One could argue that SI is far too much of a lateral thinker. All of these workarounds could make one dizzy.
I don't understand why MSB do not release more information about the CRL to stop people from speculating. John Hester said in his note that he expects MSB to conduct a single arm trial in adults. SI shot down use of a placebo and said he will check with the FDA about an adequate control group. Neither of these are consistent with an RCT.
So did the FDA specifically request an RCT or not. If they did then it's very serious, but if they didn't then it's a different story. What we know for certain is the FDA want a controlled trial in pediatrics or adults and that it's related to efficacy. What we don't know is why they want the trial. Is it to satisfy the "at least one well-controlled study" requirement or is it to provide comfort (as SI put it) to the FDA that the product will continue to provide a benefit.
So it seems there is a disconnect somewhere here. It is either between the FDA and MSB or MSB and the market or both. So if anyone has SI's mobile can you ask him to release more details about the CRL. TIA
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One could argue that SI is far too much of a lateral thinker....
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