A Clinical Study to Test How Effective and Safe GLPG1690 is for Subjects With Idiopathic Pulmonary Fibrosis (IPF) When Used Together With Standard of Care

Phase 3

Terminated

Conditions: Idiopathic Pulmonary Fibrosis

Interventions: Drug: Placebo
Drug: GLPG1690

Registration Number: NCT03711162

Lead Sponsor: Galapagos NV

Brief Summary: The main purpose of this study was to see how GLPG1690 works together with your current standard treatment on your lung function and IPF disease in general. The study also investigated how well GLPG1690 is tolerated (for example if you got any side effects while on study drug).

Detailed Description: Not available

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 525

Inclusion Criteria

Male or female subject aged ≥40 years on the day of signing the Informed Consent Form (ICF).
A diagnosis of IPF within 5 years prior to the screening visit, as per applicable American Thoracic Society (ATS)/European Respiratory Society (ERS)/Japanese Respiratory Society (JRS)/Latin American Thoracic Association (ALAT) guidelines at the time of diagnosis.
Chest high-resolution computed tomography (HRCT) historically performed within 12 months prior to the screening visit and according to the minimum requirements for IPF diagnosis by central review based on subject's HRCT only (if no lung biopsy (LB) available), or based on both HRCT and LB (with application of the different criteria in either situation). If an evaluable HRCT <12 months prior to screening is not available, an HRCT can be performed at screening to determine eligibility, according to the same requirements as the historical HRCT.
Subjects receiving local standard of care for the treatment of IPF, defined as either pirfenidone or nintedanib at a stable dose for at least two months before screening, and during screening; or neither pirfenidone or nintedanib (for any reason). A stable dose is defined as the highest dose tolerated by the subject during those two months.
The extent of fibrotic changes is greater than the extent of emphysema on the most recent HRCT scan (investigator-determined).
Meeting all of the following criteria during the screening period: FVC ≥45% predicted of normal, Forced expiratory volume in 1 second (FEV1)/FVC ≥0.7, diffusing capacity of the lung for carbon monoxide (DLCO) corrected for Hb ≥30% predicted of normal.
Estimated minimum life expectancy of at least 30 months for non IPF related disease in the opinion of the investigator.
Male subjects and female subjects of childbearing potential agree to use highly effective contraception/preventive exposure measures from the time of first dose of investigational medicinal product (IMP) (for the male subject) or the signing of the ICF (for the female subject), during the study, and until 90 days (male) or 30 days (female) after the last dose of IMP.
Able to walk at least 150 meters during the 6-Minute Walk Test (6MWT) at screening Visit 1; without having a contraindication to perform the 6MWT or without a condition putting the subject at risk of falling during the test (investigator's discretion). The use of a cane is allowed, the use of a stroller is not allowed at all for any condition. At Visit 2, for the oxygen titration test, resting oxygen saturation (SpO2) should be ≥88% with maximum 6 L O2/minute; during the walk, SpO2 should be ≥83% with 6 L O2/minute or ≥88% with 0, 2 or 4 L O2/minute.

Exclusion Criteria

History of malignancy within the past 5 years (except for carcinoma in situ of the uterine cervix, basal cell carcinoma of the skin that has been treated with no evidence of recurrence, prostate cancer that has been medically managed through active surveillance or watchful waiting, squamous cell carcinoma of the skin if fully resected, and Ductal Carcinoma In Situ).
Clinically significant abnormalities detected on ECG of either rhythm or conduction, a QT interval corrected for heart rate using Fridericia's formula (QTcF) >450 ms, or a known long QT syndrome. Patients with implantable cardiovascular devices (e.g. pacemaker) affecting the QT interval time may be enrolled in the study based upon investigator judgment following cardiologist consultation if deemed necessary, and only after discussion with the medical monitor.
Acute IPF exacerbation within 6 months prior to screening and/or during the screening period. The definition of an acute IPF exacerbation is as follows: Previous or concurrent diagnosis of IPF; Acute worsening or development of dyspnea typically < 1 month duration; Computed tomography with new bilateral ground-glass opacity and/or consolidation superimposed on a background pattern consistent with usual interstitial pneumonia pattern and deterioration not fully explained by cardiac failure or fluid overload.
Lower respiratory tract infection requiring treatment within 4 weeks prior to screening and/or during the screening period.
Interstitial lung disease associated with known primary diseases (e.g. sarcoidosis and amyloidosis), exposures (e.g. radiation, silica, asbestos, and coal dust), or drugs (e.g. amiodarone).
Diagnosis of severe pulmonary hypertension (investigator- determined).
Unstable cardiovascular, pulmonary (other than IPF), or other disease within 6 months prior to screening or during the screening period (e.g. acute coronary disease, heart failure, and stroke).
Had gastric perforation within 3 months prior to screening or during screening, and/or underwent major surgery within 3 months prior to screening, during screening or have major surgery planned during the study period.
History of nintedanib-related increase in ALT and/or AST of >5 x upper limit of the normal range (ULN) and increased susceptibility to elevated LFT; moderate to severe hepatic impairment (Child-Pugh B or C) and/or abnormal liver function test (LFT) at screening, defined as aspartate aminotransferase (AST), and/or alanine aminotransferase (ALT), and/or total bilirubin ≥1.5 x upper limit of the normal range (ULN), and/or gamma glutamyl transferase (GGT) ≥3 x ULN. Retesting is allowed once for abnormal LFT.
Abnormal renal function defined as estimated creatinine clearance, calculated according to Cockcroft-Gault calculation (CCr) <30 mL/min. Retesting is allowed once.
Use of any of the following therapies within 4 weeks prior to screening and during the screening period, or planned during the study: warfarin, imatinib, ambrisentan, azathioprine, cyclophosphamide, cyclosporine A, bosentan, methotrexate, sildenafil (except for occasional use), prednisone at steady dose >10 mg/day or equivalent.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo	Placebo	Participants received GLPG1690 (ziritaxestat) matching placebo tablets for oral use once daily (mean GLPG1690 exposure was up to 353.4 days) in addition to local standard of care. Standard of care included either pirfenidone or nintedanib at a stable dose for at least 2 months before screening, and during screening; or neither pirfenidone or nintedanib (for any reason).
GLPG1690 600 mg	GLPG1690	Participants received GLPG1690 (ziritaxestat) 600 mg, film-coated tablets orally once daily (mean GLPG1690 exposure was up to 325.3 days) in addition to local standard of care. Standard of care included either pirfenidone or nintedanib at a stable dose for at least 2 months before screening, and during screening; or neither pirfenidone or nintedanib (for any reason).
GLPG1690 200 mg	GLPG1690	Participants received GLPG1690 (ziritaxestat) 200 mg as film-coated tablet for oral use once daily (mean GLPG1690 exposure was up to 356.0 days) in addition to local standard of care. Standard of care included either pirfenidone or nintedanib at a stable dose for at least 2 months before screening, and during screening; or neither pirfenidone or nintedanib (for any reason).

Primary Outcome Measures

Name	Time	Method
Annual Rate of Decline in FVC up to Week 52	Baseline up to week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.

Secondary Outcome Measures

Name	Time	Method
Percentage of Participants With Disease Progression up to Week 52	Up to week 52	Disease progression was defined as the composite occurrence of more than or equal to (\>=)10 percent (%) absolute decline in percent predicted forced vital capacity (%FVC) or all-cause mortality. FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Annual Rate of Decline in FVC Until EoS	Baseline up to EoS (week 121)	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With All Cause Hospitalization Until EoS	Up to EoS (week 121)	Percentage of participants with all cause hospitalization was reported for this measure.
Percentage of Participants Hospitalized for Non-elective Lung Transplant Until EoS	Up to EoS (week 121)	Percentage of Participants who were hospitalized for Non-elective lung transplant were reported for this measure.
Percentage of Participants With All Cause Mortality or Hospitalization for Non-elective Lung Transplant Until EoS	Up to EoS (week 121)	Percentage of participants with all-cause mortality or hospitalization for non-elective lung transplant were reported for this measure.
Percentage of Participants With Respiratory-Related Hospitalization Until End of Study (EoS)	Up to EoS (week 121)	Percentage of participants with respiratory related hospitalization were reported in this measure.
Change From Baseline in St.George's Respiratory Questionnaire (SGRQ) Total Score at Week 52	Baseline, week 52	SGRQ is a 50-item paper questionnaire designed to measure and quantify the impact of chronic respiratory disease on health-related quality of life (QOL) and well-being, split into 3 domains: symptoms score assessing the frequency and severity of respiratory symptoms (Items 1-8), activity score assessing the effects of breathlessness on mobility and physical activity (Items 11-17 and 36 to 44), and impacts score assessing the psychosocial impact of the disease (Items 9-10, 18-35 and 45-50). Each item has a specific weight. Domain scores = 100 \* summed weights from positive items in that component/sum of maximum weights for all non-missing items in that component Total score = 100 \* summed weights from positive items in the questionnaire/sum of maximum weights for all non-missing items in the questionnaire Scores were weighted such that each domain score ranged from 0 to 100 and the total score ranged from 0 to 100, with higher scores indicating the poorer health-related QOL.
Percentage of Participants With Disease Progression Until EoS	Up to EoS (week 121)	Disease progression was defined as the composite occurrence of \>=10% absolute decline in percent predicted %FVC or all-cause mortality. FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Acute Idiopathic Pulmonary Fibrosis (IPF) Exacerbation Until EoS	Up to EoS (week 121)	Percentage of participants with acute IPF exacerbation until EoS were reported for this measure.
Change From Baseline in St.George's Respiratory Questionnaire (SGRQ) Total Score at Week 100	Baseline, week 100	SGRQ is a 50-item paper questionnaire designed to measure and quantify the impact of chronic respiratory disease on health-related quality of life (QOL) and well-being, split into 3 domains: symptoms score assessing the frequency and severity of respiratory symptoms (Items 1-8), activity score assessing the effects of breathlessness on mobility and physical activity (Items 11-17 and 36 to 44), and impacts score assessing the psychosocial impact of the disease (Items 9-10, 18-35 and 45-50). Each item has a specific weight. Domain scores = 100 \* summed weights from positive items in that component/sum of maximum weights for all non-missing items in that component Total score = 100 \* summed weights from positive items in the questionnaire/sum of maximum weights for all non-missing items in the questionnaire Scores were weighted such that each domain score ranged from 0 to 100 and the total score ranged from 0 to 100, with higher scores indicating the poorer health-related QOL.
FVC at Week 112	Week 112	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Respiratory Related Mortality Until EoS	Up to EoS (week 121)	Percentage of participants with respiratory related mortality until EoS were reported for this study.
Percentage of Participants With All-Cause Mortality or Hospitalization That Meets >=10% Absolute Decline in %FVC or Respiratory-Related Hospitalization Until EoS	Up to EoS (week 121)	Percentage of participants with all-cause mortality or respiratory related hospitalization that meets \>=10% absolute decline in %FVC or respiratory-related hospitalization were reported for this measure.
Percentage of Participants With All-Cause Mortality or Respiratory-Related Hospitalizations Until EoS	Up to EoS (week 121)	Percentage of participants with all-cause mortality or respiratory related hospitalization were reported for this measure.
FVC at Week 52	Week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Changes From Baseline Leicester Cough Questionnaire (LCQ) Total Score and Individual Domain Score at Week 52 and Week 100	Baseline, week 52, week 100	Cough was evaluated using the LCQ. The LCQ was a 19-item questionnaire split into three domains: physical, psychological, and social. Scores were calculated by domain (range from 1 to 7, higher scores indicated a better health status) and then the total score was calculated by adding the individual domain score. Total score ranged from 3 to 21, with higher scores indicated a better health status.
Change From Baseline in Total Distance Walked in Six-minute Walk Test (6MWT) at Week 52 and Week 100	Baseline, week 52, week 100	The 6-MWT depicted the total distance covered by a participant during 6 minutes of walking.
Percentage of Participants With All Cause Mortality, Hospitalization for Non-elective Lung Transplant or Hospitalization for Qualifying for Lung Transplant Until EoS	Up to EoS (week 121)	Percentage of participants with all-cause mortality or hospitalization for non-elective lung transplant or hospitalization for qualifying for lung transplant were reported for this measure.
Change From Baseline in FVC at Week 112	Baseline, week 112	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Absolute Categorical Change From Baseline in Percent FVC at Week 52: FVC Change Within ≤10	Baseline, week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Absolute Categorical Change From Baseline in Percent FVC at Week 112: FVC Change Within ≤10	Baseline, week 112	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Change From Baseline in Visual Analogue Score (VAS): Urge to Cough at Week 52 and Week 100	Baseline, week 52, week 100	Urge to Cough was assessed using VAS score, ranged from 0 (no urge to cough) to 100 mm (highest urge to cough).
Change From Baseline in King's Brief Interstitial Lung Disease (K-BILD) at Week 52 and Week 100	Baseline, week 52, week 100	The K-BILD questionnaire was specifically developed to analyze the health status of participants with ILD. The questionnaire consists of 15 items (assessed by the participants on a scale ranging from 1 to 7, where 1 and 7 represent worst and best health status). Items are compiled into 3 domains: breathlessness and activities (range: 0-21), psychological (range: 0-34) , and chest symptoms (range: 0-8). To score the K-BILD, the Likert response scale weightings for individual items are combined and scores are transformed to a range of 0-100 by using logit values (higher scores indicate better health status).
Change From Baseline in FVC at Week 52	Baseline, week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percent Change From Baseline in FVC at Week 52	Baseline, week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percent Change From Baseline in FVC at Week 112	Baseline, week 112	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Change From Baseline in Visual Analogue Score (VAS): Cough at Week 52 and Week 100	Baseline, week 52, week 100	Cough was assessed using VAS score, ranged from 0 (no cough) to 100 millimeter (mm) (worst possible cough).
Change From Baseline in European Quality Of Life (EQ) VAS at Week 52 and Week 100	Baseline, week 52, week 100	EuroQol outcome measurements is a printed 20 cm VAS that appears somewhat like a thermometer, on which a score from 0 (worst imaginable health state or death) to 100 (best imaginable health state) was marked by the participant (or, when necessary, their proxy) with the scale in view.
Percentage of Participants With Absolute Categorical Change From Baseline in Percent FVC at Week 52: FVC Change Within ≤5	Baseline, week 52	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Absolute Categorical Change From Baseline in Percent FVC at Week 112: FVC Change Within ≤5	Baseline, week 112	FVC (in mL) is the maximum amount of air exhaled from lungs by a participant after taking their deepest possible breath, as measured by spirometry.
Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) and Serious TEAEs	Baseline up to 30 days after the last dose (up to week 121)	Safety was assessed by AEs, which included abnormalities identified during a medical test (example, laboratory tests, vital signs, electrocardiogram, etc.) if the abnormality induced clinical signs or symptoms, needed active intervention, interruption or discontinuation of study drug or was clinically significant. A Treatment emergent AE (TEAE) was defined as any AE that started or worsened after the first dose of study drug up to 30 days after the last dose of study drug. AEs were considered serious (SAEs) if the AE resulted in death, was life-threatening, resulted in persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions, resulted in congenital anomaly, or birth defect or required inpatient hospitalization or led to prolongation of hospitalization.
Change From Baseline in Diffusing Capacity of Lung for Carbon Monoxide (DLCO) (Corrected for Hemoglobin [Hb]) at Week 52 and Week 100	Baseline, week 52, week 100	Change from baseline in DLCO (percent predicted hemoglobin level corrected) was reported for this measure.mmol/min/kPa: Millimole per minute per kilopascal
Area Under The Concentration Time Curve (AUC) of Ziritaxtestat	Sparse samples collected on day 1 pre-dose, day 85 post-dose, day 237 post-dose, day 183 pre-dose, day 365 pre-dose	Area under the concentration time curve of ziritaxtestat was reported.
Maximum Observed Plasma Concentration (Cmax) of Ziritaxtestat	Sparse samples collected on day 1 pre-dose, day 85 post-dose, day 237 post-dose, day 183 pre-dose, day 365 pre-dose	Maximum Observed Plasma Concentration of Ziritaxtestat was reported.

Trial Locations

Locations (132): Hospital of the University of Pennsylvania
🇺🇸
Philadelphia, Pennsylvania, United States
Flinders Medical Centre
🇦🇺
Bedford Park, Australia
Box Hill Hospital
🇦🇺
Box Hill, Australia
Royal Adelaide Hospital
🇦🇺
Adelaide, Australia
The Alfred Hospital
🇦🇺
Melbourne, Australia
UZ Leuven
🇧🇪
Leuven, Belgium
Instituto Nacional Torax
🇨🇱
Santiago, Chile
Fakultni nemocnice Ostrava
🇨🇿
Ostrava, Czechia
Thomayerova nemocnice
🇨🇿
Praha, Czechia
Evangelische Lungenklinik
🇩🇪
Berlin, Germany
Thorax Klinik
🇩🇪
Heidelberg, Germany
Universitatsklinikum Leipzig
🇩🇪
Leipzig, Germany
Sotiria Chest Hospital of Athens
🇬🇷
Athens, Greece
Klinikum Rosenheim
🇩🇪
Rosenheim, Germany
University General Hospital of Heraklion
🇬🇷
Iraklio, Greece
Tenryu Hospital
🇯🇵
Hamamatsu, Japan
National Hospital Organization Kinki-Chuo Chest Medical Center
🇯🇵
Sakai, Japan
Saiseikai Kumamoto Hospital
🇯🇵
Kumamoto, Japan
Clinica Ricardo Palma - PPDS
🇵🇪
San Isidro, Peru
Clinica Providencia (Inverconsult Sociedad Anonima)
🇵🇪
San Miguel, Peru
CHUVI - H.U. Alvaro Cunquerio
🇪🇸
Vigo, Pontevedra, Spain
Hospital Clinico San Carlos
🇪🇸
Madrid, Spain
Kaohsiung Medical University Hospital
🇨🇳
Kaohsiung City, Taiwan
Far Eastern Memorial Hospital
🇨🇳
New Taipei City, Taiwan
Ege Universitesi Tıp Fakultesi Hastanesi Gögus Hastalıkları Anabilim Dalı
🇹🇷
İzmir, Turkey
National Taiwan University Hospital
🇨🇳
Taipei, Taiwan
Birmingham Heartlands Hospital
🇬🇧
Birmingham, United Kingdom
Papworth Hospital
🇬🇧
Cambridge, United Kingdom
Nottingham City Hospital
🇬🇧
Nottingham, United Kingdom
Northern General Hospital
🇬🇧
Sheffield, United Kingdom
Northwestern Memorial Hospital
🇺🇸
Chicago, Illinois, United States
Washington University School of Medicine
🇺🇸
Saint Louis, Missouri, United States
Metroplex Pulmonary and Sleep Medicine Center
🇺🇸
McKinney, Texas, United States
University of Texas Southwestern Medical Center
🇺🇸
Dallas, Texas, United States
University of Virginia
🇺🇸
Charlottesville, Virginia, United States
University of Washington Medical Center
🇺🇸
Seattle, Washington, United States
Western Washington Medical Group
🇺🇸
Everett, Washington, United States
University of California San Diego
🇺🇸
San Diego, California, United States
University of Utah Medical Care
🇺🇸
Salt Lake City, Utah, United States
Minnesota Lung Center
🇺🇸
Minneapolis, Minnesota, United States
UC Health Department of Internal Medicine, Pulmonary, Critical Care & Sleep Medicine
🇺🇸
Cincinnati, Ohio, United States
University of Texas Health Science Center San Antonio
🇺🇸
San Antonio, Texas, United States
Pulmonary Associates
🇺🇸
Phoenix, Arizona, United States
Gentofte Hospital
🇩🇰
Hellerup, Denmark
Mayo Clinic Arizona - PPDS
🇺🇸
Scottsdale, Arizona, United States
Hospital Nacional Guillermo Almenara Irigoyen ESSALUD
🇵🇪
Lima, Peru
University of Louisville
🇺🇸
Louisville, Kentucky, United States
Irmandade Da Santa Casa de Misericordia de Porto Alegre
🇧🇷
Porto Alegre, Brazil
Centro de Investigación Curico
🇨🇱
Curicó, Chile
Centro de Investigaciones Medicas Respiratorias CIMER
🇨🇱
Santiago, Chile
Hospital Dr Sotero Del Rio
🇨🇱
Santiago, Chile
Centro de Investigacion del Maule
🇨🇱
Talca, Chile
CINVEC- Estudos Clínicos Quinta Región Limitada
🇨🇱
Viña Del Mar, Chile
University of Colorado
🇺🇸
Aurora, Colorado, United States
St. Francis Medical Institute - BTC - PPDS
🇺🇸
Clearwater, Florida, United States
PAB Clinical Research - ClinEdge - PPDS
🇺🇸
Brandon, Florida, United States
Massachusetts General Hospital, Division of Pulmonary and Critical Care Medicine
🇺🇸
Boston, Massachusetts, United States
Hospital Clínico Regional de Concepción Dr Guillermo Grant Benavente
🇨🇱
Concepción, Chile
University General Hospital of Larissa
🇬🇷
Larissa, Greece
Vanderbilt University Medical Center
🇺🇸
Nashville, Tennessee, United States
North Florida/South Georgia Veterans Health System-NAVREF-PPDS
🇺🇸
Gainesville, Florida, United States
Advanced Pulmonary Research Institute
🇺🇸
Loxahatchee Groves, Florida, United States
Western Connecticut Medical Group
🇺🇸
Danbury, Connecticut, United States
Tosei General Hospital
🇯🇵
Seto, Japan
Tulane Medical Center
🇺🇸
New Orleans, Louisiana, United States
MedStar Georgetown University Hospital
🇺🇸
Washington, District of Columbia, United States
National Hospital Organization Kyushu Medical Center
🇯🇵
Tokyo, Japan
Hospital Chancay y Servicios Basicos de Salud
🇵🇪
Chancay, Peru
Henry Ford Health System
🇺🇸
Dearborn, Michigan, United States
Atria Clinical Research - BTC - PPDS
🇺🇸
Little Rock, Arkansas, United States
University of Wisconsin
🇺🇸
Madison, Wisconsin, United States
National Jewish Health
🇺🇸
Denver, Colorado, United States
The Oregon Clinic
🇺🇸
Portland, Oregon, United States
Mayo Clinic - PPDS
🇺🇸
Rochester, Minnesota, United States
Wythenshawe Hospital - PPDS
🇬🇧
Manchester, United Kingdom
Hospital Universitario de Bellvitge, Hospitalet De Llobregat
🇪🇸
Barcelona, Spain
Respire Research
🇺🇸
Palm Springs, California, United States
David Geffen School of Medicine at UCLA
🇺🇸
Los Angeles, California, United States
Yale University School of Medicine
🇺🇸
New Haven, Connecticut, United States
University of Florida
🇺🇸
Gainesville, Florida, United States
Pulmonary and Infections Disease Associates
🇺🇸
Council Bluffs, Iowa, United States
Caritas St. Elizabeth's Medical Center
🇺🇸
Boston, Massachusetts, United States
University of Maryland Medical Center
🇺🇸
Baltimore, Maryland, United States
Creighton University
🇺🇸
Omaha, Nebraska, United States
University of Rochester Medical Center - PPDS
🇺🇸
Rochester, New York, United States
Cleveland Clinic
🇺🇸
Cleveland, Ohio, United States
PulmonIx LLC
🇺🇸
Greensboro, North Carolina, United States
Penn State Milton S Hershey Medical Center
🇺🇸
Hershey, Pennsylvania, United States
Houston Methodist Hospital
🇺🇸
Houston, Texas, United States
Corte Royal Prince Alfred Hospital
🇦🇺
Camperdown, Australia
Lung Research Queensland
🇦🇺
Chermside, Australia
Concord Repatriation General Hospital
🇦🇺
Concord, Australia
St Vincent's Hospital Sydney
🇦🇺
Darlinghurst, Australia
Austin Health
🇦🇺
Heidelberg, Australia
Respiratory Clinical Trials Pty Ltd
🇦🇺
Kent Town, Australia
ZNA Middelheim
🇧🇪
Antwerp, Belgium
Hôpital Erasme
🇧🇪
Brussels, Belgium
Cliniques Universitaires Saint-Luc
🇧🇪
Brussels, Belgium
CHU UCL Namur asbl - Site Godinne
🇧🇪
Yvoir, Belgium
Faculdade de Medicina Do ABC
🇧🇷
Santo André, Brazil
Centro Respiratorio Integral LTDA. (CENRESIN)
🇨🇱
Quillota, Chile
Hospital Carlos Van Buren
🇨🇱
Valparaíso, Chile
Nemocnice Na Bulovce
🇨🇿
Praha, Czechia
Odense Universitetshospital
🇩🇰
Odense, Denmark
Aarhus Universitetshospital
🇩🇰
Aarhus, Denmark
Zentralklinik Bad Berka GmbH
🇩🇪
Bad Berka, Germany
Fachkrankenhaus Coswig
🇩🇪
Coswig, Germany
Medizinische Hochschule Hannover
🇩🇪
Hannover, Germany
Attikon University General Hospital
🇬🇷
Athens, Greece
Georgios Papanikolaou General Hospital of Thessaloniki
🇬🇷
Thessaloníki, Greece
Center Hospital of the National Center for Global Health and Medicine
🇯🇵
Tokyo, Japan
Clinica Internacional - PPDS
🇵🇪
Lima Cercado, Peru
Kanagawa Cardiovascular and Respiratory Center
🇯🇵
Yokohama, Japan
Clinica San Pablo
🇵🇪
Santiago De Surco, Peru
Hospital Clinical de Barcelona
🇪🇸
Barcelona, Spain
Hospital Universitario de La Princesa
🇪🇸
Madrid, Spain
Clinica Universidad Navarra
🇪🇸
Pamplona, Spain
Consorcio Hospital General Universitario de Valencia
🇪🇸
Valencia, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸
Santander, Spain
Taipei Medical University Shuang Ho Hospital
🇨🇳
New Taipei City, Taiwan
Süreyyapaşa Göğüs Hastalıkları Ve Göğüs Cerrahisi Eğitim Ve Araştırma Hastanesi
🇹🇷
Istanbul, Turkey
Uludag Universitesi Tıp Fakultesi Hastanesi Gögüs Hastalıkları Anabilim Dalı
🇹🇷
İzmir, Turkey
Mersin Üniversitesi Tıp Fakültesi Hastanesi Göğüs Hastalıkları Polikinliği
🇹🇷
Mersin, Turkey
Southmead Hospital
🇬🇧
Bristol, United Kingdom
Royal Devon and Exeter Hospital NHS Trust
🇬🇧
Exeter, United Kingdom
Aintree University Hospital NHS Foundation Trust
🇬🇧
Liverpool, United Kingdom
The Newcastle Upon Tyne Hospitals NHS Foundation Trust
🇬🇧
Newcastle, United Kingdom
Fakultni nemocnice Brno
🇨🇿
Brno, Czechia
Stanford University Medical Center
🇺🇸
Stanford, California, United States
Royal Brompton Hospital
🇬🇧
London, United Kingdom
Castle Hill Hospital
🇬🇧
Cottingham, United Kingdom
Rhode Island Hospital
🇺🇸
Providence, Rhode Island, United States