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Clinical Perspectives from a Physician-Led Development Team Early-stage immunology programs particularly in dermatology and rheumatology carry unique complexity. Mechanisms are often novel, biomarkers are evolving, and patient heterogeneity is high. In this setting, protocol quality is not a formality; it is a primary driver of whether a study will generate interpretable data or stall due to avoidable issues. Across early-phase programs, a consistent pattern emerges: many set