MedPath

Tanezumab in Osteoarthritis Of The Hip

Phase 3
Completed
Conditions
Arthritis
Osteoarthritis
Osteoarthritis, Hip
Interventions
Biological: Placebo
Biological: tanezumab
Registration Number
NCT00744471
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to test the efficacy and safety of 3 doses of tanezumab in osteoarthritis of the hip in patients

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
627
Inclusion Criteria
  • Osteoarthritis of the hip according to ACR criteria with Kellgren-Lawrence x-ray grade of 2
  • Unwilling or unable to take non-opiate pain medications, for whom non-opiate pain medications have not provided adequate pain relief or are candidates for Hip injections, arthroplasty or replacement surgery
  • Pain level and function levels as required by the protocol at Screening and Baseline
  • Willing to discontinue pain medications (acetaminophen will be permitted up to a certain level) before and during the study
  • Must agree to the contraceptive requirements of the protocol if applicable
  • Must agree to the treatment plan, scheduled visits, and procedures of the protocol
Read More
Exclusion Criteria
  • Pregnancy
  • BMI greater than 39
  • Other severe pain, significant cardiac, neurological or psychological conditions, or above the protocol limits for laboratory and blood pressure results
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo
Tanezumab 5 mgtanezumabTanezumab 5mg IV every 8 weeks
Tanezumab 2.5 mgtanezumabTanezumab 2.5 mg IV every 8 weeks.
Tanezumab 10 mgtanezumabTanezumab 10 mg IV every 8 weeks
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscale Score at Week 16: Baseline Observation Carried Forward (BOCF)Baseline, Week 16

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC physical function subscale is a 17-item questionnaire used to assess the degree of difficulty experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 17 individual questions scored on a NRS of 0 to 10, where higher scores indicate worse function. Total score range for WOMAC physical function subscale score is 0 to 10, where higher scores indicate worse function. Physical function refers to participant's ability to move around and perform usual activities of daily living.

Change From Baseline in Patient Global Assessment (PGA) of Osteoarthritis at Week 16: Baseline Observation Carried Forward (BOCF)Baseline, Week 16

Participants answered: "Considering all the ways your osteoarthritis in your hip joint affects you, how are you doing today?", participants responded by using a 5-point scale where 1 = very good (no symptom and limitation of normal activities) and 5 = very poor (very severe symptoms and inability to carry out normal activities), where lower scores indicates better condition.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Score at Week 16: Baseline Observation Carried Forward (BOCF)Baseline (Day 1), Week 16

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It was calculated as mean of the scores from 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Total score range for WOMAC pain subscale score is 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants With at Least 30 Percent (%), and 50% Reduction From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Score: Last Observation Carried Forward (LOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 5 individual questions scored on a NRS of 0 to 10, where higher scores indicate higher pain. Total score range for WOMAC pain subscale score is 0 to 10, where higher scores indicate higher pain. Percentage of participants with \>=30% or \>=50% reduction in WOMAC pain subscale score from baseline to specified weeks were reported.

Percentage of Participants With at Least 2 Points Improvement From Baseline in Patient Global Assessment (PGA) of Osteoarthritis at Week 2, 4, 8, 12 ,16 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12 ,16, 24

Participants answered: "Considering all the ways your osteoarthritis in your knee affects you, how are you doing today?", participants responded by using a 5-point scale where 1 = very good and 5 = very poor where lower scores indicating better condition. Percentage of participants with an improvement of greater than or equal to 2 points from baseline at specified weeks were reported.

Change From Baseline in Average Daily Pain Score in the Hip Joint at Week 2, 4, 8, 12, 16 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 16, 24

Participants assessed daily average hip joint pain during the past 24 hours on an 11-point NRS ranging from 0 (no pain) to 10 (worst pain). Post baseline weekly scores were calculated as the mean of the scores over the last 7 days prior to each assessment time point.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Stiffness Subscale Score at Week 2, 4, 8, 12, 16 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12 ,16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC stiffness subscale is a 2-item questionnaire used to assess the amount of stiffness experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 2 individual questions each scored on numerical rating scale of 0 (minimum stiffness) to 10 (maximum stiffness), giving an overall possible mean score range of 0 (minimum stiffness) to 10 (maximum stiffness). Higher scores indicate higher stiffness. Stiffness is defined as a sensation of decreased ease in movement of hip joint.

Change From Baseline in Patient Global Assessment (PGA) of Osteoarthritis at Week 2, 4, 8, 12 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 24

Participants answered: "Considering all the ways your osteoarthritis in your hip joint affects you, how are you doing today?", participants responded by using a 5-point scale where 1 = very good (no symptom and limitation of normal activities) and 5 = very poor (very severe symptoms and inability to carry out normal activities), where lower scores indicates better condition.

Percentage of Participants With Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) Response: Baseline Observation Carried Forward (BOCF)Week 2, 4, 8, 12, 16, 24

A participant was considered as an OMERACT-OARSI responder if at least one of the following criteria were met: Improvement in WOMAC pain or physical function subscale from baseline to week of interest was greater than or equal to (\>=) 50 percent (%)and absolute change of \>=2 units from baseline at the week of interest, or at least 2 of the following 3 being true: \>=20% improvement from baseline and absolute change from baseline of \>=1 unit at the week of interest in 1) WOMAC pain subscale, 2) WOMAC physical function subscale, 3) PGA of osteoarthritis. Score range for PGA: 1 = very good to 5 = very poor, where higher scores=more affected). WOMAC pain, physical function subscales assess amount of pain/difficulty experienced (score: 0 \[no pain\] to 10 \[worst possible pain\], higher score=higher pain/difficulty).

Percentage of Participants With Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) Response: Last Observation Carried Forward (LOCF)Week 2, 4, 8, 12 ,16, 24

A participant was considered as an OMERACT-OARSI responder if at least one of the following criteria were met: Improvement in WOMAC pain or physical function subscale from baseline to week of interest was greater than or equal to (\>=) 50 percent (%)and absolute change of \>=2 units from baseline at the week of interest, or at least 2 of the following 3 being true: \>=20% improvement from baseline and absolute change from baseline of \>=1 unit at the week of interest in 1) WOMAC pain subscale, 2) WOMAC physical function subscale, 3) PGA of osteoarthritis. Score range for PGA: 1 = very good to 5 = very poor, where higher scores=more affected). WOMAC pain, physical function subscales assess amount of pain/difficulty experienced (score: 0 \[no pain\] to 10 \[worst possible pain\], higher score=higher pain/difficulty).

Percentage of Participants With at Least 2 Points Improvement From Baseline in Patient Global Assessment (PGA) of Osteoarthritis at Week 2, 4, 8, 12, 16, 24: Last Observation Carried Forward (LOCF)Baseline, Week 2, 4, 8, 12, 16, 24

Participants answered: "Considering all the ways your osteoarthritis in your knee affects you, how are you doing today?", participants responded by using a 5-point scale where 1 = very good and 5 = very poor where lower scores indicating better condition. Percentage of participants with an improvement of greater than or equal to 2 points from baseline at specified weeks were reported.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Pain Subscale Score at Week 2, 4, 8, 12 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It was calculated as mean of the scores from 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Total score range for WOMAC pain subscale score is 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Pain Subscale Score at Week 2, 4, 8, 12,16 and 24: Last Observation Carried Forward (LOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It was calculated as mean of the scores from 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Total score range for WOMAC pain subscale score is 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Subscale Score at Week 2, 4, 8, 12 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It was calculated as mean of the scores from 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Total score range for WOMAC pain subscale score is 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Physical function refers to participant's ability to move around and perform usual activities of daily living.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Subscale at Week 2, 4, 8, 12, 16 and 24: Last Observation Carried Forward (LOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC physical function subscale is a 17-item questionnaire used to assess the degree of difficulty experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 17 individual questions scored on a NRS of 0 to 10, where higher scores indicate worse function. Total score range for WOMAC physical function subscale score is 0 to 10, where higher scores indicate worse function. Physical function refers to participant's ability to move around and perform usual activities of daily living.

Change From Baseline in Patient Global Assessment (PGA) of Osteoarthritis at Week 2, 4, 8, 12, 16 and 24: Last Observation Carried Forward (LOCF)Baseline, Week 2, 4, 8, 12, 16, 24

Participants answered: "Considering all the ways your osteoarthritis in your hip joint affects you, how are you doing today?", participants responded by using a 5-point scale where 1 = very good (no symptom and limitation of normal activities) and 5 = very poor (very severe symptoms and inability to carry out normal activities), where lower scores indicates better condition.

Percentage of Participants With at Least 30 Percent (%), and 50 % Reduction From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Score at Week 2, 4, 8, 12, 16, 24: Baseline Observation Carried ForwardBaseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It was calculated as mean of the scores from 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Total score range for WOMAC pain subscale score is 0 (no pain) to 10 (worst possible pain), where higher scores indicated higher pain. Percentage of participants with \>=30% or \>=50% reduction in WOMAC pain subscale score from baseline to specified weeks were reported.

Percentage of Participants With Cumulative Reduction From Baseline in Western Ontario and McMaster Osteoarthritis Index (WOMAC) Pain Subscale Score at Week 16: Baseline Observation Carried Forward (BOCF)Baseline, Week 16

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 5 individual questions scored on a NRS of 0 to 10, where higher scores indicate higher pain. Total score range for WOMAC pain subscale score is 0 to 10, where higher scores indicate higher pain. Participants with specified reduction (as percent) from baseline at Week 16 were reported.

Percentage of Participants With Cumulative Reduction From Baseline in Western Ontario and McMaster Osteoarthritis Index (WOMAC) Pain Subscale Score at Week 16: Last Observation Carried Forward (LOCF)Baseline, Week 16

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC pain subscale is a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in hip joint during past 48 hours. It is calculated as mean of the scores from 5 individual questions scored on a NRS of 0 to 10, where higher scores indicate higher pain. Total score range for WOMAC pain subscale score is 0 to 10, where higher scores indicate higher pain. Participants with specified reduction (as percent) from baseline at Week 16 were reported.

Change From Baseline in 36-Item Short-Form Health Survey Version 2 (SF-36v2) Domain Scores at Week 12 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 12, 24

The SF-36 health survey was a self-administered questionnaire that measures each of the following 8 health domains: domain 1= general health, domain 2= physical function, domain 3= role physical, domain 4= bodily pain, domain 5= vitality, domain 6= social function, domain 7= role emotional, domain 8= mental health. Total score for each domain are scaled 0 (minimum) to 100 (maximum), where higher score indicates highest level of functioning.

Amount of Rescue Medication TakenWeek 2, 4, 8, 12, 16, 24

In case of inadequate pain relief for osteoarthritis, acetaminophen up to 4000 mg per day up to 3 days per week could be taken as rescue medication. The total dosage of acetaminophen in mg used during the specified week were summarized.

Change From Baseline in Neuropathy Impairment Score (NIS) at Week 2, 4, 6, 8, 12, 16 and 24Baseline, Week 2, 4, 6, 8, 12, 16, 24

The NIS is a standardized instrument used to evaluate participant for signs of peripheral neuropathy. Neurologic examination assessed strength of groups of muscles of the head and neck, upper limbs and lower limbs, deep tendon reflexes and sensation (tactile, vibration, joint position sense and pin prick) of index fingers and great toes in order to complete the NIS. The NIS is the sum of scores of over all 37 items (24 scored 0-4; 13 scored 0-2), made separately for left and right sides, giving a possible overall score range of 0 (no impairment) to 122 (severe impairment). NIS Total score range (total of both left and right sides) was 0 (no impairment) to 244 (severe impairment), where higher scores indicated increased impairment.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) Average Score at Week 2, 4, 8, 12,16 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. WOMAC: self-administered, disease-specific 24-item questionnaire which assesses clinically important, participant-relevant symptoms for pain (5 items), stiffness (2 items) and physical function (17 items) in participants with osteoarthritis of hip joint. Each item is scored on a 0 (no pain) to 10 (worst possible pain) NRS scale, where higher scores indicate higher pain/stiffness or worse function. WOMAC average score is the mean of WOMAC pain, physical function and stiffness subscale scores and ranges from 0 (no pain) to 10 (worst possible pain), where higher score indicates worse response.

Change From Baseline of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale (Pain When Going up or Down Stairs) Score at Week 2, 4, 8, 12, 16 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. Participants answered "How much pain have you had when going up or down the stairs?". Participants responded by using a NRS of 0 to 10, where 0 = no pain and 10 = worst possible pain, where higher scores indicating higher pain.

Change From Baseline in 36-Item Short-Form Health Survey Version 2 (SF-36v2) Physical and Mental Component Scores at Week 12 and 24: Baseline Observation Carried Forward (BOCF)Baseline, Week 12, 24

The SF-36 health survey was a self-administered questionnaire that measures each of the following 8 health domains: domain 1= general health, domain 2= physical function, domain 3= role physical, domain 4= bodily pain, domain 5= vitality, domain 6= social function, domain 7= role emotional, domain 8= mental health. Total score for each domain are scaled 0 (minimum) to 100 (maximum), where higher score indicates highest level of functioning. These 8 domains were also summarized as summary scores: mental component aggregate (MCA) and physical component aggregate (PCA). Total score range for the each summary scores =0 to 100, where higher scores represented higher level of functioning. Higher summary scores indicated a better health related quality of life.

Time to Discontinuation Due to Lack of EfficacyBaseline up to Week 16

Median time to discontinuation due to lack of efficacy was estimated using Kaplan-Meier method.

Percentage of Participants Who Used Rescue MedicationWeek 2, 4, 8, 12 ,16, 24

In case of inadequate pain relief for osteoarthritis, acetaminophen up to 4000 mg per day up to 3 days per week could be taken as rescue medication. Percentage of participants with any use of rescue medication during the particular study week were summarized.

Duration of Rescue Medication UseWeek 2, 4, 8, 12, 16, 24

In case of inadequate pain relief for osteoarthritis, acetaminophen up to 4000 mg per day up to 3 days per week could be taken as rescue medication. Number of days participant used any of the rescue medication, during the specified week were summarized.

Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)Baseline up to Week 32

An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to Week 32 that were absent before treatment or that worsened relative to pretreatment state. Adverse events included both serious and all non-serious adverse events.

Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) Pain Subscale Item (Pain When Walking on Flat Surface) Score at Week 2, 4, 8, 12, 16 and 24 : Baseline Observation Carried Forward (BOCF)Baseline, Week 2, 4, 8, 12, 16, 24

WOMAC: Self-administered, disease-specific questionnaire which assesses clinically important, participant-relevant symptoms for pain, stiffness and physical function in participants with osteoarthritis. Participants answered "How much pain have you had when walking on a flat surface?". Participants responded by using a NRS of 0 to 10, where 0 = no pain and 10 =extreme pain. Higher scores indicated more pain.

Trial Locations

Locations (96)

Providence Clinical Research

🇺🇸

Burbank, California, United States

Trinity Clinical Trials

🇺🇸

Santa Ana, California, United States

Stamford Therapeutics Consortium

🇺🇸

Stamford, Connecticut, United States

Arthritis and Rheumatology of Georgia

🇺🇸

Atlanta, Georgia, United States

North Georgia Clinical Research

🇺🇸

Woodstock, Georgia, United States

North Georgia Internal medicine

🇺🇸

Woodstock, Georgia, United States

Clinical Pharmacology Study Group

🇺🇸

Worcester, Massachusetts, United States

Piedmont Medical Research Associates

🇺🇸

Winston-Salem, North Carolina, United States

Sonora Clinical Research

🇺🇸

Boise, Idaho, United States

The Arthritis and Osteoporosis Center of Maryland

🇺🇸

Frederick, Maryland, United States

Laureate Clinical Reseach Group

🇺🇸

Atlanta, Georgia, United States

Palm Beach Research Center

🇺🇸

West Palm Beach, Florida, United States

Northwest Indiana Center for Clinical Research

🇺🇸

Valparaiso, Indiana, United States

The Arthritis Center

🇺🇸

Springfield, Illinois, United States

Avivoclin Clinical Services

🇺🇸

Port Orange, Florida, United States

The Medical Research Network, LLC

🇺🇸

New York, New York, United States

Advent Clinical Research Centers

🇺🇸

Pinellas Park, Florida, United States

Medical Advanced Pain Specialists

🇺🇸

Edina, Minnesota, United States

Mercy Health Research

🇺🇸

Saint Louis, Missouri, United States

Comprehensive Clinical Research

🇺🇸

Berlin, New Jersey, United States

Albuquerque Clinical Trials, Inc.

🇺🇸

Albuquerque, New Mexico, United States

Carolina Bone & Joint, P.A.

🇺🇸

Charlotte, North Carolina, United States

Southwest Rheumatology and Research Group, LLC

🇺🇸

Middleburg Heights, Ohio, United States

Brandywine Clinical Research

🇺🇸

Downingtown, Pennsylvania, United States

Sushma V. Gorrela, MD

🇺🇸

Spring, Texas, United States

International Research Associates, LLC

🇺🇸

Miami, Florida, United States

Rheumatic Disease Clinical Research Center

🇺🇸

Houston, Texas, United States

Pioneer Research Solutions

🇺🇸

Houston, Texas, United States

Mirkil Medical

🇺🇸

Las Vegas, Nevada, United States

Consultants for Clinical Research/Ohio GI and Liver Institute

🇺🇸

Cincinnati, Ohio, United States

Arizona Research Center, Inc.

🇺🇸

Phoenix, Arizona, United States

Clinical Research Advantage, Inc. /Stonecreek Medical Associates, PC

🇺🇸

Phoenix, Arizona, United States

Health Research Institute

🇺🇸

Oklahoma City, Oklahoma, United States

Radiant Research San Antonio NE

🇺🇸

San Antonio, Texas, United States

Texas Arthritis Research Center, PA

🇺🇸

San Antonio, Texas, United States

Diagnostics Research Group

🇺🇸

San Antonio, Texas, United States

Optimum Clinical Research

🇺🇸

Salt Lake City, Utah, United States

EPIC Imaging East

🇺🇸

Portland, Oregon, United States

Covance CRU, Inc.

🇺🇸

Portland, Oregon, United States

Horizon Research Group

🇺🇸

Mobile, Alabama, United States

Arizona Arthritis & Rheumatology Associates, PC

🇺🇸

Phoenix, Arizona, United States

Pivotal Research Center

🇺🇸

Peoria, Arizona, United States

Quality of Life Medical & Research Center, LLC

🇺🇸

Tucson, Arizona, United States

Quality of Life Medical and Research Center

🇺🇸

Tucson, Arizona, United States

Tucson Orthopaedic Institute

🇺🇸

Tucson, Arizona, United States

St. Joseph's Mercy Clinic

🇺🇸

Hot Springs, Arkansas, United States

Arthritis Medical Clinic of North County, Inc.

🇺🇸

Escondido, California, United States

Talbert Medical Group

🇺🇸

Huntington Beach, California, United States

Clinical Research Center of Connecticut

🇺🇸

Danbury, Connecticut, United States

Javed Rheumatology Associates, Inc.

🇺🇸

Newark, Delaware, United States

Innovative Research of West Florida, Inc.

🇺🇸

Clearwater, Florida, United States

Tampa Bay Medical Research Inc

🇺🇸

Clearwater, Florida, United States

Avail Clinical Research, LLC

🇺🇸

DeLand, Florida, United States

Avail Clinical Research

🇺🇸

DeLand, Florida, United States

Delray Research Associates

🇺🇸

Delray Beach, Florida, United States

Arthritis Associates of South Florida

🇺🇸

Delray Beach, Florida, United States

Westside Center for Clinical Research

🇺🇸

Jacksonville, Florida, United States

Adult Medicine Specialists

🇺🇸

Longwood, Florida, United States

Genesis Research International

🇺🇸

Longwood, Florida, United States

Quality Clinical Research, Inc.

🇺🇸

Omaha, Nebraska, United States

Clinical Investigations of Texas, LLC

🇺🇸

Plano, Texas, United States

All Florida Orthopaedic Associates

🇺🇸

Saint Petersburg, Florida, United States

Accord Clinical Research, LLC

🇺🇸

Port Orange, Florida, United States

Office of Dr. Danka Michaels, MD

🇺🇸

Las Vegas, Nevada, United States

Maine Research Associates

🇺🇸

Auburn, Maine, United States

MAPS Applied Research Center

🇺🇸

Edina, Minnesota, United States

Pharmquest

🇺🇸

Greensboro, North Carolina, United States

Early Family Practice Center

🇺🇸

Fort Valley, Georgia, United States

Arthritis and Diabetes Clinic

🇺🇸

Monroe, Louisiana, United States

Rheumatology, PC

🇺🇸

Kalamazoo, Michigan, United States

Clinical Research Consortium

🇺🇸

Las Vegas, Nevada, United States

Northeast Georgia Diagnostic Clinic

🇺🇸

Gainesville, Georgia, United States

Arthritis and Osteoporosis Center of Brooklyn Heights

🇺🇸

Brooklyn, New York, United States

EPIC Imaging West

🇺🇸

Beaverton, Oregon, United States

Ann Arbor Clinical Research

🇺🇸

Ann Arbor, Michigan, United States

Mansfield Health Center

🇺🇸

Mansfield, Massachusetts, United States

Prem C. Chatpar, MD, LLC

🇺🇸

Plainview, New York, United States

Pioneet Research Solutions, Inc

🇺🇸

Houston, Texas, United States

Hilltop Physicians Inc, Hightop Medical Research Center

🇺🇸

Cincinnati, Ohio, United States

New Mexico Clinical Research & Osteoporosis Center, Incorporated

🇺🇸

Albuquerque, New Mexico, United States

Office of Dr. Andrew Porges

🇺🇸

Roslyn, New York, United States

Pharmacotherapy Research Associates,Inc

🇺🇸

Zanesville, Ohio, United States

East Penn Rheumatology Associates, PC

🇺🇸

Bethlehem, Pennsylvania, United States

Walter Chase MD

🇺🇸

Austin, Texas, United States

Holston Medical Group

🇺🇸

Kingsport, Tennessee, United States

Altoona Center for Clinical Research

🇺🇸

Duncansville, Pennsylvania, United States

Health Concepts

🇺🇸

Rapid City, South Dakota, United States

Appalachian Medical Research Inc.

🇺🇸

Johnson City, Tennessee, United States

Capital Medical Clinic

🇺🇸

Austin, Texas, United States

Charlottesville Medical Research

🇺🇸

Charlottesville, Virginia, United States

Internal Medicine Northwest, Frank S Baker Center

🇺🇸

Tacoma, Washington, United States

Clinical Trials Northwest

🇺🇸

Yakima, Washington, United States

Compass Research, LLC

🇺🇸

Orlando, Florida, United States

The Center for Rheumatology and Bone Research

🇺🇸

Wheaton, Maryland, United States

American Health Network of IN, LLC

🇺🇸

Fishers, Indiana, United States

Radiant Research

🇺🇸

Dallas, Texas, United States

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