The February pause did not kill PATHWAYS. On 19 June 2026 the MHRA said it had finished scientific dialogue with King’s College London. A modified protocol met the required regulatory standards. The Health Research Authority approved the ethics in parallel.
MHRA’s own list of strengthened safeguards: minimum ages of entry; clearer discontinuation rules for bone health, cognition, and vaginal bleeding; more detail on fertility preservation. The Commission on Human Medicines advised on participant safety. The modified protocol also went to the Research Ethics Committee.
Recruitment was “currently not due to commence until 1 August 2026, due to legal proceedings” — MHRA’s own words.
Cass found they do not have the evidence. This is how they propose to get it — on children. A modified protocol is not a green light. The ban on routine prescribing is still the progress.
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