A Research Study to Evaluate the Effects of a New Oral Medicine Called Cenerimod in Adults With Systemic Lupus Erythematosus
- Registration Number
- NCT05648500
- Lead Sponsor
- Idorsia Pharmaceuticals Ltd.
- Brief Summary
The goal of this clinical trial is to see how well cenerimod reduces symptoms of Systemic Lupus Erythematosus in adult patients with moderate to severe symptoms. The main questions it aims to answer are:
* How well cenerimod works on top of the treatment already being administered.
* How safe cenerimod is for adult patients with Systemic Lupus Erythematosus.
Researchers will compare one dose of cenerimod and a placebo to see how well cenerimod works when it is added to the treatment already being administered.
In this research study approximately 210 participants will receive cenerimod and approximately 210 participants will receive placebo for 12 months.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 420
Inclusion criteria at screening:
-
Signed Informed Consent Form (ICF) prior to any study-mandated procedure.
-
Diagnosis of Systemic Lupus Erythematosus (SLE) made at least 6 months prior to Screening, according to 2019 European League Against Rheumatism / American College of Rheumatology Criteria.
-
A modified Systemic Lupus Erythematosus Disease Activity Index-2000 (mSLEDAI-2K) score ≥ 6 and clinical mSLEDAI-2K score ≥ 4 with at least 2 points for musculoskeletal or mucocutaneous manifestations (i.e., myositis, arthritis, rash, alopecia, mucosal ulcers). The mSLEDAI-2K score does not include "leukopenia".
-
British Isles Lupus Assessment Group-2004 (BILAG) Grade B in ≥ 2 organ systems or a BILAG Grade A in ≥ 1 organ system.
-
Physician's Global Assessment (PGA) score ≥ 1.0 on a 0 to 3 visual analog scale.
-
Currently treated with one or more of the following SLE background medications:
-
Anti-malarials (≤ 400 mg/day hydroxychloroquine, ≤ 500 mg/day chloroquine, ≤ 100 mg/day quinacrine).
-
Mycophenolate mofetil (≤ 2 g/day) / mycophenolic acid (≤1.44 g/day).
-
Azathioprine (≤ 2 mg/kg/day).
-
Methotrexate (≤ 25 mg/week).
-
Oral Corticosteroids (OCS):
- if OCS is the only SLE background medication: ≥ 7.5 mg/day and ≤ 30 mg/day prednisone or equivalent.
- if OCS is not the only SLE background medication: ≤ 30 mg/day prednisone or equivalent.
-
Belimumab (≤10 mg/kg every 4 weeks intravenously [i.v.], or 200 mg/week subcutaneously [s.c.]).
-
Treatment with antimalarials, mycophenolate mofetil, mycophenolic acid, azathioprine, methotrexate or belimumab must have been started at least 90 days prior to Screening. Treatment with OCS must have been started at least 30 days prior to Screening.
• For women of childbearing potential (WoCBP):
- Negative serum pregnancy test at Screening.
- Agreement to undertake monthly urine pregnancy tests from Randomization up to 6 months after study treatment discontinuation.
- Agreement to use a highly effective method of contraception from Screening (Visit 1) up to 6 months after study treatment discontinuation.
Inclusion criteria at randomization:
-
A clinical mSLEDAI-2K score ≥ 4 with at least 2 points for musculoskeletal or mucocutaneous manifestations (i.e., myositis, arthritis, rash, alopecia, mucosal ulcers).
-
BILAG Grade B in 2 or more organ systems or a BILAG Grade A in 1 or more organ system.
-
PGA score ≥ 1.0 on a 0 to 3 visual analog scale.
-
Presence of at least one of the following biomarkers of serological evidence of active SLE (in a Screening sample as measured by central laboratory):
- Anti-dsDNA antibodies elevated above normal,
- Antinuclear antibodies with a titer of at least 1:160,
- Anti-Smith antibody elevated above normal.
-
Currently treated with one or more of the following SLE background medications that must be stable for at least 30 days prior to Randomization (except OCS, which must be stable for at least 15 days prior to Randomization):
-
Antimalarials (≤ 400 mg/day hydroxychloroquine, ≤ 500 mg/day chloroquine, ≤ 100 mg/day quinacrine);
-
Mycophenolate mofetil (≤ 2 g/day) / mycophenolic acid (≤ 1.44g/day);
-
Azathioprine (≤ 2 mg/kg/day);
-
Methotrexate (≤ 25 mg/week);
-
OCS:
- if OCS is the only SLE background medication: ≥ 7.5 mg/day and ≤ 30 mg/day prednisone or equivalent.
- if OCS is not the only SLE background medication: ≤ 30 mg/day prednisone or equivalent.
-
Belimumab (≤ 10 mg/kg every 4 weeks i.v. or ≤ 200 mg/week s.c.).
-
-
WoCBP must have a negative urine pregnancy test at Randomization.
Main
-
Pregnant, planning to be become pregnant up to Final Study Visit, or lactating women.
-
Severe active central nervous system lupus or active severe or unstable neuropsychiatric SLE including but not limited to: aseptic meningitis; cerebral vasculitis; myelopathy; demyelination syndromes (ascending, transverse, acute inflammatory demyelinating polyradiculopathy); acute confusional state; impaired level of consciousness; psychosis; acute stroke or stroke syndrome; cranial neuropathy; status epilepticus; cerebellar ataxia; or mononeuritis multiplex:
- That would make the subject unable to fully understand the ICF; OR
- Where, in the opinion of the investigator/delegate, protocol-specified standard of care is insufficient and the use of a more aggressive therapeutic approach, such as adding i.v. cyclophosphamide and/or high dose i.v. pulse corticosteroid (CS) therapy or other treatments not permitted in the protocol is indicated.
-
A diagnosis of mixed connective tissue disease or any history of overlap syndromes of SLE with psoriasis, rheumatoid arthritis, erosive arthritis, scleroderma, autoimmune hepatitis or uncontrolled autoimmune thyroid disease.
-
History or presence of Mobitz type II or third-degree atrioventricular block, sick sinus syndrome, symptomatic bradycardia or syncope associated with cardiac disorders.
-
Subjects who experienced myocardial infarction, unstable angina pectoris, stroke, transient ischemic attack, vascular thrombosis, decompensated heart failure requiring hospitalization, or heart failure defined by the New York Heart Association Class III/IV within 6 months prior to Screening.
-
Resting heart rate < 50 bpm as measured by the 12-lead ECG at Screening or at Randomization.
-
An elevated QT interval corrected according to Fridericia's formula (QTcF) interval of > 470 ms (females) / > 450 ms (males) at Screening or at Randomization.
-
History or presence of severe respiratory disease or pulmonary fibrosis, based on medical history, lung function, and chest X-ray (or CT scan as per local guidelines), performed at Screening or within 6 months prior to Screening.
-
History of clinically relevant bronchial asthma or chronic obstructive pulmonary disease that has required treatment with oral or parenteral CS for more than a total of 2 weeks within the last 6 months prior to Screening.
-
History or presence of malignancy (except for surgically excised and non-recurrent cutaneous basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma), lymphoproliferative disease, or history of total lymphoid irradiation within 10 years prior to Screening.
-
Presence of macular edema or active uveitis detected by optical coherence tomography (OCT) during screening.
-
History of chronic liver or biliary disease (other than Gilbert's Syndrome) or subjects with alanine aminotransferase or aspartate aminotransferase > 3 × Upper Limit of Normal (ULN) or total bilirubin > 1.5 × ULN (unless in the context of known Gilbert's Syndrome).
-
Significant hematology abnormality at screening assessment:
- lymphocyte count < 500 /μL (0.5 × 10^9/L);
- hemoglobin < 7 g/dL;
- white blood cell count < 2000/μL (2.0 × 10^9/L); or
- platelets < 25000/μL (25 × 10^9/L).
-
Estimated glomerular filtration rate < 15 mL/min/1.73 m^2.
-
Treatment with the following medications within 15 days or 5 half-lives of the medication (whichever is longer) prior to Randomization:
- β-blockers, diltiazem, verapamil, digoxin, digitoxin, or any other anti-arrhythmic or heart-rate -lowering systemic therapy.
- QT-prolonging drugs with known risk of torsade de pointes irrespective of indication.
-
Treatment with the following medications within 30 days or 5 half-lives of the medication (whichever is longer) prior to Randomization:
- Cyclophosphamide, cyclosporine, voclosporin, tacrolimus, sirolimus, etc.
- Pulse methylprednisolone.
- Vaccination with live vaccines (including live vaccines for COVID-19).
-
Intra-articular, intramuscular or i.v. CS within 6 weeks prior to Randomization.
-
Treatment with the following medications within 90 days or 5 half-lives of the medication (whichever is longer) prior to Randomization:
- Leflunomide.
- i.v. immunoglobulins.
-
Treatment with any investigational agent within 90 days or 5 half-lives of the drug (whichever is longer) prior to Randomization.
-
Treatment with B cell-depleting biological agents (e.g., rituximab or ocrelizumab) or biological immunosuppressive agents (e.g., anti-tumor necrosis factor [TNF], anti-interleukin [IL]-1, anti-IL6 therapies), within 12 months prior to Randomization.
-
Treatment with anifrolumab within 6 months prior to Randomization.
-
Treatment with any of the following medications any time prior to Screening:
- Alemtuzumab,
- Sphingosine-1-phosphate receptor modulators (e.g., fingolimod),
- Subjects previously randomized to cenerimod or placebo in any trial involving cenerimod.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Matching placebo Placebo Participants will receive matching placebo once daily in addition to background SLE therapy. Cenerimod 4 mg Cenerimod Participants will receive cenerimod once daily in addition to background SLE therapy.
- Primary Outcome Measures
Name Time Method Response on Systemic Lupus Erythematosus Responder Index 4 (SRI-4) at Month 12 compared to baseline At Month 12 compared to Day 1 (pre-dose baseline) Response on SRI-4 is defined as:
* Reduction from baseline of at least 4 points in the modified Systemic Lupus Erythematosus Disease Activity Index-2000 score (mSLEDAI-2K \[SLEDAI-2K modified to exclude leukopenia, thus mSLEDAI-2K\]), and
* No new British Isles Lupus Assessment Group-2004 (BILAG) A organ domain score and not more than one new BILAG B organ domain score compared to baseline, and
* No worsening from baseline in subjects' lupus disease activity, where worsening is defined as an increase ≥ 0.30 points on a 3-point Physician's Global Assessment visual analog scale (PGA VAS), and
* No violation of specified medication rules detailed in the core protocol.
- Secondary Outcome Measures
Name Time Method Time to first confirmation of a 4-month sustained modified Systemic Lupus Erythematosus Disease Activity Index-2000 (mSLEDAI-2K) response Day 1 (pre-dose baseline) to Month 12 A response is defined as a reduction of at least 4 points from baseline.
Time to first confirmation of a 4-month sustained response in mucocutaneous manifestations (i.e., rash, alopecia, mucosal ulcers) Day 1 (pre-dose baseline) to Month 12 Response is defined as:
* No increase in the overall mSLEDAI-2K score excluding mucocutaneous manifestations, and
* Remission (score of zero) from baseline in the mSLEDAI 2K score of mucocutaneous manifestations.Response on BILAG-based Composite Lupus Assessment (BICLA) at Month 12 compared to baseline At Month 12 compared to Day 1 (pre-dose baseline) Response on BICLA is defined as:
* Improvement from baseline in disease activity as measured by BILAG. Improvement is defined as a reduction of all baseline BILAG A to B/C/D and baseline BILAG B to C/D and no BILAG worsening in other organ systems, where worsening is defined as ≥ 1 new BILAG A or ≥ 2 new BILAG B, and
* No worsening from baseline in mSLEDAI-2K, where worsening is defined as an increase from baseline of \> 0 points in mSLEDAI-2K, and
* No worsening from baseline in the patient's lupus disease activity, where worsening is defined as an increase of ≥ 0.30 points on a 3-point PGA VAS, and
* No discontinuation of investigational product, and
* No violation of specified medication rules detailed in the core protocol.
Trial Locations
- Locations (147)
DCC Equita EOOD
🇧🇬Varna, Bulgaria
Allen Arthritis
🇺🇸Allen, Texas, United States
CPClin - Centro de Pesquisas Clínicas
🇧🇷São Paulo, Brazil
Providence Medical Foundation
🇺🇸Fullerton, California, United States
California Research Institute
🇺🇸Huntington Park, California, United States
University of Colorado Denver
🇺🇸Aurora, Colorado, United States
RASF-Clinical Research Inc.
🇺🇸Boca Raton, Florida, United States
Clinical Research of West Florida, Inc.
🇺🇸Clearwater, Florida, United States
Omega Research MetroWest, LLC
🇺🇸DeBary, Florida, United States
SouthCoast Research Center, Inc.
🇺🇸Miami, Florida, United States
IRIS Research and Development, LLC
🇺🇸Plantation, Florida, United States
Renew Health Clinical Research LLC
🇺🇸Tampa, Florida, United States
Augusta University
🇺🇸Augusta, Georgia, United States
Advance Quality Medical Research
🇺🇸Orland Park, Illinois, United States
Accurate Clinical Research Inc. - Lake Charles
🇺🇸Lake Charles, Louisiana, United States
Louisiana State University School of Medicine section of Rheumatology
🇺🇸New Orleans, Louisiana, United States
Axon Clinical Research -Baltimore
🇺🇸Baltimore, Maryland, United States
Klein & Associates, M.D., P.A.
🇺🇸Hagerstown, Maryland, United States
June DO, PC
🇺🇸Lansing, Michigan, United States
Bronx Care Health and Wellness Center
🇺🇸Bronx, New York, United States
DJL Clinical Research, PLLC
🇺🇸Charlotte, North Carolina, United States
Superior Clinical Reseach LLC
🇺🇸Smithfield, North Carolina, United States
University of Oklahoma College of Medicine
🇺🇸Oklahoma City, Oklahoma, United States
Temple University Health Systems/ Lewis Katz School of Medicine
🇺🇸Philadelphia, Pennsylvania, United States
Shelby Research, LLC
🇺🇸Memphis, Tennessee, United States
Accurate Clinical Research Inc.
🇺🇸Houston, Texas, United States
Rheumatology Care Center, PLLC
🇺🇸Bellaire, Texas, United States
Metroplex Clinical Research Center
🇺🇸Dallas, Texas, United States
Houston MD Medspa and Wellness Clinic
🇺🇸Houston, Texas, United States
Sun Research Institute
🇺🇸San Antonio, Texas, United States
Instituto Medico CER
🇦🇷Buenos Aires, Argentina
Fundación Respirar
🇦🇷Ciudad Autónoma de Buenos Aires, Argentina
Aprillus Asistencia e Investigacion
🇦🇷Ciudad Autónoma de Buenos Aires, Argentina
Hospital Ramos Mejia
🇦🇷Ciudad Autónoma de Buenos Aires, Argentina
Arsema Clinica Adventista Belgrano
🇦🇷Ciudad Autónoma de Buenos Aires, Argentina
IR Medical Center /Hospital de Día/ Instituto de Reumatología y Traumatología
🇦🇷Mendoza, Argentina
Instituto CAICI SRL
🇦🇷Rosario, Argentina
Centro Integral de Reumatología
🇦🇷San Miguel de Tucumán, Argentina
ICT (Investigaciones Clínicas Tucumán)
🇦🇷San Miguel De Tucumán, Argentina
Centro de investigaciones medicas Tucuman
🇦🇷Tucuman, Argentina
Santa Casa de Belo Horizonte
🇧🇷Belo Horizonte, Brazil
Hospital Brasília
🇧🇷Brasilia, Brazil
Centro Mineiro de Pesquisas
🇧🇷Juiz De Fora, Brazil
Instituto Méderi de Pesquisa e Saúde
🇧🇷Passo Fundo, Brazil
Centro Multidisciplinar de Pesquisa Clínica (Irmandade da Santa Casa de Misericórdia de Porto Alegre
🇧🇷Porto Alegre, Brazil
LMK Servicos Medico S/S
🇧🇷Porto Alegre, Brazil
IMPAR SERVICOS HOSPITALARES S/A ; Hospital São Lucas
🇧🇷Rio de Janeiro, Brazil
SER - Serviços Especializados em Reumatologia da Bahia
🇧🇷Salvador, Brazil
Hospital de Clínicas de Porto Alegre
🇧🇷Santa Cecília, Brazil
Centro Multidiciplinar de Estudos Clínicos- CEMEC
🇧🇷São Bernardo do Campo, Brazil
Fundação Faculdade Regional de Medicina de São José do Rio Preto
🇧🇷São José do Rio Preto, Brazil
Ebserh Hospital de Clínicas da Universidade Federal de Uberlândia-HC-UFU
🇧🇷Uberlandia, Brazil
University Multi-profile Hospital for Active Treatment - Plovdiv AD
🇧🇬Plovdiv, Bulgaria
"University Multiprofile Hospital for Active Treatment - Pulmed" OOD
🇧🇬Plovdiv, Bulgaria
Medical Center ArtMed OOD
🇧🇬Plovdiv, Bulgaria
Outpatient Clinic for Specialized Outpatient Medical Care - Medical Center Kyuchuk Parizh Ltd.
🇧🇬Plovdiv, Bulgaria
DCC 1 Ruse
🇧🇬Ruse, Bulgaria
Acibadem City Clinic Diagnostic-Consultative Center" EOOD, 127 Okolovrasten pat, Mladost
🇧🇬Sofia, Bulgaria
Clínica de la costa Ltda.
🇨🇴Barranquilla, Colombia
IDEARG (Instituto de Enfermedades Autoinmunes Renato Guzmán)
🇨🇴Bogota, Colombia
Bluecare salud SAS
🇨🇴Bogotá, Colombia
SERVIMED S.A.S Bucaramanga
🇨🇴Bucaramanga, Colombia
Fundación Valle de Lili
🇨🇴Cali, Colombia
Centro de Estudios de Reumatología y Dermatología
🇨🇴Cali, Colombia
Preventive Care SAS
🇨🇴Chía, Colombia
Hospital Pablo Tobón Uribe
🇨🇴Medellín, Colombia
Fundación Centro De Excelencia En Enfermedades Crónicas No Transmisibles-FUNCENTRA
🇨🇴Monteria, Colombia
Healthy Medical Center SAS
🇨🇴Zipaquira, Colombia
Hôpital Pitié-Salpêtrière
🇫🇷Paris, France
CHU Félix Guyon Site Nord
🇫🇷Saint-Denis, France
CHU de Purpan
🇫🇷Toulouse, France
Naval Hospital of Athens
🇬🇷Athens, Greece
General Hospital of Athens "Hippokration"
🇬🇷Athens, Greece
University General Hospital "Attikon"
🇬🇷Athens, Greece
General Hospital of Athens "Laiko"
🇬🇷Athen, Greece
General University Hospital of Larissa
🇬🇷Larissa, Greece
General University Hospital of Patras
🇬🇷Patras, Greece
General Hospital of Thessaloniki "Hippokration"
🇬🇷Thessaloniki, Greece
424 General Military Hospital
🇬🇷Thessaloniki, Greece
Euromedica - Kyanos Stavros
🇬🇷Thessaloníki, Greece
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Catholic University of Daegu (Daegu Catholic University Medical Center)
🇰🇷Daegu, Korea, Republic of
Seoul National University Hospital
🇰🇷Junggu, Korea, Republic of
Hanyang University Hospital, Seongdong-gu
🇰🇷Seoul, Korea, Republic of
Ewha University Mokdong Hospital, Yangcheon-gu
🇰🇷Seoul, Korea, Republic of
KonKuk University Medical Center, Gwangjin-gu
🇰🇷Seoul, Korea, Republic of
Seoul Saint Mary's Hospital of the Catholic University of Korea, Seocho-gu
🇰🇷Seoul, Korea, Republic of
Biológicos Especializados S.A. de C.V.
🇲🇽Ciudad de México, Mexico
CITER, Centro de Investigación y Tratamiento de las Enfermedades Reumáticas S.A. de C.V.
🇲🇽Ciudad de México, Mexico
Panamerican Clinical Research Mexico S.A. de C.V.
🇲🇽Cuernavaca, Mexico
Consultorio Privado de Especialidad
🇲🇽Guadalajara, Mexico
Centro de Estudios de Investigación Básica y Clínica, S.C.
🇲🇽Guadalajara, Mexico
Consultorio Médico de Reumatología - Hospital Aranda de la Parra
🇲🇽León, Mexico
Centro de Investigación Clínica Chapultepec S. A. de C. V.
🇲🇽Morelia, Mexico
Unidad de Atención Médica e Investigación en Salud
🇲🇽Mérida, Mexico
SMIQ, S. de R.L. de C.V.
🇲🇽Querétaro, Mexico
Unidad de Investigaciones Reumatológicas A.C
🇲🇽San Luis Potosi, Mexico
Centro de Atención e Investigación Cardiovascular del Potosí, S.C.
🇲🇽San Luis Potosí, Mexico
Investigación Biomédica para el Desarrollo de Fármacos S.A. de C.V.
🇲🇽Zapopan, Mexico
Chong-Hua Hospital
🇵🇭Cebu City, Philippines
Davao Doctors Hospital
🇵🇭Davao City, Philippines
Mary Mediatrix Medical Center
🇵🇭Lipa, Philippines
Makati Medical Center
🇵🇭Makati, Philippines
UP-PGH
🇵🇭Manila, Philippines
Far Eastern University - Nicanor Reyes Medical Foundation
🇵🇭Quezon City, Philippines
Jose R. Reyes Memorial Medical Center
🇵🇭Santa Cruz, Philippines
Centrum Medyczne Pratia Częstochowa
🇵🇱Częstochowa, Poland
Centrum Medyczne Angelius Provita
🇵🇱Katowice, Poland
Vita Longa Sp. z o.o.
🇵🇱Katowice, Poland
Małopolskie Badania Kliniczne
🇵🇱Kraków, Poland
Centrum Medyczne Plejady
🇵🇱Kraków, Poland
Zespół Poradni Specjalistycznych REUMED
🇵🇱Lublin, Poland
Malwa-Med Iwona Chlebicka
🇵🇱Wrocław, Poland
Neomed Brasov
🇷🇴Brasov, Romania
Spitalul Clinic Dr. Ion Cantacuzino
🇷🇴Bucharest, Romania
SC Sana Monitoring SRL
🇷🇴Bucuresti, Romania
Delta Health Care SRL
🇷🇴Bucuresti, Romania
Spitalul Clinic Judetean de Urgentã Craiova
🇷🇴Craiova, Romania
SC Medaudio-Optica SRL
🇷🇴Râmnicu Vâlcea, Romania
Kaohsiung Medical University Hospital
🇨🇳Kaohsiung, Taiwan
Far Eastern Memorial Hospital
🇨🇳New Taipei City, Taiwan
China Medical University Hospital
🇨🇳Taichung, Taiwan
Chi Mei Medical Center
🇨🇳Tainan City, Taiwan
Taipei Medical University Hospital
🇨🇳Taipei City, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei City, Taiwan
Cheng Hsin General Hospital
🇨🇳Taipei City, Taiwan
TRI-Service General Hospital
🇨🇳Taipei City, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Linkou Chang Gung Memorial Hospital
🇨🇳Taoyuan City, Taiwan
Vajira Hospital
🇹🇭Bangkok, Thailand
Srinagarind Hospital, Khon Kaen University
🇹🇭Khon Kaen, Thailand
Songklanagarind Hospital
🇹🇭Songkla, Thailand
Communal Non-Commercial Enterprise "Cherkasy Regional Hospital of Cherkasy Regional Council"
🇺🇦Cherkasy, Ukraine
Communal Non-Commercial Enterprise "Khmelnytsky Regional Hospital" of Khmelnytsky Regional Council
🇺🇦Khmelnytskyi, Ukraine
Clinic of Modern Rheumatology
🇺🇦Kyiv, Ukraine
Kyiv City Clinical Hospital #3
🇺🇦Kyiv, Ukraine
Kyiv Railway Clinical Hospital #2 of Branch "Health Center" of Joint-Stock Company "Ukrainian Railway"
🇺🇦Kyiv, Ukraine
State Ins Nat Scie Cen M.D.Strazhesko Ins of Cardio Clin
🇺🇦Kyiv, Ukraine
Communal Non-Commercial Enterprise of Kyiv Regional Council Kyiv Clinical Regional Hospital, Consultation and Diagnostic Center
🇺🇦Kyiv, Ukraine
Volyn Regional Clinical Hospital
🇺🇦Lutsk, Ukraine
Com Non-Com Entr of Lviv Reg Coun "Lviv Reg Clin Hos, Rheu Dprt, Danylo Halytsky Lviv Nat Med Uni
🇺🇦Lviv, Ukraine
Medical Center of Limited Liability Company "Kalyna. Center of Modern Medicine
🇺🇦Lviv, Ukraine
Medical Centre "Academical Medical Group" LLC
🇺🇦Lviv, Ukraine
Uzhhorod City Multidisciplinary Clinical Hospital
🇺🇦Uzhhorod, Ukraine
Private Small-Scale Enterprise Medical Centre "Pulse", Therapeutical Department
🇺🇦Vinnytsia, Ukraine
Municipal Nonprofit Institution "Vinnytsia City Clinical Hospital #1"
🇺🇦Vinnytsia, Ukraine
Communal Enterprise "Hospital #1" of Zhytomyr City Council, Consultation and Treatment Department "Scientific Research Center"
🇺🇦Zhytomyr, Ukraine