MedPath

Study Of Pregabalin (Lyrica) In Patients With Painful Diabetic Peripheral Neuropathy

Phase 3
Completed
Conditions
Diabetic Neuropathy, Painful
Interventions
Registration Number
NCT01057693
Lead Sponsor
Pfizer's Upjohn has merged with Mylan to form Viatris Inc.
Brief Summary

Patients will be switched from their current medication for painful diabetic peripheral neuropathy to evaluate the safety and efficacy of pregabalin as compared to placebo. All patients will receive pregabalin, and half of patients will receive placebo at some point during the study.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
633
Inclusion Criteria
  • Patients must have painful diabetic peripheral neuropathy and be receiving treatment for this condition.
Exclusion Criteria
  • Patients with other pain conditions cannot participate.

Study & Design

Study Type
INTERVENTIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
pregabalin (Lyrica)pregabalin (Lyrica)-
PlaceboPlacebo-
Primary Outcome Measures
NameTimeMethod
Change From Single-Blind Baseline in Mean Pain Score at Week 19 During Double-Blind PhaseSB Baseline, Week 19 (DB Phase)

Mean pain score was defined as the mean of the last 7 daily diary pain ratings. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. SB baseline refers to the last 7 pain diary entries up to and including Day 1.

Secondary Outcome Measures
NameTimeMethod
Weekly Mean Sleep Interference Score (Double-Blind Phase)DB Baseline, Week 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

Weekly mean sleep interference score was defined as the mean of the daily sleep interference diary ratings split into 7 day intervals. Participants rated how painful DPN has interfered with their sleep during the past 24 hours on an 11-point numeric rating scale ranging from 0 = does not interfere with sleep to 10 = completely interferes (unable to sleep due to pain).

Change From Single-Blind Baseline in Mean Pain Score at Week 6 During Single-Blind PhaseSB Baseline, Week 6 (SB Phase)

Mean pain score was defined as the mean of the last 7 daily diary pain ratings. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. SB baseline refers to the last 7 pain diary entries up to and including Day 1.

Time to Loss of Pain Response (Double-Blind Phase)SB Baseline up to Week 19

Time to loss of pain response (based on the daily pain diary data) during the DB treatment phase was analyzed using survival analysis technique. Loss of pain response was defined as less than (\<) 15% pain response relative to the SB baseline. SB baseline refers to the last 7 pain diary entries up to and including Day 1.

Medical Outcomes Study -Sleep Scale (MOS-SS) (Double-Blind Phase)Week 19

Participant-rated 12-item questionnaire to assess constructs of sleep over past week; 7 subscales: sleep disturbance (range 0-100), snoring (range 0-100), awaken short of breath (SOB) or with headache (range 0-100), sleep adequacy (range 0-100), somnolence (range: 0-100); sleep quantity (range: 0-24), optimal sleep (yes/no), and 9 item index measures of sleep disturbance provide composite scores: sleep problems index (range 0-100). Except adequacy, optimal sleep and quantity, higher scores=more impairment.

Weekly Mean Pain Scores (Single-Blind Phase)Week 1, 2, 3, 4, 5, 6

Weekly mean pain score was defined as the mean of the daily diary pain ratings split into 7 day intervals. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain.

Percentage of Participants With At Least 30 Percent and 50 Percent Reduction in Mean Pain Score (Single-Blind Phase)Week 6

Mean pain score was defined as the mean of the last 7 daily diary pain ratings. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. Percentage of participants who had at least 30% and 50% pain reduction from SB baseline to Week 6 is reported. SB baseline refers to the last 7 pain diary entries up to and including Day 1.

Endpoint Mean Sleep Interference Score (Single-Blind Phase)Week 6

Endpoint mean sleep interference score was defined as the mean of the last 7 sleep interference diaries while receiving SB treatment. Participants rated how painful DPN has interfered with their sleep during the past 24 hours on an 11-point numeric rating scale ranging from 0 = does not interfere to 10 = completely interferes (unable to sleep due to pain).

Hospital Anxiety and Depression Scale (HADS) (Single-Blind Phase)SB Baseline, Week 6

HADS: self-administered questionnaire, consists of 2 sub-scales; measuring anxiety (HADS-A), and depression (HADS-D). Each sub-scale consists of 7 items on which participants responded as to how each item applies to them on a 4-point scale ranging from 0 (no anxiety or depression) to 3 (severe feeling of anxiety or depression). Total score range for each sub-scale = 0 to 21, where higher score indicates more severe anxiety or depression.

Medical Outcomes Study -Sleep Scale (MOS-SS) (Single-Blind Phase)SB Baseline, Week 6

Participant-rated 12-item questionnaire to assess constructs of sleep over past week; 7 subscales: sleep disturbance (range 0-100), snoring (range 0-100), awaken short of breath (SOB) or with headache (range 0-100), sleep adequacy (range 0-100), somnolence (range: 0-100); sleep quantity (range: 0-24), optimal sleep (yes/no), and 9 item index measures of sleep disturbance provide composite scores: sleep problems index (range 0-100). Except adequacy, optimal sleep and quantity, higher scores=more impairment.

Number of Participants With Optimal Sleep Assessed Using Medical Outcomes Study-Sleep Scale (MOS-SS) (Double-Blind Phase)Week 19

MOS-SS: participant-rated 12 item questionnaire to assess constructs of sleep over past week. It included 7 subscales: sleep disturbance, snoring, awaken short of breath or with headache, sleep adequacy, somnolence, sleep quantity, optimal sleep, and 9 item index measures of sleep disturbance provide composite scores: sleep problems index. Participants responded whether their sleep was optimal or not optimal by choosing yes or no.

Weekly Mean Sleep Interference Score (Single-Blind Phase)SB Baseline, Week 1, 2, 3, 4, 5, 6

Weekly mean sleep interference score was defined as the mean of the daily sleep interference diary ratings split into 7 day intervals. Participants rated how painful DPN has interfered with their sleep during the past 24 hours on an 11-point numeric rating scale ranging from 0 = does not interfere with sleep to 10 = completely interferes (unable to sleep due to pain). SB baseline refers to the last 7 pain diary entries up to and including Day 1.

Endpoint Mean Sleep Interference Score (Double-Blind Phase)Week 19

Endpoint mean sleep interference score was defined as the mean of the last 7 sleep interference diaries while receiving DB treatment. Participants rated how painful DPN has interfered with their sleep during the past 24 hours on an 11-point numeric rating scale ranging from 0 = does not interfere to 10 = completely interferes (unable to sleep due to pain).

Patient Global Evaluation of Study Medication (GESM) (Double-Blind Phase)Week 19

GESM: single-item, self-administered treatment satisfaction questionnaire. Participants answered "how would you rate the study medication you received for pain?" on a 7-point scale ranging from 1 (very satisfied) to 7 (very dissatisfied). Number of participants in each category are reported.

Weekly Mean Pain Scores (Double-Blind Phase)DB Baseline, Week 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19

Weekly mean pain score was defined as the mean of the daily diary pain ratings split into 7 day intervals. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. SB baseline refers to the last 7 pain diary entries up to and including Day 1. DB baseline refers to the last 7 pain diary entries up to and including DB Day 1.

Percentage of Participants With At Least 30 Percent and 50 Percent Reduction in Mean Pain Score (Double-Blind Phase)Week 19

Mean pain score was defined as the mean of the last 7 daily diary pain ratings. Participants rated their DPN pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. Percentage of participants who had at least 30% and 50% pain reduction from SB baseline to Week 19 is reported.

Patient Global Impression of Change (PGIC) (Single-Blind Phase)Week 6

PGIC: participant rated instrument to measure participant's change in overall status on a 7-point scale; range from 1 (very much improved) to 7 (very much worse). Number of participants in each category are reported.

Patient Global Impression of Change (PGIC) (Double-Blind Phase)Week 19

PGIC: participant rated instrument to measure participant's change in overall status on a 7-point scale; range from 1 (very much improved) to 7 (very much worse). Number of participants in each category are reported.

Number of Participants With Optimal Sleep Assessed Using Medical Outcomes Study-Sleep Scale (MOS-SS) (Single-Blind Phase)SB Baseline, Week 6

MOS-SS: participant-rated 12 item questionnaire to assess constructs of sleep over past week. It included 7 subscales: sleep disturbance, snoring, awaken short of breath or with headache, sleep adequacy, somnolence, sleep quantity, optimal sleep, and 9 item index measures of sleep disturbance provide composite scores: sleep problems index. Participants responded whether their sleep was optimal or not optimal by choosing yes or no.

Quality of Life Questionnaire- Diabetic Neuropathy (QOL-DN) (Double-Blind Phase)Week 19

QOL-DN: 35-item participant-rated questionnaire used to assess impact of diabetic neuropathy on the quality of life of participants with diabetic neuropathy. Consists of 5 domains: Physical functioning(Ph Fn)/large fiber (sum of item 8, 11, 13-15, 24, 27-35; range -4 to 56); Activities of daily living (sum of item 12, 22, 23, 25, 26; range 0 to 20); Symptoms (sum of item 1-7, 9; range 0 to 32); Small fiber (sum of item 10, 16, 17, 18; range 0 to 16); Autonomic (sum of item 19, 20, 21; range 0 to 12) and total QOL score (sum of items 1-35) range: -4 to 136. Higher score implied worse QOL.

Pain Visual Analog Scale (VAS) (Single-Blind Phase)SB Baseline, Week 6

Participants rated their pain on a 100 millimeter (mm) Visual Analog Scale (VAS) ranging from 0 mm = no pain to 100 mm = worst possible pain.

Pain Visual Analog Scale (VAS) (Double-Blind Phase)Week 19

Participants rated their pain on a 100 millimeter (mm) Visual Analog Scale (VAS) ranging from 0 mm = no pain to 100 mm = worst possible pain.

Brief Pain Inventory-Short Form (BPI-sf) (Single-Blind Phase)SB Baseline, Week 6

BPI-sf: self-administered questionnaire developed to assess severity, impact of pain on daily functions, consisted of 5 questions. Questions 1-4 measured the severity of pain based on pain experienced over the past 24-hours on an 11-point scale ranged from 0 (no pain) to10 (worst possible pain). Question 5: 7 item subsets that measured level of interference of pain on daily functions on an 11-point scale ranged from 0 (does not interfere) to 10 (completely interferes).

Hospital Anxiety and Depression Scale (HADS) (Double-Blind Phase)Week 19

HADS: self-administered questionnaire, consists of 2 sub-scales; measuring anxiety (HADS-A), and depression (HADS-D). Each sub-scale consists of 7 items on which participants responded as to how each item applies to them on a 4-point scale ranging from 0 (no anxiety or depression) to 3 (severe feeling of anxiety or depression). Total score range for each sub-scale = 0 to 21, where higher score indicates more severe anxiety or depression.

Quality of Life Questionnaire- Diabetic Neuropathy (QOL-DN) (Single-Blind Phase)SB Baseline, Week 6

QOL-DN: 35-item participant-rated questionnaire used to assess impact of diabetic neuropathy on the quality of life of participants with diabetic neuropathy. Consists of 5 domains: Physical functioning(Ph Fn)/large fiber (sum of item 8, 11, 13-15, 24, 27-35; range -4 to 56); Activities of daily living (sum of item 12, 22, 23, 25, 26; range 0 to 20); Symptoms (sum of item 1-7, 9; range 0 to 32); Small fiber (sum of item 10, 16, 17, 18; range 0 to 16); Autonomic (sum of item 19, 20, 21; range 0 to 12) and total QOL score (sum of items 1-35) range: -4 to 136. Higher score implied worse QOL.

Brief Pain Inventory-Short Form (BPI-sf) (Double-Blind Phase)Week 19

BPI-sf: self-administered questionnaire developed to assess severity, impact of pain on daily functions, consisted of 5 questions. Questions 1-4 measured the severity of pain based on pain experienced over the past 24-hours on an 11-point scale ranged from 0 (no pain) to10 (worst possible pain). Question 5: 7 item subsets that measured level of interference of pain on daily functions on an 11-point scale ranged from 0 (does not interfere) to 10 (completely interferes).

Patient Global Evaluation of Study Medication (GESM) (Single-Blind Phase)Week 6

GESM: single-item, self-administered treatment satisfaction questionnaire. Participants answered "how would you rate the study medication you received for pain?" on a 7-point scale ranging from 1 (very satisfied) to 7 (very dissatisfied). Number of participants in each category are reported.

Trial Locations

Locations (163)

NeuroTrials Research, Incorporated

🇺🇸

Atlanta, Georgia, United States

Research Protocol Management Specialists

🇺🇸

Pittsburgh, Pennsylvania, United States

Carolina Pharmaceutical Research

🇺🇸

Statesville, North Carolina, United States

TLM Medical Services, LLC

🇺🇸

Columbia, South Carolina, United States

Dot Shuttleworth Centre for Diabetes

🇿🇦

Durban, Overport, South Africa

Dr Jeevren Reddy's Surgery

🇿🇦

Stanger, Kwazulu Natal, South Africa

Genova Clinical Research, Inc.

🇺🇸

Tucson, Arizona, United States

Family Care Specialists, Inc.

🇺🇸

Ocala, Florida, United States

Borgess Diabetes Center

🇺🇸

Kalamazoo, Michigan, United States

Borgess Research Institute

🇺🇸

Kalamazoo, Michigan, United States

William Beaumont Hospital

🇺🇸

Troy, Michigan, United States

KMED Research

🇺🇸

Saint Clair Shores, Michigan, United States

Physician's Surgery Center

🇺🇸

Jackson, Mississippi, United States

CRC of Jackson

🇺🇸

Jackson, Mississippi, United States

Randall T. Huling, Jr., MD, CPI

🇺🇸

Olive Branch, Mississippi, United States

Lincoln Internal Medicine Associates

🇺🇸

Lincoln, Nebraska, United States

University Diabetes & Endocrine Consultants

🇺🇸

Chattanooga, Tennessee, United States

Foot and Ankle Clinic

🇺🇸

West Jordan, Utah, United States

Neurology and Pain Clinic, LLC

🇺🇸

Orangeburg, South Carolina, United States

Memphis Internal Medicine

🇺🇸

Memphis, Tennessee, United States

Radiant Research Inc.

🇺🇸

Greer, South Carolina, United States

SCRI Research Center

🇺🇸

Germantown, Tennessee, United States

AM Diabetes & Endocrinology Center

🇺🇸

Memphis, Tennessee, United States

University of Calgary

🇨🇦

Calgary, Alberta, Canada

Sarah Cannon Research Institute

🇺🇸

Jackson, Tennessee, United States

Instituto de Endocrinologia Diabetes y Metabolismo

🇵🇷

Toa Baja, Puerto Rico

Bloemfontein Medi-Clinic

🇿🇦

Bloemfontein, FREE State, South Africa

The Nerve and Muscle Center of Texas

🇺🇸

Houston, Texas, United States

Elite Research Institute

🇺🇸

Miami, Florida, United States

Rehabilitation Associates of Indiana

🇺🇸

Indianapolis, Indiana, United States

CNRI-San Diego, LLC

🇺🇸

San Diego, California, United States

San Diego Clinical Trials

🇺🇸

San Diego, California, United States

Desert Endocrinology

🇺🇸

Las Vegas, Nevada, United States

Office of Dr. Danka Michaels, MD

🇺🇸

Las Vegas, Nevada, United States

Office of Stephen Miller, M.D.

🇺🇸

Las Vegas, Nevada, United States

Community Research

🇺🇸

Cincinnati, Ohio, United States

Paragon Research Center, LLC

🇺🇸

San Antonio, Texas, United States

Alamo Clinical Research

🇺🇸

San Antonio, Texas, United States

Cetero Research - San Antonio

🇺🇸

San Antonio, Texas, United States

Convergys Clinical Research, Inc.

🇺🇸

Anaheim, California, United States

University of Southern California, Keck School of Medicine, Department of Neurology

🇺🇸

Los Angeles, California, United States

Richard S. Cherlin, MD

🇺🇸

Los Gatos, California, United States

Northridge Neurological Research

🇺🇸

Northridge, California, United States

Remek Research

🇺🇸

Pomona, California, United States

MediSphere Medical Research Center, LLC

🇺🇸

Evansville, Indiana, United States

Hometown Urgent Care and Research

🇺🇸

Dayton, Ohio, United States

Providence Health Partners - Center for Clinical Research

🇺🇸

Dayton, Ohio, United States

Baylor University Medical Center

🇺🇸

Dallas, Texas, United States

University of Texas Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

ClinRx Research LLC

🇺🇸

Carrollton, Texas, United States

National Clinical Research - Norfolk, Inc.

🇺🇸

Norfolk, Virginia, United States

Medical Group of Texas

🇺🇸

Fort Worth, Texas, United States

MAPS Applied Research Center, Inc.

🇺🇸

Edina, Minnesota, United States

Alpine Clinical Research Center, Inc.

🇺🇸

Boulder, Colorado, United States

Medical Advanced Pain Specialists

🇺🇸

Shakopee, Minnesota, United States

Heartland Research Associates, LLC

🇺🇸

Wichita, Kansas, United States

Medical Advanced Pain Specialists (MAPS)

🇺🇸

Edina, Minnesota, United States

Memorial Hospital of Rhode Island

🇺🇸

Pawtucket, Rhode Island, United States

Center for Clinical Research, Inc.

🇺🇸

San Francisco, California, United States

Harris and Associates MD, PC

🇺🇸

Detroit, Michigan, United States

Veronique Sebastian, MD

🇺🇸

Oklahoma City, Oklahoma, United States

Angelique Barreto, MD

🇺🇸

Oklahoma City, Oklahoma, United States

Daniel B. Vine, MD

🇺🇸

Salt Lake City, Utah, United States

Wasatch Clinical Research

🇺🇸

Salt Lake City, Utah, United States

Jean Brown Research

🇺🇸

Salt Lake City, Utah, United States

Arizona Research Center

🇺🇸

Phoenix, Arizona, United States

Innovative Research of West Florida, Inc.

🇺🇸

Clearwater, Florida, United States

Greystone Medical Research, LLC

🇺🇸

Birmingham, Alabama, United States

Mountain View Clinical Research

🇺🇸

Denver, Colorado, United States

East-West Medical Research Institute

🇺🇸

Honolulu, Hawaii, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

Aurora Family Medicine Center, PC

🇺🇸

Aurora, Colorado, United States

Clinical Research of West Florida, Inc.

🇺🇸

Tampa, Florida, United States

Aurora Advanced Healthcare, Inc.

🇺🇸

Milwaukee, Wisconsin, United States

Winnipeg Health Sciences Centre

🇨🇦

Winnipeg, Manitoba, Canada

Neurology Clinic, PC

🇺🇸

Northport, Alabama, United States

Horizon Clinical Research Associates, PLLC

🇺🇸

Gilbert, Arizona, United States

Dedicated Clinical Research, Inc.

🇺🇸

Goodyear, Arizona, United States

Novara Clinical Research

🇺🇸

Mesa, Arizona, United States

Dedicated Clinical Research

🇺🇸

Goodyear, Arizona, United States

Radiant Research, Inc.

🇺🇸

Akron, Ohio, United States

Central Arkansas Research

🇺🇸

Hot Springs, Arkansas, United States

Little Rock Diagnostic Clinic

🇺🇸

Little Rock, Arkansas, United States

Providence Clinical Research

🇺🇸

Burbank, California, United States

Healthcare Partners Medical Group

🇺🇸

Los Angeles, California, United States

Valley Research

🇺🇸

Fresno, California, United States

Center for United Research, Inc.

🇺🇸

Lakewood, California, United States

Sierra Clinical Research

🇺🇸

Roseville, California, United States

Neurological Research Institute

🇺🇸

Santa Monica, California, United States

Apex Research Institute

🇺🇸

Santa Ana, California, United States

Foothills Pain Management

🇺🇸

West Covina, California, United States

Diablo Clinical Research, Inc.

🇺🇸

Walnut Creek, California, United States

Chase Medical Research, LLC

🇺🇸

Waterbury, Connecticut, United States

Metabolic Research Institute, Inc.

🇺🇸

Boynton Beach, Florida, United States

Bradenton Research Center

🇺🇸

Bradenton, Florida, United States

Meridien Research

🇺🇸

Tampa, Florida, United States

Deerfield Beach Cardiology Research

🇺🇸

Deerfield Beach, Florida, United States

MD Clinical

🇺🇸

Hallandale Beach, Florida, United States

Gulfcoast Clinical Research Center

🇺🇸

Fort Myers, Florida, United States

Laszlo J. Mate, MD

🇺🇸

North Palm Beach, Florida, United States

Suncoast Clinical Research, Inc.

🇺🇸

New Port Richey, Florida, United States

Compass Research, LLC

🇺🇸

Orlando, Florida, United States

Renstar Medical Research

🇺🇸

Ocala, Florida, United States

Palm Beach Neurological Center, Advanced Research Consultants, Inc.

🇺🇸

Palm Beach Gardens, Florida, United States

Suncoast Clinical Research

🇺🇸

Palm Harbor, Florida, United States

Neurology Clinical Research, Inc.

🇺🇸

Sunrise, Florida, United States

Clinical Research of Central Florida

🇺🇸

Winter Haven, Florida, United States

Columbus Research Foundation

🇺🇸

Columbus, Georgia, United States

CPM Research Institute

🇺🇸

Austell, Georgia, United States

Rockdale Medical Research Associates

🇺🇸

Conyers, Georgia, United States

Prism Research Group

🇺🇸

Rome, Georgia, United States

Valley Health Care

🇺🇸

Rome, Georgia, United States

AMR Sakeena Research

🇺🇸

Aurora, Illinois, United States

Advanced Clinical Research

🇺🇸

Meridian, Idaho, United States

Chicago Research Center, Inc.

🇺🇸

Chicago, Illinois, United States

American Medical Research, Inc.

🇺🇸

Oak Brook, Illinois, United States

American Health Network

🇺🇸

Greenfield, Indiana, United States

Kentucky Medical Research Center

🇺🇸

Lexington, Kentucky, United States

Endocrinology Center of Southwest Louisiana

🇺🇸

Lake Charles, Louisiana, United States

Clinical Research Center of Cape Cod, Inc.

🇺🇸

Hyannis, Massachusetts, United States

Heartland Research, LLC

🇺🇸

Lake Charles, Louisiana, United States

Primary Physician Care, LLC

🇺🇸

Lake Charles, Louisiana, United States

Miray Medical Center

🇺🇸

Brockton, Massachusetts, United States

Arthritis and Diabetes Clinic, Inc

🇺🇸

Monroe, Louisiana, United States

MedVadis Research Corporation

🇺🇸

Watertown, Massachusetts, United States

Michigan Head Pain and Neurological Institute

🇺🇸

Ann Arbor, Michigan, United States

Troy Internal Medicine, PC

🇺🇸

Troy, Michigan, United States

University of Missouri Healthcare/Cosmopolitan Diabetes and Endocrinology Center

🇺🇸

Columbia, Missouri, United States

Mercy Health Research

🇺🇸

Saint Louis, Missouri, United States

A & A Pain Institute of Saint Louis

🇺🇸

Saint Louis, Missouri, United States

Clinvest

🇺🇸

Springfield, Missouri, United States

Melinda A. Crockett-Maples

🇺🇸

Marionville, Missouri, United States

Raleigh Neurology Associates, P.A.

🇺🇸

Raleigh, North Carolina, United States

Sooner Clinical Research

🇺🇸

Oklahoma City, Oklahoma, United States

Blair Orthopedic Associates, Inc.

🇺🇸

Altoona, Pennsylvania, United States

Coastal Medical

🇺🇸

East Greenwich, Rhode Island, United States

Altoona Center for Clinical Research

🇺🇸

Duncansville, Pennsylvania, United States

Omega Medical Research

🇺🇸

Warwick, Rhode Island, United States

Aiken Center for Clinical Research

🇺🇸

Aiken, South Carolina, United States

ClinRx Research, LLC

🇺🇸

Richardson, Texas, United States

Pioneer Research Solutions, Inc

🇺🇸

Sugar Land, Texas, United States

L. Craig Larsen and Clark C. Larsen

🇺🇸

Murray, Utah, United States

Aspen Clinical Research

🇺🇸

Orem, Utah, United States

Neurological Associates, Incorporated

🇺🇸

Henrico, Virginia, United States

Spokane Internal Medicine

🇺🇸

Spokane, Washington, United States

The Ottawa Hospital, Riverside Campus - Riverside Professional Building

🇨🇦

Ottawa, Ontario, Canada

Capital District Health Authority, QEII Health Sciences Centre

🇨🇦

Halifax, Nova Scotia, Canada

Winnipeg Regional Health Authority Sciences Centre Winnipeg

🇨🇦

Winnipeg, Manitoba, Canada

Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

Ponce School of Medicine & Health Sciences

🇵🇷

Ponce, Puerto Rico

Dr Makan's Rooms

🇿🇦

Johannesburg, Gauteng, South Africa

Chelmsford Medical Centre

🇿🇦

Durban, Kwazulu Natal, South Africa

Chris Hani Baragwanath Hospital

🇿🇦

Soweto, Gauteng, South Africa

Randles Road Medical Centre

🇿🇦

Durban, Kwa-zulu Natal, South Africa

Centre for Diabetes and Endocrinology

🇿🇦

Houghton, Johannesburg, South Africa

Parklands Medical Centre

🇿🇦

Overport, Kwazulu Natal, South Africa

102 Parklands Medical Centre

🇿🇦

Overport, Durban, South Africa

Dr's Sauermann and Meyer

🇿🇦

Polokwane, South Africa

Diabetes Care Centre

🇿🇦

Pretoria, South Africa

Desert Endocrinology Clinical Research Center

🇺🇸

Henderson, Nevada, United States

Clinical Pharmacology Study Group

🇺🇸

Worcester, Massachusetts, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

Radiant Research

🇺🇸

Cincinnati, Ohio, United States

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