A Study of Baricitinib in Participants With Systemic Lupus Erythematosus (SLE-BRAVE II)
- Registration Number
- NCT03616964
- Lead Sponsor
- Eli Lilly and Company
- Brief Summary
The reason for this study is to see how effective and safe the study drug known as baricitinib is in participants with systemic lupus erythematosus (SLE).
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 778
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Have a clinical diagnosis of SLE at least 24 weeks prior to screening.
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Have documentation of having met at least 4 of 11 Revised Criteria for Classification of Systemic Lupus Erythematosus according to the 1997 Update of the 1982 American College of Rheumatology (ACR) criteria for classification of SLE prior to randomization.
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Have a positive antinuclear antibody (ANA) (titer ≥1:80) and/or a positive anti-double-stranded deoxyribonucleic acid (dsDNA), and/or a positive anti-Smith (anti-Sm) as assessed by a central laboratory during screening.
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Have a total Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score ≥6 during screening.
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Have a clinical SLEDAI-2K score ≥4 at randomization.
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Have at least 1 British Isles Lupus Assessment Group (BILAG) A score or 2 BILAG B scores during screening.
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Are receiving at least one of the following standard of care medications for SLE:
- A single antimalarial at a stable dose for at least 8 weeks prior to screening
- A single immunosuppressant at a stable dose for at least 8 weeks prior to screening
- An oral corticosteroid, initiated at least 4 weeks prior to screening, at a stable dose ≤40 milligrams/day prednisone (or equivalent) for at least 2 weeks prior to screening. If the participant is not receiving an antimalarial or immunosuppressant, the dose of corticosteroid must be ≥7.5 milligrams/day prednisone (or equivalent)
- Have severe active lupus nephritis.
- Have active central nervous system (CNS) lupus.
- Have a history or presence of cardiovascular, respiratory, hepatic, gastrointestinal, endocrine, hematological, neurological, or neuropsychiatric disorders or any other serious and/or unstable illness that, in the opinion of the investigator, could constitute an unacceptable risk when taking investigational product or interfere with the interpretation of data.
- Have a current or recent clinically serious viral, bacterial, fungal, or parasitic infection.
- Have received cyclophosphamide (or any other cytotoxic agent) within 12 weeks prior to screening.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description 2 milligram (mg) Baricitinib Baricitinib Participants received one 2 mg baricitinib tablet and one placebo tablet matching 4 mg baricitinib administered orally once daily (QD) for 52 weeks. 2 milligram (mg) Baricitinib Placebo Participants received one 2 mg baricitinib tablet and one placebo tablet matching 4 mg baricitinib administered orally once daily (QD) for 52 weeks. 4 mg Baricitinib Baricitinib Participants received one 4 mg baricitinib tablet and one placebo tablet matching 2 mg baricitinib administered orally QD for 52 weeks. 4 mg Baricitinib Placebo Participants received one 4 mg baricitinib tablet and one placebo tablet matching 2 mg baricitinib administered orally QD for 52 weeks. Placebo Placebo Participants received 2 placebo tablets: one placebo tablet matching 4 mg baricitinib and one placebo tablet matching 2 mg baricitinib administered orally QD for 52 weeks.
- Primary Outcome Measures
Name Time Method Percentage of Participants Achieving a Systemic Lupus Erythematosus Responder Index 4 (SRI-4) Response (4 mg Baricitinib) Week 52 SRI-4 response defined as 1)greater than or equal to (\>=) 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) total score 2)no new British Isles Lupus Assessment Group (BILAG) A and no more than 1 new BILAG B domain score and 3)no worsening in Physician Global Assessment (PGA) of Disease Activity (worsening defined as an increase of \>=0.3 from baseline on a 0-3 visual analogue scale).
SLEDAI-2K assessment consists of 24 items with total score of 0(no symptoms) to 105 (presence of all defined symptoms) with higher scores representing increased disease activity. BILAG Index: assessing clinical signs, symptoms,or laboratory parameters related to Systemic Lupus Erythematosus (SLE),divided into 9 organ systems. For each organ system A=severe disease,B=moderate disease,C=mild stable disease,D=inactive,but previously active,E=inactive and never affected. PGA assess disease activity on a visual analogue scale from 0 to 3 (1=mild, 2=moderate, 3=severe).
- Secondary Outcome Measures
Name Time Method Percentage of Participants Achieving SRI-4 Response (2 mg Baricitinib) Week 52 SRI-4 response defined as 1)greater than or equal to (\>=) 4-point reduction in Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) total score 2)no new British Isles Lupus Assessment Group (BILAG) A and no more than 1 new BILAG B domain score and 3)no worsening in Physician Global Assessment (PGA) of Disease Activity (worsening defined as an increase of \>=0.3 from baseline on a 0-3 visual analogue scale).
SLEDAI-2K assessment consists of 24 items with total score of 0(no symptoms) to 105 (presence of all defined symptoms) with higher scores representing increased disease activity. BILAG Index: assessing clinical signs, symptoms,or laboratory parameters related to Systemic Lupus Erythematosus (SLE),divided into 9 organ systems. For each organ system A=severe disease,B=moderate disease,C=mild stable disease,D=inactive,but previously active,E=inactive and never affected. PGA assess disease activity on a visual analogue scale from 0 to 3 (1=mild, 2=moderate, 3=severe).Percentage of Participants Achieving a Lupus Low Disease Activity State (LLDAS) Week 52 The LLDAS is a composite measure designed to identify patients achieving a state of low disease activity. The LLDAS response criteria were: (1) SLEDAI-2K \<=4, with no activity in major organ systems (CNS, vascular, renal, cardiorespiratory and constitutional); where "no activity" is defined as all items of SLEDAI-2K within these major organ systems equal to 0. (2) no new features of lupus disease activity compared to previous occurred visit, where the "new feature" is defined as any of the SLEDAI-2K 24 items changed from 0 to greater than 0; (3) PGA (scale 0-3), \<=1; (4) current prednisolone (or equivalent) dose \<=7.5 mg daily.
Time to First Severe Flare Baseline to Week 52 Time to first severe flare analyzed using a Cox proportional hazards model with treatment group, baseline disease activity \[Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) \<10; SLEDAI-2K ≥10\], baseline corticosteroid dose (\<10 mg/day; ≥10 mg/day prednisone or equivalent), and region fitted as explanatory variables. Participants who did not have severe flare during the flare exposure time period were censored at the end of the flare exposure time.
Percentage of Participants Whose Average Prednisone Dose Had Been Reduced by >=25% From Baseline to <=7.5 mg/Day During Weeks 40 Through 52 in Participants Receiving Greater Than 7.5 mg/Day at Baseline Baseline, Week 40 through Week 52 For the analysis of steroid use, steroid dosages were converted to a prednisone equivalent in mg. A responder was defined as having a prednisone reduction by \>=25% from Baseline to \<=7.5 mg/day during Weeks 40 through 52.
Percentage of Participants With Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) Total Activity Score ≥10 at Baseline With ≥50% Reduction in CLASI Total Activity Score Week 52 The CLASI is a single-page tool that separately quantifies disease activity and damage. For the activity score, points are given for the presence of erythema, scale, mucous membrane lesions, recent hair loss, and inflammatory alopecia. The total score represents the sum of the individual scores and ranges from 0 to 70. Higher scores are awarded for more severe manifestations.
Change From Baseline in Tender Joint Count Baseline, Week 52 The number of tender and painful joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as tender or not tender. LS mean was calculated using Mixed Model Repeated Measures (MMRM) analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Change From Baseline in Worst Pain Numeric Rating Scale (NRS) Baseline, Week 52 Participants assessed the worst pain in the last 24 hours on an 11-point numeric rating scale (NRS) ranging from 0 (no pain) to 10 (pain as bad as you can imagine). The average worst daily pain score was calculated as the mean of the scores over the last 7 days prior to each assessment time point. Higher score indicated severe pain. Least Squares (LS) mean was calculated using Mixed Model Repeated Measures (MMRM) analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>= 10 mg/day prednisone or equivalent), region (North America, Central/South, America/Mexico, Europe, Asia Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Change From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Total Score Baseline, Week 52 FACIT-Fatigue score calculated according to a 13-item questionnaire that assess self reported fatigue and its impact upon daily activities and function. It uses a 5-point Likert-type scale (0 = not at all; 1 = a little bit; 2 = somewhat; 3 = quite a bit; 4 = very much). The sum of all responses resulted in the FACIT-Fatigue score for a total possible score of 0 (worse possible score) to 52 (best score). A higher score reflected an improvement in the participant's health status. Least Squares (LS) mean was calculated using Mixed Model Repeated Measures (MMRM) analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>= 10 mg/day prednisone or equivalent), region (North America, Central/South, America/Mexico, Europe, Asia Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Change From Baseline in Swollen Joint Count Baseline, Week 52 The number of swollen joints is determined by examination of 28 joints (14 on each side) which include: the 2 shoulders, the 2 elbows, the 2 wrists, the 10 metacarpophalangeal joints, the 2 interphalangeal joints of the thumb, the 8 proximal interphalangeal joints, and the 2 knees. The joints are assessed and classified as swollen or not swollen. LS mean was calculated using MMRM analysis with treatment, baseline disease activity (total SLEDAI-2K \<10; \>=10), baseline corticosteroid dose (\<10 mg/day; \>=10 mg/day prednisone or equivalent), region (North America, Central/South America/Mexico, Europe, Asia and Rest of World), visit (as categorical variable), baseline value, treatment-by-visit interaction, and baseline value-by-visit interaction.
Population Pharmacokinetics (PK): Area Under the Concentration-Time Curve for Dosing Interval of Baricitinib at Steady State (AUCtau,ss) Week 0 (Baseline): 15 minutes (min) and 60 min postdose; Week 4: 2 to 4 hours (hr) postdose; Week 8: 4 to 6 hr postdose; Week 12 and Week 16 predose AUCtau,ss reported for participants who received multiple doses of mg baricitinib was derived by a population pharmacokinetics approach.
Population PK: Maximum Observed Drug Concentration at Steady State (Cmax,ss) Week 0 (Baseline): 15 minutes (min) and 60 min postdose; Week 4: 2 to 4 hours (hr) postdose; Week 8: 4 to 6 hr postdose; Week 12 and Week 16 predose PK: Maximum Concentration of Baricitinib at steady-state (Cmax,ss) was derived by a population pharmacokinetics approach.
Trial Locations
- Locations (159)
Centrum Medyczne AMED
🇵🇱Warszawa, Poland
Joint and Muscle Medical Care
🇺🇸Charlotte, North Carolina, United States
Arthritis and Osteoporosis Associates of New Mexico
🇺🇸Las Cruces, New Mexico, United States
Clinica Alemana de Osorno
🇨🇱Osorno, Chile
Clinica de la Costa
🇨🇴Barranquilla, Atlantico, Colombia
Box Arthritis & Rheumatology of the Carolinas, PLLC
🇺🇸Charlotte, North Carolina, United States
Articularis Healthcare d/b/a/ Low Country Rheumatology, PA
🇺🇸Summerville, South Carolina, United States
Aprillus Asistencia e Investigacion - Servicio de neurologia
🇦🇷Caba, Buenos Aires, Argentina
St. Lawrence Health System
🇺🇸Canton, New York, United States
New York University Medical Center
🇺🇸New York, New York, United States
Clinica Adventista Belgrano
🇦🇷Caba, Ciudad Autónoma De Buenos Aire, Argentina
North Georgia Rheumatology, PC
🇺🇸Lawrenceville, Georgia, United States
Eagle Medical
🇺🇸Crossville, Tennessee, United States
Centro Medico Privado de Reumatologia
🇦🇷SAN M. DE Tucuman, Tucumán, Argentina
Framingham Centro Medico
🇦🇷La Plata, Buenos Aires, Argentina
Sanatorio Británico
🇦🇷Rosario, Santa Fe, Argentina
Arthritis Clinic of Northern VA, P.C.
🇺🇸Arlington, Virginia, United States
Clinical Research Center of Reading,LLC
🇺🇸Wyomissing, Pennsylvania, United States
Jp Red Cross Society Himeji Hp
🇯🇵Himeji, Hyogo, Japan
Prosalud y cia. Ltda.
🇨🇱Santiago, Chile
Azienda Ospedaliera Universitaria Pisana
🇮🇹Pisa, Toscana, Italy
Hopital Européen
🇫🇷Marseille, France
Tohoku University Hospital
🇯🇵Sendai-shi, Miyagi, Japan
Clear Lake Specialties
🇺🇸Webster, Texas, United States
Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico
🇮🇹Milano, Italy
Spectrum Medical Inc.
🇺🇸Danville, Virginia, United States
Centre hospitalier universitaire Pellegrin
🇫🇷Bordeaux, France
Hokkaido University Hospital
🇯🇵Sapporo, Hokkaido, Japan
DOM Centro de Reumatologia
🇦🇷Ciudad de Buenos Aires, Buenos Aires, Argentina
HPTU-El Hospital con alma Pablo Tobon Uribe
🇨🇴Medellin, Antioquia, Colombia
Centre hospitalier universitaire de Haut Leveque
🇫🇷Pessac, Gironde, France
Azienda Ospedaliera Santa Maria Della Misericordia
🇮🇹Udine, Italy
Sterling Hospital
🇮🇳Vadodara, Gujarat, India
Hiroshima University Hospital
🇯🇵Hiroshima-shi, Hiroshima-ken, Japan
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
CHU Montpellier Lapeyronie Hospital
🇫🇷Montpellier, Hérault, France
Asan Medical Center
🇰🇷Seoul, Seoul-teukbyeolsi [Seoul], Korea, Republic of
Hamanomachi Hospital
🇯🇵Fukuoka, Japan
CIMS Hospital Private Limited
🇮🇳Ahmedabad, Gujarat, India
University of Occupational and Enviromental Health
🇯🇵Kitakyushu, Fukuoka, Japan
Azienda Ospedaliera Universitaria
🇮🇹Modena, MO, Italy
IRCCS Ospedale Policlinico San Martino
🇮🇹Genova, Italy
Panchshil Hospital
🇮🇳Ahmedabad, Gujarat, India
Kyung Pook National University Hospital
🇰🇷Daegu, Korea, Korea, Republic of
National Hospital Organization Asahikawa Medical Center
🇯🇵Asahikawa, Hokkaido, Japan
Kobe University Hospital
🇯🇵Kobe, Hyogo, Japan
Zespol Poradni Specjalistycznych REUMED
🇵🇱Lublin, Polska, Poland
Suite 509 Umhlanga Netcare Medical Centre
🇿🇦Umhlanga, Durban, South Africa
Hanyang University Medical Center
🇰🇷Seoul, Korea, Korea, Republic of
Hospital Quiron Infanta Luisa
🇪🇸Sevilla, Spain
Reumatika - Centrum Reumatologii
🇵🇱Warszawa, Mazowieckie, Poland
Corporació Sanitària Clínic
🇪🇸Barcelona, Spain
Jakaranda Hospital
🇿🇦Muckleneuk, Pretoria, South Africa
Napoca Emergency Clinical County Hospital
🇷🇴Napoca, Cluj, Romania
SC CMDTA Neomed SRL
🇷🇴Brasov, Romania
St. Maria Clinical Hospital
🇷🇴Bucharest, Romania
Spitalul Clinic "Dr. Ioan Cantacuzino"
🇷🇴Bucuresti, Romania
Institute for Treatment and Rehabilitation Niska Banja
🇷🇸Niska Banja, Serbia
University Of Pretoria
🇿🇦Pretoria, South Africa
Hospital De Fuenlabrada
🇪🇸Fuenlabrada, Madrid, Spain
Corporacion Sanitaria Parc Tauli
🇪🇸Sabadell, Sapin, Spain
Clinical Center of Vojvodina
🇷🇸Novi Sad, Serbia
Charlotte Maxeke Johannesburg Academic Hospital
🇿🇦Parktown, Guateng, South Africa
St. Luke's Medical Center
🇵🇭Quenzon City, Philippines
Clinical Research Chile SpA
🇨🇱Valdivia, Los Ríos, Chile
Sociedad Medica Del Aparato Locomotor SA
🇨🇱Santiago, Chile
Ambulatorium Barbara Bazela
🇵🇱Elblag, Warminsko-Mazurki, Poland
Malopolskie Centrum Medyczne S.C.
🇵🇱Krakow, Poland
Spitalul Clinic Sf Maria Bucuresti
🇷🇴Bucuresti, Romania
University Clinical Center of Serbia
🇷🇸Belgrade, Serbia
Denver Arthritis Clinic - Lowry
🇺🇸Denver, Colorado, United States
SUNY Upstate Medical University
🇺🇸Syracuse, New York, United States
University of Arizona Arthritis Center
🇺🇸Gilbert, Arizona, United States
Arizona Arthritis & Rheumatology Research
🇺🇸Phoenix, Arizona, United States
Dr. Dhiman Basu Private Practice
🇺🇸Colleyville, Texas, United States
Office: Dr Robin K Dore
🇺🇸Tustin, California, United States
Clinical Research of West Florida, Inc. (Clearwater)
🇺🇸Clearwater, Florida, United States
Northside Hospital
🇺🇸Atlanta, Georgia, United States
Integral Rheumatology & Immunology Specialists
🇺🇸Plantation, Florida, United States
Advanced Rheumatology, PC
🇺🇸Lansing, Michigan, United States
Glacier View Research Institute - Endocrinology
🇺🇸Kalispell, Montana, United States
Cincinnati Rheumatic Disease Study Group
🇺🇸Cincinnati, Ohio, United States
Oklahoma Medical Research Foundation
🇺🇸Oklahoma City, Oklahoma, United States
Advanced Rheumatology of Houston
🇺🇸The Woodlands, Texas, United States
Emory University
🇺🇸Atlanta, Georgia, United States
Johns Hopkins University School of Medicine
🇺🇸Baltimore, Maryland, United States
Innovative Health Research
🇺🇸Las Vegas, Nevada, United States
Metroplex Clinical Research Center
🇺🇸Dallas, Texas, United States
Fortis Escorts Hospital
🇮🇳Jaipur, Rajasthan, India
Panorama Medical Centre
🇿🇦Cape Town, Western Cape, South Africa
Instituto de Investigaciones Clinicas Quilmes
🇦🇷Quilmes, Buenos Aires, Argentina
IR Medical Center S.A. Instituto de Reumatologia
🇦🇷Mendoza, Argentina
Comite de Etica en Investigacion - CEMIC
🇦🇷Buenos Aires, Ciudad Autonoma De Buenos Aire, Argentina
Showa University Hospital
🇯🇵Shinagawa-ku, Tokyo, Japan
Clinical Research of West Florida
🇺🇸Tampa, Florida, United States
Tampa Medical Group, P.A.
🇺🇸Tampa, Florida, United States
Arizona Arthritis & Rheumatology Associates, P. C.
🇺🇸Tucson, Arizona, United States
Wallace Rheumatic Studies Center
🇺🇸Beverly Hills, California, United States
Medvin Clinical Research - Weidmann
🇺🇸Covina, California, United States
Inland Rheumatology & Osteoporosis Medical Group
🇺🇸Upland, California, United States
Millennium Research
🇺🇸Ormond Beach, Florida, United States
CER Instituto Medico
🇦🇷Quilmes, Buenos Aires, Argentina
Sanatorio Guemes Cardiocirugia
🇦🇷Ciudad Autonoma Buenos Aires, Argentina
Circaribe SAS
🇨🇴Barranquilla, Atlántico, Colombia
Centro de Medicina Interna
🇨🇴Cali, Valle Del Cauca, Colombia
Preventive Care Ltdac
🇨🇴Chia, Colombia
CHRU Brest - Hopital Cavale Blanche
🇫🇷Brest Cedex, Finistère, France
ChanRe Rheumatology And Immunology Center And Research
🇮🇳Bangalore, Karnataka, India
St. John Medical College & Hospital
🇮🇳Bangalore, Karnataka, India
Sushruta Multispecialty Hospital & Research Center Pvt Ltd
🇮🇳Hubli, Karnataka, India
Jasleen Hospital
🇮🇳Nagpur, Maharashtra, India
Azienda Policlinico Umberto I
🇮🇹Roma, Italy
Juntendo University Hospital
🇯🇵Bunkyo-ku, Tokyo, Japan
Kagawa University Hospital
🇯🇵Kita-gun, Kagawa, Japan
Gachon University Gil Hospital
🇰🇷Incheon, Korea, Korea, Republic of
National Hospital Organization Kyushu Medical Center
🇯🇵Fukuoka, Japan
Nippon Medical School Hospital
🇯🇵Tokyo, Japan
The Catholic University of Korea-Seoul St. Mary's Hospital
🇰🇷Seocho-Gu, Seoul, Korea, Republic of
Mary Mediatrix Medical Center
🇵🇭Lipa, Batangas, Philippines
Gabinet Internistyczno- Reumatologiczny Piotr Adrian Klimiuk
🇵🇱Bialystok, Podlaskie, Poland
Centrum Medyczne Plejady
🇵🇱Krakow, Poland
Military Medical Academy
🇷🇸Belgrade, Serbia
Spitalul Euroclinic
🇷🇴Bucureti, Romania
Institute of Rheumatology
🇷🇸Belgrade, Serbia
Winelands Medical Research Centre
🇿🇦Stellenbosch, Western Cape, South Africa
Hospital Universitari Vall d'Hebron
🇪🇸Barcelona, Spain
St. Lukes International Hospital
🇯🇵Chuo-Ku, Tokyo, Japan
Cebu Doctors Hospital
🇵🇭Cebu City, Cebu, Philippines
Angeles University Foundation and Medical Center
🇵🇭Angeles City, Pampanga, Philippines
Niepubliczny Zaklad Opieki Zdrowotnej Biogenes Sp. z o.o.
🇵🇱Wroclaw, Dolnoslaskie, Poland
Arthritis Clinical Trial Centre
🇿🇦Pinelands, Western Cape, South Africa
Idearg S.A.S.
🇨🇴Bogota, Cundinamarca, Colombia
Centro Integral de Reumatologia e Inmunologia
🇨🇴Bogotá, Cundinamarca, Colombia
Krishna Institute of Medical Science
🇮🇳Hyderabad, Andhra Pradesh, India
Chong Hua Medical Arts Center
🇵🇭Cebu City, Philippines
Twoja Przychodnia Centrum Medyczne Nowa Sol
🇵🇱Nowa Sol, Lubuskie, Poland
Medycyna Kliniczna
🇵🇱Warszawa, Mazowieckie, Poland
Craiova Emergency Clinical County Hospital
🇷🇴Craiova, Dolj, Romania
SANA Medical Center
🇷🇴Bucharest, Romania
Hospital Marina Baixa
🇪🇸La Vila Joiosa, Alicante, Spain
Toho University Ohashi Med C
🇯🇵Meguro-ku, Tokyo, Japan
Kasturba Medical College Hospital, Mangalore
🇮🇳Madhav Nagar, Manipal, Karnataka, India
Enroll SpA
🇨🇱Providencia, Región Metropolitana De Santia, Chile
ReumaCen Centro Reumatologico Integral
🇨🇱Vina del Mar, Chile
Southern Philippines Medical Center
🇵🇭Davao, Davao Del Norte, Philippines
Makati Medical Center
🇵🇭Makati City, Philippines
Szpital Uniwersytecki Nr 2 w Bydgoszczy, Klinika Reumatologii i Ukladowych Chorob Tkanki Lacznej
🇵🇱Bydgoszcz, Poland
Centrum Medyczne Pratia Katowice
🇵🇱Katowice, Poland
NZOZ Lecznica MAK-MED s.c.
🇵🇱Nadarzyn, Poland
Ortopedyczno-Rehabilitacyjny Szpital Kliniczny UM w Poznaniu
🇵🇱Poznan, Poland
Servimed S.A.S.
🇨🇴Bucaramanga, Santander, Colombia
Shree Giriraj Hospital
🇮🇳Rajkot, Gujarat, India
Arthritis Center of Lexington
🇺🇸Lexington, Kentucky, United States
Albuquerque Clinical Trials, Inc.
🇺🇸Albuquerque, New Mexico, United States
Hospital do Meixoeiro
🇪🇸Vigo, Pontevedra, Spain
Nirmal Hospital Private Limited
🇮🇳Surat, Gujarat, India
Synexus Affiliate - Sujata Birla Hospital & Medical Research Center
🇮🇳Nashik, Maharashtra, India
Keio University Hospital
🇯🇵Shinjuku-Ku, Tokyo, Japan
NHL Municipal Medical College & VS General Hospital
🇮🇳Ahmedabad, Gujarat, India