Study of Abrocitinib Compared With Dupilumab in Adults With Moderate to Severe Atopic Dermatitis on Background Topical Therapy
- Conditions
- Atopic Dermatitis
- Interventions
- Drug: Abrocitinib 200 mgCombination Product: Dupilumab 300 mg
- Registration Number
- NCT04345367
- Lead Sponsor
- Pfizer
- Brief Summary
This is a randomized, double-blind, double-dummy, active-controlled, multi-center study to assess the efficacy and safety of abrocitinib 200 mg (2 x 100 mg tablets) administered orally QD compared with dupilumab 300 mg administered by subcutaneous injection every other week (as per label guidelines) in adult participants on background topical therapy, with moderate to severe AD. The treatment duration is 26 weeks. A total of approximately 600 participants will be enrolled from approximately 220 sites globally. Approximately 600 participants will be randomly assigned to study intervention. There are primary efficacy assessments at Week 2 and Week 4, and a key secondary efficacy assessment at Week 16. Efficacy and safety endpoints will be assessed throughout the entire study. Exploratory endpoints related to hand eczema efficacy will be assessed throughout the study.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 727
- 18 years of age or older
- Diagnosis of chronic atopic dermatitis (AD) for at least 6 months
- Moderate to severe AD (BSA at least 10%, IGA at least 3, EASI at least 16, and PP-NRS severity score at least 4)
- Recent history of inadequate response to treatment with medicated topical therapy for AD, or who have required systemic therapies for control of their disease
- Acute or chronic medical or laboratory abnormality that may increase the risk associated with study participation
- Have increased risk of developing venous thromboembolism
- Unwilling to discontinue current AD medications prior to the study or require treatment with prohibited medications during the study
- Prior treatment with systemic JAK inhibitors or IL-4 or IL-13 antagonists including dupilumab, lebrikizumab or tralokinumab
- Other active non-AD inflammatory skin diseases or conditions affecting skin
- Medical history including thrombocytopenia, coagulopathy or platelet dysfunction, malignancies, current or history of certain infections, lymphoproliferative disorders and other medical conditions at the discretion of the investigator
- Pregnant or breastfeeding women, or women of childbearing potential who are unwilling to use contraception
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Abrocitinib 200 mg plus placebo injection Abrocitinib 200 mg Abrocitinib 200 mg daily through Week 26, plus placebo injections every other week through Week 24 Dupilumab 300 mg plus placebo tablets Dupilumab 300 mg Dupilumab 300 mg every other week (2 injections on Day 1) through Week 24, plus placebo tablets daily through Week 26
- Primary Outcome Measures
Name Time Method Percentage of Participants Achieving Greater Than or Equal to (>=) 4 Points Improvement in Peak Pruritus Numerical Rating Scale (PP-NRS4) From Baseline at Week 2 Week 2 The severity of itch (pruritus) due to atopic dermatitis (AD) was assessed using the PP-NRS, a validated horizontal NRS. Participants were asked to assess their worst itching due to AD over the past 24 hours on an NRS with scale ranging from 0 to 10, where 0= no itch and 10= worst itch imaginable. Higher scores indicated worse itch.
Percentage of Participants Achieving >= 90% Improvement From Baseline in Eczema Area and Severity Index (EASI-90) Response at Week 4 Week 4 EASI quantifies severity of AD based on severity of lesion clinical signs and percentage (%) of body surface area (BSA) affected. Severity of clinical signs of AD lesions (erythema, induration/papulation, excoriation and lichenification) were scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin)\] and lower limbs \[including buttocks\]) on a 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based on % BSA with AD in body region: 0 (0%), 1 (\>0 to \<10%), 2 (10 to \<30%), 3 (30 to \<50%), 4 (50 to \<70%), 5 (70 to \<90%) and 6 (90 to 100%). Total EASI score =0.1\*Ah\*(Eh+Ih+Exh+Lh) + 0.2\*Au\*(Eu+Iu+ExU+Lu) + 0.3\*At\*(Et+It+Ext+Lt) + 0.4\*Al\*(El+Il+Exl+Ll); A = EASI area score; E = erythema; I = induration/papulation; Ex = excoriation; L = lichenification; h = head and neck; u = upper limbs; t = trunk; l = lower limbs. Total EASI score ranged from 0.0 to 72.0, with higher scores indicating greater severity of AD.
- Secondary Outcome Measures
Name Time Method Percentage of Participants Achieving PP-NRS4 From Baseline at Days 2 to 15 Day 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15 The severity of itch (pruritus) due to AD was assessed using the PP-NRS, a validated horizontal NRS. Participants were asked to assess their worst itching due to AD over the past 24 hours on an NRS with scale ranging from 0 to 10, where 0= no itch and 10= worst itch imaginable. Higher scores indicated worse itch.
Percent Change From Baseline in the Percentage (%) Body Surface Area (BSA) Affected at Week 2, 4, 8, 12, 16, 20 and 26 Baseline (Day 1), Week 2, 4, 8, 12, 16, 20 and 26 The extent (%) to which a body region was involved with AD was determined using handprint method. Number of handprints (size of participant's hand with fingers in a closed position) fitting in the affected area of a body region was estimated. Four body regions were evaluated: head and neck, upper limbs, trunk (including axillae and groin/genitals) and lower limbs (including buttocks). Total number of handprints were 10 for head and neck, 20 for upper limbs, 30 for trunk and 40 for lower limbs. Surface area of body region equivalent to 1 handprint: 1 handprint was equal to 10% for head and neck, 5% for upper limbs, 3.33% for trunk and 2.5% for lower limbs. Percent BSA for a body region was calculated as = total number of handprints in a body region \* % surface area equivalent to 1 handprint. Overall % BSA for an individual was derived as sum of % BSA across all 4 body regions and ranged from 0 to 100%, with higher values representing greater severity of AD.
Change From Baseline in Total Anxiety Score Measured Using the Hospital Anxiety and Depression Scale (HADS) at Week 12,16 and 26 Baseline (Day 1), Week 12, 16 and 26 HADS was a validated 14-item questionnaire to assess states of anxiety and depression over the past week. HADS consisted of 2 subscales: HADS-Anxiety (HADS-A) scale and HADS-Depression (HADS-D) scale, each of which comprised of 7 items. Each item was rated on a 4-point scale, with scores ranging from 0 to 3, where higher scores indicated more anxiety/depression symptoms. HADS-A assessed state of generalized anxiety (anxious mood, restlessness, anxious thoughts, panic attacks). HADS-A total score was calculated as the sum of all 7 items with score ranging from 0 (no presence of anxiety) to 21 (severe feeling of anxiety); higher score indicated greater severity of anxiety.
Percentage of Participants Achieving EASI-90 Response at Week 16 Week 16 EASI quantifies severity of AD based on severity of lesion clinical signs and % of BSA affected. Severity of clinical signs of AD lesions (erythema, induration/papulation, excoriation and lichenification) were scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin)\] and lower limbs \[including buttocks\]) on a 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based on % BSA with AD in body region: 0 (0%), 1 (\>0 to \<10%), 2 (10 to \<30%), 3 (30 to \<50%), 4 (50 to \<70%), 5 (70 to \<90%) and 6 (90 to 100%). Total EASI score =0.1\*Ah\*(Eh+Ih+Exh+Lh) + 0.2\*Au\*(Eu+Iu+ExU+Lu) + 0.3\*At\*(Et+It+Ext+Lt) + 0.4\*Al\*(El+Il+Exl+Ll); A = EASI area score; E = erythema; I = induration/papulation; Ex = excoriation; L = lichenification; h = head and neck; u = upper limbs; t = trunk; l = lower limbs. Total EASI score ranged from 0.0 to 72.0, with higher scores indicating greater severity of AD.
Percentage of Participants Achieving EASI-90 Response at Weeks 2, 8, 12, 20 and 26 Week 2, 8, 12, 20 and 26 EASI quantifies severity of AD based on severity of lesion clinical signs and % of BSA affected. Severity of clinical signs of AD lesions (erythema, induration/papulation, excoriation and lichenification) were scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin)\] and lower limbs \[including buttocks\]) on a 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based on % BSA with AD in body region: 0 (0%), 1 (\>0 to \<10%), 2 (10 to \<30%), 3 (30 to \<50%), 4 (50 to \<70%), 5 (70 to \<90%) and 6 (90 to 100%). Total EASI score =0.1\*Ah\*(Eh+Ih+Exh+Lh) + 0.2\*Au\*(Eu+Iu+ExU+Lu) + 0.3\*At\*(Et+It+Ext+Lt) + 0.4\*Al\*(El+Il+Exl+Ll); A = EASI area score; E = erythema; I = induration/papulation; Ex = excoriation; L = lichenification; h = head and neck; u = upper limbs; t = trunk; l = lower limbs. Total EASI score ranged from 0.0 to 72.0, with higher scores indicating greater severity of AD.
Percentage of Participants Achieving PP-NRS4 From Baseline at Week 4, 8, 12, 16, 20 and 26 Week 4, 8, 12, 16, 20 and 26 The severity of itch (pruritus) due to AD was assessed using the PP-NRS, a validated horizontal NRS. Participants were asked to assess their worst itching due to AD over the past 24 hours on an NRS with scale ranging from 0 to 10, where 0= no itch and 10= worst itch imaginable. Higher scores indicated worse itch.
Time to Achieve >=4 Points Improvement in Peak Pruritus Numerical Rating Scale (PP-NRS4) Baseline (Day 1) up to Week 30 The severity of itch (pruritus) due to AD was assessed using the PP-NRS, a validated horizontal NRS. Participants were asked to assess their worst itching due to AD over the past 24 hours on an NRS with scale ranging from 0 to 10, where 0= no itch and 10= worst itch imaginable. Higher scores indicated worse itch.
Change From Baseline in Dermatology Life Quality Index (DLQI) Total Score at Week 2, 12, 16, 20 and 26 Baseline (Day 1), Week 2, 12, 16, 20 and 26 DLQI is a 10-item questionnaire that measured the impact of skin disease. Each question was evaluated on a 4-point scale (range 0 to 3) where, 0 = not at all, 1= a little, 2= a lot, 3= very much, where higher scores indicated more impact on quality of life. Scores from all 10 questions were added up to give DLQI total score, ranging from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.
Percentage of Participants Achieving >= 75% Improvement From Baseline in EASI (EASI-75) Response at Weeks 2, 4, 8, 12, 16, 20 and 26 Week 2, 4, 8, 12, 16, 20 and 26 EASI quantifies severity of AD based on severity of lesion clinical signs and % of BSA affected. Severity of clinical signs of AD lesions (erythema, induration/papulation, excoriation and lichenification) were scored separately for each of 4 body regions (head and neck, upper limbs, trunk \[including axillae and groin)\] and lower limbs \[including buttocks\]) on a 4-point scale: 0= absent; 1= mild; 2= moderate; 3= severe. EASI area score was based on % BSA with AD in body region: 0 (0%), 1 (\>0 to \<10%), 2 (10 to \<30%), 3 (30 to \<50%), 4 (50 to \<70%), 5 (70 to \<90%) and 6 (90 to 100%). Total EASI score =0.1\*Ah\*(Eh+Ih+Exh+Lh) + 0.2\*Au\*(Eu+Iu+ExU+Lu) + 0.3\*At\*(Et+It+Ext+Lt) + 0.4\*Al\*(El+Il+Exl+Ll); A = EASI area score; E = erythema; I = induration/papulation; Ex = excoriation; L = lichenification; h = head and neck; u = upper limbs; t = trunk; l = lower limbs. Total EASI score ranged from 0.0 to 72.0, with higher scores indicating greater severity of AD.
Percentage of Participants Achieving Investigator's Global Assessment (IGA) Score of 'Clear' or 'Almost Clear' and >=2 Points Improvement From Baseline up to Week 26 Week 2, 4, 8, 12, 16, 20 and 26 IGA assessed severity of AD on a 5 point scale (0 to 4, higher scores indicate more severity). Scores: 0= clear, except any residual discoloration (post-inflammatory hyperpigmentation and/or hypopigmentation); 1= almost clear, AD not fully cleared- light pink residual lesions (except post-inflammatory hyperpigmentation), just perceptible erythema, papulation/induration lichenification, excoriation, and no oozing/crusting; 2= mild AD with light red lesions, slight but definite erythema, papulation/induration, lichenification, excoriation and no oozing/crusting; 3= moderate AD with red lesions, moderate erythema, papulation/induration, lichenification, excoriation and slight oozing/crusting; 4= severe AD with deep dark red lesions, severe erythema, papulation/induration, lichenification, excoriation and moderate to severe oozing/crusting.
Percent Change From Baseline in the SCORing Atopic Dermatitis (SCORAD) Total Score at Week 2, 4, 8, 12, 16, 20 and 26 Baseline (Day 1), Week 2, 4, 8, 12, 16, 20 and 26 SCORAD is a scoring index for AD which combined extent (A), severity (B) and subjective symptoms (C). For A, a rule of 9 was used to calculate BSA affected by AD as % of whole BSA for each body region- head and neck 9%; upper limbs 9% each; lower limbs 18% each; anterior trunk 18%; back 18%; genitals 1%. Score of each body region was added to determine A (range: 0-100). B: severity of each sign (erythema; edema/papulation; oozing/crusting; excoriation; skin thickening; dryness) was assessed as none (0), mild (1), moderate (2), severe (3); severity scores were added to give B (range: 0-18). C: pruritus and sleep loss, each of these 2 were scored by participant/caregiver using visual analog scale (VAS) where, 0=no itch/no sleep loss and 10=worst imaginable itch/sleep loss, higher scores=worse symptoms. Scores for itch and sleep loss were added to give 'C' (range: 0-20). SCORAD total score was calculated as: A/5+7\*B/2+C; range (0-103); higher values=worse outcome.
Change From Baseline in Medical Outcomes Study - Sleep Scale (MOS-Sleep Scale) at Week 12, 16 and 26 Baseline (Day 1), Week 12, 16 and 26 The MOS Sleep Scale is a 12-item measure that is segregated into subscales addressing seven sleep domains (i.e. sleep disturbance, snoring, short of breath or headache, adequacy of sleep, somnolence, sleep problems index I and sleep problems index II). An additional single item assessed quantity of sleep. Each of the sleep domains were scored on a range of 0 to 100, and higher scores indicated worse outcomes. The quantity of sleep scores ranged from 0 to 24 (number of hours slept). Change from baseline scores for each individual sleep domain and quantity of sleep are reported in this outcome measure.
Change From Baseline in Patient-Oriented Eczema Measure (POEM) Total Score at Week 12, 16 and 26 Baseline (Day 1), Week 12, 16 and 26 POEM was a 7-item participant reported outcome measure used to assess the impact of AD (dryness, itching, flaking, cracking, sleep loss, bleeding and weeping) over the past week. Each item was scored as: no days=0, 1-2 days=1, 3-4 days=2, 5-6 days=3 and every day=4. The item scores were added to provide a total score ranging from 0 to 28, where higher score indicated greater severity.
Change From Baseline in Skin Pain NRS at Week 2, 12, 16, 20 and 26 Baseline (Day 1), Week 2, 12, 16, 20 and 26 The skin pain NRS was a participant reported outcome where participants were asked to rate the "worst skin pain" in the past 24 hours on a 11-point scale from 0=no skin pain to 10=worst skin pain imaginable. Higher scores indicated worse pain.
Medicated Topical Background Therapy-free Days Day 1 up to Week 26 Medicated topical background therapy-free days was defined as number of days where a participant maintained a response of EASI-90 or greater without the use of medicated topical background therapy.
Percentage of Participants Achieving >=4 Points Improvement From Baseline in DLQI at Week 2, 12, 16, 20 and 26 Week 2, 12, 16, 20 and 26 DLQI was a 10-item questionnaire that measured the impact of skin disease. Each question was evaluated on a 4-point scale (range 0 to 3) where, 0 = not at all, 1= a little, 2= a lot, 3= very much, where higher scores indicated more impact on quality of life. Scores from all 10 questions were added up to give DLQI total score range from 0 (not at all) to 30 (very much). Higher scores indicated more impact on quality of life of participants.
Change From Baseline in Total Depression Score Measured Using the HADS at Week 12,16 and 26 Baseline (Day 1), Week 12, 16 and 26 HADS was a validated 14-item questionnaire to assess states of anxiety and depression over the past week. HADS consisted of 2 subscales: HADS-A scale and HADS-D scale, each of which comprised of 7 items. Each item was rated on a 4-point scale, with scores ranging from 0 to 3, where higher scores indicated more anxiety/depression symptoms. HADS-D assessed the state of lost interest and diminished pleasure response (lowering of hedonic tone). HADS-D: total score was calculated as the sum of all 7 items with score ranging from 0 (no presence of depression) to 21 (severe feeling of depression); higher score indicated greater severity of depression symptoms.
Change From Baseline in EuroQol Quality of Life 5-Dimension 5-Level (EQ-5D-5L) Visual Analog Scale (VAS) Score at Week 12, 16 and 26 Baseline (Day 1), Week 12, 16 and 26 The EQ-5D-5L is a self-reported health status questionnaire that consisted of six questions used to calculate a health utility score. There were two components to the EQ-5D-5L: a five-item health state profile that assessed mobility, self-care, usual activities, pain/discomfort, and anxiety/depression used to obtain an Index Utility Score, as well as a VAS that measured health state. EQ-5D VAS was used to record participant's rating for his/her current health-related quality of life state on a vertical VAS with scores ranging from 0 to 100, where 0 = worst imaginable health state and 100 = best imaginable health state.
Trial Locations
- Locations (149)
One Health Research Clinic
🇺🇸Norcross, Georgia, United States
Paddington Testing Co, Inc.
🇺🇸Philadelphia, Pennsylvania, United States
Centrum Medyczne Promed
🇵🇱Krakow, Poland
BeneDerma s.r.o.
🇸🇰Bratislava, Slovakia
The Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Karma Clinical Trials, Inc.
🇨🇦St. John's, Newfoundland and Labrador, Canada
Military Medical Academy MHAT Sofia
🇧🇬Sofia, Bulgaria
LLC J.Kisis
🇱🇻Riga, Latvia
Taipei Medical University-Shuang Ho Hospital
🇨🇳New Taipei City, Taiwan
Dawes Fretzin Clinical Research Group, LLC
🇺🇸Indianapolis, Indiana, United States
Center for Clinical Studies, LTD. LLP
🇺🇸Houston, Texas, United States
First OC Dermatology
🇺🇸Fountain Valley, California, United States
Clinical Neuroscience Solutions, Inc.
🇺🇸Memphis, Tennessee, United States
Wolverine Clinical Trials, Llc
🇺🇸Santa Ana, California, United States
Sinclair Dermatology
🇦🇺East Melbourne, Victoria, Australia
Miami Dermatology & Laser Research, LLC
🇺🇸Miami, Florida, United States
Sneeze, Wheeze & Itch Associates, LLC
🇺🇸Normal, Illinois, United States
Clinical Science Institute
🇺🇸Santa Monica, California, United States
Dundee Dermatology
🇺🇸West Dundee, Illinois, United States
The South Bend Clinic Center for Research
🇺🇸South Bend, Indiana, United States
Revival Research Institute, LLC
🇺🇸Troy, Michigan, United States
Boice-Willis Clinic, PA
🇺🇸Rocky Mount, North Carolina, United States
Onyx Clinical Research
🇺🇸Flint, Michigan, United States
International Clinical Research - Tennessee LLC
🇺🇸Murfreesboro, Tennessee, United States
Ark Clinical Research
🇺🇸Long Beach, California, United States
Integrated Clinical Research
🇺🇸West Palm Beach, Florida, United States
Hamzavi Dermatology
🇺🇸Fort Gratiot, Michigan, United States
Wallace Medical Group, Inc
🇺🇸Los Angeles, California, United States
Skin Care Research, LLC
🇺🇸Boca Raton, Florida, United States
Beach Allergy and Asthma Specialty Group, A Medical Corporation
🇺🇸Long Beach, California, United States
MedDerm Associates
🇺🇸San Diego, California, United States
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Avant Research Associates, LLC
🇺🇸Crowley, Louisiana, United States
Melbourne Health Radiology
🇦🇺Pakrville, Victoria, Australia
MetroBoston Clinical Partners, LLC
🇺🇸Brighton, Massachusetts, United States
Klinikum Bielefeld Rosenhöhe
🇩🇪Bielefeld, Germany
Health Concepts
🇺🇸Rapid City, South Dakota, United States
Psoriasis Treatment Center of Central New Jersey
🇺🇸East Windsor, New Jersey, United States
Linden Road Imaging Center
🇺🇸Flint, Michigan, United States
Vida lntegra
🇨🇱Nunoa, Santiago, Region Metropolitana, Chile
Mehiläinen Neo
🇫🇮Turku, Finland
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Dermatologische Gemeinschaftspraxis Dres. Quist
🇩🇪Mainz, Germany
Korea University Ansan Hospital
🇰🇷Ansan-si, Gyeonggi-do, Korea, Republic of
Centro de Especialidades Mollabao (Area Sanitaria de Pontevedra e O Salnes)
🇪🇸Pontevedra, Spain
Medicien
🇨🇱Las Condes, Santiago, Region Metropolitana, Chile
Hospital Clinico Universidad de Chile
🇨🇱Santiago, Region Metropolitana, Chile
Centro Internacional de Estudios Clinicos - CIEC
🇨🇱Santiago, Region Metropolitana, Chile
Klinische Forschung Dresden GmbH
🇩🇪Dresden, Germany
MIRES (M Y F Estudios Clinicos Limitada)
🇨🇱Nunoa, Santiago, Region Metropolitana, Chile
Centre de Recherche Saint-Louis
🇨🇦Quebec, Canada
Fachklinik Bad Bentheim
🇩🇪Bad Bentheim, Germany
Centro Radiologico Plaza Baquedano
🇨🇱Santiago, Region Metropolitana, Chile
Hospital de Montecelo
🇪🇸Pontevedra, Spain
SRH Wald-Klinikum Gera GmbH
🇩🇪Gera, Germany
SIBAmed GmbH
🇩🇪Leipzig, Germany
University Clinical Trials Inc.
🇺🇸San Diego, California, United States
Vivida Dermatology
🇺🇸Las Vegas, Nevada, United States
Dermatology Clinical Research Center of San Antonio
🇺🇸San Antonio, Texas, United States
Epiphany Dermatology of Kansas, LLC
🇺🇸Overland Park, Kansas, United States
Synergy Dermatology
🇺🇸San Francisco, California, United States
Clinical Research Center Of Alabama
🇺🇸Birmingham, Alabama, United States
Total Skin & Beauty Dermatology Center, PC
🇺🇸Birmingham, Alabama, United States
Alliance Dermatology & MOHS Center, PC
🇺🇸Phoenix, Arizona, United States
Skin Specialists, PC
🇺🇸Omaha, Nebraska, United States
Oregon Medical Research Center
🇺🇸Portland, Oregon, United States
Olympian Clinical Research
🇺🇸Tampa, Florida, United States
Clinical Research Trials of Florida, Inc.
🇺🇸Tampa, Florida, United States
Empire Clinical Research
🇺🇸Pomona, California, United States
University of California San Diego Dermatology
🇺🇸San Diego, California, United States
Regional Medical Imaging, P.C. ( Local X-Ray)
🇺🇸Royal Oak, Michigan, United States
Carolina Research Center, Inc.
🇺🇸Shelby, North Carolina, United States
Acclaim Dermatology, PLLC
🇺🇸Sugar Land, Texas, United States
Jordan Valley Dermatology Center
🇺🇸West Jordan, Utah, United States
St George Dermatology and Skin Cancer Centre
🇦🇺Kogarah, New South Wales, Australia
Royal North Shore Hospital
🇦🇺St Leonards, New South Wales, Australia
Skin Health Institute Inc.
🇦🇺Carlton, Victoria, Australia
Emeritus Research
🇦🇺Camberwell, Victoria, Australia
Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
MHAT Dobrich AD
🇧🇬Dobrich, Bulgaria
MC Asklepii OOD
🇧🇬Dupnitsa, Bulgaria
DCC Fokus-5 - Medical Establishment for Outpatient Care EOOD
🇧🇬Sofia, Bulgaria
DCC Alexandrovska EOOD
🇧🇬Sofia, Bulgaria
Dermatology Research Institute
🇨🇦Calgary, Alberta, Canada
Alberta DermaSurgery Centre
🇨🇦Edmonton, Alberta, Canada
CARE Clinic Ltd
🇨🇦Red Deer, Alberta, Canada
Dr. Chih-ho Hong Medical Inc
🇨🇦Surrey, British Columbia, Canada
Wiseman Dermatology Research Inc.
🇨🇦Winnipeg, Manitoba, Canada
DermEffects
🇨🇦London, Ontario, Canada
Kingsway Clinical Research
🇨🇦Etobicoke, Ontario, Canada
Lynderm Research Inc.
🇨🇦Markham, Ontario, Canada
DermEdge Research
🇨🇦Mississauga, Ontario, Canada
North Bay Dermatology Centre
🇨🇦North Bay, Ontario, Canada
Dermatology Ottawa Research Centre
🇨🇦Ottawa, Ontario, Canada
The Centre for Clinical Trials
🇨🇦Oakville, Ontario, Canada
SKiN Centre for Dermatology
🇨🇦Peterborough, Ontario, Canada
Medicor Research Inc
🇨🇦Sudbury, Ontario, Canada
The Centre for Dermatology
🇨🇦Richmond Hill, Ontario, Canada
Toronto Research Centre
🇨🇦Toronto, Ontario, Canada
Sudbury Skin Clinique
🇨🇦Sudbury, Ontario, Canada
Centre de Recherche Dermatologique du Quebec metropolitain
🇨🇦Quebec, Canada
Intermed groupe santé
🇨🇦Chicoutimi, Quebec, Canada
Centro Medico SkinMed Limitada
🇨🇱Santiago, Region Metropolitana, Chile
Turun yliopistollinen keskussairaala
🇫🇮Turku, Finland
Clínica Dermacross S.A.
🇨🇱Santiago, Región Metropolitana, Chile
Terveystalo Tampere
🇫🇮Tampere, Finland
IKF Pneumologie GmbH & Co KG
🇩🇪Frankfurt am Main, Germany
Studienzentrum Dr. med. Beate Schwarz
🇩🇪Langenau, Germany
Universitätsklinikum Schleswig-Holstein, Campus Lübeck
🇩🇪Lübeck, Germany
Debreceni Egyetem Klinikai Központ
🇭🇺Debrecen, Hungary
Clinexpert Kft.
🇭🇺Budapest, Hungary
University of Muenster
🇩🇪Muenster, Germany
Fondazione Policlinico Universitario A. Gemelli IRCCS Universita Cattolica del Sacro Cuore
🇮🇹Roma, Italy
Trial Pharma Kft.
🇭🇺Kaposvár, Hungary
Szegedi Tudományegyetem Szent-Györgyi Albert Klinikai Központ
🇭🇺Szeged, Hungary
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea, Incheon St. Mary's Hospital
🇰🇷Incheon, Korea, Republic of
Health Centre 4 Ltd. Diagnostics Centre
🇱🇻Riga, Latvia
Chung-Ang University Hospital
🇰🇷Seoul, Korea, Republic of
Outpatient Clinic of Ventspils
🇱🇻Ventspils, Latvia
NZOZ Specjalistyczny Osrodek Dermatologiczny DERMAL s.c.
🇵🇱Bialystok, Poland
MCBK
🇵🇱Grodzisk Mazowiecki, Poland
Niepubliczny Zaklad Opieki Zdrowotnej "DERMED" Centrum Medyczne
🇵🇱Lodz, Poland
DERMAPOLIS Medical Dermatology Center
🇵🇱Chorzow, Poland
Uniwersyteckie Centrum Kliniczne
🇵🇱Gdansk, Poland
Krakowskie Centrum Medyczne Sp. z o.o.
🇵🇱Krakow, Poland
Care Clinic Centrum Medyczne
🇵🇱Katowice, Poland
Centrum Terapii Wspolczesnej J.M. Jasnorzewska Spolka Komandytowo-Akcyjna
🇵🇱Lodz, Poland
Dermedic Jacek Zdybski
🇵🇱Ostrowiec Swietokrzyski, Poland
Gabinety Lekarskie Rivermed
🇵🇱Poznan, Poland
Spolka Cywilna Andrzej Krolicki, Tomasz Kochanowski, ,,Laser Clinic"
🇵🇱Szczecin, Poland
Twoja Przychodnia - Szczecinskie Centrum Medyczne
🇵🇱Szczecin, Poland
Medycyna Kliniczna
🇵🇱Warszawa, Poland
MTZ Clinical Research Sp. z o.o.
🇵🇱Warszawa, Poland
Carpe Diem Centrum Medycyny Estetycznej
🇵🇱Warszawa, Poland
Cityclinic Przychodnia Lekarsko Psychologiczna Matusiak Spółka Partnerska
🇵🇱Wroclaw, Poland
EMC Instytut Medyczny S.A. Przychodnia przy ul. Lowieckiej
🇵🇱Wroclaw, Poland
Centrum Medyczne Oporow
🇵🇱Wroclaw, Poland
Kliniczny Oddzial Chorob Wewnetrznych, Dermatologii i Alergologii
🇵🇱Zabrze, Poland
SUMMIT CLINICAL RESEARCH, s.r.o.
🇸🇰Bratislava, Slovakia
SKINKLINIK s.r.o
🇸🇰Bratislava, Slovakia
Hospital Germans Trias i Pujol
🇪🇸Badalona, Barcelona, Spain
Derma therapy spol. s.r.o.
🇸🇰Bratislava, Slovakia
Dermatovenerologicka ambulancia
🇸🇰Nove Zamky, Slovakia
SANARE spol.s.r.o.
🇸🇰Svidnik, Slovakia
Taipei Veterans General Hospital
🇨🇳Taipei City, Taiwan (r.o.c), Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Chonnam National University Hospital
🇰🇷Gwangju, Korea, Republic of
Accel Research Sites - Pure Skin Dermatology & Aesthetics
🇺🇸Orlando, Florida, United States