A 104-Week Study of Ritlecitinib Oral Capsules in Adults With Nonsegmental Vitiligo (Active and Stable) Tranquillo 2

Phase 3

Recruiting

• Conditions: Stable Nonsegmental Vitiligo; Active Nonsegmental Vitiligo
• Interventions: Drug: Ritlecitinib; Drug: Placebo

• Registration Number: NCT06072183
• Lead Sponsor: Pfizer

Brief Summary

The purpose of this study is to learn about the safety and effects of the study medicine ritlecitinib for the possible treatment of nonsegmental vitiligo. Vitiligo causes white patches on your skin when the cells that give your skin color are destroyed. Nonsegmental means that it can affect both sides of the body such as both knees and both hands.

Ritlecitinib has been tested in earlier clinical studies and has a favorable safety profile. At present there are no approved medications taken by mouth to treat nonsegmental vitiligo.

This study is seeking participants who:

* Are 18 years of age or older.

* are confirmed to have nonsegmental vitiligo for at least 3 months.

* Are willing to stop all other treatments that they may be taking for vitiligo.

In this study participants will be chosen by chance, like drawing names out of a hat to receive 1 of 3 treatments:

•Part I where two different amounts of ritlecitinib (50 mg and 100 mg) are taken once daily. It will be compared to placebo. Placebo is a dummy capsule. It doesn't have any medicine used in the study.

Participants receiving placebo who have not responded to treatment after 52 weeks will be given 100 milligrams or 50 milligrams of ritlecitinib for the remaining 52 weeks of the study.

• In Part II, participants will only receive 100 milligrams of ritlecitinib. About 1000 participants will take part in Part I and around 450 in Part II globally. The study will compare the experiences of people receiving ritlecitinib to those of the people who do not. This will help see if ritlecitinib is safe and effective.

People in Part I will be in this study for about 26 months and people in Part II will be in this study for about 14 months. During the study, participants in part I will need to visit the study site at least 17 times. In part II, participants will visit at least 11 times.

Participants will undergo various tests and procedures such as:

* vitiligo rating,

* physical examinations,

* hearing tests,

* blood tests,

* x-ray,

* ECG,

* photographs of areas with vitiligo. Participants will be asked to complete questionnaires about their vitiligo.

Detailed Description

Study B7981080 is a Phase 3 randomized, double-blind, multicenter study with a 52-week placebo-controlled period (Part Ia) followed by a double-blind 52-week extension period (Part Ib) that includes randomized dose-up/down titration and a de novo 52-week non-randomized open-label cohort (Part II), investigating the efficacy, safety, and tolerability of ritlecitinib 100 mg QD and 50 mg QD compared with placebo in adult participants with nonsegmental active or stable vitiligo

Study Timeline

• Study First Submitted: 2023-10-02
• Study First Submitted QC: 2023-10-02
• Study First Posted: 2023-10-10
• Study Start: 2023-11-08
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-02
• Last Update Posted: 2024-12-04
• Primary Completion: 2027-07-14
• Study Completion: 2027-07-14

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 1450

Inclusion Criteria

1. Participants aged 18 years (or the minimum age of consent in accordance with local regulations) or older (no upper age limit) at Screening.

   • Meeting reproductive criteria for female participants.

   Disease Characteristics:

2. Eligible participants must have at both Screening and BL:

   • A clinical diagnosis of nonsegmental vitiligo for at least 3 months; and
   • BSA involvement 4% to 60% inclusive, excluding involvements at palms of the hands, soles of the feet, or dorsal aspect of the feet and
   • BSA ≥0.5% involvement on the face. Face is defined as including the area on the forehead to the original hairline, on the cheek to the jawline vertically to the jawline and laterally from the corner of the mouth to the tragus. Face will not include scalp, ears, neck, or surface area of the lips, but will include the nose and the eyelids; and
   • F-VASI ≥0.5 and T-VASI ≥3; and
   • Either active or stable nonsegmental vitiligo at Screening and BL visits. All participants who do not have the features of active vitiligo (defined below) will be classified as having stable disease.

   Active vitiligo is defined as:

   Participants will be classified as having active vitiligo based on the presence of at least one active lesion at BL defined as one of the following:

   • New/extending lesions(s) in the 3 months prior to Screening visit (confirmed by photographs or medical record);
   • Confetti-like lesion(s); Confetti-like depigmentation is characterized by the presence of numerous 1-mm to 5-mm depigmented macules in clusters;
   • Trichrome lesion(s); Trichrome lesions have a hypopigmented zone of varying width between normal and completely depigmented skin, resulting in 3 different hues of skin;
   • Koebner phenomenon/phenomena (excluding Type 1 [history based on isomorphic reaction]). The Koebner phenomenon manifests as depigmentation at sites of trauma, usually in a linear arrangement.

   Stable vitiligo is defined as:

   • Participants will be classified as having stable vitiligo based on an absence of signs of active disease. All participants who do not have the features of active vitiligo (defined above) will be classified as having stable disease.

   Eligibility is determined at Screening and Baseline based on the resulting scores from the local in-person reads of F-VASI, T-VASI, and BSA.

3. Additional inclusion criteria are:

   • If receiving concomitant medications for any reason other than vitiligo, participant must be on a stable regimen, which is defined as not starting a new drug or changing dosage within 7 days or 5 half-lives (whichever is longer) prior to Day 1. Participant must be willing to stay on a stable regimen during the duration of the study.
   • Must agree to stop all other treatments for vitiligo from Screening through the final follow-up visit.

Exclusion Criteria

Medical Conditions:

1. Any medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.

   • Any psychiatric condition including recent or active suicidal ideation or behavior that meets defined criteria.

2. Medical conditions pertaining to vitiligo and other diseases/conditions affecting the skin:

   • Participants that have other types of vitiligo that do not meet criteria for active or stable vitiligo as noted in inclusion criteria (including but not limited to segmental vitiligo and mixed vitiligo).
   • Currently have active forms of other hypopigmentation (including but not limited to Vogt-Koyanagi-Harada disease, malignancy-induced hypopigmentation [melanoma and mycosis fungoides], post-inflammatory hypopigmentation, pityriasis alba [minor manifestation of atopic dermatitis], senile leukoderma [age-related depigmentation], chemical/drug-induced leukoderma, ataxia telangiectasia, tuberous sclerosis, melasma, and congenital hypopigmentation disorder including piebaldism, Waardenburg syndrome, hypomelanosis of Ito, incontinentia pigmenti, dyschromatosis symmetrica hereditarian, xeroderma pigmentosum, and nevus depigmentosus). NOTE: Coexistence of halo nevus/nevi (also known as Sutton nevus/nevi) is permitted.
   • Currently have active forms of inflammatory skin disease(s) or evidence of skin conditions (for example, but not limited to morphea, discoid lupus, leprosy, syphilis, psoriasis, seborrheic dermatitis) at the time of the Screening or BL Visit that in the opinion of the investigator would interfere with evaluation of vitiligo or response to treatment.
   • Leukotrichia in more than 33% of the face surface area affected with vitiligo lesions or leukotrichia in more than 33% of the total body surface area affected with vitiligo lesions.
   • Have a superficial skin infection within 2 weeks prior to first dose on Day 1. NOTE: participants may be rescreened after the infection resolves.

3. General Infection History:

   • Have a history of systemic infection requiring hospitalization, parenteral antimicrobial, antiviral (including biologic treatment), antiparasitic, antiprotozoal, or antifungal therapy, or as otherwise judged clinically significant by the investigator within 6 months prior to Day 1.
   • Have active acute or chronic infection requiring treatment with oral antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 4 weeks prior to Day 1. NOTE: participants may be rescreened after the infection resolves.
   • Evidence or history of untreated, currently treated or inadequately treated active or latent infection with Mycobacterium tuberculosis.

4. Specific Viral Infection History:

   • History (single episode) of disseminated HZ or disseminated herpes simplex or recurrent (more than one episode of) localized, dermatomal HZ.
   • Infected with HBV or HCV: all participants will undergo screening for HBV and HBC for eligibility.
   • Participants who are positive for HCVAb and HCV RNA will not be eligible for this study.
   • Have a known immunodeficiency disorder (including positive serology for HIV at screening) or a first-degree relative with a hereditary immunodeficiency.

5. Other Medical Conditions:

   • Current or recent history of clinically significant severe, progressive, or uncontrolled renal (including but not limited to active renal disease or recent kidney stones), hepatic, hematological, gastrointestinal, metabolic, endocrine (eg, untreated hypovitaminosis D or hypothyroidism), pulmonary, cardiovascular, psychiatric, immunologic/rheumatologic or neurologic disease; or have any other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration, or interfere with the interpretation of study results; or in the opinion of the investigator or Pfizer (or designee), the participant is inappropriate for entry into this study, or unwilling/unable to comply with study procedures and lifestyle requirements.
   • History of severe allergic or anaphylactoid reaction to any kinase inhibitor or a known allergy/hypersensitivity to any component (including excipients) of the study intervention.
   • Have hearing loss with progression over the previous 5 years, sudden hearing loss, or middle or inner ear disease such as otitis media, cholesteatoma, Meniere's disease, labyrinthitis, or other auditory condition that is considered current, fluctuating, or progressive.
   • Have a history of any lymphoproliferative disorder such as EBV-related lymphoproliferative disorder, history of lymphoma, history of leukemia, or signs and symptoms suggestive of current lymphatic or lymphoid disease.
   • Abnormal findings on the Screening chest imaging (eg, chest x-ray). Chest imaging may be performed up to 12 weeks prior to screening. Documentation of the official reading must be located and available in the source documentation.
   • Long QT Syndrome, a family history of Long QT Syndrome, or a history of TdP.
   • Have any malignancies or have a history of malignancies with the exception of adequately treated or excised nonmetastatic basal cell or squamous cell cancer of the skin or cervical carcinoma in situ.
   • Significant trauma or major surgery within 1 month of the first dose of study drug or considered in imminent need for surgery or with elective surgery scheduled to occur during the study.

   Prior/Concomitant Therapy:

6. Have received any of the prohibited treatment regimens specified.

   Prior/Concurrent Clinical Study Experience:

7. Previous administration with an investigational drug or vaccine that do not affect vitiligo within 4 weeks of Day 1 [Baseline] or within 5 half-lives, whichever is longer.

   Diagnostic Assessments:

   Any of the following abnormalities in clinical laboratory tests at Screening, as assessed by the study-specific laboratory and, if deemed necessary, confirmed by a single repeat:

8. Renal impairment

9. Hepatic dysfunction

10. Other laboratory abnormalities

11. Standard 12-lead ECG that demonstrates clinically relevant abnormalities

    Other Exclusion Criteria:

12. Investigator site staff directly involved in the conduct of the study and their family members, site staff otherwise supervised by the investigator, and sponsor and sponsor delegate employees directly involved in the conduct of the study and their family members.

13. In South Africa only participants are excluded without one of the following:

    • Document evidence form a health professional of having received varicella vaccination (two doses); or
    • Evidence of prior exposure to VZV based on serological testing (ie a positive VZV IgG Ab result) at Screening.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm 1- Ritlecitinib 100 milligrams (mg)	Ritlecitinib	Randomized to Ritlecitinib 100 mg QD for 52 weeks before progressing into the up/down titration extension period, rerandomized according to responder status.
Arm 2- Ritlecitinib 50mg	Ritlecitinib	Randomized to Ritlecitinib 50 mg QD for 52 weeks before progressing into the up/down titration extension period, rerandomized according to responder status.
Arm 3- Placebo	Placebo	Randomized to Placebo QD for 52 weeks before progressing into the up/down titration extension period, rerandomized according to responder status.
Arm 4- Ritlecitinib 100mg	Ritlecitinib	Non-randomized open-label Ritlecitinib 100mg QD for 52 weeks.

Primary Outcome Measures

Name	Time	Method
US only Co-Primary Endpoints: Response based on Facial Vitiligo Area Scoring Index 75 (F-VASI75) at Week 52 and Total body Vitiligo Area Scoring Index 50 (T-VASI50) at Week 52	52 Weeks	Proportion of participants achieving F-VASI75 (defined as at least 75% improvement in F-VASI from Baseline) and T-VASI50 (defined as at least 50% improvement in T-VASI from Baseline)
Global (Other than US): Response based on Facial Vitiligo Area Scoring Index 75 (F-VASI75) at Week 52	52 Weeks	Proportion of participants achieving F-VASI75 (defined as at least 75% improvement in F-VASI from Baseline).
Incidence of Treatment Emergent Adverse Events (TEAEs), Serious Adverse Events (SAEs) and Adverse Events (AEs) leading to discontinuation.	Baseline through 108 weeks	To evaluate the safety and tolerability of ritlecitinib in adult participants with non segmental vitiligo
Incidence of Clinically significant laboratory abnormalities.	Baseline through 108 weeks

Secondary Outcome Measures

Name	Time	Method
Response based on F-VASI75 at 24 and 36 weeks	24 and 36 Weeks	Proportion of participants achieving at least a 75% improvement in F-VASI from Baseline.
US-Only: Response based on T-VASI50 at 24 and 36 weeks	24 and 36 weeks	Proportion of participants achieving T-VASI50 (defined as at least 50% improvement in T-VASI from Baseline).
Global (Other than US):Patient Global Impression of Severity-Face (PGIS-F)	Week 24, 36 and week 52	To assess the effect of ritlecitinib compared to placebo on the PGIS-F at Week 24, 36 and 52
Global (Other than US): Patient Global Impression of Severity-Overall Vitiligo (PGIS-V)	Week 24, 36 and week 52	To assess the effect of ritlecitinib compared to placebo on the PGIS-V at Week 24, 36 and 52
Global (Other Than US): Response based on T-VASI50 at Week 24, 36 and 52	Week 24, 36 and 52	Proportion of participants achieving T-VASI50 (defined as at least 50% improvement in T-VASI from Baseline).
Patient Global Impression of Change-Face (PGIC-F)	Week 36 and week 52	To assess the effect of ritlecitinib compared to placebo on the PGIC-F at Weeks 36 and 52.
Patient Global Impression of Change- Overall vitiligo(PGIC-V)	Week 36 and week 52	To assess the effect of ritlecitinib compared to placebo on the PGIC-V at Weeks 36 and 52.
Change from baseline in Dermatology Life Quality Index (DLQI)	Week 52	To evaluate the change from baseline in DLQI at week 52
Proportion of participants achieving disease stabilization	Baseline through week 104	The difference in the proportion of participants with stable disease at all timepoints in participants with non segmental vitiligo treated with ritlecitinib 50 mg QD and 100mg compared to placebo
Response based on T-VASI50	Baseline through week 4, week 8, week 12, week 48, week 56, week 60, week 64, week 76, week 88 and week 104.	Proportion of participants achieving T-VASI50 (defined as at least 50% improvement in T-VASI from Baseline)
Proportion of participants with sustained improvement in T-VASI	Week 36 through week 52	Defined as maintenance of ≥T-VASI50 from Week 36 to Week 52
Response based on F-VASI75	Baseline through week 4, week 8, week 12, week 48, week 56, week 60, week 64, week 76, week 88 and week 104.	Proportion of participants achieving F-VASI75 (defined as at least 75% improvement in F-VASI from Baseline)
Response based on T-VASI75	Baseline through week 4, week 8, week 12, week 24, week 36, week 48, week 56, week 60, week 64, week 76, week 88 and week 104.	Proportion of participants achieving T-VASI75 (defined as at least 75% improvement in T-VASI from Baseline)
Global (Other than US): Response based on T-VASI75	Baseline through week 52	Proportion of participants achieving T-VASI75 (defined as at least 75% improvement in T-VASI from Baseline)
US-Only: Percentage change from baseline (% CFB) in F-VASI at Weeks 24, 36 and 52	Weeks 24, 36 and 52	To compare the efficacy of ritlecitinib 100 mg QD versus placebo on % CFB in F-VASI at Weeks 24, 36 and 52
US-Only: % CFB in T-VASI at weeks 24, 36 and 52	Weeks 24, 36 and 52	To compare the efficacy of ritlecitinib 100 mg QD versus placebo on % CFB in T-VASI at Weeks 24,36 and 52
Proportion of participants with sustained improvement in F-VASI	Week 36 through week 52	Defined as maintenance of ≥F-VASI75 from Week 36 to 52
Time to rescue medication use	Baseline through week 104
Response based on T-VASI90	Baseline through week 52	Proportion of participants achieving T-VASI90 (defined as at least 90% improvement in T-VASI from Baseline)
Change from baseline in the Hospital Anxiety and Depression Scale (HADS)	Week 52	To assess the effect of ritlecitinib compared to placebo on depression and anxiety subscales of the HADS at week 52
Response based on T-VASI100	Baseline through week 52	Proportion of participants achieving T-VASI90 (defined as at least 100% improvement in T-VASI from Baseline)
The proportion of patients achieving absence of anxiety on HADS anxiety subscale	Week 52	Response based on a 'normal' subscale score indicative of an absence of anxiety (in participants with baseline HADS subscale scores indicative of anxiety)
Response based on F-VASI50	Baseline through week 104	Proportion of participants achieving F-VASI50 (defined as at least 50% improvement in F-VASI from Baseline).
The proportion of patients achieving absence of depression on HADS depression subscale	Week 52	Response based on a 'normal' subscale score indicative of an absence of depression (in participants with baseline HADS subscale scores indicative of depression)
US-Only: Patient Global Impression of Severity-Face (PGIS-F)	Week 52	To assess the effect of ritlecitinib compared to placebo on the PGIS-F at 52
US-Only: Patient Global Impression of Severity-Overall Vitiligo (PGIS-V)	Week 52	To assess the effect of ritlecitinib compared to placebo on the PGIS-V at 52
% CFB in F-VASI at Week 4, 8, 12, 48, 56, 60, 64, 76, 88 and 104.	Baseline through week 104	To compare the efficacy of ritlecitinib 100 mg QD versus placebo on % CFB in F-VASI at all time points
% CFB in T-VASI at Week 4, 8, 12, 48, 56, 60, 64, 76, 88 and 104.	Baseline through week 104	To compare the efficacy of ritlecitinib 100 mg QD versus placebo on % CFB in T-VASI at all time points

Trial Locations

Locations (230)

FXM Clinical Research - Miramar; 🇺🇸 Miramar, Florida, United States

GCP Research, Global Clinical professionals; 🇺🇸 Saint Petersburg, Florida, United States

USF Health; 🇺🇸 Tampa, Florida, United States

Coastal Imaging; 🇺🇸 Savannah, Georgia, United States

Sidney P. Smith, MD, PC dba Georgia Skin & Cancer Clinic; 🇺🇸 Savannah, Georgia, United States

NorthShore University Health System; 🇺🇸 Skokie, Illinois, United States

Indiana University School of Medicine - Indiana Clinical and Translational Sciences Institute (CTSI); 🇺🇸 Indianapolis, Indiana, United States

Indiana University School of Medicine - Indiana CTSI Clinical Research Center; 🇺🇸 Indianapolis, Indiana, United States

The South Bend Clinic, LLC; 🇺🇸 South Bend, Indiana, United States

Velocity Clinical Research at The Dermatology Clinic, Baton Rouge; 🇺🇸 Baton Rouge, Louisiana, United States

Dermatology & Advanced Aesthetics; 🇺🇸 Lake Charles, Louisiana, United States

Dermatology and Skin Cancer Specialists, LLC; 🇺🇸 Rockville, Maryland, United States

Concentra Urgent Care; 🇺🇸 Auburn Hills, Michigan, United States

Oakland Hills Dermatology; 🇺🇸 Auburn Hills, Michigan, United States

Great Lakes Research Group, Inc.; 🇺🇸 Bay City, Michigan, United States

Henry Ford Medical Center - New Center One; 🇺🇸 Detroit, Michigan, United States

Great Lakes Hearing Care; 🇺🇸 Rochester, Michigan, United States

MediSearch Clinical Trials; 🇺🇸 Saint Joseph, Missouri, United States

Canfield Scientific Inc.; 🇺🇸 Parsippany, New Jersey, United States

Juva Skin & Laser Center; 🇺🇸 New York, New York, United States

OptiSkin Medical; 🇺🇸 New York, New York, United States

DermResearchCenter of New York, Inc.; 🇺🇸 Stony Brook, New York, United States

Dermatology Specialists of Charlotte; 🇺🇸 Charlotte, North Carolina, United States

Darst Dermatology; 🇺🇸 Charlotte, North Carolina, United States

Bexley Dermatology Research; 🇺🇸 Bexley, Ohio, United States

Austin Institute for Clinical Research; 🇺🇸 Pflugerville, Texas, United States

Global Imaging; 🇺🇸 Sugar Land, Texas, United States

Complete Dermatology; 🇺🇸 Sugar Land, Texas, United States

Centricity Research Dublin Multispeciality; 🇺🇸 Dublin, Ohio, United States

Centricity Research Dublin Multispecialty; 🇺🇸 Dublin, Ohio, United States

Oregon Dermatology and Research Center; 🇺🇸 Portland, Oregon, United States

Columbia Dermatology & Aesthetics; 🇺🇸 Columbia, South Carolina, United States

Palmetto Clinical Trial Services - Greenville; 🇺🇸 Greenville, South Carolina, United States

International Clinical Research - Tennessee LLC; 🇺🇸 Murfreesboro, Tennessee, United States

Center for Clinical Studies; 🇺🇸 Houston, Texas, United States

Fort Bend Hearing; 🇺🇸 Sugar Land, Texas, United States

The Woodlands Dermatology Associates, PA; 🇺🇸 The Woodlands, Texas, United States

University of Utah; 🇺🇸 Murray, Utah, United States

University of Utah Medical Center; 🇺🇸 Salt Lake City, Utah, United States

Springville Dermatology - Springville/CCT Research; 🇺🇸 Springville, Utah, United States

The Education & Research Foundation, Inc.; 🇺🇸 Lynchburg, Virginia, United States

Virginia Dermatology and Skin Cancer Center; 🇺🇸 Norfolk, Virginia, United States

St George Dermatology & Skin Cancer Centre; 🇦🇺 Kogarah, New South Wales, Australia

Veracity Clinical Research; 🇦🇺 Woolloongabba, Queensland, Australia

Dr Rodney Sinclair Pty Ltd; 🇦🇺 East Melbourne, Victoria, Australia

UZ Leuven; 🇧🇪 Leuven, Vlaams-brabant, Belgium

Diagnostic Consultative Centre (DCC) - Foкus 5; 🇧🇬 Sofia, Sofia (stolitsa), Bulgaria

Clinic EvroDerma; 🇧🇬 Sofia, Sofia (stolitsa), Bulgaria

MHAT Pazardzhik; 🇧🇬 Pazardzhik, Bulgaria

Diagnostic Consultative Center 1 - Pernik; 🇧🇬 Pernik, Bulgaria

Medical Center Exacta Medica; 🇧🇬 Pleven, Bulgaria

Medical Center Prolet EOOD; 🇧🇬 Ruse, Bulgaria

Diagnostic Consultative Center "Ascendent"; 🇧🇬 Sofia, Bulgaria

Diagnostic - Consultative Center XXVIII - Sofia; 🇧🇬 Sofia, Bulgaria

"Diagnostic - Consultative Center XX - Sofia" EOOD; 🇧🇬 Sofia, Bulgaria

Center for Skin and Venereal Diseases - Veliko Tarnovo; 🇧🇬 Veliko Tarnovo, Bulgaria

Multiprofile Hospital for Active Treatment Sv. Panteleymon - Yambol AD; 🇧🇬 Yambol, Bulgaria

Dermatology Research Institute; 🇨🇦 Calgary, Alberta, Canada

Beacon Dermatology; 🇨🇦 Calgary, Alberta, Canada

Alberta Dermasurgery Centre; 🇨🇦 Edmonton, Alberta, Canada

Wiseman Dermatology Research Inc.; 🇨🇦 Winnipeg, Manitoba, Canada

SimcoDerm Medical and Surgical Dermatology Center; 🇨🇦 Barrie, Ontario, Canada

DermEffects; 🇨🇦 London, Ontario, Canada

DermEdge Research; 🇨🇦 Mississauga, Ontario, Canada

The Centre for Clinical Trials; 🇨🇦 Oakville, Ontario, Canada

York Dermatology Clinic & Research Centre; 🇨🇦 Richmond Hill, Ontario, Canada

Medicor Research Inc; 🇨🇦 Sudbury, Ontario, Canada

Sudbury Skin Clinique; 🇨🇦 Sudbury, Ontario, Canada

North York Research Inc; 🇨🇦 Toronto, Ontario, Canada

Dermatology on Bloor - Research Toronto; 🇨🇦 Toronto, Ontario, Canada

Centre de Recherche Saint-Louis; 🇨🇦 Sherbrooke, Quebec, Canada

Innovaderm Research Inc.; 🇨🇦 Montréal, Quebec, Canada

Diex Recherche sherbrooke Inc.; 🇨🇦 Sherbrooke, Quebec, Canada

Skinsense Medical Research; 🇨🇦 Saskatoon, Saskatchewan, Canada

Diex Recherche Quebec Inc.; 🇨🇦 Quebec, Canada

Centre de Recherche Dermatologique du Quebec metropolitain; 🇨🇦 Quebec, Canada

Alpha Recherche Clinique; 🇨🇦 Quebec, Canada

Beijing Friendship Hospital Affiliate of Capital University; 🇨🇳 Beijing, Beijing, China

Peking Union Medical College Hopital; 🇨🇳 Beijing, Beijing, China

Peking Union Medical College Hospital; 🇨🇳 Beijing, Beijing, China

The First Affiliated Hospital Of Fujian Medical University; 🇨🇳 Fuzhou, China

Dermatology Hospital of Southern Medical University; 🇨🇳 Guangzhou, Guangdong, China

Guangzhou First People's Hospital; 🇨🇳 Guangzhou, Guangdong, China

The Affiliated Hospital of Guizhou Medical University; 🇨🇳 Guiyang, Guizhou, China

The First Hospital of Hebei Medical University; 🇨🇳 Shijiazhuang, China

NanYang First people's hospital; 🇨🇳 Nanyang, Henan, China

The First Hospital of Wuhan; 🇨🇳 Wuhan, Hubei, China

The Second Xiangya Hospital of Central South University; 🇨🇳 Changsha, Hunan, China

The First Affiliated Hospital of Baotou Medical College; 🇨🇳 Baotou, Inner Mongolia, China

Jiangsu Province Hospital; 🇨🇳 Nanjing, Jiangsu, China

The First Hospital of Jilin University; 🇨🇳 Changchun, Jilin, China

The First Affiliated Hospital of Xi'an Jiaotong University; 🇨🇳 Xi'an, Shaanxi, China

Huashan Hospital, Fudan University; 🇨🇳 Shanghai, Shanghai, China

West China Hospital, Sichuan University; 🇨🇳 Cheng Du, Sichuan, China

Chengdu second people's hospital; 🇨🇳 Chengdu, Sichuan, China

Tianjin Medical University General Hospital; 🇨🇳 Tianjin, Tianjin, China

First Affiliated Hospital of Kunming Medical University; 🇨🇳 Kunming, Yunnan Sheng, China

Hangzhou Third Hospital; 🇨🇳 Hangzhou, Zhejiang, China

Sir Run Run Shaw Hospital of Zhejiang University School of Medicine; 🇨🇳 Hangzhou, Zhejiang, China

Shanghai General Hospital; 🇨🇳 Shanghai, China

Rosenpark Research GmbH; 🇩🇪 Darmstadt, Hessen, Germany

Klinikum Bielefeld gem. GmbH; 🇩🇪 Bielefeld, Nordrhein-westfalen, Germany

Szegedi Tudományegyetem Szent-Györgyi Albert Klinikai Központ; 🇭🇺 Szeged, Csongrád, Hungary

Klinikum Bielefeld Rosenhöhe; 🇩🇪 Bielefeld, Nordrhein-westfalen, Germany

Hautzentrum im Jahrhunderthaus; 🇩🇪 Bochum, Nordrhein-westfalen, Germany

Universitätsklinikum Bonn; 🇩🇪 Bonn, Nordrhein-westfalen, Germany

BAG Drs. Med. Quist PartG; 🇩🇪 Mainz, Rheinland-pfalz, Germany

HNO-Praxis Dr. Kugler in Magdeburg; 🇩🇪 Magdeburg, Sachsen-anhalt, Germany

Magdeburger Company for Medical Studies and Services; 🇩🇪 Magdeburg, Sachsen-anhalt, Germany

Radiologie Ulrichshaus; 🇩🇪 Magdeburg, Sachsen-anhalt, Germany

Hautarztpraxis Dr. Gerlach; 🇩🇪 Dresden, Sachsen, Germany

Universitaetsklinikum Carl Gustav Carus Dresden; 🇩🇪 Dresden, Sachsen, Germany

Universitätsklinikum Carl Gustav Carus Dresden; 🇩🇪 Dresden, Sachsen, Germany

Hautarztpraxis Dr. Neubauer; 🇩🇪 Leipzig, Sachsen, Germany

Pécsi Tudományegyetem Klinikai Központ; 🇭🇺 Pécs, Baranya, Hungary

Synexus Magyarorszag Kft. (Gyula DRS); 🇭🇺 Gyula, Békés, Hungary

Allergo-Derm Bakos Kft; 🇭🇺 Szolnok, Jász-nagykun-szolnok, Hungary

Óbudai Egészségügyi Centrum; 🇭🇺 Budapest, Hungary

Orvostudomanyi Kutato es Fejleszto Kft; 🇭🇺 Debrecen, Hungary

Japan Community Health Care Organization Chukyo Hospital; 🇯🇵 Nagoya, Aichi, Japan

DERMA-B Egészségügyi és Szolgáltató; 🇭🇺 Debrecen, Hungary

Debreceni Egyetem Klinikai Kozpont; 🇭🇺 Debrecen, Hungary

Derm-Surg Kft.; 🇭🇺 Kaposvár, Hungary

ASL1 Avezzano-Sulmona-L'Aquila; 🇮🇹 L'Aquila, Abruzzo, Italy

Presidio Ospedaliero Firenze Centro Piero Palagi; 🇮🇹 Florence, Firenze, Italy

Istituto Dermopatico Immacolata; 🇮🇹 Rome, Roma, Italy

Ospedale Civile - Azienda Ospedaliera Universitaria di Cagliari; 🇮🇹 Cagliari, Italy

Japan Community Healthcare Organization Chukyo Hospital; 🇯🇵 Nagoya, Aichi, Japan

Toho University Sakura Medical Center; 🇯🇵 Sakura, Chiba, Japan

Twoja Przychodnia SCM; 🇵🇱 Szczecin, Zachodniopomorskie, Poland

"DERMED" Centrum Medyczne Sp. z o.o.; 🇵🇱 Lodz, Łódzkie, Poland

Clinmedica Research Sp. z. o. o.; 🇵🇱 Skierniewice, Łódzkie, Poland

Centrum Medyczne Angelius Provita; 🇵🇱 Katowice, Śląskie, Poland

Fakultna nemocnica s poliklinikou F.D.Roosevelta Banska Bystrica; 🇸🇰 Banska Bystrica, Banskobystrický KRAJ, Slovakia

SANARE, s.r.o; 🇸🇰 Svidnik, Prešovský KRAJ, Slovakia

Fakultna nemocnica Trnava; 🇸🇰 Trnava, Trnavský KRAJ, Slovakia

CLINIQ s.r.o.; 🇸🇰 Bratislava, Slovakia

BeneDerma; 🇸🇰 Bratislava, Slovakia

Derma therapy spol. s.r.o.; 🇸🇰 Bratislava, Slovakia

Topskin pro s.r.o.; 🇸🇰 Kosice, Slovakia

Poliklinika ProCare Kosice s.r.o.; 🇸🇰 Kosice, Slovakia

Hospital Universitario Reina Sofia; 🇪🇸 Cordoba, Andalucía, Spain

AUDIKA; 🇪🇸 Córdoba, Andalucía, Spain

Hospital Germans Trias i Pujol; 🇪🇸 Badalona, Barcelona [barcelona], Spain

Hospital Universitari de Bellvitge; 🇪🇸 L'Hospitalet de Llobregat, Barcelona [barcelona], Spain

Hospital de la Santa Creu i Sant Pau; 🇪🇸 Barcelona, Catalunya [cataluña], Spain

Clínica Gaias - Santiago; 🇪🇸 Santiago de Compostela, Spain

Hospital Universitario Infanta Leonor; 🇪🇸 Madrid, Spain

Clinica Universidad de Navarra; 🇪🇸 Madrid, Spain

Hospital Universitario 12 de Octubre; 🇪🇸 Madrid, Spain

Hospital Universitari i Politecnic La Fe; 🇪🇸 València, Spain

Hospital Universitario Miguel Servet; 🇪🇸 Zaragoza, Spain

Chang Gung Memorial Hospital at Kaohsiung; 🇨🇳 Kaohsiung Niao Sung Dist, Kaohsiung, Taiwan

Kaohsiung Medical University Chung-Ho Memorial Hospital; 🇨🇳 Kaohsiung, Taiwan

National Taiwan University Hospital; 🇨🇳 Taipei, Taiwan

Taipei Veterans General Hospital; 🇨🇳 Taipei, Taiwan

Chang Gung Medical Foundation-Linkou Branch; 🇨🇳 Taoyuan, Taiwan

Gazi University Health Research and Application Center Gazi Hospital; 🇹🇷 Ankara, Turkey

Bezmialem Vakf Üniversitesi; 🇹🇷 Istanbul, Turkey

West Middlesex University Hospital; 🇬🇧 Isleworth, England, United Kingdom

Southampton General Hospital; 🇬🇧 Southampton, Hampshire, United Kingdom

Guy's & St Thomas' NHS Foundation Trust; 🇬🇧 London, London, CITY OF, United Kingdom

JD Medical Group; 🇺🇸 Miami, Florida, United States

Kendall Audiology & Hearing Aid Center; 🇺🇸 Miami, Florida, United States

Floridian Research Institute Llc; 🇺🇸 Miami, Florida, United States

Sanitas Research; 🇺🇸 Miami, Florida, United States

Peninsula Research Associates; 🇺🇸 Rolling Hills Estates, California, United States

Royal North Shore Hospital; 🇦🇺 St Leonards, New South Wales, Australia

The Royal Melbourne Hospital; 🇦🇺 Parkville, Victoria, Australia

Saskatoon Dermatology Centre; 🇨🇦 Saskatoon, Saskatchewan, Canada

DermoDent Centrum Medyczne Aldona Czajkowska Rafał Czajkowski s.c.; 🇵🇱 Osielsko, Kujawsko-pomorskie, Poland

Total Dermatology; 🇺🇸 Birmingham, Alabama, United States

Total Skin & Beauty Dermatology Center, PC; 🇺🇸 Birmingham, Alabama, United States

Center for Dermatology and Plastic Surgery/CCT Research; 🇺🇸 Scottsdale, Arizona, United States

Dermatology Trial Associates; 🇺🇸 Bryant, Arkansas, United States

First OC Dermatology Research Inc; 🇺🇸 Fountain Valley, California, United States

Seaside Audiology Vertigo & Ear Specialists; 🇺🇸 Huntington Beach, California, United States

Wallace Medical Group, Inc; 🇺🇸 Los Angeles, California, United States

L.A. Universal Research Center, Inc.; 🇺🇸 Los Angeles, California, United States

Kaiser Permanente; 🇺🇸 San Francisco, California, United States

Cura Clinical Research - Oxnard; 🇺🇸 Oxnard, California, United States

Mission Dermatology Center; 🇺🇸 Rancho Santa Margarita, California, United States

Integrative Skin Science and Research; 🇺🇸 Sacramento, California, United States

University of California San Diego - La Jolla; 🇺🇸 San Diego, California, United States

Wolverine Clinical Trials; 🇺🇸 Tustin, California, United States

Encore Medical Research of Boynton Beach; 🇺🇸 Boynton Beach, Florida, United States

De La Pedraja Radiology Associates; 🇺🇸 Coral Gables, Florida, United States

Gamma Diagnostic Lab; 🇺🇸 Doral, Florida, United States

FXM Clinical Research - Fort Lauderdale; 🇺🇸 Fort Lauderdale, Florida, United States

Direct Helpers Research Center; 🇺🇸 Hialeah, Florida, United States

Hear 4 U; 🇺🇸 Hialeah, Florida, United States

Harmony Medical Research Institute; 🇺🇸 Hialeah, Florida, United States

Unlimited Diagnostic Center; 🇺🇸 Hialeah, Florida, United States

Wellness Clinical Research; 🇺🇸 Miami Lakes, Florida, United States

Clever Medical Research; 🇺🇸 Miami, Florida, United States

Miami Dermatology and Laser Institute; 🇺🇸 Miami, Florida, United States

Miami Dermatology and Laser Research; 🇺🇸 Miami, Florida, United States

SouthCoast Research Center; 🇺🇸 Miami, Florida, United States

Bio-Medical Research LLC; 🇺🇸 Miami, Florida, United States

Ecco Lab Group Co; 🇺🇸 Miami, Florida, United States

All Hearing Aid, LLC; 🇺🇸 Miami, Florida, United States

Health and Life Research Institute; 🇺🇸 Miami, Florida, United States

South Miami Medical & Research Group; 🇺🇸 Miami, Florida, United States

New Horizon Research Center; 🇺🇸 Miami, Florida, United States

Skin Research of South Florida; 🇺🇸 Miami, Florida, United States

Well Pharma Medical Research, Corp.; 🇺🇸 Miami, Florida, United States

FXM Clinical Research - Miami; 🇺🇸 Miami, Florida, United States

Juntendo University Urayasu Hospital; 🇯🇵 Urayasu, Chiba, Japan

Takarazuka City Hospital; 🇯🇵 Takarazuka, Hyōgo, Japan

Tokyo Medical University Ibaraki Medical Center; 🇯🇵 Inashiki, Ibaraki, Japan

Kindai University Nara Hospital; 🇯🇵 Ikoma City, Nara, Japan

Osaka Habikino Medical Center; 🇯🇵 Habikino, Osaka, Japan

Hamamatsu University Hospital; 🇯🇵 Hamamatsu, Shizuoka, Japan

Tokyo Medical And Dental University Hospital; 🇯🇵 Bunkyō, Tokyo, Japan

Yamaguchi University Hospital; 🇯🇵 Ube, Yamaguchi, Japan

Trials in Medicine; 🇲🇽 Mexico City, Distrito Federal, Mexico

Clinica de Enfermedades Cronicas y Procedimientos Especiales, SC; 🇲🇽 Morelia, Michoacan, Mexico

Centro Regiomontano de Investigación; 🇲🇽 Monterrey, Nuevo LEÓN, Mexico

Servicios Hospitalarios de Mexico S.A. DE C.V.; 🇲🇽 Chihuahua, Mexico

Arké SMO S.A de C.V; 🇲🇽 Veracruz, Mexico

Wromedica I Bielicka A Strzalkowska s.c.; 🇵🇱 Wroclaw, Dolnośląskie, Poland

Clinica Dermatoestetica Prywatny Gabinet Dermatologiczny I Alergologiczny Prof.Dr Hab.Med. Barbara Z; 🇵🇱 Bydgoszcz, Kujawsko-pomorskie, Poland

ETG Warszawa; 🇵🇱 Warszawa, Mazowieckie, Poland

Klinika Ambroziak Dermatologia; 🇵🇱 Warszawa, Mazowieckie, Poland

Royalderm Agnieszka Nawrocka; 🇵🇱 Warszawa, Mazowieckie, Poland

Carpe Diem Centrum Medycyny Estetycznej; 🇵🇱 Warszaw, Mazowieckie, Poland

Krakowskie Centrum Medyczne; 🇵🇱 Krakow, Małopolskie, Poland

Specjalistyczny Gabinet Dermatologiczny Aplikacyjno-Badawczy, Marek Brzewski, Paweł Brzewski spółka; 🇵🇱 Kraków, Małopolskie, Poland

Specderm Poznanska sp.j.; 🇵🇱 Bialystok, Podlaskie, Poland

ClinicMed Daniluk, Nowak Spółka komandytowa; 🇵🇱 Bialystok, Podlaskie, Poland