Phase 3 Study of M923 and Humira® in Subjects With Chronic Plaque-type Psoriasis
- Conditions
- Chronic Plaque PsoriasisPsoriasis
- Interventions
- Biological: M923Biological: Humira
- Registration Number
- NCT02581345
- Lead Sponsor
- Momenta Pharmaceuticals, Inc.
- Brief Summary
The purpose of the study is to evaluate efficacy, safety, and immunogenicity of a proposed adalimumab biosimilar (M923) and Humira in participants with moderate to severe chronic plaque-type psoriasis.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 572
- Must be able to understand and communicate with the investigator and comply with the requirements of the study
- Chronic plaque-type psoriasis diagnosed for at least 6 months before screening
- Stable plaque psoriasis
- History of receipt of or candidate for therapy.
- Moderate to severe psoriasis at screening and baseline
- Must be willing and able to self-administer SC injections or have a caregiver available to administer injections
- Male participants of childbearing potential must employ a highly effective contraceptive measure
- Female participants must have a negative pregnancy test; are not planning to become pregnant; and must not be lactating. Female participants must also agree to employ a highly effective contraceptive measure.
- Forms of psoriasis other than chronic plaque-type
- Drug-induced psoriasis.
- Other skin conditions which would interfere with assessment of psoriasis
- Medical conditions other than psoriasis for which systemic corticosteroids were used in the last year prior to screening
- Other inflammatory conditions other than psoriasis or psoriatic arthritis
- Prior use of systemic tumor necrosis factor (TNF) inhibitors, or 2 or more non-TNF biologic therapies
- Ongoing use of prohibited psoriasis treatments
- Ongoing use of other non-psoriasis prohibited treatments
- All other prior non-psoriasis concomitant treatments must be on a stable dose for at least 4 weeks
- Laboratory abnormalities at screening deemed clinically significant by the investigator
- Any condition or illness which in the opinion of the investigator or sponsor poses an unacceptable safety risk
- History of latex allergy
- History of or current signs or symptoms or diagnosis of a demyelinating disorder
- History of or current Class III or IV New York Heart Association congestive heart failure
- Signs, symptoms, or diagnosis of lymphoproliferative disorders, lymphoma, leukemia, myeloproliferative disorders, or multiple myeloma
- Current malignancy or history of any malignancy except adequately treated or excised non metastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ; no more than 3 lifetime basal cell and squamous cell carcinomas permitted
- Chronic infections, recurrent infections; recent infection to be evaluated
- History of or presence of human immunodeficiency virus (HIV), or Hepatitis B (HBV) or C virus (HCV)
- History of active tuberculosis (TB) or untreated or inadequately treated latent TB.
- Exposure to an investigational product ≤30 days prior to enrollment or participation in another clinical study during the course of this study
- Participant is a family member or employee of the investigator or site staff or study team
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- FACTORIAL
- Arm && Interventions
Group Intervention Description M923 and Humira M923 Participants assigned to receive M923 and Humira M923 M923 Participants assigned to receive M923 Humira Humira Participants assigned to receive Humira M923 and Humira Humira Participants assigned to receive M923 and Humira
- Primary Outcome Measures
Name Time Method Percentage of Participants Who Achieved a 75% Reduction in Psoriasis Area and Severity Index (PASI) (PASI 75) Scores at Week 16 Baseline; Week 16 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 75 are defined as having an improvement (reduction) of at least 75% in the Week 16 PASI score compared to the score at Baseline.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With a Response of Clear or Almost Clear on the Static Physician Global Assessment (sPGA) at Week 16 Week 16 The sPGA response rate was defined as the percentage of participants who had achieved a clear or almost clear response on the 6-point sPGA scale. The sPGA was the physician's determination of the participant's psoriasis lesions overall at a given time point. Overall lesions were categorized by descriptions for induration, erythema, and scaling. For the analysis of responses, the participant's psoriasis was assessed at a given time point on a 6-point scale on which 0 = cleared, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe, and 5 = very severe.
Number of Participants Achieving PASI 50 Response at Week 16 Baseline; Week 16 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 50 are defined as having an improvement (reduction) of at least 50% compared to Baseline.
Number of Participants Achieving PASI 50 Response at Week 52 (Follow-Up Visit) Baseline; Week 52 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 50 are defined as having an improvement (reduction) of at least 50% compared to Baseline.
Number of Participants Achieving PASI 75 Response at Week 52 (Follow-Up Visit) Baseline; Week 52 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 75 are defined as having an improvement (reduction) of at least 75% compared to Baseline.
Number of Participants Achieving PASI 90 Response at Week 16 Baseline; Week 16 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 90 are defined as having an improvement (reduction) of at least 90% compared to Baseline.
Number of Participants Achieving PASI 90 Response at Week 52 (Follow-Up Visit) Baseline; Week 52 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Participants achieving PASI 90 are defined as having an improvement (reduction) of at least 90% compared to Baseline.
Absolute PASI Score at Baseline Baseline The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score.
Absolute PASI Score at Week 16 Week 16 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score.
Absolute PASI Score at Week 52 (Follow-Up Visit) Week 52 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score.
Percent Change From Baseline in PASI Score at Week 16 Baseline; Week 16 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Percent change from Baseline was calculated as: (post-Baseline value - Baseline value) / (Baseline value) \* 100.
Percent Change From Baseline in PASI Score at Week 52 (Follow-Up Visit) Baseline; Week 52 The PASI combines assessments of the extent of body surface involvement in 4 anatomical regions (head, arms, trunk, and legs) and the severity of scaling, redness, and thickness in each region, yielding an overall score of 0 for no disease to 72 for the most severe disease. Each of the body areas was scored by itself, and then the 4 scores were combined into the final PASI score. Percent change from Baseline was calculated as: (post-Baseline value - Baseline value) / (Baseline value) \* 100.
Health-Related Quality of Life During Treatment: Dermatology Life Quality Index (DLQI) Score at Baseline Baseline The DLQI score was calculated by summing the individual scores of each question at a given time point, resulting in a maximum score of 30 and a minimum score of 0. The higher the score, the more quality of life is impaired. For the analysis of responses, the participant's results were assessed on a scoring scale on which 3 = very much or yes (applicable to question 7 only), 2 = a lot, 1 = a little, 0 = not at all or not relevant. Interpretation of DLQI scoring can be taken as 0 - 1 = no effect at all on participant's life, 2 - 5 = small effect on participant's life, 6 - 10 = moderate effect on participant's life, 11 - 20 = very large effect on participant's life, and 21 - 30 = extremely large effect on participant's life.
Health-Related Quality of Life During Treatment: DLQI Score at Week 16 Week 16 The DLQI score was calculated by summing the individual scores of each question at a given time point, resulting in a maximum score of 30 and a minimum score of 0. The higher the score, the more quality of life is impaired. For the analysis of responses, the participant's results were assessed on a scoring scale on which 3 = very much or yes (applicable to question 7 only), 2 = a lot, 1 = a little, 0 = not at all or not relevant. Interpretation of DLQI scoring can be taken as 0 - 1 = no effect at all on participant's life, 2 - 5 = small effect on participant's life, 6 - 10 = moderate effect on participant's life, 11 - 20 = very large effect on participant's life, and 21 - 30 = extremely large effect on participant's life.
Health-Related Quality of Life During Treatment: DLQI Score at Week 48 (Completion/Termination Visit) Week 48 The DLQI score was calculated by summing the individual scores of each question at a given time point, resulting in a maximum score of 30 and a minimum score of 0. The higher the score, the more quality of life is impaired. For the analysis of responses, the participant's results were assessed on a scoring scale on which 3 = very much or yes (applicable to question 7 only), 2 = a lot, 1 = a little, 0 = not at all or not relevant. Interpretation of DLQI scoring can be taken as 0 - 1 = no effect at all on participant's life, 2 - 5 = small effect on participant's life, 6 - 10 = moderate effect on participant's life, 11 - 20 = very large effect on participant's life, and 21 - 30 = extremely large effect on participant's life.
Health-Related Quality of Life During Treatment: EuroQoL 5-Dimension Health Status Questionnaire (EQ-5D-5L) at Baseline Baseline The EQ-5D-5L health score was measured on a Visual Analog Scale (VAS) anchored by 0 = "worst health you can imagine" and 100 = "best health you can imagine". Baseline was defined as the last scheduled observation prior to dosing, typically Day 1, predose.
Health-Related Quality of Life During Treatment: EQ-5D-5L at Week 16 Week 16 The EQ-5D-5L health score was measured on a Visual Analog Scale (VAS) anchored by 0 = "worst health you can imagine" and 100 = "best health you can imagine".
Health-Related Quality of Life During Treatment: EQ-5D-5L at Week 48 (Completion/Termination Visit) Week 48 The EQ-5D-5L health score was measured on a Visual Analog Scale (VAS) anchored by 0 = "worst health you can imagine" and 100 = "best health you can imagine".
Number of Participants With Clinically Meaningful Changes in Vital Signs Up to Week 52 Vital signs included body temperature, respiratory rate, pulse rate, systolic and diastolic blood pressure, and weight. Clinically meaningful changes were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Laboratory Parameters at Baseline Baseline Laboratory results included hematology \[Hemoglobin, Hematocrit, Platelet count, Mean cell volume, White blood cell count (total leucocytes), Neutrophils absolute, Neutrophils, Lymphocytes absolute, Lymphocytes, Monocytes, Eosinophils absolute, and Eosinophils\], chemistry (Aspartate transaminase, Alanine transaminase, Gamma glutamyl transferase, Creatine kinase, C-reactive protein, Cholesterol, Triglycerides, Total protein, Potassium, Urea, Creatinine, Phosphate, Glucose, and Uric acid) and urinalysis \[Specific Gravity\] parameters. Laboratory results of a few hematology (Red Blood Cell Count and Monocytes absolute), chemistry (Alkaline Phosphatase, Total bilirubin, Sodium, Chloride, and Albumin), and urinalysis (pH) parameters were not assessed at Baseline and Week 16. Clinically meaningful changes were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Laboratory Parameters at Week 16 Week 16 Laboratory results included hematology \[Hemoglobin, Hematocrit, Platelet count, Mean cell volume, White blood cell count (total leucocytes), Neutrophils absolute, Neutrophils, Lymphocytes absolute, Lymphocytes, Monocytes, Eosinophils absolute, and Eosinophils\], chemistry (Aspartate transaminase, Alanine transaminase, Gamma glutamyl transferase, Creatine kinase, C-reactive protein, Cholesterol, Triglycerides, Total protein, Potassium, Urea, Creatinine, Phosphate, Glucose, and Uric acid) and urinalysis \[Specific Gravity\] parameters. Laboratory results of a few hematology (Red Blood Cell Count and Monocytes absolute), chemistry (Alkaline Phosphatase, Total bilirubin, Sodium, Chloride, and Albumin), and urinalysis (pH) parameters were not assessed at Baseline and Week 16. Clinically meaningful changes were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Laboratory Parameters at Week 48 (Completion/Termination Visit) Week 48 Laboratory results included hematology \[Red Blood Cell Count, Hemoglobin, Hematocrit, Platelet count, Mean cell volume, White blood cell count (total leucocytes), Neutrophils absolute, Neutrophils, Lymphocytes absolute, Lymphocytes, Monocytes absolute, Monocytes, Eosinophils absolute, and Eosinophils\], chemistry (Aspartate transaminase, Alanine transaminase, Alkaline Phosphatase, Gamma glutamyl transferase, Total bilirubin, Creatine kinase, C-reactive protein, Cholesterol, Triglycerides, Total protein, Sodium, Potassium, Chloride, Urea, Creatinine, Albumin, Phosphate, Glucose, and Uric acid) and urinalysis \[pH and Specific Gravity\] parameters. Clinically meaningful changes were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Electrocardiogram Parameters at Baseline Baseline Clinically significant abnormalities were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Electrocardiogram Parameters at Week 16 Week 16 Clinically significant abnormalities were classified as such by the Investigator and reported as adverse events.
Number of Participants With Clinically Significant Abnormalities in Electrocardiogram Parameters at Week 48 (Completion/Termination Visit) Week 48 Clinically significant abnormalities were classified as such by the Investigator and reported as adverse events.
Number of Participants With Treatment-emergent Adverse Events (TEAEs) Up to Week 52 TEAEs are adverse events that occurred during or after study drug administration. For more details on adverse events please refer the safety section.
Pharmacokinetics: Serum Concentrations by Treatment Baseline (Week 0), Week 8, 16, 17, 21, 25, 29, 37, and 41 Serum samples were collected at Baseline (Week 0, perdose), approximately 1 week (peak) after IP administration (Weeks 8 and 16), and 2 weeks after dose administration as a trough sample collected prior to the next dose administration (Weeks 17, 21, 25, 29, 37, 41).
Immunogenicity: Number of Participants With Anti-Drug Antibodies (ADA) at Baseline Baseline (Week 0) The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose; if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. The same convention applied for the neutralizing assay results.
Immunogenicity: Number of Participants With ADA at Week 16 Week 16 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose; if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. The same convention applied for the neutralizing assay results.
Immunogenicity: Number of Participants With ADA at Week 25 Week 25 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose; if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. The same convention applied for the neutralizing assay results.
Immunogenicity: Number of Participants With ADA at Week 52 (Completion/Termination Visit) Week 52 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose; if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. The same convention applied for the neutralizing assay results.
Immunogenicity: Number of Participants With ADA and nADA by Titer at Baseline Baseline (Week 0) The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose); if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. In confirmed positive samples, an assay was used to determine the relative titer of the ADA; a subsequent neutralizing antibodies assay was used to determine the presence of neutralizing antibodies.
Immunogenicity: Number of Participants With ADA and nADA by Titer at Week 16 Week 16 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose); if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. In confirmed positive samples, an assay was used to determine the relative titer of the ADA; a subsequent neutralizing antibodies assay was used to determine the presence of neutralizing antibodies.
Immunogenicity: Number of Participants With ADA and nADA by Titer at Week 25 Week 25 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose); if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. In confirmed positive samples, an assay was used to determine the relative titer of the ADA; a subsequent neutralizing antibodies assay was used to determine the presence of neutralizing antibodies.
Immunogenicity: Number of Participants With ADA and nADA by Titer at Week 52 (Completion/Termination Visit) Week 52 The M923 confirmation assay was evaluated only if the EU Humira confirmation assay was negative. Overall Result: a participant was considered to be positive if a confirmed positive result was observed at any assay (including predose); if a participant had either a negative result in the screening assay or a positive result at screening followed by a negative result in all confirmation tiers, the overall result was negative. Overall Status: a participant was considered to have developed ADA or neutralizing ADAs if a confirmed positive result was observed at any time during the treatment period inclusive of the predose results; the designation of negative required either a negative screening assay or a negative confirmation result at each sampling time. In confirmed positive samples, an assay was used to determine the relative titer of the ADA; a subsequent neutralizing antibodies assay was used to determine the presence of neutralizing antibodies.
Median Time to Seroconversion Up to Week 52 Time to seroconversion (in days) was defined as the time to the observation of the first confirmed positive ADA response. Participants with confirmed positive ADA response at baseline (Week 0 predose) were excluded.
Trial Locations
- Locations (84)
DCC Sveti Georgi EOOD
🇧🇬Haskovo, Bulgaria
The Centre for Dermatology
🇨🇦Richmond Hill, Ontario, Canada
London Road Diagnostic Clinic and Medical Centre
🇨🇦Sarnia, Ontario, Canada
Bay State Clinical Trials, Inc
🇺🇸Watertown, Massachusetts, United States
UMHAT Dr.Georgi Stranski, EAD
🇧🇬Pleven, Bulgaria
Mediprobe Research Inc
🇨🇦London, Ontario, Canada
North Bay Dermatology Centre
🇨🇦North Bay, Ontario, Canada
Centre de Recherche Dermatologique du Quebec metropolitain (CRDQ)
🇨🇦Ste-Foy, Quebec, Canada
Office of Dr. Michael Robern
🇨🇦Ottawa, Ontario, Canada
Recherche GCP Research
🇨🇦Montréal, Quebec, Canada
Parnu Hospital
🇪🇪Pärnu, Estonia
Universitaetsklinikum Schleswig Holstein
🇩🇪Schleswig, Holstein, Germany
Klinische Forschunq Schwerin GmbH
🇩🇪Mecklenburg, Vorpommern, Germany
Health Centre 4
🇱🇻Riga, Latvia
Praxis fuer Dermatologie und Venerologie
🇩🇪Dresden, Germany
Klinikum der Johann Wolfgang Goethe-Universitaet
🇩🇪Frankfurt am Main, Germany
Riga 1 st Hospital
🇱🇻Riga, Latvia
NZOZ POLIMEDICA FILIA KIELCE (Niepubliczny Zaklad Opieki Zdrowotnej POLIMEDICA)
🇵🇱Kielce, Poland
Derma Clinic Riga Ltd
🇱🇻Riga, Latvia
Medica Pro Familia Sp. z o. o. S.K.A. Oddzial w Gdyni
🇵🇱Gdynia, Poland
Centrum Terapii Wspolczesnej _J.M. Jasnorzewska Sp. Komandytowo-Akcyjna
🇵🇱Lodz, Poland
NZOZ ALL-MED Centrum Medyczne Specjalistyczne Gabinety Lekarskie
🇵🇱Lodz, Poland
J. Kisis Ltd
🇱🇻Riga, Latvia
Ventspils Outpatient Clinic
🇱🇻Ventspils, Latvia
Medica Pro Familia Sp. z o.o. S.K.A.
🇵🇱Warsaw, Mazowieckie, Poland
Nzoz Polimedica
🇵🇱Zgierz, Poland
Pedi-Derma s.r.o.
🇸🇰Kosice, Kosicky Kraj, Slovakia
Poradnia Kardiologiczna Jaroslaw Jurowiecki
🇵🇱Gdansk, Poland
MTZ Clinical Research Sp z o.o.
🇵🇱Warsaw, Poland
Nemocnica Kosice-Saca, a.s., 1.sukromna nemocnica
🇸🇰Kosice, Slovakia
Sanare S.r.o
🇸🇰Svidnik, Slovakia
National Clinical Research-Richmond, Inc
🇺🇸Richmond, Virginia, United States
Encino Research Center
🇺🇸Encino, California, United States
Wallace Medical Group, Inc.
🇺🇸Beverly Hills, California, United States
Radiant Research, Inc.
🇺🇸Greer, South Carolina, United States
Palmetto Clinical Trial Services, LLC
🇺🇸Fountain Inn, South Carolina, United States
K Papp Clinical Research Inc
🇨🇦Waterloo, Ontario, Canada
Krajska zdravotni a.s. - Masarykova nemocnice v Usti nad Labem Dermatovenerologicke oddeleni
🇨🇿Usti nad Labem, Czechia
Vahlberg & Pild OU
🇪🇪Tallinn, Estonia
Universitaetsklinikum Carl Gustav Carus TU Dresden
🇩🇪Dresden, Germany
Medicum AS
🇪🇪Tallinn, Estonia
Tartu University Hospital; Dermatology Clinic
🇪🇪Tartu, Estonia
Clinical Research Hamburg
🇩🇪Hamburg, Germany
Medica Pro Familia Sp. z o.o. SK.A.
🇵🇱Krakow, Poland
Derma therapy spol. s.r.o.
🇸🇰Bratislava, Slovakia
Department of Dermatology and Venereology, Faculty of Medicine, UMHAT Alexandrovska
🇧🇬Sofia, Bulgaria
Renstar Medical Research
🇺🇸Ocala, Florida, United States
Medical Centre Asklepii, OOD
🇧🇬Dupnitsa, Bulgaria
DCC Sv. Georgi, EOOD
🇧🇬Plovdiv, Bulgaria
Dermatologie - MUDr. HELENA KORANDOVA s.r.o.
🇨🇿Olomouc, Povel, Czechia
CCBR Czech Prague s.r.o
🇨🇿Praha 3, Czech Republic, Czechia
Shahram Jacobs MD, INC
🇺🇸Sherman Oaks, California, United States
Austin Institute for Clinical Research, LLC
🇺🇸Pflugerville, Texas, United States
Dr. David Gratton Dermatologue Inc.
🇨🇦Montreal, Quebec, Canada
Kliiniliste Uuringute Keskus (Clinical Research Centre)
🇪🇪Tartu, Estonia
CCBR Czech Brno, s.r.o
🇨🇿Brno, Czechia
Clintrial s.r.o
🇨🇿Praha 10, Czechia
MUDr. Jaroslav Dragon - Kozni ordinace
🇨🇿Ústí nad Labem, Czechia
Fakultni nemocnice Kralovske Vinohrady
🇨🇿Praha 10, Czechia
East Tallinn Central Hospital
🇪🇪Tallinn, Estonia
North Estonia Medical Centre Foundation
🇪🇪Tallinn, Estonia
Centrum Medyczne Szpital Swietej Rodziny
🇵🇱Lodz, Poland
Medicome sp.zoo
🇵🇱Oswiecim, Poland
Centrum Badan Klinicznych S.C.
🇵🇱Poznan, Poland
Ai Centrum Medyczne
🇵🇱Poznan, Poland
KO-MED Centra Kliniczne Pulawy
🇵🇱Pulawy, Poland
Centrum Medyczne Medyk
🇵🇱Rzeszow, Poland
KO-MED Centra Kliniczne Zamosc
🇵🇱Zamosc, Poland
Dema-beauty, s.r.o
🇸🇰Nitra, Slovakia
Grazyna Pulka Specjalistyczny Osrodek ALL-MED
🇵🇱Krakow, Poland
KO-MED Centra Kliniczne Lublin II
🇵🇱Lublin, Poland
NZOZ Nasz Lekarz
🇵🇱Torun, Poland
CCBR Czech a.s
🇨🇿Pardubice, Czechia
Horizons Clinical Research Center, LLC
🇺🇸Denver, Colorado, United States
Bioclinical Research Alliance; Inc
🇺🇸Miami, Florida, United States
eStudySite
🇺🇸Las Vegas, Nevada, United States
Sanitas Reasearch, LLC
🇺🇸Miami, Florida, United States
Compass Research, LLC
🇺🇸Orlando, Florida, United States
Dawes Fretzin Clinical Research Group, LLC
🇺🇸Indianapolis, Indiana, United States
Radiant Research; Inc.
🇺🇸Cincinnati, Ohio, United States
SKDS Research Inc
🇨🇦Newmarket, Ontario, Canada
Tufts Medical Center; Inc.
🇺🇸Boston, Massachusetts, United States
Radiant Clinical Research
🇺🇸Anderson, South Carolina, United States
Clinical Trials of Texas; Inc.
🇺🇸San Antonio, Texas, United States