A Study of Gefapixant (MK-7264) in Adult Participants With Chronic Cough (MK-7264-027)
- Registration Number
- NCT03449134
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
The main objectives of this study will be to evaluate the efficacy of gefapixant in reducing cough frequency as measured over a 24-hour period at Week 12, and to evaluate the safety and tolerability of gefapixant. The primary hypothesis is that at least one gefapixant dose is superior to placebo in reducing coughs per hour (over 24 hours) at Week 12.
- Detailed Description
The study will include a screening period to determine participant inclusion, and the Baseline visit will include 24 hours of objective measurement of cough. The study will consist of two treatment periods, a main 12-week treatment period and a 40-week extension period (52 weeks total treatment), followed by a 14-day telephone follow-up period.
Participants at selected sites and countries who complete the main and extension study periods may consent to participate in an observational, 3-month, Off-treatment Durability Study Period, which extends the Estimated Study Completion Date. The Off-treatment Durability Study Period will explore the impact of withdrawing gefapixant in refractory or unexplained chronic cough participants who have been treated for 1 year.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 732
- Chest radiograph or computed tomography scan of the thorax (within 5 years of Screening/Visit 1 and after the onset of chronic cough) not demonstrating any abnormality considered to be significantly contributing to the chronic cough or any other clinically significant lung disease in the opinion of the principal investigator or the sub-investigator
- Has had chronic cough for at least 1 year with a diagnosis of refractory chronic cough or unexplained chronic cough
- Female participants are eligible if not pregnant, not breastfeeding, and either not of childbearing potential, or agree to follow contraceptive guidance
- Provides written informed consent and is willing and able to comply with the study protocol (including use of the digital cough recording device and completion of study questionnaires)
- Is a current smoker or has given up smoking within 12 months of Screening
- Has forced expiratory volume in 1 second (FEV1)/ forced vital capacity (FVC) ratio <60%
- Has a history of respiratory tract infection or recent clinically significant change in pulmonary status
- Has a history of chronic bronchitis
- Is currently taking an angiotensin converting enzyme inhibitor (ACEI), or has used an ACEI within 3 months of Screening
- Has an estimated glomerular filtration rate (eGFR) <30mL/min/1.73 m^2 at Screening OR eGFR ≥30 mL/min/1.73 m^2 and <50 mL/min/1.73 m^2 at Screening with unstable renal function
- Has a history of malignancy <=5 years
- Is a user of recreational or illicit drugs or has had a recent history of drug or alcohol abuse or dependence
- Has a history of anaphylaxis or cutaneous adverse drug reaction (with or without systemic symptoms) to sulfonamide antibiotics or other sulfonamide-containing drugs
- Has systolic blood pressure >160 mm Hg or diastolic blood pressure >90 mm Hg at Screening
- Has a known allergy/sensitivity or contraindication to gefapixant
- Has donated or lost >=1 unit of blood within 8 weeks prior to the first dose of gefapixant
- Has previously received gefapixant or is currently participating in or has participated in an interventional clinical study
- Had significantly abnormal laboratory tests at Screening
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Gefapixant 45 mg BID Placebo Participants receive a gefapixant 45 mg tablet and placebo tablet to match gefapixant 15 mg BID during the 12-week main study period and 40-week extension period. Placebo Placebo Participants receive dose-matched placebo tablets twice daily (BID) during the 12-week main study period and 40-week extension period. Gefapixant 15 mg BID Placebo Participants receive a gefapixant 15 mg tablet and placebo tablet to match gefapixant 45 mg BID during the 12-week main study period and 40-week extension period. Gefapixant 45 mg BID Gefapixant Participants receive a gefapixant 45 mg tablet and placebo tablet to match gefapixant 15 mg BID during the 12-week main study period and 40-week extension period. Gefapixant 15 mg BID Gefapixant Participants receive a gefapixant 15 mg tablet and placebo tablet to match gefapixant 45 mg BID during the 12-week main study period and 40-week extension period.
- Primary Outcome Measures
Name Time Method Model-Based Geometric Mean Ratio (GMR) of 24-hour Objective Coughs Per Hour (Week 12/Baseline) Baseline, Week 12 24-hour objective coughs per hour was defined as the total number of cough events during the monitoring period (24-hour interval) divided by 24 hours (denominator could be different if the recording period was actually \<24 hours but ≥20 hours). Assessment was based on 24-hour sound recordings using a digital recording device which recorded sounds from the lungs and trachea through a chest contact sensor, as well as ambient sounds through a lapel microphone. A longitudinal analysis of covariance (ANCOVA) model was applied to log-transformed cough counts to determine geometric mean (GM) 24-hour objective coughs per hour at baseline and Week 12 on the original scale. The GMR corresponding to the Week 12 GM 24-hour objective coughs per hour divided by the Baseline GM 24-hour objective coughs per hour was reported for all treatment study arms.
Number of Participants Experiencing At Least One Adverse Event (AE) During Treatment and Follow-up Up to approximately 54 weeks An AE was defined as any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants with at least one AE during either the 52-week treatment period or 2-week telephone follow-up was reported for all treatment study arms.
Number of Participants Who Discontinued Treatment Due to AEs Up to approximately 52 weeks An AE was defined as any untoward medical occurrence in a participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. The number of participants who discontinued study intervention during the 52-week treatment period due to an AE for which the action taken was listed as 'drug withdrawn' was reported for all treatment study arms.
- Secondary Outcome Measures
Name Time Method Model-Based Geometric Mean Ratio (GMR) of Awake Objective Coughs Per Hour (Week 12/Baseline) Baseline, Week 12 Awake objective coughs per hour was defined as the total number of cough events during the monitoring period (24-hour interval) while the participant is awake divided by the total duration (in hours) for the monitoring period that the participant was awake. Assessment was based on 24-hour sound recordings using a digital recording device which recorded sounds from the lungs and trachea through a chest contact sensor, as well as ambient sounds through a lapel microphone. A longitudinal ANCOVA model was applied to log-transformed cough counts to determine GM awake objective coughs per hour at baseline and Week 12 on the original scale. The GMR corresponding to the Week 12 GM awake objective coughs per hour divided by the Baseline GM awake objective coughs per hour was reported for all treatment study arms.
Percentage of Participants (Model-Based) With a ≤ -30% Change From Baseline in 24-hour Objective Coughs Per Hour at Week 12 Baseline, Week 12 24-hour coughs per hour was defined as the total number of cough events during the monitoring period (24-hour interval) divided by 24 hours (denominator could be different if the recording period was actually \<24 hours but ≥20 hours). Assessment based on 24-hour sound recordings using a digital recording device. Percent change in 24-hour coughs per hour = (change from baseline in 24-hour coughs per hour / baseline 24-hour coughs per hour) ×100%. Negative values indicate a decrease in cough rate, while positive values indicate an increase in cough rate. A participant was considered a responder if the percent change from baseline in 24-hour coughs per hour was ≤ -30% (or a ≥30% reduction from baseline); a participant was considered a non-responder otherwise. The percentage of participants (logistic regression model-based) with a ≤ -30% change from baseline in 24-hour coughs per hour at Week 12 (≥30% reduction from baseline) was reported for all treatment study arms.
Percentage of Participants (Model-Based) With a ≤ -1.3-point Change From Baseline in Mean Weekly Cough Severity Diary (CSD) Total Score at Week 12 Baseline, Week 12 The CSD evaluates frequency of cough, intensity of cough and disruption and has a total of 7 items, each with scores ranging from 0 (best) to 10 (worst). The total daily CSD score was the sum of these seven item scores (Min=0, Max=70). Mean weekly total score was defined as the average of the mean total daily scores collected during the week prior to each visit. Baseline was defined as the average CSD scores collected during the week prior to Day 1 (Day -6 to Day 0). Participants were considered responders if the change from baseline in mean weekly CSD total score was ≤ -1.3 points (or a ≥1.3 point reduction from baseline); and considered a non-responder otherwise. Negative values indicate a decrease in cough severity, while positive values indicate an increase in cough severity. The percentage of participants (logistic regression model-based) with a ≤ -1.3 point change from baseline in CSD at Week 12 (or ≥1.3 point reduction from baseline) was reported for all treatment study arms.
Percentage of Participants (Model-Based) With a ≤ -2.7-point Change From Baseline in Mean Weekly CSD Total Score at Week 12 Baseline, Week 12 The CSD evaluates frequency of cough, intensity of cough and disruption and has a total of 7 items, each with scores ranging from 0 (best) to 10 (worst). The total daily CSD score was the sum of these seven item scores (Min=0, Max=70). Mean weekly total score was defined as the average of the mean total daily scores collected during the week prior to each visit. Baseline was defined as the average CSD scores collected during the week prior to Day 1 (Day -6 to Day 0). Participants were considered responders if the change from baseline in mean weekly CSD total score was ≤ -2.7 points (or a ≥2.7 point reduction from baseline); and considered a non-responder otherwise. Negative values indicate a decrease in cough severity, while positive values indicate an increase in cough severity. The percentage of participants (logistic regression model-based) with a ≤ -2.7 point change from baseline in CSD at Week 12 (or ≥2.7 point reduction from baseline) was reported for all treatment study arms.
Percentage of Participants (Model-Based) With a ≤ -30 Millimeter (mm) Change From Baseline in Cough Severity Visual Analog Scale (VAS) Score at Week 12 Baseline, Week 12 Cough severity was scored using the Cough Severity VAS, a single-item question asking the participant to rate the severity of their cough "today" using a 100 mm VAS (100-point scale) ranging from 0 ("No Cough") to 100 ("Extremely Severe Cough"). Mean weekly VAS score was derived as the average of VAS scores collected during the week prior to each visit. Baseline was defined as the average VAS scores collected during the week prior to Day 1 (Day -6 to Day 0). A participant was considered a responder if the change from baseline in mean weekly Cough Severity VAS score was ≤-30 mm (or a ≥30 mm reduction from baseline); participants considered non-responders otherwise. Negative values indicate a decrease in cough severity, while positive values indicate an increase in cough severity. The percentage of participants (logistic regression model-based) with ≤ -30 mm change from baseline in Cough Severity VAS at Week 12 (≥30 mm reduction from baseline) was reported for all treatment study arms.
Percentage of Participants (Model-Based) With a ≥1.3-point Change From Baseline in Leicester Cough Questionnaire (LCQ) Total Score at Week 12 Baseline, Week 12 The LCQ assesses the impact of chronic cough on health-related quality of life. It consists of 19 items which are divided over 3 domains: Physical (items 1, 2, 3, 9, 10, 11, 14 and 15), Psychological (4, 5, 6, 12, 13, 16, and 17), and Social (7, 8, 18, 19). A 7-point Likert scale is used to rate each item. For each domain, the domain score (range 1-7) is the sum of individual item score within the domain divided by the number of items in the domain. LCQ total score is the sum of the three domain scores and ranges from 3-21; with a higher score corresponding to a better health status. A participant was considered a responder if the change from baseline in LCQ total score was ≥1.3-points (increase from baseline); a participant was considered a non-responder otherwise. The percentage of participants (logistic regression model-based) with a ≥1.3-point change from baseline in LCQ total score at Week 12 was reported for all treatment study arms.
Trial Locations
- Locations (156)
Research Solutions of Arizona PC ( Site 0036)
🇺🇸Litchfield Park, Arizona, United States
Medical Research of AZ ( Site 0060)
🇺🇸Scottsdale, Arizona, United States
InAER Investigaciones en Alergia y Enfermedades Respiratorias ( Site 0324)
🇦🇷Caba, Buenos Aires, Argentina
Centro Medico Dra De Salvo ( Site 0310)
🇦🇷Buenos Aires, Argentina
CIC Mauricie Inc. ( Site 0503)
🇨🇦Trois-Rivieres, Quebec, Canada
Fundacion CIDEA ( Site 0323)
🇦🇷Ciudad de Buenos Aires, Buenos Aires, Argentina
Centro Medico Privado de Reumatologia ( Site 0309)
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
CEMEDIC - Centro de Especialidades Medicas ( Site 0304)
🇦🇷Ciudad Autonoma de Buenos Aires, Argentina
Recherche GCP Research ( Site 0500)
🇨🇦Montreal, Quebec, Canada
Erzsebet Gondozohaz ( Site 1207)
🇭🇺Godollo, Hungary
Hillel Yaffe Medical Center ( Site 1303)
🇮🇱Hadera, Israel
Kinki Central Hospital ( Site 1576)
🇯🇵Itami, Hyogo, Japan
Kanazawa University Hospital ( Site 1536)
🇯🇵Kanazawa, Ishikawa, Japan
Medical Corporation Shintokai Yokohama Minoru Clinic ( Site 1568)
🇯🇵Yokohama, Kanagawa, Japan
Investigaciones en Patologias Respiratorias ( Site 0325)
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
Q & T Research Sherbrooke Inc. ( Site 0512)
🇨🇦Sherbrooke, Quebec, Canada
Dynamik Research ( Site 0505)
🇨🇦Pointe-Claire, Quebec, Canada
Petz Aladar Megyei Oktato Korhaz ( Site 1206)
🇭🇺Gyor, Hungary
National Hospital Organization Ehime Medical Center ( Site 1556)
🇯🇵Toon, Ehime, Japan
Komatsu Municipal Hospital ( Site 1508)
🇯🇵Komatsu, Ishikawa, Japan
Kanagawa Cardiovascular and Respiratory Center ( Site 1503)
🇯🇵Yokohama, Kanagawa, Japan
CRU Hungary KFT ( Site 1205)
🇭🇺Miskolc, Hungary
Carmel Medical Center ( Site 1305)
🇮🇱Haifa, Israel
Chaim Sheba Medical Center. ( Site 1304)
🇮🇱Ramat Gan, Israel
National Hospital Organization Nagoya Medical Center ( Site 1539)
🇯🇵Nagoya, Aichi, Japan
National Hospital Organization Ibarakihigashi National Hospital ( Site 1526)
🇯🇵Naka-gun, Ibaraki, Japan
Ishikawa Prefectural Central Hospital ( Site 1554)
🇯🇵Kanazawa, Ishikawa, Japan
Kamei Internal Medicine and Respiratory Clinic ( Site 1509)
🇯🇵Takamatsu, Kagawa, Japan
Fujisawa City Hospital ( Site 1505)
🇯🇵Fujisawa, Kanagawa, Japan
NZOZCentrum Medyczne Kermed ( Site 1905)
🇵🇱Znin, Poland
Yokohama City Minato Red Cross Hospital ( Site 1506)
🇯🇵Yokohama, Kanagawa, Japan
Urasoe General Hospital ( Site 1572)
🇯🇵Urasoe, Okinawa, Japan
Tokyo Medical University Hachioji Medical Center ( Site 1569)
🇯🇵Hachioji, Tokyo, Japan
Shizuoka Prefectural Hospital Organization Shizuoka General Hospital ( Site 1524)
🇯🇵Shizuoka, Japan
Tokyo Shinagawa Hospital ( Site 1560)
🇯🇵Tokyo, Japan
Hospital Chancay y Servicios Basicos de Salud ( Site 1810)
🇵🇪Lima, Peru
Specjalistyczny osrodek .All-Med. Grazyna Pulka ( Site 1919)
🇵🇱Krakow, Poland
Prywatny Gabinet Specjalistyczny ( Site 1927)
🇵🇱Lodz, Poland
F.G.Yanovskyy Institute of Phthisiology and Pulmonology ( Site 2830)
🇺🇦Kyiv, Ukraine
Sher Allergy Specialists/Center For Cough ( Site 0078)
🇺🇸Largo, Florida, United States
Midwest Allergy Sinus Asthma, SC ( Site 0081)
🇺🇸Normal, Illinois, United States
Well Pharma Medical Research, Corp. ( Site 0093)
🇺🇸Miami, Florida, United States
Center for Clinical Trials, LLC ( Site 0059)
🇺🇸Paramount, California, United States
Clinical Research of Gastonia ( Site 0043)
🇺🇸Gastonia, North Carolina, United States
Diagnostics Research Group ( Site 0035)
🇺🇸San Antonio, Texas, United States
Pulmonary Associates of Richmond Inc. ( Site 0101)
🇺🇸Richmond, Virginia, United States
MUDr. I. Cierna Peterova s.r.o. ( Site 0707)
🇨🇿Brandys nad Labem, Czechia
Hopital Cavale Blanche ( Site 0909)
🇫🇷Brest, France
CHU de Toulouse - Hopital Larrey ( Site 0900)
🇫🇷Toulouse, France
CHU Hotel Dieu Nantes ( Site 0906)
🇫🇷Nantes, France
Synexus Magyarorszag Kft. ( Site 1210)
🇭🇺Gyula, Hungary
Meir Medical Center ( Site 1301)
🇮🇱Kfar Saba, Israel
Rabin Medical Center ( Site 1302)
🇮🇱Petah-Tikva, Israel
Nagoya City University Hospital ( Site 1528)
🇯🇵Nagoya, Aichi, Japan
Idaimae Minamiyojo Int Clinic ( Site 1521)
🇯🇵Sapporo, Hokkaido, Japan
Terada Clinic Respiratory Medicine & General Practice ( Site 1565)
🇯🇵Himeji, Hyogo, Japan
Itami City Hospital ( Site 1580)
🇯🇵Itami, Hyogo, Japan
Saiseikai Yokohamashi Nanbu Hospital ( Site 1533)
🇯🇵Yokohama, Kanagawa, Japan
Nagaoka Red Cross Hospital ( Site 1507)
🇯🇵Nagaoka, Niigata, Japan
Matsusaka City Hospital ( Site 1525)
🇯🇵Matsusaka, Mie, Japan
National Hospital Organization Minami-Okayama Medical Center ( Site 1553)
🇯🇵Tsukubo-gun, Okayama, Japan
Osaka Habikino Medical Center ( Site 1546)
🇯🇵Habikino, Osaka, Japan
National Hospital Organization Kinki-chuo Chest Medical Center ( Site 1519)
🇯🇵Sakai, Osaka, Japan
Kawaguchi Respiratory Clinic ( Site 1504)
🇯🇵Higashiosaka, Osaka, Japan
National Hospital Organization Tokyo National Hospital ( Site 1557)
🇯🇵Kiyose, Tokyo, Japan
National Hospital Organization Disaster Medical Center ( Site 1558)
🇯🇵Tachikawa, Tokyo, Japan
Hiroshima Allergy & Respiratory Clinic ( Site 1529)
🇯🇵Hiroshima, Japan
Shimonoseki City Hospital ( Site 1573)
🇯🇵Shimonoseki, Yamaguchi, Japan
National Hospital Organization Fukuoka Hospital ( Site 1552)
🇯🇵Fukuoka, Japan
Kyoto University Hospital ( Site 1547)
🇯🇵Kyoto, Japan
JA Niigatakoseiren Niigata Medical Center ( Site 1522)
🇯🇵Niigata, Japan
Juntendo University Hospital ( Site 1578)
🇯🇵Tokyo, Japan
Showa University Hospital ( Site 1531)
🇯🇵Tokyo, Japan
Center Hospital of the National Center for Global Health and Medicine ( Site 1574)
🇯🇵Tokyo, Japan
Tokyo Metropolitan Geriatric Hospital ( Site 1577)
🇯🇵Tokyo, Japan
Wonju Severance Christian Hospital ( Site 2214)
🇰🇷Wonju-si, Gangwon-do, Korea, Republic of
Incheon St. Mary s Hospital ( Site 2200)
🇰🇷Incheon, Korea, Republic of
The Catholic University of Korea Eunpyeong St Mary s Hospital ( Site 2209)
🇰🇷Seoul, Korea, Republic of
Seoul National University Hospital ( Site 2210)
🇰🇷Seoul, Korea, Republic of
Severance Hospital ( Site 2204)
🇰🇷Seoul, Korea, Republic of
Konkuk University Medical Center ( Site 2205)
🇰🇷Seoul, Korea, Republic of
Asan Medical Center ( Site 2203)
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center ( Site 2212)
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea St. Mary s Hospital ( Site 2215)
🇰🇷Seoul, Korea, Republic of
Korea University Guro Hospital ( Site 2213)
🇰🇷Seoul, Korea, Republic of
Hospital Nacional Adolfo Guevara Velasco ( Site 1808)
🇵🇪Cusco, Peru
Clinica Ricardo Palma ( Site 1802)
🇵🇪San Isidro, Lima, Peru
Asociacion Civil por la Salud ( Site 1805)
🇵🇪Lima, Peru
Prywatny Gabinet Internistyczno ( Site 1928)
🇵🇱Bialystok, Poland
Centrum Medycyny Oddechowej Mroz Spolka Jawna ( Site 1918)
🇵🇱Białystok, Poland
Centrum Medyczne Pratia Bydgoszcz ( Site 1418)
🇵🇱Bydgoszcz, Poland
Centrum Medyczne Pratia Gdynia ( Site 1910)
🇵🇱Gdynia, Poland
USK nr 1 ( Site 1921)
🇵🇱Lodz, Poland
Hospital Clinic ( Site 2302)
🇪🇸Barcelona, Spain
Hospital General Universitario Gregorio Maranon ( Site 2309)
🇪🇸Madrid, Spain
Hospital Parc Tauli ( Site 2308)
🇪🇸Sabadell, Spain
Chang Gung Medical Foundation - Keelung Branch ( Site 2404)
🇨🇳Keelung, Taiwan
Hospital Clinico Universitario de Santiago ( Site 2303)
🇪🇸Santiago de Compostela, Spain
Changhua Christian Hospital ( Site 2403)
🇨🇳Changhua, Taiwan
National Taiwan University Hospital ( Site 2400)
🇨🇳Taipei, Taiwan
Far Eastern Memorial Hospital ( Site 2402)
🇨🇳New Taipei City, Taiwan
I.U. Cerrahpasa Tip Fakultesi Gogus Hastaliklari Anabilim Dali ( Site 2600)
🇹🇷Fatih, Turkey
Hacettepe Universitesi Tip Fakultesi Hastanesi ( Site 2613)
🇹🇷Ankara, Turkey
Kocaeli Universitesi Tip Fakultesi ( Site 2611)
🇹🇷Kocaeli, Turkey
Recep Tayyip Erdogan Universitesi Tip Fakultesi Egitim ve Aras. Has ( Site 2620)
🇹🇷Rize, Turkey
Ondokuz Mayis Universitesi Tip Fakultesi Hastanesi ( Site 2606)
🇹🇷Samsun, Turkey
Private Small-Scale Enterprise Medical Centre "Pulse" ( Site 2815)
🇺🇦Vinnytsya, Ukraine
Royal Preston Hospital ( Site 2709)
🇬🇧Preston, Lancashire, United Kingdom
Medinova Lakeside Dedicated Research Centre ( Site 2710)
🇬🇧Corby, Northamptonshire, United Kingdom
Broomfield Hospital ( Site 2722)
🇬🇧Chelmsford, United Kingdom
Belfast City Hospital ( Site 2705)
🇬🇧Belfast, United Kingdom
Wythenshawe Hospital ( Site 2700)
🇬🇧Manchester, United Kingdom
Glenfield Hospital ( Site 2701)
🇬🇧Leicester, United Kingdom
Royal Brompton Hospital ( Site 2703)
🇬🇧London, United Kingdom
Rothwell Medical Centre ( Site 2712)
🇬🇧Rothwell, United Kingdom
Churchill Hospital ( Site 2706)
🇬🇧Oxford, United Kingdom
MeDiNova Yorkshire Dedicated Research Centre ( Site 2708)
🇬🇧Shipley, United Kingdom
Herlev Hospital ( Site 0803)
🇩🇰Herlev, Denmark
CCBR AS Vejle, Center for Clinical & Basic Research ( Site 0801)
🇩🇰Vejle, Denmark
Yedikule Gogus Hast. ve Gogus Cer. Egitim ve Arastirma Hastanesi ( Site 2601)
🇹🇷Istanbul, Turkey
Ajou University Hospital ( Site 2211)
🇰🇷Suwon, Gyeonggi-do, Korea, Republic of
Centrum Medyczne Pratia Czestochowa ( Site 1926)
🇵🇱Czestochowa, Poland
Taichung Veterans General Hospital ( Site 2401)
🇨🇳Taichung, Taiwan
Pharmaceutical Research & Consulting, Inc. ( Site 0029)
🇺🇸Dallas, Texas, United States
American Health Research ( Site 0082)
🇺🇸Charlotte, North Carolina, United States
Florida Pulmonary Research Institute, LLC ( Site 0019)
🇺🇸Winter Park, Florida, United States
Biosolutions Clinical Research Center ( Site 0070)
🇺🇸La Mesa, California, United States
Cotton-O'Neil Clinical Research Center ( Site 0052)
🇺🇸Topeka, Kansas, United States
Clinical Research Institute LLC ( Site 0004)
🇺🇸Minneapolis, Minnesota, United States
Lung and Sleep Specialists ( Site 0091)
🇺🇸Williamsburg, Virginia, United States
The Center for Pharmaceutical Research PC ( Site 0016)
🇺🇸Kansas City, Missouri, United States
BreatheAmerica Inc ( Site 0048)
🇺🇸Shreveport, Louisiana, United States
Bernstein Clinical Research Center, LLC ( Site 0005)
🇺🇸Cincinnati, Ohio, United States
Sirius Clinical Research, LLC ( Site 0102)
🇺🇸Austin, Texas, United States
Intermountain Clinical Research ( Site 0033)
🇺🇸Draper, Utah, United States
Vital Prospects Clinical Research Institute, PC ( Site 0037)
🇺🇸Tulsa, Oklahoma, United States
City Polyclinic N20 ( Site 2822)
🇺🇦Odesa, Ukraine
Allergy & Asthma Center ( Site 0001)
🇺🇸Waco, Texas, United States
Canadian Phase Onward Inc. ( Site 0509)
🇨🇦Toronto, Ontario, Canada
National Clinical Research-Richmond, Inc. ( Site 0073)
🇺🇸Richmond, Virginia, United States
Instituto Ave Pulmo ( Site 0322)
🇦🇷Mar del Plata, Buenos Aires, Argentina
Hospital Privado Universitario de Cordoba ( Site 0313)
🇦🇷Cordoba, Argentina
Fundacion Scherbovsky ( Site 0300)
🇦🇷Mendoza, Argentina
167877 Canada Inc. Dr. Jaime Del Carpio ( Site 0506)
🇨🇦Montreal, Quebec, Canada
Plicni ambulance ( Site 0701)
🇨🇿Rokycany, Czechia
Diex Recherche Quebec Inc ( Site 0515)
🇨🇦Quebec, Canada
CCBR AS Aalborg, Center for Clinical & Basic Research ( Site 0802)
🇩🇰Aalborg, Denmark
Plicni stredisko Teplice s. r. o ( Site 0700)
🇨🇿Teplice, Czechia
Pneumologie Varnsdorf S.R.O. ( Site 0706)
🇨🇿Varnsdorf, Czechia
Hopital Nord du Marseille ( Site 0910)
🇫🇷Marseille, France
Hopital Arnaud de Villeneuve ( Site 0905)
🇫🇷Montpellier, France
Dr Kenessey Albert Korhaz-Rendelointezet ( Site 1200)
🇭🇺Balassagyarmat, Hungary
Hallym University Sacred Heart Hospital ( Site 2208)
🇰🇷Anyang si, Gyeonggi Do, Korea, Republic of
Asthma Nasal Disease & Allergy Research Center of New England ( Site 0075)
🇺🇸East Providence, Rhode Island, United States
Mainland Medical Research Institute ( Site 0003)
🇺🇸Dickinson, Texas, United States
Charlottesville Medical Research Center, LLC ( Site 0006)
🇺🇸Charlottesville, Virginia, United States