: Likelihood of approval from phase 1: 7.5% haematologic vs 4.6% solid (BIO / Informa / QLS 2021, 2011–2020). Population-level, not a prediction.

• Targets: No investigational drug among the registered interventions (devices, radiation, procedures and background therapy are not looked up). · Open Targets Platform

• Not loaded on this app yet: Normal-tissue expression in vital organs. Source: Human Protein Atlas (ticket 36).
• Not loaded on this app yet: Pan-essential in cell lines. Source: DepMap (ticket 36).
• Not loaded on this app yet: Approved drug on this target. Source: Drugs@FDA (ticket 30).

2. Can the result be trusted?

• Randomised: yes · Randomised allocation

  Rule: Registry allocation field. Source: ClinicalTrials.gov NCT03511248, 2026-11-11
• Small denominator: yes · 2 enrolled; each patient moves a rate by 100 ÷ 2 = 50.0 points

  Rule: Enrolment under 30; the arithmetic is shown, not a benchmark. Source: ClinicalTrials.gov NCT03511248, 2026-11-11
• Primary endpoint is overall survival: no · Change in serum uric acid levels

  Rule: A registered primary outcome measure names overall survival. Source: ClinicalTrials.gov NCT03511248, 2026-11-11

  Published context: Non-OS primary endpoint: odds ratio 2.79 for a positive phase 3 (Otsuka 2021, 400 phase 3 oncology trials, to 2020). Shown with the next figure: a surrogate is easier to hit, and often a weak guide to survival.

  Published context: 52% of surrogate-to-OS correlations are low (Prasad 2015, published to 2014). Shown with the figure above.
• Results overdue: yes · Primary completion 2025-01-07, 22 months ago; no results posted

  Rule: Primary completion (actual) more than 12 months ago and no results posted to the registry. Source: ClinicalTrials.gov NCT03511248, 2026-11-11

  Published context: 40.9% of applicable trials report results within a year (Results-reporting studies summarised in spec §11, all therapy areas). All areas, not oncology only.

• Not loaded on this app yet: Treated and evaluable counts, assessor, confirmed response, follow-up and data cutoff. Source: Readout extraction (ticket 32).
• Not loaded on this app yet: Primary endpoint changed between registry versions. Source: Registry versions in the store (ticket 32).

3. What must it beat?

• Not loaded on this app yet: Control-arm result and approved therapies for the same segment, with label links. Source: Drugs@FDA, FDA labels and readouts (tickets 30, 32).

4. Too crowded, or too late?

• Not loaded on this app yet: Programs on the target by phase and months behind the leader. Source: Programs and Drugs@FDA (ticket 33).

5. Can it be approved, and stay approved?

• Single-country: yes · The only site is in United Kingdom

  Rule: All listed sites are in one country; the share of US sites is shown. Source: ClinicalTrials.gov NCT03511248, 2026-11-11

• Caveat: Site counts are not patients per country, and trials registered only outside ClinicalTrials.gov are not covered. Where the sites are is a fact about the record, not a judgement of its quality.
• Cited case: In February 2022 FDA asked its Oncologic Drugs Advisory Committee whether sintilimab's application, resting on ORIENT-11, a phase 3 run only in China, needed further trials showing it applies to US patients and US practice. One case, not a rule. · FDA, ODAC 10 Feb 2022, draft questions

• Not loaded on this app yet: Precedent approvals for target, modality and endpoint; accelerated-approval status. Source: Drugs@FDA and FDA accelerated-approval tables (ticket 30).
• Not loaded on this app yet: Orphan designation, EU paediatric plan, pediatric incentives. Source: No investigational drug was named, so EMA and FDA records were not looked up.

6. Can the sponsor finish?

• Sponsor: Queen Mary University of London (academic or other) · ClinicalTrials.gov NCT03511248
• principal investigator: Dr Simon Woldman, MD FRCP FESC, Fellow of the Royal College of Physicians and Fellow of the European Society of Cardiology · Person page
• principal investigator: Dr Ceri Davies, MD FRCP FESC, Fellow of the Royal College of Physicians and Fellow of the European Society of Cardiology · Person page
• study chair: Prof Amrita Ahluwalia, BSc PhD, William Harvey Research Institute, Queen Mary University of London · Person page

• Not loaded on this app yet: Filed cash, quarterly spend and the runway arithmetic. Source: SEC XBRL company facts (ticket 37).
• Not loaded on this app yet: Sponsor's completed vs stopped oncology trials and results-reporting record. Source: Registry, by company (ticket 37).

What public data cannot tell you

Public records cannot show: sales forecasts; a probability of success for this asset; full deal terms and net prices; FDA designations and action dates before approval (shown only as company-reported); clinical holds unless the company disclosed them; manufacturing; patents on unapproved drugs; whether preclinical findings have been replicated.