MedPath

Efficacy and Safety Study of Apixaban for Extended Treatment of Deep Vein Thrombosis or Pulmonary Embolism

Phase 3
Completed
Conditions
Venous Thrombosis
Interventions
Drug: Placebo
Registration Number
NCT00633893
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The purpose is to evaluate the effects of an investigational blood thinner, apixaban, in preventing venous thromboembolic (VTE) recurrence or death in patients who have completed their intended treatment for deep vein thrombosis (DVT) or pulmonary embolism (PE)

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
2711
Inclusion Criteria
  • Men and women ≥ 18 years of age;
  • Clinical diagnosis of Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE);
  • Anticoagulant treatment completed
  • No recurrence of Venous Thromboembolism (VTE)
Exclusion Criteria
  • Subjects with indications for long-term treatment with a vitamin K antagonist
  • Active bleeding or high risk for serious bleeding
  • Short life expectancy
  • Uncontrolled high blood pressure
  • Impaired kidney or liver function

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Apixaban2.5 mg
3Placebo0 mg
2Apixaban5.0 mg
Primary Outcome Measures
NameTimeMethod
Adjudicated Composite of Symptomatic, Recurrent Venous Thromboembolism (VTE) or All-Cause Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

VTE included: nonfatal deep vein thrombosis (DVT) or nonfatal pulmonary embolism (PE). All index events, DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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 events; N=number of 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. For missing endpoint data, participants were imputed as having had a primary efficacy outcome event.

Adjudicated Composite of Symptomatic, Recurrent Venous Thromboembolism (VTE) or All-Cause Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 months

VTE included: nonfatal DVT or nonfatal PE. Event rate (proportion of participants with event) calculated as n/N (n=number of events; N=number of 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. No imputation was done for these endpoints; participants who had an event during the intended treatment period were counted. Confidence interval (CI) for single event rate was calculated based on the Wald asymptotic confidence limits.

Secondary Outcome Measures
NameTimeMethod
Adjudicated Composite of Recurrent, Symptomatic Venous Thromboembolism (VTE) or VTE-related Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

VTE includes nonfatal DVT or nonfatal PE. All index events, DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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 events; N=number of 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. For missing endpoint data, participants were imputed as having had a primary efficacy outcome event.

Adjudicated Composite of Major/Clinically Relevant Non-major Bleeding During the Treatment Period - Treated ParticipantsDay 1 up to 12 Months

Major bleeding and clinically relevant non-major bleeding were adjudicated/confirmed by a central independent adjudication committee blinded to treatment. Major bleeding was defined as acute clinically overt bleeding: associated with a fall in hemoglobin of 2 g/dL or more, or leading to a transfusion of 2 or more units of packed red blood cells or 1000 mL or more of whole blood, or in a critical site: intracranial, intraspinal, intraocular, pericardial, intra-articular, intramuscular with compartment syndrome, retroperitoneal, or another critical organ or is fatal. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). CI for single event rate was calculated based on the Wald asymptotic confidence limits. Treated population includes randomized participants who received at least one dose of study drug.

Adjudicated Composite of Recurrent, Symptomatic Venous Thromboembolism (VTE) or Cardio Vascular (CV) -Related Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

VTE includes nonfatal DVT or nonfatal PE. All index events, DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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 is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Composite endpoint included events that occurred any time from randomization until end of the intended treatment period, regardless of whether the participants were receiving drug treatment. Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. If there were missing endpoint data, participants were imputed as having had an efficacy outcome event.

Adjudicated Cardiovascular (CV)-Related Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

CV-related death was defined as myocardial infarction, stroke, or other specified cardiovascular event and were adjudicated/confirmed by a central independent adjudication committee blinded to treatment. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. Participants with missing endpoint information were classified as having had the efficacy event (imputation). CI for single event rate was calculated based on the Wald asymptotic confidence limits.

Adjudicated All-Cause Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. New/recurrent VTE, death, venous/arterial thromboembolic events, bleeding, thrombocytopenia, acute myocardial infarction and stroke were also adjudicated. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Participants with missing endpoint information were classified as having had the efficacy event (imputation). CI for single event rate was calculated based on the Wald asymptotic confidence limits.

Number of Participants With an Adjudicated Symptomatic Nonfatal Venous Thromboembolism (VTE) Recurrence or Death (All Cause) During the Intended Treatment Period - Randomized Participants Without ImputationDay 1 up to 12 Months

All index events, DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. First event category was the first primary event for each participant and each participant was counted once. CV-related death was presented excluding VTE-related death. In participants with event category, each participant was counted once in each event category but could have been counted in multiple categories. No imputation was done for these endpoints; participants who had an event during the intended treatment period were counted.

Adjudicated Total Bleeding During the Treatment Period - Treated ParticipantsDay 1 up to 12 months

All bleeding events were adjudicated/confirmed by a central independent adjudication committee blinded to treatment. Total bleeding was defined as any major, clinically relevant non-major, or minor bleeding. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). CI for single event rate was calculated based on the Wald asymptotic confidence limits. Treated population includes randomized participants who received at least one dose of study drug.

Adjudicated Composite of Recurrent, Symptomatic Venous Thromboembolism (VTE) or Venous Thromboembolism-related Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

VTE related death defined as PE (based on objective diagnostic testing, autopsy), unexplained death (and VTE cannot be ruled out), sudden death (and VTE cannot be ruled out). DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. New/recurrent VTE and death, were also adjudicated. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for these endpoints.

Adjudicated Nonfatal Deep Vein Thrombosis (DVT) During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

DVT was adjudicated/confirmed by a central independent adjudication committee blinded to treatment and assessed by compression ultrasound and/or venography. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period: longer of the dosing period plus 2 days (completed treatment) or 355 days (discontinued early). Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. Participants with missing endpoint information were classified as having had the efficacy event (imputation). Confidence interval (CI) for single event rate was calculated based on the Wald asymptotic confidence limits.

Adjudicated Nonfatal Pulmonary Embolism (PE) During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

PE was adjudicated/confirmed by a central independent adjudication committee blinded to treatment and was assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. Participants with missing endpoint information were classified as having had the efficacy event (imputation). CI for single event rate was calculated based on the Wald asymptotic confidence limits.

Adjudicated Venous Thromboembolism (VTE) - Related Death During the Intended Treatment Period - Randomized Population With ImputationDay 1 up to 12 Months

VTE-related death defined as: PE (based on objective diagnostic testing, autopsy), unexplained death (and VTE cannot be ruled out), sudden death (and VTE cannot be ruled out). DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. New/recurrent VTE, death, venous/arterial thromboembolic events, bleeding, thrombocytopenia, acute myocardial infarction and stroke were also adjudicated. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Participants with missing endpoint information were classified as having had the efficacy event (imputation).

Adjudicated Major Bleeding During the Treatment Period - Treated PopulationDay 1 up to 12 Months

Major bleeding was adjudicated/confirmed by a central independent adjudication committee blinded to treatment and was defined as acute clinically overt bleeding: associated with a fall in hemoglobin of 2 grams per deciliter (g/dL) or more, or leading to a transfusion of 2 or more units of packed red blood cells or 1000 milliliters (mL) or more of whole blood, or in a critical site: intracranial, intraspinal, intraocular, pericardial, intra-articular, intramuscular with compartment syndrome, retroperitoneal, or another critical organ; or is fatal. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Confidence interval (CI) for event rate was calculated based on the Wald asymptotic confidence limits. Treated population includes randomized participants who received at least one dose of study drug.

Adjudicated Composite of Recurrent, Symptomatic Venous Thromboembolism (VTE) or Cardio Vascular (CV) - Related Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

CV-related death was defined as myocardial infarction, stroke, or other specified cardiovascular event. Index events of DVT and/or PE, along with myocardial infarction and stroke were adjudicated/confirmed by a central independent adjudication committee 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 is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Composite endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for these endpoints; participants who had an event during the intended treatment period were counted.

Adjudicated Clinically Relevant Minor Bleeding During the Treatment Period - Treated ParticipantsDay 1 up to 12 months

All bleeding events were reviewed by the central independent adjudication committee blinded to treatment and classified as major bleeding, clinically relevant non-major bleeding, minor bleeding or no bleeding. If event was not major or clinically relevant non-major, it was judged to be minor. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Confidence interval (CI) for single event rate was calculated based on the Wald asymptotic confidence limits. Treated population includes randomized participants who received at least one dose of study drug.

Adjudicated Nonfatal Pulmonary Embolism (PE) During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

PE was adjudicated/confirmed by a central independent adjudication committee blinded to treatment: PE assessed by spiral computed tomography scanning, pulmonary angiography, and/or ventilation/perfusion lung scan. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for this endpoint; participants who had an event during the intended treatment period were counted.

Adjudicated Clinically Relevant Non-major Bleeding During the Treatment Period - Treated ParticipantsDay 1 up to 12 months

Non-major clinically relevant bleeding was adjudicated/confirmed by a central independent adjudication committee blinded to treatment and defined as: acute clinically overt bleeding compromising hemodynamics; leading to hospitalization; traumatic subcutaneous hematoma; intramuscular hematoma; epistaxis that lasted for more than 5 minutes, was repetitive or led to an intervention; spontaneous gingival bleeding (or lasting more than 5 minutes); spontaneous hematuria (macroscopic or lasted more than 24 hours after instrumentation of the urogenital tract); macroscopic gastrointestinal hemorrhage (including at least 1 episode of melena or hematemesis (if clinically apparent with positive results on a fecal occult-blood test); rectal blood loss. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). CI for single event rate was calculated based on the Wald asymptotic confidence limits.

Adjudicated Nonfatal Deep Vein Thrombosis (DVT) During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

DVT was adjudicated/confirmed by a central independent adjudication committee blinded to treatment: DVT assessed by compression ultrasound and/or venography. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for this endpoint; participants who had an event during the intended treatment period were counted.

Adjudicated Venous Thromboembolism (VTE)- Related Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

VTE related death defined as PE (based on objective diagnostic testing, autopsy), unexplained death (and VTE cannot be ruled out), sudden death (and VTE cannot be ruled out). DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. New/recurrent VTE, and death, were also adjudicated. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for this endpoint.

Adjudicated Cardio Vascular (CV)-Related Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

CV-related death was defined as myocardial infarction, stroke, or other specified cardiovascular event and these were adjudicated/confirmed by a central independent adjudication committee blinded to treatment. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for this endpoint; participants who had an event during the intended treatment period were counted.

Adjudicated All-Cause Death During the Intended Treatment Period - Randomized Population Without ImputationDay 1 up to 12 Months

DVT and/or PE were adjudicated/confirmed by a central independent adjudication committee 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. New/recurrent VTE, death, venous/arterial thromboembolic events, bleeding, thrombocytopenia, acute myocardial infarction and stroke were also adjudicated. Event rate is proportion of participants with event; calculated as n/N (n=number of events; N=number of participants). Intended treatment period was defined as the longer of the dosing period plus 2 days or 355 days. Endpoint included events at any time from randomization until end of the intended treatment period, regardless whether drug treatment was received. No imputation was done for this endpoint; participants who had an event during the intended treatment period were counted.

Trial Locations

Locations (87)

Mercury Street Medical Group, Pllc

🇺🇸

Butte, Montana, United States

Piedmont Healthcare/Research

🇺🇸

Statesville, North Carolina, United States

William Beaumont Hospital

🇺🇸

Royal Oak, Michigan, United States

Akron General Medical Center

🇺🇸

Akron, Ohio, United States

Robert J. Bloomberg, Md, Pc

🇺🇸

Tempe, Arizona, United States

Richard A. Mclean M.D., P.A.

🇺🇸

Plantation, Florida, United States

Infectious Disease Of Indiana Psc

🇺🇸

Carmel, Indiana, United States

Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

Remington Davis Inc.

🇺🇸

Columbus, Ohio, United States

University Of Virginia Health System

🇺🇸

Charlottesville, Virginia, United States

Ankur Doshi, Md

🇺🇸

Houston, Texas, United States

South Miami Heart Center

🇺🇸

Miami, Florida, United States

Thomas L. Ortel, Md, Phd

🇺🇸

Durham, North Carolina, United States

New West Physicians

🇺🇸

Golden, Colorado, United States

Saltzer Medical Group

🇺🇸

Nampa, Idaho, United States

New York Medical College

🇺🇸

Valhalla, New York, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Alabama Clinical Therapeutics, Llc

🇺🇸

Birmingham, Alabama, United States

Cardiovascular Consultants, Ltd.

🇺🇸

Phoenix, Arizona, United States

Creighton University Medical Center

🇺🇸

Omaha, Nebraska, United States

Cor Clinical Research, Llc

🇺🇸

Oklahoma City, Oklahoma, United States

University Of Utah Hospital

🇺🇸

Salt Lake City, Utah, United States

Tampa Clinical Research

🇺🇸

Tampa, Florida, United States

Jobst Vascular Center At The Toledo Hospital

🇺🇸

Toledo, Ohio, United States

Scripps Clinic/Scripps Health And Green Hospital

🇺🇸

La Jolla, California, United States

Healthcare Partners Medical Group

🇺🇸

Los Angeles, California, United States

Beaver Medical Group

🇺🇸

Banning, California, United States

Mission Internal Medical Group

🇺🇸

Mission Viejo, California, United States

Fort Smith Lung Center

🇺🇸

Fort Smith, Arkansas, United States

Indus Clinical Research Institute, Inc.

🇺🇸

Pomona, California, United States

Desert Med Grp Inc, Dba Desert Oasis Healthcare Med Group

🇺🇸

Palm Springs, California, United States

Stanford University Medical Center

🇺🇸

Stanford, California, United States

Kaiser Permanente Medical Center

🇺🇸

San Francisco, California, United States

Harbor Ucla Medical Center

🇺🇸

Torrance, California, United States

Progressive Clinical Research

🇺🇸

Vista, California, United States

Alfieri Cardiology

🇺🇸

Newark, Delaware, United States

Healthworx

🇺🇸

Hollywood, Florida, United States

St. Francis Sleep Allergy & Lung Institute

🇺🇸

Clearwater, Florida, United States

Berma Research Group

🇺🇸

Fort Lauderdale, Florida, United States

Research Alliance, Inc.

🇺🇸

Clearwater, Florida, United States

Hematology Oncology Associates

🇺🇸

Loxahatchee, Florida, United States

Bay Pines Va Healthcare Systems

🇺🇸

Bay Pines, Florida, United States

Physicians Regional Medical Group

🇺🇸

Naples, Florida, United States

Primary Care Of The Treasure Coast, Inc.

🇺🇸

Vero Beach, Florida, United States

Cleveland Clinic Florida

🇺🇸

Weston, Florida, United States

Vascular Surgical Associates, Pc

🇺🇸

Austell, Georgia, United States

Gwinnett Biomedical Research

🇺🇸

Lawrenceville, Georgia, United States

Boise Orthopedic Clinic

🇺🇸

Boise, Idaho, United States

Atlanta Institute For Medical Research, Inc

🇺🇸

Decatur, Georgia, United States

Office Of:Eugene C. Fletcher, Md

🇺🇸

New Albany, Indiana, United States

Heartland Vascular Medicine And Surgery

🇺🇸

Windsor Heights, Iowa, United States

Kentucky Lung Clinic

🇺🇸

Hazard, Kentucky, United States

Owensboro Heart & Vascular

🇺🇸

Owensboro, Kentucky, United States

Cape Cod Research Institute

🇺🇸

Hyannis, Massachusetts, United States

Pen Bay Medical Center

🇺🇸

Rockport, Maine, United States

Anne Arundel Health System Research Institute, Inc.

🇺🇸

Annapolis, Maryland, United States

Great Falls Clinic, Llp

🇺🇸

Great Falls, Montana, United States

Internal Medical Associates Of Grand Island, P.C

🇺🇸

Grand Island, Nebraska, United States

Kaleida Health System

🇺🇸

Buffalo, New York, United States

Goshen Medical Associates

🇺🇸

Goshen, New York, United States

Sjh Cardiology Associates

🇺🇸

Liverpool, New York, United States

Richmond University Medical Center

🇺🇸

Staten Island, New York, United States

Rex Healthcare

🇺🇸

Raleigh, North Carolina, United States

Whiteville Medical Associates, P.A.

🇺🇸

Whiteville, North Carolina, United States

Valley Internal Medicine

🇺🇸

Fayetteville, North Carolina, United States

Wilmington Medical Research

🇺🇸

Wilmington, North Carolina, United States

Community Health Care, Inc.

🇺🇸

Canal Fulton, Ohio, United States

Valley Medical Research

🇺🇸

Centerville, Ohio, United States

Greenville Hospital System

🇺🇸

Greenville, South Carolina, United States

Pma Medical Specialists

🇺🇸

Phoenixville, Pennsylvania, United States

Three Rivers Medical Associates, Pa

🇺🇸

Irmo, South Carolina, United States

Clinical Research Authority, Llc

🇺🇸

Murrells Inlet, South Carolina, United States

Palmetto Clinical Research

🇺🇸

Summerville, South Carolina, United States

Corsicana Medical Research

🇺🇸

Corsicana, Texas, United States

Holston Medical Group

🇺🇸

Kingsport, Tennessee, United States

Amarillo Heart Clinical Research Institute Inc.

🇺🇸

Amarillo, Texas, United States

Tanner Clinic

🇺🇸

Layton, Utah, United States

Northwest Heart Center

🇺🇸

Tomball, Texas, United States

Lake Washington Vascular, Pllc

🇺🇸

Bellevue, Washington, United States

Sentara York Clinical Research

🇺🇸

Norfolk, Virginia, United States

Local Institution

🇬🇧

Dudley, West Midlands, United Kingdom

Franciscan Research Center

🇺🇸

Tacoma, Washington, United States

Medical Assoicates Inc.

🇺🇸

Menomonee Falls, Wisconsin, United States

Rocky Mountain Internal Medicine

🇺🇸

Aurora, Colorado, United States

Veterans Affairs Medical Center

🇺🇸

Kansas City, Missouri, United States

Charleston Hematology Oncology Associates, Pa

🇺🇸

Charleston, South Carolina, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

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