A Study of Gefapixant (MK-7264) in Adult Participants With Chronic Cough (MK-7264-030)
- Conditions
- Chronic Cough
- Interventions
- Registration Number
- NCT03449147
- Lead Sponsor
- Merck Sharp & Dohme LLC
- Brief Summary
The primary objectives of this study are to evaluate the efficacy of gefapixant (MK-7264) in reducing cough frequency as measured over a 24-hour period, and to determine the safety and tolerability of gefapixant. The primary hypothesis is that at least one dose of gefapixant is superior to placebo in reducing coughs per hour (over 24 hours) at Week 24.
- Detailed Description
This study will have a main 24-week treatment period and a 28-week extension period of treatment (total treatment period of 52 weeks). Participants at selected sites and countries who complete the main and extension study periods may consent to participate in an observational, 12-week, Off-treatment Durability Study Period. Any assessments conducted in the observational period will be exploratory.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1317
- Chest radiograph or computed tomography scan of the thorax (within 5 years of Screening/Visit 1 and after the onset of chronic cough) not demonstrating any abnormality considered to be significantly contributing to the chronic cough or any other clinically significant lung disease in the opinion of the principal investigator or the sub-investigator
- Has had chronic cough for at least 1 year with a diagnosis of refractory chronic cough or unexplained chronic cough
- Is a female who is not pregnant, not breastfeeding, not of childbearing potential, or agrees to follow contraceptive guidance
- Provides written informed consent and is willing and able to comply with the study protocol (including use of the digital cough recording device and completion of study questionnaires)
- Is a current smoker or has given up smoking within 12 months of Screening, or is a former smoker with greater than 20 pack-years
- Has a history of respiratory tract infection or recent clinically significant change in pulmonary status
- Has a history of chronic bronchitis
- Is currently taking an angiotensin converting enzyme inhibitor (ACEI), or has used an ACEI within 3 months of Screening
- Has an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m^2 at Screening OR an eGFR ≥30 mL/min/1.73 m^2 and <50 mL/min/1.73 m^2 at Screening with unstable renal function
- Has a history of malignancy ≤5 years
- Is a user of recreational or illicit drugs or has had a recent history of drug or alcohol abuse or dependence
- Has a history of anaphylaxis or cutaneous adverse drug reaction (with or without systemic symptoms) to sulfonamide antibiotics or other sulfonamide-containing drugs
- Has a known allergy/sensitivity or contraindication to gefapixant
- Has donated or lost ≥1 unit of blood within 8 weeks prior to the first dose of gefapixant
- Has previously received gefapixant
- Currently participating in or has participated in an interventional clinical study within 30 days of screening
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Gefapixant 15 mg BID Gefapixant 15 mg BID Participants will receive a gefapixant 15 mg tablet BID and placebo tablet to match gefapixant 45 mg BID during the 24-week main study period and the 28-week extension period. Gefapixant 45 mg BID Gefapixant 45 mg BID Participants will receive a gefapixant 45 mg tablet BID and placebo tablet to match gefapixant 15 mg BID during the 24-week main study period and during the 28-week extension period. Placebo Placebo Participants will receive a matching placebo tablet BID during the 24-week main study period and the 28-week extension period. Gefapixant 45 mg BID Placebo Participants will receive a gefapixant 45 mg tablet BID and placebo tablet to match gefapixant 15 mg BID during the 24-week main study period and during the 28-week extension period. Gefapixant 15 mg BID Placebo Participants will receive a gefapixant 15 mg tablet BID and placebo tablet to match gefapixant 45 mg BID during the 24-week main study period and the 28-week extension period.
- Primary Outcome Measures
Name Time Method Model-Based Geometric Mean Ratio (GMR) of 24-Hour Coughs Per Hour at Week 24/Baseline Baseline, Week 24 24-hour coughs per hour was defined as the average hourly cough frequency based on 24-hour sound recordings using a digital recording device (cough monitor). A longitudinal analysis of covariance (ANCOVA) model was applied to log-transformed cough data to determine geometric mean (GM) 24-hour coughs per hour at baseline and week 24. The GMR (Week 24 GM 24-hour coughs per hour divided by Baseline GM 24-hour coughs per hour) is reported.
Number of Participants Who Experienced At Least One Adverse Event (AE) During Treatment and Follow-up Up to 54 Weeks An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
Number of Participants Who Discontinued a Study Drug Due to an AE Up to 52 weeks An AE is any untoward medical occurrence in a clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a study intervention.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With a ≥1.3 Point Change From Baseline in the Leicester Questionnaire (LCQ) Total Score at Week 24 Baseline, Week 24 The 19-item LCQ assessed the impact of chronic cough in three health-related quality of life (HRQoL) domains (physical, social and psychological). The LCQ is calculated as a mean score for each domain ranging from 1 to 7, with a total score ranging from 3 to 21. Higher scores indicate better HRQoL. A clinically meaningful improvement from baseline in HRQoL was defined as ≥1.3-point increase in the LCQ total score at Week 24. The percentage of participants (logistic regression model-based) with a ≥1.3-point increase in the LCQ total score at Week 24 is presented.
Model-Based GMR of Awake Coughs Per Hour at Week 24/Baseline Baseline, Week 24 Awake coughs per hour was defined as the average hourly cough frequency while the participant is awake, based on a 24-hour interval of sound recordings using a digital recording device (cough monitor). ANCOVA model was applied to log-transformed cough data to determine GM of awake coughs per hour at baseline and week 24. The GMR (Week 24 GM awake coughs per hour divided by Baseline GM awake coughs per hour) is reported.
Percentage of Participants With a ≤-30% Change From Baseline in 24-hour Coughs Per Hour at Week 24 Baseline, Week 24 24-hour coughs per hour was defined as the average hourly cough frequency based on 24-hour sound recordings using a digital recording device (cough monitor). A clinically meaningful improvement from baseline is defined as a ≤-30% change (≥30% reduction) in 24-hour coughs per hour at week 24. The percentage of participants (logistic regression model-based) with a ≤ -30% change from baseline in 24-hour coughs per hour at Week 24 (≥30% reduction from baseline) is presented.
Percentage of Participants With ≤-1.3 Point Change From Baseline of Mean Weekly Cough Severity Diary (CSD) Total Score at Week 24 Baseline, Week 24 The 7-item CSD was used to record participants' daily cough frequency, cough intensity, and disruption due to cough. Each item was rated on an 11-point scale ranging from 0 (best) to 10 (worst); the total daily CSD score was the sum of these seven item scores (Min=0, Max=70). Mean weekly CSD total score was defined as the average of the mean total daily scores collected during the week prior to each visit. The percentage of participants (logistic regression model-based) with a ≤-1.3 point change from baseline in CSD at Week 24 (or ≥1.3 point reduction from baseline) is reported.
Percentage of Participants With ≤-2.7 Point Change From Baseline of Mean Weekly CSD Total Score at Week 24 Baseline, Week 24 The 7-item CSD was used to record participants' daily cough frequency, cough intensity, and disruption due to cough. Each item was rated on an 11-point scale ranging from 0 (best) to 10 (worst); the total daily CSD score was the sum of these seven item scores (Min=0, Max=70). Mean weekly CSD total score was defined as the average of the mean total daily scores collected during the week prior to each visit. The percentage of participants (logistic regression model-based) with a ≤-2.7 point change from baseline in CSD at Week 24 (or ≥2.7 point reduction from baseline) is reported.
Percentage of Participants With a ≤-30 Millimeter (mm) Change From Baseline in Cough Severity Visual Analog Scale (VAS) Score at Week 24 Baseline, Week 24 The VAS is a single-item questionnaire with the response on a 100- point scale ranging from 0 ("No Cough") to 100 ("Extremely Severe Cough"). Mean weekly VAS score was defined as the average of the VAS scores collected during the week prior to each visit. The percentage of participants (logistic regression model-based) with a ≤-30 mm change from baseline in cough severity VAS score at Week 24 is reported.
Trial Locations
- Locations (171)
Bethesda Allergy Asthma and Research Center LLC ( Site 0019)
🇺🇸Bethesda, Maryland, United States
Atlanta Allergy & Asthma Clinic PA ( Site 0029)
🇺🇸Stockbridge, Georgia, United States
University of Missouri ENT & Allergy Center ( Site 0066)
🇺🇸Columbia, Missouri, United States
Allergy & Asthma Associates of SCV Research Center ( Site 0064)
🇺🇸San Jose, California, United States
Lenus Research & Medical Group Llc ( Site 0075)
🇺🇸Sweetwater, Florida, United States
Healthcare Research Network LLC ( Site 0093)
🇺🇸Flossmoor, Illinois, United States
Royal Adelaide Hospital [Adelaide, Australia] ( Site 0214)
🇦🇺Adelaide, South Australia, Australia
Albuquerque Clinical Trials ( Site 0039)
🇺🇸Albuquerque, New Mexico, United States
Aerztezentrum Axel Springer Passage ( Site 1009)
🇩🇪Berlin, Germany
Trialswest ( Site 0208)
🇦🇺Murdoch, Australia
Minnesota Lung Center ( Site 0041)
🇺🇸Woodbury, Minnesota, United States
PneumoConsult Ulm ( Site 1008)
🇩🇪Ulm, Germany
Allergic Disease and Asthma Center ( Site 0043)
🇺🇸Greenville, South Carolina, United States
Azienda Ospedaliero Universitaria Careggi ( Site 1400)
🇮🇹Firenze, Italy
Minnesota Lung Center ( Site 0108)
🇺🇸Edina, Minnesota, United States
Middlemore Clinical Trials ( Site 0232)
🇳🇿Auckland, New Zealand
PNEUMO-NB s.r.o. ( Site 0710)
🇨🇿Novy Bor, Czechia
Clinical Research Institute of Southern Oregon, PC ( Site 0099)
🇺🇸Medford, Oregon, United States
Ordinace Pneumologie a diagnostiky Plicnich funkci ( Site 0705)
🇨🇿Karlovy Vary, Czechia
AAPRI Clinical Research Institute ( Site 0001)
🇺🇸Warwick, Rhode Island, United States
Bellingham Asthma & Allergy ( Site 0076)
🇺🇸Bellingham, Washington, United States
Australian Clinical Research Network ( Site 0201)
🇦🇺Maroubra, New South Wales, Australia
MUDr. I. Cierna Peterova s.r.o. ( Site 0707)
🇨🇿Brandys nad Labem, Czechia
Wake Research Associates, LLC ( Site 0058)
🇺🇸Raleigh, North Carolina, United States
Clinique Specialisee en Allergie de la Capitale - CSAC ( Site 0504)
🇨🇦Quebec, Canada
Montefiore Medical Center ( Site 0098)
🇺🇸Bronx, New York, United States
Gemeinschaftspraxis Zentrum ( Site 1005)
🇩🇪Frankfurt, Germany
Hamilton Medical Research Group ( Site 0510)
🇨🇦Hamilton, Ontario, Canada
Marycliff Clinical Research ( Site 0062)
🇺🇸Spokane, Washington, United States
Atemwegszentrum Neukoeln ( Site 1003)
🇩🇪Berlin, Germany
Pneumologicum im Suedstadtforum ( Site 1004)
🇩🇪Hannover, Germany
Dr N K Gounden Mediclinic ( Site 2134)
🇿🇦Shallcross, Kwazulu Natal, South Africa
Southern Clinical Trials - Waitemata ( Site 0230)
🇳🇿Auckland, New Zealand
Clinica Internacional ( Site 1801)
🇵🇪Lima, Peru
Belfast City Hospital ( Site 2705)
🇬🇧Belfast, United Kingdom
Cukurova Universitesi Tıp Fakultesi Balcalı Hastanesi ( Site 2612)
🇹🇷Adana, Turkey
Lakeland Clinical Trials ( Site 0233)
🇳🇿Rotorua, New Zealand
P3 Research Ltd. ( Site 0228)
🇳🇿Tauranga, New Zealand
Medinova East London Dedicated Research Centre ( Site 2715)
🇬🇧Romford, Essex, United Kingdom
Hospital Nacional Cayetano Heredia [Lima, Peru] ( Site 1806)
🇵🇪Lima, Peru
NZOZ CENTRUM ALERGOLOGII ( Site 1909)
🇵🇱Lublin, Lubelskie, Poland
Jongaie Research ( Site 2131)
🇿🇦Pretoria, Gauteng, South Africa
Ankara Universitesi Tip Fakultesi Cebeci Hastanesi ( Site 2602)
🇹🇷Ankara, Turkey
Ege Universitesi Tip Fakultesi Hastanesi ( Site 2603)
🇹🇷Izmir, Turkey
Wythenshawe Hospital ( Site 2700)
🇬🇧Manchester, United Kingdom
Prince Phillip Hospital ( Site 2722)
🇬🇧Llanelli, United Kingdom
I Engelbrecht Research ( Site 2128)
🇿🇦Centurion, Tswane, South Africa
Taunton and Somerset Hospital ( Site 2723)
🇬🇧Taunton, United Kingdom
Kherson City Clinical Hospital n.a. Y.Y. Karabelesh ( Site 2812)
🇺🇦Kherson, Ukraine
Medical Association Medbud of the PJSC Kyivmiskbud ( Site 2803)
🇺🇦Kyiv, Ukraine
Synexus Scotland Clinical Research Centre ( Site 2721)
🇬🇧Glasgow, United Kingdom
Synexus Merseyside Clinical Research Centre ( Site 2720)
🇬🇧Liverpool, United Kingdom
Trakya Universitesi Saglik Arastirma ve Uygulama Merkezi ( Site 2619)
🇹🇷Edirne, Turkey
Istanbul Universitesi Istanbul Tip Fakultesi Gogus Hastalıklari ABD ( Site 2610)
🇹🇷Istambul, Turkey
Rothwell Medical Centre ( Site 2712)
🇬🇧Rothwell, United Kingdom
Remington-Davis, Inc. ( Site 0082)
🇺🇸Columbus, Ohio, United States
Rush University Medical Center ( Site 0103)
🇺🇸Chicago, Illinois, United States
The First Affiliated Hospital of Fujian Medical University ( Site 5017)
🇨🇳Fuzhou, Fujian, China
The First Affiliated Hospital of Guangzhou Medical University ( Site 5000)
🇨🇳Guangzhou, Guangdong, China
The First Affiliated Hospital of Nanchang University ( Site 5012)
🇨🇳Nanchang, Jiangxi, China
ShengJing Hospital of China Medical University ( Site 5024)
🇨🇳Shenyang, Liaoning, China
Peking University Third Hospital ( Site 5005)
🇨🇳Beijing, China
Shanghai General Hospital ( Site 5010)
🇨🇳Shanghai, Shanghai, China
The First Affiliated Hospital of Zhejiang University ( Site 5014)
🇨🇳Hangzhou, Zhejiang, China
Medinova South London Dedicated Research Centre ( Site 2714)
🇬🇧Sidcup, Kent, United Kingdom
Phoenix Medical Group ( Site 0022)
🇺🇸Peoria, Arizona, United States
The Lung Research Center ( Site 0072)
🇺🇸Chesterfield, Missouri, United States
Lowcountry Lung & Critical Care, PA ( Site 0045)
🇺🇸Charleston, South Carolina, United States
Clinical Research Partners, LLC. ( Site 0080)
🇺🇸Richmond, Virginia, United States
Recherche GCP Research ( Site 0500)
🇨🇦Montreal, Quebec, Canada
Inner Mongolia Autonomous Region Hospital ( Site 5018)
🇨🇳Hohhot, Inner Mongolia, China
MediTrial s.r.o ( Site 0702)
🇨🇿Jindrichuv Hradec III, Czechia
Nemocnice Tabor a.s. ( Site 0703)
🇨🇿Tabor, Czechia
Ballenberger Freytag Wenisch Institut fuer klinische Forschung GmbH ( Site 1011)
🇩🇪Neu-Isenburg, Germany
Pneumologenzentrum ( Site 1006)
🇩🇪Leipzig, Germany
Synexus Magyarorszag Kft. ( Site 1208)
🇭🇺Budapest, Hungary
Kaplan Medical Center ( Site 1300)
🇮🇱Rehovot, Israel
Centrum Medyczne Pratia Katowice ( Site 1917)
🇵🇱Katowice, Slaskie, Poland
Rochester Place Medical Centre ( Site 2129)
🇿🇦Morningside, Gauteng, South Africa
SSK Sureyyapasa Gogus Hastaliklari Hastanesi ( Site 2608)
🇹🇷Istambul, Turkey
Chernihiv City hospital N2 ( Site 2801)
🇺🇦Chernihiv, Ukraine
SBU Dr. Suat Seren Gogus Hast. ve Cer. Egitim ve Arastirma Hast. ( Site 2604)
🇹🇷Izmir, Turkey
Medinova Warwickshire Dedicated Research Centre ( Site 2717)
🇬🇧Kenilworth, Warwickshire, United Kingdom
Synexus Manchester Clinical Research Centre ( Site 2718)
🇬🇧Manchester, United Kingdom
North Tyneside General Hospital ( Site 2707)
🇬🇧North Shields, United Kingdom
Allergy Associates Research Center ( Site 0026)
🇺🇸Portland, Oregon, United States
Herlev Hospital ( Site 0803)
🇩🇰Herlev, Denmark
Bispebjerg Hospital ( Site 0804)
🇩🇰Kobenhavn NV, Denmark
Paul A. Shapero, MD ( Site 0104)
🇺🇸Bangor, Maine, United States
Clinical Research Consortium ( Site 0050)
🇺🇸Las Vegas, Nevada, United States
Neumo Investigaciones SAS ( Site 0622)
🇨🇴Bogota, Cundinamarca, Colombia
Fundacion Valle del Lili ( Site 0618)
🇨🇴Cali, Valle Del Cauca, Colombia
Instituto Neumologico del Oriente S.A. ( Site 0649)
🇨🇴Bucaramanga, Colombia
Clinica Privada Dr. Jose Francisco Flores Lopez ( Site 2903)
🇬🇹Guatemala, Guatemala
Synexus Magyarorszag Kft. ( Site 1210)
🇭🇺Gyula, Hungary
Pulmonary Associates, PA ( Site 0063)
🇺🇸Phoenix, Arizona, United States
Fundacion Centro de Investigacion Clinica CIC ( Site 0603)
🇨🇴Medellin, Antioquia, Colombia
Centro Especializado en Enfermedades Pulmonares. ( Site 0620)
🇨🇴Bogota, Cundinamarca, Colombia
MedPlus Medicina Prepagada S.A. ( Site 0612)
🇨🇴Bogota, Colombia
Diex Recherche Victoriaville Inc. ( Site 0514)
🇨🇦Victoriaville, Quebec, Canada
Hospital Pablo Tobon Uribe ( Site 0600)
🇨🇴Medellin, Antioquia, Colombia
CIC Mauricie Inc. ( Site 0503)
🇨🇦Trois-Rivieres, Quebec, Canada
Clinipharm ( Site 2902)
🇬🇹Guatemala, Guatemala
Erzsebet Gondozohaz ( Site 1207)
🇭🇺Godollo, Hungary
Clinical Research Consortium ( Site 0088)
🇺🇸Tempe, Arizona, United States
Lumniczer Sandor Korhaz es Rendelointezet ( Site 1212)
🇭🇺Kapuvar, Hungary
Q & T Research Sherbrooke Inc. ( Site 0512)
🇨🇦Sherbrooke, Quebec, Canada
Atlantic Research Center LLC ( Site 0012)
🇺🇸Ocean City, New Jersey, United States
Centro Medico Imbanaco de Cali S.A ( Site 0619)
🇨🇴Cali, Valle Del Cauca, Colombia
Clinique de Pneumologie et du Sommeil de Lanaudiere- CPSL ( Site 0516)
🇨🇦St-Charles-Borromee, Quebec, Canada
Universidad Pontificia Bolivariana - Clinica Universitaria Bolivariana ( Site 0602)
🇨🇴Medellin, Antioquia, Colombia
Inst. Prestadora de Servicios de Salud Universidad Antioquia ( Site 0621)
🇨🇴Medellin, Colombia
Clinical Research of Rock Hill ( Site 0079)
🇺🇸Rock Hill, South Carolina, United States
Celan SA ( Site 2900)
🇬🇹Guatemala, Guatemala
Consultorio Privado Dr. Jeremias Guerra ( Site 2909)
🇬🇹Guatemala, Guatemala
CRU Hungary KFT ( Site 1205)
🇭🇺Miskolc, Hungary
Institut Perubatan Respiratori ( Site 1605)
🇲🇾Kuala Lumpur, Malaysia
Centrum Medycyny Oddechowej Mroz Spolka Jawna ( Site 1918)
🇵🇱Białystok, Poland
Medical Clinic Blagomed LLC ( Site 2807)
🇺🇦Kiev, Ukraine
F.G.Yanovskyy Institute of Phthisiology and Pulmonology ( Site 2804)
🇺🇦Kyiv, Ukraine
Clinica Medica Especializada en Neumologia ( Site 2901)
🇬🇹Guatemala, Guatemala
Dr Kenessey Albert Korhaz-Rendelointezet ( Site 1200)
🇭🇺Balassagyarmat, Hungary
Da Vinci Private Clinic - Da Vinci Maganklinika ( Site 1201)
🇭🇺Pecs, Hungary
Puspokladanyi Egeszsegugyi Szolgaltato Nonprofit Kft ( Site 1203)
🇭🇺Puspokladany, Hungary
Hospital Sultanah Bahiyah ( Site 1607)
🇲🇾Alor Star, Kedah, Malaysia
University Malaya Medical Centre ( Site 1601)
🇲🇾Kuala Lumpur, Malaysia
Lubelskie Centrum Diagnostyczne ( Site 1913)
🇵🇱Swidnik, Poland
SE Road Clinical Hospital 2 of Kyiv station ( Site 2809)
🇺🇦KYiv, Ukraine
Vinnytsia Regional Clinical Hospital n.a. M.I. Pyrogov ( Site 2819)
🇺🇦Vinnytsia, Ukraine
MI Zaporizhzhia City Multispecialty Clinical Hospital 9 ( Site 2811)
🇺🇦Zaporizhzhia, Ukraine
Zhytomyr Central City Hospital #1 ( Site 2828)
🇺🇦Zhytomyr, Ukraine
Hospital Pulau Pinang. ( Site 1606)
🇲🇾George town, Pulau Pinang, Malaysia
Universiti Teknologi MARA ( Site 1602)
🇲🇾Batu Caves, Selangor, Malaysia
Hospital Nacional Adolfo Guevara Velasco ( Site 1808)
🇵🇪Cusco, Peru
Hospital Taiping ( Site 1600)
🇲🇾Taiping, Perak, Malaysia
Asociacion Civil por la Salud ( Site 1805)
🇵🇪Lima, Peru
Centrum Medyczne Silmedic Sp z o o ( Site 1920)
🇵🇱Katowice, Slaskie, Poland
Specjalistyczny osrodek .All-Med. Grazyna Pulka ( Site 1919)
🇵🇱Krakow, Poland
RCMed ( Site 1912)
🇵🇱Sochaczew, Poland
KLIMED ( Site 1902)
🇵🇱Bychawa, Poland
Gyncentrum Clinic Sp. z o.o. ( Site 1908)
🇵🇱Katowice, Poland
Centrum Nowoczesnych Terapii Dobry Lekarz ( Site 1924)
🇵🇱Krakow, Poland
Uniwersytecki Szpital Kliniczny im. Norberta Barlickiego nr 1 ( Site 1921)
🇵🇱Lodz, Poland
Ostrowieckie Centrum Medyczne ( Site 1915)
🇵🇱Ostrowiec Swietokrzyski, Poland
UCT Lung Institute - Bateman ( Site 2126)
🇿🇦Cape Town, Western Cape, South Africa
Centrum Medyczne Lucyna Andrzej Dymek - Zawadzkie ( Site 1923)
🇵🇱Zawadzkie, Poland
Kyiv City Tuberculosis Hospital No. 1 ( Site 2814)
🇺🇦Kyiv, Ukraine
F.G.Yanovskyy Institute of Phthisiology and Pulmonology ( Site 2830)
🇺🇦Kyiv, Ukraine
Volyn Regional Clinical Hospital ( Site 2829)
🇺🇦Lutsk, Ukraine
Institute of Otolaryngology n. a. Prof. A. I. Kolomiychenko ( Site 2833)
🇺🇦Kyiv, Ukraine
Poltava City Clinical Hospital 1 ( Site 2808)
🇺🇦Poltava, Ukraine
Centrum Medyczne Pratia Warszawa ( Site 1911)
🇵🇱Warszawa, Poland
CE Chernivtsi state city clinical hospital 3 ( Site 2806)
🇺🇦Chernivtsi, Ukraine
Medinova Lakeside Dedicated Research Centre ( Site 2710)
🇬🇧Corby, Northamptonshire, United Kingdom
Uludag Universitesi Tip Fakultesi ( Site 2621)
🇹🇷Bursa, Gorukle, Turkey
Celal Bayar University Faculty of Medicine ( Site 2614)
🇹🇷Manisa, Turkey
Hull & East Yorkshire NHS Trust. Castle Hill Hospital ( Site 2704)
🇬🇧Cottingham, East Yorkshire, United Kingdom
Synexus Midlands Clinical Research Centre Ltd ( Site 2719)
🇬🇧Birmingham, Edgbaston, United Kingdom
Medinova North London Dedicated Research Centre ( Site 2716)
🇬🇧Northwood, Middlesex, United Kingdom
1Kings College Hospital ( Site 2702)
🇬🇧London, United Kingdom
West Walk Surgery ( Site 2711)
🇬🇧Yate, United Kingdom
Diex Recherche Quebec Inc ( Site 0515)
🇨🇦Quebec, Canada
CHI Health Creighton University Medical Center ( Site 0024)
🇺🇸Omaha, Nebraska, United States
Mayo Clinic - Rochester ( Site 0006)
🇺🇸Rochester, Minnesota, United States
Iatros International ( Site 2130)
🇿🇦Brandwag, Bloemfontein, South Africa
Drs Lalloo & Ambaram ( Site 2132)
🇿🇦Umhlanga Ridge, Kwazulu Natal, South Africa
Abraham Research, PLLC ( Site 0107)
🇺🇸Fort Mitchell, Kentucky, United States
Respiratory Medicine Research Institute of Michigan, PLC ( Site 0034)
🇺🇸Ypsilanti, Michigan, United States
Holdsworth House Medical Practice ( Site 0206)
🇦🇺Sydney, New South Wales, Australia
Multicare Health System ( Site 0018)
🇺🇸Tacoma, Washington, United States
Clinica Ricardo Palma ( Site 1802)
🇵🇪San Isidro, Lima, Peru