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CORE-OLE: A Study of Olezarsen (ISIS 678354) Administered Subcutaneously to Participants With Severe Hypertriglyceridemia (SHTG)

Phase 3
Recruiting
Conditions
Severe Hypertriglyceridemia
Interventions
Registration Number
NCT05681351
Lead Sponsor
Ionis Pharmaceuticals, Inc.
Brief Summary

The purpose of this study is to evaluate the safety and tolerability of olezarsen in participants with SHTG.

Detailed Description

This is a multi-center, open-label extension (OLE) study of approximately 800 participants with SHTG who would be rolled over from studies ISIS 678354-CS5 (NCT05079919) or ISIS 678354-CS6 (NCT05552326). Day 1 of this study may be same as the Week 53 visit of either ISIS 678354-CS5 or ISIS 678354-CS6, as applicable. Participants will receive olezarsen during the 157-week treatment period. The study will include a 31-day qualification Period, a 157-week treatment period, and a 13-week post-treatment period.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
800
Inclusion Criteria
  • Satisfactory completion of either ISIS 678354-CS5 or ISIS 678354-CS6 with an acceptable safety profile, per Investigator judgment. Satisfactory completion requires that the patient did not terminate early from treatment.
  • Participants must be on a stable regimen of lipid-lowering therapy that should adhere to standard of care (SOC) per local guidelines. A patient may be eligible if their regimen of lipid-lowering therapy has been changed recently, provided that lipid lowering medications are optimized and stabilized for at least 4 weeks prior to the end of the Qualification Period of this OLE study; ideally, such changes are initiated after Week 53 of the index study (ISIS 678354-CS5 or CS6).
  • A patient may re-enroll in the study after having completed the study when the Treatment Period was 53 weeks, if the patient satisfactorily completed the study with an acceptable safety profile, per Investigator judgment. In the case of re-enrollment, there is no limit on the time gap between completion of treatment under the previous protocol and dosing upon re-enrollment (i.e., may exceed 17 weeks between doses).

Key

Exclusion Criteria

• Have any new condition or worsening of existing condition which in the opinion of the Investigator would make the participant unsuitable for enrollment, or could interfere with the participant participating in or completing the study, including need for treatment with disallowed medications, or need to change the required stable regimen as per either ISIS 678354-CS5 or ISIS 678354-CS6 study entry criteria. It is acceptable to adjust a regimen of lipid-lowering therapy as described in the second Key Inclusion Criterion above, and it is acceptable to adjust or stop lipid-lowering therapy at or after Week 13 per Investigator judgment.

NOTE: Other Inclusion/Exclusion criteria may apply.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
OlezarsenOlezarsenParticipants who completed either ISIS 678354-CS5 (NCT05079919) or ISIS 678354-CS6 (NCT05552326) study would be enrolled to receive olezarsen, subcutaneous (SC) injection, once every 4 weeks from Week 1 through Week 153.
Primary Outcome Measures
NameTimeMethod
Proportion of Participants With Change in Clinical Laboratory Values From Baseline to Week 53, From Baseline to Week 105, and From Baseline to Week 157Baseline up to Week 157
Proportion of Participants Who Experience Adverse Events (AEs)Baseline up to Week 157
Proportion of Participants Who Use Concomitant MedicationsBaseline up to Week 157
Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (254)

Hospital Universitario de Jaen

🇪🇸

Jaén, Spain

Hospital Abente y Lago

🇪🇸

La Coruna, Spain

Hospital Universitario 12 de Octubre

🇪🇸

Madrid, Spain

SBAL "Special Medic" Ltd.

🇧🇬

Plovdiv, Bulgaria

UHMAT Kaspela Ltd

🇧🇬

Plovdiv, Bulgaria

Evangelismos General Hospital Athens

🇬🇷

Athens, Greece

Hygeia Hospital

🇬🇷

Athens, Greece

Lausmed Kft

🇭🇺

Baja, Hungary

Milan Kvapil s.r.o.

🇨🇿

Příbram, Czechia

AeskuLab k.s

🇨🇿

Teplice, Czechia

MU Dr. Nina Zemkova s.r.o. Interni Ambulance

🇨🇿

Uherské Hradiště, Czechia

Aalborg University Hospital

🇩🇰

Aalborg, Denmark

Aarhus Universitet Hospital

🇩🇰

Aarhus, Denmark

Esbjerg Hospital

🇩🇰

Esbjerg, Denmark

Viborg Regional Hospital

🇩🇰

Viborg, Denmark

Turku University Hospital

🇫🇮

Turku, Finland

Louis Pradel Hospital

🇫🇷

Bron, France

Chu Dijon Bourgogne

🇫🇷

Dijon, France

Hôpitaux de Marseille

🇫🇷

Marseille, France

Hopital Lapeyronie

🇫🇷

Montpellier, France

AP-HP Hopital Pitie-Salpetriere

🇫🇷

Paris, France

CHU de Nantes - Hôpital Nord Laennec

🇫🇷

Saint-Herblain, France

CHRU de Strasbourg

🇫🇷

Strasbourg, France

Groupement de Cooperation Sanitaire (GCS) ESLAN - Polyclinique Vauban

🇫🇷

Valenciennes, France

GHM les Portes du Sud

🇫🇷

Vénissieux, France

Charite- Universitaetsmedizin Berlin

🇩🇪

Berlin, Germany

Universitaetsklinikum Carl Gustav Carus

🇩🇪

Dresden, Germany

Universitaetsklinikum Koeln

🇩🇪

Koeln, Germany

Forschungszentrum Ruhr

🇩🇪

Witten, Germany

DRC Gyógyszervizsgáló Központ Korlátolt felelősségű társaság Balatonfüred

🇭🇺

Balatonfüred, Hungary

Obudai Egeszsegugyyi Centrum

🇭🇺

Budapest, Hungary

Debreceni Egyetem Klinikai Központ

🇭🇺

Debrecen, Hungary

Rakoczi Ferenc Korhaz

🇭🇺

Miskolc, Hungary

Dr. Vasas Szilard Haziorvosi Rendelo

🇭🇺

Nyíregyháza, Hungary

Kardiologia Szakrendeles

🇭🇺

Nyíregyháza, Hungary

Cardio D&R, S.R.O. Kosice

🇸🇰

Košice, Slovakia

Human-Care s.r.o.

🇸🇰

Košice, Slovakia

Vychodoslovensky Utsav srdcovych a cievnych chorob a.s.

🇸🇰

Košice, Slovakia

Interna a diabetologicka ambulancia- IN- DRA- s.r.o.

🇸🇰

Lučenec, Slovakia

Diab sro

🇸🇰

Rožňava, Slovakia

Interna SK, s.r.o., Kardiologicka a interna ambulancia

🇸🇰

Svidník, Slovakia

Nemocnica arm. generala L. Svobodu Svidnik, a.s

🇸🇰

Svidník, Slovakia

Areteus sro

🇸🇰

Trebišov, Slovakia

Latros International

🇿🇦

Bloemfontein, South Africa

Medi Clinic Vergelegen

🇿🇦

Cape Town, South Africa

TREAD Research

🇿🇦

Cape Town, South Africa

University of Cape Town

🇿🇦

Cape Town, South Africa

Hospital Germans Trias i Pujol

🇪🇸

Badalona, Spain

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Clinic De Barcelona

🇪🇸

Barcelona, Spain

Hospital Universitari de Bellvitge

🇪🇸

Barcelona, Spain

Hospital Universitario Reina Sofia

🇪🇸

Córdoba, Spain

Hospital Universitario Virgen de la Victoria

🇪🇸

Málaga, Spain

Corporacio Sanitaria Parc Tauli- Hospital de Sabadell

🇪🇸

Sabadell, Spain

Hospital Universitario Virgen Macarena

🇪🇸

Sevilla, Spain

Hospital Virgen del Rocío

🇪🇸

Sevilla, Spain

Hospital Universitari Sant Joan de Reus

🇪🇸

Tarragona, Spain

Hospital Clinico Universitario de Valencia

🇪🇸

Valencia, Spain

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Sahlgrenska, University Hospital

🇸🇪

Göteborg, Sweden

Karolinska University Hospital Huddinge

🇸🇪

Stockholm, Sweden

DCC-1 Sliven Ltd.

🇧🇬

Sliven, Bulgaria

Medical Center Smolyan Clinical Research OOD

🇧🇬

Smolyan, Bulgaria

LA Universal Research Center, Inc.

🇺🇸

Los Angeles, California, United States

University of California, San Diego (UCSD)

🇺🇸

San Diego, California, United States

Metabolic Institute of America

🇺🇸

Tarzana, California, United States

Excel Medical Clinical Trials

🇺🇸

Boca Raton, Florida, United States

Finlay Medical Research

🇺🇸

Miami, Florida, United States

Columbus Clinical Services, LLC

🇺🇸

Miami, Florida, United States

Innovia Research Center, Inc.

🇺🇸

Miramar, Florida, United States

Harmony Clinical Research, Inc.

🇺🇸

North Miami Beach, Florida, United States

R & B Medical Center LLC

🇺🇸

Tampa, Florida, United States

VICIS Clinical Research

🇺🇸

Tampa, Florida, United States

JSV Clinical Research Study, Inc.

🇺🇸

Tampa, Florida, United States

Bayside Clinical Research

🇺🇸

Trinity, Florida, United States

Centricity Research

🇺🇸

Columbus, Georgia, United States

IACT Health

🇺🇸

Columbus, Georgia, United States

Affinity Health

🇺🇸

Oak Brook, Illinois, United States

St. Vincent Medical Group, Inc.

🇺🇸

Carmel, Indiana, United States

University of Kansas Medical Center (KUMC)

🇺🇸

Kansas City, Kansas, United States

The Research Group of Lexington, LLC

🇺🇸

Lexington, Kentucky, United States

Louisville Metabolic and Atherosclerosis Research Center (L-MARC)

🇺🇸

Louisville, Kentucky, United States

Grace Research, LLC

🇺🇸

Bossier City, Louisiana, United States

IRC Clinics

🇺🇸

Towson, Maryland, United States

Massachusetts General Hospital Heart Center

🇺🇸

Boston, Massachusetts, United States

University of Michigan- Endocrinology & Metabolism

🇺🇸

Ann Arbor, Michigan, United States

Aa Mrc, Llc

🇺🇸

Flint, Michigan, United States

Washington School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Bryan Medical Center

🇺🇸

Lincoln, Nebraska, United States

Palm Research Center, Inc.

🇺🇸

Las Vegas, Nevada, United States

Hudson County Clinical Trials Research Center

🇺🇸

Union City, New Jersey, United States

Modern Medical

🇺🇸

Brooklyn, New York, United States

NYU Langone Health

🇺🇸

Mineola, New York, United States

Langone Medical Center

🇺🇸

New York, New York, United States

Vagelos College of Physicians and Surgeons of Columbia University

🇺🇸

New York, New York, United States

Orchard Park Family Practice

🇺🇸

Orchard Park, New York, United States

The Presbyterian Hospital DBA Novant Health Heart and Vascular Institute

🇺🇸

Charlotte, North Carolina, United States

Kenneth Hilty

🇺🇸

Greensboro, North Carolina, United States

Clinical Trials of America, LLC

🇺🇸

Lenoir, North Carolina, United States

Lexington

🇺🇸

Winston-Salem, North Carolina, United States

The Ohio State University

🇺🇸

Columbus, Ohio, United States

Central Oklahoma Early Detection Center

🇺🇸

Edmond, Oklahoma, United States

Oklahoma Heart Institute

🇺🇸

Tulsa, Oklahoma, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Walker Family Care

🇺🇸

Little River, South Carolina, United States

Monument Health Clinical Research

🇺🇸

Rapid City, South Dakota, United States

Health Concepts

🇺🇸

Rapid City, South Dakota, United States

Chattanooga Research & Medicine, PLLC

🇺🇸

Chattanooga, Tennessee, United States

The Jackson Clinic

🇺🇸

Jackson, Tennessee, United States

Clinical of Cardiology

🇧🇬

Stara Zagora, Bulgaria

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

Juno Research

🇺🇸

Houston, Texas, United States

Pioneer Research Solutions

🇺🇸

Houston, Texas, United States

FMC Science

🇺🇸

Lampasas, Texas, United States

DCT- McAllen Primary Care, LLC

🇺🇸

McAllen, Texas, United States

Texas Institute of Cardiology

🇺🇸

McKinney, Texas, United States

SMS Clinical Research, LLC

🇺🇸

Mesquite, Texas, United States

Southern Endocrinology Associates

🇺🇸

Mesquite, Texas, United States

Permian Research Foundation

🇺🇸

Odessa, Texas, United States

Diabetes & Glandular Disease Clinic, P.A.

🇺🇸

San Antonio, Texas, United States

Tranquil Clinical and Research Consulting Services

🇺🇸

Webster, Texas, United States

Manassas Clinical Research

🇺🇸

Manassas, Virginia, United States

York Clinical Research

🇺🇸

Norfolk, Virginia, United States

WVU Heart and Vascular Institute

🇺🇸

Morgantown, West Virginia, United States

CIPREC

🇦🇷

Buenos Aires, Argentina

Fundacion Favaloro

🇦🇷

Buenos Aires, Argentina

Centro Medico Dra. Laura Maffei-Investigacion Clinica Aplicad

🇦🇷

Buenos Aires, Argentina

Glenny Corp SA

🇦🇷

Buenos Aires, Argentina

Instituto Medico DAMIC

🇦🇷

Córdoba, Argentina

Clinica FUSAVIM Privada

🇦🇷

Villa María, Argentina

Royal North Shore Hospital

🇦🇺

Saint Leonards, New South Wales, Australia

Royal Adelaide Hospital

🇦🇺

Adelaide, Australia

Royal Prince Alfred Hospital

🇦🇺

Camperdown, Australia

Monash Medical Centre

🇦🇺

Clayton, Australia

Dr Heart Pty Ltd

🇦🇺

Woolloongabba, Australia

Jessa Ziekenhuis

🇧🇪

Hasselt, Belgium

Universitaire Ziekenhuizen Leuven

🇧🇪

Leuven, Belgium

Centro Especializado em Cardiologia

🇧🇷

Campinas, Brazil

Nucleo de Pesquisa Clinica S/S

🇧🇷

Curitiba, Brazil

Hospital Universitario Walter Cantidio- UFC

🇧🇷

Fortaleza, Brazil

Instituto do Coracao (InCor) do Hospital das Clinicas da FMUSP

🇧🇷

São Paulo, Brazil

CPQuali Pesquisa Clinica Ltda.

🇧🇷

São Paulo, Brazil

MHAT- Blagoevgrad AD

🇧🇬

Blagoevgrad, Bulgaria

Medical Center Doctor Staykov EOOD

🇧🇬

Burgas, Bulgaria

Medical Center Diamedical 2013 OOD

🇧🇬

Dimitrovgrad, Bulgaria

MHAT

🇧🇬

Gabrovo, Bulgaria

MHAT Haskovo AD

🇧🇬

Haskovo, Bulgaria

Multiprofile Hospital for Active Treament Pazardzhik, Cardiology Department

🇧🇬

Pazardzhik, Bulgaria

University Multiprofile Hospital for Active Treatment Pulmed, Clinic of Endocrinology

🇧🇬

Plovdiv, Bulgaria

Medical Center Rusemed EOOD

🇧🇬

Ruse, Bulgaria

UMHAT Kanev AD

🇧🇬

Ruse, Bulgaria

Medical Center for Specialized Medical Help in Cardiovascular Diseases OOD

🇧🇬

Sofia, Bulgaria

Praha Poliklinika Hurka

🇨🇿

Praha, Czechia

UMHAT Tsaritsa Yoanna ISUL- Clinic of Cardiology

🇧🇬

Sofia, Bulgaria

Medical Center Endomedical

🇧🇬

Sofia, Bulgaria

Medical Center Kalimat EOOD

🇧🇬

Sofia, Bulgaria

MC Doctor Kalchev OOD

🇧🇬

Sofia, Bulgaria

Medical Centre Synexus Sofia

🇧🇬

Sofia, Bulgaria

UMHAT Sofiamed

🇧🇬

Sofia, Bulgaria

MHAT Silven to MMA Sofia

🇧🇬

Sofia, Bulgaria

Medical Center Zara-Med

🇧🇬

Stara Zagora, Bulgaria

Diagnostic Consultative Center Equita (DCC Equita)

🇧🇬

Varna, Bulgaria

Specialized Hospital for Active Treatment of Cardiology

🇧🇬

Varna, Bulgaria

Medical Centre "Nevromedics" EOOD

🇧🇬

Veliko Tarnovo, Bulgaria

Bluewater Clinical Research Group, Inc.

🇨🇦

Sarnia, Ontario, Canada

Canadian Phase Onward Inc.

🇨🇦

Toronto, Ontario, Canada

Ecogene-21

🇨🇦

Chicoutimi, Quebec, Canada

Clinique des Maladies Lipidiques de Quebec Inc.

🇨🇦

Québec, Quebec, Canada

Institut de Recherches Cliniques de Montreal

🇨🇦

Montréal, Canada

Toronto General Hospital

🇨🇦

Toronto, Canada

MEDICUS SERVICES s.r.o.

🇨🇿

Brandýs Nad Labem, Czechia

University Hospital Hradec Králové

🇨🇿

Hradec Králové, Czechia

KardioBusak s.r.o.

🇨🇿

Louny, Czechia

EDUMED s.r.o.

🇨🇿

Náchod, Czechia

Fakultni nemocnice Ostrava

🇨🇿

Ostrava, Czechia

Vseobecna fakultni nemocnice

🇨🇿

Prague, Czechia

Endokrinologie Cerny Most s.r.o.

🇨🇿

Prague, Czechia

Fakultni Nemocnice v Motole

🇨🇿

Praha, Czechia

Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz

🇭🇺

Székesfehérvár, Hungary

Vinaya Hospital and Research Centre

🇮🇳

Mangalore, India

Soroka Medical Center

🇮🇱

Be'er Sheva, Israel

Bnai Zion Medical Center

🇮🇱

Haifa, Israel

The Lady Davis Carmel Medical Center

🇮🇱

Haifa, Israel

Shaare Zedek Medical Center

🇮🇱

Jerusalem, Israel

Rabin Medical Center

🇮🇱

Petach Tikva, Israel

The Chaim Sheba Medical Center

🇮🇱

Ramat Gan, Israel

Kaplan Medical Center

🇮🇱

Reẖovot, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Azienda Socio Sanitaria Territoriale Papa Giovanni XXII

🇮🇹

Bergamo, Italy

Policlinico di Sant'Orsola

🇮🇹

Bologna, Italy

Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione "Sant' Anna e San Sebastiano" di Caserta

🇮🇹

Caserta, Italy

Ospdale E. Bassini

🇮🇹

Milano, Italy

Asst Grande Ospedale Metropolitano Niguarda

🇮🇹

Milano, Italy

Azienda Ospedaliera Universitaria Federico II

🇮🇹

Napoli, Italy

Azienda Ospedaliera Universitaria Policlinico

🇮🇹

Palmero, Italy

Department of Translational and Precision Medicine

🇮🇹

Rome, Italy

Klinikiniai Sprendimai, UAB

🇱🇹

Kaunas, Lithuania

Saules Seimos Medicinos Centras

🇱🇹

Kaunas, Lithuania

Kardiologijos ir reabilitacijos klinika, UAB

🇱🇹

Klaipėda, Lithuania

University Malaya Medical Centre (UMMC)

🇲🇾

Kuala Lumpur, Malaysia

Pulau Pinang Hospital

🇲🇾

Pulau Pinang, Malaysia

Scientia Investigacion Clinical Sc

🇲🇽

Chihuahua, Mexico

Clinstile, S.A. de C.V.

🇲🇽

Mexico City, Mexico

Centro de Investigacion Cardiometabolica S.C.

🇲🇽

Mexico City, Mexico

Academic Medical Center

🇳🇱

Amsterdam, Netherlands

Gelre Ziekenhuizen

🇳🇱

Apeldoorn, Netherlands

Ziekenhuis Rijnstate

🇳🇱

Arnhem, Netherlands

Het Van Weel-Bethesda Ziekenhuis

🇳🇱

Dirksland, Netherlands

Ziekenhuis Gelderse Vallei

🇳🇱

Ede, Netherlands

Bethesda Diabetes Research Center

🇳🇱

Hoogeveen, Netherlands

Radboud UMC

🇳🇱

Nijmegen, Netherlands

Erasmus MC

🇳🇱

Rotterdam, Netherlands

University Medical Center Utrecht

🇳🇱

Utrecht, Netherlands

Albert Schweitzer Ziekenhuis

🇳🇱

Zwijndrecht, Netherlands

New Zealand Clinical Research

🇳🇿

Auckland, New Zealand

Edgar Diabetes and Obesity Research Centre

🇳🇿

Wellington, New Zealand

The Lipid Clinic (Oslo University Hospital)

🇳🇴

Oslo, Norway

Uniwersytecki Centrum Kliniczne, I Klinika Kardiologii

🇵🇱

Gdańsk, Poland

Biokinetica Spolka Akcujna

🇵🇱

Józefów, Poland

Centrum Medyczne Salvia

🇵🇱

Katowice, Poland

Clinical Best Solutions

🇵🇱

Lublin, Poland

ETG Lublin

🇵🇱

Lublin, Poland

Centrum Zdrowia Metabolicznego Pawel Bogdanski

🇵🇱

Poznań, Poland

Osrodek Badan Klinicznych Metabolica

🇵🇱

Tarnów, Poland

Clinical Best Solutions Sp. z.o.o. Spolka Komandytowa

🇵🇱

Warsaw, Poland

Przychodnia Futuremeds Wroclaw

🇵🇱

Wrocław, Poland

ETG Zamosc

🇵🇱

Zamość, Poland

Instytut Centrum Zdrowia Matki Polki

🇵🇱

Łódź, Poland

Hospital Infante D. Pedro

🇵🇹

Aveiro, Portugal

Hospital COF Tejo

🇵🇹

Lisboa, Portugal

Hospital CUF Tejo

🇵🇹

Lisboa, Portugal

Centro Hospitalar Universitario De Sao Joao

🇵🇹

Porto, Portugal

Centro Hospitalar de Entre o Douro e Vouga, E.P.E.

🇵🇹

Santa Maria Da Feira, Portugal

Cardioplus Center SRL

🇷🇴

Baia Mare, Romania

Ambulancia diabetologicka a poruch latkovej premeny a vyzivy

🇸🇰

Bratislava, Slovakia

Kardiologická ambulancia

🇸🇰

Brezno, Slovakia

Kaohsiung Medical University Ching-Ho Memorial Hospital

🇨🇳

Kaohsiung, Taiwan

Mackay Memorial Hospital

🇨🇳

New Taipei City, Taiwan

Taichung Veterans General Hospital

🇨🇳

Taichung, Taiwan

National Cheng Kung University Hospital

🇨🇳

Tainan, Taiwan

Shing Kong Wu Ho-Su Memorial Hospital

🇨🇳

Taipei City, Taiwan

Ege University School of Medicine, Department of Cardiology

🇹🇷

İzmir, Turkey

Necmettin Erbakan Universitesi Meram Tip Fakultesi

🇹🇷

Konya, Turkey

Hacettepe Üniversitesi Tıp Fakültesi

🇹🇷

Sulhiye, Turkey

Centre for Diabetes, Endocrinology and Metabolic Disease

🇬🇧

Woodhurst, Chatsworth, United Kingdom

Huddersfield Royal Infirmary

🇬🇧

Huddersfield, England, United Kingdom

Waterloo Medical Care

🇬🇧

Blackpool, United Kingdom

Hull Royal Infirmiry

🇬🇧

Hull, United Kingdom

Oak Tree Surgery and Pensilva Health Centre

🇬🇧

Liskeard, United Kingdom

Manchester University NHS Foundation Trust

🇬🇧

Manchester, United Kingdom

Newquay Health Centre

🇬🇧

Newquay, United Kingdom

The Adam Practice

🇬🇧

Poole, United Kingdom

Sandwell and West Birmingham NHS Trust

🇬🇧

West Bromwich, United Kingdom

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