Clinical Trial Intelligence

Which EU/EEA sites lead IBD phase II–III trials, and where are patients concentrated?

17 June 2026

Across 100 unique inflammatory bowel disease (IBD) phase II–III trials, the dataset contains 3,123 CTIS-country site slots, 787 normalized site names, and 13,636 country-level planned participant allocations. Medical Network Sp. z o.o. is the leading site by trial participation, appearing in 37 of 100 trials, while Poland is the largest country hub with 611 site slots and 3,254 planned participants. Monoclonal antibodies remain the dominant modality, covering 43 of 100 trials and 6,601 planned participants.

Trials analyzed
100
Site slots
3,123
Planned participants
13,636
Leading site
Medical Network
37 / 100 trials

Which sites participate in the most IBD phase II–III trials?

The top 10 sites account for 252 cumulative trial participations across 100 IBD phase II–III trials. Medical Network Sp. z o.o. leads with 37 trial participations, followed by UZ Leuven and Semmelweis University with 30 each.

Top 10 sites by share of 100 trials
Medical Network Sp. z o.o. Poland37.0%
UZ Leuven Belgium30.0%
Semmelweis University Hungary30.0%
Centre Hospitalier Universitaire De Nice France24.0%
Ospedale San Raffaele S.r.l. Italy23.0%
Hospices Civils De Lyon France23.0%
Twoja Przychodnia Szczecinskie Centrum Medyczne Poland23.0%
CHRU De Nancy France22.0%
Fondazione Policlinico Universitario Agostino Gemelli IRCCS Italy20.0%
Universitaetsklinikum Ulm AöR Germany20.0%
Site ranking uses normalized site names and counts unique trial participations across 100 IBD phase II–III trials.
Interpretation

IBD site leadership is not concentrated only in major Western European academic centers. The top 10 includes Poland, Belgium, Hungary, France, Italy, and Germany, showing that high-volume IBD execution capacity is distributed across both hospital systems and specialized private/site-network models.

Which countries carry the largest IBD site and patient load?

Poland is the largest country hub by both site slots and planned participants: 611 of 3,123 site slots (19.6%) and 3,254 of 13,636 participants (23.9%). France ranks second with 372 site slots and 2,329 participants.

Top 10 countries by site slots and participant allocations
Country Sites Site share Patients Patient share
Poland61119.6%3,25423.9%
France37211.9%2,32917.1%
Italy31210.0%8476.2%
Germany2849.1%1,53011.2%
Belgium1805.8%4893.6%
Spain1785.7%4753.5%
Hungary1685.4%6044.4%
Czechia1665.3%6654.9%
Romania1203.8%7365.4%
Bulgaria1073.4%4073.0%
Country totals sum CTIS country-level site and planned participant allocations across unique IBD phase II–III trials.
Interpretation

Poland and France are the clearest country-level recruitment anchors: together they represent 983 of 3,123 site slots (31.5%) and 5,583 of 13,636 planned participants (40.9%). Germany contributes fewer sites than Italy but nearly twice as many participant allocations, suggesting larger expected enrollment per country authorization.

How does trial activity split between ulcerative colitis and Crohn’s disease?

Ulcerative colitis accounts for 49 of 100 trials and 7,288 of 13,636 planned participants. Crohn’s disease accounts for 37 of 100 trials but uses 1,409 of 3,123 site slots, slightly more than ulcerative colitis.

Disease category contribution
Ulcerative colitis
49.0%
49 trials · 1,331 sites · 7,288 patients
Crohn’s disease
37.0%
37 trials · 1,409 sites · 5,277 patients
Mixed Crohn’s + UC / broad IBD
12.0%
12 trials · 375 sites · 966 patients
Broad IBD / unspecified
2.0%
2 trials · 8 sites · 105 patients
UC = ulcerative colitis. Disease categories are assigned from stated trial disease labels.
Interpretation

Ulcerative colitis is the larger patient-allocation market, but Crohn’s disease appears more site-intensive: Crohn’s trials average 38.1 site slots per trial versus 27.2 for ulcerative colitis. This implies Crohn’s programs may require broader site activation to reach comparable enrollment goals.

Which modalities drive the IBD phase II–III site network?

Monoclonal antibodies are the dominant modality, appearing in 43 of 100 trials, 1,511 of 3,123 site slots, and 6,601 of 13,636 planned participants. Small molecules are second with 29 trials, 917 site slots, and 3,925 planned participants.

Trials by modality category
Monoclonal antibody43.0%
Small molecule29.0%
Peptide / protein / enzyme10.0%
mAb + small molecule7.0%
Other / non-drug / diagnostic7.0%
Subcutaneous
49 / 100
Oral
41 / 100
IV / infusion
34 / 100
mAb = monoclonal antibody. Route counts are not mutually exclusive because a trial can include more than one route.
Interpretation

IBD development remains biologic-heavy, but oral small molecules are a meaningful second pillar. The route mix shows why IBD trial sites need both infusion/injection infrastructure and conventional oral-drug trial workflows; 12 of 100 trials also involve combination treatment.

At what complexity level are CROs most used in IBD trials?

CROs or external operational vendors are present in 67 of 100 trials and cover 2,683 of 3,123 site slots (85.9%). CRO use rises sharply once trials exceed 15 site slots: 14 of 21 trials with 16–30 sites use CROs, and 35 of 39 trials with 31+ sites use CROs.

Share of trials with CRO or operational vendor present
1–5 site slots15.8%
3 / 19 trials
6–15 site slots14.3%
1 / 7 trials
16–30 site slots66.7%
14 / 21 trials
31+ site slots89.7%
35 / 39 trials
Top CRO/vendor
IQVIA
27 trials
Second
ICON / PRA
24 trials
Third
Labcorp
19 trials
CRO = contract research organization. Vendor counts are normalized across sponsor-declared CRO and operational support names.
Interpretation

The practical CRO-use threshold in IBD appears around 16 site slots. Below 16 sites, CRO presence is under 16%; above 30 sites, it approaches 90%. Trial managers planning broad IBD programs should expect external support to be the norm, especially for central lab, eCOA, imaging/endoscopy review, monitoring, data, and logistics workflows.

What is the phase and authorization-year mix behind the IBD site landscape?

Phase III trials make up 50 of 100 trials and 6,958 of 13,636 planned participants. Phase II trials make up 44 of 100 trials and 5,167 planned participants, while phase II/III hybrid trials account for 6 trials and 1,511 planned participants.

Phase and year distribution
Phase III
50
1,528 sites · 6,958 patients
Phase II
44
1,428 sites · 5,167 patients
Phase II/III
6
167 sites · 1,511 patients
Authorization year Trials Site slots Planned participants
2024541,8027,956
2025321,0433,860
2026142781,820
Year grouping uses first CTIS authorization year in the dataset.
Interpretation

The IBD site landscape is almost evenly split between phase II and phase III by trial count, but phase III contributes the largest patient allocation. The 2024 cohort is the largest contributor, representing 54.0% of trials, 57.7% of site slots, and 58.3% of planned participants.

Definitions used in this report

IBD means inflammatory bowel disease, primarily Crohn’s disease and ulcerative colitis. A CTIS-country site slot counts a site listed within a country-level trial authorization; a single normalized site may appear across multiple trials. Planned participants are country-level participant allocations summed across trials.

IBD
Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis.
mAb
Monoclonal antibody.
CRO
Contract research organization or sponsor-declared external operational trial support provider.
Site slot
A country-level site listing within a CTIS trial geography record.