Stock Markets February 23, 2026

Adial Shares Climb After FDA Signals Flexibility on Pivotal Trial Requirements

Regulatory commentary may allow approval based on one robust trial plus confirmatory evidence, a change Adial says could lower Phase 3 costs for AD04

By Leila Farooq ADIL
Adial Shares Climb After FDA Signals Flexibility on Pivotal Trial Requirements
ADIL

Adial Pharmaceuticals saw its stock rise after new FDA policy commentary suggested the agency may accept one adequate and well-controlled clinical investigation with confirmatory evidence in place of two independent pivotal trials when scientifically appropriate. The shift, described in a New England Journal of Medicine commentary, could reduce Phase 3 expenses and accelerate the company’s pathway to a New Drug Application for AD04, the company’s lead candidate for Alcohol Use Disorder.

Key Points

  • Adial’s shares rose 2.9% following company disclosures about recent FDA policy guidance.
  • A New England Journal of Medicine commentary by FDA Commissioner Martin A. Makary and Vinay Prasad indicates the agency may accept one adequate and well-controlled trial plus confirmatory evidence rather than two independent pivotal studies, when scientifically appropriate.
  • The potential regulatory shift could reduce Phase 3 costs and accelerate the company’s path to a New Drug Application for AD04, affecting the biotech and capital markets tied to clinical-stage drug development.

Adial Pharmaceuticals Inc. (NASDAQ:ADIL) registered a modest uptick in its share price after the company pointed to recent federal regulatory commentary that alters the evidentiary expectations for drug approvals. On Monday, Adial’s stock rose 2.9% following the announcement.

The company cited a commentary published February 19, 2026, in The New England Journal of Medicine authored by FDA Commissioner Martin A. Makary and Vinay Prasad. That piece outlined an updated approach to demonstrating clinical effectiveness under Section 505(d) of the Federal Food, Drug, and Cosmetic Act.

Under the newly emphasized policy direction, regulatory approval in certain circumstances may be supported by one adequate and well-controlled clinical investigation supplemented by confirmatory evidence, rather than the longstanding expectation of two independent pivotal studies. The commentary frames this change as a modernization of evidentiary standards that prioritizes the quality of trials and confirmatory support over the raw number of pivotal studies conducted.

Adial said its Phase 3 planning for AD04 had previously been oriented around conducting two pivotal trials. The company indicated that the agency’s updated stance could have material effects on the later-stage program, noting that this direction could significantly lower Phase 3 costs, improve capital efficiency, and speed the route toward submission of a New Drug Application.

AD04 is described by the company as a genetically targeted serotonin-3 receptor antagonist being developed to treat Alcohol Use Disorder in heavy drinking patients. Adial stated it plans to engage with the FDA to determine an appropriate evidentiary strategy for AD04 that aligns with current regulatory standards.

The policy commentary referenced pertains specifically to interpretation of Section 505(d) and emphasizes confirmatory evidence alongside trial rigor. Adial’s public statement connects that regulatory conversation directly to its development strategy and anticipated resource allocation for Phase 3 activities.


Contextual notes

  • The company relied on a New England Journal of Medicine commentary by FDA officials to explain the regulatory shift.
  • Adial previously planned two pivotal Phase 3 trials for AD04; the agency commentary suggests fewer trials may be acceptable in some cases.
  • Adial intends to discuss evidentiary requirements with the FDA to determine the next steps for AD04.

Risks

  • Adial must still engage with the FDA to define an appropriate evidentiary strategy for AD04, creating regulatory uncertainty until those discussions conclude.
  • The commentary indicates potential flexibility but does not guarantee reduced trial requirements; anticipated cost savings and timeline acceleration remain contingent on how standards are applied.

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