A Phase 3 Study of Barzolvolimab in Participants With Chronic Spontaneous Urticaria
- Conditions
- Chronic Spontaneous Urticaria
- Interventions
- Biological: Matching placebo
- Registration Number
- NCT06445023
- Lead Sponsor
- Celldex Therapeutics
- Brief Summary
The purpose of this study is to establish the efficacy, safety and tolerability of barzolvolimab in adult participants with Chronic Spontaneous Urticaria (CSU) inadequately controlled by non-sedating second generation H1-antihistamines in comparison to placebo.
- Detailed Description
This is a global, multicenter, randomized, double-blind, parallel group, placebo-controlled phase 3 study investigating the efficacy, safety and tolerability of barzolvolimab in adult participants with Chronic Spontaneous Urticaria (CSU) who are symptomatic despite treatment with non-sedating second generation H1-antihistamines at 1-4 times the locally approved dose.
There is a screening period of up to 4 weeks, followed by a 24-week placebo-controlled treatment period, a 28-week active treatment period where all participants receive barzolvolimab followed by a 16-week treatment free period.
Approximately 915 adult participants (610 in the active arms and 305 in the placebo arm) will be randomly assigned to the treatment arms.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 915
-
Males and females, >/= 18 years of age.
-
Chronic spontaneous urticaria (CSU) >/= 6 months prior to Screening (Visit 1).
-
CSU despite the use of a stable regimen of second generation non-sedating H1-antihistamine as defined by:
- The presence of hives for >/= 6 weeks at any time prior to Visit 1 despite the use of non-sedating H1-antihistamines.
- Must be on a stable regimen of second generation non-sedating H1-antihistamine for >/= 4 weeks prior to study treatment.
- UAS7 of >/= 16 and ISS7 of >/= 8 during the 7 days prior to study treatment.
-
Normal blood counts and liver function tests.
-
Both males and females of child-bearing potential must agree to use highly effective contraceptives during the study and for 150 days after treatment.
-
Willing and able to complete a daily symptom electronic diary and comply with study visits.
-
Participants with and without prior biologic experience are eligible.
Key
- Women who are pregnant or nursing.
- Chronic urticaria whose predominant manifestation is due to CIndU.
- Other diseases associated with urticaria.
- Active pruritic skin condition in addition to CSU.
- Medical condition that would cause additional risk or interfere with study procedures.
- Known HIV, hepatitis B or hepatitis C infection.
- Vaccination of a live vaccine within 30 days prior to Screening (Visit 1) (subjects must agree to avoid live vaccinations during the study). Inactivated vaccines are allowed such as seasonal influenza injection or authorized COVID-19 vaccine.
- History of anaphylaxis.
- Prior treatment with barzolvolimab.
There are additional criteria that your study doctor will review with you to confirm you are eligible for the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo then barzolvolimab 150 mg barzolvolimab Placebo injection subcutaneous every 4 weeks for 24 weeks and then barzolvolimab 300 mg followed by 150 mg administered every 4 weeks for 28 weeks. barzolvolimab 150 mg barzolvolimab barzolvolimab given once as a 300 mg subcutaneous injection followed by 150 mg administered every 4 weeks for 52 weeks barzolvolimab 300 mg barzolvolimab barzolvolimab given once as a 450 mg subcutaneous injection followed by 300 mg administered every 8 weeks for 52 weeks Placebo then barzolvolimab 150 mg Matching placebo Placebo injection subcutaneous every 4 weeks for 24 weeks and then barzolvolimab 300 mg followed by 150 mg administered every 4 weeks for 28 weeks. Placebo then barzolvolimab 300 mg Matching placebo Placebo injection subcutaneous every 4 weeks for 24 weeks and then barzolvolimab 450 mg followed by 300 mg administered every 8 weeks for 28 weeks. Placebo then barzolvolimab 300 mg barzolvolimab Placebo injection subcutaneous every 4 weeks for 24 weeks and then barzolvolimab 450 mg followed by 300 mg administered every 8 weeks for 28 weeks.
- Primary Outcome Measures
Name Time Method Mean change from baseline to Week 12 of UAS7 (Urticaria Activity Score) From Day 1 (first dose) to Day 85 (Week 12) Evaluate efficacy of barzolvolimab on urticaria activity as measured by urticaria activity score (UAS).
The UAS7 is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42, and a minimum possible score of 0.
- Secondary Outcome Measures
Name Time Method Percentage of participants with UAS7 = 0 at Week 12 From Day 1 (first dose) to Day 85 (Week 12) Proportion of participants who achieve complete absence of hives and itch (UAS7 = 0) at Week 12.
Mean change from baseline to Week 12 of ISS7 (Itch Severity Score) From Day 1 (first dose) to Day 85 (Week 12) The ISS7 and HSS7 combined together make up the UAS7 scoring system to evaluate urticaria signs and symptoms. The ISS7 is the itch severity score for 7 days, the scores range from 0 to 21.
Percentage of participants with UAS7 ≤ 6 at Week 12 From Day 1 (first dose) to Day 85 (Week 12) Proportion of participants who achieve control of their urticaria signs and symptoms (UAS7 \</=6) at Week 12.
Mean change from baseline in UAS7 at Week 4 From Day 1 (first dose) to Day 29 (Week 4) Evaluate efficacy of barzolvolimab on urticaria activity as measured by urticaria activity score (UAS).
The UAS7 is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42, and a minimum possible score of 0.Proportion of participants with UAS7 = 0 in participants refractory to omalizumab treatment at Week 12 From Day 1 (first dose) to Day 85 (Week 12) Proportion of participants who achieve complete absence of hives and itch (UAS7 = 0) at Week 12 in participants who did not respond to or did not tolerate omalizumab.
Mean change from baseline in UAS7 in participants refractory to omalizumab treatment at Week 12 From Day 1 (first dose) to Day 85 (Week 12) Evaluate efficacy of barzolvolimab on urticaria activity as measured by urticaria activity score (UAS) in participants who did not respond to or did not tolerate omalizumab.
The UAS7 is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42, and a minimum possible score of 0.Mean change from baseline in UAS7 at Week 24 From Day 1 (first dose) to Day 169 (Week 24) Evaluate efficacy of barzolvolimab on urticaria activity as measured by urticaria activity score (UAS).
The UAS7 is a simple scoring system to evaluate urticaria signs and symptoms. It is based on scoring wheals (hive severity score) and itch (itch severity score) separately on a scale of 0 (no signs/symptoms) to 3 (intense signs/symptoms) over 7 days. The final score is calculated by adding together the daily scores, which can range from 0 to 6, for 7 days. This results in a maximum total score of 42, and a minimum possible score of 0.Incidence of Treatment-Emergent Adverse Events From Day 1 (first dose) to Day 477 (Week 68) Occurrence of treatment emergent adverse events and serious adverse events during the study.
Mean change from baseline to Week 12 of HSS7 (Hives Severity Score) From Day 1 (first dose) to Day 85 (Week 12) The ISS7 and HSS7 combined together make up the UAS7 scoring system to evaluate urticaria signs and symptoms. The HSS7 score is the wheal/hives severity score for 7 days, the scores range from 0 to 21.
Percentage of participants with UAS7 = 0 at Week 24 From Day 1 (first dose) to Day 169 (Week 24) Proportion of participants who achieve complete absence of hives and itch (UAS7 = 0) at Week 24.
Trial Locations
- Locations (195)
Dermatologie Maldegem
🇧🇪Maldegem, Belgium
Premier Clinical Research
🇺🇸Spokane, Washington, United States
UZ Antwerp
🇧🇪Edegem, Antwerpen, Belgium
CHRU Rouen - Hôpital Charles-Nicolle
🇫🇷Rouen, France
UMHATEM " N.I.Pirogov"
🇧🇬Sofia, Bulgaria
Cahaba Dermatology Skin Health Center
🇺🇸Birmingham, Alabama, United States
Clear Dermatology & Aesthetics Center Scottsdale
🇺🇸Scottsdale, Arizona, United States
First OC Dermatology - Fountain Valley
🇺🇸Fountain Valley, California, United States
Dermatology Research Associates
🇺🇸Los Angeles, California, United States
Cura Clinical Research
🇺🇸Oxnard, California, United States
Allergy and Asthma Consultants
🇺🇸Redwood City, California, United States
West Dermatology Research Center
🇺🇸San Diego, California, United States
Therapeutics Clinical Research
🇺🇸San Diego, California, United States
Integrated Research of Inland, Inc.
🇺🇸Upland, California, United States
Western States Clinical Research Inc
🇺🇸Wheat Ridge, Colorado, United States
Encore Medical Research Boynton Beach
🇺🇸Boynton Beach, Florida, United States
Florida Academic Centers Research
🇺🇸Coral Gables, Florida, United States
Direct Helpers Research Center
🇺🇸Hialeah, Florida, United States
GSI Clinical Research
🇺🇸Margate, Florida, United States
International Dermatology Research Inc - Miami
🇺🇸Miami, Florida, United States
Miami Dade Medical Research Institute, LLC
🇺🇸Miami, Florida, United States
GCP Global Clinical Professionals, LLC
🇺🇸Saint Petersburg, Florida, United States
Sarasota Clinical Research
🇺🇸Sarasota, Florida, United States
Alliance Clinical Research of Tampa
🇺🇸Tampa, Florida, United States
Endeavor Health
🇺🇸Skokie, Illinois, United States
DS Research - 1005 E. Lewis & Clark Pkwy Indiana Location
🇺🇸Clarksville, Indiana, United States
Dawes Fretzin Clinical Research Group-7910 N Shadeland Ave
🇺🇸Indianapolis, Indiana, United States
DS Research of Kentucky, LLC
🇺🇸Louisville, Kentucky, United States
Allergy and Asthma Specialists PSC
🇺🇸Owensboro, Kentucky, United States
Clinical Trials Management LLC - Southshore Office
🇺🇸Metairie, Louisiana, United States
Johns Hopkins Asthma and Allergy Center
🇺🇸Baltimore, Maryland, United States
DermAssociates, LLC
🇺🇸Rockville, Maryland, United States
Institute For Asthma and Allergy
🇺🇸Wheaton, Maryland, United States
David Fivenson MD Dermatolgy PLLC
🇺🇸Ann Arbor, Michigan, United States
Oakland Hills Dermatology
🇺🇸Auburn Hills, Michigan, United States
Resp Medicine Research Institute of MI
🇺🇸Ypsilanti, Michigan, United States
Dermatolgy and Skin Cancer Center
🇺🇸Lee's Summit, Missouri, United States
MediSearch, LLC
🇺🇸Saint Joseph, Missouri, United States
Montana Medical Research
🇺🇸Missoula, Montana, United States
Allergy Partners of N.J., P.C.
🇺🇸Ocean City, New Jersey, United States
Smith Allergy & Asthma Specialists of Central New York
🇺🇸Cortland, New York, United States
Sadick Research Group
🇺🇸New York, New York, United States
Bexley Dermatology Research
🇺🇸Bexley, Ohio, United States
Bernstein Clinical Research Center, LLC
🇺🇸Cincinnati, Ohio, United States
Wright State Physicians
🇺🇸Fairborn, Ohio, United States
Auni Allergy
🇺🇸Findlay, Ohio, United States
Apex Clinical Research Center
🇺🇸Mayfield Heights, Ohio, United States
Toledo Institute of Clinical Research
🇺🇸Toledo, Ohio, United States
Southern Plains Medical Center - Chickasha
🇺🇸Oklahoma City, Oklahoma, United States
Portland Allergy and Asthma
🇺🇸Clackamas, Oregon, United States
Oregon Medical Research Center
🇺🇸Portland, Oregon, United States
Clinical Research Philadelphia, LLC
🇺🇸Philadelphia, Pennsylvania, United States
National Allergy and Asthma Research, LLC - CRN - PPDS
🇺🇸North Charleston, South Carolina, United States
Alina Clinical Trials
🇺🇸Dallas, Texas, United States
VAST Clinical Research - Plano
🇺🇸Plano, Texas, United States
Allergy and Asthma Care of Waco
🇺🇸Waco, Texas, United States
University of Utah - MidValley Dermatology - PPDS
🇺🇸Murray, Utah, United States
Buenos Aires Skin
🇦🇷Buenos Aires, Buenos Aires Province, Argentina
Fundacion Cidea
🇦🇷Buenos Aires, Buenos Aires Province, Argentina
CEMLO:Centro de Especialidades Medicas Lobos
🇦🇷Lobos, Buenos Aires Province, Argentina
Hospital Italiano De Buenos Aires
🇦🇷Buenos Aires, Caba, Argentina
Conexa Investigacion Clinica
🇦🇷Caba, Ciudad Autonoma de Buenos Aires, Argentina
Aprillus Asistencia e Investigacion
🇦🇷Caba, Ciudad Autonoma de Buenos Aires, Argentina
CARE- Centro de Alergia y Enfermedades Respiratorias
🇦🇷Caba, Ciudad Autonoma de Buenos Aires, Argentina
Centro Respiratorio Infantil
🇦🇷Rosario, Sante Fe, Argentina
Instituto de Especialidades de Salud Rosario
🇦🇷Rosario, Sante Fe, Argentina
Servicio de Investigacion de Patologias Alergicas
🇦🇷Rosario, Sante Fe, Argentina
Instituto Medico de la Fundacion Estudios Clinicos
🇦🇷Rosario, Sante Fe, Argentina
C.I.C.E 9 de Julio - Sanatorio 9 de Julio S.A.
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
Clinica Mayo
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
Centro de Investigaciones Medicas Tucuman
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
Instituto de Alergia e Inmunologia del Sur
🇦🇷Buenos Aires, Argentina
UZ Leuven
🇧🇪Leuven, Vlaams Brabant, Belgium
UZ Brussel
🇧🇪Brussels, Belgium
Saint Luc
🇧🇪Brussels, Belgium
CHU de Liège
🇧🇪Brussels, Belgium
UZ Gent
🇧🇪Gent, Belgium
"Medical center MedTech Services" OOD
🇧🇬Haskovo, Bulgaria
Diagnostic Consultative Center Pulmed
🇵🇱Wrocław, Poland
Aipsimpa D-R Talyat Sali Cholak Eood
🇧🇬Razgrad, Bulgaria
Medical Center Iskar EOOD
🇧🇬Sofia, Bulgaria
MC Excelsior OOD
🇧🇬Sofia, Bulgaria
DCC Fokus - 5 OOD LZIBP
🇧🇬Sofia, Bulgaria
Medical Center Hera EOOD
🇧🇬Sofia, Bulgaria
Medical Center Pulmovision
🇧🇬Sofia, Bulgaria
Medical Center "Zara-Med" EOOD
🇧🇬Stara Zagora, Bulgaria
MBAL Sv. Panteleymon AD
🇧🇬Yambol, Bulgaria
Alberta DermaSurgery Centre - Probity - PPDS
🇨🇦Edmonton, Alberta, Canada
Skincare Research
🇨🇦St. John's, Newfoundland and Labrador, Canada
Triple A Lab
🇨🇦Hamilton, Ontario, Canada
Lynderm Research Inc
🇨🇦Markham, Ontario, Canada
Centre for Dermatology and Cosmetic Surgery
🇨🇦Richmond Hill, Ontario, Canada
Canadian Dermatology Centre - Probity - PPDS
🇨🇦Toronto, Ontario, Canada
Evidence Based Medical Educator Inc.
🇨🇦Toronto, Ontario, Canada
Fakultní nemocnice Královské Vinohrady, Dermatovenerologická klinika
🇨🇿Praha 10, Czechia
Sanatorium profesora Arenbergera
🇨🇿Praha 1, Czechia
Kožní ambulance Fialová, s.r.o.
🇨🇿Praha 6, Czechia
Fakultní nemocnice Bulovka, Dermatovenerologická klinika
🇨🇿Praha 8, Czechia
Aarhus Universitetshospital
🇩🇰Aarhus N, Denmark
Bispebjerg Hospital
🇩🇰Copenhagen NV, Denmark
Gentofte Hospital
🇩🇰Hellerup, Denmark
Hospices Civils de Lyon - Hôpital Lyon Sud
🇫🇷Pierre-Benite, Rhone, France
CHU de Grenoble Alpes - Hôpital Michallon
🇫🇷La Tronche, France
CHRU Nantes Hôtel Dieu
🇫🇷Nantes, France
CHU de Nice-Hôpital L'Archet
🇫🇷Nice, France
Hôpital La Pitié Salpêtrière
🇫🇷Paris, France
Praxis Dr. Beate Schwarz
🇩🇪Langenau, Baden-Württemberg, Germany
Rosenpark Research GmbH
🇩🇪Darmstadt, Hesse, Germany
Siteworks Prüfzentrum Lohne - PPDS
🇩🇪Löhne, Niedersachsen, Germany
MVZ Dermatologisches Zentrum Bonn GmbH - Praxis Friedensplatz
🇩🇪Bonn, Nordrhein-Westfalen, Germany
ProDerma
🇩🇪Dülmen, Nordrhein-Westfalen, Germany
UKSH Kiel
🇩🇪Kiel, Schleswig-Holstein, Germany
Medizinisches Versorgungszentrum DermaKiel GmbH
🇩🇪Kiel, Schleswig-Holstein, Germany
Studienzentrum an der Hase Weyergraf / Frick / Heiber GbR
🇩🇪Bramsche, Germany
Dermatologie Quist
🇩🇪Mainz, Germany
LMU Klinikum der Universität München
🇩🇪München, Germany
Naval Hospital of Athens
🇬🇷Athens, Greece
Andreas Syggros Hospital
🇬🇷Athens, Greece
Attikon General University Hospital
🇬🇷Attikí, Greece
General Hospital of Thessaloniki 'Papageorgiou'
🇬🇷Thessaloníki, Greece
Azienda Ospedaliero Universitaria delle Marche
🇮🇹Ancona, Italy
ASST Carlo Poma
🇮🇹Mantova, Italy
Istituti Clinici Scientifici Maugeri IRCCS
🇮🇹Milano, Italy
Azienda Ospedaliera Ordine Mauriziano di Torino
🇮🇹Torino, Italy
Centro Ricerche Cliniche Verona s.r.l./Ospedale G.B. Rossi Borgo Roma
🇮🇹Verona, Italy
Hanyang University Seoul Hospital
🇰🇷Seongdong, Seoul Teugbyesolsi, Korea, Republic of
Korea University Ansan Hospital
🇰🇷Ansan, Korea, Republic of
CHA Bundang Medical Center, CHA University
🇰🇷Seongnam-si, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Ajou University Hospital
🇰🇷Suwon-si, Korea, Republic of
Hospital Pulau Pinang
🇲🇾George Town, Malaysia
Hospital Raja Permaisuri Bainun
🇲🇾Ipoh, Malaysia
Hospital Sultan Ismail
🇲🇾Johor Bahru, Malaysia
Hospital Kuala Lumpur
🇲🇾Kuala Lumpur, Malaysia
Hospital Umum Sarawak
🇲🇾Kuching, Malaysia
NZOZ Specjalistyczny Ośrodek Dermatologiczny "DERMAL"
🇵🇱Bialystok, Poland
Prywatna Praktyka Lekarska Gabinet Pediatryczno-Alergologiczny Anna Ploszczuk
🇵🇱Białystok, Poland
Pratia Bydgoszcz
🇵🇱Bydgoszcz, Poland
Ambulatorium Sp. zo.o.
🇵🇱Elbląg, Poland
Centrum Badan Klinicznych PI-House Sp. z o.o
🇵🇱Gdańsk, Poland
"SYNEXUS POLSKA" sp. z o.o. Odział w Katowicach
🇵🇱Katowice, Poland
Centrum Medyczne Katowice - PRATIA - PPDS
🇵🇱Katowice, Poland
Polimedica PTG Kielce
🇵🇱Kielce, Poland
Centrum Nowoczesnych Terapii "Dobry Lekarz" Sp. o.o.
🇵🇱Kraków, Poland
Pratia S.A. Centrum Medyczne Pratia Poznań
🇵🇱Poznan, Poland
Specjalistyczna Przychodnai Lekarska Alergo-Med Sp. z o.o.
🇵🇱Poznań, Poland
NSZOZ Puls-Med Anna Bogusz, Agnieszka Musielak spolka jawna
🇵🇱Skarzysko-Kamienna, Poland
Laser Clinic S.C
🇵🇱Szczecin, Poland
MICS Centrum Medyczne Torun
🇵🇱Toruń, Poland
Klinika Ambroziak Dermatologia
🇵🇱Warsaw, Poland
Royalderm Agnieszka Nawrocka
🇵🇱Warsaw, Poland
Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji im. Prof. Dr hab. Med. Eleonory Reicher
🇵🇱Warszawa, Poland
Przychodnia FutureMeds Wroclaw
🇵🇱Wroclaw, Poland
Ginemedica
🇵🇱Wrocław, Poland
EuroMediCare Szpital Specjalistyczny z Przychodnia we Wroclawiu
🇵🇱Wrocław, Poland
Santa Familia PTG Łódź
🇵🇱Łódź, Poland
ULS da Região de Aveiro, EPE - Hospital Infante D. Pedro
🇵🇹Aveiro, Portugal
Centro Clínico Académico, Braga - Hospital de Braga
🇵🇹Braga, Portugal
ULS de Coimbra, EPE - Hospitais da Universidade de Coimbra
🇵🇹Coimbra, Portugal
Hospital Lusiadas Lisboa
🇵🇹Lisboa, Portugal
Unidade Local de Saúde de Santa Maria
🇵🇹Lisboa, Portugal
ULS de Matosinhos, EPE - Hospital Pedro Hispano
🇵🇹Matosinhos, Portugal
ULS de Santo António, EPE - Hospital de Santo António
🇵🇹Porto, Portugal
ULS da Arrábida, EPE - Hospital de São Bernardo
🇵🇹Setúbal, Portugal
Unidade Local de Saúde de Gaia/Espinho - Unidade I
🇵🇹Vila Nova De Gaia, Portugal
Iatros International
🇿🇦Bloemfontein, Free State, South Africa
Worthwhile Clinical Trials
🇿🇦Benoni, Gauteng, South Africa
Ubuntu Clinical Research
🇿🇦Krugersdorp, Gauteng, South Africa
Newtown Clinical Research Centre
🇿🇦Newtown, Gauteng, South Africa
About Allergy
🇿🇦Pretoria, Gauteng, South Africa
Ryexo Clinical Research
🇿🇦Pretoria, Gauteng, South Africa
FCRN Clinical Trial Centre
🇿🇦Vereeniging, Gauteng, South Africa
Synapta Clinical Research
🇿🇦Durban, Kwa-Zulu Natal, South Africa
University of Cape Town Lung Institute
🇿🇦Mowbray, Western Cape, South Africa
Global Clinical Trials
🇿🇦Pretoria, South Africa
Corporació Sanitaria Parc Taulí
🇪🇸Sabadell, Barcelona, Spain
Hospital General Universitario Dr. Balmis
🇪🇸Alicante, Spain
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
C.H. Regional Reina Sofia
🇪🇸Córdoba, Spain
Future Meds Madrid
🇪🇸Madrid, Spain
Hospital Clínico San Carlos
🇪🇸Madrid, Spain
Complejo Asistencial Universitario De Salamanca
🇪🇸Salamanca, Spain
Hospital Universitario de la Plana
🇪🇸Villareal, Spain
National Taiwan University Hospital Hsin-Chu Branch
🇨🇳Hsinchu, Taiwan
Chang Gung Medical Foundation Kaohsiung Chang Gung Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Kaohsiung Veterans General Hospital
🇨🇳Kaohsiung, Taiwan
Taipei Medical University-Shuang Ho Hospital
🇨🇳New Taipei City, Taiwan
China Medical University Hospital -PPDS
🇨🇳Taichung City, Taiwan
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
National Taiwan University Hospital
🇨🇳Taipei City, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei City, Taiwan
MacKay Memorial Hospital -Taipei branch
🇨🇳Taipei City, Taiwan
Chang Gung Memorial Hospital, Linkou
🇨🇳Taoyuan, Taiwan