A Study Comparing Risankizumab to Placebo in Participants With Active Psoriatic Arthritis Including Those Who Have a History of Inadequate Response or Intolerance to Biologic Therapy(Ies)
- Conditions
- Psoriatic Arthritis (PsA)
- Interventions
- Biological: PlaceboBiological: Risankizumab
- Registration Number
- NCT03671148
- Lead Sponsor
- AbbVie
- Brief Summary
The purpose of this study is to evaluate the safety and efficacy of risankizumab in adults with moderately to severely active psoriatic arthritis (PsA).
- Detailed Description
The study consists of a Screening Period (approximately 35 days), Period 1, Period 2, and a 20-week Follow-up Period. Period 1 is a 24-week randomized, double-blind, placebo-controlled, parallel-group period. Period 2 is the long-term period and starts at Week 24. To maintain the blind to the original treatment allocation, treatment at the Week 24 Visit is blinded: participants randomized to placebo receive blinded risankizumab 150 mg, and participants randomized to risankizumab receive blinded placebo. At Week 28 and for the remaining dosing visits (to Week 316), all participants receive open-label risankizumab 150 mg every 12 weeks. Participants remain blinded to the original randomization allocation for the duration of the study. The total study duration is 336 weeks including a telephone call 140 days (20 weeks) after last dose of study drug.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 444
- Clinical diagnosis of psoriatic arthritis (PsA) with symptom onset at least 6 months prior to the Screening Visit and fulfillment of the Classification Criteria for PsA (CASPAR) at Screening Visit.
- Participant has active disease defined as ≥ 5 tender joints (based on 68 joint counts) and ≥ 5 swollen joints (based on 66 joint counts) at both the Screening Visit and Baseline.
- Diagnosis of active plaque psoriasis, with at least one psoriatic plaque of ≥ 2 cm diameter or nail changes consistent with psoriasis at Screening Visit.
- Participant has demonstrated an inadequate response or intolerance to biologic therapy(ies) or conventional synthetic disease modifying anti-rheumatic drugs (csDMARD) therapy(ies).
- Participant is considered by investigator, for any reason, to be an unsuitable candidate for the study.
- Participant has a known hypersensitivity to risankizumab.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Risankizumab Participants randomized to receive double-blind placebo at Week 0, Week 4, and Week 16 in Period 1. At Week 24 participants will receive 150 mg risankizumab followed by open-label 150 mg risankizumab at Week 28, and every 12 weeks thereafter in Period 2 until the final dosing time point at Week 316. Risankizumab Placebo Participants randomized to receive 150 mg risankizumab administered by subcutaneous injection at Week 0, Week 4, and Week 16 in Period 1. At Week 24 participants will receive blinded placebo followed by open-label 150 mg risankizumab at Week 28, and every 12 weeks thereafter in Period 2 until the final dosing time point at Week 316. Placebo Placebo Participants randomized to receive double-blind placebo at Week 0, Week 4, and Week 16 in Period 1. At Week 24 participants will receive 150 mg risankizumab followed by open-label 150 mg risankizumab at Week 28, and every 12 weeks thereafter in Period 2 until the final dosing time point at Week 316. Risankizumab Risankizumab Participants randomized to receive 150 mg risankizumab administered by subcutaneous injection at Week 0, Week 4, and Week 16 in Period 1. At Week 24 participants will receive blinded placebo followed by open-label 150 mg risankizumab at Week 28, and every 12 weeks thereafter in Period 2 until the final dosing time point at Week 316.
- Primary Outcome Measures
Name Time Method Percentage of Participants With an American College of Rheumatology 20% (ACR20) Response at Week 24 Baseline and Week 24 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).
- Secondary Outcome Measures
Name Time Method Percentage of Participants With Resolution of Dactylitis at Week 24 Week 24 Resolution of dactylitis is defined as a Leeds Dactylitis Index (LDI) score = 0.
The LDI basic is a score based on finger circumference and tenderness, assessed across all digits. The LDI basic measures the ratio of the circumference of the affected digit to the circumference of the digit on the opposite hand or foot, using a minimum difference of 10% to define a dactylitic digit. The ratio of circumference is multiplied by a tenderness score (1 for tender, 0 for non-tender). If both sides of a digit are considered involved, or the circumference of the contralateral digit cannot be obtained, a standard reference table is used.
Scores from each digit are summed to provide the final LDI. A higher LDI indicates worse dactylitis.Change From Baseline In Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 24 Baseline and Week 24 The Health Assessment Questionnaire Disability Index is a patient-reported questionnaire that measures the degree of difficulty a person has in accomplishing tasks in 8 functional areas (dressing, arising, eating, walking, hygiene, reaching, gripping, and errands and chores) over the past week. Participants assessed their ability to do each task on a scale from 0 (without any difficulty) to 3 (unable to do). Scores were averaged to provide an overall score ranging from 0 to 3, where 0 represents no disability and 3 represents very severe, high-dependency disability.
A negative change from Baseline in the overall score indicates improvement.Percentage of Participants With an American College of Rheumatology 50% (ACR50) Response at Week 24 Baseline and Week 24 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR50 response criteria:
1. ≥ 50% improvement in 68-tender joint count;
2. ≥ 50% improvement in 66-swollen joint count; and
3. ≥ 50% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage Of Participants Achieving Psoriasis Area Severity Index (PASI) 90 Response at Week 24 Baseline and Week 24 PASI is a composite score based on the percentage of the body surface area (BSA) affected by psoriasis and the intensity of erythema (reddening), induration (thickening or hardening of the skin), and desquamation (peeling of the skin) of lesions assessed at 4 anatomic sites (head, upper extremities, trunk, and lower extremities). At each location, the percentage of BSA involvement is assigned a score from 0 (no involvement) to 6 (90% to 100% involvement), and erythema, induration, and desquamation are scored on a scale from 0 (no symptoms) to 4 (very marked).
The PASI score ranges from 0 (no psoriasis) to 72 (very severe psoriasis). A PASI 90 response is the percentage of participants who achieved at least a 90% reduction (improvement) from Baseline in PASI score.Percentage of Participants With an ACR20 Response at Week 16 Baseline and Week 16 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR20 response criteria:
1. ≥ 20% improvement in 68-tender joint count;
2. ≥ 20% improvement in 66-swollen joint count; and
3. ≥ 20% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants With an American College of Rheumatology 70% (ACR70) Response at Week 24 Baseline and Week 24 Participants who met the following 3 conditions for improvement from Baseline were classified as meeting the ACR70 response criteria:
1. ≥ 70% improvement in 68-tender joint count;
2. ≥ 70% improvement in 66-swollen joint count; and
3. ≥ 70% improvement in at least 3 of the 5 following parameters:
* Physician global assessment of disease activity
* Patient global assessment of disease activity
* Patient assessment of pain
* Health Assessment Questionnaire - Disability Index (HAQ-DI)
* High-sensitivity C-reactive protein (hsCRP).Percentage of Participants Achieving Minimal Disease Activity (MDA) at Week 24 Week 24 A participant was classified as achieving MDA if 5 of the following 7 criteria were met:
* Tender joint count (out of 68 joints) ≤ 1
* Swollen joint count (out of 66 joints) ≤ 1
* PASI score ≤ 1 (score ranges from 0 - 72) or percent BSA involved with psoriasis ≤ 3%
* Patient's assessment of pain ≤ 15 (VAS from 0 to 100)
* Patient's Global Assessment of disease activity ≤ 20 (VAS from 0 to 100)
* HAQ-DI score ≤ 0.5 (index score ranges from 0 to 3)
* Leeds Enthesitis Index ≤ 1 (assesses the presence or absence of enthesitis at 3 bilateral sites, for an overall score range from 0 to 6)Change From Baseline in 36-Item Short Form Health Survey (SF-36) Physical Component Summary (PCS) Score at Week 24 Baseline and Week 24 The Short Form 36-Item Health Survey (SF-36) Version 2 is a self-administered questionnaire that measures the impact of disease on overall quality of life during the past 4 weeks. The SF-36 consists of 36 questions in eight domains (physical function, pain, general and mental health, vitality, social function, physical and emotional health).
The physical component summary is a weighted combination of the 8 subscales with positive weighting for physical functioning, role-physical, bodily pain, and general health. The SF-36 PCS ranges from 0 to 100. A linear algorithm was applied to the calculation of the PCS which has a normative mean value of 50. Higher scores are associated with less disability; a score of 100 is equivalent to no disability and a score of 0 is equivalent to maximum disability. A positive change from Baseline score indicates improvement.Change From Baseline In Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) Score at Week 24 Baseline and Week 24 The FACIT-Fatigue questionnaire is a self-administered patient questionnaire that consists of 13 questions designed to measure the degree of fatigue experienced by participants in the previous 7 days, including physical fatigue (e.g., I feel tired), functional fatigue (e.g., trouble finishing things), emotional fatigue (e.g., frustration), and social consequences of fatigue (e.g., limits social activity). Participants respond to the questions on a scale from 0 (not at all) to 4 (very much). The FACIT-Fatigue score is computed by summing the item scores, after reversing those items that are worded in the negative direction. The FACIT-Fatigue score ranges from 0 to 52, where higher scores represent less fatigue. A positive change from Baseline indicates improvement.
Percentage of Participants With Resolution of Enthesitis at Week 24 Week 24 Resolution of enthesitis is defined as a Leeds Enthesitis Index (LEI) score = 0.
LEI is an enthesitis measure developed specifically for PsA and assesses the presence or absence of tenderness at the following 3 bilateral enthesial sites: medial femoral condyles, lateral epicondyles of the humerus, and Achilles tendon insertions. Tenderness on examination is recorded as either present (coded as 1), absent (coded as 0), or not assessed for each of the 6 sites. The LEI is calculated by taking the sum of the scores from the 6 sites. The LEI ranges from 0 to 6 (worst).
Trial Locations
- Locations (138)
Arthritis and Rheumatology /ID# 169438
🇺🇸Atlanta, Georgia, United States
Clinic of Robert Hozman/Clinical Investigation Specialists /ID# 166681
🇺🇸Skokie, Illinois, United States
DM Clinical Research /ID# 208350
🇺🇸Tomball, Texas, United States
New England Research Associates, LLC /ID# 166525
🇺🇸Bridgeport, Connecticut, United States
Arthritis Rheumatic and Back Disease Associates. P.A. /ID# 166658
🇺🇸Voorhees, New Jersey, United States
Precision Comprehensive Clinical Research Solutions /ID# 208156
🇺🇸Colleyville, Texas, United States
Amarillo Ctr for Clin Research /ID# 208340
🇺🇸Amarillo, Texas, United States
The Canberra Hospital /ID# 207591
🇦🇺Garran, Australian Capital Territory, Australia
Griffith University /ID# 207504
🇦🇺Southport, Queensland, Australia
Emeritus Research /ID# 207195
🇦🇺Camberwell, Victoria, Australia
University General Hospital of Heraklion PA.G.N.I /ID# 206930
🇬🇷Heraklion, Kriti, Greece
Malopolskie Centrum Kliniczne /ID# 208011
🇵🇱Krakow, Malopolskie, Poland
CGM Research Trust /ID# 210596
🇳🇿Burwood Christchurch, New Zealand
GCM Medical Group PSC - Hato Rey /ID# 208461
🇵🇷San Juan, Puerto Rico
Rheumatology Clinic of Houston /ID# 166636
🇺🇸Houston, Texas, United States
Rabin Medical Center /ID# 207470
🇮🇱Petakh Tikva, Israel
Bispebjerg and Frederiksberg Hospital /ID# 168763
🇩🇰Frederiksberg, Hovedstaden, Denmark
Health Research of Oklahoma /ID# 166408
🇺🇸Oklahoma City, Oklahoma, United States
Rheumatic Disease Center, LLP /ID# 166682
🇺🇸Glendale, Wisconsin, United States
Ochsner Clinic Foundation /ID# 166622
🇺🇸Baton Rouge, Louisiana, United States
The Arthritis & Diabetes Clinic, Inc. /ID# 166707
🇺🇸Monroe, Louisiana, United States
UZ Gent /ID# 210037
🇧🇪Gent, Oost-Vlaanderen, Belgium
Barzilai Medical Center /ID# 207471
🇮🇱Ashkelon, Israel
Meir Medical Center /ID# 207469
🇮🇱Kfar Saba, Israel
Universitair Medisch Centrum Groningen /ID# 168450
🇳🇱Groningen, Netherlands
Centro de Enfermedades del Hígado y Aparato Digestivo /ID# 169151
🇦🇷Rosario, Santa Fe, Argentina
Unidade Local de Saúde do Alto Minho, EPE - Hospital Conde de Bertiandos /ID# 208138
🇵🇹Ponte de Lima, Viana Do Castelo, Portugal
Glacier View Research Institute /ID# 169344
🇺🇸Kalispell, Montana, United States
Naval Hospital of Athens /ID# 206928
🇬🇷Athens, Greece
Olympion General Clinic SA /ID# 207047
🇬🇷Patras, Greece
Antonius Ziekenhuis /ID# 208581
🇳🇱Sneek, Fryslan, Netherlands
Centrum Badan Klinicznych PI-House sp. z o.o. /ID# 208012
🇵🇱Gdansk, Pomorskie, Poland
Rheumatology and Pulmonary Clinic /ID# 169341
🇺🇸Beckley, West Virginia, United States
Dartmouth-Hitchcock Medical Center /ID# 169443
🇺🇸Lebanon, New Hampshire, United States
Hospital Italiano de Buenos Aires /ID# 208473
🇦🇷Ciudad Autonoma Buenos Aires, Ciuadad Autonoma De Buenos Aires, Argentina
Cimer /Id# 169155
🇦🇷San Miguel de Tucuman, Argentina
Universitair Ziekenhuis Leuven /ID# 208209
🇧🇪Leuven, Vlaams-Brabant, Belgium
Hospital General de Agudos J. M. Ramos Mejia /ID# 169152
🇦🇷Buenos Aires, Ciuadad Autonoma De Buenos Aires, Argentina
DOM Centro de Reumatologia /ID# 208478
🇦🇷Ciudad Autonoma de Buenos Aire, Ciuadad Autonoma De Buenos Aires, Argentina
Percuro Clinical Research, Ltd /ID# 169530
🇨🇦Victoria, British Columbia, Canada
West Tennessee Research Institute /ID# 166429
🇺🇸Jackson, Tennessee, United States
Instituto CAICI /ID# 169156
🇦🇷Rosario, Santa Fe, Argentina
Centre Rhumatologie de l'Est /ID# 208302
🇨🇦Rimouski, Quebec, Canada
MediTrials /ID# 207815
🇪🇪Tartu, Tartumaa, Estonia
Turku University Hospital /ID# 208199
🇫🇮Turku, Finland
CRU Hungary Egeszsegugyi és Szolgaltato Kft. /ID# 169248
🇭🇺Miskolc, Borsod-Abauj-Zemplen, Hungary
Sheba Medical Center /ID# 207468
🇮🇱Ramat Gan, Tel-Aviv, Israel
Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont /ID# 169237
🇭🇺Szeged, Csongrad, Hungary
Rambam Health Care Campus /ID# 208169
🇮🇱Haifa, Israel
Consorci Corporacio Sanitaria Parc Tauli Sabadell /ID# 207822
🇪🇸Sabadell, Barcelona, Spain
Betegapolo Irgalmasrend Budai Irgalmasrendi Korhaz /ID# 209054
🇭🇺Budapest, Hungary
Centrum Kliniczno-Badawcze /ID# 208014
🇵🇱Elblag, Warminsko-mazurskie, Poland
Medisch Centrum Leeuwarden /ID# 168449
🇳🇱Leeuwarden, Netherlands
Centrum Medyczne Reuma Park w Warszawie /ID# 210956
🇵🇱Warsaw, Mazowieckie, Poland
Arthritis Clinical Research Trials /ID# 167611
🇿🇦Cape Town, Western Cape, South Africa
Centro Hospitalar Universitário de Lisboa Norte, EPE - Hospital de Santa Maria /ID# 208139
🇵🇹Lisboa, Portugal
Dr Jenny Potts /ID# 167628
🇿🇦Port Elizabeth, Eastern Cape, South Africa
CIADS Research Co Ltd /ID# 169526
🇨🇦Winnipeg, Manitoba, Canada
Pinnacle Research Group /ID# 167953
🇺🇸Anniston, Alabama, United States
St. Jude Heritage /ID# 166842
🇺🇸Fullerton, California, United States
Newport Huntington Medica /ID# 207423
🇺🇸Huntington Beach, California, United States
East Bay Rheumatology Medical /ID# 166845
🇺🇸San Leandro, California, United States
Inland Rheum Clin Trials Inc. /ID# 166621
🇺🇸Upland, California, United States
Arthritis & Rheumatic Disease Specialties /ID# 212582
🇺🇸Aventura, Florida, United States
Sweet Hope Research Specialty Inc /ID# 168163
🇺🇸Hialeah, Florida, United States
Arthritis Center, Inc. /ID# 208116
🇺🇸Palm Harbor, Florida, United States
Millennium Research /ID# 201627
🇺🇸Ormond Beach, Florida, United States
West Broward Rheumatology Associates /ID# 201234
🇺🇸Tamarac, Florida, United States
IRIS Research and Development, LLC /ID# 166351
🇺🇸Plantation, Florida, United States
BayCare Medical Group /ID# 201630
🇺🇸Saint Petersburg, Florida, United States
Springfield Clinic /ID# 166345
🇺🇸Springfield, Illinois, United States
Klein and Associates MD /ID# 166549
🇺🇸Hagerstown, Maryland, United States
Duplicate_The Center for Rheumatology & Bone Research /ID# 166448
🇺🇸Wheaton, Maryland, United States
Clinical Pharmacology Study Gr /ID# 166455
🇺🇸Worcester, Massachusetts, United States
MMP Women's Health /ID# 169334
🇺🇸Portland, Maine, United States
St. Paul Rheumatology /ID# 166599
🇺🇸Eagan, Minnesota, United States
Clayton Medical Associates, P.C. dba Saint Louis Rheumatology /ID# 166389
🇺🇸Saint Louis, Missouri, United States
Clinvest Research LLC /ID# 166745
🇺🇸Springfield, Missouri, United States
Paramount Medical Research Con /ID# 166334
🇺🇸Middleburg Heights, Ohio, United States
Ocean Rheumatology, PA /ID# 166561
🇺🇸Toms River, New Jersey, United States
Clinical Research Ctr Reading /ID# 166354
🇺🇸Wyomissing, Pennsylvania, United States
Altoona Ctr Clinical Res /ID# 166691
🇺🇸Duncansville, Pennsylvania, United States
Nashville Arthritis and Rheumatology /ID# 208395
🇺🇸Nashville, Tennessee, United States
SW Rheumatology Res. LLC /ID# 166587
🇺🇸Mesquite, Texas, United States
West Texas Clinical Research /ID# 208155
🇺🇸Lubbock, Texas, United States
Trinity Universal Research Associates, Inc /ID# 208387
🇺🇸Plano, Texas, United States
Kadlec Clinic Rheumatology /ID# 167667
🇺🇸Kennewick, Washington, United States
Arthritis Northwest, PLLC /ID# 169535
🇺🇸Spokane, Washington, United States
Centro Medico Privado de Reumatologia /ID# 208342
🇦🇷San Miguel de Tucuman, Tucuman, Argentina
Rheumatology Research Unit Sunshine Coast /ID# 207191
🇦🇺Maroochydore, Queensland, Australia
Monash Medical Centre /ID# 208033
🇦🇺Clayton, Victoria, Australia
ReumaClinic /ID# 208211
🇧🇪Genk, Belgium
ZNA - Jan Palfijn /ID# 208210
🇧🇪Merksem, Belgium
LMK Sevicos Medicos S/S /ID# 169541
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Dermatrials Research /ID# 208303
🇨🇦Hamilton, Ontario, Canada
Aarhus University Hospital /ID# 168762
🇩🇰Aarhus C, Midtjylland, Denmark
CIP - Centro Internacional de Pesquisa /ID# 169524
🇧🇷Goiânia, Goias, Brazil
K. Papp Clinical Research /ID# 169527
🇨🇦Waterloo, Ontario, Canada
East Tallinn Central Hospital /ID# 208317
🇪🇪Tallinn, Harjumaa, Estonia
North Estonia Medical Centre /ID# 208319
🇪🇪Tallinn, Estonia
Ite Pihlajanlinna Kuopio /ID# 208316
🇫🇮Kuopio, Finland
Duplicate_CHU Bordeaux-Hopital Pellegrin /ID# 211159
🇫🇷Bordeaux, France
CHRU Tours - Hopital Trousseau /ID# 209343
🇫🇷Chambray Les Tours, France
Rheumazentrum Ruhrgebiet /ID# 207212
🇩🇪Herne, Nordrhein-Westfalen, Germany
Immanuel Krankenhaus Berlin /ID# 207214
🇩🇪Berlin-buch, Germany
Vital-Medicina Kft. /ID# 208123
🇭🇺Veszprém, Veszprem, Hungary
Center of Innovative Diagnostics and Therapeutics (CIRI GmbH) /ID# 209494
🇩🇪Frankfurt, Germany
MVZ Rheumatologie und Autoimmunmedizin Hamburg GmbH /ID# 209493
🇩🇪Hamburg, Germany
Duplicate_Azienda Ospedaliero-Universitaria Policlinico di Modena /ID# 207800
🇮🇹Modena, Emilia-Romagna, Italy
Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona /ID# 207268
🇮🇹Ancona, Italy
Azienda Ospedaliera Universitaria di Verona/Ospedale Borgo Roma /ID# 207264
🇮🇹Verona, Italy
Middlemore Clinical Trials /ID# 214293
🇳🇿Auckland, New Zealand
Waikato Hospital /ID# 214276
🇳🇿Hamilton, Waikato, New Zealand
Osteo-Medic S.C. /ID# 208013
🇵🇱Bialystok, Podlaskie, Poland
Instituto Português De Reumatologia /ID# 208140
🇵🇹Lisboa, Portugal
Changi General Hospital /ID# 208966
🇸🇬Singapore, Singapore
Winelands Medical Research Centre /ID# 167630
🇿🇦Stellenbosch, Western Cape, South Africa
Hospital Universitario A Coruna - CHUAC /ID# 207819
🇪🇸A Coruna, Spain
Hospital Unversitario Marques de Valdecilla /ID# 208541
🇪🇸Santander, Cantabria, Spain
Hospital Universitario y Politecnico La Fe /ID# 207823
🇪🇸Valencia, Spain
Hospital Universitario 12 de Octubre /ID# 207820
🇪🇸Madrid, Spain
Uppsala University Hospital /ID# 169098
🇸🇪Uppsala, Sweden
Orebro Universitetssjukhuset /ID# 169400
🇸🇪Orebro, Orebro Lan, Sweden
Duplicate_Vastmanlands Sjukhus /ID# 168620
🇸🇪Vasteras, Sweden
Duplicate_Karolinska Univ Sjukhuset /ID# 208174
🇸🇪Solna, Sweden
Duplicate_Barts Health NHS Trust /ID# 210794
🇬🇧London, London, City Of, United Kingdom
Torbay and South Devon Nhs Foundation Trust /Id# 207926
🇬🇧Torquay, United Kingdom
Manchester University NHS Foundation Trust /ID# 207923
🇬🇧Manchester, United Kingdom
Duplicate_Wirral University Teaching Hospital NHS Foundation Trust /ID# 210536
🇬🇧Wirral, United Kingdom
Arthritis & Osteo Medical Ctr /ID# 166541
🇺🇸La Palma, California, United States
SIMED Health, LLC /ID# 207457
🇺🇸Gainesville, Florida, United States
Tekton Research, Inc. /ID# 166493
🇺🇸Austin, Texas, United States
Denver Arthritis Clinic /ID# 166442
🇺🇸Denver, Colorado, United States
Yale University /ID# 166330
🇺🇸New Haven, Connecticut, United States
Rheum Assoc of Central FL /ID# 201629
🇺🇸Orlando, Florida, United States
HMD Research LLC /ID# 208428
🇺🇸Orlando, Florida, United States
ForCare Clinical Research /ID# 166375
🇺🇸Tampa, Florida, United States
University of South Florida /ID# 208467
🇺🇸Tampa, Florida, United States