MedPath

A DOSE-RANGING STUDY TO EVALUATE EFFICACY AND SAFETY OF PF-06700841 IN SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

Phase 2
Completed
Conditions
Systemic Lupus Erythematosus
Interventions
Registration Number
NCT03845517
Lead Sponsor
Pfizer
Brief Summary

Assessment of PF-06700841 in participants with moderate to severe active, generalized Systemic Lupus Erythematosus (SLE) that have inadequate response to standard of care.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
350
Inclusion Criteria
  • Male and/or female subjects between ≥18 and ≤75 years of age inclusive.
  • Diagnosis of moderate to severe active Lupus.
  • Receiving a stable dose of methotrexate, azathioprine, leflunomide, mizoribine, mycophenolate/mycophenolic acid, anti-malarials or corticosteroids.
Read More
Exclusion Criteria
  • Active renal lupus
  • Severe active central nervous system (CNS) lupus
  • Have cancer or a history of cancer within 5 years of screening.
  • Have a history of thrombosis (venous or arterial) or other vascular complications within the last 6 months, or any history of either recurrent thrombosis or a pulmonary embolus.
  • Active bacterial, viral, fungal, mycobacterial or other infections
  • Psychiatric condition including recent or active suicidal ideation or behavior
  • Have active fibromyalgia/myofascial/chronic pain.
  • Pregnant female subjects; breastfeeding female subjects; females subjects planning to become pregnant during the study; fertile male subjects and WOCBP who are unwilling or unable to use a highly effective method of contraception.
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PF-06700841 30 mgPF-06700841 30 mgPF-06700841 30 mg
PF-06700841 45 mgPF-06700841 45 mgPF-06700841 45 mg
PlaceboPlaceboPlacebo
PF-06700841 15 mgPF-06700841 15 mgPF-06700841 15 mg
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving SLE Responder Index (SRI) Change of 4 (SRI-4) at Week 52Week 52

SRI-4 components included Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), British Isles Lupus Assessment Group (BILAG) 2004 and Physician's Global Assessment (PhGA). Participants were classified as SRI-4 responders, if they met all of the following criteria compared with baseline: 1) greater than or equal to (\>=) 4 point reduction in SLEDAI-2K score; 2) no new BILAG A organ domain score or 2 new BILAG B organ domain scores; 3) no worsening (less than \[\<\] 0.3 point increase) in PhGA score. SLEDAI-2K: assesses improvement in disease activity (range: 0 to 105; higher score = higher severity). BILAG: assesses disease extent, severity in individual organ system (range: A \[severe\] to E \[no disease\]; higher score = less severity). PhGA: assesses worsening in participant's general health status (range: 0 \[none\] to 3 \[severe\]; higher score = higher severity).

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Achieving British Isles Lupus Assessment Group-Based Composite Lupus Assessment (BICLA) at Week 52Week 52

BICLA included: BILAG-2004, SLEDAI-2K and PhGA. Participants were classified as responders, if they met all the following criteria: BILAG-2004 improvement (all A scores at baseline improved to B/C/D and all B scores improved to C or D); no worsening in disease activity (no new BILAG-2004 A scores or =\<1 new B score); no worsening of total SLEDAI-2K score; no significant deterioration (\<10 percent \[%\] worsening) in analogue PhGA. SLEDAI-2K: assesses improvement in disease activity (range: 0 to 105; higher score = higher severity). BILAG: assesses disease extent, severity in individual organ system (range: A \[severe\] to E \[no disease\]; higher score = less severity). PhGA: assesses worsening in participant's general health status (range: 0 \[none\] to 3 \[severe\]; higher score = higher severity).

Percentage of Participants Achieving a SRI-4 Response With Prednisone Dose Reduced to <=7.5 mg/Day and Sustained for 12 Weeks at Week 52 in Participants on Prednisone >7.5 mg/Day (or Equivalent) at Baseline12 Weeks prior at Week 52 (Week 40 to Week 52)

In this outcome measure data is reported for participants who achieved a reduction in SRI-4 response with prednisone dose reduced to \<=7.5 mg/day and sustained for 12 weeks at Week 52.

Percentage of Participants Achieving Lupus Low Disease Activity State (LLDAS) at Week 52Week 52

LLDAS was defined as SLE disease activity index (SLEDAI-2k \<=4, with no activity in major organ systems \[renal, central nervous system, cardiopulmonary, vasculitis, fever\]) and no haemolytic anaemia or gastrointestinal activity; no new lupus disease activity compared with the previous assessment; a Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)-SLEDAI PhGA (scale 0-3; higher scores = higher severity) \<=1; a current prednisolone (or equivalent) dose \<=7.5 milligram per day (mg/daily); and well tolerated standard maintenance doses of immunosuppressive drugs and approved biological agents.

Percentage of Participants Achieving a Reduction in Prednisone (or Equivalent) Dose to <=7.5 mg/Day and Sustained for 12 Weeks Prior to Week 52 in Participants on Prednisone >7.5 mg/Day (or Equivalent) at BaselineWeek 52 for achieving reduction in dose along with Week 40 to Week 52 for sustained dosing

In this outcome measure data is reported for participants who achieved a reduction in prednisone (or equivalent) dose to \<=7.5 mg/day and sustained for 12 Weeks prior at Week 52 and they also sustained this dose reduction for 12 weeks prior to Week 52 (Week 40 to Week 52).

Percentage of Participants With >= 50% Reduction in Cutaneous Lupus Erythematosus Disease Area and Severity Index Activity (CLASI-A) Score at Week 52 in Participants With Baseline CLASI-A Score >=10Week 52

CLASI is an validated measurement instrument for lupus erythematosus developed for use in clinical studies that consists of separate scores for the activity of the disease (CLASI-A). The CLASI activity score is calculated on the basis of erythema, scale/hyperkeratosis, mucous membrane involvement, acute hair loss and non-scarring alopecia. The CLASI activity score ranges from 0-70, with higher scores indicating more severe skin disease. Severity categories based on the CLASI activity score are as follows: mild (0-9), moderate (10-20), and severe (21-70).

Change From Baseline in Planning Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Planning domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Fatigue Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Fatigue domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Intimate Relationship Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Intimate relationship domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Burden to Others Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Burden to others domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Incidence Rate of Severe Flare EventWeek 52

Incidence rate was defined as the number of new events per 100 person-years.

Change From Baseline in Total Scores of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) at Week 52Baseline, Week 52

The FACIT-F Scale is a participant completed questionnaire consisting of 13 items that assess fatigue. Participants responded to each item on a 5-point scale based on their experience of fatigue during the past 7 days (0 = not at all; 1 = a little bit; 2 =somewhat; 3 = quite a bit; 4 = very much). Instrument scoring yielded a range from 0 to 52 (negatively worded items were reversed during analysis), with higher scores representing better participant status (less fatigue).

Change From Baseline in Physical Health Domain Scores of Lupus Quality of Life (LupusQoL) at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others; measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Physical health domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Pain Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Pain domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Emotional Health Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Emotional health domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Change From Baseline in Body Image Domain Scores of LupusQoL at Week 52Baseline, Week 52

The LupusQoL questionnaire is a validated questionnaire used to evaluate SLE -specific concepts of SLE as reported by participants. It consists of 34 items in 8 different domains: physical health, emotional health, body image, pain, planning, fatigue, intimate relationship, and burden to others measured on a 5-point scale ranging from 0 (not at all) to 4 (very much). The individual domain scores are transformed to a 0 to 100 scale wherein higher scores indicate better quality of life. Body image domain score of LupusQoL had score range from 0 to 100, where higher scores = better quality of life.

Number of Participants With Treatment-Emergent Adverse Events (AE)Day 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

An AE was any untoward medical occurrence in a participant who received study intervention without regard to possibility of causal relationship. TEAEs are events from first dose of study intervention to 4 weeks after last dose of study intervention that were absent before treatment or that worsened relative to pre-treatment state. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. AEs included both SAEs and all non-SAEs.

Number of Participants With Serious Adverse Events (SAEs)Day 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

An AE was any untoward medical occurrence in a participant who received study intervention without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Number of Participants With Adverse Events Leading to Discontinuation From StudyDay 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

An AE was any untoward medical occurrence in a participant who received study intervention without regard to possibility of causal relationship. In this outcome measure, participants with adverse events leading to discontinuation from study were reported.

Number of Participants With Clinically Significant Vital Signs AbnormalitiesDay 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

Vital signs included blood pressure, pulse rate, respiratory rate, and temperature. Clinical significance in vital signs abnormalities was judged by investigator.

Number of Participants With Clinically Significant Electrocardiogram (ECG) AbnormalitiesDay 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

Clinical significance in ECG abnormalities was judged by investigator.

Number of Participants With Laboratory Test AbnormalitiesDay 1 of dosing up to 4 weeks after last dose of study drug (maximum treatment was up to 52 weeks, follow-up up to 56 weeks)

Hematology (Hemoglobin\[hgb\], hematocrit, erythrocytes\[ery\]:\<0.8\*lower limit of normal\[LLN\];reticulocytes, reticulocytes/ery:\<0.5\*LLN,\>1.5\*upper LN\[ULN\];ery mean corpuscular volume\[EMC\], EMC hgb:\<0.9\*LLN,\>1.5\*ULN;EMC hgb concentration:\<0.9\* LLN;platelet:\<0.5\*LLN;leukocytes\[leu\]:\<0.6\*LLN,\>1.5\*ULN;lymphocytes, lymphocytes/leu, neutrophils, neutrophils/leu:\<0.8\* LLN,\>1.2\*ULN;basophils, basophils/leu, eosinophils, eosinophils/leu, monocytes, monocytes/leu:\>1.2\*ULN;activated partial thromboplastin time\[PTT\], PTT, prothrombin time:\>1.1\*ULN);Clinical chemistry (Total/direct/indirect bilirubin, glucose-fasting:\>1.5\*ULN; aspartate aminotransferase\[AT\], alanine AT:\>3.0\*ULN; protein, albumin, HDL cholesterol:\<0.8\*LLN;urea nitrogen, creatinine, triglyceride, cholesterol:\>1.3\*ULN;urate, LDL cholesterol:\>1.2\*ULN;potassium:\<0.9\*LLN,\>1.1\*ULN;calcium, bicarbonate:\<0.9\*LLN;creatine kinase:\>2.0\*ULN);Urinalysis (pH\<4.5;glucose, protein, hgb, ketones, nitrite, leu esterase, granular/hyaline/WBCs casts:\>1).

Trial Locations

Locations (157)

Stamford Therapeutics Consortium

🇺🇸

Stamford, Connecticut, United States

Institute of Arthritis Research

🇺🇸

Idaho Falls, Idaho, United States

Northshore University Hospital

🇺🇸

Manhasset, New York, United States

UAB Hospital-Clinical Research Unit (CRU)

🇺🇸

Birmingham, Alabama, United States

Arthritis and Osteoporosis Medical Center

🇺🇸

La Palma, California, United States

Arthritis & Rheumatology Center of Oklahoma PLLC

🇺🇸

Oklahoma City, Oklahoma, United States

The Kirklin Clinic

🇺🇸

Birmingham, Alabama, United States

UAB Department of Medicine Clinical Research Enterprise

🇺🇸

Birmingham, Alabama, United States

UAB Hospital Department of Pharmacy

🇺🇸

Birmingham, Alabama, United States

Advanced Medical Research, LLC

🇺🇸

La Palma, California, United States

East Bay Rheumatology Medical Group, Inc.

🇺🇸

San Leandro, California, United States

Innovative health Research

🇺🇸

Las Vegas, Nevada, United States

Accurate Clinical Research

🇺🇸

Houston, Texas, United States

Clinical Research of West Florida

🇺🇸

Tampa, Florida, United States

AdventHealth Tampa

🇺🇸

Tampa, Florida, United States

Rose Radiology dba Akumin Inc.

🇺🇸

Tampa, Florida, United States

Akumin Inc.

🇺🇸

Tampa, Florida, United States

New England Research Associates, LLC

🇺🇸

Bridgeport, Connecticut, United States

State Institution National Scientific Center "M.D. Strazhesko Institute of Cardiology" of National

🇺🇦

Kyiv, Ukraine

The University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Multifield Medical Center of Odesa National Medical University

🇺🇦

Odesa, Ukraine

St. Joseph Heritage Healthcare

🇺🇸

Fullerton, California, United States

Desert Medical Advances

🇺🇸

Palm Desert, California, United States

Inland Rheumatology and Osteoporosis Medical Group

🇺🇸

Upland, California, United States

Millennium Clinical Trials

🇺🇸

Thousand Oaks, California, United States

Inland Rheumatology Clinical Trials, Inc.

🇺🇸

Upland, California, United States

New England Research Associates

🇺🇸

Bridgeport, Connecticut, United States

Private Practice of Robert W. Levin

🇺🇸

Clearwater, Florida, United States

SIMEDHealth, LLC Attn: Rheumatology

🇺🇸

Gainesville, Florida, United States

SIMEDHealth, LLC

🇺🇸

Gainesville, Florida, United States

Akumin, Inc

🇺🇸

Palm Harbor, Florida, United States

Jefrey D. Lieberman, M.D., P.C.

🇺🇸

Decatur, Georgia, United States

Atlanta Research Center for Rheumatology

🇺🇸

Marietta, Georgia, United States

West Broward Rheumatology Associates, Inc

🇺🇸

Tamarac, Florida, United States

Akumin Inc

🇺🇸

Saint Petersburg, Florida, United States

Investigational Drug Services University of Kansas Hospital

🇺🇸

Kansas City, Kansas, United States

The University of Kansas Hospital

🇺🇸

Kansas City, Kansas, United States

Ochsner Clinic Foundation, Baton Rouge

🇺🇸

Baton Rouge, Louisiana, United States

University of Michigan Brighton Center for Specialty Care

🇺🇸

Brighton, Michigan, United States

Feinstein Institute for Medical Research

🇺🇸

Manhasset, New York, United States

St. Lawrence Health System

🇺🇸

Potsdam, New York, United States

Columbia University Medical Center.

🇺🇸

New York, New York, United States

NYU Langone Ambulatory Care Brooklyn Heights

🇺🇸

Brooklyn, New York, United States

Joint and Muscle Research Institute

🇺🇸

Charlotte, North Carolina, United States

Irving Institute for Clinical and Transitional Research

🇺🇸

New York, New York, United States

Gupta, Ramesh C MD

🇺🇸

Memphis, Tennessee, United States

West Tennessee Research Institute

🇺🇸

Jackson, Tennessee, United States

Rheumatic Disease Clinical Research Center, LLC

🇺🇸

Houston, Texas, United States

Accurate Clinical Management, LLC

🇺🇸

Baytown, Texas, United States

Arthritis Clinic of Central Texas

🇺🇸

San Marcos, Texas, United States

Arthritis Northwest, PLLC

🇺🇸

Spokane, Washington, United States

Optimus Clinical Research

🇦🇺

Kogarah, New South Wales, Australia

Centro de Investigaciones Medicas Tucuman

🇦🇷

San Miguel de Tucuman, Tucuman, Argentina

Emeritus Research

🇦🇺

Camberwell, Victoria, Australia

Ziekenhuisnetwerk Antwerpen Jan Palfijn (ZNA Jan Palfijn)

🇧🇪

Merksem, Belgium

UMHAT "Sv.Ivan Rilski" EAD

🇧🇬

Sofia, Bulgaria

DCC Sveti Georgi EOOD

🇧🇬

Plovdiv, Bulgaria

MHAT Plovdiv AD

🇧🇬

Plovdiv, Bulgaria

Hospital Pablo Tobon Uribe

🇨🇴

Medellin, Antioquia, Colombia

Centro Integral de Reumatología del Caribe S.A.S - CIRCARIBE S.A.S

🇨🇴

Barranquilla, Atlantico, Colombia

Bluecare Salud S.A.S Sede Centro Médico Integral Chicó MedPlus CRI

🇨🇴

Bogota, Cundinamarca, Colombia

UZ Leuven

🇧🇪

Leuven, Belgium

Peking Union Medical College Hospital

🇨🇳

Beijing, China

Umhat Kanev Ad

🇧🇬

Ruse, Bulgaria

Anhui Provincial Hospital

🇨🇳

Hefei, Anhui, China

Tianjin Medical University General Hospital

🇨🇳

Tianjin, Tianjin, China

Fudan University Hua Shan Hospital

🇨🇳

Shanghai, China

UMHAT "Sv. Ivan Rilski" EAD

🇧🇬

Sofia, Bulgaria

Centre intégré de santé et de services sociaux du Bas-Saint-Laurent

🇨🇦

Rimouski, Quebec, Canada

Centre de Recherche Musculo-Squelettique

🇨🇦

Trois-Rivieres, Quebec, Canada

The Second Xiangya Hospital of Central South University

🇨🇳

Changsha, Hunan, China

The First Affiliated Hospital of Soochow University

🇨🇳

Suzhou, Jiangsu, China

Centro de Investigación en Reumatología y Especialidades Médicas SAS - CIREEM SAS

🇨🇴

Bogotá, Cundinamarca, Colombia

Ruijin Hospital- Shanghai Jiaotong University School of Medicine

🇨🇳

Shanghai, China

Medicity S.A.S.

🇨🇴

Bucaramanga, Santander, Colombia

Vseobecna fakultni nemocnice v Praze

🇨🇿

Praha 2, Czechia

Nemocnicni lekarna VFN

🇨🇿

Praha 2, Czechia

Revmatologicky ustav

🇨🇿

Praha 2, Czechia

Hôpital Pitié Salpêtrière, Centre des Maladies Auto-immunes

🇫🇷

Paris, France

Hôpital Cochin

🇫🇷

Paris, France

CHU de Bordeaux, Groupe Hospitalier Sud, Hôpital Haut Lévèque

🇫🇷

Pessac, France

Medizinische Hochschule Hannover

🇩🇪

Hannover, Germany

Universitätsklinikum Schleswig Holstein - Campus Lübeck

🇩🇪

Lübeck, Germany

University General Hospital of Heraklion

🇬🇷

Heraklion, Crete, Greece

Laiko General Hospital, University of Athens

🇬🇷

Athens, Greece

Qualiclinic Kft.

🇭🇺

Budapest, Hungary

University Hospital ATTIKON

🇬🇷

Haidari, Greece

Debreceni Egyetem Klinikai Kozpont

🇭🇺

Debrecen, Hungary

Békés Vármegyei Központi Kórház

🇭🇺

Gyula, Hungary

Fondazione IRCCS Policlinico S.Matteo

🇮🇹

Pavia, Italy

National Hospital Organization Asahikawa Medical Center

🇯🇵

Asahikawa, Hokkaido, Japan

Hokkaido University Hospital

🇯🇵

Sapporo, Hokkaido, Japan

Tohoku University Hospital

🇯🇵

Sendai, Miyagi, Japan

Sasebo Chuo Hospital

🇯🇵

Sasebo, Nagasaki, Japan

Shinkenko clinic

🇯🇵

Naha, Okinawa, Japan

St. Luke's International Hospital

🇯🇵

Chuo-ku, Tokyo, Japan

National Hospital Organization Chiba-East Hospital

🇯🇵

Chiba, Japan

National Hospital Organization Kyushu Medical Center

🇯🇵

Fukuoka, Japan

Hiroshima University Hospital

🇯🇵

Hiroshima, Japan

Ajou University Hospital

🇰🇷

Suwon, Gyeonggi-do, Korea, Republic of

The Catholic Univ. of Korea Seoul St. Mary's Hospital

🇰🇷

Seocho-gu, Seoul, Korea, Republic of

Morales Vargas Centro de Investigación S.C.

🇲🇽

León, Guanajuato, Mexico

Kyungpook National University Hospital (KNUH)

🇰🇷

Daegu, Korea, Republic of

CITER Centro de Investigación y Tratamiento de las Enfermedades Reumáticas S.A. de C.V.

🇲🇽

Mexico City, Cuauhtémoc, Mexico

Investigación Biomédica para el Desarrollo de Fármacos S.A. de C.V

🇲🇽

Guadalajara, Mexico

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

🇲🇽

Mexico City, Tlalpan, Mexico

Investigación y Biomedicina de Chihuahua, Sociedad Civil

🇲🇽

Chihuahua, Mexico

CINTRE Centro de Investigación y Tratamiento Reumatológico S.C.

🇲🇽

Mexico City, Mexico

Szpital Biziela

🇵🇱

Bydgoszcz, Poland

Centrum Wsparcia Badan Klinicznych

🇵🇱

Warszawa, Mazowieckie, Poland

Stanislaw Sierakowski Centrum Miriada

🇵🇱

Bialystok, Poland

Zespol Poradni Specjalistycznych Reumed, Onyksowa Filia nr 2

🇵🇱

Lublin, Poland

NZOZ "Lecznica Mak-Med" s.c.

🇵🇱

Nadarzyn, Poland

Centrum Medyczne MEDENS S.C. Grupowa Praktyka Lekarska

🇵🇱

Sosnowiec, Poland

Hospital Garcia de Orta, E.P.E

🇵🇹

Almada, Portugal

Hospital Professor Doutor Fernando da Fonseca, E.P.E

🇵🇹

Amadora, Portugal

Unidade Local de Saude do Alto Minho, E.P.E.

🇵🇹

Ponte de Lima, Portugal

Centro Hospitalar Universitario do Porto, E.P.E

🇵🇹

Porto, Portugal

SC Centrul Medical de Diagnostic si Tratament Ambulator Neomed SRL

🇷🇴

Brasov, JUD. Brasov, Romania

Spitalul Clinic Judetean de Urgenta Cluj-Napoca

🇷🇴

Cluj-Napoca, Jud. Cluj, Romania

S.C. Euroclinic Hospital S.A

🇷🇴

Bucuresti, Sector 1, Romania

Narodowy Instytutu Geriatrii, Reumatologii i Rehabilitacji

🇵🇱

Warszawa, Poland

Mazowieckie Centrum Reumatologii i Osteoporozy M. Przygodzka Spolka jawna

🇵🇱

Warszawa, Poland

Spitalul Clinic Sf. Maria

🇷🇴

Bucuresti, Romania

Institut za Reumatologiju

🇷🇸

Beograd, Serbia

Klinicki Centar Srbije, Klinika za alergologiju i imunologiju

🇷🇸

Beograd, Serbia

Hospital do Meixoeiro

🇪🇸

Vigo, Pontevedra, Spain

Institut Niska Banja, Klinika za Reumatologiju

🇷🇸

Niska Banja, Serbia

Vojnomedicinska akademija, Klinika za reumatologiju

🇷🇸

Beograd, Serbia

Hospital Germans Trias i Pujol

🇪🇸

Badalona, Spain

Clinica Sagrada Familia

🇪🇸

Barcelona, Spain

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

Complexo Hospitalario Universitario A Coruna

🇪🇸

La Coruna, Spain

Hospital Quiron Infanta Luisa

🇪🇸

Sevilla, Spain

China Medical University Hospital

🇨🇳

Taichung City, Taiwan

Chung Shan Medical University Hospital

🇨🇳

Taichung, Taiwan

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

Kaohsiung Veterans General Hospital

🇨🇳

Kaohsiung City, Taiwan

National Taiwan University Hospital

🇨🇳

Taipei, Taiwan

Chang Gung Memorial Hospital Linkou Branch

🇨🇳

Taoyuan City, Taiwan

State Institution National Scientific Center "M.D. Strazhesko Institute of Cardiology"

🇺🇦

Kyiv, Ukraine

Communal non-profitable enterprise "Lviv City Clinical Hospital #4"

🇺🇦

Lviv, Ukraine

Multifield Medical Center of Odessa National Medical University

🇺🇦

Odesa, Ukraine

CNPE "Odesa Regional Clinical Hospital" of Odesa Regional Council

🇺🇦

Odesa, Ukraine

CNPE "Ternopil University Hospital" of Ternopil regional council, Department of Rheumatology

🇺🇦

Ternopil, Ukraine

Zakarpattia Regional Clinical Hospital n.a. A. Novak

🇺🇦

Uzhgorod, Ukraine

CNPE "Vinnytsya regional Clinical Hospital named after N.I.Pirogov Vinnytsia Regional Council"

🇺🇦

Vinnytsia, Ukraine

Southampton General Hospital

🇬🇧

Southampton, Hampshire, United Kingdom

Doncaster Royal Infirmary, Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust

🇬🇧

Doncaster, United Kingdom

The Leeds Teaching Hospitals NHS Trust, Chapel Allerton Hospital

🇬🇧

Leeds, United Kingdom

Guy's and St Thomas' NHS Foundation Trust Guy's Hospital

🇬🇧

London, United Kingdom

Omega Research MetroWest, LLC

🇺🇸

Orlando, Florida, United States

Centro Peninsular de Investigación Clínica S.C.P.

🇲🇽

Mérida, Yucatán, Mexico

Tekton Research

🇺🇸

Austin, Texas, United States

Taipei Veterans General Hospital

🇨🇳

Taipei, Taiwan

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

Tuen Mun Hospital

🇭🇰

Hong Kong, Hong Kong

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