A Research Study to Compare a New Weekly Insulin, Insulin Icodec, and an Available Daily Insulin, Insulin Degludec, Both in Combination With Mealtime Insulin in People With Type 1 Diabetes (ONWARDS 6)
- Conditions
- Diabetes Mellitus, Type 1
- Interventions
- Registration Number
- NCT04848480
- Lead Sponsor
- Novo Nordisk A/S
- Brief Summary
This study compares insulin icodec (a new insulin) to insulin degludec (an insulin already available on the market) in people with type 1 diabetes.
The study will look at how well insulin icodec taken weekly controls blood sugar compared to insulin degludec taken daily.
Participants will either get insulin icodec that participants will have to inject once a week on the same day of the week, or insulin degludec that participants will have to inject once a day at the same time every day. Which treatment participants get is decided at random. Participants will also get a mealtime insulin.
The insulin is injected with a needle in a skin fold in the thigh, upper arm or stomach.
The study will last for about 1 year and 2 months. Participants will have 28 clinic visits and 28 phone calls with the study doctor. At 11 clinic visits participants will have blood samples taken.
At 6 clinic visits participants cannot eat or drink (except for water) for 8 hours before the visit.
Participants will be asked to wear a sensor that measures your blood sugar all the time. Participants will be asked to wear it for a total of 57 weeks (around 1 year).
Women cannot take part if pregnant, breast-feeding or plan to become pregnant during the study period.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 582
- Male or female aged greater than or equal to 18 years at the time of signing informed consent.
- Diagnosed with type 1 diabetes mellitus greater than or equal to 1 year prior to the day of screening.
- Treated with multiple daily insulin injections (basal and bolus insulin analogue regimes) greater than or equal to 1 year prior to the day of screening.
- HbA1c below10% at screening visit based on analysis from central laboratory.
- Myocardial infarction, stroke, hospitalization for unstable angina pectoris or transient ischaemic attack within 180 days prior to the day of screening.
- Chronic heart failure classified as New York Heart Association (NYHA) Class IV at screening.
- Anticipated initiation or change in concomitant medications (for more than 14 consecutive days) known to affect weight or glucose metabolism (e.g. treatment with orlistat, thyroid hormones, or corticosteroids).
- Uncontrolled and potentially unstable diabetic retinopathy or maculopathy. Verified by a fundus examination performed within the past 90 days prior to screening or in the period between screening and randomisation. Pharmacological pupil-dilation is a requirement unless using a digital fundus photography camera specified for non-dilated examination.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Insulin icodec + insulin aspart insulin aspart insulin icodec once a week in combination with 2-4 times daily injections of insulin aspart at meal times. Insulin degludec + insulin aspart insulin aspart insulin degludec once a day in combination with 2-4 times daily injections of insulin aspart at meal times. Insulin degludec + insulin aspart insulin degludec insulin degludec once a day in combination with 2-4 times daily injections of insulin aspart at meal times. Insulin icodec + insulin aspart insulin icodec insulin icodec once a week in combination with 2-4 times daily injections of insulin aspart at meal times.
- Primary Outcome Measures
Name Time Method Change in Glycosylated Haemoglobin (HbA1c) at Week 26 Baseline (week 0), week 26 Change in HbA1c from baseline to week 26 is presented. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
- Secondary Outcome Measures
Name Time Method Change in Glycosylated Haemoglobin (HbA1c) at Week 52 Baseline (week 0), week 52 Change in HbA1c from baseline to week 52 is presented. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Change in Fasting Plasma Glucose (FPG) Baseline (week 0), week 26 Change in FPG from baseline to week 26 is presented. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Number of Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 26 From baseline (week 0) to week 26 Number of severe hypoglycaemic episodes (level 3) from baseline to week 26 are presented. Severe hypoglycaemia (level 3) is defined as hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'main-on-treatment' period. The main-on-treatment period started at the date of first dose of trial product as recorded on the electronic case report form (eCRF), and ended at the first date of any of the following: the end date of the on-treatment period; week 26. On-treatment: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit, the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL) Confirmed by Blood Glucose [BG] Meter): From Baseline (Week 0) to Week 26 From baseline (week 0) to week 26 Number of clinically significant hypoglycaemic episodes (level 2) from baseline to week 26 are presented. Clinically significant hypoglycaemia (level 2) is defined as plasma glucose value of less than (\<) 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Data is reported for 'main-on-treatment' period. The main-on-treatment period started at the date of first dose of trial product as recorded on the eCRF, and ended at the first date of any of the following: the end date of the on-treatment period; week 26. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Number of Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 57 From baseline (week 0) to week 57 Number of severe hypoglycaemic episodes (level 3) from baseline to week 57 are presented. Severe hypoglycaemia (level 3) is defined as hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'on-treatment' period. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL), Confirmed by BG Meter) or Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 26 From baseline (week 0) to week 26 Number of clinically significant hypoglycaemic episodes (level 2) or severe hypoglycaemic episodes (level 3) from baseline to week 26 are presented. Clinically significant hypoglycaemia (level 2) is defined as plasma glucose value of less than (\<) 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Severe hypoglycaemia (level 3) is defined as hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'main-on-treatment' period. The main-on-treatment period started at the date of first dose of trial product as recorded on the eCRF, and ended at the first date of any of the following: the end date of the on-treatment period; week 26. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL), Confirmed by BG Meter) or Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 57 From baseline (week 0) to week 57 Number of clinically significant hypoglycaemic episodes (level 2) or severe hypoglycaemic episodes (level 3) from baseline to week 57 are presented. Clinically significant hypoglycaemia (level 2) is defined as plasma glucose value of less than (\<) 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Severe hypoglycaemia (level 3) is defined as hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'on-treatment' period. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Number of Nocturnal Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL), Confirmed by BG Meter) or Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 26 From baseline (week 0) to week 26 Number of nocturnal clinically significant hypoglycaemic episodes (level 2) or severe hypoglycaemic episodes (level 3) from baseline to week 26 are presented. Nocturnal: The period between 00:01 and 05:59 (both included). Clinically significant hypoglycaemia (level 2): Plasma glucose value of \< 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Severe hypoglycaemia (level 3): Hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'main-on-treatment' period. The main-on-treatment period started at the date of first dose of trial product as recorded on the eCRF, and ended at the first date of any of the following: the end date of the on-treatment period; week 26. On-treatment period: Onset date on or after first dose of trial product and no later than first date of either follow-up visit, last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for in-trial period.
Number of Nocturnal Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL), Confirmed by BG Meter) or Severe Hypoglycaemic Episodes (Level 3): From Baseline (Week 0) to Week 57 From baseline (week 0) to week 57 Number of nocturnal clinically significant hypoglycaemic episodes (level 2) or severe hypoglycaemic episodes (level 3) from baseline to week 57 are presented. Nocturnal: The period between 00:01 and 05:59 (both included). Clinically significant hypoglycaemia (level 2): Plasma glucose value of \< 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Severe hypoglycaemia (level 3): Hypoglycaemia with severe cognitive impairment requiring external assistance for recovery. Data is reported for 'on-treatment' period. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Percentage of Time in Range 3.9-10.0 mmol/L (70-180 Milligrams Per Deciliter [mg/dL]) Using Continuous Glucose Monitoring (CGM) System From week 22 to week 26 Percentage of time in range 3.9-10.0 mmol/L (70-180 mg/dL) using CGM system from week 22 to week 26 is presented. Time in range is defined as 100 times the number of recorded measurements in glycaemic range 3.9-10.0 mmol/L (70-180 mg/dL), both inclusive, divided by the total number of recorded measurements. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Change in Diabetes Treatment Satisfaction Questionnaire (DTSQs) in Total Treatment Satisfaction Baseline (week 0), week 26 Change in DTSQs in total treatment satisfaction from baseline to week 26 is presented. The sum score for DTSQ in total treatment satisfaction was calculated by adding the six item scores of items 1, 4, 5, 6, 7 and 8. The sum score for DTSQ can range from 0 to 36, with 0 being the lowest and 36 being the highest score in total treatment satisfaction. Higher scores on the DTSQ total score indicate higher treatment satisfaction. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Percentage of Time spent Greater Than (>) 10 mmol/L (180 mg/dL) Using Continuous Glucose Monitoring (CGM) System From week 22 to week 26 Percentage of time spent \> 10 mmol/L using CGM system from week 22 to week 26 is presented. Time spent above threshold (\> 10 mmol/L \[180 mg/dL\]) was defined as 100 times the number of recorded measurements above the threshold, divided by the total number of recorded measurements. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Number of Clinically Significant Hypoglycaemic Episodes (Level 2) (Less Than 3.0 mmol/L (54 mg/dL) Confirmed by BG Meter): From Baseline (Week 0) to Week 57 From baseline (week 0) to week 57 Number of clinically significant hypoglycaemic episodes (level 2) from baseline to week 57 are presented. Clinically significant hypoglycaemia (level 2) is defined as plasma glucose value of less than (\<) 3.0 mmol/L (54 mg/dL) confirmed by BG meter. Data is reported for 'on-treatment' period. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Percentage of Time spent Less Than (<) 3.0 mmol/L (54 mg/dL) Using Continuous Glucose Monitoring (CGM) System From week 22 to week 26 Percentage of time spent \< 3.0 mmol/L using CGM system from week 22 to week 26 is presented. Time spent below threshold (\< 3.0 mmol/L \[54 mg/dL\]) was defined as 100 times the number of recorded measurements below the threshold, divided by the total number of recorded measurements. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Mean Total Weekly Insulin Dose: From Week 24 to Week 26 From week 24 to week 26 Mean total weekly insulin dose from week 24 to week 26 is presented. Data is reported for 'main-on-treatment' period. The main-on-treatment period started at the date of first dose of trial product as recorded on the eCRF, and ended at the first date of any of the following: the end date of the on-treatment period; week 26. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Mean Total Weekly Insulin Dose: From Week 50 to Week 52 From week 50 to week 52 Mean total weekly insulin dose from week 50 to week 52 is presented. Data is reported for 'on-treatment' period. The on-treatment period: Onset date on or after the first dose of trial product and no later than the first date of either the follow-up visit (FU2), the last date on trial product + 5 weeks for once daily insulin and + 6 weeks for once weekly insulin or the end-date for the in-trial period.
Change in Body Weight Baseline (week 0), week 26 Change in body weight from baseline to week 26 is presented. Data is reported for 'in-trial' period. In-trial observation period started at randomisation and ended at the date of: the last direct participant-site contact; withdrawal for participants who withdrew their informed consent; the last participant-investigator contact as defined by the investigator for participants who were lost to follow-up (i.e. possibly an unscheduled phone visit); death for participants who died before any of the above.
Trial Locations
- Locations (97)
Yuri Ono Clinic
🇯🇵Sapporo-shi, Hokkaido, Japan
Churchill Hospital
🇬🇧Oxford, United Kingdom
Lister Hospital
🇬🇧Stevenage, United Kingdom
Valley Research
🇺🇸Fresno, California, United States
Klinik Landstraße
🇦🇹Wien, Austria
Universitätsklinikum AKH Wien
🇦🇹Wien, Austria
Klinik Hietzing
🇦🇹Wien, Austria
H.E.C Science Clinic
🇯🇵Kanagawa, Japan
John Muir Physicians Network
🇺🇸Concord, California, United States
Scripps Whittier Diabetes Inst
🇺🇸La Jolla, California, United States
Diabetes & Endocrine Associates
🇺🇸La Mesa, California, United States
Mills-Peninsula Hlth Services
🇺🇸San Mateo, California, United States
Creekside Endocrine Associates, PC
🇺🇸Denver, Colorado, United States
Northeast Research Institute
🇺🇸Saint Augustine, Florida, United States
Center For Diabetes & Endo Care
🇺🇸Fort Lauderdale, Florida, United States
Hanson Clinical Research Center
🇺🇸Port Charlotte, Florida, United States
Physicians Research Assoc. LLC
🇺🇸Lawrenceville, Georgia, United States
Endo Res Solutions Inc
🇺🇸Roswell, Georgia, United States
Cotton-O'Neil Diab & Endo Ctr
🇺🇸Topeka, Kansas, United States
Endo and Metab Consultants
🇺🇸Rockville, Maryland, United States
Methodist Physicians Clin
🇺🇸Omaha, Nebraska, United States
Palm Research Center Inc-Vegas
🇺🇸Las Vegas, Nevada, United States
Southern NH Diabetes and Endo_Nashua
🇺🇸Nashua, New Hampshire, United States
Albany Medical College - Endo
🇺🇸Albany, New York, United States
Accellacare
🇺🇸Wilmington, North Carolina, United States
Prisma Health-Upstate
🇺🇸Greenville, South Carolina, United States
Univ Diab & Endo Consultants
🇺🇸Chattanooga, Tennessee, United States
Amarillo Med Spec LLP
🇺🇸Amarillo, Texas, United States
Texas Diab & Endo, P.A.
🇺🇸Austin, Texas, United States
Velocity Clinical Res-Dallas
🇺🇸Dallas, Texas, United States
North Texas Endocrine Center
🇺🇸Dallas, Texas, United States
PlanIt Research, PLLC
🇺🇸Houston, Texas, United States
NE Clin Res of San Antonio
🇺🇸San Antonio, Texas, United States
Rainier Clin Res Ctr Inc
🇺🇸Renton, Washington, United States
Univ.-Klinik für Innere Medizin
🇦🇹Graz, Austria
Univ.-Klinik für Innere Medizin I
🇦🇹Innsbruck, Austria
Fließer-Görzer [Ordination]
🇦🇹Saint Stefan, Austria
Winnipeg Clinic
🇨🇦Winnipeg, Manitoba, Canada
Eastern Health Authority
🇨🇦St. Johns, Newfoundland and Labrador, Canada
Nova Scotia Hlth Halifax
🇨🇦Halifax, Nova Scotia, Canada
Centricity Research LMC
🇨🇦Toronto, Ontario, Canada
Ctr de rech Clin de Laval
🇨🇦Laval, Quebec, Canada
Medizinisches Versorgungszentrum Am Bahnhof Spandau GbR
🇩🇪Berlin, Germany
InnoDiab Forschung GmbH
🇩🇪Essen, Germany
Zentrum für klinische Forschung, Dr. med. Lüdemann
🇩🇪Falkensee, Germany
Diabetologische Gemeinschaftspraxis Dr. Staudenmeyer und Dr. Schiwietz
🇩🇪Lingen, Germany
Die Praxis am Ludwigsplatz
🇩🇪Ludwigshafen, Germany
Universitätsklinikum Schleswig-Holstein - Medizinischen Klinik I am Campus Lübeck
🇩🇪Lübeck, Germany
Institut für Diabetesforschung GmbH Münster - Dr. med. Rose
🇩🇪Münster, Germany
RED-Institut für medizinische Studien und Fortbildung GmbH
🇩🇪Oldenburg I. Holst, Germany
Zentrum für klinische Studien Alexander Segner
🇩🇪Saint Ingbert-Oberwürzbach, Germany
Diacare diabetes Hormonal Clinic
🇮🇳Ahmedabad, Gujarat, India
Calicut Medical College
🇮🇳Kozhikode, Kerala, India
All India Institute of Medical Sciences
🇮🇳New Dehli, New Delhi, India
Care Hospital
🇮🇳Hyderabad, India
Lady Hardinge Medical College
🇮🇳New Delhi, India
Jothydev's Diabetes & Research Center
🇮🇳Thriruvananthapuram, India
Policlinico Mater Domini Università di Catanzaro
🇮🇹Catanzaro, Italy
Osp. San Raffaele Diabetes Research Institute, Dibit 1
🇮🇹Milano, Italy
Azienda Ospedaliera di Perugia;Ospedale S. Maria della Misericordia
🇮🇹Perugia, Italy
Policlinico Umberto I Clinica Medica DH Diabetologia
🇮🇹Roma, Italy
Policlinico A. Gemelli
🇮🇹Rome, Italy
Seino Internal Medicine Clinic
🇯🇵Koriyama-shi, Fukushima, Japan, Japan
Manda Memorial Hospital
🇯🇵Sapporo-shi, Hokkaido, Hokkaido, Japan, Japan
Jinnouchi Hospital
🇯🇵Kumamoto-shi, Kumamoto, Japan, Japan
The Institute of Medical Science, Asahi Life Foundation
🇯🇵Chuo-ku, Tokyo, Japan
Tokyo Women's Medical University
🇯🇵Tokyo, Japan
Gelre Ziekenhuizen Apeldoorn
🇳🇱Apeldoorn, Netherlands
Rijnstate Ziekenhuis
🇳🇱Arnhem, Netherlands
Ikazia Ziekenhuis
🇳🇱Rotterdam, Netherlands
National Medical Research Center of Endocrinology
🇷🇺Moscow, Russian Federation
Endocrinological Dispensary of Department of healthcare ser.
🇷🇺Moscow, Russian Federation
Endocrinology Dpt,Post-Graduate Medical Education Faculty
🇷🇺Moscow, Russian Federation
SPb SBHI "Snegirev Maternity Hospital No. 6"
🇷🇺Saint Petersburg, Russian Federation
City Consultative & Diagnostic Centre #1
🇷🇺Saint-Petersburg, Russian Federation
SHI Saratov City Clinical Hospital #9
🇷🇺Saratov, Russian Federation
Saratov regional clinical hospital
🇷🇺Saratov, Russian Federation
SPb SBHI City Multifield Hospital #2
🇷🇺St. Petersburg, Russian Federation
Voronezh Regional Clinical Consultive-diagnostic Centre
🇷🇺Voronezh, Russian Federation
Yaroslavl Regional Hospital
🇷🇺Yaroslavl, Russian Federation
Hospital Clinic i Provincial
🇪🇸Barcelona, Spain
Hospital ClÃnico Virgen de la Victoria
🇪🇸Málaga, Spain
Hospital Central de Asturias
🇪🇸Oviedo, Spain
ClÃnica Nuevas TecnologÃas en Diabetes y EndocrinologÃa
🇪🇸Sevilla, Spain
Cukurova Universitesi Tip Fakultesi
🇹🇷Adana, Turkey
Adnan Menderes Universitesi Uygulama ve Arastirma Hastanesi
🇹🇷Aydin, Turkey
Seyrantepe Hamidiye Etfal Egitim ve Arastirma Hastanesi
🇹🇷Istanbul, Turkey
TC SB Ist.İl Sag.Müd.Prof.Dr.Cemil Tascioglu Sehir Hastanesi
🇹🇷Istanbul, Turkey
Haydarpasa Numune Egitim Arastirma Hastanesi Endokrinoloji
🇹🇷Istanbul, Turkey
Erciyes Universitesi Tip Fakultesi
🇹🇷Kayseri, Turkey
Inonu University Turgut Ozal Medical Center
🇹🇷Malatya, Turkey
Southmead Hospital
🇬🇧Bristol, United Kingdom
Addenbrooke's Hospital_Cambridge
🇬🇧Cambridge, United Kingdom
Royal Derby Hospital
🇬🇧Derby, United Kingdom
Western General Hospital
🇬🇧Edinburgh, United Kingdom
Royal Surrey County Hospital
🇬🇧Guildford, United Kingdom
Joint Clinical Research Facility - Swansea
🇬🇧Swansea, United Kingdom