A Study of Oseltamivir (Tamiflu) for Treatment of Influenza in Immunocompromised Participants.

Phase 3

Completed

Conditions: Influenza, Human

Interventions: Drug: oseltamivir
Other: placebo

Registration Number: NCT00545532

Lead Sponsor: Hoffmann-La Roche

Brief Summary: This 2-arm study will investigate the safety and tolerability of oseltamivir for the treatment of influenza in immunocompromised participants and characterize the effects of oseltamivir in immunocompromised participants on the development of resistant influenza virus. Eligible immunocompromised participants with laboratory-confirmed influenza will be randomized to receive either conventional dose (30 milligrams \[mg\] to 75 mg twice daily orally \[po\], depending on age and weight) or double dose (60 mg-150 mg twice daily po depending on age and weight) olseltamivir for 10 days. Nasal and throat swabs will be taken, and safety evaluations made, at intervals during the study. The anticipated time on study medication is 10 days and the anticipated time on study is 40 days.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 228

Inclusion Criteria

Rapid diagnostic test, PCR, or viral culture positive for influenza in the 96 hours prior to first dose
Immunocompromised participants with primary or secondary immunodeficiency
Symptoms suggestive of influenza-like illness
Use of an effective contraceptive, as specified by protocol; women of childbearing potential cannot be pregnant or breastfeeding

Exclusion Criteria

Influenza vaccination with live attenuated vaccine in the 2 weeks prior to randomization
Antiviral treatment for influenza in 2 weeks prior to randomization
Severe hepatic impairment
Any current renal replacement therapy
Any gastrointestinal disorders which may interfere with the absorption of oseltamivir
Participation in a study with an investigational drug from 4 weeks prior to study start until study end

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Conventional dose	oseltamivir	Immunocompromised participants will receive oseltamivir syrup at a dose ranging from 30 to 75 mg based on body weight, twice daily for children (1 to 12 years old) and oseltamivir capsules 75 mg twice daily for adults/adolescents greater than or equal to (\>/=) 13 years old or placebo-matched to oseltamivir twice daily over 10 days.
Conventional dose	placebo	Immunocompromised participants will receive oseltamivir syrup at a dose ranging from 30 to 75 mg based on body weight, twice daily for children (1 to 12 years old) and oseltamivir capsules 75 mg twice daily for adults/adolescents greater than or equal to (\>/=) 13 years old or placebo-matched to oseltamivir twice daily over 10 days.
Double dose	oseltamivir	Immunocompromised participants will receive oseltamivir syrup at a dose ranging from 60 to 150 mg based on body weight, twice daily for children (1 to 12 years old) and oseltamivir capsules 150 mg twice daily for adults/adolescents (\>/=13 years old) or placebo matched to oseltamivir twice daily over 10 days.
Double dose	placebo	Immunocompromised participants will receive oseltamivir syrup at a dose ranging from 60 to 150 mg based on body weight, twice daily for children (1 to 12 years old) and oseltamivir capsules 150 mg twice daily for adults/adolescents (\>/=13 years old) or placebo matched to oseltamivir twice daily over 10 days.

Primary Outcome Measures

Name	Time	Method
Percentage of Participants With Tissue Rejection or Graft Versus Host Disease (GVHD)	Baseline up to Day 40	The percentage of transplant patients in the safety population who experienced tissue rejection and/or GvHD is reported.
Percentage of Participants With Adverse Events	Baseline up to Day 40	An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Percentage of Participants Who Developed Viral Resistance to Oseltamivir	Baseline up to Day 40	Resistance was defined as the presence of oseltamivir resistance mutations in viruses isolated from nasopharyngeal swab samples, identified by sequencing of the neuraminidase (NA) and hemagglutinin (HA) genes (genotypic resistance) and/or determination of the oseltamivir concentration at which the response is reduced by half (IC50) in an NA inhibition assay (phenotypic resistance). Reported are post-baseline phenotypic and genotypic resistance in adults \>/= 18 years and children and adolescents \<18 years in the modified Intent-to-Treat infected (mITTi) population.

Secondary Outcome Measures

Name	Time	Method
Percentage of Participants With Persistent Viral Shedding	Baseline to Day 11 (EOT)	Persistent shedding was defined as a viral load reduction \<1 log10 vp/mL at end of treatment compared with baseline. Reported is the percentage of participants with persistent viral shedding at end of treatment in adults \>/= 18 years and adolescents and children \< 18 years.
Percentage of Participants Who Developed Secondary Illness	Baseline up to Day 40	Secondary illness included bronchitis, pneumonia, acute sinusitis, sinusitis, lower respiratory infection or otitis media. Reported is the percentage of participants with at least one event in adults \>/= 18 years and adolescents and children \< 18 years.
Percentage of Participants Who Initiated Antibiotic Treatment	Baseline up to Day 40	Secondary illness included bronchitis, pneumonia, acute sinusitis, sinusitis, lower respiratory infection or otitis media. Reported is the percentage of participants with secondary illness, who initiated antibiotic treatment, in adults \>/= 18 years and adolescents and children \< 18 years.
Percentage of Participants Hospitalized	Baseline up to Day 40	Reported is the percentage of participants, who required hospitalization at any time between treatment initiation and the end of the study period, in adults \>/= 18 years and adolescents and children \< 18 years.
Duration of Hospitalization	Baseline up to Day 40	Reported is the duration of hospitalization at any time between treatment initiation and the end of the study period, in adults \>/= 18 years and adolescents and children \< 18 years.
Pharmacokinetics: Maximum Plasma Concentration (Cmax) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Cmax data for adults \>/= 18 years.
Pharmacokinetics: Trough Plasma Concentration (Ctrough) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Ctrough data for adults \>/= 18 years.
Pharmacokinetics : Area Under the Concentration-Time Curve From 0 to 12 Hours (AUC0-12) at Steady State of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours on Day 6 or any day after the 11th dose	AUC0-12 was reported at steady state as nanograms per hour per milliliter. (ng\*hr/mL). Reported here are oseltamivir AUC0-12 data for adults \>/= 18 years.
Pharmacokinetics: Time to Maximum Concentration (Tmax) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir tmax data for adults \>/= 18 years.
Pharmacokinetics: Elimination Constant (ke) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir ke data for adults \>/= 18 years.
Pharmacokinetics: Apparent Clearance (CL/F) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir CL/F data for adults \>/= 18 years.
Pharmacokinetics: Cmax of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Cmax data for adults \>/= 18 years.
Pharmacokinetics: Ctrough of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Ctrough data for adults \>/= 18 years.
Time to Resolution (TTR) of All Clinical Influenza Symptoms	Baseline up to Day 40	TTR of all clinical influenza symptoms was defined as the time from treatment initiation to the start of the 24-hour period in which all 7 influenza symptoms had scores \</= 1 (mild) and remained \</=1 for at least 21.5 hours. . Reported are TTRs in adults \>/= 18 years, adults and adolescents \>/= 13 years and children \<13 years in the mITTi population.
Total Symptom Score Area Under the Efficacy Curve (AUE)	Baseline up to Day 40	The overall extent and severity of illness was quantified by the AUE of the total symptom scores over the duration of illness, i.e., from the start of treatment to the time symptoms first alleviated. Total symptom scores were calculated from the sum of seven individual symptom scores with each individual symptom scored from 0 (healthy) to 3 (worst sickness) and a maximum total symptom score of 21. The AUE of these average scores was then calculated for each participant using the trapezoidal rule (the trapezoidal rule calculates the area under any curve by adding up all trapezoids under such a curve). A larger area indicates more severe disease. In this study participants were treated for 10 days. If a participant had scored 21 on every visit then AUE would have been 21 score x 10 days x 24 hours/day =5040 score x hours units, which is the highest possible score. The lowest possible score is 0. Reported are results for adults \>/= 18 years in the mITTi population.
Time to Cessation of Viral Shedding by RT-PCR	Baseline up to Day 40	Viral shedding was determined by direct viral load measurement from nasopharyngeal swabs by RT-PCR assay and expressed in log10 vp/mL. Reported is the time to cessation of viral shedding over time in adults \>/= 18 years and adolescents and children \< 18 years.
Time to Resolution of Fever	Baseline up to Day 40	Fever was defined as temperature \>/= 37.8 degrees Celsius at any time point during the study. TTR of fever was determined in Adults \>/= 18 years, Adults and adolescents \>/= 13 years and Children \< 13 years of the mITTi population.
Change From Baseline in Viral Load Assessed by Culture	Baseline (Day 1), Day 2/3, Day 6, Day 8, Day 11 end of treatment (EOT), follow-up (FU) Day 15 and FU Day 40.	Nasopharyngeal swab samples were cultured in Madin-Darby Canine Kidney cells. Culture supernatants were harvested after 2 weeks, or after a full-blown cytopathic effect was observed. Presence of infectious viruses in the cell culture supernatants (viral titer), expressed as log10 50% Tissue Culture Infectious Dose/milliliter (TCID50/mL), was determined by hemagglutination assay using turkey erythrocytes for H1 and B viruses or by detection of the virus nucleoprotein (NP) using ELISA for H3 viruses. A value of \< 0.5 log10 TCID50/mL was interpreted as negative. Data are reported for adults \>/= 18 years and adolescents and children \< 18 years.
Percentage of Participants With Viral Shedding Assessed by Culture Over Time	Baseline (Day 1), Day 2/3, Day 6, Day 8, Day 11 end of treatment (EOT), follow-up (FU) Day 15 and FU Day 40.	Viral shedding was determined through measurement of the viral titer after viral culture in Madin-Darby Canine Kidney cells by hemagglutination assay (for Flu A/H1N1 and Flu B) and NP-ELISA (for Flu A/H3N2) and expressed in log10 TCID50/mL. Reported is the percentage of participants with viral shedding over time in adults \>/= 18 years and adolescents and children \< 18 years.
Time to Cessation of Viral Shedding by Cell Culture	Baseline up to Day 40	Viral shedding was determined through measurement of the viral titer after viral culture in Madin-Darby Canine Kidney cells by hemagglutination assay (for Flu A/H1N1 and Flu B) and NP-ELISA (for Flu A/H3N2) and expressed in log10 TCID50/mL. Reported is the time to cessation of viral shedding over time in adults \>/= 18 years and adolescents and children \< 18 years.
Change From Baseline in Viral Load Assessed by Reverse Transcription Polymerase Chain Reaction (RT-PCR)	Baseline (Day 1), Day 2/3, Day 6, Day 8, Day 11 end of treatment (EOT), follow-up (FU) Day 15 and FU Day 40.	Nasopharyngeal swab samples were tested for influenza A and B RNA using semi-quantitative RT-PCR specific for influenza A and B matrix gene, respectively, after viral RNA isolation. Cycle threshold (Ct) value was determined for each sample. Conversion of Ct values into viral load, expressed as log10 virus particles/mL (vp/mL), was obtained using external standard curves ran in parallel in all RT-PCR experiments. A value of \< 2.6 log10 vp/mL for Flu A strains and \< 3.0 log10 vp/mL for Flu B strains was interpreted as a negative result. Data are reported for adults \>/= 18 years and adolescents and children \< 18 years.
Percentage of Participants With Viral Shedding Assessed by RT-PCR Over Time	Baseline (Day 1), Day 2/3, Day 6, Day 8, Day 11 end of treatment (EOT), follow-up (FU) Day 15 and FU Day 40.	Viral shedding was determined by direct viral load measurement from nasopharyngeal swabs by RT-PCR assay and expressed in log10 vp/mL. Reported is the percentage of subjects with viral shedding over time in adults \>/= 18 years and adolescents and children \< 18 years.
Pharmacokinetics: Apparent Volume of Distribution (Vc/F) of Oseltamivir in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Vc/F data for adults \>/= 18 years.
Pharmacokinetics : AUC0-12 at Steady State of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate AUC0-12 data for adults \>/= 18 years.
Pharmacokinetics: Tmax of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate tmax data for adults \>/= 18 years.
Pharmacokinetics: Elimination Constant (ke) of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oxeltamivir carboxylate ke data for adults \>/= 18 years.
Pharmacokinetics: Apparent Clearance (CL/F) of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate CL/F data for adults \>/= 18 years.
Pharmacokinetics: Apparent Volume of Distribution (Vc/F) of Oseltamivir Carboxylate in Adults	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Vc/F data for adults \>/= 18 years.
Pharmacokinetics: Cmax of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Cmax data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Ctrough of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Ctrough data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Tmax of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Cmax of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Cmax data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Ctrough of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Ctrough data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: AUC0-12 at Steady State of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours on Day 6 or any day after the 11th dose	AUC0-12 will be reported at steady state as ng\*hr/mL. Reported here are oseltamivir carboxylate AUC0-12 data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Tmax of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate tmax data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Elimination Constant (ke) of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir ke data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: AUC0-12 at Steady State of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours on Day 6 or any day after the 11th dose	AUC0-12 will be reported at steady state as ng\*hr/mL. Reported here are oseltamivir AUC0-12 data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Apparent Clearance (CL/F) of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir CL/F data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Apparent Volume of Distribution (Vc/F) of Oseltamivir in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir Vc/F data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Elimination Constant (ke) of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate ke data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Apparent Clearance (CL/F), of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate CL/F data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.
Pharmacokinetics: Apparent Volume of Distribution (Vc/F) of Oseltamivir Carboxylate in Adolescents and Children	Pre-dose (30 minutes), 1.5, 4, 8 hours postdose on Day 6 or any day after the 11th dose	Reported here are oseltamivir carboxylate Vc/F data for adolescents and children \< 18 years. Individual data are provided as participants received different drug doses. Drug dose is indicated in the row title for each participant.

Trial Locations

Locations (208): Baylor University Medical Center Transplant Administration
🇺🇸
Dallas, Texas, United States
Sammons Cancer Center-Baylor University; Blood & Marrow Transplantation
🇺🇸
Dallas, Texas, United States
UCLA Medical center Medicine/Nephrology
🇺🇸
Los Angeles, California, United States
University of Maryland School of Medicine
🇺🇸
Baltimore, Maryland, United States
Uni of Pennsylvania; Infectious Diseases
🇺🇸
Philadelphia, Pennsylvania, United States
University of Pennsylvania Health System
🇺🇸
Philadelphia, Pennsylvania, United States
Northwestern Memorial Hospital; Divison of Infectious Diseases/ Dept of Medicine
🇺🇸
Chicago, Illinois, United States
University of Chicago; Infectious Disease
🇺🇸
Chicago, Illinois, United States
Duke University Health Systems
🇺🇸
Raleigh, North Carolina, United States
EMORY UNIVERSITY; Bone Marrow & Stem Cell Transplant Center
🇺🇸
Atlanta, Georgia, United States
Novant Health Pulmonary and Critical Care
🇺🇸
Matthews, North Carolina, United States
Christiana Care Health System
🇺🇸
Newark, Delaware, United States
All Children'S Hospital; Pediatric Blood & Marrow Transplant Program
🇺🇸
Saint Petersburg, Florida, United States
Hospital Universitario 12 de Octubre; HIV Unit
🇪🇸
Madrid, Spain
Children'S Medical Center of Dallas
🇺🇸
Dallas, Texas, United States
Piedmont Hospital; Transplant Services
🇺🇸
Atlanta, Georgia, United States
Beals Institute PC
🇺🇸
Lansing, Michigan, United States
Drexel University; College of Medicine
🇺🇸
Philadelphia, Pennsylvania, United States
Kaunas Clinics Public Institution; Clinic of Nephrology
🇱🇹
Kaunas, Lithuania
Hospital Dr. Sotero del Rio
🇨🇱
Santiago, Chile
Phylaxis Clinical Research S de RL de CV
🇲🇽
Cuautitlan Izcalli, Mexico
Govind U
🇿🇦
Durban, South Africa
Republican Tuberculosis and Infectious Diseases University H
🇱🇹
Vilnius, Lithuania
Mzansi Ethical Research Centre
🇿🇦
Middelburg, South Africa
Global Clinical Trials Port Elizabeth
🇿🇦
Port Elizabeth, South Africa
SPZOZ Uniwersytecki Szp Klin; nr1 im.N.Barlickiego UM
🇵🇱
Lodz, Poland
Szpital Dzieciatka Jezus-Centrum Lecezenia Obrazen; Dpt of Transplantation Medicine & Nephrology
🇵🇱
Warszawa, Poland
Klaipeda University Hospital; Public Institution
🇱🇹
Klaipeda, Lithuania
Universitätsklinikum Hamburg-Eppendorf
🇩🇪
Hamburg, Germany
Hospital Universitari Vall d'Hebron; Departamento de Enfermedades Infecciosas
🇪🇸
Barcelona, Spain
Londisizwe Research Centre
🇿🇦
Durban, South Africa
Dr V Naidoo Private Practice
🇿🇦
Durban, South Africa
Soweto CTC - Dr Phoshoko site
🇿🇦
Johannesburg, South Africa
Sebastian Peter
🇿🇦
Durban, South Africa
Newtown Clinical Research
🇿🇦
Johannesburg, South Africa
Hospital Clínic i Provincial; Servicio de Hematología y Oncología
🇪🇸
Barcelona, Spain
INER- Instituto Nacional de Enfermedades Respiratorias"Ismae
🇲🇽
Mexico, Mexico
Be Part Yoluntu Centre
🇿🇦
Paarl, South Africa
Vilnius University Hospital Santariskiu Clinic, Hematology, Oncology and Tranfusion Medicine Center
🇱🇹
Vilnius, Lithuania
Kalafong Hospital; Pathology
🇿🇦
Pretoria, South Africa
Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde; Infectología piso 7
🇲🇽
Guadalajara, Mexico
Synexus Clinical Research Centres SA Stanza Bopape
🇿🇦
Pretoria, South Africa
Hospital General Universitario Gregorio Marañon
🇪🇸
Madrid, Spain
Hospital Clinico San Carlos; Servicio de Nefrologia
🇪🇸
Madrid, Spain
Hospital Universitari Vall d'Hebron
🇪🇸
Barcelona, Spain
Manchester Royal Infirmary; Renal Transplant Unit
🇬🇧
Manchester, United Kingdom
Hospital Universitario la Paz; Servicio de Enfermedades Infecciosas - HIV unit
🇪🇸
Madrid, Spain
Hospital Universitari de Bellvitge; Servicio de Nefrologia
🇪🇸
Hospitalet de Llobregat, Barcelona, Spain
Soweto CTC - Dr Mushwana site
🇿🇦
Johannesburg, South Africa
Hospital Clinico Universitario de Santiago
🇪🇸
Santiago de Compostela, LA Coruña, Spain
University Hospitals Bristol NHS Foundation Trust
🇬🇧
Bristol, United Kingdom
Josha Research
🇿🇦
Bloemfontein, South Africa
Hospital Universitario Clínico San Carlos; Servicio de Enfermedades Infecciosas
🇪🇸
Madrid, Spain
Nottingham City Hospital; Transplant Unit
🇬🇧
Nottingham, United Kingdom
Hospital Universitario 12 de Octubre; Servicio de Pediatria
🇪🇸
Madrid, Spain
Tygerberg Hospital Pediatrics and Child Health
🇿🇦
Tygerberg; Cape Town, South Africa
Ukrainian Pediatric Specialized Hospital of Ministry of Health of Ukraine Dept of BMT
🇺🇦
Kiev, Ukraine
Hospital Universitario La Paz; Hepatología y Trasplantes
🇪🇸
Madrid, Spain
Zaporozhye State Medical University; Dept of Transplantology
🇺🇦
Zaporozhye, Ukraine
Fondazione IRCCS CA' Granda Ospedale Maggiore Policlinico; Clinica Pediatica De Macchi
🇮🇹
Milano, Molise, Italy
Emmed Research
🇿🇦
Pretoria, South Africa
Soweto Clinical Trial Centre
🇿🇦
Soweto, South Africa
Welkom Clinical Trial Centre
🇿🇦
Welkom, South Africa
Hospital Infantil Universitario Nino Jesus
🇪🇸
Madrid, Spain
Providence Clinical Research
🇺🇸
Burbank, California, United States
Mount Sinai Medical Center; Division of Liver Diseases
🇺🇸
New York, New York, United States
Long Island Jewish/North Shore Hospital
🇺🇸
New Hyde Park, New York, United States
Toledo Hospital
🇺🇸
Toledo, Ohio, United States
Penn State Milton S. Hershey Medical Center
🇺🇸
Hershey, Pennsylvania, United States
Texas Tech University Health Sciences Center; Department of Urology
🇺🇸
Lubbock, Texas, United States
UT Southwestern Medical Center; Pediatrics Dept.
🇺🇸
Dallas, Texas, United States
Hospital Italiano de La Plata
🇦🇷
La Plata, Argentina
Hospital General de Agudos Juan Antonio Fernandez; infectología
🇦🇷
Buenos Aires, Argentina
Instituto Medico Especializado Alexander Fleming
🇦🇷
Ciudad Autonoma Buenos Aires, Argentina
Hospital de Niños Dr. Orlando Alassia
🇦🇷
Santa Fe, Argentina
Onze Lieve Vrouwziekenhuis Aalst
🇧🇪
Aalst, Belgium
Hospital Erasme; Neurologie
🇧🇪
Bruxelles, Belgium
Institut Jules Bordet
🇧🇪
Bruxelles, Belgium
UZ Brussel
🇧🇪
Brussel, Belgium
Fiocruz - Fundação Oswaldo Cruz
🇧🇷
Rio de Janeiro, RJ, Brazil
Iop - Graacc - Unifesp
🇧🇷
Sao Paulo, SP, Brazil
Hospital das Clinicas - FMUSP
🇧🇷
Sao Paulo, SP, Brazil
Hospital do Rim e Hipertensão - Fundação Oswaldo Ramos
🇧🇷
Sao Paulo, SP, Brazil
Infectologos Asociados
🇨🇴
Barranquilla, Colombia
Centro de Investigaciones Clinicas Viña del Mar
🇨🇱
Viña Del Mar Valparaiso, Chile
St Paul'S
🇨🇦
Saskatoon, Saskatchewan, Canada
Hospital Luis Calvo Mackenna; Unidad de Investigacion
🇨🇱
Santiago, Chile
Simedics Ips
🇨🇴
Bogota, Colombia
Fundacion Cardiovascular de Colombia - Instituto del Corazón
🇨🇴
Floridablanca, Colombia
Centro de Investigaciones Clinicas S.A.S
🇨🇴
Cali, Colombia
Fakultni Nemocnice; Hemato-Oncology
🇨🇿
Plzen, Czechia
Fakultni nemocnice v Motole; Klinika detske hematologie a onkologie UK 2.LF
🇨🇿
Praha 5, Czechia
The Institute of Hematology and Blood Transfusion Transplantation Unit; Hematology and Blood Transf
🇨🇿
Praha, Czechia
Hopital Rangueil; Nephrologie
🇫🇷
Toulouse, France
KASMED, s.r.o.; Alergologie a klinicka imunologie
🇨🇿
Tabor, Czechia
Tartu Uni Clinics; Clinic of Surgery & Internal Medicine Dept of Nephrology
🇪🇪
Tartu, Estonia
Revmatologicka Ambulance-Terezin
🇨🇿
Terezin, Czechia
North Estonia medical Centre; Hematology
🇪🇪
Tallinn, Estonia
Tartu University Hospital; Department of Infectious Diseases
🇪🇪
Tartu, Estonia
Revmatologicka ambulance
🇨🇿
Zlin, Czechia
West Tallinn Central Hospital; Nephrology
🇪🇪
Tallinn, Estonia
Hopital Robert Debre; Pediatric Hematology Dept
🇫🇷
Paris, France
Hopital Saint Louis; Service de Nephrologie - Transplantation
🇫🇷
Paris, France
Centre Hospitalier de la Croix Rousse
🇫🇷
Lyon, France
Hopital Europeen Georges Pompidou; Service de Nephrologie
🇫🇷
Paris, France
CHRU Bretonneau
🇫🇷
Tours, France
Universitätsklinikum Essen; Innere Klinik und Poliklinik für Tumorforschung
🇩🇪
Essen, Germany
Uniklinik RWTH Aachen; Med. Klinik II; Klinik für Nephrologie und klinische Immunologie
🇩🇪
Aachen, Germany
Ludwig-Maximilian-Universitaetsklinik; Med. Poliklinik/Infektiologie
🇩🇪
Muenchen, Germany
UNI-Klinikum Heidelberg Chirurgische Klinik
🇩🇪
Heidelberg, Germany
Ludwig-Maximilians-Universitaet; Medizinische Klinik und Poliklinik IV
🇩🇪
Muenchen, Germany
Charite - Campus Virchow Klinikum; Abteilung fuer Chirurgie
🇩🇪
Berlin, Germany
Universitaetsklinikum Muenster; Paedriatrische Haematologie und Onkologie
🇩🇪
Muenster, Germany
Clinica Familiar Luis Angel Garcia
🇬🇹
Ciudad de Guatemala, Guatemala
CERICAP
🇬🇹
Ciudad de Guatemala, Guatemala
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum;
🇭🇺
Debrecen, Hungary
Unidad Nacional de Oncologia Pediatrica
🇬🇹
Guatemala, Guatemala
Fov.Onk.Egyesitett Szt. Istvan es Szt Laszlo Korh.-Rend.Int.
🇭🇺
Budapest, Hungary
Petz Aladar Megyei Korhaz; Hematologia
🇭🇺
Gyor, Hungary
Bekes Megyei Kepviselotestulet Pandy Kalman Korhaza
🇭🇺
Gyula, Hungary
Pecsi Tudomanyegyetem
🇭🇺
Pecs, Hungary
Fejer Megyei Szent Gyorgy Korhaz
🇭🇺
Szekesfehervar, Hungary
University of Szeged; Transplantation Department
🇭🇺
Szeged, Hungary
Rambam Health Care Campus; Hematology
🇮🇱
Haifa, Israel
Veszprem Megyei Csolnoky Ferenc Korhaz Nonprofit Zrt.
🇭🇺
Veszprem, Hungary
Rabin MC- Belinson campus
🇮🇱
Petach Tikva, Israel
Hadassah University Hospital - Ein Kerem; BMT & Cancer Immunotherapy Dept.
🇮🇱
Jerusalem, Israel
Rabin Medical Center-Golda Campus - Hasharon; Department of Transplantation
🇮🇱
Petach Tikva, Israel
Rabin Medical Center; Liver Inst.
🇮🇱
Petach Tikva, Israel
Azienda Ospedaliera; Divisione Malattie Infettive E Tropicali
🇮🇹
Parma, Emilia-Romagna, Italy
POLICLINICO Universitatio A.Gemelli, Div. Chirurgia Generale e Trapianti d'Organo
🇮🇹
Roma, Lazio, Italy
Chaim Sheba Medical Center; Hematology BMT & CBB
🇮🇱
Ramat Gan, Israel
Sourasky MC; Transplant Unit
🇮🇱
Tel Aviv, Israel
Chaim Sheba MC; Pediatric Hematology Oncology
🇮🇱
Tel Hashomer, Israel
ASST DEGLI SPEDALI CIVILI DI BRESCIA; Dipartimento Malattie Infettive
🇮🇹
Brescia, Lombardia, Italy
ASST DI MONZA; Divisione Malattie Infettive
🇮🇹
Monza, Lombardia, Italy
Fondazione IRCCS Policlinico San Matteo
🇮🇹
Pavia, Lombardia, Italy
Latvia Transplantation Center P. Stradina Hospital; Transplantation
🇱🇻
Riga, Latvia
Children's Clinical University Hospital
🇱🇻
Riga, Latvia
Pacific Oaks Medical Group
🇺🇸
Beverly Hills, California, United States
New England Research Associates
🇺🇸
Trumbull, Connecticut, United States
Medical College of Georgia; Medicine/ Nephrology
🇺🇸
Augusta, Georgia, United States
Kendall South Medical Center Inc.
🇺🇸
South Miami, Florida, United States
Vita Research Solutions, Inc
🇺🇸
Tamarac, Florida, United States
AIDS Research Alliance
🇺🇸
Los Angeles, California, United States
Rush Uni Medical Center; Medicine/ Section of Infectious Diseases
🇺🇸
Chicago, Illinois, United States
Washington University; Wash Uni. Sch. Of Med
🇺🇸
Saint Louis, Missouri, United States
Western New England Renal & Transplant Associates, P.C.
🇺🇸
Springfield, Massachusetts, United States
Our Lady of Lourdes Medical Center; Transplant Dept
🇺🇸
Camden, New Jersey, United States
Hackensack University Medical Center
🇺🇸
Hackensack, New Jersey, United States
DJL Clinical Research PLLC
🇺🇸
Charlotte, North Carolina, United States
Children'S Hospital of Pittsburgh; Infectious Disease
🇺🇸
Pittsburgh, Pennsylvania, United States
Scott and White Division of Nephrology Dept of Medicine
🇺🇸
Temple, Texas, United States
Instituto Medico Platense
🇦🇷
Buenos Aires, Argentina
UMHAT Sv. Georgi, EAD; Clinic of Infectious Diseases
🇧🇬
Plovdiv, Bulgaria
Mhat Alexandrovska Ead ; Clinic of Nephrology & Transplantation, Uni Hospital
🇧🇬
Sofia, Bulgaria
Hospital General de Agudos Dr. Ignacio Pirovano
🇦🇷
Ciudad Autonoma Buenos Aires, Argentina
Specialized Hospital for children with oncohaematologica Diseases; Dept. Of Transplantations
🇧🇬
Sofia, Bulgaria
Békés Megyei Pándy Kálmán Kórház; Onkologiai tanszek
🇭🇺
Gyula, Hungary
Hospital Alemao Oswaldo Cruz; Oncologia
🇧🇷
Sao Paulo, SP, Brazil
UMHA - Sv. Georgi; Clinic of Nephrology & Haemodialysis
🇧🇬
Plovdiv, Bulgaria
Fakultni nemocnice Brno; Interni hematologicka a onkologicka klinika
🇨🇿
Brno, Czechia
Uni of Manitoba; Faculty of Medicine
🇨🇦
Winnipeg, Manitoba, Canada
Jasz-Nagykun-Szolnok Megyei Hetenyi Geza Korhaz-Rend.Int.
🇭🇺
Szolnok, Hungary
Hospital Roosevelt Guatemala; Clinica de Infecciosas
🇬🇹
Guatemala City, Guatemala
Uniwersyteckie Centrum Kliniczne
🇵🇱
Gdansk, Poland
Instytut Pomnik-Centrum Zdrowia Dziecka, Klinika Nefrologii, Transp. Nerek i Nadcisnienia Tetniczego
🇵🇱
Warszawa, Poland
Institutul de Urologie Si Transplant Renal Fundeni
🇷🇴
Bucharest, Romania
I.N.M.I. L. Spallanzani IRCCS
🇮🇹
Roma, Lazio, Italy
Instituto Nacional de Ciencias Medicas y Nutricion Salvador; Infectologia
🇲🇽
Mexico, Mexico
Wojewodzki Szp.Specjalistyczny im.K.Dluskiego w Bialymstoku
🇵🇱
Bialystok, Poland
NZOZ Vitamed
🇵🇱
Bydgoszcz, Poland
SP Szpital Kliniczny Nr 1 we Wroclawiu
🇵🇱
Wroclaw, Poland
ALL-MED Specjalistyczna Opieka Medyczna
🇵🇱
Wroclaw, Poland
Tartu Uni Hospital; Hematology - Oncology Clinic
🇪🇪
Tartu, Estonia
Centro de Investigaciones Pediatricas
🇬🇹
Guatemala City, Guatemala
Vilnius University Hospital Santariskiu Clinic
🇱🇹
Vilnius, Lithuania
Hospital Universitario de Monterrey; Infectologia
🇲🇽
Monterrey, Mexico
Hospital de Especialidades del Centro Medico Puerta de Hierr
🇲🇽
Zapopan, Mexico
SPZOZ Szpital Uniw W Krakowie
🇵🇱
Krakow, Poland
Universitätsspital Zürich; Klinik für Nephrologie
🇨🇭
Zürich, Switzerland
Siauliai Republican Hospital Public Institution
🇱🇹
Siauliai, Lithuania
Centro de Investigacion Clínica GRAMEL S.C
🇲🇽
Mexico, Mexico
SPSK nr 2 Pomorskiej Akademii Medycznej w Szczecinie
🇵🇱
Szczecin, Poland
Lugansk Regional Clinical Hospital; Chair of Therapy Faculty of Postgr.Ed
🇺🇦
Lugnansk, Ukraine
Institute of Nephrology AMS; Dept of Nephrology & dialysis
🇺🇦
Kiev, Ukraine
University of Colorado; Kidney Transplant Center Office of Dr. Laurence Chan
🇺🇸
Aurora, Colorado, United States
Uni of Alabama At Birmingham; Division of Nephrology
🇺🇸
Birmingham, Alabama, United States
University of Alabama at Birmingham; Pediatric Nephrology
🇺🇸
Birmingham, Alabama, United States
University of California Davis Health System
🇺🇸
Sacramento, California, United States
CALIFORNIA PACIFIC MEDICAL CENTER; Office of Dr. Venkat Peddi
🇺🇸
San Francisco, California, United States
Omega Research Consultants
🇺🇸
Orlando, Florida, United States
University of South Florida
🇺🇸
Tampa, Florida, United States
Tulane University Medical Center
🇺🇸
New Orleans, Louisiana, United States
Brigham & Women'S Hospital
🇺🇸
Boston, Massachusetts, United States
Uni of Michigan Medical Center; Internal Medicine/ Infectious Disease
🇺🇸
Ann Arbor, Michigan, United States
Karmanos Cancer Inst. ; Hudson Webber; Cancer Research Building
🇺🇸
Detroit, Michigan, United States
Henry Ford Health System; Gastroenterology
🇺🇸
Detroit, Michigan, United States
Wayne State University School of Medicine
🇺🇸
Detroit, Michigan, United States
Wake Forest University Baptist Medical Center
🇺🇸
Winston-Salem, North Carolina, United States
Uni of Cincinnati Medical Center; Nephrology & Hypertension
🇺🇸
Cincinnati, Ohio, United States
Cleveland Clinic Foundation; Infectious Disease
🇺🇸
Cleveland, Ohio, United States
Nazih Zuhdi Transplant Inst. ; Integris Baptist Medical Center
🇺🇸
Oklahoma City, Oklahoma, United States
Medical University of South Carolina; Pediatric Cardiology
🇺🇸
Charleston, South Carolina, United States
The Methodist Hospital
🇺🇸
Houston, Texas, United States
M.D Anderson Cancer Center; Infectious Diseases, Infection Control, and Employee Health
🇺🇸
Houston, Texas, United States
University of Texas Health Science Center Transplant center
🇺🇸
San Antonio, Texas, United States
University of Utah Health Science Center Gastroenterology
🇺🇸
Salt Lake City, Utah, United States