A Study Comparing Upadacitinib (ABT-494) to Placebo and to Adalimumab in Participants With Psoriatic Arthritis Who Have an Inadequate Response to at Least One Non-Biologic Disease Modifying Anti-Rheumatic Drug (DMARD)
- Conditions
- Psoriatic Arthritis
- Interventions
- Registration Number
- NCT03104400
- Lead Sponsor
- AbbVie
- Brief Summary
This study includes two periods. The main objective of Period 1 is to compare the efficacy of upadacitinib 15 mg once daily (QD) and 30 mg QD versus placebo and versus adalimumab (Humira®) in participants with moderately to severely active psoriatic arthritis (PsA) who have had an inadequate response to non-biologic DMARDs (DMARD-IR). Period 1 is also designed to compare the efficacy of upadacitinib 15 mg and 30 mg QD versus placebo for the prevention of structural progression.
The objective of Period 2 is to evaluate the long-term safety, tolerability and efficacy of upadacitinib 15 mg and 30 mg QD in participants who have completed Period 1.
- Detailed Description
The study includes a 35-day screening period, a 56-week blinded period (Period 1), a long-term extension period of up to a total treatment duration of approximately 5 years (Period 2), a 30-day follow-up call or visit, and a 70-day follow-up call.
Period 1 includes 24 weeks of randomized, double-blind, placebo-controlled and active comparator-controlled treatment followed by 32 weeks of active comparator-controlled upadacitinib; at Week 24 participants assigned to placebo will be switched to upadacitinib according to their randomization assignment.
Participants who meet eligibility criteria will be randomized in a 2:2:2:1:1 ratio to one of five treatment groups:
* Group 1: Upadacitinib 15 mg QD
* Group 2: Upadacitinib 30 mg QD
* Group 3: Adalimumab 40 mg every other week (EOW)
* Group 4: Placebo followed by upadacitinib 15 mg QD
* Group 5: Placebo followed by upadacitinib 30 mg QD
Randomization will be stratified by extent of psoriasis (≥ 3% body surface area \[BSA\] or \< 3% BSA), current use of at least 1 non-biologic DMARD, presence of dactylitis, and presence of enthesitis, except for participants from China and Japan, where randomization for each country will be stratified by extent of psoriasis (≥ 3% BSA or \< 3% BSA) only.
Participants who complete the Week 56 visit (end of Period 1) will enter the long-term extension portion of the study, Period 2 (total treatment up to approximately 5 years), and continue study treatment as assigned in Period 1 in a blinded manner until the last subject completes the last visit of Period 1 (Week 56), when study drug assignment in both periods will be unblinded and participants will be dispensed study drug in an open-label fashion until the completion of Period 2.
At Week 16, rescue therapy will be offered to participants classified as non-responders (defined as not achieving at least 20% improvement in tender joint count (TJC) and / or swollen joint count (SJC) at both Week 12 and Week 16). Starting at Week 36, participants who fail to demonstrate at least 20% improvement in either or both TJC and SJC compared to Baseline at 2 consecutive visits will be discontinued from study drug treatment. Additionally, in participants continuing on study drug, starting at the Week 36 visit, initiation of or change in background PsA medication(s) is allowed as per local label.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1705
-
Clinical diagnosis of PsA with symptom onset at least 6 months prior to the Screening Visit and fulfillment of the Classification Criteria for PsA (CASPAR) criteria.
-
Participant has active disease at Baseline defined as >= 3 tender joints (based on 68 joint counts) and >= 3 swollen joints (based on 66 joint counts) at Screening and Baseline Visits.
-
Presence of either at Screening:
- >= 1 erosion on x-ray as determined by central imaging review or;
- high-sensitivity C-reactive protein (hs-CRP) > laboratory defined upper limit of normal (ULN).
-
Diagnosis of active plaque psoriasis or documented history of plaque psoriasis.
-
Participant has had an inadequate response (lack of efficacy after a minimum 12 week duration of therapy) to previous or current treatment with at least 1 non-biologic DMARD at maximally tolerated dose (methotrexate (MTX), sulfasalazine (SSZ), leflunomide (LEF), cyclosporine, apremilast, bucillamin or iguratimod), or participant has an intolerance to or contraindication for DMARDs as defined by the investigator.
-
Participant who is on current treatment with concomitant non-biologic DMARDs at study entry must be on <= 2 non-biologic DMARDs (except the combination of MTX and leflunomide). The following non-biologic DMARDs are allowed: MTX, sulfasalazine, leflunomide, apremilast, hydroxychloroquine (HCQ) , bucillamine or iguratimod, and have been ongoing for >= 12 weeks and at stable dose for >= 4 weeks prior to the Baseline Visit. No other DMARDs are permitted during the study.
i. Participants who need to discontinue DMARDs prior to the Baseline Visit to comply with this inclusion criterion must follow the procedure specified below or at least five times the mean terminal elimination half-life of a drug:
- >= 8 weeks for LEF if no elimination procedure was followed, or adhere to an elimination procedure (i.e., 11 days with cholestyramine, or 30 days washout with activated charcoal or as per local label);
- >= 4 weeks for all others.
- Prior exposure to any Janus Kinase (JAK) inhibitor (including but not limited to ruxolitinib, tofacitinib, baricitinib, and filgotinib).
- Current treatment with > 2 non-biologic DMARDs; or use of DMARDs other than methotrexate, sulfasalazine, leflunomide, apremilast, hydroxychloroquine, bucillamine, or iguratimod; or use of methotrexate in combination with leflunomide.
- History of fibromyalgia, any arthritis with onset prior to age 17 years, or current diagnosis of inflammatory joint disease other than PsA (including, but not limited to rheumatoid arthritis, gout, overlap connective tissue diseases, scleroderma, polymyositis, dermatomyositis, systemic lupus erythematosus). Prior history of reactive arthritis or axial spondyloarthritis including ankylosing spondylitis and nonradiographic axial spondyloarthritis is permitted if documentation of change in diagnosis to PsA or additional diagnosis of PsA is made. Prior history of fibromyalgia is permitted if documentation of change in diagnosis to PsA or documentation that the diagnosis of fibromyalgia was made incorrectly.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo / Upadacitinib 15 mg Placebo to Upadacitinib Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 15 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 15 mg once daily. Placebo / Upadacitinib 15 mg Placebo to Adalimumab Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 15 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 15 mg once daily. Placebo / Upadacitinib 30 mg Placebo to Adalimumab Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 30 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 30 mg once daily. Placebo / Upadacitinib 30 mg Placebo to Upadacitinib Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 30 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 30 mg once daily. Upadacitinib 15 mg Upadacitinib Period 1: Participants receive upadacitinib 15 mg orally once a day (QD) and matching placebo to adalimumab by subcutaneous injection every other week (EOW) for 56 weeks. Period 2: Participants will continue to receive upadacitinib 15 mg once daily. Adalimumab Placebo to Upadacitinib Period 1: Participants receive adalimumab 40 mg by subcutaneous injection every other week and matching placebo to upadacitinib orally QD for 56 weeks. Period 2: Participants continue to receive adalimumab 40 mg every other week. Upadacitinib 30 mg Placebo to Adalimumab Period 1: Participants receive upadacitinib 30 mg orally once a day and matching placebo to adalimumab by subcutaneous injection every other week for 56 weeks. Period 2: Participants will continue to receive upadacitinib 30 mg once daily. Upadacitinib 15 mg Placebo to Adalimumab Period 1: Participants receive upadacitinib 15 mg orally once a day (QD) and matching placebo to adalimumab by subcutaneous injection every other week (EOW) for 56 weeks. Period 2: Participants will continue to receive upadacitinib 15 mg once daily. Adalimumab Adalimumab Period 1: Participants receive adalimumab 40 mg by subcutaneous injection every other week and matching placebo to upadacitinib orally QD for 56 weeks. Period 2: Participants continue to receive adalimumab 40 mg every other week. Upadacitinib 30 mg Upadacitinib Period 1: Participants receive upadacitinib 30 mg orally once a day and matching placebo to adalimumab by subcutaneous injection every other week for 56 weeks. Period 2: Participants will continue to receive upadacitinib 30 mg once daily. Placebo / Upadacitinib 15 mg Upadacitinib Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 15 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 15 mg once daily. Placebo / Upadacitinib 30 mg Upadacitinib Period 1: Participants receive matching placebo to upadacitinib orally once a day for 24 weeks then upadacitinib 30 mg once daily for 32 weeks, and matching placebo to adalimumab by subcutaneous injection EOW for the entire 56 weeks. Period 2: Participants will continue to receive upadacitinib 30 mg once daily.
- Primary Outcome Measures
Name Time Method Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 12 Baseline and Week 12 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).
- Secondary Outcome Measures
Name Time Method Change From Baseline in Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 12 Baseline and Week 12 The Health Assessment Questionnaire - Disability Index is a patient-reported questionnaire that measures the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and errands and chores) over the past week. Participants assessed their ability to do each task on a scale from 0 (without any difficulty) to 3 (unable to do). Scores were averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 represents very severe, high-dependency disability.
A negative change from Baseline in the overall score indicates improvement.Percentage of Participants Achieving a Static Investigator Global Assessment (sIGA) of Psoriasis of 0 or 1 and at Least a 2-point Improvement From Baseline (sIGA 0/1) at Week 16 Baseline and Week 16 The sIGA is a 5 point scale ranging from 0 to 4, based on the investigator's assessment of the average elevation, erythema, and scaling of all psoriatic lesions at the current visit. A lower score indicates less severe psoriasis (0 = clear, 1 = almost clear, 2 = mild, 3 = moderate and 4 = severe).
Percentage of Participants Achieving Psoriasis Area Severity Index (PASI) 75 Response at Week 16 Baseline and Week 16 PASI is a composite score based on the percentage of the body surface area (BSA) affected by psoriasis and the intensity of erythema (reddening), induration (thickening or hardening of the skin), and desquamation (peeling of the skin) of lesions assessed at 4 anatomic sites (head, upper extremities, trunk, and lower extremities). At each location, the percentage of BSA involvement is assigned a score from 0 (no involvement) to 6 (90% to 100% involvement), and erythema, induration, and desquamation are scored on a scale from 0 (no symptoms) to 4 (very marked).
The PASI score ranges from 0 (no psoriasis) to 72 (very severe psoriasis). A PASI-75 response is the percentage of participants who achieved at least a 75% reduction (improvement) from Baseline in PASI score, and was assessed in participants with Baseline psoriasis BSA involvement ≥ 3%.Percentage of Participants With Resolution of Enthesitis at Week 24 Week 24 Resolution of enthesitis is defined as a Leeds Enthesitis Index (LEI) score = 0.
LEI is an enthesitis measure developed specifically for PsA and assesses the presence or absence of tenderness at the following 3 bilateral enthesial sites: medial femoral condyles, lateral epicondyles of the humerus, and Achilles tendon insertions. Tenderness on examination is recorded as either present (coded as 1), absent (coded as 0), or not assessed for each of the 6 sites. The LEI is calculated by taking the sum of the scores from the 6 sites. The LEI ranges from 0 to 6 (worst).Change From Baseline in Modified PsA Total Sharp/Van Der Heijde Score (mTSS) at Week 24 Baseline and Week 24 The Sharp-van der Heijde modified scoring method for PsA measures the level of joint damage from radiographs of the hands and feet, and was assessed by 2 independent, blinded readers.
Joint erosion severity was assessed in 20 joints in each hand and wrist and 6 joints in each foot. Each joint was scored from 0 (no erosion) to 5 for hands/wrists or to 10 for feet (complete collapse). The total erosion score ranges from 0 to 320 (worst).
Joint space narrowing (JSN) was assessed in 20 joints of each hand and wrist, and 6 joints of each foot, from 0 (normal) to 4 (complete loss of joint space, bony ankylosis, or luxation). The total JSN score ranges from 0 to 208 (worst).
Joints with gross osteolysis or pencil in cup were assigned the maximum score for both erosions and JSN.
The total mTSS score is the sum of the joint erosion and JSN scores and ranges from 0 (normal) to 528 (worst). A negative change from Baseline indicates improvement in joint damage.Percentage of Participants With an ACR20 Response at Week 12 - Non-inferiority Versus Adalimumab Baseline and Week 12 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants Achieving Minimal Disease Activity (MDA) at Week 24 Week 24 A participant was classified as achieving MDA if 5 of the following 7 criteria were met:
* Tender joint count (out of 68 joints) ≤ 1
* Swollen joint count (out of 66 joints) ≤ 1
* PASI score ≤ 1 (score ranges from 0 - 72) or percent BSA involved with psoriasis ≤ 3%
* Patient's assessment of pain ≤ 1.5 (NRS from 0 to 10)
* Patient's Global Assessment of disease activity ≤ 2 (NRS from 0 to 10)
* HAQ-DI score ≤ 0.5 (index score ranges from 0 to 3)
* Leeds Enthesitis Index ≤ 1 (assesses the presence or absence of enthesitis at 3 bilateral sites, with an overall score range from 0 to 6)Change From Baseline in Short-Form 36 (SF-36) Physical Component Score (PCS) at Week 12 Baseline and Week 12 The Short Form 36-Item Health Survey (SF-36) Version 2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health).
The physical component score is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The PCS was calculated using norm-based scoring so that 50 is the average score and the standard deviation equals 10. Higher scores are associated with better functioning/quality of life; a positive change from Baseline score indicates an improvement.Change From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Score at Week 12 Baseline and Week 12 The FACIT-Fatigue questionnaire is a self-administered patient questionnaire that consists of 13 questions designed to measure the degree of fatigue experienced by participants in the previous 7 days, including physical fatigue (e.g., I feel tired), functional fatigue (e.g., trouble finishing things), emotional fatigue (e.g., frustration), and social consequences of fatigue (e.g., limits social activity). Participants respond to the questions on a scale from 0 'not at all' to 4 'very much'. The FACIT Fatigue score is computed by summing the item scores, after reversing those items that are worded in the negative direction. The FACIT-Fatigue subscale score ranges from 0 to 52, where higher scores represent less fatigue. A positive change from Baseline indicates improvement.
Percentage of Participants With an ACR20 Response at Week 12 - Superiority Versus Adalimumab Baseline and Week 12 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants With Resolution of Dactylitis at Week 24 Week 24 Resolution of dactylitis is defined as a Leeds Dactylitis Index (LDI) score = 0.
The Leeds Dactylitis Index (LDI) is a score based on finger circumference and tenderness, assessed and summed across all dactylitic digits (fingers and toes). The presence of a dactylitic digit is defined as at least one affected AND tender digit with circumference increase over reference digit ≥ 10%. The reference digit circumference is either the contralateral digit (unaffected digit on opposite hand or foot) if available, or from a standard reference table if otherwise. Tenderness of affected digits is assessed on a scale from 0 \[none\] to 3 \[worst\].
The ratio of circumference between an affected digit and reference digit is multiplied by the tenderness score for each affected digit. The results from each involved digit are summed to provide the final LDI. A higher LDI indicates worse dactylitis.Change From Baseline in Patient's Assessment of Pain - Superiority Versus Adalimumab Baseline and Week 12 Participants were asked to indicate the severity of their arthritis pain within the previous week on a numerical rating scale (NRS) from 0 to 10. A score of 0 indicates "no pain" and a score of 10 indicates "worst possible pain." A negative change from Baseline indicates improvement.
Change From Baseline in HAQ-DI - Superiority Versus Adalimumab Baseline and Week 12 The Health Assessment Questionnaire - Disability Index is a patient-reported questionnaire that measures the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and errands and chores) over the past week. Participants assessed their ability to do each task on a scale from 0 (without any difficulty) to 3 (unable to do). Scores were averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 represents very severe, high-dependency disability.
A negative change from Baseline in the overall score indicates improvement.Change From Baseline in Self-Assessment of Psoriasis Symptoms (SAPS) Questionnaire at Week 16 Baseline and Week 16 The SAPS is an 11-item self-assessment of psoriasis symptoms that includes questions on: pain, itching, redness, scaling, flaking, bleeding, burning, stinging, tenderness, pain due to skin cracking, and joint pain. Each item is scored from 0 to 10, with 0 being least severe and 10 being most severe. The total score is generated by summing the 11 items and ranges from 0 to 110 (worst). A negative change from Baseline in the total score indicates improvement.
Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 12 Baseline and Week 12 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria:
1. ≥ 50% improvement in 68-tender joint count;
2. ≥ 50% improvement in 66-swollen joint count; and
3. ≥ 50% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 12 Baseline and Week 12 Participants who met the following 3 conditions for improvement from baseline were classified as meeting the ACR70 response criteria:
1. ≥ 70% improvement in 68-tender joint count;
2. ≥ 70% improvement in 66-swollen joint count; and
3. ≥ 70% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 2 Baseline and Week 2 Participants who met the following 3 conditions for improvement from baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).
Trial Locations
- Locations (345)
Great Lakes Clinical Trials /ID# 163435
🇺🇸Chicago, Illinois, United States
1st Aff Hosp of Bengbu Medical College /ID# 201021
🇨🇳Bengbu, Anhui, China
The First Affiliated Hospital of Shantou University Medical College /ID# 203371
🇨🇳Shantou, Guangdong, China
Zhuzhou Central Hospital /ID# 200201
🇨🇳Zhuzhou, Hunan, China
The First Affiliated Hospital of Baotou Medical College, Inner Monggolia Univers /ID# 171204
🇨🇳Baotou, Inner Mongolia, China
The First People's Hospital of Linyi /ID# 201970
🇨🇳Linyi, Shandong, China
Ningbo First Hospital /ID# 201874
🇨🇳Ningbo, Zhejiang, China
People's Hospital of Xinjiang /ID# 201592
🇨🇳Urumqi, China
Covina Arthritis Clinic /ID# 159891
🇺🇸Covina, California, United States
Graves Gilbert Clinic /ID# 161285
🇺🇸Bowling Green, Kentucky, United States
Deerbrook Medical Associates /ID# 159804
🇺🇸Vernon Hills, Illinois, United States
Four Rivers Clinical Research /ID# 159982
🇺🇸Paducah, Kentucky, United States
MetroHealth Medical Center /ID# 159888
🇺🇸Cleveland, Ohio, United States
Cape Fear Arthritis Care /ID# 161224
🇺🇸Leland, North Carolina, United States
Diagnostic Group Integrated He /ID# 159794
🇺🇸Beaumont, Texas, United States
Adriana Pop-Moody MD Clinic PA /ID# 159984
🇺🇸Corpus Christi, Texas, United States
Metroplex Clinical Research /ID# 159785
🇺🇸Dallas, Texas, United States
Arth and Osteo Clin Brazo Valley /ID# 163436
🇺🇸College Station, Texas, United States
Rheumatic Disease Clin Res Ctr /ID# 161240
🇺🇸Houston, Texas, United States
Arthritis & Osteoporosis Clinic /ID# 159786
🇺🇸Waco, Texas, United States
Arthritis Clinic of Central TX /ID# 164049
🇺🇸San Marcos, Texas, United States
Swedish Medical Center /ID# 159890
🇺🇸Seattle, Washington, United States
Arthritis Clinic of N. VA, P.C /ID# 159849
🇺🇸Arlington, Virginia, United States
Arthritis Northwest, PLLC /ID# 166380
🇺🇸Spokane, Washington, United States
Arthritis and Rheum Clin N. CO /ID# 160039
🇺🇸Fort Collins, Colorado, United States
Colorado Arthritis Associates /ID# 159847
🇺🇸Lakewood, Colorado, United States
Hospital de Clinicas de Porto Alegre /ID# 161820
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
LMK Sevicos Medicos S/S /ID# 161812
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Tufts Medical Center /ID# 165144
🇺🇸Boston, Massachusetts, United States
Precision Research Org, LLC /ID# 161287
🇺🇸Miami Lakes, Florida, United States
Johns Hopkins University /ID# 167665
🇺🇸Baltimore, Maryland, United States
AZ Arth & Rheum Res /ID# 166381
🇺🇸Tucson, Arizona, United States
International Medical Research - Daytona /ID# 160040
🇺🇸Daytona Beach, Florida, United States
Gulf Region Clinical Res Inst /ID# 159851
🇺🇸Pensacola, Florida, United States
Mansfield Health Center /ID# 159805
🇺🇸Mansfield, Massachusetts, United States
Institute of Arthritis Researc /ID# 165873
🇺🇸Idaho Falls, Idaho, United States
Centro Integral de Medicina Respiratoria (CIMER) /ID# 211237
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
SunValley Arthritis Center, Lt /ID# 161221
🇺🇸Peoria, Arizona, United States
The Center for Rheumatology & Bone Research /ID# 159874
🇺🇸Wheaton, Maryland, United States
Organizacion Medica de Investigacion (OMI) /ID# 160118
🇦🇷Buenos Aires, Argentina
Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto - USP /ID# 163273
🇧🇷Ribeirao Preto, Sao Paulo, Brazil
Reg Gen Univ Hosp Larissa /ID# 163496
🇬🇷Larisa, Greece
Little Rock Diagnostics Clinic /ID# 165161
🇺🇸Little Rock, Arkansas, United States
Florida Medical Clinic /ID# 159992
🇺🇸Zephyrhills, Florida, United States
UMHAT Sv. Ivan Rilski /ID# 202393
🇧🇬Sofia, Bulgaria
Synexus Magyarorszag Kft. - Zalaegerszeg AS /ID# 201884
🇭🇺Zalaegerszeg, Zala, Hungary
P. Stradins Clinical Univ Hosp /ID# 164442
🇱🇻Riga, Latvia
Erasmus Medisch Centrum /ID# 161092
🇳🇱Rotterdam, Netherlands
Chung Shan Medical University /ID# 159403
🇨🇳Taichung, Taiwan
Linkou Chang Gung Memorial Ho /ID# 166221
🇨🇳Taoyuan City, Taiwan
Barwon Rheumatology /ID# 166782
🇦🇺Geelong, Victoria, Australia
Medical Centre Synexus Sofia, branch Stara Zagora /ID# 202524
🇧🇬Stara Zagora, Bulgaria
Centro Inter Estud Clin CIEC /ID# 168725
🇨🇱Santiago, Chile
Slovak research center Team Member, Thermium s.r.o. /ID# 166489
🇸🇰Pieštany, Slovakia
Dartmouth-Hitchcock Medical Center /ID# 161235
🇺🇸Lebanon, New Hampshire, United States
Ctr. de Recherche Musculo-Sque /ID# 207069
🇨🇦Trois-rivières, Quebec, Canada
CEMEC - Centro Multidisciplinar de Estudos Clínicos do ABC /ID# 161810
🇧🇷Santo André, Sao Paulo, Brazil
Qualiclinic Kft. /ID# 163278
🇭🇺Budapest III, Pest, Hungary
NZOZ Nasz Lekarz /ID# 163774
🇵🇱Toruń, Kujawsko-pomorskie, Poland
HFR Fribourg - Hopital Canton /ID# 162090
🇨🇭Fribourg, Switzerland
Winelands Medical Research Ctr /ID# 163853
🇿🇦Stellenbosch, Western Cape, South Africa
Revita Reumatologiai Rendelo /ID# 163277
🇭🇺Budapest, Hungary
Synexus Magyarorszag Kft. /ID# 203012
🇭🇺Budapest, Hungary
Azienda Unita Sanitaria Locale/IRCCS c/o Arcispedale Santa Maria Nuova /ID# 161090
🇮🇹Reggio Emilia, Emilia-Romagna, Italy
Middlemore Hospital /ID# 166414
🇳🇿Auckland, New Zealand
LLC Medical Center /ID# 164529
🇷🇺Novosibirsk, Novosibirskaya Oblast, Russian Federation
Odessa National Medical Univ /ID# 164244
🇺🇦Odesa, Ukraine
National Taiwan University Hospital /ID# 160878
🇨🇳Taipei City, Taiwan
Necmettin Erbakan Universitesi /ID# 163382
🇹🇷Meram Konya, Turkey
China Medical University Hosp /ID# 159402
🇨🇳Taichung City, Taichung, Taiwan
State Institution L. T. Malaya Therapy National Institution of NAMS of Ukraine /ID# 164170
🇺🇦Kharkiv, Kharkivska Oblast, Ukraine
Kotha and Kotha /ID# 159823
🇺🇸La Mesa, California, United States
Advanced Clinical Research /ID# 159894
🇺🇸Meridian, Idaho, United States
TriWest Research Associates- La Mesa /ID# 159887
🇺🇸La Mesa, California, United States
Rheum Assoc of North Alabama /ID# 163231
🇺🇸Huntsville, Alabama, United States
University of California, Los Angeles /ID# 164542
🇺🇸Los Angeles, California, United States
Medallion Clinical Research Institute, LLC /ID# 161228
🇺🇸Naples, Florida, United States
Millennium Research /ID# 159822
🇺🇸Ormond Beach, Florida, United States
W. Broward Rheum Assoc Inc. /ID# 161388
🇺🇸Tamarac, Florida, United States
OrthoIllinois /ID# 164546
🇺🇸Rockford, Illinois, United States
Clinical Investigation Specialists - Skokie /ID# 160062
🇺🇸Skokie, Illinois, United States
Atlantic Coast Research /ID# 159799
🇺🇸Toms River, New Jersey, United States
"DMCR-Texas Cent for Drug Dev /ID# 164191
🇺🇸Houston, Texas, United States
Altoona Ctr Clinical Res /ID# 159852
🇺🇸Duncansville, Pennsylvania, United States
Trinity Universal Research Association /ID# 205721
🇺🇸Plano, Texas, United States
Arthritis and Osteoporosis Associates /ID# 159802
🇺🇸Freehold, New Jersey, United States
Shores Rheumatology, PC /ID# 159889
🇺🇸Saint Clair Shores, Michigan, United States
Advanced Rheumatology, PC /ID# 159893
🇺🇸Lansing, Michigan, United States
Aa Mrc Llc /Id# 159846
🇺🇸Grand Blanc, Michigan, United States
Clayton Medical Associates dba Saint Louis Rheumatology /ID# 159878
🇺🇸Saint Louis, Missouri, United States
Beals Institute PC /ID# 163128
🇺🇸Lansing, Michigan, United States
Glacier View Research Institut /ID# 167023
🇺🇸Kalispell, Montana, United States
St. Luke's Hospital of Duluth /ID# 165671
🇺🇸Duluth, Minnesota, United States
Clinical Pharmacology Study Gr /ID# 158700
🇺🇸Worcester, Massachusetts, United States
Clinvest Research LLC /ID# 161227
🇺🇸Springfield, Missouri, United States
DM Clinical Research /ID# 161735
🇺🇸Tomball, Texas, United States
The Ohio State University /ID# 159892
🇺🇸Columbus, Ohio, United States
Ctr for Arth and Rheum Disease /ID# 159830
🇺🇸Chesapeake, Virginia, United States
Clinical Research Source, Inc. /ID# 164545
🇺🇸Perrysburg, Ohio, United States
Rheumatology Clinic of Houston /ID# 161234
🇺🇸Houston, Texas, United States
West Tennessee Research Inst /ID# 159871
🇺🇸Jackson, Tennessee, United States
Accurate Clinical Management /ID# 159905
🇺🇸Baytown, Texas, United States
Shanahan Rheuma & Immuno /ID# 159987
🇺🇸Raleigh, North Carolina, United States
Rheumatology Consultants, PLLC /ID# 159796
🇺🇸Knoxville, Tennessee, United States
American Health Research /ID# 164354
🇺🇸Charlotte, North Carolina, United States
Ocean Rheumatology, PA /ID# 163898
🇺🇸Toms River, New Jersey, United States
Santa Fe Rheumatology /ID# 163783
🇺🇸Santa Fe, New Mexico, United States
St. Lawrence Health System /ID# 159848
🇺🇸Potsdam, New York, United States
Trinity Health Med Arts Clinic /ID# 159800
🇺🇸Minot, North Dakota, United States
NYU Langone Medical Center /ID# 163230
🇺🇸New York, New York, United States
Physicians East, PA /ID# 159872
🇺🇸Greenville, North Carolina, United States
Arthritis and Osteo Assoc /ID# 159994
🇺🇸Las Cruces, New Mexico, United States
STAT Research, Inc. /ID# 161392
🇺🇸Vandalia, Ohio, United States
PA Regional Center /ID# 165670
🇺🇸Wyomissing, Pennsylvania, United States
PCCR Solution /ID# 205723
🇺🇸Colleyville, Texas, United States
Hospital General de Agudos Ram /ID# 164378
🇦🇷Buenos Aires, Argentina
Dr. Ramesh Gupta /ID# 160061
🇺🇸Memphis, Tennessee, United States
West Virginia Research Inst /ID# 159791
🇺🇸South Charleston, West Virginia, United States
Aurora Rheumatology and Immunotherapy Center /ID# 160043
🇺🇸Franklin, Wisconsin, United States
University Clinical Centre of the Republic of Srpska /ID# 164503
🇧🇦Banja Luka, Republika Srpska, Bosnia and Herzegovina
Emeritus Research Sydney /ID# 166780
🇦🇺Botany, New South Wales, Australia
Centro Medico Privado/Reuma /ID# 159775
🇦🇷San Miguel de Tucuman, Ciuadad Autonoma De Buenos Aires, Argentina
Inst. de Rehab. Psicofisica /ID# 165154
🇦🇷Caba, Argentina
Centro de Enfermedades del Hígado y Aparato Digestivo /ID# 165795
🇦🇷Santa Fe, Argentina
CIP - Centro Internacional de Pesquisa /ID# 161821
🇧🇷Goiânia, Goias, Brazil
Department of Rheumatology, Mu /ID# 169606
🇧🇬Plovdiv, Bulgaria
Psoriahue Med Interdisciplinar /ID# 160506
🇦🇷Buenos Aires, Argentina
Instituto CAICI /ID# 160119
🇦🇷Rosario, Santa FE, Argentina
Centro Integral de Medicina Re /ID# 160258
🇦🇷SAN Miguel DE Tucuman, Latam, Argentina
Brest Regional Hospital /ID# 164535
🇧🇾Brest, Belarus
Healthcare Institution /ID# 164536
🇧🇾Grodno, Belarus
First City Clinical Hospital /ID# 164534
🇧🇾Minsk, Belarus
Reuma clinic /ID# 164243
🇧🇪Genk, Belgium
University Clinical Hospital Mostar /ID# 165799
🇧🇦Mostar, Bosnia and Herzegovina
Clinical Center University of Sarajevo /ID# 164502
🇧🇦Sarajevo, Bosnia and Herzegovina
Instituto de Ciencias Farmacêuticas /ID# 163274
🇧🇷Aparecida de Goiania, Goias, Brazil
The Queen Elizabeth Hospital /ID# 169333
🇦🇺Woodville, South Australia, Australia
CMiP - Centro Mineiro de Pesquisa Ltda - ME /ID# 161819
🇧🇷Juiz de Fora, Minas Gerais, Brazil
Excelsior Medical Center /ID# 169609
🇧🇬Sofia, Bulgaria
Diagnostic Consultative Center /ID# 169607
🇧🇬Varna, Bulgaria
Faculdade de Medicina do ABC /ID# 163491
🇧🇷Santo André, Sao Paulo, Brazil
EDUMED Educacao em Saude S/S L /ID# 161816
🇧🇷Curitiba, Parana, Brazil
CPCLIN - Centro de Pesquisas Clínicas /ID# 161818
🇧🇷Sao Paulo, Brazil
Instituto de Educação e Pesquisa do Hospital Moinhos de Vento /ID# 161813
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Clinica Dermacross S.A /ID# 168726
🇨🇱Vitacura Santiago, Chile
Ciads /Id# 157831
🇨🇦Winnipeg, Manitoba, Canada
The Waterside Clinic /ID# 157826
🇨🇦Barrie, Ontario, Canada
Percuro Clinical Research, Ltd /ID# 157823
🇨🇦Victoria, British Columbia, Canada
Groupe de Recherche en Maladies Osseuses Inc /ID# 157824
🇨🇦Sainte-foy, Quebec, Canada
M y F Estudios Clínicos Ltda. /ID# 168722
🇨🇱Ñuñoa, Region Metropolitana De Santiago, Chile
CTR Estudios SpA /ID# 206217
🇨🇱Providencia, Chile
Prosalud Ltda. /ID# 169546
🇨🇱Santiago, Chile
Porter Rheumatology Ltd /ID# 200421
🇳🇿Nelson, New Zealand
Salve Medica Sp. z o.o. S.K. /ID# 206300
🇵🇱Lodz, Lodzkie, Poland
Malopolskie Centrum Kliniczne /ID# 163777
🇵🇱Cracow, Malopolskie, Poland
Synexus Polska Sp. z o.o. Oddzial w Gdansku /ID# 206299
🇵🇱Gdańsk, Pomorskie, Poland
ETYKA-Osrodek Badan Klinicznyc /ID# 163776
🇵🇱Olsztyn, Warminsko-mazurskie, Poland
Krakowskie Centrum Medyczne /ID# 206302
🇵🇱Krakow, Poland
Centro Hospitalar Lisboa Norte, EPE /ID# 165860
🇵🇹Lisboa, Portugal
Ponce Medical School Foundation /ID# 163920
🇵🇷Ponce, Puerto Rico
Family Outpatient clinic#4 LLC /ID# 164530
🇷🇺Korolev, Moskva, Russian Federation
Ctr Int de Reum del Caribe SAS /ID# 164051
🇨🇴Barranquilla, Colombia
Revmatologicka ambulance /ID# 159671
🇨🇿Prague 4, Praha 4, Czechia
Medical Plus, s.r.o. /ID# 159635
🇨🇿Uherské Hradište, Czechia
Hospital Pablo Tobon Uribe /ID# 164233
🇨🇴Medellín, Colombia
Medical Center Kuna-Peric /ID# 161160
🇭🇷Zagreb, Croatia
Timaru Rheumatology Studies /ID# 166413
🇳🇿Timaru, New Zealand
Helse Forde /ID# 167853
🇳🇴Forde, Sogn Og Fjordane, Norway
St. Olavs Hospital HF /ID# 163321
🇳🇴Trondheim, Sor-Trondelag, Norway
Hospital Universitario A Coruña - CHUAC /ID# 161129
🇪🇸A Coruña, A Coruna, Spain
Cruz-Santana, Carolina, PR /ID# 163307
🇵🇷Carolina, Puerto Rico
Reumatologická ambulancia Reum.hapi s.r.o. /ID# 166486
🇸🇰Nové Mesto Nad Váhom, Slovakia
Hospital Campus de la Salud /ID# 170760
🇪🇸Granada, Spain
Clinic ORTO /ID# 161486
🇱🇻Riga, Latvia
Taipei Veterans General Hosp /ID# 166222
🇨🇳Taipei City, Taiwan
Hospital Universitario Ramon y Cajal /ID# 161130
🇪🇸Madrid, Spain
CINTRE, Centro de Investigación y Tratamiento Reumatológico SC /ID# 164006
🇲🇽Mexico City, Ciudad De Mexico, Mexico
Invest y Biomed de Chihuahua /ID# 164007
🇲🇽Chihuahua, Mexico
Medisch Centrum Leeuwarden /ID# 161575
🇳🇱Leeuwarden, Netherlands
Rheumazentrum Ruhrgebiet /ID# 163930
🇩🇪Herne, Nordrhein-Westfalen, Germany
Immanuel-Krankenhaus /ID# 163931
🇩🇪Berlin-buch, Germany
Polikilinik fuer Rheumatologie /ID# 163933
🇩🇪Duesseldorf, Germany
Synexus Polska Sp. z o.o. Oddzial w Poznaniu /ID# 207158
🇵🇱Poznan, Poland
Reumatika - Centrum Reumatologii NZOZ /ID# 161831
🇵🇱Warsaw, Poland
Centro Hospitalar de Vila Nova Gaia/Espinho, EPE /ID# 165862
🇵🇹Vila Nova De Gaia, Porto, Portugal
Hacettepe Universitesi Tip Fak /ID# 162518
🇹🇷Sihhiye, Ankara, Turkey
Bakirkoy Dr. Sadi Konuk Training & Research Hospital /ID# 162517
🇹🇷Istanbul, Turkey
Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi /ID# 163383
🇹🇷Istanbul, Turkey
Sakarya Universitesi Egitim /ID# 163397
🇹🇷Sakarya, Turkey
Hospital Universitario 12 de Octubre /ID# 163198
🇪🇸Madrid, Spain
Cukurova Universitesi Tip Fakultesi /ID# 162516
🇹🇷Saricam Adana, Adana, Turkey
MediTrials /ID# 163706
🇪🇪Tartu, Tartumaa, Estonia
State budgetary institution /ID# 164532
🇷🇺St. Petersburg, Russian Federation
Institute for Rheumatology /ID# 166223
🇷🇸Belgrade, Beograd, Serbia
MEDMAN s.r.o. /ID# 165892
🇸🇰Martin, Slovakia
Univ Medical Ctr Ljubljana /ID# 164212
🇸🇮Ljubljana, Slovenia
Arthritis Clinical Research Tr /ID# 163855
🇿🇦Cape Town, Western Cape, South Africa
Greenacres Hospital /ID# 164190
🇿🇦Port Elizabeth, Eastern Cape, South Africa
Kantonsspital St. Gallen /ID# 158131
🇨🇭St. Gallen, Sankt Gallen, Switzerland
Vital Medical Center Orvosi-es Fogaszati Kozpont /ID# 163275
🇭🇺Veszprem, Hungary
St Vincent's University Hosp /ID# 161073
🇮🇪Dublin, Ireland
Hospital of the University of Occupational and Environmental Health /ID# 161473
🇯🇵Kitakyushu-shi, Fukuoka, Japan
Mie University Hospital /ID# 162080
🇯🇵Tsu-shi, Mie, Japan
National Hospital Organization Osaka Minami Medical Center /ID# 162590
🇯🇵Kawachinagano-shi, Osaka, Japan
Inha University Hospital /ID# 163890
🇰🇷Jung-gu, Incheon Gwang Yeogsi, Korea, Republic of
D.Saulites-Kandevicas PP in Cardiology and Rheumatology /ID# 161488
🇱🇻Liepaja, Latvia
Public Institution Republican /ID# 165155
🇱🇹Siauliai, Lithuania
Hospital Tuanku Ja afar /ID# 161096
🇲🇾Seremban, Malaysia
Waikato Hospital /ID# 166415
🇳🇿Hamilton, Waikato, New Zealand
Centro de Investigacion en Reumatologia CIREEM /ID# 166030
🇨🇴Bogota, Cundinamarca, Colombia
Poliklinika Repromed /ID# 203555
🇭🇷Zagreb, Grad Zagreb, Croatia
Klinicki bolnicki centar Rijeka /ID# 161159
🇭🇷Rijeka, Primorsko-goranska Zupanija, Croatia
Poliklinika Bonifarm /ID# 206662
🇭🇷Zagreb, Croatia
East Tallinn Central Hospital /ID# 163790
🇪🇪Tallinn, Estonia
Dr. med. Jochen Walter FA fuer /ID# 168638
🇩🇪Rendsburg, Germany
West China Hospital /ID# 200199
🇨🇳Chengdu, Sichuan, China
The First Affiliated Hospital of Soochow University /ID# 201875
🇨🇳Soochow, China
Shanghai Changhai Hospital /ID# 200202
🇨🇳Shanghai, Shanghai, China
Institute for Rheumatology /ID# 166229
🇷🇸Belgrade, Beograd, Serbia
University Medical Ctr Maribor /ID# 169260
🇸🇮Maribor, Slovenia
General Hospital Murska Sobota /ID# 164211
🇸🇮Murska Sobota, Slovenia
Wits Clinical Research Site /ID# 163919
🇿🇦Johannesburg, Gauteng, South Africa
Fundacion Centro de Investigac /Id# 168201
🇨🇴Antioquia, Colombia
University Clinic Carl Gustav /ID# 163926
🇩🇪Dresden, Germany
Betegapolo Irgalmas Rend - Budai Irgalmasrendi Korhaz /ID# 170719
🇭🇺Budapest, Hungary
Med. Universitaetsklinik Inner /ID# 163929
🇩🇪Tuebingen, Germany
General Hospital of Athens Laiko /ID# 163478
🇬🇷Athens, Attiki, Greece
Instituto Jalisciense de Metabolismo SC /ID# 164005
🇲🇽Guadalajara, Jalisco, Mexico
Debreceni Egyetem Kenezy Gyula /ID# 163276
🇭🇺Debrecen, Hungary
Croom Orthopaedic Hospital /ID# 164998
🇮🇪Limerick, Ireland
Azienda Ospedaliera Universitaria Policlinico "G. Rodolico - San Marco" /Id# 161084
🇮🇹Catania, Italy
Ajou University Hospital /ID# 163891
🇰🇷Suwon-si, Gyeonggido, Korea, Republic of
Klaipeda University Hospital /ID# 167258
🇱🇹Klaipeda, Lithuania
First Affiliated Hospital of Kunming Medical University /ID# 201264
🇨🇳Kunming, China
Affiliated hospital of nantong university /ID# 208234
🇨🇳Nantong, China
Preventive Care Sas /Id# 163781
🇨🇴Chia, Colombia
Center of Clinical and Basic Research /ID# 163870
🇪🇪Tallinn, Harjumaa, Estonia
Cent fur Innovative Diagnostik /ID# 163927
🇩🇪Frankfurt, Germany
General Hospital of Athens Laiko /ID# 163476
🇬🇷Athens, Attiki, Greece
University General Hospital Attikon /ID# 163477
🇬🇷Athens, Attiki, Greece
Naval Hospital of Athens /ID# 163486
🇬🇷Athens, Greece
Revmatologie Bruntal, s.r.o /ID# 159636
🇨🇿Bruntál, Czechia
Revmatologicka ambulance /ID# 159637
🇨🇿Prague 4, Praha 4, Czechia
Artroscan s.r.o. /ID# 159634
🇨🇿Ostrava, Czechia
Ospedali Riuniti Universita /ID# 161085
🇮🇹Ancona, Italy
Nagoya City University Hospital /ID# 162564
🇯🇵Nagoya-shi, Aichi, Japan
Fukuoka University Hospital /ID# 162086
🇯🇵Fukuoka-shi, Fukuoka, Japan
St.Luke's International Hospital /ID# 162016
🇯🇵Chuo-ku, Tokyo, Japan
Singapore General Hospital /ID# 161094
🇸🇬Singapore, Central Singapore, Singapore
Tan Tock Seng Hospital /ID# 161095
🇸🇬Singapore, Singapore
Policlinico Universitario Campus Bio-Medico /ID# 162306
🇮🇹Rome, Lazio, Italy
North Shore Hospital /ID# 169409
🇳🇿Auckland, New Zealand
Synexus Polska Sp. z o.o. Oddzial w Gdyni /ID# 207157
🇵🇱Gdynia, Pomorskie, Poland
Synexus Polska Sp. z o.o. Oddzial Katowice /ID# 204510
🇵🇱Katowice, Slaskie, Poland
Medycyna Kliniczna /ID# 166288
🇵🇱Warsaw, Poland
Synexus Polska Sp. z.o.o. /ID# 203987
🇵🇱Warsaw, Poland
Instituto Portugues De Reumatologia /ID# 165858
🇵🇹Lisbon, Lisboa, Portugal
Centro Hospitalar Lisboa Ocidental, EPE /ID# 165861
🇵🇹Lisbon, Lisboa, Portugal
Hospital CUF Descobertas /ID# 165866
🇵🇹Lisbon, Portugal
Hospital Beatriz Angelo /ID# 165865
🇵🇹Loures, Portugal
Unidade Local De Saude Do Alto Minho /ID# 165863
🇵🇹Viana Do Castelo, Portugal
Synexus Magyarorszag Kft. - Gyula DRS /ID# 202209
🇭🇺Gyula, Bekes, Hungary
Szabolcs-Szatmar-Bereg Megyei Korhazak & Egyetemi Oktatok.- Klinikai Kutatasi O. /ID# 202584
🇭🇺Nyíregyháza, Szabolcs-Szatmar-Bereg, Hungary
Moscow S.P.Botkin City Clinica /ID# 164533
🇷🇺Moscow, Russian Federation
GCM Medical Group, PSC /ID# 162160
🇵🇷San Juan, Puerto Rico
Kazan State Medical University /ID# 164531
🇷🇺Kazan, Tatarstan, Respublika, Russian Federation
Institute for Rheumatology /ID# 166217
🇷🇸Belgrade, Beograd, Serbia
Institute for Rheumatology /ID# 166231
🇷🇸Belgrade, Beograd, Serbia
Military Medical Academy /ID# 166293
🇷🇸Belgrade, Beograd, Serbia
Kharkiv Regional Council Regional Clinical Hospital /ID# 210189
🇺🇦Kharkiv, Ukraine
Med Ctr of Private High Ed Ins /ID# 208527
🇺🇦Kyiv, Ukraine
LLC Revmocentr /ID# 164177
🇺🇦Kyiv, Ukraine
Glasgow Royal Infirmary /ID# 162703
🇬🇧Glasgow, United Kingdom
NSC Strazhesko Ist Cardiology /ID# 164043
🇺🇦Kiev, Ukraine
Medical Center of LLC Medbud-Clinic /ID# 208528
🇺🇦Kyiv, Ukraine
Kyiv Railway Clinical Hosp No.2 /ID# 208951
🇺🇦Kyiv, Ukraine
MNI KRC Kyiv Regional Clinical Hospital /ID# 210188
🇺🇦Kyiv, Ukraine
Vinnytsia Regional Clinical Hospital n.a. M.I.Pyrogov /ID# 164245
🇺🇦Vinnytsia, Ukraine
Whipps Cross Univ Hospital /ID# 161055
🇬🇧London, London, City Of, United Kingdom
Christchurch Hospital /ID# 162702
🇬🇧Christchurch, United Kingdom
Guy's and St Thomas' NHS Found /ID# 161065
🇬🇧London, London, City Of, United Kingdom
UH Coventry & Warwickshire /ID# 162701
🇬🇧Coventry, United Kingdom
Luton & Dunstable University Hospital /ID# 162704
🇬🇧Luton, United Kingdom
AZ Arthritis and Rheumotology Research, PLLC /ID# 160033
🇺🇸Phoenix, Arizona, United States
AZ Arthritis and Rheumotology Research, PLLC /ID# 160036
🇺🇸Phoenix, Arizona, United States
Arthritis & Osteo Medical Ctr /ID# 166760
🇺🇸La Palma, California, United States
AZ Arthritis & Rheuma Research /ID# 160037
🇺🇸Phoenix, Arizona, United States
Denver Arthritis Clinic /ID# 159873
🇺🇸Denver, Colorado, United States
LeJenue Research Associates /ID# 170965
🇺🇸Miami, Florida, United States
Clinical Research of West Florida, Inc /ID# 160063
🇺🇸Tampa, Florida, United States
M3-Emerging Medical Research, LLC /ID# 161391
🇺🇸Durham, North Carolina, United States
Health Research of Oklahoma /ID# 159880
🇺🇸Oklahoma City, Oklahoma, United States
BayCare Medical Group, Inc. /ID# 159879
🇺🇸Tampa, Florida, United States
Arthritis & Osteo Ctr of S. TX /ID# 163784
🇺🇸San Antonio, Texas, United States
AZ Arthritis and Rheumotology Research, PLLC /ID# 159981
🇺🇸Phoenix, Arizona, United States
C.V. Mehta MD, Med Corporation /ID# 161216
🇺🇸Hemet, California, United States
St. Joseph Heritage Healthcare /ID# 159980
🇺🇸Fullerton, California, United States
Care Access Research, Huntingt /ID# 160038
🇺🇸Huntington Beach, California, United States
East Bay Rheumatology Medical /ID# 166382
🇺🇸San Leandro, California, United States
VA Sacramento Medical Center /ID# 164196
🇺🇸Mather, California, United States
Inland Rheum Clin Trials Inc. /ID# 159828
🇺🇸Upland, California, United States
Medvin Clinical Research /ID# 160034
🇺🇸Whittier, California, United States
Clinical Res of West FL, Inc. /ID# 159829
🇺🇸Clearwater, Florida, United States
Stamford Therapeutics Consorti /ID# 165131
🇺🇸Stamford, Connecticut, United States
Omega Research Maitland, LLC /ID# 164193
🇺🇸DeBary, Florida, United States
BayCare Medical Group /ID# 159792
🇺🇸Saint Petersburg, Florida, United States
University of South Florida /ID# 161286
🇺🇸Tampa, Florida, United States
Arthritis Center, Inc. /ID# 163465
🇺🇸Palm Harbor, Florida, United States
Klein & Associates, M.D., P.A. /ID# 164013
🇺🇸Cumberland, Maryland, United States
Westroads Clinical Research /ID# 159979
🇺🇸Omaha, Nebraska, United States
Multiprofile Hospital for Active Treatment - Sofia at Military Medical Academy /ID# 169608
🇧🇬Sofia, Bulgaria
Medical Centre Synexus Sofia /ID# 202394
🇧🇬Sofia, Bulgaria
Manitoba Clinic /ID# 157829
🇨🇦Winnipeg, Manitoba, Canada
Peking University Third Hospital /ID# 201973
🇨🇳Beijing, Beijing, China
Huashan Hospital of Fudan University /ID# 202191
🇨🇳Shanghai, Shanghai, China
The Aff Hosp Inner Mongolia /ID# 207787
🇨🇳Huhehaote, China
University General Hospital of Heraklion PA.G.N.I /ID# 163472
🇬🇷Heraklion, Greece
Obudai Egeszsegugyi Centrum Kft. /ID# 163279
🇭🇺Budapest, Hungary
Tel Aviv Sourasky Medical Center /ID# 169845
🇮🇱Tel Aviv-Yafo, Tel-Aviv, Israel
The Lady Davis Carmel MC /ID# 170262
🇮🇱Haifa, Israel
AOU Federico II /ID# 202411
🇮🇹Naples, Campania, Italy
Sheba Medical Center /ID# 202532
🇮🇱Ramat Gan, Israel
VAKK dr. Kildos Clinic /ID# 167257
🇱🇹Kaunas, Lithuania
M &M Centrs /Id# 161483
🇱🇻Adazi, Latvia
Vilnius University Hospital /ID# 165123
🇱🇹Vilnius, Lithuania
Maasstad Ziekenhuis /ID# 160168
🇳🇱Rotterdam, Netherlands
Synexus Polska Sp. z o.o. /ID# 204506
🇵🇱Wrocław, Dolnoslaskie, Poland
Centrum Kliniczno-Badawcze /ID# 161830
🇵🇱Elblag, Poland
Jakaranda Hospital /ID# 164242
🇿🇦Pretoria, Gauteng, South Africa
Ochsner Clinic Foundation-New Orleans /ID# 165672
🇺🇸New Orleans, Louisiana, United States
Univ of Michigan Hospitals /ID# 164014
🇺🇸Ann Arbor, Michigan, United States
DJL Clinical Research, PLLC /ID# 161390
🇺🇸Charlotte, North Carolina, United States
NYU Langone Rheum Assoc /ID# 159985
🇺🇸Lake Success, New York, United States
Articularis Healthcare Group, Inc d/b/a Low Country Rheumatology /ID# 163464
🇺🇸Summerville, South Carolina, United States
West Texas Clinical Research /ID# 205722
🇺🇸Lubbock, Texas, United States
P&I Clinical Research /ID# 159826
🇺🇸Lufkin, Texas, United States
SW Rheumatology Res. LLC /ID# 159993
🇺🇸Mesquite, Texas, United States
Heidelberg Repatriation Hospital /ID# 167450
🇦🇺Heidelberg West, Victoria, Australia
Hamburger Rheuma Forschungszentrum II im MVZ Rheumatologie und Autoimmunmedizin /ID# 204421
🇩🇪Hamburg, Germany
Hospital Raja Permaisuri Bainun /ID# 161099
🇲🇾Ipoh, Perak, Malaysia
University of Pretoria /ID# 163852
🇿🇦Pretoria, Gauteng, South Africa
Lviv Regional Clinical Hospita /ID# 164178
🇺🇦Lviv, Lvivska Oblast, Ukraine
Prince of Wales Hospital /ID# 163506
🇭🇰Hong Kong, Hong Kong
Queen Mary Hospital /ID# 162492
🇭🇰Hong Kong, Hong Kong
Tuen Mun Hospital /ID# 162493
🇭🇰Tuen Mun, Hong Kong