A Study of Ocrelizumab in Participants With Relapsing Remitting Multiple Sclerosis (RRMS) Who Have Had a Suboptimal Response to an Adequate Course of Disease-Modifying Treatment (DMT)
- Conditions
- Multiple Sclerosis, Relapsing-Remitting
- Interventions
- Biological: Ocrelizumab
- Registration Number
- NCT02861014
- Lead Sponsor
- Hoffmann-La Roche
- Brief Summary
The purpose of this prospective, multicenter, open-label, efficacy, and safety study is to assess the efficacy and safety of ocrelizumab in participants with Relapsing Remitting Multiple Sclerosis (RRMS) who have had a suboptimal response to an adequate course of a Disease-Modifying Treatment (DMT). The study will consist of a Screening period (up to 4 weeks), an Open-label treatment period (96 weeks; with last dose administered at Week 72), and a Follow-up period of at least 2 years.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 681
- Have a definite diagnosis of RRMS, confirmed as per the revised McDonald 2010 criteria
- Have a length of disease duration, from first symptom, of less than (<) 10 years
- Have received no more than two prior DMTs, and the discontinuation of the most recent DMT was due to lack of efficacy
- Suboptimal disease control while on a DMT
- Expanded Disability Status Scale (EDSS) of 0.0 to 4.0, inclusive, at Screening
- For women of childbearing potential: agreement to use an acceptable birth control method during the treatment period and for at least 6 months after the last dose of study drug
- Secondary progressive multiple sclerosis (SPMS) or history of primary progressive or progressive relapsing multiple sclerosis (MS)
- Inability to complete an Magnetic Resonance Imaging (MRI) procedure
- Known presence of other neurological disorders
- Any concomitant disease that may require chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study
- History or currently active primary or secondary immunodeficiency
- History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies
- History of opportunistic infections
- History or known presence of recurrent or chronic infection
- History of malignancy
- Congestive heart failure
- Known active bacterial, viral, fungal, mycobacterial infection or other infection, excluding fungal infection of nail beds
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Ocrelizumab Ocrelizumab Ocrelizumab will be administered as two 300 mg IV infusions on Days 1 and 15 followed by one 600 mg IV infusions administered at Weeks 24, 48, and 72.
- Primary Outcome Measures
Name Time Method Percentage of Participants With No Evidence of Disease Activity (NEDA) as Per Protocol Defined Events During a 96-Week Period Week 96 A protocol-defined event of disease activity was defined by the occurrence of at least one of the following while on treatment with ocrelizumab:
* A protocol-defined relapse (PDR)
* 24-week CDP based on increase in EDSS while on treatment with ocrelizumab
* A T1 Gd-enhanced lesion after Week 8
* A new and/or enlarging T2 hyperintense lesion on MRI after Week 8 compared to the Week 8 MRI scan
- Secondary Outcome Measures
Name Time Method Percentage Change From Baseline at Week 48 and 96 in T1 Hypointense Lesion Volume Weeks 48, 96 Absolute Change From Baseline in EDSS Category at Week 96 Up to Week 96 The EDSS is an ordinal clinical rating scale ranging from 0 (normal neurologic examination) to 10 (death due to MS) in half-point increments.
Change From Baseline to Week 96 in Total T2 Lesion Volume Detected by Brain MRI From Baseline, Week 96 Adjusted Mean Percentage Change From Baseline in Brain Volume Weeks 24, 48, 96 Mean Number of T1 Gd-enhancing Lesions Per MRI Scan at Weeks 24, 48 and 96 Weeks: 24, 48, 96 Mean number of T1 Gd-enhancing lesions per MRI scan: Total number of T1 Gd-enhanced lesions divided by the total number of interpretable MRI scans
Percentage of Participants With a Baseline EDSS Score ≥2 With CDI at Week 96 Week 96 The EDSS is an ordinal clinical rating scale ranging from 0 (normal neurologic examination) to 10 (death due to MS) in half-point increments.
Time to Onset of First New and/or Enlarging T2 Lesion Baseline up to 96 Weeks Change From Baseline at Week 48 and 96 in T1 Hypointense Lesion Volume Weeks 48, 96 Adjusted Mean Percentage Change From Baseline in Cortical Grey Matter Volume Weeks 48, 96 Adjusted Mean Percentage Change From Baseline in White Matter Volume Weeks 48, 96 Percentage Change From Baseline in Cognitive Performance (Processing Speed/Working Memory) at Week 48 and Week 96 as Measured by the Brief International Cognitive Assessment for MS - Symbol Digit Modalities Test (SDMT) Score Baseline, Weeks 48, 96 Brief International Cognitive Assessment for MS (BICAMS) is assessing cognitive processing speed and verbal and visual memory. Symbol Digits Modalities Test (SDMT) is assessing processing speed/working memory. The SDMT presents a series of nine symbols, each paired with a single digit in a key at the top of a standard sheet of paper. Participants are asked to voice the digit associated with each symbol as rapidly as possible for 90 sec. There is a single outcome measure - the number correct over the 90 sec time span.
Percentage Change From Baseline in Cognitive Performance (Visuospatial Memory) at Week 48 and Week 96 as Measured by the Brief International Cognitive Assessment for MS - Brief Visuospatial Memory Test-Revised (BVMT-R) Score Baseline, Weeks: 48, 96 Brief International Cognitive Assessment for MS (BICAMS) is assessing cognitive processing speed and verbal and visual memory. Brief Visuospatial Memory Test-Revised (BVMT-R) is assessing visuospatial memory. In this test, six abstract designs are presented for 10 sec. The display is removed from view and patients render the stimuli via pencil on paper manual responses. Each design receives from 0 to 2 points representing accuracy and location. There are three learning trials, and the outcome measure is the total number of points earned over the three learning trials, thus the scale range is 0-36. The higher the result, the better visual/spatial memory.
Change From Baseline to Week 96 in Expanded Disability Status Scale (EDSS) Baseline, Weeks: 24, 48, 72, 96 The EDSS is an ordinal clinical rating scale ranging from 0 (normal neurologic examination) to 10 (death due to MS) in half-point increments.
Time to Onset of First Protocol-Defined Relapse Baseline up to 96 Weeks A protocol-defined multiple sclerosis (MS) relapse is an occurrence of new or worsening neurological symptoms attributable to MS that meets the following criteria:
* Symptoms must persist for \>24 hours and should not be attributable to confounding clinical factors (e.g., fever, infection, injury, adverse reactions to medications)
* Symptoms should be preceded by neurological stability for at least 30 days
* Symptoms should be accompanied by new objective neurological worsening determined with a timely EDSS/ Functional Systems Score (FSS) assessment, consistent with an increase of at least:
* ≥ 0.5 points on EDSS scale
* or ≥ 2 points on one of the following FSS scales: pyramidal, ambulation, cerebellar, brainstem, sensory, or visual
* or ≥ 1 point on two or more of the following FSS scales: pyramidal, ambulation, cerebellar, brainstem, sensory, or visualVolume of New and/or Enlarging T2 Hyperintense Lesions Volume of Lesions Per MRI Scan at Weeks 24, 48, 96 Weeks 24, 48, 96 The number of new and/or enlarging T2 lesions at week 24, 48 and 96 is calculated as the sum of the individual number of new and/or enlarging lesions at each visit. Data from other unscheduled assessments is included in this summary or analysis.
Adjusted Mean Change From Baseline at Week 48 and 96 in T1 Hypointense Lesion Volume Weeks 48, 96 Mean Change From Baseline in Cognitive Performance (Processing Speed/Working Memory) at Week 48 and Week 96 as Measured by the Brief International Cognitive Assessment for MS - Symbol Digit Modalities Test (SDMT) Score Baseline, Weeks: 48, 96 Brief International Cognitive Assessment for MS (BICAMS) is assessing cognitive processing speed and verbal and visual memory. Symbol Digits Modalities Test (SDMT) is assessing processing speed/working memory. The SDMT presents a series of nine symbols, each paired with a single digit in a key at the top of a standard sheet of paper. Participants are asked to voice the digit associated with each symbol as rapidly as possible for 90 sec. There is a single outcome measure - the number correct over the 90 sec time span. The higher the results, the better processing speed/working memory.
Percentage of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs) Baseline up to to 96 weeks after the end of the Treatment Period Percentage of Participants Free From a Protocol-Defined Event of Disease Activity During 24 Weeks Period Baseline up to 24 weeks A protocol-defined event of disease activity was defined by the occurrence of at least one of the following while on treatment with ocrelizumab:
* A protocol-defined relapse (PDR)
* 24-week CDP based on increase in EDSS while on treatment with ocrelizumab
* A T1 Gd-enhanced lesion after Week 8
* A new and/or enlarging T2 hyperintense lesion on MRI after Week 8 compared to the Week 8 MRI scanPercentage of Participants Free From a Protocol-Defined Event of Disease Activity During 48 Weeks Period Baseline up to 48 weeks A protocol-defined event of disease activity was defined by the occurrence of at least one of the following while on treatment with ocrelizumab:
* A protocol-defined relapse (PDR)
* 24-week CDP based on increase in EDSS while on treatment with ocrelizumab
* A T1 Gd-enhanced lesion after Week 8
* A new and/or enlarging T2 hyperintense lesion on MRI after Week 8 compared to the Week 8 MRI scanTime to First Protocol-Defined Event of Disease Activity Baseline up to 96 Weeks The definition of a protocol-defined event of disease activity is the occurrence of at least one of the following while on treatment with ocrelizumab:
* A protocol-defined relapse defined as: Symptoms must persist for \>24 hours and should not be attributable to confounding clinical factors; Symptoms should be preceded by neurological stability for at least 30 days; Symptoms should be accompanied by new objective neurological worsening determined with a timely EDSS/ Functional Systems Score (FSS) assessment
* 24 weeks confirmed disability progression based on increases in EDSS while on treatment with ocrelizumab
* A T1 Gd-enhanced lesion after Week 8
* A new and/or enlarging T2 hyperintense lesion on MRI after Week 8 compared to the Week 8 MRI scan.Annualized Protocol-defined Relapse Rate at Week 96 Week 96 Time to Onset of 24-week Confirmed Disability Progression Baseline up to 96 Weeks Percentage Change From Baseline to Week 96 in Total T2 Lesion Volume Detected by Brain MRI Baseline, Week 96 Mean Number of New and/or Enlarging T2 Hyperintense Lesions Per MRI Scan Weeks 24, 48, 96 Mean number of new and/or enlarging T2 hyperintense lesions per MRI scan: Total number of new and/or enlarging T2 hyperintense lesions divided by the total number of interpretable MRI scans
Change From Baseline in Cognitive Performance (Visuospatial Memory) at Week 48 and Week 96 as Measured by the Brief International Cognitive Assessment for MS - Brief Visuospatial Memory Test-Revised (BVMT-R) Score Baseline, Weeks 48, 96 Brief International Cognitive Assessment for MS (BICAMS) is assessing cognitive processing speed and verbal and visual memory. Brief Visuospatial Memory Test-Revised (BVMT-R) is assessing visuospatial memory. In this test, six abstract designs are presented for 10 sec. The display is removed from view and patients render the stimuli via pencil on paper manual responses. Each design receives from 0 to 2 points representing accuracy and location. There are three learning trials, and the outcome measure is the total number of points earned over the three learning trials, thus the scale range is 0-36. The higher the result, the better visual/spatial memory.
Trial Locations
- Locations (163)
Hôpital Maison Blanche; Service de Neurologie
🇫🇷Reims, France
Hôpitaux Universitaires de strasbourg - hôpital civil
🇫🇷Strasbourg, France
Gesundheitszentrum St. Johannes Hospital; Neurolog. Gemeinschaftspraxis Dres. Schmidt, Neudecker etc
🇩🇪Bonn, Germany
Klinikum Grosshadern der LMU; Neuroimmunologie II
🇩🇪München, Germany
Gemeinschaftspraxis Dr.med. Reinhard Ehret/Dr. med Wolfram von Pannwitz
🇩🇪Berlin, Germany
Hopital Gabriel Montpied CHU de Clermont-Ferrand; Service de Neurologie B
🇫🇷Clermont-Ferrand, France
CHU de Besancon Hopital Jean Minjoz; Service de Neurologie
🇫🇷Besançon, France
Hôpital Guillaume et René Laënnec; Service Neurologie
🇫🇷Nantes, France
East Tallinn Central Hospital; Neurology Department
🇪🇪Tallinn, Estonia
CHRU - Hôpital Bretonneau; Neurologie
🇫🇷Tours, France
Neurologische Gemeinschaftspraxis Kassel und Vellmar, Ch. Lassek, Dres. Ammerbach, Fetzer, M. Fische
🇩🇪Kassel, Germany
Universitätsklinikum Magdeburg,Otto-von-Guericke-Universität A.ö.R., Klinik für Neurologie
🇩🇪Magdeburg, Germany
Universitätsklinikum Münster; Klinik und Poliklinik für Neurologie
🇩🇪Münster, Germany
Ruppiner Kliniken, Hochschulklinikum der Medizinischen Hochschule Brandenburg, Klinik für Neurologie
🇩🇪Neuruppin, Germany
Cork University Hospital; Clinical Research Facility
🇮🇪Cork, Ireland
Jüdisches Krankenhaus Berlin; Abteilung fur Neurologie
🇩🇪Berlin, Germany
Tartu University Hospital
🇪🇪Tartu, Estonia
Klinikum Augsburg, Neurologische Klinik und klinische Neurophysiologie
🇩🇪Augsburg, Germany
Universitätsklinikum "Carl Gustav Carus", Zentrum für Klinische Neurowissenschaften
🇩🇪Dresden, Germany
St. Josefs-Krankenhaus, Klinik für Neurologie
🇩🇪Potsdam, Germany
NeuroConcept AG C/O mind mvz GmbH
🇩🇪Stuttgart, Germany
A. O. U. Federico II; Dip Neuroscienze, Scienze Riproduttive ed Odontostomatologiche
🇮🇹Napoli, Campania, Italy
NeuroCentrum Odenwald; Dres. Reifschneider, Unsorg, Ries, Schumann, Hoffmann, Knoblich
🇩🇪Erbach/Odenwald, Germany
Neurologische Praxisgemeinschaft Hamburger-Straße; Dres. Müller-Habich/Emrich/Vogt
🇩🇪Hamburg, Germany
Henriettenstiftung Hannover; Klinik fuer Neurologie und Klinische Neurophysiologie
🇩🇪Hannover, Germany
Neurologische Klinik, Universitätsklinikum Heidelberg
🇩🇪Heidelberg, Germany
Neurozentrum am Klosterforst in Itzehoe
🇩🇪Itzehoe, Germany
NeuroPoint, Gesellschaft für vorbeugende Gesundheitspflege mbH
🇩🇪Ulm, Germany
Klinikum rechts der Isar der TU Muenchen; Neurologische Klinik und Poliklinik im Neuro-Kopf-Zentrum
🇩🇪München, Germany
Policlinico Tor Vergata Dip. Neuroscienze-Clinica Neurologica-UOSD Sclerosi Multipla
🇮🇹Roma, Lazio, Italy
Ospedale Bellaria; Istituto delle Scienze Neurologiche - UO RIABILITAZIONE SCLEROSI MULTIPLA
🇮🇹Bologna, Emilia-Romagna, Italy
Studienzentrum Nordwest, Dr. med. Joachim Springub / Herr Wolfgang Schwarz
🇩🇪Westerstede, Germany
Ospedale SS. Annunziata - Clinica Neurologica - Centro Sclerosi Multipla
🇮🇹Chieti, Abruzzo, Italy
St Vincents University Hospital
🇮🇪Dublin 4, Ireland
Ospedale San Salvatore; Clinica Neurologica - Centro Sclerosi Multipla
🇮🇹L'Aquila, Abruzzo, Italy
Ospedale S.Antonio Abate; Neurologia 2 - Sclerosi Multipla e Recupero Neurologico
🇮🇹Gallarate, Lombardia, Italy
Fondazione Istituto S. Raffaele - Giglio; UO Neurologia
🇮🇹Cefalù, Sicilia, Italy
AOU Senese - Presidio Ospedaliero Le Scotte; UOSA Neurologia Sperimentale
🇮🇹Siena, Toscana, Italy
Policlinico G.B. Rossi; Dip. Scienze Neurologiche Biomediche - Neurologia B - Amb. Sclerosi Multipla
🇮🇹Verona, Veneto, Italy
Ondokuz Mayis Univ. Med. Fac.; Neurology
🇹🇷Samsun, Turkey
Hospital Universitari de Bellvitge; Servicio de Neurologia
🇪🇸L'Hospitalet de Llobregat, Barcelona, Spain
Hospital Universitari de Girona Dr. Josep Trueta; Servicio de Neurologia
🇪🇸Salt, Girona, Spain
Karadeniz Tecnical Uni. Med. Fac.; Neurology
🇹🇷Trabzon, Turkey
Istanbul Universitesi - Cerrahpasa Cerrahpasa Tip Fakultesi; Noroloji Anabilim Dali
🇹🇷Istanbul, Turkey
Terveystalo Tampere
🇫🇮Tampere, Finland
Hopital Roger Salengro; Service de Neurologie
🇫🇷Lille, France
CHU toulouse - Hôpital Purpan; Departement de Neurologie
🇫🇷Toulouse, France
Azienda Ospedaliera Sant'Andrea; UOC Neurologia
🇮🇹Roma, Lazio, Italy
Irccs A.O.U.San Martino Ist; Dinogmi
🇮🇹Genova, Liguria, Italy
Universitätsspital Basel Medizin Neurologie; Neurologische Poliklinik
🇨🇭Basel, Switzerland
Hospital Quiron de Madrid; Servicio de Neurologia
🇪🇸Pozuelo de Alarcon, Madrid, Spain
IRCCS Istituto Neurologico Neuromed; Centro per lo Studio e la Cura della Sclerosi Multipla
🇮🇹Pozzilli, Molise, Italy
AO di Perugia - Ospedale S. Maria della Misericordia; Clinica Neurologica
🇮🇹Perugia, Umbria, Italy
Sydjysk Skleroseklinik - Sønderborg
🇩🇰Sønderborg, Denmark
UZ Antwerpen
🇧🇪Edegem, Belgium
Hospital Erasme
🇧🇪Bruxelles, Belgium
St George Hospital
🇦🇺Kogarah, New South Wales, New South Wales, Australia
Cliniques Universitaires St-Luc
🇧🇪Bruxelles, Belgium
UZ Gent
🇧🇪Gent, Belgium
CHU Tivoli
🇧🇪La Louvière, Belgium
UZ Leuven Gasthuisberg
🇧🇪Leuven, Belgium
Nationaal MS Centrum
🇧🇪Melsbroek, Belgium
Fakultni nemocnice u sv. Anny; Neurologicka klinika
🇨🇿Brno, Czechia
Revalidatie en MS Centrum
🇧🇪Overpelt, Belgium
Nemocnice Jihlava; NEU-Neurologicke oddeleni
🇨🇿Jihlava, Czechia
VFN Praha Poliklinika Rs Centrum - Budova A
🇨🇿Prague, Czechia
Fakultni nemocnice Motol; Neurologicka klinika
🇨🇿Praha, Czechia
Odense Universitetshospital, Neurologisk Afdeling N
🇩🇰Odense C, Denmark
Aarhus Universitetshospital, Neurologisk Afd. F, Skleroseklinikken
🇩🇰Aarhus N, Denmark
West Tallinn Central Hospital
🇪🇪Tallinn, Estonia
Rigshospitalet Glostrup; Neurologisk Klinik
🇩🇰Glostrup, Denmark
Hopital Neurologique et Neurochirurgical Pierre Wertheimer; Service de Neurologie A
🇫🇷Bron, France
Groupe Hospitalier Pellegrin; Service de neurochirurgie B
🇫🇷Bordeaux, France
Mehiläinen Neo Turku
🇫🇮Turku, Finland
CHU de la Timone - Hopital d Adultes; Service de Neurologie
🇫🇷Marseille, France
Hopital Gui de Chauliac; Neurologie
🇫🇷Montpellier, France
Fondation Rothschild; Service de Neurologie
🇫🇷Paris, France
Hôpital Pasteur; Service de Neurologie
🇫🇷Nice, France
Groupe Hospitalier Pitié- Salpétrière; Service Neurologie
🇫🇷Paris, France
Marianne-Strauß-Klinik; Behandlung Kempfen für Multip Sklero Kranke gemeinnütz GmbH
🇩🇪Berg, Germany
Charite - Universitatsmedizin Berlin; Klinik fur Neurologie
🇩🇪Berlin, Germany
St. Josef-Hospital, Klinik für Neurologie
🇩🇪Bochum, Germany
Praxis Dr. Said Masri
🇩🇪Berlin, Germany
PNP Buchholz, Praxis für Neurologie - Psychiatrie, Dres. Dee/Gößling/Hoge
🇩🇪Buchholz, Germany
Studienzentrum für Neurologie und Psychiatrie
🇩🇪Böblingen, Germany
Gemeinschaftspraxis für Neurologie; Dr. Katrin Schulte, Dr. Nils Richter, Dr. Margarete Capito
🇩🇪Düsseldorf, Germany
Universitaetsklinikum Frankfurt; Klinik für Neurologie
🇩🇪Frankfurt, Germany
Universiätsklinikum Hamburg-Eppendorf , Multiple Sklerose Tagesklinik u. Ambulanz Neurol. Poliklinik
🇩🇪Hamburg, Germany
MultipEL Studies - Institut für klinische Studien
🇩🇪Hamburg, Germany
Universitätsklinikum Freiburg, Klinik für Neurologie und Neurophysiologie
🇩🇪Freiburg, Germany
Oberhavel Kliniken GmbH, Klinik Hennigsdorf, Neurologie
🇩🇪Hennigsdorf, Germany
PANAKEIA - Arzneimittelforschung Leipzig GmbH
🇩🇪Leipzig, Germany
Max-Planck-Institut für Psychiatrie
🇩🇪München, Germany
Universitaetsklinikum Marburg; Klinik fuer Neurologie
🇩🇪Marburg, Germany
Universitaetsklinikum Mainz - PS; Klinik und Poliklinik fuer Neurologie
🇩🇪Mainz, Germany
AMEOS Klinikum Oldenburg, Klinik für Neurologie und Neurophysiologie
🇩🇪Oldenburg in Holstein, Germany
Universitätsklinikum Tübingen, Zentrum für Neurologie
🇩🇪Tübingen, Germany
Beaumont Hospital
🇮🇪Dublin, Ireland
Università degli Studi della Campania Luigi Vanvitelli; Dip. Ass. Integrato Med Int-II Clinica Neur
🇮🇹Napoli, Campania, Italy
Ospedale S.Camillo Forlanini; UOSD Day Hospital Neurologico e Neurochirurgico
🇮🇹Roma, Lazio, Italy
Policlinico Universitario A. Gemelli; UOC Neurologia - Centro Sclerosi Multipla
🇮🇹Roma, Lazio, Italy
ASST PAPA GIOVANNI XXIII Neurologia USS Malattie Autoimmuni Centro Sclerosi Multipla
🇮🇹Bergamo, Lombardia, Italy
IRCCS Ospedale San Raffaele; Neurologia Neurofisiologia Neuroriabilitazione-Centro Sclerosi Multipla
🇮🇹Milano, Lombardia, Italy
Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico; UOSD Malattie Neurodegenerative
🇮🇹Milano, Lombardia, Italy
Fond. Istituto Neurologico C.Besta; UO Neurologia IV - Neuroimmunologia Malattie Neuromuscolari
🇮🇹Milano, Lombardia, Italy
Ospedale Civile di Montichiari; Centro Sclerosi Multipla
🇮🇹Montichiari, Lombardia, Italy
IRCCS Istituto Neurologico C. Mondino-Dip. Neurologia Neuroriabilitazione S.S. Sclerosi Multipla
🇮🇹Pavia, Lombardia, Italy
Ospedale Dimiccoli Barletta; Dipartimento Testa-Collo - UO Neurologia
🇮🇹Barletta, Puglia, Italy
AOU Ospedali Riuniti Umberto I-G.M. Lancisi-G. Salesi; SOD Clinica Neurologica-Am.Sclerosi Multipla
🇮🇹Ancona, Marche, Italy
Ospedale Binaghi; Centro Sclerosi Multipla
🇮🇹Cagliari, Sardegna, Italy
IRCCS Ospedale Casa Sollievo Della Sofferenza; SC Neurologia
🇮🇹San Giovanni Rotondo, Puglia, Italy
AOU Policlinico V. Emanuele - P.O G. Rodolico; Clinica Neurologica, Centro Sclerosi Multipla
🇮🇹Catania, Sicilia, Italy
AOU Policlinico Giaccone; UOC Neurologia e Neurofisiopatologia-Amb Sclerosi Multipla
🇮🇹Palermo, Sicilia, Italy
AOU Careggi; Neurologia 1-Dip. Neuroscienze Psicologia Area Farmaco Salute del Bambino(NEUROFARBA)
🇮🇹Firenze, Toscana, Italy
AOUC Azienda Ospedaliero-Universitaria Careggi; Neurologia 2
🇮🇹Firenze, Toscana, Italy
AO Ospedali Riuniti Villa Sofia-Cervello;PO Villa Sofia - UO Neurologia - U.O.S. Neuroimmunologia
🇮🇹Palermo, Sicilia, Italy
Azienda Ospedaliera di Padova; Clinica Neurologica
🇮🇹Padova, Veneto, Italy
Amphia Ziekenhuis
🇳🇱Breda, Netherlands
St. Antonius Ziekenhuis Nieuwegein
🇳🇱Nieuwegein, Netherlands
Zuyderland Medisch Centrum - Sittard Geleen
🇳🇱Sittard-Geleen, Netherlands
Sykehuset Buskerud HF; Nevrologisk avdeling
🇳🇴Drammen, Norway
Sint Elizabeth Ziekenhuis
🇳🇱Tilburg, Netherlands
Haukeland Universitetssykehus
🇳🇴Bergen, Norway
Maasstadziekenhuis
🇳🇱Rotterdam, Netherlands
Hospital Universitario Central de Asturias; Servicio de Neurología
🇪🇸Oviedo, Asturias, Spain
Hospital Universitari Arnau de Vilanova de Lleida; Servicio de Neurología
🇪🇸Lleida, Lerida, Spain
Complejo Hospitalario Universitario A Coruña (CHUAC); Servicio de Neurologia
🇪🇸Coruña, LA Coruña, Spain
Hospital General de Castellon; Servicio de Neurología
🇪🇸Castelló de la Plana, Castellon, Spain
Complejo Hospitalario Universitario de Vigo - Xeral Cies; Servicio de Neurologia
🇪🇸Vigo, Pontevedra, Spain
Hospital Puerta del Mar; Sevicio de Neurologia
🇪🇸Cadiz, Spain
Universitario de La Princesa; Servicio de Neurología
🇪🇸Madrid, Spain
Hospital del Mar; Servicio de Neurologia
🇪🇸Barcelona, Spain
Hospital Universitario Clínico San Carlos; Servicio de Neurología
🇪🇸Madrid, Spain
Hospital Vall d'Hebron; Servicio de Neurología
🇪🇸Barcelona, Spain
Hospital Universitario 12 de Octubre; Servicio de Neurologia
🇪🇸Madrid, Spain
Hospital Universitario La Paz; Servicio de Neurologia
🇪🇸Madrid, Spain
Hospital Universitario Virgen de Arrixaca; Servicio de Neurología
🇪🇸Murcia, Spain
Centrum för Neurologi
🇸🇪Stockholm, Sweden
Hospital Clinico Universitario de Valencia; Servicio de Neurologia
🇪🇸Valencia, Spain
Sahlgrenska Sjukhuset; Neurology
🇸🇪Göteborg, Sweden
Hospital Universitario la Fe; Servicio de Neurologia
🇪🇸Valencia, Spain
Hospital Universitario Virgen Macarena; Servicio de Neurologia
🇪🇸Sevilla, Spain
Länssjukhuset Ryhov; Medicinkliniken / Neurologmottagningen
🇸🇪Jönköping, Sweden
CHUV Lausanne Méd.Neurologie
🇨🇭Lausanne, Switzerland
Ege University Medical Faculty
🇹🇷Izmir, Turkey
Hacettepe University Medical Faculty; Neurology
🇹🇷Ankara, Turkey
Istanbul Uni Istanbul Medical Faculty
🇹🇷Istanbul, Turkey
Kocaeli University Hospital; Department of Neurology
🇹🇷Kocaeli, Turkey
Mersin University Medical Faculty; Neurology
🇹🇷Mersin, Turkey
Western General Hospital
🇬🇧Edinburgh, United Kingdom
New Queen Elizabeth Hospital Birmingham
🇬🇧Birmingham, United Kingdom
Royal Devon and Exeter Hospital (Wonford)
🇬🇧Exeter, United Kingdom
Queen Elizabeth University Hospital
🇬🇧Glasgow, United Kingdom
Kings College Hospital
🇬🇧London, United Kingdom
The Royal London Hospital
🇬🇧London, United Kingdom
Leeds Teaching Hospitals NHS Trust
🇬🇧Leeds, United Kingdom
Raigmore Hospital
🇬🇧Inverness, United Kingdom
Royal Victoria Infirmary
🇬🇧Newcastle upon Tyne, United Kingdom
Salford Royal NHS Foundation Trust
🇬🇧Salford, United Kingdom
Royal Hallamshire Hospita
🇬🇧Sheffield, United Kingdom
Morriston Hospital
🇬🇧Swansea, United Kingdom
Royal Cornwall Hospital
🇬🇧Truro, United Kingdom
Charing Cross Hospital
🇬🇧London, United Kingdom