Efficacy and Safety Study of Apixaban for the Treatment of Deep Vein Thrombosis or Pulmonary Embolism
- Conditions
- Venous Thrombosis
- Interventions
- Registration Number
- NCT00643201
- Lead Sponsor
- Bristol-Myers Squibb
- Brief Summary
The purpose of this study is to evaluate the effects of an investigational blood thinner, apixaban, in preventing venous thromboembolic (VTE) recurrence or death in patients with deep vein thrombosis (DVT) or pulmonary embolism (PE)
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 5614
- Men and women ≥ 18 years of age
- Clinical diagnosis of DVT or PE
- Contraindications for enoxaparin or warfarin
- Active bleeding or high risk for serious bleeding
- Short life expectancy
- Uncontrolled high blood pressure
- Significantly impaired kidney or liver function
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Apixaban Enoxaparin apixaban: tablets, oral, 10 milligram (mg) tablets, twice daily, for 7 days followed by apixaban 5 mg, twice daily, 6 months. Apixaban Placebo for apixaban apixaban: tablets, oral, 10 milligram (mg) tablets, twice daily, for 7 days followed by apixaban 5 mg, twice daily, 6 months. Enoxaparin + Warfarin Placebo for enoxaparin Enoxaparin: solution, subcutaneous, 1 mg/kg Q12h until international normalized ratio (INR) ≥2. Enoxaparin + Warfarin Placebo for warfarin Enoxaparin: solution, subcutaneous, 1 mg/kg Q12h until international normalized ratio (INR) ≥2. Apixaban warfarin apixaban: tablets, oral, 10 milligram (mg) tablets, twice daily, for 7 days followed by apixaban 5 mg, twice daily, 6 months. Enoxaparin + Warfarin apixaban Enoxaparin: solution, subcutaneous, 1 mg/kg Q12h until international normalized ratio (INR) ≥2.
- Primary Outcome Measures
Name Time Method Incidence of Adjudicated Composite of Symptomatic, Recurrent Venous Thromboembolism (VTE) or VTE-Related Death During 6 Months of Treatment Day 1 to Week 24 + 2 Days or 355 days (Discontinued Early) VTE: nonfatal deep vein thrombosis (DVT) or nonfatal pulmonary embolism (PE). All events were adjudicated by an ICAC blinded to treatment. DVT assessed by compression ultrasound and/or venography; PE assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate (proportion of participants): n/N (n=number of participants with observation; N=total number of efficacy evaluable participants). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Composite endpoint: events at any time from randomization until end of intended treatment, regardless whether drug treatment was received. All randomized participants with a non-missing primary endpoint were summarized. Missing endpoint = outcomes which could not be documented on or after study Day 154. Participants were categorized to the assigned group regardless of the treatment actually received (intent-to-treat).
- Secondary Outcome Measures
Name Time Method Incidence of Adjudicated Composite of Recurrent Symptomatic VTE or VTE-related Death or Major Bleeding Day 1 up to 24 Weeks + 2 Days or 355 Days (Discontinued Early) VTE included: nonfatal DVT or nonfatal PE. All events were adjudicated by an ICAC blinded to treatment. DVT assessed by compression ultrasound and/or venography; PE assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Major bleeding defined by International Society on Thrombosis and Haemostasis: acute, clinically overt bleeding associated with decrease in hemoglobin (Hgb) of 2 g/dL or more or bleeding leading to transfusion or bleeding in a critical site or bleeding that is fatal . Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants, excluding those with missing endpoint and including those not in the efficacy evaluable population with a bleeding event that occurred during treatment period. Events included regardless of whether or not participant received treatment, ie, ITT principle
Incidence of Adjudicated Symptomatic Nonfatal Deep Vein Thrombosis (DVT) During the Intended Treatment Period Day 1 up to 24 Weeks + 2 Days or 355 Days (Discontinued Early) DVT adjudicated by an ICAC blinded to treatment. DVT evaluated by: compression ultrasound and/or venography. Includes events that occurred during the intended treatment period, regardless of whether the participant received study medication, intent to treat principle (ITT). Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants, excluding those with missing endpoint). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early).
Incidence of Adjudicated Composite of Recurrent Symptomatic Venous Thromboembolism (VTE) or All-Cause Death Day 1 up to 24 Weeks + 2 Days or 355 Days (Discontinued Early) VTE included: nonfatal DVT or nonfatal PE. All events were adjudicated by an ICAC blinded to treatment. DVT was assessed by compression ultrasound and/or venography; PE was assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate (proportion of participants with event) calculated as n/N (n=number of participants with observation; N=total number of efficacy evaluable participants). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Composite endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received, ie intent to treat (ITT) principle. Each participant scored as having an event only if they experienced one or more of the elements of the composite. Participants with missing endpoint information excluded.
Incidence of Adjudicated Composite of Recurrent Symptomatic VTE or Cardiovascular (CV)-Related Death Day 1 up to 24 Weeks + 2 Days or 355 Days (Discontinued Early) VTE included: nonfatal DVT or nonfatal PE. All events were adjudicated by an ICAC blinded to treatment. DVT was assessed by compression ultrasound and/or venography; PE was assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate (proportion of participants with event) calculated as n/N (n=number of participants with observation; N=total number of efficacy evaluable participants, participants with missing endpoint information excluded). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Composite endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received, ie, ITT principle. Each participant scored as having an event only if the participant experienced one or more of the elements of the composite.
Incidence of Adjudicated Composite of Recurrent Symptomatic VTE, Myocardial Infarction, Stroke, CV-related Death, Clinically Relevant Non-major (CRNM) Bleeding or Major Bleeding Day 1 up to 24 Weeks + 2 Days or 355 Days (Discontinued Early) VTE=Nonfatal DVT or nonfatal PE adjudicated by ICAC blinded to treatment. DVT: compression ultrasound and/or venography; PE: spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Major Bleeding = acute, clinically overt bleeding: decrease in Hgb of 2 g/dL or more or bleeding leading to transfusion or bleeding in a critical site or fatal bleeding. CRNM = acute clinically overt bleeding: compromising hemodynamics, leading to hospitalization, hematoma, epistasis \>5 minutes or repetitive, gingival bleeding, hematuria, macroscopic gastrointestinal hemorrhage, rectal blood loss, hemoptysis. n/N (n=number of participants with observation; N=Total number of participants, excluding those with missing endpoint and including those not in the efficacy evaluable population with a bleeding event that occurred during treatment period). Events included regardless of whether or not treatment was received (ITT).
Incidence of Adjudicated Symptomatic Nonfatal Pulmonary Embolism (PE) During the Intended Treatment Period Day 1 to Week 24 + + 2 Days or 355 Days (Discontinued Early) PE adjudicated by an ICAC blinded to treatment. PE: spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Includes events that occurred during the intended treatment period, regardless of whether the participant received study medication (ITT principle). Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants, excluding those with missing endpoint). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early).
Incidence of Adjudicated Venous Thromboembolism (VTE)-Related Death During the Intended Treatment Period Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) VTE-related death included: DVT-related death or PE-related death. All events were adjudicated by an ICAC blinded to treatment. DVT was assessed by compression ultrasound and/or venography; PE was assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate (proportion of participants with event) calculated as n/N (n=number of participants with observation; N=total number of participants in respective treatment groups excluding participants with missing endpoint information). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Includes events that occur during the intended treatment period regardless of whether or not the participant received study medication (ITT principle).
Incidence of Cardiovascular (CV)-Related Death Including VTE-related Death During the Intended Treatment Period Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) VTE-related death included: DVT-related death or PE-related death. All events were adjudicated by an ICAC blinded to treatment. DVT assessed by compression ultrasound and/or venography; PE assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate (proportion of participants with event) calculated as n/N (n=number of participants with observation; N=total number of participants in respective treatment groups excluding participants with missing endpoint information). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Includes events that occur during the intended treatment period regardless of whether or not the participant received study medication (ITT principle).
Incidence of All-Cause Death During the Intended Treatment Period Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Includes events that occurred during the intended treatment period, regardless of whether the participant received study medication (ITT principle). Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants, excluding those with missing endpoint information).
Incidence of Adjudicated Major Bleeding During the Treatment Period in Treated Participants Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) All events were adjudicated by an ICAC blinded to treatment. Bleeding defined by International Society on Thrombosis and Haemostasis: Major Bleeding: acute, clinically overt bleeding: decrease in hemoglobin (hgb) of 2 g/dL or more or bleeding leading to transfusion or bleeding in a critical site or fatal bleeding. Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants in respective treatment group (all participants who received at least one dose of study drug). Participants were categorized to the treatment group to which they were assigned unless incorrect study treatment was received throughout the study, in which case the participant was categorized according to the treatment received.
Incidence of Adjudicated Clinically Relevant Non Major (CRNM) Bleeding During the Treatment Period in Treated Participants Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Bleeding defined by International Society on Thrombosis and Haemostasis: CRNM defined as acute clinically overt bleeding: compromising hemodynamics, leading to hospitalization, hematoma, epistasis \>5 minutes or repetitive, gingival bleeding, hematuria, macroscopic gastrointestinal hemorrhage, rectal blood loss, hemoptysis. All events were adjudicated by an ICAC blinded to treatment. Event rate (proportion of participants with event): calculated as n/N (n=number of participants with observation; N=Total number of participants in respective treatment group (all participants who received at least one dose of study drug). Participants were categorized to the treatment group to which they were assigned unless incorrect study treatment was received throughout the study, in which case the participant was categorized according to the treatment received.
Incidence of Adjudicated Minor Bleeding During the Treatment Period in Treated Participants Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Bleeding defined by International Society on Thrombosis and Haemostasis: Minor bleeding: all acute clinically overt bleeding events not meeting the criteria for either major bleeding or CRNM. All events wre adjudicated by an ICAC blinded to treatment. Event rate (proportion of participants) calculated as n/N (n=number of participants with observation; N=Total number of participants in respective treatment group (all participants who received at least one dose of study drug). Participants were categorized to the treatment group to which they were assigned unless incorrect study treatment was received throughout the study, in which case the participant was categorized according to the treatment received.
Incidence of Adjudicated Total Bleeding During the Treatment Period in Treated Participants Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Bleeding defined by International Society on Thrombosis and Haemostasis: Total Bleeding defined as any of major, CRNM, or minor bleeding. All events were adjudicated by an ICAC blinded to treatment. Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of participants in respective treatment group (all participants who received at least one dose of study drug). Participants were categorized to the treatment group to which they were assigned unless incorrect study treatment was received throughout the study, in which case the participant was categorized according to the treatment received.
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Bleeding AEs, Discontinuations Due to AEs and Death During the Treatment Period in Treated Participants First dose to last dose of 24 Weeks + 2 days (AEs) or + 30 days (SAEs) or until drug discontinued Treated Participants: all who received at least 1 dose of study drug. Participants categorized to the treatment group to which they were assigned unless incorrect study treatment was received throughout the study, in which case the participant was categorized according to treatment received. Included all SAEs and AEs with onset from first dose to last dose + 2 days (for AEs) or + 30 days (for SAEs); note; bleeding AEs and SAEs from first dose to last dose + 2 days included. Discontinuations due to AE included all AEs/SAEs from first dose until drug was discontinued. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization.
Number of Treated Participants With Marked Abnormalities in Hematology Laboratory Tests Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Lower limit of normal (LLN). Upper limit of normal (ULN). Pre-therapy (PreRx). Absolute (Abs) neutrophil count, bands + neutrophils (ANC). Cells per microliter (c/µL). Grams per deciliter (g/dL). Cells per Liter (c/L). Millimeter (MM). White blood cells: \< 0.75\*LLN, \> 1.25\*ULN; Hemoglobin: \<= 11.5 g/dL (males), \<= 9.5 g/dL (females); Hematocrit: \<= 37% (males), \<= 32% (females); Erythrocytes: \<0.75\*10\^6 c/µL\*PreRx; Platelet count: \< 75\*10\^9 c/L, \> 700\*10\^9 c/L; ANC: \< 1.00\*10\^3 c/µL; Abs eosinophils: \> 0.750\*10\^3 c/µL; Abs Basophils: \> 400/MM\^3; Abs Monocytes\> 2000/MM\^3; Abs Lymphocytes: \< 0.750\*10\*3 c/ µL, \> 7.5\*10\^3 c/ µL.
Number of Treated Participants With Marked Abnormalities in Electrolyte Laboratory Tests Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Bicarbonate milliequivalents/Liter (mEq/L) Low/High: \< 0.75\*LLN or \> 1.25\*ULN, or if pre-dose \< LLN then use \< 0.75\*pre-dose or \> ULN if pre-dose \> ULN then use \> 1.25\*pre-dose or \< LLN; Serum Calcium mg/dL Low/High: \< 0.8\*LLN or \> 1.2\*ULN, or if pre-dose \< LLN then use \< 0.75\*pre-dose or \> ULN if pre-dose \> ULN then use \> 1.25\*pre-dose or \< LLN; Serum Chloride mEq/L: \< 0.9\*LLN or \> 1.1\*ULN, or if pre-dose \< LLN then use \< 0.9\*pre-dose or \> ULN if pre-dose \> ULN then use \> 1.1\*pre-dose or \< LLN; Serum Potassium mEq/L: \< 0.9\*LLN or \> 1.1\*ULN, or if pre-dose \< LLN then use \< 0.9\*pre-dose or \> ULN if pre-dose \> ULN then use \> 1.1\*pre-dose or \< LLN; Serum Sodium mEq/L: \< 0.95\*LLN or \> 1.05\*ULN, or if pre-dose \< LLN then use \< 0.95\*pre-dose or \> ULN if pre-dose \> ULN then use \> 1.05\*pre-dose or \< LLN.
Number of Treated Participants With Marked Abnormalities in Kidney and Liver Function Laboratory Tests Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Blood urea nitrogen (BUN), milligrams/deciliter (mg/dL), units per liter (U/L). BUN mg/dL High: \> 1.5\*ULN; Creatinine mg/dL: \> 1.5\*ULN; Alanine aminotransferase (ALT) U/L: \> 3\*ULN; Aspartate aminotransferase (AST) U/L: \> 3\*ULN; Alkaline phosphatase U/L: \> 2\*ULN; Bilirubin Direct mg/dL: \> 1.5\*ULN; Bilirubin Total mg/dL: \> 2\*ULN.
Incidence of Adjudicated Major/CRNM Bleeding During the Treatment Period in Treated Participants Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Major Bleeding = acute, clinically overt bleeding: decrease in hemoglobin of 2 g/dL or more, or bleeding leading to transfusion, or bleeding in a critical site, or fatal bleeding. CRNM = acute clinically overt bleeding: compromising hemodynamics, leading to hospitalization, hematoma, epistasis \>5 minutes or repetitive, gingival bleeding, hematuria, macroscopic gastrointestinal hemorrhage, rectal blood loss, hemoptysis. Minor =: All acute clinically overt bleeding events not meeting the criteria for either major bleeding or CRNM. All events were adjudicated by an ICAC blinded to treatment. Total bleeding = any of major, or CRNM, or minor bleeding. Event rate (proportion of participants with event): n/N (n=number of participants with observation; N=Total number of treated (received at least 1 dose of study drug).
Number of Treated Participants With Marked Abnormalities in Creatine Kinase, Uric Acid, and Total Protein Laboratory Tests Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) Creatine kinase High: \>5\*ULN Units/Liter (U/L); Total Protein High/Low: \< 0.9 \*LLN or \> 1.1\*ULN, or if pre-dose \< LLN then use 0.9\* pre-dose or \> ULN if pre-dose \> ULN then use 1.1 \*pre-dose or \<LLN; Uric acid High: \> 1.5\* ULN, or if pre-dose \> ULN then use \> 2 \*pre-dose.
Number of Treated Participants With Marked Abnormalities in Urinalysis Laboratory Tests Day 1 to Week 24 + 2 Days or 355 Days (Discontinued Early) All tests in urine: Glucose: If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4; Protein: If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4; Blood: If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4; Leukocyte esterase: If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4;Red blood cells (RBC): If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4; White blood cells (WBC): If missing pre-dose use ≥ 2, or if value ≥ 4, or if pre-dose = 0 or 0.5 use ≥ 2, or if pre-dose = 1 use ≥ 3, or if pre-dose = 2 or 3 use ≥ 4.
Trial Locations
- Locations (74)
Pasadena Center For Medical Research
🇺🇸St. Petersburg, Florida, United States
Great Falls Clinic, Llp
🇺🇸Great Falls, Montana, United States
Infectious Disease Of Indiana Psc
🇺🇸Carmel, Indiana, United States
Richmond University Medical Center
🇺🇸Staten Island, New York, United States
University Of Missouri-Columbia
🇺🇸Columbia, Missouri, United States
Mercury Street Medical Group, Pllc
🇺🇸Butte, Montana, United States
Anne Arundel Medical Center
🇺🇸Annapolis, Maryland, United States
R Adams Cowley Shock Trauma Center
🇺🇸Baltimore, Maryland, United States
Medstar Research Health Institute
🇺🇸Baltimore, Maryland, United States
Hurley Medical Center
🇺🇸Flint, Michigan, United States
Carolinas Medical Center
🇺🇸Charlotte, North Carolina, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
University Of Utah Medical Center
🇺🇸Salt Lake City, Utah, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Alabama Clinical Therapeutics, Llc
🇺🇸Birmingham, Alabama, United States
Creighton University Medical Center
🇺🇸Omaha, Nebraska, United States
Horizon Research Group, Inc.
🇺🇸Mobile, Alabama, United States
Fort Smith Lung Center
🇺🇸Fort Smith, Arkansas, United States
University Of Arkansas For Medical Sciences
🇺🇸Little Rock, Arkansas, United States
Beaver Medical Group
🇺🇸Banning, California, United States
University Of California San Francisco-Fresno
🇺🇸Fresno, California, United States
Chest Medicine & Critical Care Medical Gr. Inc.
🇺🇸San Diego, California, United States
Harbor Ucla Medical Center
🇺🇸Torrance, California, United States
Stanford University Medical Center
🇺🇸Stanford, California, United States
New West Physicians
🇺🇸Golden, Colorado, United States
Bridgeport Hospital
🇺🇸Bridgeport, Connecticut, United States
Drogue Medical, Llc
🇺🇸Wheat Ridge, Colorado, United States
George Washington University Medical Faculty Associates
🇺🇸Washington, District of Columbia, United States
Bay Pines Va Healthcare Systems
🇺🇸Bay Pines, Florida, United States
Research Alliance, Inc.
🇺🇸Clearwater, Florida, United States
River City Clinical Research
🇺🇸Jacksonville, Florida, United States
Daniel G. Lorch, Jr, Md, Cpi
🇺🇸Brandon, Florida, United States
Office Of Michele S. Maholtz Md
🇺🇸Vero Beach, Florida, United States
Cleveland Clinic Florida
🇺🇸Weston, Florida, United States
Chatham Hospitalists
🇺🇸Savannah, Georgia, United States
Atlanta Institute For Medical Research, Inc
🇺🇸Decatur, Georgia, United States
Atlanta Pulmonary Group
🇺🇸Atlanta, Georgia, United States
Gateway Cardiology. P.C
🇺🇸Jerseyville, Illinois, United States
West Suburban Medical Center
🇺🇸Oak Park, Illinois, United States
Heartland Vascular Medicine And Surgery
🇺🇸Windsor Heights, Iowa, United States
Research Integrity, Llc
🇺🇸Owensboro, Kentucky, United States
Univ. Of Kentucky Dept. Of Surgery
🇺🇸Lexington, Kentucky, United States
Pen Bay Medical Center
🇺🇸Rockport, Maine, United States
Kentucky Lung Clinic
🇺🇸Hazard, Kentucky, United States
Mississippi Medical Research, Llc
🇺🇸Picayune, Mississippi, United States
Washington University School Of Medicine
🇺🇸St Louis, Missouri, United States
Internal Medical Associates Of Grand Island, P.C
🇺🇸Grand Island, Nebraska, United States
St. John'S Mercy Medical Center
🇺🇸St. Louis, Missouri, United States
Morristown Memorial Hospital
🇺🇸Morristown, New Jersey, United States
Pulmonary & Critical Care Services, Pc
🇺🇸Albany, New York, United States
New York Medical College
🇺🇸Valhalla, New York, United States
Kaleida Health System
🇺🇸Buffalo, New York, United States
Piedmont Healthcare/Research
🇺🇸Statesville, North Carolina, United States
Rex Healthcare
🇺🇸Raleigh, North Carolina, United States
Wilmington Medical Research
🇺🇸Wilmington, North Carolina, United States
Clinical Trials Of America, Inc.
🇺🇸Winston Salem, North Carolina, United States
Altru Health System Clinic
🇺🇸Grand Forks, North Dakota, United States
Huron Hospital
🇺🇸Cleveland, Ohio, United States
Remington Davis Inc.
🇺🇸Columbus, Ohio, United States
Greenville Hospital System
🇺🇸Greenville, South Carolina, United States
Oregon Health Science University
🇺🇸Portland, Oregon, United States
Penn State Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
Palmetto Clinical Research
🇺🇸Summerville, South Carolina, United States
Primecare Medical Group
🇺🇸Houston, Texas, United States
Kore Cv Research
🇺🇸Jackson, Tennessee, United States
Holston Medical Group
🇺🇸Bristol, Tennessee, United States
Cancer Care Centers Of South Texas
🇺🇸San Antonio, Texas, United States
Local Institution
🇬🇧Livingston, West Lothian, United Kingdom
Lake Washington Vascular, Pllc
🇺🇸Bellevue, Washington, United States
Franciscan Research Center
🇺🇸Tacoma, Washington, United States
University Of California, Davis Medical Center
🇺🇸Sacramento, California, United States
Dept Of Internal Med, Sect Of Pulmonary & Critical Care Med
🇺🇸New Haven, Connecticut, United States
Tampa Clinical Research
🇺🇸Tampa, Florida, United States
Veterans Affairs Medical Center
🇺🇸Kansas City, Missouri, United States