Ranolazine When Added to Glimepiride in Subjects With Type 2 Diabetes Mellitus

Phase 3

Completed

Conditions: Type 2 Diabetes Mellitus

Interventions: Drug: Placebo
Drug: Ranolazine
Drug: Glimepiride
Behavioral: Diet
Behavioral: Exercise

Registration Number: NCT01494987

Lead Sponsor: Gilead Sciences

Brief Summary: This is a randomized, double-blind, placebo-controlled, parallel-group, multi-center study to determine the effect of ranolazine when added to glimepiride on glycemic control in adults with type 2 diabetes mellitus (T2DM) who are inadequately controlled despite current treatment with stable sulfonylurea or metformin therapy in addition to diet and exercise.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 431

Inclusion Criteria

Written informed consent
Males and females, 18 to 75 years old, inclusive
Documented history of T2DM
Receiving one of the following sulfonylurea or metformin therapies in addition to diet and exercise for at least 90 days prior to Screening:
1. glimepiride at a daily dose of ≥ 2 mg and ≤ 4 mg
2. glipizide, glyburide, or glibenclamide (or equivalent) at a daily dose of ≥ 7.5 mg
3. gliclazide at a daily dose of > 160 mg (or ≥ 60 mg for the modified release [MR] formulation)
4. metformin at a daily dose of ≥ 1500 mg
Body mass index (BMI) 25 kg/m2 to 45 kg/m2, inclusive, at Screening
HbA1c 7% to 10%, inclusive, at Screening and the end of the Qualifying Period (Day 14)
Fasting Serum C-peptide ≥ 0.8 ng/mL at Screening
Fasting serum glucose (FSG) ≥ 130 mg/dL (7.2 mmol/L) and ≤ 240 mg/dL (13.3 mmol/L) at Screening and at the end of the Qualifying Period (Day 14): A one-time central laboratory re-test of FSG is allowed in subjects with an initial central laboratory FSG ≥ 120 mg/dL (6.7 mmol/L) and < 130 mg/dL (7.2 mmol/L) who are otherwise eligible as determined by the investigator.
Able and willing to comply with all study procedures during the course of the study
Females of child-bearing potential must have a negative serum pregnancy test at Screening and must agree to use highly effective contraception methods from Screening throughout the duration of the Treatment Period and for 14 days following the last dose of study drug.
At least 80% compliant in dosing during the Qualifying Period

Exclusion Criteria

History of or current diagnosis of type 1 diabetes mellitus
History of diabetic ketoacidosis, ketosis-prone diabetes, or hyperosmolar hyperglycemic coma
History of a severe episode of hypoglycemia (≥ 1 episode within 3 months prior to Screening or ≥ 2 episodes within 6 months prior to Screening), defined as hypoglycemia requiring 3rd party assistance to actively administer carbohydrate, glucagon, or other resuscitative actions due to severe impairment in consciousness or behavior
Clinically significant complications of diabetes that in the judgment of the investigator would make the subject unsuitable to participate in this study
History of any clinically significant cardiovascular (CV) or cerebrovascular event (eg, myocardial infarction [MI], acute coronary syndrome [ACS], recent revascularization [including coronary artery bypass graft procedures or percutaneous coronary intervention], transient ischemic attack, or ischemic stroke) ≤ 3 months prior to Screening
Inadequately controlled or unstable hypertension as defined by a systolic blood pressure (SBP) > 160 mmHg or diastolic blood pressure (DBP) > 100 mmHg at Screening and at Randomization
Prolonged QT interval corrected for heart rate (QTc) interval > 500 msec by electrocardiogram (ECG) at Screening, a personal or family history of QTc prolongation, congenital long QT syndrome, or subjects who are receiving drugs that prolong the QTc interval, such as Class Ia or Class III antiarrhythmic agents, erythromycin, and certain antipsychotics (eg, ziprasidone)
History of bariatric surgery at any time in the past or or any other surgery < 2 months before Screening; or planning to undergo surgery during the study. Subjects with a planned minor surgery may be enrolled upon approval by the medical monitor.
Any other hospitalization in the 14 days prior to Screening or planned hospitalization at any time during the study
Significant weight change (± 5%) < 2 months prior to Screening or enrollment in a weight-loss program other than a maintenance phase at Screening.
Severe renal impairment, defined as an estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease (MDRD) equation < 30 mL/min/1.73 m2 at Screening or undergoing any type of dialysis at Screening or planning to undergo any type of dialysis during the course of the study
History of liver cirrhosis (Child-Pugh Class A, B or C)
Active liver disease and/or significant abnormal liver function defined as aspartate aminotransferase (AST) > 3 x upper limit of the normal range (ULN) and/or alanine aminotransferase (ALT) > 3 x ULN and/or serum total bilirubin > 2.0 mg/dL
History of cancer (except nonmelanomic skin cancers or cervical in situ) within 5 years prior to Screening
History of alcohol or other drug abuse < 12 months prior to Screening
Any other clinically significant existing medical or psychiatric condition, including clinically significant laboratory abnormalities, or one requiring further evaluation that in the opinion of the investigator could interfere with conduct of the study or interpretation of the data
Use of antihyperglycemic agents other than sulfonylurea agents or metformin, including but not limited to dipeptidyl peptidase-4 inhibitors (eg, saxagliptin and sitagliptin), glucagon-like peptide-mimetics (eg, exenatide), or insulin < 3 months prior to Screening; use of thiazolidinediones (TZDs) (eg, rosiglitazone or pioglitazone) < 24 weeks prior to Screening
Previous history of intolerance of glimepiride (as a single-agent therapy)
Prior treatment with open-label ranolazine, or known hypersensitivity or intolerance to ranolazine or any of its excipients
Treatment with strong or moderate cytochrome P (CYP)3A inhibitors or P-glycoprotein (P-gp) inhibitors within 14 days prior to randomization
Treatment with CYP3A inducers or P-gp inducers within 14 days prior to randomization
Treatment with CYP3A4 substrates with a narrow therapeutic range (eg, cyclosporine, tacrolimus, or sirolimus) within 14 days prior to Randomization
Treatment with simvastatin at a dose of > 20 mg daily or lovastatin at a dose of > 40 mg daily within 14 days prior to Randomization
Weight loss medication or anti-obesity medication (prescription or non-prescription) < 3 months prior to Screening
Treatment with niacin > 200 mg daily; if receiving ≤ 200 mg daily, should be on stable doses for ≥ 3 months prior to Screening
Expected or current treatment with systemic corticosteroids (oral or injectable) for > 14 days from Screening through the end of the Treatment Period. Topical or inhaled corticosteroid formulations are permitted at any time during the study.
If receiving thyroid replacement therapy, should be on stable doses for at least 6 weeks prior to randomization
Hemoglobin < 12 g/dL for males or < 11 g/dL for females at Screening
Participation in another clinical study involving an investigational drug or device < 30 days prior to Screening; participation in another clinical study involving an oral antihyperglycemic agent (OHA) < 90 days prior to Screening
Donation of blood < 2 months prior to Screening or plans to donate blood while participating in the study
Females who are pregnant or are breastfeeding
Other condition(s) that, in the opinion of the investigator, would compromise the safety of the individual, prevent compliance with the study protocol (including the ability to comply with Mixed Meal Tolerance Test [MMTT]), or compromise the quality of the clinical study

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo+glimepiride	Placebo	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive placebo to match ranolazine plus glimepiride 4 mg once daily for 24 weeks. Participants will be required to maintain their diet and exercise regimen.
Ranolazine+glimepiride	Diet	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive ranolazine 500 mg twice daily plus glimepiride 4 mg once daily on Days 1 through 7, followed by ranolazine 1000 mg twice daily plus glimepiride 4 mg once daily from Day 8 (or by Day 16 if not well tolerated) through Week 24. Participants will be required to maintain their diet and exercise regimen.
Ranolazine+glimepiride	Exercise	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive ranolazine 500 mg twice daily plus glimepiride 4 mg once daily on Days 1 through 7, followed by ranolazine 1000 mg twice daily plus glimepiride 4 mg once daily from Day 8 (or by Day 16 if not well tolerated) through Week 24. Participants will be required to maintain their diet and exercise regimen.
Placebo+glimepiride	Exercise	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive placebo to match ranolazine plus glimepiride 4 mg once daily for 24 weeks. Participants will be required to maintain their diet and exercise regimen.
Placebo+glimepiride	Diet	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive placebo to match ranolazine plus glimepiride 4 mg once daily for 24 weeks. Participants will be required to maintain their diet and exercise regimen.
Ranolazine+glimepiride	Ranolazine	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive ranolazine 500 mg twice daily plus glimepiride 4 mg once daily on Days 1 through 7, followed by ranolazine 1000 mg twice daily plus glimepiride 4 mg once daily from Day 8 (or by Day 16 if not well tolerated) through Week 24. Participants will be required to maintain their diet and exercise regimen.
Ranolazine+glimepiride	Glimepiride	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive ranolazine 500 mg twice daily plus glimepiride 4 mg once daily on Days 1 through 7, followed by ranolazine 1000 mg twice daily plus glimepiride 4 mg once daily from Day 8 (or by Day 16 if not well tolerated) through Week 24. Participants will be required to maintain their diet and exercise regimen.
Placebo+glimepiride	Glimepiride	Glimepiride stabilization period (up to 8 weeks): participants not on stable glimepiride will receive glimepiride 2 mg once daily, and if tolerated the dose will be increased on Day 8 (+ 2 days) to 4 mg once daily. Qualifying period: participants will receive placebo to match ranolazine twice daily in addition to glimepiride for 14 days (+ 2 days) and if ≥ 80% compliant and meeting eligibility criteria will continue to the treatment period. Treatment period: participants will be randomized to receive placebo to match ranolazine plus glimepiride 4 mg once daily for 24 weeks. Participants will be required to maintain their diet and exercise regimen.

Primary Outcome Measures

Name	Time	Method
Change From Baseline in Glycosylated Hemoglobin (HbA1c) at Week 24	Baseline; Week 24	The average (mean) change from baseline in HbA1c at Week 24 was analyzed.

Secondary Outcome Measures

Name	Time	Method
Change From Baseline in Incremental Change of 2-hour Postprandial Serum Glucose at Week 24	Baseline; Week 24	The average (mean) change from baseline in incremental change of 2-hour postprandial serum glucose at Week 24 was analyzed. Mixed Meal Tolerance Test (MMTT) Full Analysis Set: randomized participants who received at least one dose of study treatment with a baseline and at least one postbaseline measurement of serum glucose at T=120 minutes during the MMTT, administered under fasting conditions, excluding participants with major eligibility protocol violations, analyzed based on the randomized treatment regardless of actual treatment received.
Change From Baseline in Fasting Serum Glucose at Week 24	Baseline; Week 24	The average (mean) change from baseline in fasting serum glucose at Week 24 was analyzed.
Change From Baseline in 2-hour Postprandial Serum Glucose at Week 24	Baseline; Week 24	The average (mean) change from baseline in 2-hour postprandial serum glucose at Week 24 was analyzed.

Trial Locations

Locations (139): Clinical Research Advantage/Desert Clinical Research, LLC
🇺🇸
Mesa, Arizona, United States
Desert Sun Clinical Research, LLC
🇺🇸
Tucson, Arizona, United States
Southland Clinical Research Center, Inc.
🇺🇸
Fountain Valley, California, United States
Eclipse Clinical Research
🇺🇸
Tucson, Arizona, United States
Paul W. Davis, MD, PA
🇺🇸
Pine Bluff, Arkansas, United States
Del Rosario Medical Clinic, Inc.
🇺🇸
Huntington Park, California, United States
Valley Research
🇺🇸
Fresno, California, United States
Scripps Whittier Diabetes Institute
🇺🇸
La Jolla, California, United States
Spectrum Clinical Research Institute, Inc
🇺🇸
Moreno Valley, California, United States
Florida Research Network, LLC
🇺🇸
Gainesville, Florida, United States
NewPhase Clinical Trials, Inc.
🇺🇸
Miami Beach, Florida, United States
Sacramento Heart and Vascular Medical Associates
🇺🇸
Sacramento, California, United States
Infosphere Clinical Research
🇺🇸
West Hills, California, United States
PAB Clinical Research
🇺🇸
Brandon, Florida, United States
Regenerate Clinical Trials
🇺🇸
South Miami, Florida, United States
Comprehensive Clinical Development, Inc.
🇺🇸
St. Petersburg, Florida, United States
Clinical Research of Central Florida
🇺🇸
Winter Haven, Florida, United States
CTL Research
🇺🇸
Eagle, Idaho, United States
LaPorte County Institute for Clinical Research
🇺🇸
Michigan City, Indiana, United States
L-MARC Research Center
🇺🇸
Louisville, Kentucky, United States
Horizon Research Group of Opelousas
🇺🇸
Eunice, Louisiana, United States
MD Medical Research
🇺🇸
Oxon Hill, Maryland, United States
Endeavor Medical Research, PLC
🇺🇸
Alpena, Michigan, United States
IRC Clinics, Inc
🇺🇸
Towson, Maryland, United States
Albuquerque Clinical Trials
🇺🇸
Albuquerque, New Mexico, United States
Associated Internal Medicine Specialists, P.C.
🇺🇸
Battle Creek, Michigan, United States
PMG Research of Charlotte
🇺🇸
Charlotte, North Carolina, United States
PharmQuest
🇺🇸
Greensboro, North Carolina, United States
Clinical Inquest Center, Ltd.
🇺🇸
Beavercreek, Ohio, United States
Southeastern Research Associates, Inc.
🇺🇸
Taylors, South Carolina, United States
Holston Medical Group
🇺🇸
Kingsport, Tennessee, United States
The University of Texas Southwestern Medical Center at Dallas
🇺🇸
Dallas, Texas, United States
HCCA Clinical Research Solution
🇺🇸
Franklin, Tennessee, United States
New Phase Research & Development
🇺🇸
Knoxville, Tennessee, United States
Humble Cardiology Associates
🇺🇸
Humble, Texas, United States
Drug Research Center
🇭🇺
Balatonfüred, Hungary
Interni oddeleni
🇨🇿
Havirov, Moravskoslezsky kraj, Czech Republic
Synexus Hungary Ltd
🇭🇺
Budapest, Hungary
Kanizsai Dorottya Hospital
🇭🇺
Nagykanizsa, Hungary
Borbanya Praxis Kft., Outpatient Clinic
🇭🇺
Nyíregyháza, Hungary
Medifarma 98
🇭🇺
Nyíregyháza, Hungary
Hospital Universiti Sains Malaysia
🇲🇾
Kubang Kerian, Kelantan, Malaysia
NZOZ Centrum Medyczne Szpital Sw. Rodziny
🇵🇱
Lodz, Lodzkie, Poland
NZOZ Centrum Badan Klinicznych
🇵🇱
Wroclaw, Dolnoslaskie, Poland
Centrum Terapii Wspolczesnej J.M. Jasnorzewska Sp. Komandytowo - Akcyjna
🇵🇱
Lodz, Lodzkie, Poland
LANDA - Specjalistyczne Gabinety Lekarskie
🇵🇱
Krakow, Poland
SPZOZ Uniwersytecki Szpital Kliniczny Nr 1 im. Norberta Barlickiego Uniwersytetu Medycznego w Łodzi, Oddział Kliniczny Diabetologii
🇵🇱
Lodz, Poland
NZOZ Centrum Badan Klinicznych Oswiecim
🇵🇱
Oswięcim, Poland
Consultmed SRL
🇷🇴
Iasi, Jud. Iasi, Romania
Spital Clinic Judetean de Urgenta Oradea Stationarul 1
🇷🇴
Oradea, Jud Bihor, Romania
CMI Morosanu V. Magdalena
🇷🇴
Galati, Judetul Galati, Romania
Tehnomed Trading Srl
🇷🇴
Bucharest, Romania
O.D. Medica Srl
🇷🇴
Bucharest, Romania
Institutul de Diabet, Nutritie si Boli Metabolice "Dr. N. C. Paulescu"
🇷🇴
Bucuresti, Romania
Institutul National De Diabet, Nutritie Si Boli Metabolice "Prof. Dr. N.C. Paulescu"
🇷🇴
Bucuresti, Romania
CMI Mateescu S. Ana-Maria
🇷🇴
Constanta, Romania
Spitalul Clinic Judetean de Urgenta "Sf. Apostol Andrei" Galati
🇷🇴
Galati, Romania
Diabmed Dr. Popescu Alexandrina SRL
🇷🇴
Ploiesti, Romania
GOU VPO "Chita State Medical Academy" of Minzdravsocrazvitie RF
🇷🇺
Chita, Russian Federation
3rd Central Military Clinical Hospital named after A.A.Vishnevskogo
🇷🇺
Arkhangelskoe, Russian Federation
"Clinic of New Medical Technology" Company Limited
🇷🇺
Dzerzhinskiy, Russian Federation
The Urals State Medical Academy
🇷🇺
Ekaterinburg, Russian Federation
Kemerovo Regional Clinical Hospital
🇷🇺
Kemerovo, Russian Federation
"Krasnoyarsk State Medical University n.a. Prof. V.F. Voyno-Yasenetsky
🇷🇺
Krasnoyarsk, Russian Federation
State Healthcare Institution of Moscow "Cardiologival Dispensary #2 of Management Department of South Administrative District"
🇷🇺
Moscow, Russian Federation
Central Clinical Hospital of Russian Academy of Sciences
🇷🇺
Moscow, Russian Federation
Medical Sanitary Unit of Minestry of Internal Affairs of Russia in Moscow
🇷🇺
Moscow, Russian Federation
Novosibirsk State Medical University
🇷🇺
Novosibirsk, Russian Federation
City Clinical Hospital # 13 of Avtozavodsky District of Nizhniy Novgorod
🇷🇺
Nizhniy Novgorod, Russian Federation
Scientific Research Institute of Physiology of Siberian Department RAMS
🇷🇺
Novosibirsk, Russian Federation
Rostov State Medical University
🇷🇺
Rostov-on-Don, Russian Federation
City Hospital # 38 named after N A Semashko
🇷🇺
Pushkin, Russian Federation
Medinet, LLC
🇷🇺
St. Petersburg, Russian Federation
Ryazan State Medical University
🇷🇺
Ryazan, Russian Federation
Smolensk State Medical Academy, Sanatorium-Preventorium
🇷🇺
Smolensk, Russian Federation
Center "Diabetes", LLC
🇷🇺
Samara, Russian Federation
North-Western State Medical Unversity n.a. I.I.Mechnikov
🇷🇺
St. Petersburg, Russian Federation
Saint-Petersburg City Outpatient Clinic#37
🇷🇺
St. Petersburg, Russian Federation
Military Medical Academy named after S.M. Kirov
🇷🇺
St. Petersburg, Russian Federation
Saint-Petersburg state budgetary healthcare institution "City Polyclinic #109"
🇷🇺
St. Petersburg, Russian Federation
Alexanders City Hospital
🇷🇺
St. Petersburg, Russian Federation
Clinical Hospital #122 n.a. Sokolov of FMBA
🇷🇺
St. Petersburg, Russian Federation
ANO "Medical Centre "XXI century"
🇷🇺
St. Petersburg, Russian Federation
St. Elizabeth City Hospital
🇷🇺
St. Petersburg, Russian Federation
Federal Centre of Heart, Blood and Endocrinology named after V.A. Almazov
🇷🇺
St. Petersburg, Russian Federation
Krestovsky Island Medical Institute, LLC
🇷🇺
St. Petersburg, Russian Federation
International Medical Center "SOGAZ", LLC
🇷🇺
St. Petersburg, Russian Federation
Saint-Petersburg City Pokrovskaya Hospital
🇷🇺
St. Petersburg, Russian Federation
Voronezh Regional Clinical Hospital #1
🇷🇺
Voronezh, Russian Federation
City Hospital named after N.A.Semashko
🇷🇺
Yaroslavl, Russian Federation
Tyumen State Medical Academy
🇷🇺
Tyumen, Russian Federation
Clinical Hospital for Emergency Care named after N.V. Solovyov
🇷🇺
Yaroslavl, Russian Federation
Medical Sanitary Unit of Novo-Yaroslavsky Oil Refinery
🇷🇺
Yaroslavl, Russian Federation
Yaroslavl Regional Clinical Hospital
🇷🇺
Yaroslavl, Russian Federation
Clinical Center of Serbia
🇷🇸
Belgrade, Serbia
Zvezdara University Medical Center
🇷🇸
Belgrade, Serbia
Clinical Center of Kragujevac
🇷🇸
Kragujevac, Serbia
METABOLKLINIK s.r.o.
🇸🇰
Bratislava, Bratislavsky kraj, Slovakia
ARETEUS s.r.o., Diabetologicka ambulancia
🇸🇰
Trebisov, Kosicky kraj, Slovakia
ENDIAMED s.r.o
🇸🇰
Dolny Kubin, Zilinsky kraj, Slovakia
Newkwa Medical Centre
🇿🇦
Newlands West, Durban, South Africa
Drs. Naiker and Naicker Inc.
🇿🇦
Overport, Durban, South Africa
MediVet s.r.o.
🇸🇰
Malacky, Slovakia
Centre for Diabetes and Endocrinology Suite 1
🇿🇦
Durban, South Africa
Centre for Diabetes, Asthma and Allergy
🇿🇦
Johannesburg, South Africa
Soweto Clinical Trial Centre
🇿🇦
Johannesburg, South Africa
Centre fro Diabetes and Endocrinology (Pty) Ltd
🇿🇦
Johannesburg, South Africa
Paarl Research Centre
🇿🇦
Paarl, Cape Town, South Africa
Aliwal Shoal Medical & Clinical Trial Centre
🇿🇦
Kwa Zulu Natal, South Africa
Helderberg Clinical Trials Centre
🇿🇦
Somerset West, South Africa
Tiervlei Trial Centre
🇿🇦
Western Cape, South Africa
Phramongkutklao Hospital
🇹🇭
Bangkok, Thailand
Rajavithi Hospital
🇹🇭
Bangkok, Thailand
Songklanagarind Hospital
🇹🇭
Songkla, Thailand
Educational Scientific Medical Centre "University clinic" of Donetsk National Medical University n.a. M.Gorkiy
🇺🇦
Donetsk, Ukraine
City Clinical Hospital#9, Dnipropetrovsk State Medical Academy
🇺🇦
Dnipropetrovsk, Ukraine
Administration of Medical Service and Rehabilitation of "ARTEM" State Holding Company
🇺🇦
Kyiv, Ukraine
National Medical University n.a. O.O. Bogomolets, Chair of Family Medicine based on Outpatient Clinic # 2 of Shevchenkovsky District
🇺🇦
Kyiv, Ukraine
V. P. Komissarenko Institute of Endocrinology and Metabolism of AMS of Ukraine
🇺🇦
Kyiv, Ukraine
Zhytomyr Regional Clinical Hospital
🇺🇦
Zhytomyr, Ukraine
Lviv Regional Endocrinology Dispensary
🇺🇦
Lviv, Ukraine
Odessa State Medical University
🇺🇦
Odesa, Ukraine
Municipal Institution Lutsk City Clinical Hospital
🇺🇦
Lutsk, Ukraine
Chulalongkorn University
🇹🇭
Patumwan, Bangkok, Thailand
Synergy Therapeutic Partners
🇺🇸
Atlanta, Georgia, United States
Infinity Research Group, LLC
🇺🇸
Oklahoma City, Oklahoma, United States
Texas Center for Drug Development, Inc.
🇺🇸
Houston, Texas, United States
Cetero Research
🇺🇸
San Antonio, Texas, United States
National Research Institute
🇺🇸
Los Angeles, California, United States
Cedar-Crosse Research Center
🇺🇸
Chicago, Illinois, United States
Excel Clinical Research, LLC
🇺🇸
Houston, Texas, United States
Highland Clinical Research
🇺🇸
Salt Lake City, Utah, United States
Jean Brown Research
🇺🇸
Salt Lake City, Utah, United States
NZOZ Polimedica
🇵🇱
Zgierz, Lodzkie, Poland
Centrum Badan Klinicznych PI-House Sp. z o.o.
🇵🇱
Gdansk, Pomorskie, Poland
Markhot Ferenc Hospital
🇭🇺
Eger, Hungary
Centru Medical Dr. Negrisanu
🇷🇴
Timisoara, Judical Timis, Romania
Metabolic Center of Dr. Katarina Raslova Ltd.
🇸🇰
Bratislava, Bratislavsky kraj, Slovakia
Suncoast Clinical Research
🇺🇸
New Port Richey, Florida, United States