A Study of Ad26.COV2.S for the Prevention of SARS-CoV-2-mediated COVID-19 in Adults
- Conditions
- Participants With or Without Stable Co-morbidities Associated With Progression to Severe COVID-19
- Interventions
- Other: Placebo
- Registration Number
- NCT04614948
- Lead Sponsor
- Janssen Vaccines & Prevention B.V.
- Brief Summary
The study will evaluate the efficacy of Ad26.COV2.S in the prevention of molecularly confirmed moderate to severe/critical coronavirus disease-2019 (COVID-19), as compared to placebo, in SARS-CoV-2 seronegative adults in the double-blind phase and to describe COVID-19 outcomes, safety, and immunogenicity in the different study cohorts in open-label phase.
- Detailed Description
The aim of the COVID-19 vaccine clinical development program is to develop a safe and effective vaccine for the prevention of COVID-19. Ad26.COV2.S, a COVID-19 vaccine based on a human replication-incompetent Ad26 vector, constructed to encode the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus spike (S) protein, is being developed. The study will consist of: a screening phase (up to 28 days), study period (60-week), and a long-term follow-up period (1 additional year). The total study duration will be maximum 2 years and 3 months for the participants. Assessments for efficacy (COVID-19 signs and symptoms, etc.), immunogenicity (such as humoral immune responses), and safety (such as adverse events \[AEs\] monitoring) will be performed throughout the study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 31835
- Contraceptive (birth control) use should be consistent with local regulations regarding the acceptable methods of contraception for those participating in clinical studies
- All participants of childbearing potential must: have a negative highly sensitive urine pregnancy test at screening; and have a negative highly sensitive urine pregnancy test immediately prior to each study vaccine administration
- Participant agrees to not donate bone marrow, blood, and blood products from the first study vaccine administration until 3 months after receiving the last dose of study vaccine
- Must be willing to provide verifiable identification, has means to be contacted and to contact the investigator during the study
- Must be able to read, understand, and complete questionnaires in the electronic clinical outcome assessment (eCOA) (that is, the coronavirus disease-2019 [COVID 19] signs and symptoms surveillance question, the e-Diary, and the electronic patient-reported outcomes (ePROs)
- Participant has a clinically significant acute illness (this does not include minor illnesses such as diarrhea or mild upper respiratory tract infection) or temperature greater than or equal to (>=) 38.0 degree Celsius (100.4-degree Fahrenheit) within 24 hours prior to the planned first dose of study vaccine; randomization at a later date is permitted at the discretion of the investigator and after consultation with the sponsor
- Participant has a known or suspected allergy or history of anaphylaxis or other serious adverse reactions to vaccines or their excipients
- Participant received or plans to receive: (a) licensed live attenuated vaccines - within 28 days before or after planned administration of study vaccine; and (b) other licensed (not live) vaccines - within 14 days before or after planned administration of study vaccine
- Participant previously received a coronavirus vaccine
- Participant received an investigational drug within 30 days (including investigational drugs for prophylaxis of COVID-19) or used an invasive investigational medical device within 30 days or received investigational immunoglobulin (Ig) or investigational monoclonal antibodies within 3 months, or received convalescent serum for COVID-19 treatment within 4 months or received an investigational vaccine (including investigational Adenoviral-vectored vaccines) within 6 months before the planned administration of the first dose of study vaccine or is currently enrolled or plans to participate in another investigational study during the course of this study
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Placebo Participants will receive IM injection of placebo on Day 1 and Day 57 in the double-blind phase. At unblinding visit (open-label phase), participants initially receiving placebo will be offered to receive IM injection of a single dose of Ad26.COV2.S vaccine. All ongoing participants who only received a single vaccination with Ad26.COV2.S in the study will be offered to receive single booster dose of Ad26.COV2.S in the open label phase preferably within 6 to 12 months after the participant's first Ad26.COV2.S vaccination. Ad26.COV2.S Ad26.COV2.S Participants will receive intramuscular (IM) injection of Ad26.COV2.S vaccine on Day 1 and Day 57 in the double-blind phase. At unblinding visit (open-label phase), participants who have not yet received second vaccination will receive second dose of Ad26.COV2.S vaccine on Day 57, if applicable and newly enrolled participants will either receive IM injection of one dose of Ad26.COV2.S vaccine on Day 1 or two doses of Ad26.COV2.S vaccine on Day 1 and Day 57. All ongoing participants who only received a single vaccination with Ad26.COV2.S in the study will be offered to receive single booster dose of Ad26.COV2.S in the open label phase preferably within 6 to 12 months after the participant's first Ad26.COV2.S vaccination. Placebo Ad26.COV2.S Participants will receive IM injection of placebo on Day 1 and Day 57 in the double-blind phase. At unblinding visit (open-label phase), participants initially receiving placebo will be offered to receive IM injection of a single dose of Ad26.COV2.S vaccine. All ongoing participants who only received a single vaccination with Ad26.COV2.S in the study will be offered to receive single booster dose of Ad26.COV2.S in the open label phase preferably within 6 to 12 months after the participant's first Ad26.COV2.S vaccination.
- Primary Outcome Measures
Name Time Method Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 in Seronegative Participants With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) positive reverse transcription/polymerase chain reaction (RT-PCR) or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate \>=20 breaths per minute (min) and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>=90 beats/min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/min, heart rate \>=125 beats/min, oxygen saturation (SpO2) \<=93 percent (%) on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to Intensive Care Unit (ICU), death defined as per FDA guidance.
- Secondary Outcome Measures
Name Time Method Double Blind Phase: Number of Participants With First Occurrence of COVID-19 Requiring Medical Intervention With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Number of participants with first occurrence of COVID-19 requiring medical intervention (such as a composite endpoint of hospitalization, ICU admission, mechanical ventilation, and extracorporeal membrane oxygenation \[ECMO\]), linked to objective measures such as decreased oxygenation, X-ray or computed tomography \[CT\] findings and linked to any molecularly confirmed, COVID-19 with onset at least 14 days post second vaccination were reported.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 Regardless of Serostatus With Onset At Least 1 Day After the First Day 1 Vaccination From at least 1 day after first vaccination on Day 1 (Day 2) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate greater than or equal to (\>=) 20 breaths per minute and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>= 90 beats per min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/minute, heart rate \>=125 beats/minute, SpO2 less than or equal to (\<=) 93% on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to the ICU, death defined as per US Food and Drug Administration (FDA) guidance.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 Regardless of Serostatus With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate \>= 20 breaths per minute and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>= 90 beats per min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/minute, heart rate \>=125 beats/minute, SpO2 \<= 93% on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to the ICU, death defined as per FDA guidance.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 in Seronegative Participants With Onset at Least 1 Day After the First Day 1 Vaccination From at least 1 day after first vaccination on Day 1 (Day 2) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate \>= 20 breaths per minute and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>= 90 beats per min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/minute, heart rate \>=125 beats/minute, SpO2 \<= 93% on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to the ICU, death defined as per FDA guidance.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 With Onset at Least 14 Days After the First Day 1 Vaccination From at least 14 days after first vaccination on Day 1 (Day 15) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate \>= 20 breaths per minute and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>= 90 beats per min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/minute, heart rate \>=125 beats/minute, SpO2 \<= 93% on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to the ICU, death defined as per FDA guidance.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Moderate to Severe/Critical COVID-19 With Onset at Least 28 Days After the First Day 1 Vaccination From at least 28 days after the first vaccination on Day 1 (Day 29) up to end of double blind phase (7.2 months) Molecularly confirmed moderate to severe/critical COVID-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample. Moderate included one sign or symptom such as respiratory rate \>= 20 breaths per minute and symptoms such as shortness of breath or two signs or symptoms such as heart rate \>= 90 beats per min and symptoms such as cough from a list of signs and symptoms and severe/critical included one of the following signs and symptoms: respiratory rate \>=30 breaths/minute, heart rate \>=125 beats/minute, SpO2 \<= 93% on room air at sea level respiratory failure, evidence of shock, significant acute renal, hepatic, or neurologic dysfunction, admission to the ICU, death defined as per FDA guidance.
Double Blind Phase: Area Under the Curve (AUC) of SARS-CoV-2 Viral Load as Assessed by Quantitative RT-PCR in Participants With Molecularly Confirmed Symptomatic COVID-19 With Onset at Least 14 Days After Second Vaccination From Day 71 up to end of the COVID-19 episode (up to 90 days) AUC of SARS-CoV-2 viral load was assessed in confirmed COVID-19 cases using RT-PCR. Nasal swabs were used to detect and/or quantify SARS-CoV-2. Due to change in the planned analysis, data was collected and analyzed for participants with molecularly confirmed symptomatic COVID-19 regardless of severity that is mild, moderate or severe and was not collected and analyzed separately for moderate to severe cases.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed Mild COVID-19 With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Molecularly confirmed mild Covid-19 was defined as a SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample and one of the following signs and symptoms: fever (\>=38 degree Celsius or \>=100.4 degree Fahrenheit), sore throat, malaise (loss of appetite, generally unwell, fatigue, physical weakness), headache, muscle pain (myalgia), gastrointestinal symptoms, cough, chest congestion, runny nose, wheezing, skin rash, eye irritation or discharge, chills, new or changing olfactory or taste disorders, red or bruised looking feet or toes, or shaking chills or rigors.
Double Blind Phase: Number of Participants With First Occurrence of Molecularly Confirmed COVID-19 Defined by the US FDA Harmonized Case Definition With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Molecularly confirmed COVID-19 was defined as SARS-CoV-2 positive RT-PCR or molecular test result from any available respiratory tract sample (example, nasal swab sample, sputum sample, throat swab sample, saliva sample) or other sample; and COVID-19 symptoms consistent with those defined by the US FDA harmonized case definition at the time of finalization of the study protocol: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.
Double Blind Phase: Number of Participants With Burden of Disease (BOD) Based on First Occurrence of Molecularly Confirmed Symptomatic COVID-19 With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) BOD is a weighted version of the mild, moderate, and severe/critical vaccine efficacies and was evaluated based on the first occurrence of molecularly confirmed COVID-19, including mild, moderate or severe/critical COVID-19 case.
Double Blind Phase: Number of Participants With Serologic Conversion Between Day 71 up to Unblinding Visit Using an Enzyme-linked Immunosorbent Assay (ELISA) From Day 71 up to unblinding visit (7.2 months) Number of participants with serologic conversion between Day 71 up to unblinding visit using an ELISA were reported. Due to change in planned analysis, data was collected and analyzed between Day 71 up to unblinding visit instead of from baseline to unblinding visit.
Double Blind Phase: Number of Participants With Asymptomatic Infection Detected By Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR) With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Number of participants with asymptomatic infection detected by RT-PCR with onset at least 14 days after the second vaccination (Day 71) were reported.
Double Blind Phase: Number of Participants With First Occurrence of SARS-CoV-2 Infection (Serologically and/or Molecularly Confirmed) With Onset at Least 14 Days After the Second Vaccination From at least 14 days after second vaccination on Day 57 (Day 71) up to end of double blind phase (7.2 months) Number of participants with first occurrence of SARS-CoV-2 infection (serologically and/or molecularly confirmed) with onset at least 14 days after the second vaccination (Day 71) were reported.
Double Blind Phase: Number of Participants With Serious Adverse Events (SAEs) From Day 1 up to end of double blind phase (7.2 months) An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. SAE was any untoward medical occurrence that at any dose may result in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is a suspected transmission of any infectious agent via a medicinal product.
Double Blind Phase: Number of Participants With Adverse Events of Special Interest (AESIs) From Day 1 up to end of double blind phase (7.2 months) Number of participants with AESIs were reported. AESIs were significant AEs that were judged to be of special interest because of clinical importance, known or suspected class effects, or based on nonclinical signals. Thrombosis with Thrombocytopenia Syndrome (TTS), a syndrome characterized by a combination of both a thrombotic event and thrombocytopenia, was considered to be an AESI in this study. A suspected TTS case was defined as: Thrombotic events: suspected deep vessel venous or arterial thrombotic events; Thrombocytopenia, defined as platelet count below 150,000/micro liter.
Double Blind Phase: Number of Participants With Medically-Attended Adverse Events (MAAEs) From Day 1 up to 7.2 months An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. MAAEs were defined as AEs with medically-attended visits including hospital, emergency room, urgent care clinic, or other visits to or from medical personnel for any reason.
Double-Blind: Number of Participants With MAAEs Leading to Study Discontinuation From Day 1 up to end of double blind phase (7.2 months) An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. MAAEs were defined as AEs with medically-attended visits including hospital, emergency room, urgent care clinic, or other visits to or from medical personnel for any reason.
Double Blind Phase: Number of Participants With Solicited Local Adverse Events (AEs) During 7 Days Following Each Vaccination 7 days after first vaccination on Day 1 (up to Day 8), 7 days after second vaccination on Day 57 (up to Day 64) An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. Participants who were enrolled in safety subset (SS) were asked to note in the e-Diary occurrences of injection site pain/tenderness, erythema, and swelling at the study vaccine injection site daily for 7 days post each vaccination (day of vaccination and the subsequent 7 days).
Double Blind Phase: Number of Participants With Solicited Systemic AEs During 7 Days Following Each Vaccination 7 days after first vaccination on Day 1 (up to Day 8), 7 days after second vaccination on Day 57 (up to Day 64) An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. Participants who were enrolled in safety subset were instructed on how to record daily temperature using a thermometer provided for home use. Participants recorded temperature in e-Diary in evening of the day of vaccination, and then daily for next 7 days approximately at same time each day. If more than 1 measurement was made on any given day, the highest temperature of that day was recorded in e-Diary. Fever was defined as endogenous elevation of body temperature \>= 38.0 degree Celsius or \>=100.4-degree Fahrenheit, as recorded in at least 1 measurement. Participants also noted the signs and symptoms in e-Diary on a daily basis for 7 days post each vaccination (day of vaccination and subsequent 7 days), for the following events: fatigue, headache, nausea, myalgia.
Double Blind Phase: Number of Participants With Unsolicited Adverse Events (AEs) During 28 Days Post Each Vaccination 28 days after first vaccination on Day 1 (up to Day 29), 28 days after second vaccination on Day 57 (up to Day 85) An AE was any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the vaccine. Unsolicited AEs were all AEs for which the participant is not specifically questioned in the participant diary.
Double Blind Phase: SARS-CoV-2 Binding Antibodies Assessed by ELISA At Baseline (Day 1), Days 29, 57 and 71 Binding antibodies to SARS-CoV-2 S protein as assessed by ELISA to measure humoral immune response was reported. The lower limit of quantification (LLOQ) was 50.3 ELISA units per milliliter (EU/mL). A sample was considered positive if the value was strictly greater than the LLOQ (\>LLOQ).
Trial Locations
- Locations (120)
Avail Clinical Research, LLC
🇺🇸DeLand, Florida, United States
Compass Research, Melbourne
🇺🇸Melbourne, Florida, United States
Suncoast Research Group
🇺🇸Miami, Florida, United States
Atlanta Center for Medical Research
🇺🇸Atlanta, Georgia, United States
Centennial Medical Group
🇺🇸Elkridge, Maryland, United States
Optimal Research
🇺🇸Rockville, Maryland, United States
Meridian Clinical Research, LLC
🇺🇸Endwell, New York, United States
Henry Ford Health Systems
🇺🇸Detroit, Michigan, United States
Regional Clinical Research, Inc.
🇺🇸Endwell, New York, United States
Institute of Tropical Medicine Antwerp
🇧🇪Antwerpen, Belgium
Center for Vaccinology (CEVAC)
🇧🇪Gent, Belgium
UZ Leuven
🇧🇪Leuven, Belgium
Az Sint-Maarten
🇧🇪Mechelen, Belgium
Private Practice RESPISOM Namur
🇧🇪Namur, Belgium
Hospital Nossa Senhora da Conceicao S A
🇧🇷Porto Alegre, Brazil
Ministerio da Saude - Hospital dos Servidores do Estado - RJ
🇧🇷Rio de Janeiro, Brazil
Instituto Nacional de Infectologia Evandro Chagas (INI) - FIOCRUZ
🇧🇷Rio de Janeiro, Brazil
Instituto de infectologia Emilio Ribas
🇧🇷Sao Paulo, Brazil
Centro de Referencia E Treinamento Dst/Aids
🇧🇷Sao Paulo, Brazil
Fundacion Cardiomet CEQUIN
🇨🇴Armenia, Colombia
IPS Centro Cientifico Asisitencial Jose Luis Accini S.A.S.
🇨🇴Barranquilla, Colombia
Asistencia Cientifica de Alta Complejidad S.A.S
🇨🇴Bogota, Colombia
Centro Medico Imbanaco de Cali S.A.
🇨🇴Cali, Colombia
T Y C Inversiones S A S Grupsalud
🇨🇴Santa Marta, Colombia
CHU de Montpellier Hopital Saint Eloi
🇫🇷Montpellier, France
Hopital Saint-Antoine
🇫🇷Paris Cedex 12, France
University Hospitals Bristol NHS Trust
🇬🇧Bristol, United Kingdom
Achieve Clinical Research, LLC
🇺🇸Vestavia Hills, Alabama, United States
Hope Research Institute
🇺🇸Phoenix, Arizona, United States
Central Phoenix Medical Clinic
🇺🇸Phoenix, Arizona, United States
Quality of Life Medical & Research Center, LLC
🇺🇸Tucson, Arizona, United States
West Visayas State University Medical Center
🇵ðŸ‡Iloilo City, Philippines
Tropical Disease Foundation
🇵ðŸ‡Makati, Philippines
Makati Medical Center
🇵ðŸ‡Manila, Philippines
Medical Center Manila
🇵ðŸ‡Manila, Philippines
TREAD Research Tygerberg Hospital
🇿🇦Cape Town, South Africa
Centre of Tuberculosis Research Innovation
🇿🇦Cape Town, South Africa
Worthwhile Clinical trials
🇿🇦Johannesburg, South Africa
Peermed Clinical Trial Centre
🇿🇦Kempton Park, South Africa
Dr AA Mahomed Medical Centre
🇿🇦Moloto, South Africa
VX Pharma
🇿🇦Pretoria, South Africa
Dr J.M. Engelbrecht Trial Site
🇿🇦Somerset West, South Africa
Be Part Yoluntu Centre
🇿🇦Western Cape, South Africa
Hosp. Univ. Germans Trias I Pujol
🇪🇸Badalona, Spain
Hosp. Quiron Barcelona
🇪🇸Barcelona, Spain
Hosp Clinic de Barcelona
🇪🇸Barcelona, Spain
Hosp Univ Vall D Hebron
🇪🇸Barcelona, Spain
Hosp. Univ. de La Princesa
🇪🇸Madrid, Spain
Clinica Univ. de Navarra
🇪🇸Pamplona, Spain
Hosp. Univ. de La Paz
🇪🇸Madrid, Spain
Hosp. Quiron Madrid Pozuelo
🇪🇸Madrid, Spain
Queen Elizabeth Hospital
🇬🇧Birmingham, United Kingdom
Powys Teaching Local Health Board - Bronllys Hospital
🇬🇧Brecon, United Kingdom
Brighton & Sussex University Hospitals NHS Trust
🇬🇧Brighton, United Kingdom
Cambridge University Hospitals NHS Foundation Trust
🇬🇧Cambridge, United Kingdom
Ninewells Hospital
🇬🇧Dundee, United Kingdom
Royal Free Hospital
🇬🇧Hampstead, United Kingdom
Leicester Royal Infirmary
🇬🇧Leicester, United Kingdom
Guy's and St Thomas' Hospital
🇬🇧London, United Kingdom
Imperial College London and Imperial College Healthcare NHS Trust
🇬🇧London, United Kingdom
Central Manchester University Hospitals NHS Foundation Trust
🇬🇧Manchester, United Kingdom
Newcastle upon Tyne Hospitals NHS Foundation Trust
🇬🇧Newcastle upon Tyne, United Kingdom
University of Oxford
🇬🇧Oxford, United Kingdom
Derriford Hospital
🇬🇧Plymouth, United Kingdom
Riverside Medical Center
🇵ðŸ‡Bacolod, Philippines
Synexus Clinical Research US Inc
🇺🇸Cerritos, California, United States
Woodland International Research Group
🇺🇸Little Rock, Arkansas, United States
eStudySite
🇺🇸Chula Vista, California, United States
Ark Clinical Research
🇺🇸Long Beach, California, United States
Anthony Mills Medical, Inc
🇺🇸Los Angeles, California, United States
Benchmark Research
🇺🇸Sacramento, California, United States
Artemis Institute for Clinical Research
🇺🇸San Diego, California, United States
Paradigm Clinical Research Centers, Inc.
🇺🇸Wheat Ridge, Colorado, United States
JEM Research LLC
🇺🇸Atlantis, Florida, United States
Prestige Clinical Research Center, Inc.
🇺🇸Coral Gables, Florida, United States
Velocity Clinical Research, Hallandale Beach
🇺🇸Hallandale Beach, Florida, United States
Health Awareness inc.
🇺🇸Jupiter, Florida, United States
Altus Research, Inc
🇺🇸Lake Worth, Florida, United States
Behavioral Clinical Research , Inc
🇺🇸North Miami, Florida, United States
Clinical NeuroScience Solutions Inc
🇺🇸Orlando, Florida, United States
Progressive Medical Research
🇺🇸Port Orange, Florida, United States
Meridien Research
🇺🇸Saint Petersburg, Florida, United States
Palm Beach Research Center
🇺🇸West Palm Beach, Florida, United States
Accel Research Sites
🇺🇸Eatonton, Georgia, United States
The University Of Chicago Medicine
🇺🇸Chicago, Illinois, United States
Great Lakes Clinical Trials
🇺🇸Chicago, Illinois, United States
The South Bend Clinic Center for Research
🇺🇸South Bend, Indiana, United States
Heartland Research Associates, LLC
🇺🇸Newton, Kansas, United States
University of Kentucky
🇺🇸Lexington, Kentucky, United States
Centex Studies, Inc.
🇺🇸McAllen, Texas, United States
Ochsner Clinic Foundation
🇺🇸New Orleans, Louisiana, United States
Cherry Street Services, Inc.
🇺🇸Grand Rapids, Michigan, United States
Washington University School Of Medicine
🇺🇸Saint Louis, Missouri, United States
Hassman Research Institute, LLC.
🇺🇸Berlin, New Jersey, United States
Jersey Shore University Medical Center
🇺🇸Neptune, New Jersey, United States
Medpharmics, LLC
🇺🇸Albuquerque, New Mexico, United States
Allergy Asthma Immunology of Rochester, PC (AAIR) - Research Center
🇺🇸Rochester, New York, United States
Richmond Behavioral Associates
🇺🇸Staten Island, New York, United States
American Health Network, LLC
🇺🇸Charlotte, North Carolina, United States
Wilmington Health Associates
🇺🇸Wilmington, North Carolina, United States
CTI Clinical Trial and Consulting Services
🇺🇸Cincinnati, Ohio, United States
Lynn Health Science Institute
🇺🇸Oklahoma City, Oklahoma, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
Coastal Carolina Research Center
🇺🇸Mount Pleasant, South Carolina, United States
Centennial Medical Center
🇺🇸Nashville, Tennessee, United States
Texas Center for Drug Development Inc
🇺🇸Houston, Texas, United States
Endeavor Clinical Trials, LLC
🇺🇸San Antonio, Texas, United States
Tranquility Clinical Research
🇺🇸Webster, Texas, United States
JBR Clinical Research
🇺🇸Salt Lake City, Utah, United States
Alliance for Multispeciality Research
🇺🇸Norfolk, Virginia, United States
Anima
🇧🇪Alken, Belgium
Hopital Cochin
🇫🇷Paris, France
Groupe Hospitalier Sud Hôpital Haut-Leveque Service d'hematologie
🇫🇷Pessac, France
CHU Saint Etienne Hopital Nord
🇫🇷Saint-Etienne Cedex 2, France
Hopital Purpan
🇫🇷Toulouse Cedex 09, France
Hopital Rangueil
🇫🇷Toulouse, France
Hôpital de Brabois Adultes
🇫🇷Vandoeuvre les Nancy, France
Klinikum rechts der Isar der TU Munchen
🇩🇪München, Germany
Sheffield Teaching Hospitals NHS Foundation Trust
🇬🇧Sheffield, United Kingdom
Southampton General Hospital
🇬🇧Southampton, United Kingdom