Long-term Follow-up Study of GLPG0634 in Active Rheumatoid Arthritis Participants
- Registration Number
- NCT02065700
- Lead Sponsor
- Galapagos NV
- Brief Summary
The primary objective of the study was to evaluate the long-term safety and tolerability of filgotinib (formerly GLPG0634) for the treatment of rheumatoid arthritis.
Participants were enrolled in this open-label long-term follow-up study after they had completed one of the two core studies, GLPG0634-CL-203 (DARWIN1) (NCT01888874) or GLPG0634-CL-204 (DARWIN2) (NCT01894516), and were evaluated for any side effects that might have occured (long-term safety and tolerability) when taking filgotinib. During the course of the study, participants were also examined for long-term effects of filgotinib administration on disease activity (efficacy), participant's disability, fatigue, and quality of life.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 739
- Participants who completed one of the qualifying core studies GLPG0634-CL-203 or GLPG0634-CL-204 and may benefit from filgotinib long-term treatment according to the Investigator's judgment
- Females of childbearing potential and sexually active men must agree to use highly effective method of birth control as specified in the protocol, during the study and for at least 12 weeks after the last dose of filgotinib
Key
- Participants who prematurely withdrew from one of the 2 core studies (GLPG0634-CL-203 or GLPG0634-CL-204), for any reason
- Persistent abnormal lab values during one of the 2 core studies (GLPG0634-CL-203 or GLPG0634-CL-204), according to the Investigator's judgment
- Diagnosis of rheumatic autoimmune disease or inflammatory joint disease other than rheumatoid arthritis, except for secondary Sjogren's syndrome
- Any condition or circumstances which, in the opinion of the Investigator, may make a participant unlikely or unable to complete the study or comply with study procedures and requirements
Note: Other protocol defined Inclusion/Exclusion criteria may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Filgotinib Darwin 1 Filgotinib Participants in Study GLPG0634-CL-203 (NCT01888874) were rolled-over to receive an oral dose of filgotinib at a daily dose of 200 milligrams (mg) in this extension study, with the exception of male participants in the United States (US) who were limited to a daily dose of 100 mg due to a Food and Drug Administration (FDA) requirement based on a non-clinical finding. Treatment was administered until marketing, local (if applicable) regulatory and/or pertinent local reimbursement approval. In case of intolerance or for safety reasons, and as per investigator's discretion, a daily dose of filgotinib 200 mg could be decreased to 100 mg per day, and later returned to 200 mg per day after the reasons for decreasing the dose were resolved. Filgotinib Darwin 2 Filgotinib Participants from Study GLPG0634-CL-204 (NCT01894516) were rolled-over to receive oral dose of filgotinib tablet at 200 mg once daily (q.d) in this extension study. Treatment was administered until marketing, local (if applicable) regulatory and/or pertinent local reimbursement approval. Participants started the study with the same dose level (filgotinib 200 mg per day) and in case of intolerance or safety reasons and as per investigator's discretion, the daily dose of filgotinib was decreased to 100 mg q.d and was returned to 200 mg per day after the reasons for decreasing the dose had resolved and at the investigator's discretion.
- Primary Outcome Measures
Name Time Method Number of Participants Experiencing Treatment-Emergent Adverse Events From First dose to Week 437 An Adverse event (AE) was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non-investigational) product, whether or not related to that medicinal (investigational or non-investigational) product.
Treatment-emergent adverse events (TEAEs) were defined as any AEs with an onset date on or after the filgotinib start date in the core studies or GLPG0634-CL-205 (NCT02065700), and no later than 30 days after permanent discontinuation of filgotinib in GLPG0634-CL-205 (NCT02065700) or of either 30 days after the last dose date.
- Secondary Outcome Measures
Name Time Method Percentage of Participants Achieving ACR70 Response: OC Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The ACR response was a measurement of improvement in multiple disease assessment criteria.
ACR70 response was defined as : 1) ≥ 70% improvement from baseline in SJC66, and 2) ≥ 70% improvement from baseline in TJC68, and 3) ≥ 70% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2.SGA (VAS), 3. PGA (VAS), 4. Total HAQ-DI score, and 5.hsCRP.Percentage of Participants Achieving American College of Rheumatology (ACR) 20 Response: Non-Responder Imputation (NRI) Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The American College of Rheumatology (ACR) response was a measurement of improvement in multiple disease assessment criteria.
The ACR20 response was defined as: 1) ≥ 20% improvement from baseline in swollen joint count 66 (SJC66), and 2) ≥ 20% improvement from baseline in tender joint count 68 (TJC68), and 3) ≥ 20% improvement from baseline in at least 3 of the following 5 items: 1. Pain visual analog scale (VAS) (taken from the Health Assessment Questionnaire - Disability Index \[HAQ-DI\]), 2.Subject's Global Assessment of Disease Activity (SGA) (VAS), 3. Physician's Global Assessment of Disease Activity (PGA) (VAS), 4. Total HAQ-DI score, and 5. High-Sensitivity C- Reactive Protein (hsCRP).Percentage of Participants Achieving ACR20 Response: Observed Case (OC) Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The ACR response was a measurement of improvement in multiple disease assessment criteria.
The ACR20 response was defined as: 1) ≥ 20% improvement from baseline in SJC66, and 2) ≥ 20% improvement from baseline in tender TJC68, and 3) ≥ 20% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2.SGA (VAS), 3. PGA (VAS), 4. Total HAQ-DI score, and 5. hsCRP.Change From Core Baseline in Disease Activity Score Based on 28 Joints Using C-reactive Protein (DAS28[CRP]): OC Core Baseline, Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The DAS28(CRP) was a measure of the participant's disease activity calculated using the TJC (28 joints), SJC (28 joints), SGA \[using a VAS on a scale of 0 (very well) to 100 (very poor)\] and hsCRP using the formula:
DAS28(CRP) = 0.56 \* Square root \[SQRT\] (TJC28) + 0.28 \* SQRT(SJC28) + 0.36 \* Ln(CRP+1) + 0.014 \* SGA + 0.96
and the total possible score ranged from 1 to 9.4. Higher values indicated higher disease activity. A negative change from baseline indicated improvement.Change From Core Baseline in MCS of Quality of Life Using the SF-36 Scores: OC Core Baseline, Extension Baseline, Weeks 48, 96, 144, 192, 240, 288, 336, 384 The health-related quality of life of the subject was assessed using the SF-36 with a 4-week recall period. This consists of 36 questions belonging to 8 domains in 2 components:
* Physical well-being: 4 domains: physical functioning (10 items), role physical (4 items), bodily pain (2 items), and general health (GH) perceptions (5 items).
* Mental well-being: 4 domains: vitality (4 items), social functioning (2 items), role emotional (3 items), and mental health (5 items).
These scales were from 0 to 100 with higher scores indicating a better quality of life.Change From Core Baseline in Quality of Life Using Functional Assessment of Chronic Illness Therapy (FACIT) Fatigue Scale: OC Core Baseline, Extension Baseline, Weeks 48, 96, 144, 192, 240, 288, 336, 384 FACIT-Fatigue scale was a 13-item questionnaire, each scored on a 5-point scale: 0 (Not at all) to 4 (Very much). Negatively stated items were reversed by subtracting the response from "4" before being added to obtain a total score. The sum of all responses resulted in the FACIT-Fatigue score for a total possible score of 0 (worse score) to 52 (better score), with a higher score indicating less fatigue. A positive change from baseline indicated better quality of life.
Change From Core Baseline in Simple Disease Activity Index (SDAI): OC Core Baseline, Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 SDAI score consisted of following parameters: TJC (28 joints), SJC (28 joints), SGA (0 to 10 cm), PGA (0 to 10 cm), CRP (mg/dL). SDAI = TJC + SJC + SGA + PGA+ CRP. The SDAI score ranged from 0 to approximately 86. Higher SDAI indicated greater disease activity. A negative change from baseline indicated improvement.
Percentage of Participants Achieving ACR50 Response: NRI Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The ACR response was a measurement of improvement in multiple disease assessment criteria.
ACR50 response was defined as: 1) ≥ 50% improvement from baseline in SJC66, and 2) ≥ 50% improvement from baseline in TJC68, and 3) ≥ 50% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI) 2.SGA (VAS) 3. PGA (VAS) 4. Total HAQ-DI score 5. hsCRP.Percentage of Participants Achieving ACR50 Response: OC Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The ACR response was a measurement of improvement in multiple disease assessment criteria.
ACR50 response was defined as: 1) ≥ 50% improvement from baseline in SJC66, and 2) ≥ 50% improvement from baseline in TJC68, and 3) ≥ 50% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI) 2.SGA (VAS) 3. PGA (VAS) 4. Total HAQ-DI score 5. hsCRP.Percentage of Participants Achieving ACR70 Response: NRI Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The ACR response was a measurement of improvement in multiple disease assessment criteria.
ACR70 response was defined as : 1) ≥ 70% improvement from baseline in SJC66, and 2) ≥ 70% improvement from baseline in TJC68, and 3) ≥ 70% improvement from baseline in at least 3 of the following 5 items: 1. Pain VAS (taken from the HAQ-DI), 2.SGA (VAS), 3. PGA (VAS), 4. Total HAQ-DI score, and 5. hsCRP.ACR N% Improvement (ACR-N) Response: OC Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 ACR-N was defined as the smallest percentage improvement from core baseline in SJC66, TJC68 and the median of the following 5 items (Pain VAS \[taken from the HAQ-DI\], 2.SGA (VAS), 3. PGA (VAS), 4. Total HAQ-DI score, and 5. hsCRP). It had a range between 0 and 100%.
Change From Core Baseline in Clinical Disease Activity Index (CDAI): OC Core Baseline, Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 The CDAI was the SDAI modified that excluded CRP and consisted of following parameters: TJC (28 joints), SJC (28 joints), SGA (0 to 10 cm), PGA (0 to 10 cm). SDAI = TJC + SJC + SGA+ PGA. The CDAI score ranged from 0 to approximately 76. Higher CDAI indicated greater disease activity. A negative change from baseline indicated improvement.
Percentage of Participants Achieving European League Against Rheumatism (EULAR) Response: OC Core Baseline, Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 DAS28(CRP) was categorized into EULAR response categories (none, moderate, good) as follows:
None= Actual DAS28(CRP) ≤ 3.2, \> 3.2 to ≤ 5.1, or \> 5.1 AND Improvement in DAS28(CRP) from baseline ≤ 6.0 or \> 0.6 to ≤ 1.2;
Moderate= Actual DAS28(CRP) ≤ 3.2 AND Improvement in DAS28(CRP) from baseline \> 0.6 to ≤ 1.2, Actual DAS28(CRP) \> 3.2 to ≤ 5.1 or \> 5.1 AND Improvement in DAS28(CRP) from baseline \> 1.2, or Actual DAS28(CRP) \> 3.2 to ≤ 5.1 AND Improvement in DAS28(CRP) from baseline \> 0.6 to ≤ 1.2;
Good= Actual DAS28(CRP) ≤ 3.2 AND Improvement in DAS28(CRP) from baseline \> 1.2.Percentage of Participants Achieving ACR/EULAR Remission: NRI Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 A participant's disease activity status was defined as being in remission when scores on the TJC28, SJC28, CRP (actual value in mg/dL) and SGA (cm) were all ≤ 1.
Percentage of Participants Achieving ACR/EULAR Remission: OC Extension Baseline, Weeks 12, 24, 36, 48, 60, 72, 84, 96, 108, 120, 132, 144, 156, 168, 180, 192, 204, 216, 228, 240, 252, 264, 276, 288, 300, 312, 324, 336, 348, 360, 372, 384, 396, 408 A participant's disease activity status was defined as being in remission when scores on the TJC28, SJC28, CRP (actual value in mg/dL) and SGA (cm) were all ≤ 1.
Change From Core Baseline in Physical Component Score (PCS) of Quality of Life Using the Short Form-36 (SF-36) Scores: OC Core Baseline, Extension Baseline, Weeks 48, 96, 144, 192, 240, 288, 336, 384 The health-related quality of life of the subject was assessed using the SF-36 with a 4-week recall period. This consists of 36 questions belonging to 8 domains in 2 components:
* Physical well-being: 4 domains: physical functioning (10 items), role physical (4 items), bodily pain (2 items), and general health (GH) perceptions (5 items).
* Mental well-being: 4 domains: vitality (4 items), social functioning (2 items), role emotional (3 items), and mental health (5 items).
These scales were from 0 to 100 with higher scores indicating a better quality of life.
Trial Locations
- Locations (111)
Municipal Non-profit Enterprise Consultative and Diagnostic Center of Pechersk District of Kiev city
🇺🇦Kyiv, Ukraine
L.T. Malaya Therapy Institute of National Academy of Medical Sciences of Ukraine
🇺🇦Kharkiv, Ukraine
Kherson City Clinical Hospital N. A. Afanasii and Olga Tropin
🇺🇦Kherson, Ukraine
Municipal Non-Profit Institution Consultative and Diagnostic Centre of Desnyasky District of Kyiv
🇺🇦Kiev, Ukraine
Hospital Regional "Guillermo Grant Benavente"
🇨🇱Santiago, Chile
Clinstile, S.A. de C.V.
🇲🇽Mexico, Mexico
Hospital Universitario José E. Gonzalez
🇲🇽Monterrey, Mexico
Circaribe S.A.S
🇨🇴Barranquilla, Colombia
Medicity S.A.S.
🇨🇴Bucaramanga, Santander, Colombia
Someal SA
🇨🇱Santiago, Chile
Centro Medico Dalinde
🇲🇽Ciudad de Mexico, Mexico
OSMO
🇲🇽Oaxaca, Mexico
Centro de Estudios de Investigacion Basica y Clinica, SC
🇲🇽Guadalajara, Mexico
Clinica Medica
🇬🇹Guatemala, Guatemala
QualiClinic Kft.
🇭🇺Budapest, Hungary
Reumatologiai Kft.
🇭🇺Budapest, Hungary
Rambam Medical Center
🇮🇱Haifa, Israel
'Bruninieku' polyclinic
🇱🇻Riga, Latvia
Clinica de Especialidades Medicas
🇬🇹Guatemala, Guatemala
Hospitaux de Hautepierre
🇫🇷Strasbourg CEDEX, France
Revmatologicka a interni ambulance
🇨🇿Kladno, Czechia
Multiprofile Hospital for Active Treatment - Ruse
🇧🇬Ruse, Bulgaria
Flinders Medical Centre
🇦🇺Bedford Park, Flinders Drive, South Australia, Australia
Riesgo De Fractura Cayre Ips7
🇨🇴Bogotá, Colombia
Hospital Pablo Tobon Uribe
🇨🇴Medellin, Colombia
Reuma S.A.
🇬🇹Guatemala, Guatemala
Reuma-Centro
🇬🇹Guatemala, Guatemala
Cliniques Universitaires St-Luc
🇧🇪Brussels, Belgium
CER Intituto Medico
🇦🇷Buenos Aires, Argentina
Carmel Medical Center
🇮🇱Haifa, Israel
Instituto de Asistencia Reumatologia Integral - IARI
🇦🇷San Fernando, Argentina
Gyogyszervizs galo Kozpont Kft
🇭🇺Balatonfured, Hungary
Schlossparkklinik - Akad. Lehrkrankenhaus Charite
🇩🇪Berlin, Germany
Prosalud
🇨🇱Santiago, Chile
Consulta Privada Dra. Ponce
🇨🇱Temuco, Chile
Revmatologie S.R.O
🇨🇿Brno, Czechia
Diagnostic Consultative Center "Sveta Anna" LTD
🇧🇬Sofia, Bulgaria
Instituto CAICI
🇦🇷Rosario, Argentina
Monash Medical Centre
🇦🇺Clayton, Victoria, Australia
PV-Medical S.R.O.
🇨🇿Zlin, Czechia
Centro de Investigacion Clinica del Sur
🇨🇱Temuco, Chile
Centro de Investigacion en Reumatologia y Especialidades Medicas (CIREEM)
🇨🇴Bogota, Colombia
Preventive Care SAS
🇨🇴Cundinamarca, Colombia
MVZ Rheumatologie and Autoimmun Medizin HH GmbH
🇩🇪Hamburg, Germany
Centro Clinico
🇬🇹Guatemala City, Guatemala
Clinica Medica Especializada en Reumatologia
🇬🇹Guatemala, Guatemala
SIA Arijas Ancane's Family Doctor
🇱🇻Baldone, Latvia
NZOZ Przychodnia Lekarska "Eskulap"
🇵🇱Skierniewice, Poland
Markhot Ferenc Hospital, Rheumatology
🇭🇺Eger, Hungary
Ltd M&M Centr
🇱🇻Adazi, Latvia
Daugavpils Regional Hospital
🇱🇻Daugavpils, Latvia
L. Atikes doktorats
🇱🇻Liepaja, Latvia
Hospital General de México
🇲🇽Mexico, Mexico
Csolnoky Ferenc Hospital, Rheumatology
🇭🇺Veszprem, Hungary
Arke Estudios Clinicos S.A. de C.V.
🇲🇽Mexico, Mexico
Waikato Hospital
🇳🇿Hamilton, New Zealand
Timaru Rheumatology Studies
🇳🇿Timaru, New Zealand
Spitalul Clinic Sfanta Maria
🇷🇴Bucuresti, Romania
Spitalul Clinic Judetean de Urgenta Sf. Apostol Andrei Galati
🇷🇴Galati, Romania
City Clinical Hospital #5
🇷🇺Nizhniy Novgorod, Russian Federation
Kharkiv Medical Academy of Postgraduate Education, Department of Cardiology
🇺🇦Kharkiv, Ukraine
GBOU VPO Orenburg State Medical University
🇷🇺Orenburg, Russian Federation
Hospital Parc Tauli
🇪🇸Sabadell, Spain
City Hospital #26
🇷🇺St Petersburg, Russian Federation
National Multiprofile Transport Hospital "Tsar Boris III," Sofia, Clinical of Internal Diseases
🇧🇬Sofia, Bulgaria
Revmatologicka ambulance
🇨🇿Praha-Nusle, Czechia
Desert Medical Advances
🇺🇸Palm Desert, California, United States
Millenium Research
🇺🇸Ormond Beach, Florida, United States
Springfield Clinic
🇺🇸Springfield, Illinois, United States
Lovelace Scientific Resources
🇺🇸Venice, Florida, United States
West Tennessee Research Institute
🇺🇸Jackson, Tennessee, United States
CIMeL Centro dee Investigacion Medico Lanus
🇦🇷Lanus, Argentina
Atencion Integral en Reumatologa
🇦🇷Buenos Aires, Argentina
Austin Rheumatology Research PA
🇺🇸Austin, Texas, United States
Organizacion Medica de Investigaciones (OMI)
🇦🇷Buenos Aires, Argentina
Instituto Reumatologico Strusberg
🇦🇷Cordoba, Argentina
Centro Médico Privado de Reumatologia
🇦🇷San Miguel de Tucumán, Argentina
Princess Alexandra Hospital
🇦🇺Woolloongabba, Australia
UZ Leuven
🇧🇪Leuven, Belgium
University "Multiprofile Hospital for Active Treatment - Kaspela" LTD
🇧🇬Plovdiv, Bulgaria
University Multiprofile Hospital for Active Treatment "SV. Ivan Rilski" EAD, Sofia, Rheumatology Clinic
🇧🇬Sofia, Bulgaria
Idearg Sas
🇨🇴Bogota, Colombia
IMSP Institutul de Cardiologie
🇲🇩Chisinau, Moldova, Republic of
Centrum Medyczne Silesiana Sp. Z.o.o.
🇵🇱Bytom, Poland
Centrum Medyczne Pratia Katowice
🇵🇱Katowice, Poland
NZOZ Osteo-Medic s.c.
🇵🇱Bialystok, Poland
Centrum Medyczne Plejady
🇵🇱Krakow, Poland
Specjalistyczne Centrum Medyczne Nowomed
🇵🇱Krakow, Poland
Powiatowy Zaklad Opieki Zdrowotnej w Starachowicach
🇵🇱Starachowice, Poland
Rheumatica Sp. Z.o.o.
🇵🇱Warszawa, Poland
NZOZ "Nasz Lekarz" Pratyka Grupowa Lekarzy Rodzinnychz
🇵🇱Torun, Poland
First Moscow State Medical University n.a. I.M. Sechenova of the Ministry of Health
🇷🇺Moscow, Russian Federation
Scientific Research Institute of Rheumatology
🇷🇺Moscow, Russian Federation
Ryazan State Medical University
🇷🇺Ryazan, Russian Federation
Regional Clinical Hospital
🇷🇺Saratov, Russian Federation
Complejo Hospitalario Universitario A Coruña (CHUAC)
🇪🇸A Coruña, Spain
Vladimir Regional State Instituion of Healthcare
🇷🇺Vladimir, Russian Federation
Communal Institution of Healthcare - Kharkiv City Clinical Hospital #13
🇺🇦Kharkiv, Ukraine
Sanatorio Nuestra Señora de la Esperanza
🇪🇸A Coruña, Spain
Vinnitsya Regional Clinical Hospital Named after M.I.Pirogov, Rheumatology Department
🇺🇦Vinnytsya, Ukraine
NZOZ "DOBRY LEKARZ" Specjalistyczne Poradnie Lekarskie
🇵🇱Krakow, Poland
AMED Medical Center
🇵🇱Warsaw, Poland
Arthro, Arthritis Care & Research
🇺🇸Gilbert, Arizona, United States
Arizona Arthritis & Rheumatology Research PLLC
🇺🇸Mesa, Arizona, United States
C.V. Mehta MD Medical Corp.
🇺🇸Hemet, California, United States
RASF Clinical Research Center
🇺🇸Boca Raton, Florida, United States
Klein and Associates MD, PA
🇺🇸Hagerstown, Maryland, United States
Physicians East
🇺🇸Greenville, North Carolina, United States
Health Research of Oklahoma
🇺🇸Oklahoma City, Oklahoma, United States
Pioneer Research Solutions Inc
🇺🇸Houston, Texas, United States
Low County Rheumatology PA
🇺🇸Charleston, South Carolina, United States