A Study to Evaluate the Safety and Efficacy of Upadacitinib in Participants With Giant Cell Arteritis
- Conditions
- Giant Cell Arteritis (GCA)
- Interventions
- Registration Number
- NCT03725202
- Lead Sponsor
- AbbVie
- Brief Summary
This study consists of two periods. The objective of Period 1 is to evaluate the efficacy of upadacitinib in combination with a 26-week corticosteroid (CS) taper regimen compared to placebo in combination with a 52-week CS taper regimen, as measured by the proportion of participants in sustained remission at Week 52, and to assess the safety and tolerability of upadacitinib in participants with giant cell arteritis (GCA). The objective of Period 2 is to evaluate the safety and efficacy of continuing versus withdrawing upadacitinib in maintaining remission in participants who achieved sustained remission in Period 1.
Safety and efficacy data through 06 February 2024 are included in the interim analysis, which was conducted after all participants completed the Week 52 visit or discontinued from the study.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 438
-
Diagnosis of giant cell arteritis (GCA) according to the following criteria:
- History of erythrocyte sedimentation rate (ESR) >= 50 mm/hour or high sensitivity C-reactive protein (hsCRP)/CRP >=1.0 mg/dL
- Presence of at least one of the following: Unequivocal cranial symptoms of GCA or Unequivocal symptoms of polymyalgia rheumatica (PMR)
- Presence of at least one of the following: temporal artery biopsy revealing features of GCA or evidence of large vessel vasculitis by angiography or cross-sectional imaging such as ultrasound, magnetic resonance imaging (MRI), computed tomography (CT) or positron emission tomography (PET).
-
Active GCA, either new onset or relapsing, within 8 weeks of Baseline.
-
Participants must have received treatment with >=40 mg prednisone (or equivalent) at any time prior to Baseline and be receiving prednisone (or equivalent) >= 20 mg once daily (QD) at Baseline.
-
Participants must have GCA that, in the opinion of the investigator, is clinically stable to allow the participant to safely initiate the protocol-defined corticosteroid (CS) taper regimen.
-
Females must either be postmenopausal or permanently surgically sterile or, practicing at least 1 specified method of birth control through the study.
-
Prior exposure to any Janus Kinase (JAK) inhibitor.
-
Treatment with an interleukin-6 (IL-6) inhibitor within 4 weeks of study start, or prior treatment with an IL-6 inhibitor and experienced a disease flare during treatment.
-
Use of any of the following systemic immunosuppressant treatments within the specified timeframe prior to study start:
- Anakinra within 1 week of study start.
- Methotrexate, hydroxychloroquine, cyclosporine, azathioprine, or mycophenolate within 4 weeks of study start.
- Oral corticosteroid (CS) for conditions other than GCA within 4 week of study start, or intravenous CS within 4 weeks of study start.
- Greater than or equal to 8 weeks for leflunomide if no elimination procedure was followed, or adhere to an elimination procedure.
- Cell-depleting agents or alkylating agents including cyclophosphamide within 6 months of study start.
-
Current or past history of infection including herpes zoster or herpes simplex, human immunodeficiency virus (HIV), active Tuberculosis, active or chronic recurring infection, active hepatitis B or C.
-
Female who is pregnant, breastfeeding, or considering pregnancy during the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo + 52-week CS taper Corticosteroid (CS) Participants received placebo tablets for upadacitinib administered orally once daily (QD) for 52 weeks and a 52-week corticosteroid (CS) taper regimen during Period 1. Placebo + 52-week CS taper Placebo Participants received placebo tablets for upadacitinib administered orally once daily (QD) for 52 weeks and a 52-week corticosteroid (CS) taper regimen during Period 1. 7.5 mg Upadacitinib + 26-week CS taper Upadacitinib Participants received 7.5 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1. 7.5 mg Upadacitinib + 26-week CS taper Corticosteroid (CS) Participants received 7.5 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1. 15 mg Upadacitinib + 26-week CS taper Upadacitinib Participants received 15 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1. 15 mg Upadacitinib + 26-week CS taper Corticosteroid (CS) Participants received 15 mg upadacitinib tablets administered orally once daily (QD) for 52 weeks and a 26-week corticosteroid (CS) taper regimen during Period 1. Placebo + 52-week CS taper -> Placebo Placebo Participants who achieved sustained remission for at least 24 weeks prior to the Week 52 visit (at the end of Period 1) OR at remission at the Week 52 visit only who were assigned to placebo tablets for upadacitinib administered orally once daily (QD) in Period 1 continued to receive placebo tablets for upadacitinib administered orally once daily (QD) in Period 2. 7.5 mg Upadacitinib + 26-week CS taper -> 7.5 mg Upadacitinib Upadacitinib Participants received 7.5 mg upadacitinib tablets administered orally once daily (QD) in Period 2. 7.5 mg Upadacitinib + 26-week CS taper -> Placebo Placebo Participants received placebo tablets for upadacitinib administered orally once daily (QD) in Period 2. 15 mg Upadacitinib + 26-week CS taper -> 15 mg Upadacitinib Upadacitinib Participants received 15 mg upadacitinib tablets administered orally once daily (QD) in Period 2. 15 mg Upadacitinib + 26-week CS taper -> Placebo Placebo Participants received placebo tablets for upadacitinib administered orally once daily (QD) in Period 2.
- Primary Outcome Measures
Name Time Method Percentage of Participants Achieving Sustained Remission at Week 52 From Week 12 to Week 52 Sustained remission is defined as having achieved absence of giant cell arteritis (GCA) signs and symptoms from Week 12 through Week 52, and adherence to the protocol-defined corticosteroid (CS) taper regimen.
- Secondary Outcome Measures
Name Time Method Percentage of Participants Achieving Sustained Complete Remission From Week 12 Through Week 52 Week 12 through Week 52 Sustained complete remission is defined as having absence of giant cell arteritis (GCA) signs and symptoms from Week 12 through Week 52; normalization of erythrocyte sedimentation rate (ESR); normalization of high sensitivity C-reactive protein (hs-CRP) and adherence to the protocol-defined CS taper regimen.
Cumulative Corticosteroid (CS) Exposure Through Week 52 Baseline up to Week 52 The cumulative exposure to corticosteroid(s) through Week 52 of the study was documented.
Time to First Disease Flare Through Week 52 Baseline up to Week 52 Disease flare is defined as an event determined by the investigator to represent recurrence of Giant Cell Arteritis (GCA) signs or symptoms or an erythrocyte sedimentation rate (ESR) measurement \> 30 mm/hr (attributable to GCA) AND requiring an increase in corticosteroid (CS) dose.
Percentage of Participants Who Experience at Least 1 Disease Flare Through Week 52 Baseline up to Week 52 The percentage of participants who experience at least 1 disease flare was calculated. Disease flare is defined as an event determined by the investigator to represent recurrence of Giant Cell Arteritis (GCA) signs or symptoms or an erythrocyte sedimentation rate (ESR) measurement \> 30 mm/hr (attributable to GCA) AND requiring an increase in corticosteroid (CS) dose.
Percentage of Participants in Complete Remission at Week 52 At Week 52 Complete remission is defined as having achieved absence of Giant Cell Arteritis (GCA) signs and symptoms; normalization of erythrocyte sedimentation rate (ESR) to \< 30 mm/hr-- if ESR ≥30 mm/hr and elevation is not attributable to GCA, this criterion can still be met); normalization of high sensitivity C-reactive protein (hs-CRP) to \< 1 mg/dL; and adherence to the protocol-defined corticosteroid (CS) taper regimen.
Percentage of Participants in Complete Remission at Week 24 At Week 24 Complete remission is defined as having achieved absence of Giant Cell Arteritis (GCA) signs and symptoms; normalization of erythrocyte sedimentation rate (ESR) to \< 30 mm/hr-- if ESR ≥30 mm/hr and elevation is not attributable to GCA, this criterion can still be met); normalization of high sensitivity C-reactive protein (hs-CRP) to \< 1 mg/dL; and adherence to the protocol-defined corticosteroid (CS) taper regimen.
Change From Baseline in the 36-item Short Form Quality of Life Questionnaire (SF-36) Physical Component Summary (PCS) Score at Week 52 Baseline, Week 52 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 (PCS) 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 the Baseline score indicates improvement.Number of Disease Flares Per Participant Through Week 52 Baseline up to Week 52 The number of disease flares per participant during Period 1 was documented, and was adjusted by the duration of study participation.
Change From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) at Week 52 Baseline, Week 52 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, functional fatigue, emotional fatigue, and social consequences of fatigue. 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 items 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.
Assessment of Treatment Satisfaction Questionnaire for Medication (TSQM) Patient Global Satisfaction Subscale at Week 52 At Week 52 The Treatment Satisfaction Questionnaire for Medications (TSQM) is a generic ePRO measure of treatment satisfaction, developed to compare treatment satisfaction between medication types and conditions. TSQM comprises of 14 items to assess 4 domains (effectiveness, side effects, convenience, and global satisfaction). The TSQM items are rated on a Likert scale (1 = extremely dissatisfied to 7 = extremely satisfied). Scores for each of the 4 domains range from 0 to 100, with higher scores corresponding to higher satisfaction. A positive change from Baseline indicates improvement.
Rate of Corticosteroid-related Adverse Events Though Week 52 Baseline up to Week 52 The rate of corticosteroid-related adverse events was calculated, and was adjusted by duration of study drug exposure.
Trial Locations
- Locations (172)
Omega Research Group /ID# 201903
🇺🇸Orlando, Florida, United States
Universitair Ziekenhuis Leuven /ID# 202779
🇧🇪Leuven, Vlaams-Brabant, Belgium
Duplicate_University of Alberta Hospital - Division of Hematology /ID# 208629
🇨🇦Edmonton, Alberta, Canada
Spitalul Clinic Colentina /ID# 204889
🇷🇴Bucuresti, Romania
Porter Rheumatology Ltd /ID# 223830
🇳🇿Nelson, New Zealand
Drammen Sykehus /ID# 201560
🇳🇴Drammen, Buskerud, Norway
Haukeland universitetssjukehus /ID# 201602
🇳🇴Bergen, Hordaland, Norway
Rikshospitalet OUS HF /ID# 202004
🇳🇴Oslo, Norway
Unidade Local de Saude de Gaia/Espinho, EPE /ID# 208151
🇵🇹Vila Nova de Gaia, Porto, Portugal
Unidade Local de Saúde do Alto Minho, EPE - Hospital Conde de Bertiandos /ID# 205186
🇵🇹Ponte de Lima, Viana Do Castelo, Portugal
Unidade Local de Saúde da Guarda, EPE /ID# 224878
🇵🇹Guarda, Portugal
Unidade Local de Saude de Santa Maria, EPE /ID# 203530
🇵🇹Lisboa, Portugal
Spitalul Clinic Judetean de Urgenta Cluj -Napoca /ID# 204887
🇷🇴Cluj-Napoca, Cluj, Romania
Cabinet Medical Dr. Avram S.R.L /ID# 224336
🇷🇴Timisoara, Timis, Romania
Spitalul Clinic Sf. Maria /ID# 203809
🇷🇴Bucuresti, Romania
Kemerovo State Medical University /ID# 203676
🇷🇺Kemerovo, Kemerovskaya Oblast, Russian Federation
Moscow Regional Research and Clinical Institute n.a. Vladimirskiy (MONIKI) /ID# 221643
🇷🇺Moscow, Moskovskaya Oblast, Russian Federation
Practicheskaya Medicina Clinic /ID# 224612
🇷🇺Moscow, Russian Federation
Rheum Assoc of North Alabama /ID# 168668
🇺🇸Huntsville, Alabama, United States
Arizona Arthritis and Rheumatology Research - Glendale Office /ID# 204702
🇺🇸Glendale, Arizona, United States
VA Long Beach Healthcare System /ID# 203833
🇺🇸Long Beach, California, United States
Robin K. Dore MD, Inc /ID# 201950
🇺🇸Tustin, California, United States
Denver Arthritis Clinic /ID# 171552
🇺🇸Denver, Colorado, United States
Duplicate_Western Connecticut Health Network- Germantown Rd /ID# 205071
🇺🇸Danbury, Connecticut, United States
Rheumatology Associates of South Florida (RASF) - Clinical Research /ID# 169040
🇺🇸Boca Raton, Florida, United States
Lakes Research, LLC /ID# 210442
🇺🇸Miami, Florida, United States
Ctr Arthritis & Rheumatic Dise /ID# 168667
🇺🇸Miami, Florida, United States
Medallion Clinical Research Institute, LLC /ID# 168666
🇺🇸Naples, Florida, United States
IRIS Research and Development, LLC /ID# 169406
🇺🇸Plantation, Florida, United States
Clinical Research of West Florida - Tampa /ID# 201899
🇺🇸Tampa, Florida, United States
Clinical Research of West Florida, Inc /ID# 201901
🇺🇸Tampa, Florida, United States
Duplicate_University of South Florida /ID# 207077
🇺🇸Tampa, Florida, United States
Lovelace Scientific Resources /ID# 169041
🇺🇸Venice, Florida, United States
Arthritis and Rheumatology /ID# 170295
🇺🇸Atlanta, Georgia, United States
Institute of Arthritis Research /ID# 168490
🇺🇸Idaho Falls, Idaho, United States
Duplicate_Rush University Medical Center /ID# 224581
🇺🇸Chicago, Illinois, United States
Ochsner Clinic Foundation /ID# 200723
🇺🇸Baton Rouge, Louisiana, United States
The Arthritis & Diabetes Clinic, Inc. /ID# 171199
🇺🇸Monroe, Louisiana, United States
Ochsner Clinic Foundation-New Orleans /ID# 171200
🇺🇸New Orleans, Louisiana, United States
Louisiana State Univ HSC /ID# 202646
🇺🇸Shreveport, Louisiana, United States
Rheumatology Associates PA - Portland /ID# 225011
🇺🇸Portland, Maine, United States
The Center for Rheumatology and Bone Research /ID# 168652
🇺🇸Wheaton, Maryland, United States
University of Michigan Hospitals /ID# 168645
🇺🇸Ann Arbor, Michigan, United States
Wayne State University Health Center /ID# 212755
🇺🇸Detroit, Michigan, United States
Henry Ford Medical Center - New Center One /ID# 207456
🇺🇸Detroit, Michigan, United States
Duplicate_AA Medical Research Center - Grand Blanc /ID# 201854
🇺🇸Grand Blanc, Michigan, United States
Duplicate_West Michigan Rheumatology /ID# 168647
🇺🇸Grand Rapids, Michigan, United States
Clinvest Research LLC /ID# 208182
🇺🇸Springfield, Missouri, United States
Physician Research Collaboration, LLC /ID# 168610
🇺🇸Lincoln, Nebraska, United States
University Clinical Research Center /ID# 202504
🇺🇸Somerset, New Jersey, United States
University of Rochester Medical Center /ID# 213527
🇺🇸Rochester, New York, United States
Marietta Memorial Hospital /ID# 210834
🇺🇸Marietta, Ohio, United States
STAT Research, Inc. /ID# 200436
🇺🇸Vandalia, Ohio, United States
University of Pennsylvania /ID# 168655
🇺🇸Philadelphia, Pennsylvania, United States
Piedmont Arthritis Clinic, PA /ID# 212431
🇺🇸Greenville, South Carolina, United States
Articularis Healthcare Group, Inc d/b/a Low Country Rheumatology /ID# 212761
🇺🇸Summerville, South Carolina, United States
West Tennessee Research Institute /ID# 209256
🇺🇸Jackson, Tennessee, United States
Arthritis Associates of Kingsport /ID# 212756
🇺🇸Kingsport, Tennessee, United States
Allen Arthritis /ID# 225527
🇺🇸Allen, Texas, United States
Tekton Research, L.L.C /ID# 201801
🇺🇸Austin, Texas, United States
Precision Comprehensive Clinical Research Solutions /ID# 201798
🇺🇸Colleyville, Texas, United States
West Texas Clinical Research /ID# 204834
🇺🇸Lubbock, Texas, United States
Arthritis and Rheumatology Institute, PLLC /ID# 214612
🇺🇸Plano, Texas, United States
First Moscow State Medical University n.a I.M. Sechenov /ID# 203673
🇷🇺Moscow, Russian Federation
Euromedservice /ID# 205345
🇷🇺Pushkin, Russian Federation
Clinical Rheumatologic Hospital No 25 /ID# 208950
🇷🇺St. Petersburg, Russian Federation
Complejo Hospitalario Universitario A Coruña /ID# 224731
🇪🇸A Coruña, A Coruna, Spain
Hospital Universitario Marques de Valdecilla /ID# 201604
🇪🇸Santander, Cantabria, Spain
Hospital Meixoeiro (CHUVI) /ID# 212084
🇪🇸Vigo, Pontevedra, Spain
Hospital Universitario Canarias /ID# 224928
🇪🇸San Cristóbal de La Laguna, Santa Cruz De Tenerife, Spain
Hospital Universitario Basurto /ID# 224730
🇪🇸Bilbao, Vizcaya, Spain
Hospital Clinic de Barcelona /ID# 201878
🇪🇸Barcelona, Spain
Hospital Universitario Virgen de las Nieves /ID# 224726
🇪🇸Granada, Spain
Hospital General Universitario Gregorio Maranon /ID# 201326
🇪🇸Madrid, Spain
Hospital Clinico San Carlos /ID# 204871
🇪🇸Madrid, Spain
Hospital Universitario La Paz /ID# 241848
🇪🇸Madrid, Spain
Skane University hospital /ID# 171407
🇸🇪Malmo, Skane Lan, Sweden
Karolinska University Hospital Solna /ID# 204945
🇸🇪Solna, Stockholms Lan, Sweden
Uppsala University Hospital /ID# 171403
🇸🇪Uppsala, Uppsala Lan, Sweden
Baylor Scott & White Center for Diagnostic Medicine /ID# 213529
🇺🇸Temple, Texas, United States
University of Vermont Medical Center /ID# 211179
🇺🇸Burlington, Vermont, United States
Carilion Clinic /ID# 212928
🇺🇸Roanoke, Virginia, United States
Kadlec Clinic Rheumatology /ID# 201618
🇺🇸Kennewick, Washington, United States
University of Washington /ID# 201619
🇺🇸Seattle, Washington, United States
Aurora Rheumatology and Immunotherapy Center /ID# 201853
🇺🇸Franklin, Wisconsin, United States
Froedtert Memorial Lutheran Hospital /ID# 224557
🇺🇸Milwaukee, Wisconsin, United States
Emeritus Research Sydney /ID# 201937
🇦🇺Botany, New South Wales, Australia
Prince of Wales Hospital /ID# 210995
🇦🇺Randwick, New South Wales, Australia
Griffith University /ID# 223829
🇦🇺Southport, Queensland, Australia
The Queen Elizabeth Hospital /ID# 201939
🇦🇺Woodville South, South Australia, Australia
Emeritus Research /ID# 201938
🇦🇺Camberwell, Victoria, Australia
Fiona Stanley Hospital /ID# 201941
🇦🇺Murdoch, Western Australia, Australia
Sahlgrenska Universitetssjukhuset /ID# 171405
🇸🇪Göteborg, Vastra Gotalands Lan, Sweden
Medizinische Universitaet Innsbruck /ID# 201786
🇦🇹Innsbruck, Tirol, Austria
Rheuma-Zentrum Wien-Oberlaa GmbH /ID# 201781
🇦🇹Vienna, Wien, Austria
Université Catholique de Louvain-Namur - Centre Hospitalier Universitaire Dinant /ID# 224334
🇧🇪Yvoir, Namur, Belgium
UZ Gent /ID# 202778
🇧🇪Gent, Oost-Vlaanderen, Belgium
St. Joseph's Healthcare /ID# 204160
🇨🇦Hamilton, Ontario, Canada
CISSSBSL -Hopital regional de Rimouski /ID# 224266
🇨🇦Rimouski, Quebec, Canada
Centre de Recherche Musculo-Squelettique /ID# 201224
🇨🇦Trois-rivières, Quebec, Canada
Rheumatology Associates /ID# 201843
🇨🇦Saskatoon, Saskatchewan, Canada
Fakultni nemocnice Olomouc /ID# 202041
🇨🇿Olomouc, Czechia
Axon Clinical, s.r.o. /ID# 202468
🇨🇿Praha, Czechia
Medical Plus, s.r.o. /ID# 200865
🇨🇿Uherske Hradiste, Czechia
Aarhus University Hospital /ID# 171177
🇩🇰Aarhus C, Midtjylland, Denmark
Sydvestjysk Sygehus /ID# 200216
🇩🇰Esbjerg, Syddanmark, Denmark
Hopital Saint Joseph /ID# 171540
🇫🇷Marseille, Bouches-du-Rhone, France
CHU Dijon /ID# 225277
🇫🇷Dijon, Cote-d Or, France
Hopital de la Cavale Blanche /ID# 171549
🇫🇷Brest, Finistere, France
CHU Toulouse - Hopital Purpan /ID# 171547
🇫🇷TOULOUSE Cedex 9, Haute-Garonne, France
Hopital Pitie Salpetriere /ID# 171542
🇫🇷Paris, Ile-de-France, France
CHRU Lille - Hopital Claude Huriez /ID# 171543
🇫🇷Lille, Nord, France
Hopitaux Universitaires Paris Centre-Hopital Cochin /ID# 171545
🇫🇷Paris CEDEX 14, Paris, France
CHU de Nantes, Hotel Dieu -HME /ID# 171544
🇫🇷Nantes, Pays-de-la-Loire, France
HCL - Hopital de la Croix-Rousse /ID# 211184
🇫🇷Lyon, Rhone, France
CHU de CAEN - Hopital de la Cote de Nacre /ID# 171539
🇫🇷Caen, France
CHRU Tours - Hopital Trousseau /ID# 245232
🇫🇷Chambray Les Tours, France
Medius Klinik Kirchheim /ID# 200637
🇩🇪Kirchheim unter Teck, Baden-Wuerttemberg, Germany
Duplicate_Danderyds sjukhus /ID# 171404
🇸🇪Stockholm, Sweden
Duplicate_Vastmanlands Sjukhus /ID# 171429
🇸🇪Vasteras, Sweden
Universitätsspital Basel /ID# 201767
🇨🇭Basel Town, Basel-Stadt, Switzerland
Kantonsspital St. Gallen /ID# 201134
🇨🇭St. Gallen, Sankt Gallen, Switzerland
Inselspital, Universitaetsspital Bern /ID# 201364
🇨🇭Bern, Switzerland
HFR Fribourg - Hôpital cantonal /ID# 201114
🇨🇭Fribourg, Switzerland
Universitaetsklinikum Tuebingen /ID# 223854
🇩🇪Tubingen, Baden-Wuerttemberg, Germany
Universitaetsklinikum Wuerzburg /ID# 213340
🇩🇪Wuerzburg, Bayern, Germany
Immanuel Krankenhaus Berlin /ID# 223855
🇩🇪Berlin-buch, Germany
Medizinische Versorgungszentren Burghausen Altoetting /ID# 208773
🇩🇪Burghausen, Germany
Medizinische Hochschule Hannover /ID# 200632
🇩🇪Hannover, Germany
General Hospital of Athens Gennimatas /ID# 210129
🇬🇷Athens, Attiki, Greece
General Hospital of Athens Ippokratio /ID# 202181
🇬🇷Athens, Attiki, Greece
424 General MILITARY Hospital /ID# 210973
🇬🇷Efkarpia (Thessalonikis), Thessaloniki, Greece
Debreceni Egyetem-Klinikai Kozpont /ID# 201526
🇭🇺Debrecen, Hajdu-Bihar, Hungary
Royal United Hospitals Bath /ID# 239850
🇬🇧Bath, Bath And North East Somerset, United Kingdom
Royal Devon & Exeter Hospital /ID# 202834
🇬🇧Exeter, Devon, United Kingdom
University Hospitals Dorset NHS Foundation Trust /ID# 202836
🇬🇧Poole, Dorset, United Kingdom
Del-Budai Centrumkorhaz Szent Imre Egyetemi Oktatokorhaz /ID# 201838
🇭🇺Budapest, Hungary
Barts Health NHS Trust /ID# 210511
🇬🇧London, Greater London, United Kingdom
UH Coventry & Warwickshire /ID# 202838
🇬🇧Coventry, Warwickshire, United Kingdom
Liverpool University University Hospitals NHS Foundation Trust /ID# 240391
🇬🇧Liverpool, United Kingdom
Portsmouth Hospitals University NHS Trust /ID# 225002
🇬🇧Portsmouth, United Kingdom
Southend Hospital /ID# 202839
🇬🇧Southend, United Kingdom
Betegapolo Irgalmasrend Budai Irgalmasrendi Korhaz /ID# 204018
🇭🇺Budapest, Hungary
Orszagos Reumatologiai es Fizioterapias Intezet /ID# 211454
🇭🇺Budapest, Hungary
Bnai Zion Medical Center /ID# 240733
🇮🇱Haifa, H_efa, Israel
The Lady Davis Carmel Medical Center /ID# 240731
🇮🇱Haifa, H_efa, Israel
Torbay and South Devon Nhs Foundation Trust /Id# 224689
🇬🇧Torquay, United Kingdom
The Chaim Sheba Medical Center /ID# 241041
🇮🇱Ramat Gan, Tel-Aviv, Israel
Azienda Sanitaria dell'Alto Adige /ID# 200081
🇮🇹Bolzano, Italy
Azienda Ospedaliero-Universitaria di Modena /ID# 200079
🇮🇹Modena, Italy
Azienda Ospedaliera Universitaria Friuli Centrale/Presidio Ospedaliero Universit /ID# 200082
🇮🇹Udine, Italy
Japan Organization of Occupational Health and Safety Chubu Rosai Hospital /ID# 202946
🇯🇵Nagoya-shi, Aichi, Japan
Kagawa University Hospital /ID# 200171
🇯🇵Kita-gun, Kagawa, Japan
St. Marianna University Hospital /ID# 218692
🇯🇵Kawasaki-shi, Kanagawa, Japan
Duplicate_Japanese Red Cross Kumamoto Hospital /ID# 203507
🇯🇵Kumamoto-shi, Kumamoto, Japan
Tohoku University Hospital /ID# 200172
🇯🇵Sendai-shi, Miyagi, Japan
Okayama University Hospital /ID# 203156
🇯🇵Okayama-shi, Okayama, Japan
Tomishiro Central Hospital /ID# 203897
🇯🇵Tomigusuku-shi, Okinawa, Japan
Sakai City Medical Center /ID# 202643
🇯🇵Sakai-shi, Osaka, Japan
Duplicate_Jichi Medical University Hosp /ID# 200169
🇯🇵Shimotsuke-shi, Tochigi, Japan
St.Luke's International Hospital /ID# 200170
🇯🇵Chuo-ku, Tokyo, Japan
Medisch Centrum Leeuwarden /ID# 201716
🇳🇱Leeuwarden, Friesland, Netherlands
Radboud Universitair Medisch Centrum /ID# 212925
🇳🇱Nijmegen, Gelderland, Netherlands
Zuyderland Medisch Centrum /ID# 224551
🇳🇱Heerlen, Limburg, Netherlands
ZiekenhuisGroep Twente /ID# 200038
🇳🇱Almelo, Overijssel, Netherlands
Duplicate_Erasmus Medisch Centrum /ID# 201717
🇳🇱Rotterdam, Zuid-Holland, Netherlands
Universitair Medisch Centrum Groningen /ID# 201715
🇳🇱Groningen, Netherlands
Optimal Clinical Trials Ltd /ID# 201946
🇳🇿Grafotn, Auckland, New Zealand
Aotearoa Clinical Trials /ID# 201942
🇳🇿Papatoetoe, Auckland, New Zealand
Timaru Medical Specialists Ltd /ID# 201943
🇳🇿Timaru, Canterbury, New Zealand
Waikato Hospital /ID# 201944
🇳🇿Hamilton, Waikato, New Zealand
CGM Research Trust /ID# 224061
🇳🇿Christchurch Central, New Zealand