Open Label Extension (OLE) Study of the Safety and Clinical Utility of IPX203 in Parkinson's Disease (PD) Participants With Motor Fluctuations
- Registration Number
- NCT03877510
- Lead Sponsor
- Impax Laboratories, LLC
- Brief Summary
The purpose of this study is to evaluate the long-term safety and clinical utility of IPX203 in the treatment of participants with advanced Parkinson's disease (PD) who have motor fluctuations.
- Detailed Description
This is a 9-month, multicenter open-label safety extension study. Participants who have successfully completed Study NCT03670953 \[A Randomized Controlled Study to Compare the Safety and Efficacy of IPX203 with Immediate-Release (IR) Carbidopa-Levodopa (CD-LD) in Parkinson's Disease Patients with Motor Fluctuations\] may have the opportunity to enroll in this open-label study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 419
- Successfully completed Study IPX203-B16-02
- Able to provide written informed consent prior to the conduct of any study-specific procedures.
- Female participants of childbearing potential must have a negative urine pregnancy test at the baseline visit (Visit 1).
- Agrees to use a medically acceptable method of contraception throughout the study and for 6 weeks after completing the study.
- Intends to use any doses of Rytary® or Duopa™ during this study.
- Plans to use an investigational treatment other than IPX203 during the course of this study.
- Neurosurgical ablation treatment for PD is planned or anticipated during the study period. Implantation of a deep brain stimulator (DBS) for the treatment of PD is permitted during this study.
- Participants who, in the opinion of the clinical investigator, should not participate in the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Open Label IPX203 IPX203 All participants received oral administration of extended-release capsules IPX203 dosing regimen that was determined at the end of the IPX203 dose conversion period of Study IPX203-B16-02 (NCT03670953) for nine months of open-label therapy. The dose and dosing frequency was determined by the investigator to achieve the optimal balance of efficacy and safety.
- Primary Outcome Measures
Name Time Method Number of Participants With Treatment-Emergent Adverse Events From first dose up to 1 day after last dose (Up to 9 months/Early Termination [ET]) An adverse event (AE) is any untoward medical occurrence in a participant or clinical trial participant administered a medicinal product and which does not necessarily have to have a causal relationship with this treatment. An adverse event can therefore be any unfavorable and unintended sign (e.g., an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE was considered as treatment-emergent if the date of onset was on or after the date of the first open-label study drug administration in this Study IPX203-B16-03 and no later than 1 day after the last study drug dose in the study.
- Secondary Outcome Measures
Name Time Method Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Total Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260).
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Total Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260).
Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part I Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part I score ranges from 0 to 52. A higher score indicated more severe symptoms of PD.
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part III Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part III score ranges from 0 to 132. A higher score indicated more severe symptoms of PD.
Change From Baseline in Patient Global Impression of Severity (PGI-S) Baseline, Month 9/ET The PGI-S is a participant answered assessment rating Parkinson's disease severity on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Extremely severely ill.
Clinical Global Impression of Severity (CGI-S) Baseline, Month 3, Month 6, Month 9/ET The CGI-S is a clinician scale rating the severity of the participant's illness on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Among the most extremely ill of participants.
Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part II Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part II score ranges from 0 to 52. A higher score indicated more severe symptoms of PD.
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Sums of Part II and Part III Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). The scale range for Part II+III score is 0-184. A higher score indicated more severe symptoms of PD.
Change From Baseline in Clinical Global Impression of Severity (CGI-S) Baseline, Month 9/ET The CGI-S is a clinician scale rating the severity of the participant's illness on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Among the most extremely ill of participants.
Treatment Satisfaction Assessment (TSA) Month 3, Month 6 and Month 9/ET The TSA is a participant answered assessment rating treatment satisfaction on a scale of 1 to 7; 1 = Very much dissatisfied being least satisfied and 7 = Very much satisfied.
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part I Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part I score ranges from 0 to 52. A higher score indicated more severe symptoms of PD.
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part II Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part II score ranges from 0 to 52. A higher score indicated more severe symptoms of PD.
Patient Global Impression of Severity (PGI-S) Baseline, Month 3, Month 6, and Month 9/ET The PGI-S is a participant answered assessment rating Parkinson's disease severity on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Extremely severely ill.
Percentage of Participants With a PGI-S ≥ 4 and PGI-S ≥ 5 Baseline, Month 3, Month 6, and Month 9/ET The PGI-S is a participant answered assessment rating Parkinson's disease severity on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Extremely severely ill.
Parkinson Anxiety Scale (PAS): Total Baseline, Month 3, Month 6, and Month 9/ET The PAS is a three part participant answered assessment. Part 1 has 5 questions measuring persistent anxiety. Each question ranges from 0 - not at all, or never to 4 severe, or nearly always. Best score is 0; worst score is 20. Part 2 has 4 questions measuring episodic anxiety. Each question ranges from 0 - never to 4 - nearly always. Best score is 0; worst score is 16. Part 3 has 3 questions measuring avoidance behavior. Each question ranges from 0, never to 4 nearly always. Best score is 0; worst score is 12. Totals for all three parts are summed and ranges from 0 to 48, higher scores are associated with the more severe symptoms.
Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part III Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part III score ranges from 0 to 132. A higher score indicated more severe symptoms of PD.
Change From Baseline in Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part IV Baseline, Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part IV score ranges from 0 to 24. A higher score indicated more severe symptoms of PD.
Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Sums of Part II and Part III Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). The scale range for Part II+III score is 0-184. A higher score indicated more severe symptoms of PD.
Change From Baseline in PDQ-39: Total Baseline, Month 9/ET The PDQ-39 is a self-reported outcome of 39 questions relating to 8 domains: mobility (Questions 1-10), activities of daily living (ADL) (Questions 11-16), emotional well-being (Questions 17-22), stigma (Questions 23-26), social support (Questions 27-29), cognition (Questions 30-33), communication (Questions 34-36) and bodily discomfort (Questions 37-39). Each question is answered on a 5-point scale from 0 (Never) to 4 (Always / Cannot Do At All). Scores are calculated by summing the answers to the questions in the domain and converting to a scale from 0 to 100. Higher scores are associated with the more severe symptoms of the disease such as tremor and stiffness.
Change From Baseline in Parkinson Anxiety Scale (PAS): Total Baseline, Month 9/ET The PAS is a three part participant answered assessment. Part 1 has 5 questions measuring persistent anxiety. Each question ranges from 0 - not at all, or never to 4 severe, or nearly always. Best score is 0; worst score is 20. Part 2 has 4 questions measuring episodic anxiety. Each question ranges from 0 - never to 4 - nearly always. Best score is 0; worst score is 16. Part 3 has 3 questions measuring avoidance behavior. Each question ranges from 0, never to 4 nearly always. Best score is 0; worst score is 12. Totals for all three parts are summed and ranges from 0 to 48, higher scores are associated with the more severe symptoms.
Movement Disorders Society Version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Part IV Baseline, Month 3, Month 6, and Month 9/ET MDS-UPDRS is a multimodal scale assessing impairment and disability consisting of 4 parts. (Part I; 13 items) non-motor experiences of daily living, (Part II; 13 items) motor experiences of daily living completed by the participants, (Part III; 33 items) motor examination of PD and was administered by the rater, and (Part IV; 6 items) motor complication integrates participant-derived information with the rater's clinical observations and judgements and is completed by the rater. For each question a numeric score was assigned between 0-4, where 0 = Normal, 1 = Slight, 2 = Mild, 3 = Moderate, 4 = Severe. MDS-UPDRS Total Score equals the sum of Parts I, II, and III and IV (Range 0-260). Part IV score ranges from 0 to 24. A higher score indicated more severe symptoms of PD.
Percentage of Participants With a CGI-S ≥ 4 and CGI-S ≥ 5 Baseline, Month 3, Month 6, and Month 9/ET The CGI-S is a clinician scale rating the severity of the participant's illness on a scale of 1 to 7; 1-Normal, not at all ill, 2-Borderline ill, 3-Mildly ill, 4-Moderately ill, 5-Markedly ill, 6-Severely ill, 7-Among the most extremely ill of participants.
39-item Parkinson's Disease Questionnaire (PDQ-39): Total Baseline, Month 3, Month 6, and Month 9/ET The PDQ-39 is a self-reported outcome of 39 questions relating to 8 domains: mobility (Questions 1-10), activities of daily living (ADL) (Questions 11-16), emotional well-being (Questions 17-22), stigma (Questions 23-26), social support (Questions 27-29), cognition (Questions 30-33), communication (Questions 34-36) and bodily discomfort (Questions 37-39). Each question is answered on a 5-point scale from 0 (Never) to 4 (Always / Cannot Do At All). Scores are calculated by summing the answers to the questions in the domain and converting to a scale from 0 to 100. Higher scores are associated with the more severe symptoms of the disease such as tremor and stiffness.
Change From Baseline in Non-Motor Symptom Assessment Scale (NMSS) for Parkinson's Disease (PD): Total Baseline, Month 9/ET The NMSS assesses non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous. Severity symptoms are rated on a scale of 0-3 with 3 being most severe; and frequency on a scale of 1-4 with 4 being most frequent. Each question is answered with a severity and frequency rating which are then multiplied. The sum of the products gives the total score which ranges from 0 to 360 with a lower score more desirable than a higher score.
Parkinson's Disease Sleep Scale-2 (PDSS-2) Total Baseline, Month 3, Month 6, and Month 9/ET The PDSS-2 is a 15 question participant response scale measuring the severity of sleep disturbance. Three domains are defined: disturbed sleep (Questions 1-3, 8, 14), motor symptoms at night (Questions 4-6, 12, 13), PD symptoms at night (Questions 7, 9-11, 15). Each question is rated as very often to never on a scale of 0-4. The best overall score is 0; the worst overall score is 60.
Change From Baseline in Parkinson's Disease Sleep Scale-2 (PDSS-2):Total Baseline, Month 9/ET The PDSS-2 is a 15 question participant response scale measuring the severity of sleep disturbance. Three domains are defined: disturbed sleep (Questions 1-3, 8, 14), motor symptoms at night (Questions 4-6, 12, 13), PD symptoms at night (Questions 7, 9-11, 15). Each question is rated as very often to never on a scale of 0-4. The best overall score is 0; the worst overall score is 60.
Percentage of Participants With TSA Scores 5-7 (Satisfied) Versus Scores 1-4 (Dissatisfied or Neutral) Month 3, Month 6, and Month 9/ET The TSA is a participant answered assessment rating treatment satisfaction on a scale of 1 to 7; 1 = Very much dissatisfied being least satisfied and 7 = Very much satisfied.
Non-Motor Symptom Assessment Scale (NMSS) for Parkinson's Disease (PD): Total Baseline, Month 3, Month 6, and Month 9/ET The NMSS assesses non-motor symptoms in Parkinson's Disease. It consists of 30 questions grouped into 9 domains: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, attention/memory, gastro-intestinal tract, urinary, sexual function, and miscellaneous. Severity symptoms are rated on a scale of 0-3 with 3 being most severe; and frequency on a scale of 1-4 with 4 being most frequent. Each question is answered with a severity and frequency rating which are then multiplied. The sum of the products gives the total score which ranges from 0 to 360 with a lower score more desirable than a higher score.
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Trial Locations
- Locations (98)
University Hospitals Cleveland Medical Center (123)
🇺🇸Cleveland, Ohio, United States
Neurology Consultants of Dallas, PA (108)
🇺🇸Dallas, Texas, United States
Northwestern Medical Group Neurology Clinic (145)
🇺🇸Chicago, Illinois, United States
Emory Brain Health Center (110)
🇺🇸Atlanta, Georgia, United States
Indiana University Health Neuroscience Center(164)
🇺🇸Indianapolis, Indiana, United States
Clinical Trials, Inc (113)
🇺🇸Little Rock, Arkansas, United States
Hospital Universitari Mutua Terrassa (506)
🇪🇸Terrassa, Barcelona, Spain
St. Joseph's Hospital & Medical Center - Barrow Neurological Institute (156)
🇺🇸Phoenix, Arizona, United States
The Vanderbilt Clinic (158)
🇺🇸Nashville, Tennessee, United States
IRCCS San Raffaele Pi sana (600)
🇮🇹Roma, Italy/Roma/Lazio, Italy
Department of neuroscience, mental health and sensory system (NeSMOS), "Sapienza" University (603)
🇮🇹Roma, Italy/Roma/Lazio, Italy
Xenoscience, Inc (102)
🇺🇸Phoenix, Arizona, United States
University of Arkansas for Medical Sciences (117)
🇺🇸Little Rock, Arkansas, United States
Hoag Memorial Hospital Presbyterian (134)
🇺🇸Newport Beach, California, United States
Keek School of Medicine of USC/ University of Southern California (106)
🇺🇸Los Angeles, California, United States
SC3 Research-Reseda (146)
🇺🇸Reseda, California, United States
SC3 Research-Pasadena (148)
🇺🇸Pasadena, California, United States
ChristianaCare Neurology Specialists (153)
🇺🇸Newark, Delaware, United States
Visionary Investigators Network (168)
🇺🇸Aventura, Florida, United States
JEM Research Institute (136)
🇺🇸Atlantis, Florida, United States
Parkinson's Disease and Movement Disorders Center of Boca Raton (121)
🇺🇸Boca Raton, Florida, United States
UHealth at Boca Raton (152)
🇺🇸Boca Raton, Florida, United States
University of Miami (149)
🇺🇸Miami, Florida, United States
Infinity Clinical Research LLC (104)
🇺🇸Hollywood, Florida, United States
Medical Professional Clinical Research Center, Inc. (163)
🇺🇸Miami, Florida, United States
Charter Research (166)
🇺🇸Winter Park, Florida, United States
Infinity Clinical Research, LLC (105)
🇺🇸Sunrise, Florida, United States
University of Kansas Medical Center (118)
🇺🇸Kansas City, Kansas, United States
Quest Research Institute (103)
🇺🇸Farmington Hills, Michigan, United States
Roseman Medical Research Institute / Roseman Medical Group (154)
🇺🇸Las Vegas, Nevada, United States
Washington University (109)
🇺🇸Saint Louis, Missouri, United States
Cleveland Clinic Lou Ruvo Center for Brain Health (142)
🇺🇸Las Vegas, Nevada, United States
Albany Medical College (139)
🇺🇸Albany, New York, United States
Cleveland Clinic(144)
🇺🇸Cleveland, Ohio, United States
University of Toledo, Gardner-McMaster Parkinson Center (122)
🇺🇸Toledo, Ohio, United States
The Movement Disorder Clinic of Oklahoma (115)
🇺🇸Tulsa, Oklahoma, United States
University of Texas Southwestern Medical Center (143)
🇺🇸Dallas, Texas, United States
Houston Methodist Neurological Institute/Movement Disorders Clinic (135)
🇺🇸Houston, Texas, United States
Booth Gardner Parkinson's Care Center (112)
🇺🇸Kirkland, Washington, United States
Inland Northwest Research (119)
🇺🇸Spokane, Washington, United States
Fakultni nemocnice u sv. Anny v Brne, I. neurologicka klinika (704)
🇨🇿Brno, Czechia
Nemocnice Pardubickeho kraje, a.s., Pardubicka nemocnice, Neurologicka klinika (702)
🇨🇿Pardubice, Czechia
CLINTRIAL s.r.o. (703)
🇨🇿Praha 10, Czechia
Centre Hospitalier Universitaire de Nice (400)
🇫🇷Nice, France
Centre d'lnvestigation Clinique 1436- CHU Purpan- Hopital Pierre Paul Riquet (403)
🇫🇷Toulouse Cedex 9, France
Neurologicka ordinace FORBELI s.r.o. (706)
🇨🇿Praha 6, Czechia
Kliniken Beelitz GmbH, neurologisches Fachkrankenhaus fur Bewegungsstorungen/Parkinson (300)
🇩🇪Beelitz-Heilstätten, Beelitz, Germany
Klinik Haag i. OB Geriatric Hospital Krankenhausstrabe 4 (305)
🇩🇪Haag In Oberbayern, Germany
Centro Ricerca Parkinson San Raffaele Cassino (601)
🇮🇹Cassino, Frosinone, Italy
Dr. med. Reinhardt Ehret Neuroloqie Berlin Schlobstr. 29 (309)
🇩🇪Berlin, Germany
Università G. D'annunzio CeSi Met (604)
🇮🇹Chieti, Italy/Chieti/Abbruzzo, Italy
Fondazione I st ituto Neurologico Nazionale "C. Mondino" (606)
🇮🇹Pavia, Italy/Pavia/Lombardia, Italy
Azienda Ospedaliero-Universitaria Pisana (602)
🇮🇹Pisa, Italy/Pisa/Toscana, Italy
Department "G. F. Ingrassia" section of neuroscience - Policlinico "Vittorio Emanuele" (608)
🇮🇹Catania, Sicily, Italy
University of Rome Tor Vergata/Hospital Tor Vergata (605)
🇮🇹Roma, Lazio, Italy
Centrum Medyczne Neuromed (803)
🇵🇱Bydgoszcz, Poland
Centrum Medyczne Linden (805)
🇵🇱Kraków, Poland
Krakowska Akademia Neurologii Sp. Zo.o.(802)
🇵🇱Kraków, Poland
NZOZ Neuro-Kard Ilkowski i Partnerzy Spolka Partnerska Lekarzy (801)
🇵🇱Poznań, Poland
NZOZ Neuromed M. i M. Nastaj Sp.p. (800)
🇵🇱Lublin, Poland
Hospital General Universitario de Elche (509)
🇪🇸Elche, Alicante, Spain
Neuro-Care Sp. z o.o. sp. k. (804)
🇵🇱Siemianowice Śląskie, Poland
Centrum Medycme NeuroProtect (806)
🇵🇱Warszawa, Poland
Hospital Universitari General de Catalunya (504)
🇪🇸Sant Cugat Del Vallès, Barcelona, Spain
Clinica Universidad de Navarra (512)
🇪🇸Pamplona, Navarra, Spain
Hospital Universitario Quiron Dexeus (501)
🇪🇸Barcelona, Spain
Germanes Hospitalaries Del Sagrat Cor De Jesus Hospital Sant Rafael (516)
🇪🇸Barcelona, Spain
Hospital Universitario Vall d'Hebron (505)
🇪🇸Barcelona, Spain
Hospital Universitario de Ia Princesa (508)
🇪🇸Madrid, Spain
Hospital Universitario Ramon y Cajal (500)
🇪🇸Madrid, Spain
Hospital Universitario y Politecnico La Fe Avenida Fernando Abril Martorell (515)
🇪🇸Valencia, Spain
Imperial College Healthcare NI-lS Trust (200)
🇬🇧London, United Kingdom
Re:Cognition Health Ltd (205)
🇬🇧Plymouth, Devon, United Kingdom
Hospital Universitario Virgen del Rocio (503)
🇪🇸Sevilla, Spain
Re:Cognition Health Ltd (202)
🇬🇧London, United Kingdom
Ucgni (133)
🇺🇸Cincinnati, Ohio, United States
Inova Neurology- Fairfax (147)
🇺🇸Fairfax, Virginia, United States
VCU Health- Neuroscience Orthopaedic and Wellness Center(124)
🇺🇸Henrico, Virginia, United States
University of Florida Health Science Center (129)
🇺🇸Jacksonville, Florida, United States
St. Josef-Hospital, Universitatsklinik fur Neurologie Klinisches Forschungszentrum fur Neurodegeneration (301)
🇩🇪Bochum, Gudrunstabe 56, Germany
Rocky Mountain Movement Disorders (116)
🇺🇸Englewood, Colorado, United States
Neurology Associates, P.A. (125)
🇺🇸Maitland, Florida, United States
Parkinson's Disease Treatment Center of Southwest Florida (131)
🇺🇸Port Charlotte, Florida, United States
Central DuPage Hospital (151)
🇺🇸Winfield, Illinois, United States
NeuroStudies.net, LLC (155)
🇺🇸Decatur, Georgia, United States
CHU de Montpellier, Hopital Gui de Chauliac (405)
🇫🇷Montpellier Cedex 5, France
Henry Ford West Bloomfield Hospital(100)
🇺🇸West Bloomfield, Michigan, United States
NEUROHK. s.r.o. (701)
🇨🇿Choceň, Czechia
AXON Clinical. s.r.o. (700)
🇨🇿Praha 5, Czechia
CHU de Clermont-Ferrand-Hopital Gabriel Montpied (404)
🇫🇷Clermont-Ferrand Cedex 1, France
Gemeinschaftspraxis Dr. med. J. Springub/W. Schwarz, Studienzentrum Nordwest (306)
🇩🇪Westerstede, Germany
Klinikum rechts der lsar der Technischen Universitat Munchen Klinik und Poliklinik fur Neurologie (303)
🇩🇪München, Ismaningerstrabe, Germany
Policlinica Gipuzkoa, S.A (511)
🇪🇸Donostia San Sebastian, Gipuzkoa, Spain
Hospital de Ia Santa Creu i Sant Pau (502)
🇪🇸Barcelona, Spain
Hospital Universitario Infanta Sofia(513)
🇪🇸Madrid, Spain
University of Colorado Hospital Anschutz Outpatient Pavilion (120)
🇺🇸Aurora, Colorado, United States
University of South Florida (114)
🇺🇸Tampa, Florida, United States
Premiere Research Institute at Palm Beach Neurology (174)
🇺🇸West Palm Beach, Florida, United States