A Study Of PF-00547659 In Patients With Moderate To Severe Ulcerative Colitis
- Conditions
- Ulcerative Colitis
- Interventions
- Drug: PlaceboDrug: PF-00547659 SC Injection
- Registration Number
- NCT01620255
- Lead Sponsor
- Shire
- Brief Summary
To determine the dose or doses of PF-00547659 that will be the most effective to improve or halt the disease symptoms in patients with moderate to severe ulcerative colitis.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 357
- Subjects with diagnosis of Ulcerative Colitis for 3 or more months.
- Ulcerative colitis must be active beyond the rectum.
- Must active Ulcerative Colitis with a Total Mayo Score of 6 to 12 points
- Pregnant or breast feeding.
- Diagnosis of indeterminate colitis or Crohn's Disease
- Subjects with history of colonic or small bowel obstruction or resection.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Placebo - Drug Dose Level 1 PF-00547659 SC Injection - Drug Dose Level 2 PF-00547659 SC Injection - Drug Dose Level 4 PF-00547659 SC Injection - Drug Dose Level 3 PF-00547659 SC Injection -
- Primary Outcome Measures
Name Time Method Percentage of Participants in Clinical Remission at Week 12 Week 12 Clinical remission was defined as a Total Mayo Score of less than or equal (\<=) 2 points with no individual subscore exceeding 1 point and rectal bleed subscore of 0 or 1. The Mayo Score is a tool designed to measure disease activity for ulcerative colitis (UC). Scoring ranges from 0 to 12 points and consists of 4 subscores, each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Mucosal Healing at Week 12 Week 12 Mucosal healing was defined as absolute Mayo subscore for endoscopy of 0 or 1. The Mayo Score is a tool designed to measure disease activity for UC. Scoring ranges from 0 to 12 points and consists of 4 subscores, each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses.
Change From Baseline in Inflammatory Bowel Disease Questionnaire (IBDQ) Domain Scores at Week 12 Baseline (BL), Week 12 IBDQ: Psychometrically validated PRO instrument for measuring disease-specific QOL in participants with inflammatory bowel disease. IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). Total score is the sum of each item score, ranged from 32 to 224 with higher score indicating better QOL. Positive change in total score indicated improvement in QOL. There are 4 individual domains under the IBDQ: bowel function (fx)/symptoms (score range of 10-70), systemic symptoms (score range of 5-35), emotional status/fx (score range of 12-84), and social fx (score range of 5-35). As with total score, higher scores indicate better QOL in that domain.
Percentage of Participants With Change From Baseline in Individual Mayo Subscore - Findings on Flexible Sigmoidoscopy - at Week 12 Baseline, Week 12 The Mayo Score is a tool designed to measure disease activity for UC. Scoring ranges from 0 to 12 points and consists of 4 subscores (stool frequency, rectal bleeding, PGA, findings on flexible sigmoidoscopy), each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses. Changes from baseline in the subscore of \<0, 0, and \>0 corresponded to improvement (imp), no change (NC), and worsening (wors) in that specific subscore.
Percentage of Participants With Clinical Response at Week 12 Week 12 Clinical response was defined as a decrease from baseline of at least 3 points in Total Mayo Score with at least a 30 percent (%) change, accompanied by at least 1 point decrease or absolute score of 0 or 1 in rectal bleeding subscore. The Mayo Score is a tool designed to measure disease activity for UC. Scoring ranges from 0 to 12 points and consists of 4 subscores, each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses.
Change From Baseline in Total Mayo Score at Week 12 Baseline, Week 12 The Mayo Score is a tool designed to measure disease activity for UC. Scoring ranges from 0 to 12 points and consists of 4 subscores, each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses.
Percent Change From Baseline in High Sensitivity C-reactive Protein (hsCRP) at Weeks 4, 8, and 12 Baseline; Weeks 4, 8, and 12 hsCRP was one of the PD biomarkers of the study.
Change From Baseline in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score at Week 12 Baseline, Week 12 IBDQ: Psychometrically validated patient reported outcome (PRO) instrument for measuring disease-specific quality of life (QOL) in participants with inflammatory bowel disease. IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). Total score is the sum of each item score, ranged from 32 to 224 with higher score indicating better QOL. Positive change in total score indicated improvement in QOL.
Maximum Serum PF-00547659 Concentration Achieved Weeks 0 (baseline), 2, 4,8, 12, 16, 20, 24, 28, 32, and 36; Early Withdrawal Percentage of Participants With Absolute Partial Mayo Score of Less Than or Equal to (<=) 2 With no Individual Subscore More Than (>) 1 at Weeks 4, 8, and 12 Weeks 4, 8, and 12 An absolute Partial Mayo Score of \<=2 corresponds to remission. However, this endpoint was incorrectly stated in the protocol and instead of "absolute Partial Mayo Score \<=2", it was stated as "change from baseline in Partial Mayo Score \<=2".
Percentage of Participants With Change From Baseline in Individual Mayo Subscores - Stool Frequency, Rectal Bleeding, and Physician's Global Assessment (PGA) - at Weeks 4, 8, and 12 Baseline; Weeks (W) 4, 8, and 12 The Mayo Score is a tool designed to measure disease activity for UC. Scoring ranges from 0 to 12 points and consists of 4 subscores (stool frequency, rectal bleeding, PGA, findings on flexible sigmoidoscopy), each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses. Changes from baseline in the subscore of less than (\<) 0, 0, and \>0 corresponded to improvement (imp), no change (NC), and worsening (wors) in that specific subscore.
Percent Change From Baseline in Fecal Calprotectin at Weeks 4, 8, and 12 Baseline, Weeks 4, 8, and 12 Fecal calprotectin was one of the pharmacodynamic (PD) biomarkers of the study.
Percentage of Participants With an Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score of More Than or Equal to (>=) 170 at Week 12 Week 12 IBDQ: Psychometrically validated PRO instrument for measuring disease-specific QOL in participants with inflammatory bowel disease. IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). Total score is sum of each item score, ranged from 32 to 224 with higher score indicating better QOL. Positive change in total score indicated improvement in QOL. A score of \>=170 corresponds to clinical remission.
Number of Participants With Treatment-emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs), and Withdrawals Due to TEAEs During the Treatment Period (Weeks 0-12) Screening through to end of treatment period, up to 12 weeks An adverse event (AE) was any untoward medical occurrence attributed to study drug in a participant who received study drug. TEAEs are defined as newly occurring AEs or those worsening after first dose. AEs comprised both SAEs and non-SAEs. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.
Trial Locations
- Locations (189)
Gastroenterology Associates
🇺🇸Crystal River, Florida, United States
UCSD Health System-Pharmacy only
🇺🇸La Jolla, California, United States
GastroDiagnostics - Community Clinical Trials Drug
🇺🇸Orange, California, United States
Citrus Memorial Hospital
🇺🇸Inverness, Florida, United States
First Quality Laboratory
🇺🇸Miramar, Florida, United States
Venutre Ambulatory Sugery Center
🇺🇸North Miami Beach, Florida, United States
Endoscopic Microsurgery Associates
🇺🇸Towson, Maryland, United States
Barnes-Jewish Hospital Radiology (X-Ray Only)
🇺🇸Saint Louis, Missouri, United States
Center for Advanced Medicine
🇺🇸Saint Louis, Missouri, United States
Washington University School of Medicine
🇺🇸Saint Louis, Missouri, United States
Albany Medical College
🇺🇸Albany, New York, United States
New York Presbyterian Hospital
🇺🇸New York, New York, United States
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Royal Brisbane and Women's Hospital
🇦🇺Herston, Queensland, Australia
AZ St-Elisabeth Herentals
🇧🇪Herentals, Belgium
McMaster University Medical Center
🇨🇦Hamilton, Ontario, Canada
Pavillion Rachel Tourigny, Hopital Maisonneuve-Rosemont
🇨🇦Montreal, Quebec, Canada
Hôpital Nord Service de Gastro-entérologie
🇫🇷Saint Priest en Jarez, France
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Baylor Clinic (Drug Storage)
🇺🇸Houston, Texas, United States
Baylor College Of Medicine - Baylor Medical Center
🇺🇸Houston, Texas, United States
Yonsei University College of Medicine, Severance Hospital
🇰🇷Seoul, Korea, Republic of
Maastricht University Medical Center
🇳🇱Maastricht, Netherlands
The Hamilton Eye Clinic
🇳🇿Hamilton, New Zealand
Military medical Academy
🇷🇸Belgrade, Serbia
GI Research Institute (GIRI)
🇨🇦Vancouver, British Columbia, Canada
Hepato-Gastroenterology HK s.r.o.
🇨🇿Hradec Kralove, Czechia
Krajska zdravotni, a.s., Masarykova nemocnice v Usti nad Labem o.z.
🇨🇿Usti nad Labem, Czechia
New York Presbyterian Hospital - Weill Cornell Medical College
🇺🇸New York, New York, United States
Perlman Medical Offices
🇺🇸La Jolla, California, United States
Clinical and Translational Research Institute
🇺🇸La Jolla, California, United States
Community Clinical Trials
🇺🇸Orange, California, United States
Thornton Hospital
🇺🇸La Jolla, California, United States
Clinical Research of the Rockies
🇺🇸Lafayette, Colorado, United States
Rocky Mountain Gastroenterology Associates
🇺🇸Thornton, Colorado, United States
Endoscopy Center of Connecticut, LLC
🇺🇸Hamden, Connecticut, United States
Medical Research Network of Connecticut
🇺🇸Hamden, Connecticut, United States
Florida Surgery Center
🇺🇸Altamonte Springs, Florida, United States
Research Consultant Group
🇺🇸Hialeah, Florida, United States
Th Palmetto Surgery Center
🇺🇸Hialeah, Florida, United States
Inverness Medical Imaging
🇺🇸Inverness, Florida, United States
Sand Lake Imaging
🇺🇸Maitland, Florida, United States
Shafran Gastroenterology Center
🇺🇸Winter Park, Florida, United States
Atlanta Gastroenterology Specialist
🇺🇸Suwanee, Georgia, United States
Signature Healthcare Brockton
🇺🇸Brockton, Massachusetts, United States
Commonwealth Clinical Studies
🇺🇸Brockton, Massachusetts, United States
East Valley Endoscopy
🇺🇸Grand Rapids, Michigan, United States
Metro Health Endoscopy Unit
🇺🇸Wyoming, Michigan, United States
Surgery Center of Columbia
🇺🇸Columbia, Missouri, United States
Consulting Radiology
🇺🇸Plymouth, Minnesota, United States
Minnesota Gastroenterology, P.A.
🇺🇸Plymouth, Minnesota, United States
Dartmouth-Hitchcock Medical Center
🇺🇸Lebanon, New Hampshire, United States
Premier Medical Group Research Department - Drug
🇺🇸Poughkeepsie, New York, United States
Weill Cornell Medical College of Cornell University
🇺🇸New York, New York, United States
Premier Medical Group of the Hudson Valley, PC
🇺🇸Poughkeepsie, New York, United States
Weill Cornell Medical College - New York Presbyterian Hospital
🇺🇸New York, New York, United States
Diagnostic Imaging
🇺🇸Memphis, Tennessee, United States
University of Washington
🇺🇸Seattle, Washington, United States
GI associates drug
🇺🇸Wauwatosa, Wisconsin, United States
Allegiance Research Specialists
🇺🇸Wauwatosa, Wisconsin, United States
Mater Health Services
🇦🇺South Brisbane, Queensland, Australia
The Canberra Hospital
🇦🇺Garran, Australia
Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
AKH Wien, Universitaetsklinik fuer Innere Medizin III
🇦🇹Wien, Austria
4- MBAL
🇧🇬Sofia, Bulgaria
MBAL Sveti Ivan Rilski, Klinika po Gastroenterologia
🇧🇬Sofia, Bulgaria
University Hospital Gasthuisberg
🇧🇪Leuven, Belgium
Hamilton Health Sciences Corporation, McMaster University Medical Centre
🇨🇦Hamilton, Ontario, Canada
London Health Sciences Centre - University Hospital
🇨🇦London, Ontario, Canada
Oshawa Clinic
🇨🇦Oshawa, Ontario, Canada
Office of Dr. David C. Pearson
🇨🇦Victoria, British Columbia, Canada
Hopital Huriez CHRU de Lille
🇫🇷Lille, France
Royal University Hospital
🇨🇦Saskatoon, Saskatchewan, Canada
Klinické Centrum ISCARE I.V.F
🇨🇿Praha 7, Czechia
Hopital Haut Leveque
🇫🇷Pessac, France
CHU Amiens - Hôpital Nord
🇫🇷Amiens Cedex 01, France
Hôpital l'Archet 2 CHU de Nice
🇫🇷Nice Cedex 03, France
Centre Hospitalier Universitaire (CHU) de Caen - Hopital Cote de Nacre
🇫🇷Caen, France
Robert-Bosch-Krankenhaus GmbH
🇩🇪Stuttgart, Germany
CHU Nancy - Hopital Brabois
🇫🇷Vandoeuvre les Nancy, France
Universitaetsklinikum Schleswig-Holstein, Campus Kiel
🇩🇪Kiel, Germany
Pannonia Maganorvosi Centrum Kft
🇭🇺Budapest, Hungary
Universitaetsklinik Regensburg
🇩🇪Regensburg, Germany
Csongrad Megyei Dr. Bugyi Istvan Korhaz
🇭🇺Szentes, Hungary
Gastroenterology Division, Rabin Medical Center, Beilinson Campus
🇮🇱Petah Tikva, Israel
Digestive Disease Institute
🇮🇱Jerusalem, Israel
Gastroenterology and Liver Diseases Unit - Hadassah Ein Kerem University Hospital
🇮🇱Jerusalem, Israel
Policlinico Universitario Campus Bio-Medico
🇮🇹Roma, Italy
The Chaim Sheba Medical Center
🇮🇱Tel Hashomer, Israel
Universita' degli Studi "Magna Graecia" di Catanzaro, UO di Fisiopatologia Digestiva
🇮🇹Catanzaro, Italy
IBD Center - Divisione Gastroenterologia - Istituto Clinico Humanitas IRCCS
🇮🇹Milano, Italy
IRCCS Policlinico San Donato
🇮🇹Milano, Italy
Azienda Ospedaliera -Università di Padova
🇮🇹Padova, Italy
Azienda Ospedaliera Universitaria, Policlinico Tor Vergata
🇮🇹Roma, Italy
AOS San Camillo Forlanini
🇮🇹Rome, Italy
Kangbuk Samsung Hospital
🇰🇷Seoul, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Universita Cattolica Sacro Cuore Policlinico "A. Gemelli"
🇮🇹Roma, Italy
Ospedale Casa Sollievo della Sofferenza
🇮🇹San Giovanni Rotondo, Italy
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
Academic Medical Center - University of Amsterdam
🇳🇱Amsterdam, NH, Netherlands
Yeungnam University Hospital
🇰🇷Daegu, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
University Medical Center Groningen (UMCG)
🇳🇱Groningen, Netherlands
Christchurch Hospital
🇳🇿Christchurch, New Zealand
Centrum endoskopii Zabiegowej, Poradnia Chorob Jelitowych,
🇵🇱Bydgoszcz, Poland
Gabinet Endoskopii Przewodu Pokarmowego
🇵🇱Krakow, Poland
Cardiac Services Ltd.
🇳🇿Hamilton, New Zealand
Midland Neurology & EMG Ltd.
🇳🇿Hamilton, New Zealand
Waikato Hospital
🇳🇿Hamilton, New Zealand
Centrum Medyczne - Szpital Swietej Rodziny Sp. z o.o.
🇵🇱Lodz, Poland
Klinika Chorob Wewnetrznych i Gastroenterologii z Pododdzialem
🇵🇱Warszawa, Poland
Lexmedica
🇵🇱Wroclaw, Poland
Clinical Hospital Center Zemun, Gastroenterology and Hepatology Department
🇷🇸Belgrade, Serbia
NZOZ Vivamed
🇵🇱Warszawa, Poland
SBEI of HPE North-West State Medical University n.a. I.I. Mechnikov of the MH of the RF St.P SBIH "
🇷🇺Saint-Petersburg, Russian Federation
Wojskowy Szpital Kliniczny z Poliklinika SPOZ
🇵🇱Wroclaw, Poland
Gastro I., s.r.o.
🇸🇰Presov, Slovak Republic, Slovakia
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Clinical Hospital Centre Zvezdara Clinic for Gastroenterology and Hepatology
🇷🇸Belgrade, Serbia
Kingsbury Hospital
🇿🇦Claremont, Cape Town, South Africa
Centro Medico Teknon
🇪🇸Barcelona, Spain
Parc de Salut Mar-Hospital del Mar
🇪🇸Barcelona, Spain
Hospital Universitario Puerta de Hierro Majadahonda
🇪🇸Majadahonda, Madrid, Spain
Southern Endoscopy Centre
🇳🇿Christchurch, New Zealand
Nature Coast Clinical Research
🇺🇸Inverness, Florida, United States
GI Consultants
🇺🇸Atlanta, Georgia, United States
Georgia Endoscopy Center
🇺🇸Alpharetta, Georgia, United States
Suncoast Endoscopy Center
🇺🇸Inverness, Florida, United States
Center for Diagnostic Imaging
🇺🇸Miami Beach, Florida, United States
FQL Research, LLC
🇺🇸Miramar, Florida, United States
Houston Hospital for Specialized Surgery
🇺🇸Houston, Texas, United States
Spring Gastroenterology and Associates
🇺🇸Humble, Texas, United States
Spring Gastroenterology Drug
🇺🇸Humble, Texas, United States
Pioneer Research Solutions, Inc
🇺🇸Sugar Land, Texas, United States
Texas Digestive Disease Consultants
🇺🇸Southlake, Texas, United States
PI Radiology
🇺🇸Milwaukee, Wisconsin, United States
Dynacare Laboratories
🇺🇸Wauwatosa, Wisconsin, United States
Gastroenterology Associates of Western Michigan
🇺🇸Wyoming, Michigan, United States
Barnes-Jewish Hospital Investigational Drug Service (IP Shipping Address)
🇺🇸Saint Louis, Missouri, United States
Center for Digestive and Liver Diseases
🇺🇸Mexico, Missouri, United States
Rocky Mountain Clinical Research, LLC.
🇺🇸Denver, Colorado, United States
Sylvester Comprehensive Cancer Center
🇺🇸Miami, Florida, United States
University of Miami Hospital and Clinic - Local Lab
🇺🇸Miami, Florida, United States
University of Miami Hospital and Clinic
🇺🇸Miami, Florida, United States
University of Miami Hospital
🇺🇸Miami, Florida, United States
Coral View Surgery Center
🇺🇸Miami, Florida, United States
Boston Diagnostic Imaging
🇺🇸Orlando, Florida, United States
Citrus Ambulatory Surgery Center
🇺🇸Orlando, Florida, United States
Internal Medicine Specialists
🇺🇸Orlando, Florida, United States
Covance Central Laboratory Services Inc
🇺🇸Indianapolis, Indiana, United States
Covance Central Laboratory Services, Inc
🇺🇸Indianapolis, Indiana, United States
Covance Laboratory Services, Inc
🇺🇸Indianapolis, Indiana, United States
University of Michigan Health Systems
🇺🇸Ann Arbor, Michigan, United States
Minneapolis Medical Eye Clinic
🇺🇸Minneapolis, Minnesota, United States
Noran Neurology Clinic
🇺🇸Minneapolis, Minnesota, United States
University of Nevada School of Medicine (UNSOM)
🇺🇸Las Vegas, Nevada, United States
Las Vegas Surgery Center
🇺🇸Las Vegas, Nevada, United States
Vanderbilt University Medical Center: Drug Shipment
🇺🇸Nashville, Tennessee, United States
Steinberg Diagnostic Medical Imaging Centers
🇺🇸Las Vegas, Nevada, United States
The Oregon Clinic, PC - Gastroenterology West
🇺🇸Portland, Oregon, United States
Vanderbilt University Medical Center: GI Clinical Research
🇺🇸Nashville, Tennessee, United States
Vanderbilt University Medical Center: IBD Clinic
🇺🇸Nashville, Tennessee, United States
Vanderbilt University Medical Center: Endoscopy Lab
🇺🇸Nashville, Tennessee, United States
Vanderbilt University Medical Center: Outpatient Radiology
🇺🇸Nashville, Tennessee, United States
Office of Drs. Ranjit Andrew Singh and Jamie D. Papp
🇨🇦Victoria, British Columbia, Canada
Clinical Centre of Nis, Clinic for Gastroenterology and Hepatology
🇷🇸Nis, Serbia
Dept. of Gastroenterology & Hepatology, Meir Medical Center
🇮🇱Kfar-Saba, Israel
Gastroenterology Center of Connecticut, PC
🇺🇸Hamden, Connecticut, United States
The Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Centre Hospitalier de Mouscron
🇧🇪Mouscron, Belgium
Gastroenterological Centre Thalion
🇸🇰Bratislava, Slovakia
PerCuro Clinical Research Limited
🇨🇦Victoria, British Columbia, Canada
Minneapolis Heart Institute
🇺🇸Plymouth, Minnesota, United States
MBAL SofiaMed OOD
🇧🇬Sofia, Bulgaria
Clinical Hospital Centre Bezanijska Kosa, Clinic for Internal medicine
🇷🇸Belgrade, Serbia
KM Management spol. s.r.o. Gastroenterologicke a hepatologicke centrum Nitra
🇸🇰Nitra, Slovakia
Mayo Clinic Arizona
🇺🇸Scottsdale, Arizona, United States
Medical REsearch Center of CT Drug
🇺🇸Hamden, Connecticut, United States
Centrum Medyczne HCP Lecznictwo Ambulatoryjne Pracownia Endoskopowa
🇵🇱Poznan, Poland
Ustredna vojenska nemocnice SNP Ruzomberok
🇸🇰Ruzomberok, Slovakia
UNC Hospitals Endoscopy Center At Meadowmont
🇺🇸Chapel Hill, North Carolina, United States
Department of Pharmacy Investigational Drug Services
🇺🇸Chapel Hill, North Carolina, United States
UNC Memorial Hospital
🇺🇸Chapel Hill, North Carolina, United States
University of North Carolina at Chapel Hill
🇺🇸Chapel Hill, North Carolina, United States
University of Kentucky Chandler Medical Center
🇺🇸Lexington, Kentucky, United States
University of Kentucky Medical Center
🇺🇸Lexington, Kentucky, United States
McGuire DVAMC
🇺🇸Richmond, Virginia, United States
Gastro One
🇺🇸Germantown, Tennessee, United States