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Evaluating Safety and Efficacy in Phase III Alzheimer’s Disease Trial: Endpoints and Statistical Analysis Methods

In clinical trials studying Alzheimer’s disease — a complex neurodegenerative condition that gradually impairs cognitive functions — cognitive performance and functional abilities are often assessed together. Understanding these dimensions and how they’re measured in clinical trials is essential in shaping Cytel’s statistical analyses.

Here, we discuss our experience working with a sponsor on a Phase III clinical trial evaluating the safety and efficacy of monotherapy in patients with Alzheimer’s disease and the statistical model we used to analyze the repeated measurements on two co-primary endpoints.

 

Alzheimer’s disease

Alzheimer’s disease is a complex neurodegenerative condition that gradually impairs cognitive functions. Its onset and progression are influenced by a range of risk factors and some of the most well-established include age, gender, family history, genetic predisposition, and underlying health conditions.

The disease unfolds in distinct stages, each reflecting a different level of cognitive and functional decline. These stages range from mild cognitive impairment to severe dementia, with symptoms worsening as the disease advances.

 

Evaluation of Alzheimer’s disease in clinical trials

In clinical trials, the severity of impairment is evaluated using various scales, each addressing distinct aspects of cognitive and functional decline. The most effective approach combines both cognitive and functional assessments, as functional abilities are closely tied to cognitive performance.

Understanding these dimensions and how they’re measured in clinical trials is essential in shaping the statistical analyses used. Multiple discussions between stakeholders and the sponsor need to take place to reach a consensus on the appropriate endpoints and statistical methods to be used for the analyses.

 

Investigating safety and efficacy of monotherapy in patients with Alzheimer’s disease

We recently collaborated with a small biotech company specializing in Alzheimer’s research on a Phase III clinical trial investigating the safety and efficacy of monotherapy in participants with Alzheimer’s disease, followed by a 12-month open-label treatment. This study has been the subject of complementary analyses exploring biomarkers (p-tau181 and p-tau217) and additional comparative effectiveness analyses with external control arms.

 

Two primary endpoints: ADAS-Cog11 and ADCS-ADL23

To evaluate treatment efficacy in the Phase III trial, we focused on two co-primary endpoints: the ADAS-Cog11 and the ADCS-ADL23, measured at multiple timepoints throughout the study.

 

ADAS-Cog11: The cognitive assessment

The ADAS-Cog11 is a cognitive subscale that assesses key domains such as memory, praxis, orientation, and language. Scores range from 0 to 70, with higher scores indicating greater cognitive impairment. A more refined version of the ADAS-Cog11, known as the ADAS-Cog13, includes two additional items that assess memory and attention. This new version provides additional sensitivity to change in cognition at earlier stages of AD.

For the primary analysis, ADAS-Cog11 was retained as the primary endpoint. This decision was guided by its use in previous studies evaluating the same investigational product, ensuring consistency and comparability across trials. The added value of the ADAS-Cog13 was also analyzed as an explorative efficacy variable to provide deeper insights into cognitive outcomes.

 

ADCS-ADL23: The functional perspective

The ADCS-ADL23 scale complements the ADAS-Cog11 by providing a functional perspective that reflects the impact of cognitive decline. It evaluates the ability to perform daily living activities, with scores ranging from 0 to 78, where higher scores reflect better functional ability and thus less impairment.

 

Cytel’s approach: Analysis with Mixed Models for Repeated Measures (MMRM)

To analyze the repeated measurements on the co-primary endpoints, we employed Mixed Models for Repeated Measures (MMRM). This approach allows the comparison of cognitive and functional changes over time across treatment arms in a robust and flexible way.

In our models, several key risk factors are included to ensure a well-adjusted analysis. These include baseline disease severity, as measured by the Mini-Mental State Examination (MMSE), prior use of standard AD treatments, and geographic region, as fixed effects. Adjustment for baseline values of the ADAS-Cog11 or ADCS-ADL23 scores is considered to account for differences between subjects at baseline. This helps improve the precision of treatment effect estimates and correct for any imbalances between treatment groups. We also include the treatment group indicator along with its interactions with visit timing to capture if and how treatment effects evolve over time.

This method is particularly valuable for multiple reasons. First, it allows controlling for variables that could influence the observed outcomes — like known risk factors — to be able to understand the treatment effect more accurately. Additionally, by using mixed effects models, both the between and within-subject variability over time is accounted for, which is especially important in a heterogeneous condition like Alzheimer’s. Finally, one of the key strengths of MMRM is its ability to handle incomplete data, meaning it can account for missing values without requiring imputation.

The MMRM method supports the generation of individual and group profile graphs over time. These visualizations offer a clear and intuitive way to observe the evolution of treatment effect. They make it easier to compare trends across groups or subjects, and communicate findings in a straightforward manner, both to scientific audiences and to stakeholders who may not be familiar with the statistical details.

 

Final takeaways

Alzheimer’s disease is the most prevalent neurodegenerative disease and remains one of the most complex challenges in clinical research, requiring robust methodologies to capture both cognitive and functional decline over time. Complementary and adapted clinical scales are essential tools for assessing disease progression, and advanced statistical methods offer a robust and flexible interpretation of the treatment effect.

By leveraging adaptive models, mixed-effects approaches, and sensitivity analyses, we help sponsors generate reliable insights that drive decision-making in neurodegenerative drug research.

Empowering Patient Engagement in HTA: Lessons from an AI-Generated Plain Language Summary Case Study

The challenge: Making HTA understandable to everyone

Health technology assessments (HTAs) play a critical role in determining which treatments and innovations are adopted within healthcare systems. However, the technical language and complexity of HTA reports often make them inaccessible to patients and caregivers — the very individuals whose lives these decisions affect the most.

Plain Language Summaries (PLS) are designed to close this gap. They can translate HTA findings into clear, patient-friendly language, empowering people to engage meaningfully in healthcare decisions. Yet, producing high-quality PLS documents is a slow and resource-intensive process. Teams must balance scientific rigor with readability, cultural sensitivity, and accuracy — a demanding task that limits scalability.

This is where artificial intelligence (AI) offers a transformative opportunity.

 

The study: Can generative AI help bridge the communication gap?

At ISPOR Europe 2025, we presented a pioneering study exploring whether generative AI can create accurate and patient-friendly summaries from complex HTA documents.

Using a NICE Highly Specialized Technologies (HST) guidance on onasemnogene abeparvovec (a gene therapy for spinal muscular atrophy), the team tested Google Gemini, a large language model, to generate a full PLS automatically.

The AI-generated summary was evaluated across 18 quality measures covering readability, accuracy, relevance, and tone. A “human-in-the-loop” reviewer ensured alignment with patient communication standards and European HTA Regulation principles — integrating transparency and patient empowerment into the assessment.

 

The results: Speed meets substance

The results were striking. The AI produced an eight-page (2,570-word) PLS in just 15 seconds, structured around all key HTA components — disease context, treatment mechanism, clinical effectiveness, safety, and patient impact.

Across 18 evaluation criteria, the PLS achieved an average score of 8.27/10, reflecting strong alignment with plain language and patient-centered communication standards.

  • Mechanism simplicity (9.2/10) and plain language explanation (8.9/10) were top-performing categories, demonstrating Gemini’s ability to simplify complex gene therapy concepts without sacrificing accuracy.
  • The document met CEFR B1 readability, ensuring accessibility for non-specialist audiences.

However, the AI struggled with target population clarity (6.8/10) and unmet need articulation (6.5/10) — areas requiring deeper contextual and emotional nuance. These findings underscore the importance of maintaining a human role in refining and validating AI outputs, especially when tailoring content for specific patient groups.

 

The implications: Toward patient-centered HTA with AI

The study demonstrates that AI can accelerate and enhance the creation of patient-friendly HTA communications, promoting inclusivity and transparency in healthcare decision-making. But it also emphasizes that AI should complement, not replace, human expertise.

Generative AI tools like Gemini can help:

  • Scale patient engagement, enabling broader and faster dissemination of accessible HTA information.
  • Support regulatory compliance, aligning with EU HTA Regulation principles of transparency and participation.
  • Enhance health literacy, fostering more equitable and informed patient involvement.

Yet, meaningful adoption requires:

  • Human-in-the-loop systems to verify accuracy, tone, and contextual relevance.
  • Prompt optimization to capture nuances like unmet needs or cultural differences.
  • Ongoing validation to ensure reliability and regulatory alignment.

 

The conclusion: AI as a partner in patient empowerment

This work highlights how AI, when thoughtfully integrated, can make HTA more human-centered, transparent, and inclusive. Rather than automating empathy, it can help scale understanding — bringing patients into the conversation, not leaving them behind.

As HTA continues to evolve under new European regulations, embedding AI into communication workflows may mark a key step toward a truly patient-centered future — where every individual can understand, question, and contribute to the health decisions that shape their lives.

 

Interested in learning more?

Read the abstract published at ISPOR EUROPE 2025: “Can Generative AI Deliver Patient-Friendly Summaries? A Case Study Using NICE Guidance for Spinal Muscular Atrophy” by Manuel Cossio and Ramiro E. Gilardino.

Regulatory Guidance on Patient-Centric DMC Risk-Benefit Assessments

Data Monitoring Committees (DMCs) review unblinded clinical trial data and issue recommendations on trial conduct to designated sponsor liaisons empowered with decision-making authority. As an advisory group, a DMC is empaneled by a clinical trial sponsor to safeguard trial participants and ensure the scientific integrity of a trial.

To best support the DMC, sponsors should provide access to benefit summary data so the DMC can make informed recommendations based on risk-benefit at each DMC data review meeting. However, DMCs are often only provided with benefit summaries upon request. This informs the sponsor that the DMC has a concern about risk/benefit, which in the presence of no benefit data, implies that there is a safety concern.

Here, we discuss relevant regulatory guidance regarding risk-benefit assessments conducted by DMCs and the importance of providing appropriate benefit summaries by default to best protect trial integrity and the safety of trial participants.

 

Regulatory guidance on DMCs in clinical trials

The FDA, EMA, and CTTI all give some guidance on DMCs assessing risk-benefit. These organizations all suggest that data that describes patient benefit should be considered when evaluating an intervention.

 

FDA:Use of Data Monitoring Committees DMCs in Clinical Trials”

This draft guidance is intended to help clinical trial sponsors determine when a data monitoring committee (DMC) would be useful for trial monitoring and what procedures and practices should be considered to guide their operation.1 Regarding risk-benefit assessments, the guidance states:

  • “In order to adequately assess the benefits and risks of an intervention, the DMC should evaluate safety data within the context of the intervention’s efficacy, such that the DMC should have access to safety results as well as comparative efficacy results.”

 

Regarding oncology studies, the guidance adds:

  • “DMCs can provide the specialized expertise … for oncologic therapies with highly specific targets and potential serious risks (e.g., biological products for genetic targets, immunotherapies).”

 

FDA:The Establishment and Operation of Clinical Trial Data Monitoring Committees”

This final FDA guidance is also intended to help clinical trial sponsors determine when a DMC may be useful for study monitoring as well as how these committees should operate.2

At formal interim analyses, the guidance notes, risk-benefit should be considered along with formal statistical boundaries:

  • “The data on effectiveness may be very strong, with a stopping boundary having been crossed, but emerging safety concerns may make the benefit-to-risk assessment non-definitive at that interim review.”
  • “If the interim data suggest that the new product is of no benefit—that is, there is no trend indicating superiority of the new product—or that accrual rates are too low or noncompliance too great to provide adequate power for identifying the specified benefit, a DMC may consider whether continuation of the study is futile and may recommend early termination on this basis.”

 

European Medicines Agency: “Guideline on Data Monitoring Committees”

The EMA’s guideline highlights the key issues involved when sponsors include DMCs as part of their trial management.3 Regarding safety monitoring, the guidance notes:

  • “In most cases, safety monitoring will be the major task for a DMC. Even if the safety parameters monitored are not directly related to efficacy, a DMC might need access to unblinded efficacy information to perform a risk/benefit assessment in order to weigh possible safety disadvantages against a possible gain in efficacy.”

 

CTTI: “Recommendations: Data Monitoring Committees”

The Clinical Trials Transformation Initiative (CTTI),4 the public-private partnership co-founded by Duke University and the FDA, offers the following recommendation:

  • “DMC members should be independent of the trial sponsor and should be provided with adequate resources and flexibility to perform their role of assessing benefit-risk (e.g., performing ad hoc analyses as needed, having full access to accumulating unmasked study data).”

 

Providing appropriate benefit summaries

Common benefit summaries include data around how the patient feels, functions, or survives and does not necessarily imply formal inferential efficacy summaries. In oncology, for example, benefit data are commonly overall tumor response data or overall survival data without inferential summaries. In fact, overall survival data in oncology studies plays a key role in risk-benefit assessment if an investigational product is not performing as expected.

Sponsors can best support DMCs with access to appropriate benefit summaries before requests for such summaries become informative, discussing with the DMC in advance what data would be especially useful for them to have beyond the standard safety profile.

 

Final takeaways

DMCs should be provided with benefit summaries from the outset. Providing the benefit summaries by default ensures that the DMC’s recommendations are timely since the DMC doesn’t have to wait for the additional summaries to be provided, which protects participant safety. Providing the benefit summaries by default also ensures that sponsors are not informed that there is a safety concern when the DMC asks for additional summaries, which protects trial integrity.

 

Interested in learning more?

Join Becky Gatesman and Emily Woolley for their upcoming webinar, “Patient-Centric Risk-Benefit Assessments by DMCs” on Wednesday, December 3 at 10 am ET:

The FDA’s Roadmap to Reducing Animal Testing in Preclinical Safety Studies

For a number of years, the FDA and other regulatory agencies have been concerned about the number of animals used in drug research, particularly with regard to toxicology studies. This concern is not only based on animal welfare considerations, it is also based on the increasing realization that animal toxicology data does not always predict human toxicity.

Here, we discuss these challenges and the FDA’s new roadmap for reducing animal testing in preclinical safety studies.

 

Animal toxicity often does not predict human toxicity

There have been a number of drugs that appeared safe in animals while under development but were later shown to be toxic in humans.

Some examples include:

  • Fialuridine: No significant toxicity was observed in mice, rats, or dogs, but in a Phase II clinical trial, several cases of fatal hepatic failure occurred. The reason for this was later shown to be species-specific differences in how nucleoside analogs affect mitochondrial function.1
  • Troglitazone: No significant toxicity recorded in rats, mice, or dogs, but several reports of liver failure were reported post-approval, which ultimately led to the withdrawal of troglitazone from the U.S. market in 2000. It was later determined that toxic reactive metabolites were formed in humans, but not in animals.2
  • Rofecoxib: In non-clinical species, there were no safety signals observed. Post-approval, an increased risk of myocardial infarction and stroke were observed during long-term use. The reason for this difference in response is thought to be that rofecoxib may increase the susceptibility of human low-density lipoprotein and cellular membrane lipids to oxidative damage, which then may lead to plaque instability and thrombus formation in humans.3

According to the FDA, over 90% of drugs that appear safe and effective in animals do not ultimately receive FDA approval in humans largely due to safety and/or efficacy concerns.4 Conversely, some medications that are generally considered safe in humans may never have passed animal testing. Such physiological differences underscore why animals may not always provide adequate models of human health and disease.5

 

A new roadmap: Reducing animal testing in preclinical studies

In April 2025, the FDA published its Roadmap to Reducing Animal Testing in Preclinical Safety Studies.6 The roadmap outlines a long-term plan to reduce or possibly eliminate animal toxicology testing, starting with monoclonal antibodies, by using what is termed the “New Approach Methodologies (NAMs),” which include the use of human tissue-based systems, such as organs-on-chips, in silico modeling, and other innovative approaches.

  • Organs-on-chips (OoC): Systems that contain engineered or natural miniature tissues grown inside microfluidic chips.7
  • In silico modeling: Using computational modeling to leverage existing data to predict safety, immunogenicity, and pharmacokinetics, reducing the need for new animal testing. Key tools include PBPK modeling, AI/ML, and so on.8

Other approaches mentioned include ex vivo human tissues, high-throughput cell-based screening, microdosing and imaging in human volunteers, and refined in vivo methods. The Roadmap highlights that these methods all address one or more aspects of animal testing, and thus it will be essential to use an integrative strategy.

 

Key questions for success

Key questions that need to be answered in order for these approaches to be successful include:

  1. How predictive are NAMs with regard to determining drug safety?
  2. How are NAMs best utilized during the early stages of development, including how studies are to be designed?
  3. How consistent are the results across various manufacturers of NAMs?

Unlike animals, new approach methodologies (such as organs-on-chips) may differ significantly in terms of cell types, genetics, and composition of the overall structure.

 

Final takeaways

The FDA has laid out an ambitious long-term strategy for reducing or even eliminating animal testing initially for monoclonal antibodies, with the potential to extend this to small molecules and therapeutic proteins. The success of this strategy will depend in part on close cooperation between industry stakeholders and the FDA, as well as other regulatory bodies in the ICH.

 

Interested in learning more?

Join Cytel’s Michael Fossler, Nelia Padilla, and Mammoth Preclinical’s Edwin Garner for their upcoming webinar, “FDA’s Roadmap to Reducing Animal Testing in Monoclonal Antibody Development” on December 9 at 9 am ET:

Career Perspectives: A Conversation with Ajay Sathe

For this edition of the Career Perspectives series, we had the pleasure of speaking with Ajay Sathe, retired Country Manager, India, and now Independent Consultant, who has worked with Cytel for 28 years! Ajay shares memorable career milestones and discusses the evolving role of programmers and the skills necessary for the future of drug development.

 

Can you give us a little background on your career so far? What prompted you to join Cytel when it was a fledgling entity in India?

I got hooked on computing and quantitative methods early while studying engineering. When India’s top B-School accepted me, I didn’t want to pass up the opportunity to study for an MBA. But even during the program, I stayed focused on things like optimization and simulation rather than finance and marketing. My first job involved scheduling helicopter sorties on offshore oil rigs to minimize operational cost.

I credit my joining Cytel to our co-founder Nitin Patel, who was my professor. He knew I could handle complex quantitative stuff and reached out to me when both founders were toying with the idea of setting up operations in India. It was a fantastic intrapreneurial opportunity, which I nervously accepted. But it succeeded stupendously beyond my imagination! This is my 28th year at Cytel!

 

Looking back, what were some of the biggest challenges you faced while helping build Cytel India from the ground up, and how did you overcome them?

There are quite a few stereotypes in the western world about India’s work culture. While technical competence is well acknowledged, the work ethics and efficiency are constantly in doubt. My pioneering team resolved to resoundingly bust these myths. Thankfully we succeeded, both with Cytel’s leadership and with our earliest Functional Service Provision (FSP) services clients who were top pharma clients.

Another sustained challenge was to build a stable team ― to hold down employee attrition rates to single digit percentages. I feel proud to see the vast proportion of Cytelians tend to have long tenures.

And then there was the challenge of offering value from India, beyond mere cost arbitrage. I delightfully chuckle to say that a big part of the East team was successfully built in the East. And they continue to deliver value well beyond cost arbitrage!

 

You served as country manager but had both technical and managerial elements in your role. What made you choose this combination?

The technical elements were my first love. The managerial elements were the need of the hour, rather than my conscious choice. Looking back, my strength has been diligently doing whatever is needed. I put my head down and got to work, and it worked! I had an irrational dislike for commercial roles like business development and customer engagement but when pushed into it, I found these exciting beyond belief. While sales was never my formal role, several thrilling wins had my substantial contribution. My sound technical understanding of the client’s needs was much appreciated. To quote a top pharma VP after I had made a successful sales pitch: “You know why you impress us? Because you don’t talk like a sales guy.” I was quick to point out that folks in the Cytel Sales team generally have strong technical background ― one of our unique selling propositions.

I can emphatically say that everyone aspiring to grow into leadership roles should welcome the techno-managerial combination.

 

You have been with Cytel for almost 28 years now. What are some of your most memorable milestones or proudest achievements?

I can readily name a few that I witnessed from close quarters.

When we first built the Windows version of East, with a Graphical User Interface (GUI) rather than a character interface, I crafted a visual prototype of the user interface using MS Excel (though the engines were always steeped in sophisticated C++ code). Why Excel? Because it was extremely useful for rapid prototyping. The users liked the prototype so much that it ended up becoming the product! It took hard work to wean users away from Excel eventually. Then the day came when we proudly proclaimed on our T-shirts that 47 of the top 50 biopharma companies were East users! And so were most divisions of USFDA!

Another milestone was Cytel’s foray into outsourced services, which began with one of the top pharma companies entrusting us with a relatively simple task. Evidently, we did a good job as they became an equity investor in Cytel! That stood as a testament to our credibility and their trust. Fast forward a couple of decades, and prominent private equity firms took Cytel to greater heights.

Lastly, I always strived to give young Cytelians global exposure by encouraging and mentoring them to showcase their work on big stages. We send several people to PHUSE annual conferences in Europe regularly. The thrilling moments for me were when three years in a row, rookie colleagues from India won best-in-the-stream prizes for their presentations! We were being watched by global leaders from our client and prospect companies. I have no doubt that this approach helped us in two big ways: winning contracts in global competition and retaining and nurturing talent that could clearly see the growth path.

 

What do you enjoy most about working at Cytel, and what’s your message for our current or future workforce?

Cytel gives you unmatched opportunity to look around and get involved in a wide range of activities and functions. This is very unlike most CROs who operate in rigid functional silos. At Cytel, you get to see the big picture, and you are encouraged to grow your skillset wider too, not just deeper. This is a key catalyst to long-term career growth.

My message to the future workforce is to preserve and enhance your curiosity. It is not only appreciated at Cytel but also channeled with top-class mentoring and guidance. One has the opportunity to keep learning new things all the time. It is important to grab those opportunities and march forward. There are lots of success stories to see.

On the whiteboard in one of our founders’ offices, a biblical phrase is written in permanent marker that sums this up: “With all thy getting, get understanding!”

 

What advice would you give to someone stepping into a leadership role in a growing organization today?

Leadership roles increasingly demand leading by example. You have to be able to do what you expect your team to do. This requires an astute balancing of three elements: encouragement, posing small but achievable challenges, and empowerment to catalyze success. Small successes are incredible booster rockets for performance.

Simultaneously, deep involvement in HR matters is crucially important, regardless of your function or specialization. Handling people well is a critical success factor, and I have seen all successful leaders — without exception — develop a great ability at managing people and their needs and aspirations. You get to learn this on the job all the time. You just need the desire to learn.

 

What legacy do you hope to leave behind in the clinical research community?

I have often sought feedback from my colleagues and sought to do course correction. Hopefully, I will leave behind a few things to emulate:

  • Passion. Doing every little task thoroughly. It shows up in the quality and extent of one’s accomplishment.
  • Curiosity and hunger. Soaking up little new things to learn, all the time.
  • Attention to detail. My colleagues used to mock my obsession with correct grammar and expression, as also with accurate facts and figures. But mockery slowly morphed to admiration and emulation.
  • Leading from the front. Doing myself first, what I wanted others to do. I discovered that this was the most potent power to persuade.
  • Competition with oneself, rather than with peers. Striving to do better today than yesterday, and better tomorrow than today.

 

Looking ahead, what skills and expertise do you believe will be crucial for the future of drug development?

I feel the demand for skills is expanding sideways, from specialization to versatility . From depth to breadth. Regardless of your function, I feel the following skills will become increasingly crucial.

  • Technology skills: AI, analytics, and automation
  • Managing customer experience: Understanding true needs of the customer and delivering them.
  • Agility and flexibility: Just like agile methods in software development, the industry will demand agile methods in everything. Project plans will become fluid, and people will be expected to adjust to evolving needs.
  • Cross-disciplinary knowledge: Increasingly, you will be required to know a bit about everything. You can’t afford to say, “That’s not my area.”

The programmer will increasingly need to understand enough of data management, statistics & analytics, and computing (specifically prompt engineering). I see many different roles evolving toward a common versatile role — that of a Data Scientist. I am a firm believer that being a “jack of all trades” is more important than being a “master of one”. This will get increasingly reinforced.

 

Your enthusiasm and passion for Cytel and your work are truly infectious. What fuels that passion, even after so many years?

The most precious thing about Cytel I experienced, is that the company takes care of your growth and advancement spontaneously. Never in my 28 years did I have to ever ask for a raise or a promotion. My role evolved, and as I delivered on the growing or morphing expectations, I got rewarded, sometimes beyond my expectations.

I have been more dutiful than hardworking. Hard work was an incidental necessity of delivering on duty. It never felt like a burden, because the work was always exciting, and the results were always gratifying, and sometimes spectacular. The company truly took care of me. Such has been the leadership of the company.

My biggest motivation has been watching my next 2 or 3 levels in the organization, growing steadily in capability, and taking bits of my tasks and doing them better than I did! I see this as a multiplier effect. Instead of improving my individual performance by some percentage points, my team was delivering in increasing multiples. The aggregate competency in the company grow geometrically! That gave a stupendous sense of accomplishment.

 

You played a key role in bringing PHUSE to the Asia Pacific region and served as PHUSE’s APAC Regional Director. What inspired you to take on that initiative, and what impact do you think it had?

My first exposure to PHUSE was in Berlin, when I was gently pushed into making a presentation. I was thrilled to see the high level of energy, capability, and ingenuity in that audience. Their CSS (Computational Sciences Symposium) in USA, in partnership with the USFDA, is a fabulous collaboration of bright minds pushing the frontiers of drug development.

So a few years later in Brighton, UK, when the PHUSE board asked for a volunteer to carry the movement to Asia, my hand shot up.

I started with a Single Day Event in Hyderabad, India, and the movement rapidly spread to China and Japan and beyond. PHUSE inducted me onto their board of directors, and here we are today, with the biggest chunk of PHUSE membership in APAC! To be sure, a big credit for that goes to the Asia Director who came after me ― Sarvesh Singh.

My impact, I think, has been to help the Asian talent pool tap into global opportunity, and utilize their potential by rising to the occasion.

 

What did receiving the John Hirst Award for lifetime contribution mean to you personally and professionally?

John Hirst was a widely admired industry stalwart. I am honored to be among a handful of people recognized over the 2+ decades of PHUSE existence. The acknowledgement was very gratifying, so it motivates me to keep up the effort, despite my retirement from managerial roles, to help talent and demand find each other! Professionally, it is a recognition that makes me look back with contentment about having made a positive difference to our professional community. Personally, it’s a lovely feather in the cap along with some nice accolades I have earned.

 

Finally, what are your main interests outside of work?

Instrumental music! I am blessed with the ability of picking up new musical instruments fairly easily. Over the years, alongside long hours of work, I have de-stressed by picking up over a dozen musical instruments ― all self-taught. I have a YouTube channel that has over 250 popular songs based on Indian films and classical music, played on the flute, Hawaiian guitar, harmonica, aerophone, geoshred (an app on the iPad), piano, melodica, the santoor, and the tabla. And I keep exploring more instruments!

When I retired, I never had a problem finding ways to spend my time. Add to that an active interest in reading and sports, and I have my plate full! When I was working, I truly enjoyed the work; and now I continue to enjoy these other engagements. I have been fortunate in many dimensions in my life!

Thank you, Ajay, for sharing your experiences with us!

Ajay Sathe

The Last “C” in CMC: Why Controls Are the Safeguard of Drug Development

In the trilogy of CMC (Chemistry, Manufacturing, and Controls), the final “C” is often underestimated but is arguably the most critical for ensuring that what we produce is consistent, safe, and regulatory-compliant. If chemistry defines the drug and manufacturing brings it to life, controls are what guarantee that the product remains reliable in every vial, tablet, or dose.

Controls are the immune system of pharmaceutical development. They detect deviations, defend against risks, and validate that every batch delivers on its promise.

 

What do we mean by “controls” in CMC?

The “controls” in CMC encompass a wide range of quality assurance (QA), quality control (QC), analytical testing, and regulatory documentation processes. These are not optional extras, they are embedded into every stage of drug development and commercial production.

Controls ensure that:

  • Every product meets its specifications
  • Every batch is reproducible
  • Every anomaly is detected, investigated, and resolved
  • Every step is traceable, documented, and auditable

In short, controls create trust, with regulators, with prescribers, and most importantly, with patients.

 

Core components of CMC controls

Analytical testing and specifications

Every drug product must be tested to ensure it meets predefined criteria for:

  • Identity
  • Purity
  • Potency
  • Impurities and degradations products

These parameters are outlined in the specification document. Analytical methods must be:

  • Validated
  • Robust and reproducible
  • Fit for purpose across batches and environments

 

Stability studies and shelf-life determination

Drugs degrade over time, especially under stress conditions. To simulate and understand this, control teams perform stability testing under ICH guidelines:

  • Long-term testing
  • Accelerated testing
  • Stress testing

These studies establish the expiration date and storage conditions, which are legally binding for manufacturers and distributors.

 

Good manufacturing practice (GMP) compliance

Controls ensure that every part of the production process adheres to GMP standards, including:

  • Personnel qualifications and training
  • Validated equipment and cleaning procedures
  • Controlled environments
  • Documented procedures and deviation management

This rigor isn’t just about passing audits. It’s about building systems where quality is embedded, not inspected in.

 

Batch records and traceability

Every batch of a drug must have a complete history:

  • Raw material origins and testing
  • Manufacturing and packaging steps
  • In-process controls and deviations
  • Final QC results and release authorization

This documentation allows manufacturers to trace any issue back to its source.

 

Regulatory role: Controls as the language of compliance

Controls form the backbone of regulatory submissions such as:

  • Investigational New Drug (IND) applications
  • New Drug Applications (NDA) or Marketing Authorization Applications (MAA)
  • Annual reports, stability updates, and change control filings

Agencies like the FDA, EMA, and PMDA expect transparent, validated, and auditable data showing that the product meets safety and quality expectations at every stage of its lifecycle.

 

Modern trends: Data-driven and adaptive controls

The future of controls is increasingly digital and predictive:

  • Real-Time Release Testing (RTRT)
  • Process Analytical Technology (PAT)
  • Digital Quality Systems
  • AI-driven anomaly detection

These technologies promise faster release cycles, fewer failures, and more proactive compliance.

 

Controls turn process into product, and product into trust

In a world where patients depend on precision, safety, and consistency, the controls in CMC play a vital role. They don’t just catch errors, they prevent them, predict them, and prove that they’ve been addressed.

Controls are the final filter between a promising molecule and a reliable medicine. They bring confidence to regulators, clinicians, and patients alike.

So, while chemistry and manufacturing might get all the glory, it’s controls that ensure the promise of science becomes a trusted reality, batch after batch, dose after dose.

 

Interested in learning more?

Read Bengt’s full series on CMC, where he discusses each of Chemistry, Manufacturing, and Controls:

CMC in Drug Development: The Bridge from Lab to Market

The “C” in CMC: Why Chemistry Is the Cornerstone of Drug Development

The “M” in CMC: Manufacturing as the Engine Room of Drug Development

A Preview of Cytel’s Contributions at PHUSE EU 2025

I can’t believe it has already been a year since we wrapped up PHUSE EU Connect 2024, and in two weeks we will be gathering another exciting PHUSE EU Connect conference, only a few kilometers from Heidelberg, where everything started twenty years ago with the very first PHUSE event. I was one of the couple hundred lucky attendees and now, twenty years later, I have the great honor of supporting Jennie McGuirk and Jinesh Patel as Conference Co-chair for this year’s edition.

With a promising agenda featuring about 190 presentations, 34 posters, 9 hands-on workshops, 2 panel discussions, and 3 inspiring keynote speakers, this year we are going to the city of Hamburg for the 21st PHUSE EU Connect. The agenda is full of topics looking toward the future, with about 40 talks and posters referring to AI in their titles, and once again open source will be the confirmed leitmotif.

Cytel will make a significant contribution this year, perhaps more than ever, with six presentations, one poster, active participation in both panel discussions, and co-chairing the “Scripts, Macros and Automation” and “People Leadership & Management” streams.

 

Monday topics: Agile code writing, extracting metadata from R OOP functions, and leadership

The week kicks off on Monday with Kamil Foltynski, who will present “Overcoming Challenges in Collaborative Spreadsheet Editing with Shiny, SpreadJS and JSON-Patch” in the Application Development stream at 11:30 am. Kamil will provide a technical deep dive into enabling real-time spreadsheet editing within Shiny applications, using tools such as SpreadJS, sharing key lessons learned so far. Following Kamil’s presentation, Eswara Satyanarayana Gunisetti, will present “Micro-Decisions, Macro Impact: The Role of Agile Thinking in Every Line of Code” in theCoding Tips & Tricks” stream at 12 pm. See his recent blog on the topic. Eswara will share how an agile “mindset” can positively influence the way we write code.

In the same stream, a few hours later at 2 pm, another colleague Edward Gillian, in collaboration with Sanofi, will present “Risk.assessr: Extracting OOP Function Details,” discussing strategies for extracting metadata from R Object-Oriented Programming functions. Prior to Eswara and Edward’s sessions, at 1:30 pm, Kath Wright, will moderate the Interactive People Leadership & Management session “Invisible Glue: Trust, Influence and The Architecture of Teamwork.” With this live workshop, attendees will engage in practical exercises to learn how to identify barriers to trust, evaluate influence dynamics, and apply evidence-based strategies to strengthen collaboration in both physical and virtual environments.

 

Tuesday topics: Industry trends, extracting macro usage and dependency information from SAS programs, and integrating ECA data into CDISC-compliant datasets

Tuesday also brings two presentations and one poster. Right after lunch at 1:30 pm, Cedric Marchand will join other industry leaders in the panel discussion “Reimagining Statistical Programming: AI, Standards & the Talent of Tomorrow.” The panel will explore how current industry trends, such as AI, open source, and the evolution of data standards, will influence the next generation of statistical programmers.

The afternoon continues at 4 pm with my young and talented colleague Marie Poupelin, who will present “From Zero to Programming Hero: How Internships Shape Statistical Programmers in a CRO” in the “Professional Development” stream. Marie is a great example of the success of our internship program, and she will share her journey from having “zero” statistical programming experience to becoming an industry-ready programmer. Thirty minutes later, at 4:30 pm, Guido Wendland will present “Which Macros Are Used in the Study?” in the “Scripts, Macros and Automation” stream, a stream co-led this year for the first time by my colleague Sebastià Barceló. Guido will discuss techniques to extract macro usage and dependency information from SAS programs; this is particularly useful for identifying potential issues or estimating the impact of macro updates.

Later, in the traditional Tuesday evening poster session, you can join my colleague Cyril Sombrin in discussing “Our Journey in Integrating External Control Arms (ECAs) and RWD for Rare Disease Trials.” There you can discuss real-world case studies on integrating ECA data into CDISC-compliant datasets, exploring the unique challenges and solutions when aligning real-world data with CDISC standards.

 

Wednesday topics: Real-time spreadsheet editing within Shiny applications and real-time validation and streamlined submissions

On Wednesday at 12 pm, Hugo Signol, another young talented Cytel statistical programmer and a product of our internship program, will present his talk “From XPT to Dataset-JSON: Enabling Real-Time Validation and Streamlined Submissions.” Building on Cytel’s experience from CDISC Dataset-JSON-Viewer Hackathon, Hugo will demonstrate a Shiny application that supports interactive exploration and real-time validation through API-based checks.

 

Meet us there!

Cytel will be at Booth 9 at the conference, where you can engage in discussions with our team or meet any of us throughout the week.

I hope I didn’t miss anyone, or anything! We look forward again to reuniting with colleagues and friends from around the world and meeting new acquaintances.

See you all in Hamburg!

Statistical Insight for Strategic Impact: How Statisticians Help Medical Affairs Make the Most of Their Data

Medical affairs is a critical function in the drug development and commercialization process. It ensures that scientific and medical information about a drug is accurate, balanced, and clearly communicated to healthcare providers, medical professionals, patients, and other stakeholders.

Statisticians work closely with Medical Affairs teams to help make the most of their data.

In this blog, we will introduce medical affairs, discuss the role of statisticians in supporting their teams, and share a case study illustrating our collaboration with a sponsor for a neurology drug.

 

Medical Affairs: A bridge between clinical research and the broader healthcare community

Medical affairs guide drug development strategy and clinical communication through different aspects:

 

Post-marketing studies

In the post-marketing phase of a drug’s lifecycle, Medical Affairs play a key role by supporting:

  • Phase IV studies designed to gather additional information on a drug’s effectiveness and safety in the real-world setting.
  • Observational studies aimed at understanding treatment patterns, patient outcomes, and disease epidemiology.
  • Local affiliate studies driven by country teams to address specific market needs, regulatory requirements, or strategic priorities.

 

Exploratory analyses

Medical affairs teams perform exploratory analyses of clinical trials data to gather new insights in addition to those available at the time of the drug approval. These analyses could support:

  • Label expansion, by extending efficacy or safety results to other populations.
  • Scientific publications that help the activities in the medical and scientific community.
  • Real-world relevance, by contextualizing trial results with clinical practice or patient needs.

Exploratory medical affairs analyses also help by exploring tertiary endpoints from completed clinical trials or by looking further at endpoints such as quality of life or biomarkers.

 

Analyses for publications

In addition to exploratory analyses, medical affairs conduct data analyses that are used to support:

  • Medical education materials
  • Congress abstracts, posters, and oral presentations
  • Manuscripts

 

The role of the statistician in medical affairs

Statisticians (like those of Cytel’s Project-Based Services (PBS) team) work closely with medical affairs to support scientific and strategic objectives. Their role includes:

 

Deep understanding of the therapeutic context

Statisticians ensure analyses are relevant and aligned with clinical objectives by building a strong foundation of medical and scientific knowledge.

 

Support of medical affairs studies

Statisticians are hands-on, analyzing and interpreting medical affairs studies, helping generate real-world evidence and actionable insights.

 

Interdisciplinary collaboration
Working with clinical and medical writing teams ensures that outputs are robust and meet the latest standards in data communication.

 

Close collaboration with clients
Open communication helps align priorities, understand timelines, and ensure that deliverables support both scientific communication and business strategy.

 

Clear communication of statistical results
Statisticians translate complex analyses into accessible messages that can be shared with healthcare professionals and internal stakeholders.

 

Familiarity with regulatory submissions
Knowing the key findings from submission dossiers allows for continuity between regulatory and post-marketing activities.

 

Case Study: Supporting a neurology drug from submission to post-marketing

A pharmaceutical company conducting neurology studies needed support for the regulatory approval process and post-approval work. Cytel’s specialized team of statisticians first collaborated with the sponsor at the regulatory submission stage by:

  • Supporting the regulatory submission package (e.g., developing the statistical analysis plans for individual study and integrated safety and efficacy analyses, providing input on the clinical study report (CSR), etc.
  • Supporting the regulatory queries (e.g., conducting sensitivity checks, long-term safety and efficacy analyses, etc.

 

Key contributions

The team’s familiarity with the data, as well as their ability to quickly adapt to evolving project needs and meet tight deadlines, enabled them to help the sponsor transition seamlessly from the submission stage to the post-marketing stage. Here, key contributions included:

  • Exploratory analyses of clinical data to support scientific discussions.
  • Continuous data interpretation and communication, transforming complex results into clear, impactful messages for medical teams.
  • Support of the medical communication team in the development of congress abstracts by ensuring that statistical results are clearly and accurately presented. This includes creating high-quality graphical displays (e.g., Sankey plot, Volcano plot) and many other standard and unusual visualizations that can be directly used in congress posters.
  • Creation of slide decks for external use, tailored to different audiences such as steering committees or advisory boards. These presentations require visually engaging graphics and a clear, concise interpretation of results to effectively communicate key findings.

 

Building effective collaboration

This collaboration with the client was highly effective, built on a foundation of mutual trust, communication, and shared scientific ambition. It was based on the following principles:

  • Flexibility
    We adapt quickly to evolving project needs, changing timelines, and emerging priorities.
  • Rapid Turnaround
    Our teams, composed on statisticians and statistical programmers are structured to deliver high-quality outputs under tight deadlines, which is critical for time-sensitive materials like congress abstracts.
  • Ongoing alignment with current data
    We adjust/re-run analyses as new data becomes available, helping Medical Affairs teams stay up to date with the latest evidence.
  • Specialized teams
    Our statisticians and programmers are experienced in preparing data for scientific communication. They are not only familiar with a wide range of data presentations that are typically used in the medical literature, but can also bring in creative solutions on how to make complex results accessible and relevant for both scientific and non-specialist audiences, including graphical data displays.
  • Regular meetings and flexible communication
    Cytel PBS and client statisticians and programmers working on the same drug hold regular (usually monthly) meetings to ensure alignment and efficient progress. They embrace flexible and dynamic communication methods, including quick ad hoc meetings or written messages. This collaborative approach fosters transparency, improves cross-functional communication, and supports timely delivery of project milestones.

 

Final takeaways

This unique partnership enables high-quality deliverables and meaningful scientific engagement. Successful collaboration with medical affairs teams is driven not only by technical excellence, but also by trust, deep commitment, and cross-functional synergy.

Micro-Decisions, Macro Impact: Cultivating an Agile Mindset in Every Line of Statistical Code

Statistical programming is a cornerstone of clinical research, converting raw data into the standard datasets, tables, listings, and figures (TLFs) that support decision-making, regulatory submissions, and publications.

Traditional workflows often limit collaboration, adaptability, and early input from programmers. As timelines shrink and expectations grow, it’s clear that a new way of thinking is needed, one that goes beyond efficiency, and into adaptability, collaboration, and value creation.

In clinical statistical programming, agility isn’t only about sprints or ceremonies, it starts with the smallest choices we make at the keyboard.

 

Every day, statistical programmers make hundreds of tiny decisions such as

  • How to name a variable
  • Design a macro
  • Structure a dataset

Most of these choices happen quietly, almost on autopilot. Yet together, they define

  • How flexible our studies are
  • How easily we can adapt to change
  • How smoothly teams can collaborate.

 

These small choices (micro-decisions), multiplied across teams and studies, drive what I call a macro impact.

 

Agility at the code level

Agile thinking refers to building programs with change in mind, favoring adaptability over perfection, and prioritizing clarity and consistency over clever shortcuts. These ideas might sound subtle, but together, they create the difference between rigid code and resilient code.

Programmers can apply agile thinking directly at the code level, through clarity, simplicity, adaptability, and value orientation.

Habits like intentional naming, smart commenting, modular macros, and built-in quality checks make code more resilient and teams more responsive to change.

 

Agility at the code level shows up in many subtle but powerful ways:

  • Intentional naming makes programs self-explanatory and audit ready.
  • Smart commenting tells the why, not just the how.
  • Scalable macros turn adaptability into a default setting.
  • Readable structures make collaboration effortless.
  • Built-in quality checks turn QC from a final gate into a shared rhythm.

 

When practiced consistently, these habits turn teams into systems that learn, adapt, and deliver faster with accuracy and compliance.

 

Thinking differently

This isn’t about doing more; it’s about thinking differently while doing what we already do.

Proven models like Kaizen and Toyota Lean philosophies manifest that, through continuous improvement with a culture of cooperation and eliminating waste, we can deliver maximum value to the customers by sticking to the existing process and not letting go of what we have already learned. Through the lens of these philosophies, we see how small enhancements in daily programming can scale major gains in collaboration, reuse, and efficiency.

 

Final takeaways

Code is communication. Every variable, macro, and comment is a message to a collaborator, a regulator, or your future self.

Let every line you write carry clarity. Let every structure you build invite change. Let every decision reflect agility. That’s the path from micro-decisions to macro impact.

 

Interested in learning more?

Eswara Gunisetti will be at PHUSE EU Connect 2025 to present “Micro-Decisions, Macro Impact: The Role of Agile Thinking in Every Line of Code.” Discover how every line of code can contribute to a more adaptive, transparent, and rewarding way of working, where agility lives not just in our processes, but in our programming decisions themselves.

Register below to book a meeting or visit Booth 9 to connect with our experts:

Career Perspectives: A Conversation With Patti Arsenault

In this edition of our Career Perspectives series, we are delighted to feature Patti Arsenault, Vice President, Quality Assurance, at Cytel. Patti discusses her career in quality assurance, how clinical trials have evolved over the years, balancing regulatory compliance with innovation, and more. After 11 impactful years at Cytel, Patti is retiring, having shaped standards that will guide the organization for years to come.

Can you give us a little background on your career?

I began my career in programming, using Assembler, Fortran, and Cobol, then moved into database and web programming using SQL and Java Script. While working at an epidemiological company, I moved into data management, which felt like a natural next step. I joined Cytel to build the data management team, and later, was asked to step into a quality role. I started at Cytel 11 years ago and have been the Vice President of Quality Assurance (QA) at Cytel for almost 8 years now.

You’ve had a fascinating journey from programming to data management and now leading QA. What motivated each of those transitions?

Each transition felt like a natural progression. When I began my career in programming ― using punch cards! — it was all machine-based communications. But I’ve always been more of a people person, so when given the opportunity to move into data management, the transition was easy.

At my previous company, data managers were also programming SQL within Oracle, and I was part of a team that developed a web-based Electronic Data Capture (EDC) system. During this transition and time, I organized and brought together a disparate group of data managers who had been working independently under different principal investigators, each using their own processes. Bringing this team together and centralizing and standardizing the processes was so much more efficient.

The skills I gathered there ― technology, good communication and organization, team building, and an understanding of client and regulatory needs — were the same skills needed to help Cytel’s quality groups switch from a dispersed setup into a global, unified model.

In your experience improving processes, are there particular questions or mindsets that help you identify what needs to change?

Clinical trial process originally started on paper, and much of what exists today mimics that still. Given that, the key mindset that is needed is being willing to challenge the norm. But that mindset has to be coupled with having the right gatekeepers, people who can ensure that the proposal will be in line with regulatory and client expectations.

This is what is so great about the Cytel QA team. We have a depth of experience that allows us to challenge an existing process and inspect the proposal. We have some great debates about why we do the things we do, and the shared goal of those conversations is always continuous improvement.

When you joined Cytel in 2014, what was your vision for the data management team you were building?

My vision was for the data management team to become well known and trusted in the industry as the best. I was quite excited about building a global team and creating opportunities for team members to learn from each other’s experiences. One of the advantages of hiring data managers at Cytel was the blend of experience we could bring together, both from the sponsor side as well as the CRO side. I wanted to develop the team to have a diverse skillset, making us an adaptable group that brings even more value to our clients.

QA at Cytel touches on so many areas — from GCP to data privacy to customer satisfaction. How do you prioritize and manage such a broad scope?

Yes, our responsibilities span across many domains! This is due to the rapid growth Cytel has experienced. Everyone at Cytel rolled up their sleeves and truly dug in. Through training within the team and assigning a task owner and one to many back-ups, we can manage the broad scope and maneuver tasks amongst the team as needed.

Clinical trials have evolved significantly over the years. What are some of the biggest changes you’ve seen in how quality is managed?

Probably the biggest change I’ve seen is adding risk assessment and an acceptable level of tolerance. It’s a shift that acknowledges that perfection, while always desired, is not always achievable.

Additionally, the speed of acquisition and the types and amount of data have increased substantially. With that comes pressure to complete tasks more quickly, so it is important to strike a balance between efficiency and the quality desired.

How do you balance regulatory compliance with innovation, especially in a fast-evolving field like clinical research?

Regulations rarely tell you exactly how to do something. This allows us to be creative and discuss whether a solution truly achieves the goal of the regulation. We also actively monitor a number of regulatory websites to stay abreast of emerging regulations.

Finally, we welcome our client audits. On average, we conduct about 30 per year. If a client questions an approach they haven’t seen before, it opens a discussion between them and our internal team. These conversations often turn into learning experiences for all involved.

What do you think is the most misunderstood aspect of QA in clinical trials?

Quality assurance is often mistaken for quality control (QC). QA is intended as a proactive approach; we help prevent mistakes or defects. QC, on the other hand, should detect errors after they occur. Of course, using QC data will help us identify processes that are not working as intended!

You’ve built and led your team for over a decade now. What qualities and skills do you look for when building a strong, stable team? And how do you approach supporting junior team members as they grow into their roles?

QA folks need to know how to interpret a regulation, understand a procedural document, communicate clearly, and have a keen sense of organization.

We’ve built some pretty clear growth paths for the QA team. It’s part of my responsibility to work with every team member to find out where they want their career to go, and to help them in realizing that. For those who have the desire to go into auditing, there are multiple steps that you need to be trained in and master as you grow into an auditor role. Some junior team members have, with support, trained in data privacy. For team members who want to be more technical, we have the opportunity to work on the Trackwise application.

How do you foster shared learning across such a diverse QA team?

We maintain a skill matrix where each skill has an owner responsible for training others. We also meet as an entire group on a monthly basis and have people present on a wide range of topics — from regulations to a process or a new, clever way to use Excel. In addition to the monthly full-team meetings, we have several sub-groups such as auditors, change control, computer systems validations, and more, who meet regularly and share ideas, problems, and solutions.

You’ve led some incredible community initiatives like the yearly backpack drive providing school supplies for a local school and providing families with Thanksgiving meals. What drives your passion for giving back, and how do you see these initiatives influencing company culture?

I’ve been fortunate in my life, and I love finding opportunities to help others. A backpack is a small monetary hit for most of us at Cytel, but the impact on a middle schooler who may start school without one is huge!

I believe that people naturally enjoy doing things as a group, to feel part of a group or community. And the feel-good effect of doing good, even if it’s a little thing, builds comradery, which in turn enhances company culture.

Looking back on your 11 years at Cytel, what are you most proud of?

I am proud of our first-rate quality team! We are a dedicated and knowledgeable bunch and try to set the tone of working with the functions and business units rather than policing them. Quality is not an easy role to be in, yet my team comes to work smiling every day.

Finally, when you’re not diving into work, what hobbies or passions keep you busy?

My passion is my family — 3 sons and daughters-in-law and 6 grandchildren keep me busy. I golf and bike and try to be at the beach whenever I can.

Thank you, Patti, for sharing your experience!

Patti Arsenault,Vice President, Quality Assurance at Cytel