Study Comparing Lopinavir/Ritonavir (LPV/r) + Emtricitabine/Tenofovir Disoproxil Fumarate (FTC/TDF) With a Nucleoside Sparing Regimen Consisting of Lopinavir/Ritonavir + Raltegravir (RAL)
- Conditions
- Human Immunodeficiency Virus Infection
- Interventions
- Drug: lopinavir/ritonavir (LPV/r)Drug: emtricitabine/tenofovir disoproxil fumarate (FTC/TDF)
- Registration Number
- NCT00711009
- Lead Sponsor
- Abbott
- Brief Summary
The purpose of this study is to compare the safety, tolerability, and antiviral activity of the lopinavir/ritonavir tablet when administered in combination with reverse transcriptase inhibitors to lopinavir/ritonavir tablets when administered in combination with a human immunodeficiency virus type 1 ( HIV-1) integrase inhibitor in antiretroviral naive HIV-1 infected subjects.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 206
- Participants must provide written, voluntary informed consent to participate in the study.
- Participants must be naive to antiretroviral treatment with HIV RNA greater than or equal to 1,000 copies/mL at screening, and in the investigator's opinion, require antiretroviral therapy.
- Participant's vital signs, physical examination, and laboratory results must not exhibit evidence of acute illness.
- Participant has not been treated for an active acquired immune deficiency syndrome (AIDS)-defining opportunistic infection within 45 days of initiating study drug. Participants who are on stable maintenance therapy for an opportunistic infection may be enrolled after consultation with the Sponsor.
- Participant does not require and agrees not to take any drugs that are contraindicated or have significant pharmacokinetic interactions with study drugs during the course of the study. Participant agrees not to take any medication during the study, including over-the-counter medicines, vitamins, minerals, herbal preparations, alcohol, or recreational drugs without the knowledge and permission of the principal investigator.
- Female participants must be either postmenopausal for at least one year, surgically sterile, or must use a non-hormonal method of birth control that is acceptable to both the participant and investigator. All female participants must have a urine pregnancy test performed at screening visit and on Day minus 1/baseline, and results of both tests must be negative. Female participants may not be breastfeeding.
- Participants have received no prior treatment with an HIV-1 integrase inhibitor.
- Participants must not have history of an allergic reaction or significant sensitivity to the study drugs.
- Participants may not have an ongoing history of substance abuse or psychiatric illness that could preclude protocol adherence.
- Participant cannot have resistance to lopinavir/ritonavir, tenofovir, or emtricitabine based on the HIV-1 drug resistance genotypic test results at the screening visit.
- Participant may not have significant medical history of concomitant illness or disease that would adversely affect his/her participating in the study.
- Participants may not have received any investigational drug or investigational vaccine within 30 days prior to study drug administration.
- Participants may not have any of the following abnormal screening results: Hemoglobin <= 8.0 grams/deciliter, absolute neutrophil count <= 750 cells/microliter, Platelet count <= 50,000 per milliliter, alanine aminotransferase (ALT) (serum glutamic-pyruvic transaminase [SGPT]) or aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT]) >= 3.0 x upper limit of normal (ULN), calculated creatinine clearance < 50 milliliter/minute, hepatitis B surface antigen (HBsAg) is positive.
- The investigator considers the participant to be an unsuitable candidate for the study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description LPV/r + RAL lopinavir/ritonavir (LPV/r) lopinavir/ritonavir 400/100 mg tablet twice-daily + raltegravir 400 mg twice-daily LPV/r + RAL raltegravir (RAL) lopinavir/ritonavir 400/100 mg tablet twice-daily + raltegravir 400 mg twice-daily LPV/r + FTC/TDF lopinavir/ritonavir (LPV/r) lopinavir/ritonavir 400/100 milligram (mg) tablet twice-daily + co-formulated emtricitabine/tenofovir disoproxil fumarate 200/300 mg once-daily LPV/r + FTC/TDF emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) lopinavir/ritonavir 400/100 milligram (mg) tablet twice-daily + co-formulated emtricitabine/tenofovir disoproxil fumarate 200/300 mg once-daily
- Primary Outcome Measures
Name Time Method Percentage of Participants With Moderate or Severe Treatment-emergent, Drug-related Adverse Events Week 96 Treatment-emergent adverse events were defined as those occurring after study drug initiation and within 30 days after the last dose of study drug. Treatment-emergent, moderate or severe drug-related adverse events that occurred in at least 2% of participants in either treatment arm are presented.
Primary Outcome: Percentage of Participants With Potentially Clinically Significant Laboratory Values Baseline to Week 96 Potentially clinically significant laboratory values that occurred in at least 2% of participants in either treatment arm are presented.
Percentage of Participants Responding (Plasma HIV-1 Ribonucleic Acid [RNA] Levels Less Than 40 Copies/Milliliter [mL]) at Week 48 Based on the Food and Drug Administration (FDA) Time to Loss of Virologic Response (TLOVR) Algorithm Baseline to Week 48 A participant was classified as a responder at the first of 2 consecutive visits with plasma HIV-1 RNA levels below 40 copies/mL. The participant continued to be a responder until one of the following: the participant had 2 consecutive values greater than or equal to 40 copies/mL; the final measurement, if the final measurement was the first one documenting an increase in plasma HIV-1 RNA level to greater than or equal to 40 copies/mL; the participant discontinued participation in the study or died.
- Secondary Outcome Measures
Name Time Method Mean Change From Baseline in Creatine Phosphokinase (Units/Liter) Baseline to Week 96 Mean Change From Baseline in Total Bilirubin (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Red Blood Cell Count (x 10^12/Liter) Baseline to Week 96 Mean Change From Baseline in Creatinine (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Alanine Aminotransferase (Units/Liter) Baseline to Week 96 Mean Change in CD4+ T-Cell Counts From Baseline to Each Visit Baseline to Week 96 Time to Loss of Virologic Response - Percentage of Participants Still Categorized as Responders at Day 672 Baseline to Week 96 Time of loss of virologic response was defined as the first of the following: first of 2 consecutive visits with plasma HIV-1 RNA greater than or equal to 40 copies/milliliter (mL), if the participant previously demonstrated 2 consecutive plasma HIV-1 RNA levels below 40 copies/mL; Study Day 1, if the subject never achieved 2 consecutive plasma HIV-1 RNA levels below 40 copies/mL; the day of the final measurement, if the final measurement was the first one documenting an increase in plasma HIV-1 RNA level to greater than or equal to 40 copies/mL.
Change From Baseline on Mental Component of Medical Outcomes Study HIV Health Survey Baseline to Week 96 The Survey is a brief, comprehensive health status measure used in studies of people with HIV/AIDS. Participants rate their health and mental/emotional condition, how much their health limits physical activities (eating, dressing, bathing, climbing stairs, walking one block, etc.) and social activities (visiting with friends or relatives, etc.), and other questions that measure quality of life. The mental component summarizes answers to questions about emotional and mental wellbeing. Possible scores range from 0 to 100. Higher scores indicates better health, and increases indicate improvement.
Score on Effectiveness Scale of Treatment Satisfaction Questionnaire for Medication (TSQM) Week 96 The Effectiveness Scale of the TSQM evaluates the participant's satisfaction or dissatisfaction (1=extremely dissatisfied to 7=extremely satisfied) with the ability of the medication to prevent or treat the condition, the way the medication relieves symptoms, the amount of time it takes for the medication to start working, and other questions. Scores are converted to a range of 0 to 100. A higher score indicates greater satisfaction.
Score on Side Effects Scale of Treatment Satisfaction Questionnaire for Medication Week 96 The Side Effects scale of the TSQM asks if the participant experiences side effects (yes/no), and if so, how bothersome the side effects are, to what extent they interfere with physical health and ability to function (for example, strength and energy levels), to what extent they interfere with mental function (for example, ability to think clearly, stay awake, etc.), and to what extent the side effects affect the participants overall satisfaction with the medication. Scores are converted to a range of 0 to 100. Higher scores indicate less interference and/or less dissatisfaction.
Mean Change From Baseline in Hemoglobin (Grams/Liter) Baseline to Week 96 Mean Change From Baseline in Hematocrit (Fraction) Baseline to Week 96 Hematocrit fraction is the percentage (%) by volume of packed red blood cells (RBCs) in the participant's blood. It was measured using standard clinical laboratory analysis of participants' blood samples.
Score on Global Satisfaction Scale of Treatment Satisfaction Questionnaire for Medication Week 96 The Global Satisfaction scale of the TSQM evaluates the participants rating of whether the good things about the medication outweigh the bad things (1=not at all certain to 5=extremely certain) and how satisfied or dissatisfied the participant is with the medication (1=extremely dissatisfied to 7=extremely satisfied). Scores are converted to a range of 0 to 100. Higher scores indicate greater satisfaction.
Mean Change From Baseline in Calculated Creatinine Clearance (Milliliters/Second) Baseline to Week 96 Mean Change From Baseline in Fasting Glucose (Millimoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Lactate Dehydrogenase (Units/Liter) Baseline to Week 96 Mean Change From Baseline in Lipase (Units/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Magnesium (Millimoles/Liter) Baseline to Week 96 Percentage of Participants Responding (Plasma HIV-1 RNA Levels Below 40 Copies/Milliliter [mL]) at Each Visit Based on the FDA Time to Loss of Virologic Response (TLOVR) Algorithm Baseline to Week 96 A participant was classified as a responder at the first of 2 consecutive visits with plasma HIV-1 RNA levels below 40 copies/mL. The participant continued to be a responder until one of the following: 1) the participant had 2 consecutive values greater than or equal to 40 copies/mL; the final measurement, if the final measurement was the first one documenting an increase in plasma HIV-1 RNA level to greater than or equal to 40 copies/mL; the participant discontinued participation in the study or died.
Number of Participants Who Developed Resistance to Each Drug in the Study Regimen, as Defined by the International AIDS Society-USA (IAS-USA) Panel. Baseline to Week 96 Resistance to study drugs was defined as described by the International AIDS Society-USA (IAS-USA) Panel. All participants had an HIV-1 drug resistance genotype (lopinavir/ritonavir, tenofovir, or emtricitabine) obtained at the Screening Visit. Beginning at Week 8, if participant's plasma HIV-1 RNA was greater than or equal to 40 copies/milliliter (mL) and was below 40 copies/mL at the previous visit, additional procedures were undertaken to determine if resistance to study drug occurred.
Number of Participants Who Developed Resistance, Defined Conservatively, to Lopinavir Baseline to Week 96 Beginning at Week 8, if participant's plasma HIV-1 RNA was greater than/equal to 40 copies/milliliter (mL) and was below 40 copies/mL at the previous visit, additional procedures were undertaken to determine if resistance occurred. Evidence of lopinavir resistance was more conservatively defined as the presence of 1 or more of these mutations: protease I47V or A, G48V, I50V, V82A or F or T or S, I84V, L90M; or presence of at least 3 or more of these mutations: protease L10F or I or R or V, K20M or R, L24I, V32I, L33F, M36I, M46I or L, F53L, any change to I54, A71V or T, and G73S.
Change From Baseline on Physical Component Score of the Medical Outcomes Study HIV Health Survey Baseline to Week 96 The Survey is a brief, comprehensive health status measure used in studies of people with HIV/AIDS. Participants rate their health and mental/emotional condition, how much their health limits physical activities (eating, dressing, bathing, climbing stairs, walking one block, etc.) and social activities (for example, visiting with friends or relatives), and other questions that measure quality of life. The physical component summarizes answers to questions about physical status. Possible scores range from 0 to 100. A higher score indicates better health, and increases indicate improvement.
Mean Change From Baseline in Cholesterol (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in High Density Lipoprotein Cholesterol (HDL) (Micromoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Low Density Lipoprotein (LDL) (Micromoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Low Density Lipoprotein (LDL): High Density Lipoprotein (HDL) Ratio (Ratio) Baseline to Week 96 Mean Change From Baseline in Triglycerides (Micromoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Platelet Count (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in White Blood Cell Count (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Neutrophils (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Aspartate Aminotransferase (Units/Liter) Baseline to Week 96 Mean Change From Baseline in Alkaline Phosphatase (Units/Liter) Baseline to Week 96 Mean Change From Baseline in Lymphocytes (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Monocytes (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Eosinophils (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Basophils (x 10^9/Liter) Baseline to Week 96 Mean Change From Baseline in Blood Urea Nitrogen (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Uric Acid (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Inorganic Phosphate (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Calcium (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Sodium (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Potassium (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Chloride (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Bicarbonate (Micromoles/Liter) Baseline to Week 96 Mean Change From Baseline in Albumin (Grams/Liter) Baseline to Week 96 Mean Change From Baseline in Total Protein (Grams/Liter) Baseline to Week 96 Mean Change From Baseline in Adiponectin (Micrograms/Milliliter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Interleukin-6 (Nanograms/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Lactate (Millimoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Soluble Tumor Necrosis Factor Receptor-1 (Picograms/Milliliter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Soluble Tumor Necrosis Factor Receptor-2 (Picograms/Milliliter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Leptin (Nanograms/Milliliter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Insulin (Picomoles/Liter) Baseline to Week 96 Included in measures of metabolic toxicity
Mean Change From Baseline in Urine Specific Gravity Baseline to Week 96 Urine specific gravity is a laboratory test that measures the concentration of all chemical particles in the urine. The measurement produces a ratio of the urine density to water density.
Mean Change From Baseline in Urine pH Baseline to Week 96 Mean Change From Baseline in Sitting Systolic Blood Pressure (mm Hg) Baseline to Week 96 Mean Change From Baseline in Sitting Diastolic Blood Pressure (mm Hg) Baseline to Week 96 Mean Change From Baseline in Sitting Heart Rate (Beats Per Minute) Baseline to Week 96 Mean Change From Baseline in Weight (kg) Baseline to Week 96 Mean Change From Baseline in Temperature (°F) Baseline to Week 96 Mean Change From Baseline in Chest Measurement (cm) Baseline to Week 96 Chest circumference is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen. Participant's chest circumference was measured at 5 cm above the xiphoid process using non-stretchable measuring tape with half centimeter marks.
Mean Change From Baseline in Waist Measurement (cm) Baseline to Week 96 Waist circumference is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen. Circumference of participant's waist was measured at the level of the navel using non-stretchable measuring tape with half centimeter marks.
Mean Change From Baseline in Mid-Arm Measurement (cm) Baseline to Week 96 Arm circumference is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen. Particpant's arm circumference was measured halfway between the acromial process on the shoulder and the tip of the elbow (olecranon process) using non-stretchable measuring tape with half centimeter marks.
Mean Change From Baseline in Hips Measurement (cm) Baseline to Week 96 Hip circumference is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen. Participant was measured at widest width of the hip using non-stretchable measuring tape with half centimeter marks.
Mean Change From Baseline in Mid-Thigh Measurement (cm) Baseline to Week 96 Mid-thigh circumference is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen. Particpant's thigh circumference was measured halfway between the inguinal crease and the midpoint of the upper border of the patella using non-stretchable measuring tape with half centimeter marks.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Upper Extremity Fat (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Upper Extremity Lean Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Upper Extremity Total Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Lower Extremity Fat (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in DEXA Scan of Lower Extremity Lean Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Lower Extremity Total Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Trunk Fat (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Trunk Lean Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Trunk Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Total Body Fat (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Total Body Lean Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Total Body Mass (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan is included in the measures of somatic toxicity, which is characterized by loss of fat in the face, arms, and legs, and increase in fat in the base of the back of the neck and in the abdomen.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Bone Mineral Content (Grams) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan of bone mineral content was used to evaluate potential bone effects of treatment.
Mean Change From Baseline in Dual Energy X-ray Absorptiometry (DEXA) Scan of Bone Mineral Density (Grams/cm^2) Baseline to Week 96 The dual energy X-ray absorptiometry (DEXA) scan of bone mineral content was used to evaluate potential bone effects of treatment.
Trial Locations
- Locations (37)
Site Reference ID/Investigator# 8433
🇺🇸Houston, Texas, United States
Site Reference ID/Investigator# 8395
🇺🇸Atlanta, Georgia, United States
Site Reference ID/Investigator# 7831
🇨🇦Toronto, Ontario, Canada
Site Reference ID/Investigator# 8429
🇺🇸Decatur, Georgia, United States
Site Reference ID/Investigator# 8426
🇺🇸Charlotte, North Carolina, United States
Site Reference ID/Investigator# 8425
🇺🇸Orlando, Florida, United States
Site Reference ID/Investigator# 8403
🇺🇸Dallas, Texas, United States
Site Reference ID/Investigator# 7960
🇫🇷Montpellier Cedex 5, France
Site Reference ID/Investigator# 8063
🇫🇷Paris, France
Site Reference ID/Investigator# 8221
🇵🇱Wroclaw, Poland
Site Reference ID/Investigator# 7698
🇪🇸Madrid, Spain
Site Reference ID/Investigator# 7697
🇪🇸Barcelona, Spain
Site Reference ID/Investigator# 7689
🇪🇸Barcelona, Spain
Site Reference ID/Investigator# 11102
🇪🇸Barcelona, Spain
Site Reference ID/Investigator# 8050
🇮🇹Rome, Italy
Site Reference ID/Investigator# 7700
🇵🇷Ponce, Puerto Rico
Site Reference ID/Investigator# 7691
🇪🇸Madrid, Spain
Site Reference ID/Investigator# 7690
🇪🇸Seville, Spain
Site Reference ID/Investigator# 8052
🇮🇹Genoa, Italy
Site Reference ID/Investigator# 7821
🇫🇷Paris, France
Site Reference ID/Investigator# 8402
🇺🇸Tampa, Florida, United States
Site Reference ID/Investigator# 8431
🇺🇸Phoenix, Arizona, United States
Site Reference ID/Investigator# 8394
🇺🇸Atlantis, Florida, United States
Site Reference ID/Investigator# 8396
🇺🇸Vero Beach, Florida, United States
Site Reference ID/Investigator# 11461
🇺🇸Huntersville, North Carolina, United States
Site Reference ID/Investigator# 7959
🇨🇦Toronto, Ontario, Canada
Site Reference ID/Investigator# 7695
🇫🇷Lyon Cedex 04, France
Site Reference ID/Investigator# 7963
🇨🇦Ottawa, Ontario, Canada
Site Reference ID/Investigator# 8099
🇨🇦Montreal, Quebec, Canada
Site Reference ID/Investigator# 7789
🇮🇹Milan, Italy
Site Reference ID/Investigator# 8051
🇮🇹Perugia, Italy
Site Reference ID/Investigator# 7692
🇪🇸L'Hospitalet de Llobregat, Spain
Site Reference ID/Investigator# 7713
🇵🇷Bayamon, Puerto Rico
Site Reference ID/Investigator# 7693
🇪🇸Madrid, Spain
Site Reference ID/Investigator# 8432
🇺🇸Beverly Hills, California, United States
Site Reference ID/Investigator# 8424
🇺🇸Boston, Massachusetts, United States
Site Reference ID/Investigator# 8393
🇺🇸Fort Pierce, Florida, United States