A Clinical Study of Efinopegdutide in Participants With Precirrhotic Nonalcoholic Steatohepatitis (NASH) (MK-6024-013)
- Conditions
- Non-alcoholic Fatty Liver DiseaseFatty Liver, NonalcoholicNAFLDNonalcoholic Fatty Liver DiseaseNonalcoholic Steatohepatitis
- Interventions
- Registration Number
- NCT05877547
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
The purpose of this study is to learn how well efinopegdutide works compared to placebo in people who have non-alcoholic steatohepatitis (NASH). Researchers will also learn about the safety and benefit of efinopegdutide and how well people tolerate the medicine. The main goal of the study is to compare how many people taking efinopegdutide or placebo stop showing evidence of NASH without liver scarring getting worse.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 360
- Histological confirmation of NASH, defined as NAFLD Activity Score (NAS) ≥4 with a score ≥1 point in each component (steatosis, ballooning, and lobular inflammation) AND NASH clinical research network (CRN) fibrosis score of Stage 2 or 3
- No history of Type 2 diabetes mellitus (T2DM) OR a history of T2DM with an A1C ≤9% that is controlled by diet or stable doses of antihyperglycemic agents (AHAs)
- Participants in South Korea are eligible between the ages of 19 to 80 years of age (inclusive)
- History of liver disease other than NASH
- History or evidence of cirrhosis
- History of pancreatitis
- History of Type 1 diabetes mellitus (T1DM), diabetic ketoacidosis, or diabetes secondary to pancreatectomy
- History of a bariatric surgical procedure ≤5 years before study entry, or a known clinically significant gastric emptying abnormality
- Has significant systemic or major illnesses, including recent events (≤6 months before study entry) of congestive heart failure, unstable angina, myocardial infarction, arterial revascularization, stroke, or transient ischemic attack
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Placebo Placebo administered by SC injection once weekly for 52 weeks Efinopegdutide 7mg Efinopegdutide Efinopegdutide administered by SC injection once weekly for 52 weeks in a dose-escalation regimen of 2 mg for 4 weeks, 4 mg for 4 weeks, and 7 mg for 44 weeks. Efinopegdutide 10mg Efinopegdutide Efinopegdutide administered by SC injection once weekly for 52 weeks in a dose-escalation regimen of 2 mg for 4 weeks, 4 mg for 4 weeks, 7 mg for 4 weeks, and 10 mg for 40 weeks. Semaglutide 2.4 mg Semaglutide Semaglutide administered by SC injection once weekly for 52 weeks in a dose-escalation regimen of 0.25 mg for 4 weeks, 0.5 mg for 4 weeks, 1.0 mg for 4 weeks, 1.7 mg for 4 weeks, and 2.4 mg for 36 weeks. Efinopegdutide 4mg Efinopegdutide Efinopegdutide administered by subcutaneous (SC) injection once weekly for 52 weeks in a dose-escalation regimen of 2 mg for 4 weeks and 4mg for 48 weeks.
- Primary Outcome Measures
Name Time Method Percentage of Participants With Nonalcoholic Steatohepatitis (NASH) Resolution Without Worsening of Fibrosis At Week 52 Week 52 The NASH Clinical Research Network (CRN) scoring system evaluated by Blinded Independent Central Review (BICR) is used to assess treatment response. The NASH CRN scoring scales are: lobular inflammation score (0-3); hepatocyte ballooning score (0-2); steatosis score (0-3); and fibrosis score (0-4). NASH resolution is defined as a score of 0-1 for inflammation, 0 for ballooning, and any grade of steatosis.
Percentage of Participants Who Experienced an Adverse Event (AE) Up to 60 weeks An adverse event (AE) is a health problem that happens or worsens during a study.
Percentage of Participants Discontinuing Study Medication Due to an AE Up to 52 weeks An adverse event (AE) is a health problem that happens or worsens during a study.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With ≥1 Stage Improvement in Fibrosis Without Worsening of Steatohepatitis At Week 52 Week 52 Participants will be assessed using the NASH CRN scoring system evaluated by BICR for ≥1-stage improvement in fibrosis without worsening of steatohepatitis. Fibrosis is scored from stage 0 to 4 where 0 = None, 1=Perisinusoidal OR periportal, 2=Perisinusoidal AND portal/periportal, 3= Bridging fibrosis, 4=Cirrhosis. No worsening of steatohepatitis is defined as no increase in the ballooning, inflammation, or steatosis scores.
Change from Baseline in Body Weight At Week 52 Week 52 Body weight (kg) will be measured using a standardized, digital scale. The percent change from baseline in body weight after 52 weeks will be reported.
Trial Locations
- Locations (175)
Indago Research & Health Center, Inc ( Site 3207)
🇺🇸Hialeah, Florida, United States
Sweet Hope Research Specialty, Inc-Research ( Site 3200)
🇺🇸Hialeah, Florida, United States
Velocity Clinical Research, Syracuse ( Site 3227)
🇺🇸East Syracuse, New York, United States
Singapore General Hospital ( Site 2188)
🇸🇬Singapore, Central Singapore, Singapore
Eagle Clinical Research ( Site 3233)
🇺🇸Chicago, Illinois, United States
Houston Research Institute ( Site 3262)
🇺🇸Houston, Texas, United States
Genoma Research Group ( Site 3242)
🇺🇸Miami, Florida, United States
The Machuca Foundation ( Site 3234)
🇺🇸Las Vegas, Nevada, United States
Velocity Clinical Research, Cincinnati ( Site 3237)
🇺🇸Cincinnati, Ohio, United States
American Research Corporation ( Site 3202)
🇺🇸San Antonio, Texas, United States
Pinnacle Clinical Research ( Site 3284)
🇺🇸San Antonio, Texas, United States
Om Research - Apple Valley ( Site 3244)
🇺🇸Apple Valley, California, United States
Barzilai Medical Center ( Site 1306)
🇮🇱Ashkelon, Israel
Hospital Universitario "Dr. Jose Eleuterio Gonzalez" ( Site 1604)
🇲🇽Monterrey, Nuevo Leon, Mexico
Unidade Local de Saúde do Alto Ave - Hospital Senhora da Oliveira ( Site 1905)
🇵🇹Guimaraes, Braga, Portugal
Unidade Local de Saude Lisboa Ocidental - Hospital Egas Moniz ( Site 1906)
🇵🇹Lisbon, Lisboa, Portugal
Unidade Local de Saude de Santa Maria - Hospital de Santa Maria ( Site 1904)
🇵🇹Lisbon, Lisboa, Portugal
St James's University Hospital ( Site 3005)
🇬🇧Leeds, United Kingdom
The Institute for Liver Health II dba Arizona Clinical Trial-The Institute for Liver Health ( Site 3
🇺🇸Chandler, Arizona, United States
The Institute for Liver Health II dba Arizona Clinical Trials - Peoria ( Site 3289)
🇺🇸Peoria, Arizona, United States
The Institute for Liver Health II dba Arizona Liver Health-Tucson ( Site 3218)
🇺🇸Tucson, Arizona, United States
Del Sol Research Management, LLC ( Site 3211)
🇺🇸Tucson, Arizona, United States
Om Research LLC ( Site 3245)
🇺🇸Camarillo, California, United States
Velocity Clinical Research, Gardena ( Site 3225)
🇺🇸Gardena, California, United States
Velocity Clinical Research, Huntington Park ( Site 3217)
🇺🇸Huntington Park, California, United States
Velocity Clinical Research, San Diego ( Site 3226)
🇺🇸La Mesa, California, United States
Om Research LLC ( Site 3229)
🇺🇸Lancaster, California, United States
Velocity Clinical Research, Westlake ( Site 3216)
🇺🇸Los Angeles, California, United States
California Liver Research Institute ( Site 3232)
🇺🇸Pasadena, California, United States
Velocity Clinical Research, Panorama City ( Site 3214)
🇺🇸Panorama City, California, United States
Excel Medical Clinical Trials ( Site 3246)
🇺🇸Boca Raton, Florida, United States
Synergy Healthcare ( Site 3286)
🇺🇸Bradenton, Florida, United States
Synergy Healthcare LLC ( Site 3290)
🇺🇸Brandon, Florida, United States
Top Medical Research ( Site 3209)
🇺🇸Cutler Bay, Florida, United States
Covenant Metabolic Specialists, LLC ( Site 3231)
🇺🇸Fort Myers, Florida, United States
Velocity Clinical Research, Hallandale Beach ( Site 3241)
🇺🇸Hallandale Beach, Florida, United States
Floridian Clinical Research, LLC ( Site 3203)
🇺🇸Miami Lakes, Florida, United States
University of Iowa ( Site 3213)
🇺🇸Iowa City, Iowa, United States
Southeast Clinical Research Center ( Site 3288)
🇺🇸Dalton, Georgia, United States
Florida Research Institute ( Site 3243)
🇺🇸Lakewood Ranch, Florida, United States
New York Gastroenterology Associates ( Site 3252)
🇺🇸New York, New York, United States
Velocity Clinical Research, Dallas ( Site 3220)
🇺🇸Dallas, Texas, United States
Velocity Clinical Research, Salt Lake City ( Site 3223)
🇺🇸West Jordan, Utah, United States
Velocity Clinical Research, Providence ( Site 3222)
🇺🇸East Greenwich, Rhode Island, United States
South Texas Research Institute - Brownsville ( Site 3285)
🇺🇸Brownsville, Texas, United States
Gastroenterology Consultants of Southwest Virginia ( Site 3282)
🇺🇸Roanoke, Virginia, United States
Antwerp University Hospital-Gastr-enterologie/hepatologie ( Site 3300)
🇧🇪Edegem, Antwerpen, Belgium
Medizinische Universität Graz-Department of Internal Medicine ( Site 0302)
🇦🇹Graz, Steiermark, Austria
AZ Maria Middelares-Digestief Centrum ( Site 3301)
🇧🇪Gent, Oost-Vlaanderen, Belgium
Heritage Medical Research Clinic ( Site 0403)
🇨🇦Calgary, Alberta, Canada
UZ Leuven-Hepatology ( Site 3302)
🇧🇪Leuven, Vlaams-Brabant, Belgium
Toronto General Hospital ( Site 0402)
🇨🇦Toronto, Ontario, Canada
Vancouver General Hospital-Gastroenterology ( Site 0408)
🇨🇦Vancouver, British Columbia, Canada
McGill University Health Centre ( Site 0400)
🇨🇦Montréal, Quebec, Canada
Diex Recherche Quebec Inc. ( Site 0409)
🇨🇦Quebec, Canada
Enroll SpA ( Site 0501)
🇨🇱Providencia, Region M. De Santiago, Chile
CECIM ( Site 0500)
🇨🇱Santiago, Region M. De Santiago, Chile
Pontificia Universidad Catolica de Chile-CICUC ( Site 0502)
🇨🇱Santiago, Region M. De Santiago, Chile
The First Affiliated Hospital, Sun Yat-sen University ( Site 0603)
🇨🇳Guangzhou, Guangdong, China
Beijing Youan Hospital ( Site 0602)
🇨🇳Beijing, Beijing, China
Beijing Tsinghua Changgung Hospital ( Site 0606)
🇨🇳Beijing, Beijing, China
Chongqing University Three Gorges Hospital ( Site 0607)
🇨🇳Wanzhou, Chongqing, China
Southern Medical University Nanfang Hospital ( Site 0601)
🇨🇳Guangzhou, Guangdong, China
No. 2 Hospital of Nanjing ( Site 0605)
🇨🇳Nanjing, Jiangsu, China
West China Hospital, Sichuan University ( Site 0611)
🇨🇳Cheng Du, Sichuan, China
Tianjin Second People's Hospital ( Site 0604)
🇨🇳Tianjin, Tianjin, China
Fundación Centro de Investigación Clínica CIC ( Site 0704)
🇨🇴Medellín, Antioquia, Colombia
Sociedad De Oncología y Hematología Del Cesar SAS ( Site 0708)
🇨🇴Valledupar, Cesar, Colombia
The First Affiliated Hospital of Wenzhou Medical University ( Site 0609)
🇨🇳Wenzhou, Zhejiang, China
Oncomédica S.A.S ( Site 0702)
🇨🇴Montería, Cordoba, Colombia
Fundacion Santa Fe de Bogota ( Site 0701)
🇨🇴Bogotá, Cundinamarca, Colombia
Solano & Terront Servicios Medicos - UNIENDO ( Site 0705)
🇨🇴Bogotá, Cundinamarca, Colombia
KlinMed ( Site 0801)
🇨🇿Prague, Praha 2, Czechia
Krajská nemocnice Liberec ( Site 0800)
🇨🇿Liberec, Czechia
Vseobecna fakultni nemocnice v Praze ( Site 0802)
🇨🇿Praha 2, Czechia
CHU Charles Nicolle ( Site 0910)
🇫🇷Rouen, Haute-Normandie, France
Centre Hospitalier Universitaire de Nice - Hôpital l'Archet-Pôle de Référence Hépato Gastro-entérol
🇫🇷Nice, Alpes-Maritimes, France
Hôpital Beaujon-Hépatologie ( Site 0908)
🇫🇷Clichy, Hauts-de-Seine, France
CHU Bordeaux Haut-Leveque-Service d'Hépato-gastroentérologie ( Site 0904)
🇫🇷Pessac, Aquitaine, France
Centre Hospitalier Universitaire d'Angers-Hepato Gastroenterology ( Site 0900)
🇫🇷Angers, Maine-et-Loire, France
Hôpital Saint Antoine ( Site 0914)
🇫🇷Paris, France
Hopitaux Universitaires Paris Centre-Hopital Cochin-Service HEPATOLOGIE- Recherche Clinique ( Site 0
🇫🇷Paris, France
Centre Hospitalier Universitaire Estaing ( Site 0913)
🇫🇷Clermont-Ferrand, Puy-de-Dome, France
Hôpital de la Croix Rousse-Centre de Recherche Clinique ( Site 0911)
🇫🇷Lyon, Rhone-Alpes, France
centre hospitalier lyon sud-Endocrinologie, Diabète et Nutrition ( Site 0906)
🇫🇷Pierre-Bénite, Rhone-Alpes, France
SYNEXUS Magyarország Kft. Eü. ( Site 1110)
🇭🇺Budapest, Hungary
Dél-Pesti Centrumkórház-Hepatologiai Szakrendekő ( Site 1102)
🇭🇺Budapest, Hungary
Rambam Health Care Campus ( Site 1304)
🇮🇱Haifa, Israel
Carmel Hospital ( Site 1305)
🇮🇱Haifa, Israel
Shaare Zedek Medical Center-Liver Unit ( Site 1302)
🇮🇱Jerusalem, Israel
Rabin Medical Center ( Site 1301)
🇮🇱Petah Tikva, Israel
Sheba Medical Center ( Site 1300)
🇮🇱Ramat Gan, Israel
Maccabi Health Services - Ramat Hasharon ( Site 1303)
🇮🇱Ramat Hasharon, Israel
Fondazione Policlinico Universitario Agostino Gemelli IRCCS -Dipartimento di Medicina Interna e Gas
🇮🇹Roma, Lazio, Italy
Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico ( Site 1403)
🇮🇹Milano, Lombardia, Italy
Humanitas-Medicina interna ed Epatologia ( Site 1400)
🇮🇹Rozzano, Lombardia, Italy
A.O.U. Policlinico Paolo Giaccone-Dep. Of Internal Medicine and Specialistic ( Site 1402)
🇮🇹Palermo, Sicilia, Italy
Azienda Ospedaliero-Universitaria Città della Salute e della-S.C. Gastroenterologia U. ( Site 1401)
🇮🇹Torino, Italy
Ehime University Hospital ( Site 1509)
🇯🇵Toon, Ehime, Japan
Kurume University Hospital ( Site 1504)
🇯🇵Kurume, Fukuoka, Japan
Ogaki Municipal Hospital ( Site 1511)
🇯🇵Ogaki, Gifu, Japan
Kagawa University Hospital ( Site 1515)
🇯🇵Kita, Kagawa, Japan
Toranomon Hospital Kajigaya ( Site 1502)
🇯🇵Kawasaki, Kanagawa, Japan
Sapporo Kosei General Hospital ( Site 1521)
🇯🇵Sapporo, Hokkaido, Japan
Kagawa Prefectural Central Hospital ( Site 1514)
🇯🇵Takamatsu, Kagawa, Japan
Nara Medical University Hospital ( Site 1513)
🇯🇵Kashihara, Nara, Japan
Shinyurigaoka General Hospital ( Site 1518)
🇯🇵Kawasaki, Kanagawa, Japan
St. Marianna University Hospital ( Site 1516)
🇯🇵Kawasaki, Kanagawa, Japan
Yokohama City University Hospital ( Site 1505)
🇯🇵Yokohama, Kanagawa, Japan
Shinshu University Hospital ( Site 1512)
🇯🇵Matsumoto, Nagano, Japan
Toranomon Hospital ( Site 1501)
🇯🇵Minato-ku, Tokyo, Japan
Osaka Saiseikai Suita Hospital ( Site 1503)
🇯🇵Suita, Osaka, Japan
Fukuiken Saiseikai Hospital ( Site 1507)
🇯🇵Fukui, Japan
Gifu Municipal Hospital ( Site 1506)
🇯🇵Gifu, Japan
University Hospital,Kyoto Prefectural University of Medicine ( Site 1519)
🇯🇵Kyoto, Japan
Kawasaki Medical School General Medical Center ( Site 1508)
🇯🇵Okayama, Japan
Osaka Metropolitan University Hospital ( Site 1520)
🇯🇵Osaka, Japan
Saga University Hospital ( Site 1510)
🇯🇵Saga, Japan
Japanese Red Cross Musashino Hospital ( Site 1517)
🇯🇵Tokyo, Japan
Boramae Medical Center-Internal Medicine ( Site 2403)
🇰🇷Dongjak-gu, Seoul, Korea, Republic of
Inha University Hospital-Gastroenterolgy/Hepatology ( Site 2402)
🇰🇷Incheon, Korea, Republic of
Medica Sur-Clinica de Enfermedades Digestivas y Obesidad ( Site 1603)
🇲🇽Mexico City, Distrito Federal, Mexico
Samsung Medical Center-Gastroenterology/Internal Medicine ( Site 2400)
🇰🇷Seoul, Korea, Republic of
Servicios de Oncología Médica Integral - Monterrey ( Site 1611)
🇲🇽Monterrey, Nuevo Leon, Mexico
ICARO Investigaciones en Medicina ( Site 1608)
🇲🇽Chihuahua, Mexico
Centro de investigacion Clínica Trujillo ( Site 1802)
🇵🇪Trujillo, La Libertad, Peru
Centro de Investigación y Gastroenterología - S.C. ( Site 1609)
🇲🇽Mexico City, Mexico
Oaxaca Site Management Organization ( Site 1613)
🇲🇽Oaxaca, Mexico
Centro de Investigacion Clinica de Oaxaca ( Site 1607)
🇲🇽Oaxaca, Mexico
CLINICA DELGADO-Clinical Research ( Site 1800)
🇵🇪Miraflores, Lima, Peru
Centro de Investigación y Gastroenterología ( Site 1601)
🇲🇽Cuauhtemoc, Mexico
Instituto Médico Soy Diabetico ( Site 1804)
🇵🇪Piura, Peru
ULSAM - Hospital de Santa Luzia ( Site 1907)
🇵🇹Viana do Castelo, Portugal
ISIS CLINICAL RESEARCH CENTER ( Site 2006)
🇵🇷Guaynabo, Puerto Rico
Pan American Center for Oncology Trials ( Site 2000)
🇵🇷Rio Piedras, Puerto Rico
Klinical Investigations Group-Clinical Research ( Site 2001)
🇵🇷San Juan, Puerto Rico
Latin Clinical Trial Center ( Site 2004)
🇵🇷San Juan, Puerto Rico
Hospital Universitario Marqués de Valdecilla-Gastroenterology and Hepatology ( Site 2505)
🇪🇸Santander, Cantabria, Spain
Hospital General de Tomelloso-Aparato Digestivo ( Site 2514)
🇪🇸Tomelloso, Ciudad Real, Spain
Hospital Universitario Virgen de la Victoria-UGC Endocrinologia y nutricion ( Site 2506)
🇪🇸Malaga, Andalucia, Spain
CHUAC-Complejo Hospitalario Universitario A Coruña-Endocrinología ( Site 2511)
🇪🇸A Coruña, La Coruna, Spain
Hospital Universitari Vall d'Hebron-Liver Unit - Department of Internal Medicine ( Site 2507)
🇪🇸Barcelona, Spain
CHUS - Hospital Clinico Universitario ( Site 2503)
🇪🇸Santiago de Compostela, La Coruna, Spain
Hospital Universitario Ramón y Cajal ( Site 2508)
🇪🇸Madrid, Madrid, Comunidad De, Spain
HOSPITAL UNIVERSITARIO VIRGEN DEL ROCIO-Unidad de Ensayos Clínicos de Aparato Digestivo ( Site 2504)
🇪🇸Sevilla, Spain
Cantonal Hospital St.Gallen-Klinik für Gastroenterologie / Hepatologie ( Site 2601)
🇨🇭St.Gallen, Sankt Gallen, Switzerland
Hospital Universitario La Paz-HEPATOLOGIA ( Site 2509)
🇪🇸Madrid, Spain
HOSPITAL UNIVERSITARIO PUERTA DE HIERRO MAJADAHONDA-Gastroenterologia y Hepatologia ( Site 2500)
🇪🇸Madrid, Spain
Fondazione Epatocentro Ticino ( Site 2602)
🇨🇭Lugano, Ticino, Switzerland
UniversitätsSpital Zürich-Gastroenterologie & Hepatologie ( Site 2603)
🇨🇭Zürich, Zurich, Switzerland
Changhua Christian Hospital-Endocrinology and metabolism ( Site 2704)
🇨🇳Changhua County, Changhua, Taiwan
Chiayi Christian Hospital ( Site 2707)
🇨🇳Chiayi City, Chiayi, Taiwan
Taichung Veterans General Hospital ( Site 2703)
🇨🇳Taichung, Taiwan
National Cheng Kung University Hospital-Liver Research team of National Cheng Kung University Hospi
🇨🇳Tainan, Taiwan
National Taiwan University Hospital-Internal Medicine ( Site 2700)
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital-Division of Gastroenterology & Hepatology, Department of Medicine (
🇨🇳Taipei, Taiwan
Chang Gung Medical Foundation-Linkou Branch ( Site 2702)
🇨🇳Taoyuan, Taiwan
Maharaj Nakorn Chiang Mai Hospital ( Site 2801)
🇹🇭Muang, Chiang Mai, Thailand
Chulalongkorn University ( Site 2800)
🇹🇭Bangkok, Krung Thep Maha Nakhon, Thailand
Royal London Hospital ( Site 3003)
🇬🇧London, England, United Kingdom
Dokuz Eylul Universitesi Hastanesi-Gastroenterology ( Site 2905)
🇹🇷İzmir, Turkey
Faculty of Medicine Siriraj Hospital-Department of Medicine ( Site 2802)
🇹🇭Bangkok, Krung Thep Maha Nakhon, Thailand
Hacettepe Universite Hastaneleri-internal diseases ( Site 2901)
🇹🇷Ankara, Turkey
Bezmialem Vakf Üniversitesi-Gastroenterology ( Site 2903)
🇹🇷Istanbul, Turkey
T.C. Sağlik Bakanliği- Marmara Üniversitesi İstanbul Pendik -T.C. Sağlik Bakanliği- Marmara Ünivers
🇹🇷Istanbul, Turkey
Recep Tayyip Erdogan University Training and Research Hospital ( Site 2900)
🇹🇷Rize, Turkey
King's College Hospital ( Site 3002)
🇬🇧London, London, City Of, United Kingdom
Aberdeen Royal Infirmary-Department of Gastroenterology ( Site 3004)
🇬🇧Aberdeen, Scotland, United Kingdom
Queen Elizabeth Hospital Birmingham ( Site 3000)
🇬🇧Birmingham, Warwickshire, United Kingdom
Severance Hospital, Yonsei University Health System ( Site 2401)
🇰🇷Seoul, Korea, Republic of
Clinical Trials Research ( Site 3230)
🇺🇸Sacramento, California, United States
Kansas City Research Institute ( Site 3249)
🇺🇸Kansas City, Missouri, United States
Velocity Clinical Research, Austin ( Site 3235)
🇺🇸Austin, Texas, United States
Fundación Valle del Lili ( Site 0700)
🇨🇴Cali, Valle Del Cauca, Colombia
Prince of Wales Hospital ( Site 1000)
🇭🇰Shatin, Hong Kong