A Study To Investigate Safety And Efficacy Of CP-690,550 For Induction Therapy In Subjects With Moderate To Severe Crohn's Disease

Phase 2

Completed

Conditions: Crohn's Disease

Interventions: Drug: Placebo
Drug: CP-690,550

Registration Number: NCT01393626

Lead Sponsor: Pfizer

Brief Summary: This study investigates safety and efficacy of CP-690,550 in adult patients with moderate to severe Crohn's disease. The study hypothesis is that at least one dose of the tested drug is more effective than placebo (inactive drug).

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 280

Inclusion Criteria

Male or female subjects between the ages of 18 and 75 years at screening (upper age limit will be 64 years in India and 65 years in the Netherlands).
Subjects with clinical diagnosis of Crohn's disease for at least 6 months prior to screening.
Subjects with active moderate to severe ileal, ileocolic, or colonic CD defined by a baseline score of Crohn's Disease Activity Index (CDAI) of 220 to 450 at baseline.

Exclusion Criteria

Diagnosis of indeterminate colitis, ulcerative colitis (UC), or clinical findings suggestive of UC.
Subjects diagnosed with Crohn's disease but without previous exposure to treatment (i.e., treatment-naïve).
Subjects receiving the following treatment for Crohn's disease:
Azathioprine, 6-mercaptopurine or methotrexate within 2 weeks prior to baseline.
Anti-TNFα therapy within 8 weeks prior to baseline.
Interferon therapy within 8 weeks prior to baseline.
Cyclosporine, mycophenolate, or tacrolimus within 4 weeks prior to baseline.
Intravenous corticosteroids within 2 weeks prior to baseline.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo BID	Placebo	-
5mg BID	CP-690,550	-
10mg BID	CP-690,550	-

Primary Outcome Measures

Name	Time	Method
Percentage of Participants in Clinical Remission (as Defined by a Crohn's Disease Activity Index [CDAI] Score of Less Than [<] 150 Points) at Week 8	Week 8	Clinical remission was a CDAI \< 150 points. CDAI is a composite index consisting of a weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI score was based partly on entries (7 days before evaluation) from participant's diary kept while on study. CDAI scores range from 0 to approximately 600, higher score indicates higher disease activity. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.

Secondary Outcome Measures

Name	Time	Method
EQ-5D Visual Analogue Scale (VAS) Scores at Baseline and Week 8/ET Visit	Baseline, Week 8/ET visit	EQ-5D is a participant rated questionnaire to assess health-related QoL in terms of a single index value. The VAS component rates current health state on a scale from 0 millimeters (mm) (worst imaginable health state) to 100 mm (best imaginable health state); higher scores indicate a better health state.
Percentage of Participants in Clinical Remission (CDAI <150) at Weeks 2 and 4	Weeks 2 and 4	Clinical remission was a CDAI \<150 points. CDAI is a composite index consisting of a weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI score was based partly on entries (7 days before evaluation) from participant's diary kept while on study. CDAI scores range from 0 to approximately 600, higher score indicates higher disease activity. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
Percentage of Participants Achieving Clinical Response-70 (as Defined by a Decrease in CDAI Score of at Least 70 Points From Baseline) at Weeks 2, 4, and 8	Baseline, Weeks 2, 4, and 8	Clinical response-70 was defined as a reduction in CDAI score from baseline of at least 70 points. CDAI is a composite index consisting of weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI scores range from 0 to approximately 600 points, higher score indicates higher disease activity. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
Percentage of Participants Achieving Either Clinical Response-100 or Clinical Remission (CDAI<150) at Weeks 2, 4, and 8	Baseline, Weeks 2, 4, and 8	Clinical response-100 was defined as a reduction in CDAI score from baseline of at least 100 points. Clinical remission was a CDAI \< 150 points. CDAI is a composite index consisting of weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI scores range from 0 to approximately 600 points, higher score indicates higher disease activity. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
Percentage of Participants With ≥16 Point Increase From Baseline in IBDQ Total Score at Week 8/ET Visit	Week 8/ET visit	The IBDQ is a psychometrically validated PRO instrument for measuring disease-specific QOL in participants with IBD. IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). Total score is the sum of each item score, and ranged from 32 to 224 with a higher score indicating a better QOL. Positive change in total score indicated improvement in QOL.
Short Form 36 Health Survey (SF-36) Component and Domain Scores at Baseline and Week 8/ET Visit	Baseline, Week 8/ET visit	The component and domain scores were scored using the United States (US) 1998 general population norms. The resulting norm-based T scores for both the SF-36 version 2 and SF-36 health domain scales and component summary measures have means of 50 and standard deviations of 10. Higher scores indicate better health-related QOL.
Change From Baseline IBDQ Total Score and Domain Scores (Bowel Function, Emotional Status, Systemic Symptoms, and Social Function) at Week 8/ET Visit Using Analysis of Covariance (ANCOVA)	Baseline, Week 8/ET visit	IBDQ is a validated PRO instrument for measuring QOL in IBD consisting of 32 items scored from 1 (worst response) to 7 (best response). 32 items are grouped into 4 domains scored as follows: bowel symptoms 10 - 70; systemic symptoms 5 - 35; emotional function 12 - 84; social function 5 - 35. For each domain, higher score indicates better QOL. Total score is the sum of each item score, \& ranged from 32 to 224 with a higher score indicating better QOL. Positive change in total score indicated improvement in QOL. Adjusted means were derived from an ANCOVA model with baseline value as covariate, treatment group \& prior use of anti-tumor necrosis factor (TNF) alpha (α) treatments as factors. The 15 mg BID treatment group was closed to further enrolment early in the study by Protocol Amendment 5 after only 16 participants were enrolled in this group. Therefore, the efficacy analysis was not performed for this group as the results may be difficult to interpret due to the small sample size.
Percentage of Participants With a Response to the Patient-Reported Treatment Impact Assessment (PRTI) at Week 8/ET Visit by Category	Week 8/ET visit	The IBD Patient Reported Treatment Impact Modified (PRTI) questionnaire comprises 3 individual questions administered to the participant: participant satisfaction with study treatment; participant preference for study drug over prior treatment (this question on participant preference for study drug is prefaced by a simple question of previous treatment/s for IBD received in order to place the preference question into context) and participant willingness to re-use the study treatment again. Each of these questions (except the question on previous treatment, which is informational only) is scored on a 5 point Likert scale. PSA = Patient Satisfaction Assessment; PPTA = Patient Previous Treatment Assessment; PPA = Patient Preference Assessment; PWA = Patient Willingness Assessment.
Percentage of Participants Achieving Clinical Response-100 (as Defined by a Decrease in CDAI Score of at Least 100 Points From Baseline) at Weeks 2, 4, and 8	Baseline, Weeks 2, 4, and 8	Clinical response-100 was defined as a reduction in CDAI score from baseline of at least 100 points. CDAI is a composite index consisting of weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI scores range from 0 to approximately 600 points, higher score indicates higher disease activity. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
C-Reactive Protein (CRP) Serum Concentrations at Weeks 2, 4, and 8	Weeks 2, 4, and 8	The test for CRP is a laboratory measurement for evaluation of an acute phase reactant of inflammation through the use of an ultrasensitive assay. A decrease in the level of CRP indicates reduction in inflammation and therefore improvement.
Calprotectin Fecal Concentrations at Weeks 2, 4, and 8	Weeks 2, 4, and 8	Fecal calprotectin is an inflammatory marker for the gastrointestinal tract and considered as a measurement of neutrophil migration to the gastrointestinal tract. Higher values indicate more serious inflammation.
Tofacitinib Plasma Concentrations From 0 to 2 Hours Post Dose on Day 1 and at Week 8/Early Termination (ET) Visit	Pre-dose, 20 minutes, 40 minutes, 1 hour, and 2 to 3 hours post-dose on Day 1 and Week 8/ET visit	Plasma samples were collected from participants for the determination of tofacitinib concentrations. Only samples from tofacitinib-treated participants were subsequently analyzed. Plasma concentration data are summarized by nominal sample collection times specified in the protocol, and actual sample collection times may be different.
Percentage of Participants With an IBDQ Total Score of Greater Than or Equal to (≥) 170 at Week 8/ET Visit	Week 8/ET visit	The IBDQ is a psychometrically validated PRO instrument for measuring disease-specific QOL in participants with IBD. IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). Total score is the sum of each item score, and ranged from 32 to 224 with a higher score indicating a better QOL. Positive change in total score indicated improvement in QOL.
Change From Baseline EQ-5D VAS Scores at Week 8/ET Visit Using ANCOVA	Baseline, Week 8/ET visit	EQ-5D is a participant rated questionnaire to assess health-related QoL in terms of a single index value. The VAS component rates current health state on a scale from 0 millimeters (mm) (worst imaginable health state) to 100 mm (best imaginable health state); higher scores indicate a better health state. Adjusted means were derived from the ANCOVA model with baseline value as a covariate, treatment group \& prior use of anti-TNF alpha treatments as factors. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
CDAI Scores at Weeks 2, 4, and 8	Weeks 2, 4, and 8	CDAI is a composite index consisting of weighted scoring of 8 disease variables: number of liquid or very soft stools, extent of abdominal pain, general well-being, occurrence of extra-intestinal symptoms, need for antidiarrheal drugs, presence of abdominal masses, hematocrit, and body weight. CDAI scores range from 0 to approximately 600 points, higher score indicates higher disease activity.
Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score and Domain Scores (Bowel Function, Emotional Status, Systemic Symptoms, and Social Function) at Baseline and Week 8/ET Visit	Baseline, Week 8/ET visit	The IBDQ is a psychometrically validated patient reported outcome (PRO) instrument for measuring disease-specific quality of life (QOL) in participants with inflammatory bowel disease (IBD). IBDQ consists of 32 items, each item score ranged from 1 (worst possible response) to 7 (best possible response). The 32 items are grouped into 4 domains: bowel function, emotional status, systemic symptoms and social function. The 4 domains are scored as follows: bowel symptoms 10 to 70; systemic symptoms 5 to 35; emotional function 12 to 84; social function 5 to 35. For each domain, a higher score indicates better QOL. Total score is the sum of each item score, and ranged from 32 to 224 with a higher score indicating a better QOL. Positive change in total score indicated improvement in QOL.
Change From Baseline EQ-5D Utility Scores at Week 8/ET Visit Using ANCOVA	Baseline, Week 8/ET visit	EQ-5D is a participant rated questionnaire to assess health-related QoL via a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain \& discomfort, anxiety \& depression; 1 = better health state (no problems); 3 = worst health state ("confined to bed"). Scoring formula developed by EuroQol Group assigns a utility value for each domain. Score is transformed to a total score ranging from -0.594 to 1.000; higher score indicates better health state. Adjusted means were derived from the ANCOVA model with baseline value as a covariate, treatment group \& prior use of anti-TNFα treatments as factors. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
Change From Baseline SF-36 Component and Domain Scores at Week 8/ET Visit Using ANCOVA	Baseline, Week 8/ET visit	The component and domain scores were scored using the US 1998 general population norms. The resulting norm-based T scores for both the SF-36 version 2 and SF-36 health domain scales and component summary measures have means of 50 and standard deviations of 10. Higher scores indicate better health-related QOL. Adjusted means were derived from the ANCOVA model with baseline value as a covariate, treatment group and prior use of anti-TNF alpha treatments as factors. The 15 mg BID treatment group was closed to further enrolment early on in the study by Protocol Amendment 5 after only 16 participants were enrolled into this group. Therefore, the efficacy analysis was not performed for this group because the results may be difficult to interpret due to the small sample size.
EuroQoL 5 Dimensions Questionnaire (EQ-5D) Utility Scores at Baseline and Week 8/ET Visit	Baseline, Week 8/ET visit	EQ-5D is a participant rated questionnaire to assess health-related QoL in terms of a single utility score. Health State Profile component assesses level of current health for 5 domains: mobility, self-care, usual activities, pain and discomfort, and anxiety and depression; 1 indicates better health state (no problems); 3 indicates worst health state ("confined to bed"). Scoring formula developed by EuroQol Group assigns a utility value for each domain in the profile. Score is transformed and results in a total score range from -0.594 to 1.000; a higher score indicates a better health state.

Trial Locations

Locations (136): Alliance Clinical Research
🇺🇸
Oceanside, California, United States
Endoscopy Center of Connecticut, LLC
🇺🇸
Hamden, Connecticut, United States
Medical Research Center of Connecticut, LLC
🇺🇸
Hamden, Connecticut, United States
Gastroenterology Center of Connecticut, PC
🇺🇸
Hamden, Connecticut, United States
Metropolitan Gastroenterology Group, PC
🇺🇸
Chevy Chase, Maryland, United States
Gastroenterology Group of Naples
🇺🇸
Naples, Florida, United States
Florida Medical Clinic, P.A.
🇺🇸
Zephyrhills, Florida, United States
Center for Digestive Health
🇺🇸
Troy, Michigan, United States
Clinical Research Institute of Michigan LLC
🇺🇸
Chesterfield, Michigan, United States
University Hospitals Chagrin Highlands Health Center
🇺🇸
Beachwood, Ohio, United States
Allegiance Research Specialists
🇺🇸
Wauwatosa, Wisconsin, United States
GI Associates
🇺🇸
Wauwatosa, Wisconsin, United States
Nepean Public Hospital
🇦🇺
Kingswood, New South Wales, Australia
Royal Melbourne Hospital
🇦🇺
Parkville, Victoria, Australia
Monash Medical Center
🇦🇺
Clayton, Victoria, Australia
4-MBAL, Parvo vatreshno otdelenie
🇧🇬
Sofia, Bulgaria
MBAL Sofiamed OOD, Otdelenie po gastroenterologia
🇧🇬
Sofia, Bulgaria
MBAL Sveti Ivan Rilski, Klinika po Gastroenterologia
🇧🇬
Sofia, Bulgaria
MBAL Voennomeditsinska Akademia
🇧🇬
Sofia, Bulgaria
University of Calgary
🇨🇦
Calgary, Alberta, Canada
Hopital Maisonneuve-Rosemont
🇨🇦
Montreal, Quebec, Canada
University Hospital Centre Rijeka
🇭🇷
Rijeka, Croatia
University Hospital Center Zagreb
🇭🇷
Zagreb, Croatia
Montreal General Hospital - McGill University Health Centre
🇨🇦
Montreal, Quebec, Canada
Hopital Huriez, CHRU de Lille
🇫🇷
Lille Cedex, France
Hopital Haut-Leveque
🇫🇷
Pessac, France
Charite Universitaetsmedizin Berlin, Campus Benjamin Franklin
🇩🇪
Berlin, Germany
Universitaetsklinikum Schleswig-Holstein
🇩🇪
Kiel, Germany
Magyar Honvedseg Honvedkorhaz II. telephely/Gasztroenterologiai Osztaly
🇭🇺
Budapest, Hungary
Pannonia Maganorvosi Centrum Kft
🇭🇺
Budapest, Hungary
Clinfan Kft.
🇭🇺
Szekszard, Hungary
Dept. of Gastroenterology & Hepatology, Meir Medical Center
🇮🇱
Kfar-Saba, Israel
Digestive Diseases Institute, Shaare Zedek Medical Center
🇮🇱
Jerusalem, Israel
Fukuoka University Chikushi Hospital
🇯🇵
Chikushino, Fukuoka, Japan
Hokkaido P.W.F.A.C Sapporo-Kosei general Hospital
🇯🇵
Sapporo, Hokkaido, Japan
The Hospital of Hyogo College of Medicine
🇯🇵
Nishinomiya, Hyogo, Japan
VU University Medical Center
🇳🇱
Amsterdam, Netherlands
Hospital Clinic de Barcelona
🇪🇸
Barcelona, Spain
Parklands Medical Centre
🇿🇦
Durban, South Africa
Hospital Universitario de La Princesa
🇪🇸
Madrid, Spain
Donetsk National Medical University n.a M. Gorky, Faculty of Internal Medicine #2,
🇺🇦
Donetsk, Ukraine
Lviv National Medical University n.a Danylo Halytsky, Faculty of Surgery#1 with Proctology Course
🇺🇦
Lviv, Ukraine
Municipal Institution "Odesa Regional Clinical Hospital". Odesa Regional Centre of Gastroenterology.
🇺🇦
Odesa, Ukraine
Medical Clinical Research Center Health Clinic on base LLC "Medical Diagnostic Center Slaomed"
🇺🇦
Vinnitsa, Ukraine
Heartland Medical Research, Inc (Administrative Only)
🇺🇸
Clive, Iowa, United States
Iowa Radiology (MRI, X-Ray Only)
🇺🇸
Clive, Iowa, United States
Iowa Digestive Disease Center
🇺🇸
Clive, Iowa, United States
Iowa Endoscopy Center (Colonoscopy Only)
🇺🇸
Clive, Iowa, United States
University of Kentucky Chandler Medical Center
🇺🇸
Lexington, Kentucky, United States
Charlotte Gastroenterology and Hepatology, PLLC
🇺🇸
Charlotte, North Carolina, United States
Premier Medical Group of the Hudson Valley, PC
🇺🇸
Poughkeepsie, New York, United States
Charlotte Radiology (Chest X-Ray Only)
🇺🇸
Charlotte, North Carolina, United States
Dayton Gastroenterology, Inc.
🇺🇸
Dayton, Ohio, United States
The Endoscopy Center of Lake County
🇺🇸
Mentor, Ohio, United States
Great Lakes Gastroenterology
🇺🇸
Willoughby, Ohio, United States
University Hospitals Westlake Medical Center
🇺🇸
Westlake, Ohio, United States
Regional Gastroenterology Associates of Lancaster, Ltd.
🇺🇸
Lancaster, Pennsylvania, United States
Digestive Health Specialists of Tyler
🇺🇸
Tyler, Texas, United States
Cardiology Consultants (ECG Site Only)
🇺🇸
Norfolk, Virginia, United States
Digestive and Liver Disease Specialists
🇺🇸
Norfolk, Virginia, United States
Alliance Clinical Research, LLC
🇺🇸
Poway, California, United States
Stormont-Vail MRI Center of Kansas
🇺🇸
Topeka, Kansas, United States
Cotton-O'Neil Clinical (X-Ray)
🇺🇸
Topeka, Kansas, United States
Hospital Puerta de Hierro Majadahonda
🇪🇸
Majadahonda, Madrid, Spain
ACRI - Phase 1, LLC
🇺🇸
Anaheim, California, United States
Advanced Clinical Research Institute - Phase 1, LLC
🇺🇸
Anaheim, California, United States
AGMG Endoscopy Center
🇺🇸
Anaheim, California, United States
Sharp Rees-Stealy Medical Group, Inc.
🇺🇸
San Diego, California, United States
West Coast Endoscopy Center
🇺🇸
Clearwater, Florida, United States
Clinical Research of West Florida, Inc
🇺🇸
Clearwater, Florida, United States
Citrus Surgery & Endoscopy Center (Colonoscopy & Biopsy Only)
🇺🇸
Crystal River, Florida, United States
Endoscopy Center of the Rockies - Longmont
🇺🇸
Longmont, Colorado, United States
NYU Langone Nassau Gastroenterology Associates
🇺🇸
Great Neck, New York, United States
Cleveland Clinic
🇺🇸
Cleveland, Ohio, United States
Gasteroenterology Consultants of Clearwater
🇺🇸
Clearwater, Florida, United States
Gastroenterology Associates of Central Georgia, LLC
🇺🇸
Macon, Georgia, United States
Southwest Gastroenterology
🇺🇸
Oak Lawn, Illinois, United States
University Hospitals Case Medical Center
🇺🇸
Cleveland, Ohio, United States
UT Health Science Center
🇺🇸
Houston, Texas, United States
Medical Diagnostic Imaging (MDI) X-ray and MRI only
🇺🇸
Milwaukee, Wisconsin, United States
Office of Drs. Ranjith Andrew Singh and Jamie D. Papp
🇨🇦
Victoria, British Columbia, Canada
NYU Langone Long Island Clinical Research Associates
🇺🇸
Great Neck, New York, United States
University of Utah
🇺🇸
Salt Lake City, Utah, United States
MRI & CT Diagnostics
🇺🇸
Virginia Beach, Virginia, United States
The Center for Digestive Health
🇺🇸
Milwaukee, Wisconsin, United States
Wisconsin Center for Advanced Research - GI Associates, LLC
🇺🇸
Milwaukee, Wisconsin, United States
Wisconsin Center for Advanced Research
🇺🇸
Milwaukee, Wisconsin, United States
Office of Dr. David C. Pearson
🇨🇦
Victoria, British Columbia, Canada
PerCuro Clinical Research Ltd.
🇨🇦
Victoria, British Columbia, Canada
Sunnybrook Health Sciences Centre
🇨🇦
Toronto, Ontario, Canada
Kingsbury Hospital
🇿🇦
Cape Town, Western Cape, South Africa
Shands Endoscopy Center
🇺🇸
Gainesville, Florida, United States
Investigational Drug Service
🇺🇸
Gainesville, Florida, United States
ASAN Medical Center
🇰🇷
Seoul, Korea, Republic of
Medial Pharma spol.s.r.o.
🇨🇿
Hradec Králové, Czech Republic
General Hospital of Athens "Evangelismos",1st Gastroenterology Department
🇬🇷
Kolonaki Athens, Greece
Rabin Medical Center, Beilinson Hospital
🇮🇱
Petach Tikva, Israel
Osaka City University Hospital
🇯🇵
Osaka, Japan
Chevy Chase Endoscopy Center
🇺🇸
Chevy Chase, Maryland, United States
Charite - Campus Berlin Mitte
🇩🇪
Berlin, Germany
Universitaetsklinikum Ulm, Klinik fuer Innere Medizin I
🇩🇪
Ulm, Germany
Tokyo Medical And Dental University Hospital, Faculty of Medicine
🇯🇵
Bunkyo-ku, Tokyo, Japan
Severance Hospital, Yeonsei University Health System
🇰🇷
Seoul, Korea, Republic of
Suncoast Endoscopy Center (Colonoscopy Only)
🇺🇸
Inverness, Florida, United States
London Health Sciences Centre - University Hospital
🇨🇦
London, Ontario, Canada
Keio University Hospital
🇯🇵
Shinjuku-ku, Tokyo, Japan
North Florida Gastroenterology Research, LLC
🇺🇸
Orange Park, Florida, United States
AKH Wien Universitaetsklinik fuer Innere Medizin III
🇦🇹
Wien, Austria
Hepato-Gastroenterologie HK, s.r.o.
🇨🇿
Hradec Kralove, Czech Republic
Hopital Robert Debre
🇫🇷
Reims cedex, France
Tel Aviv Sourasky Medical Center
🇮🇱
Tel Aviv, Israel
Gulfshore Endoscopy Center (Endoscopies Only)
🇺🇸
Naples, Florida, United States
Peterfy Sandor Utcai Korhaz, Rendelointezet es Baleseti Kozpont, I. sz. Belgyogyaszat
🇭🇺
Budapest, Hungary
Laboratorium Kft. Fovarosi es Pest Megyei Mikrobiologiai Laboratorium
🇭🇺
Budapest, Hungary
Inflammatory Bowel Disease Centre, Montreal General Hospital, McGill University Health Centre
🇨🇦
Montreal, Quebec, Canada
RDG centrum s.r.o.
🇨🇿
Hradec Kralove, Czech Republic
National Hospital Organization Sendai Medical Center
🇯🇵
Sendai, Miyagi, Japan
Academisch Medisch Centrum
🇳🇱
Amsterdam, Netherlands
Dartmouth Hitchcock Medical Center
🇺🇸
Lebanon, New Hampshire, United States
Nature Coast Clinical Research
🇺🇸
Inverness, Florida, United States
Szent Janos Korhaz es Eszak-budai Egyesitett Korhazak/I. Belgyogyaszat es Gastroenterologia
🇭🇺
Budapest, Hungary
Gastroenterologische Gemeinschaftspraxis Minden
🇩🇪
Minden, Germany
Bugat Pal Korhaz Egeszsegugyi Szolgaltato Kozhasznu Nonprofit Kft
🇭🇺
Gyongyos, Hungary
Somogy megyei Kaposi Mor Oktato Korhaz / Belgyogyaszati osztaly
🇭🇺
Kaposvar, Hungary
State Institution "Institute of Therapy n.a. L.T. Mala of AMS of Ukraine"
🇺🇦
Kharkiv, Ukraine
Samsung Medical Center
🇰🇷
Seoul, Korea, Republic of
Toho University Sakura Medical Center
🇯🇵
Chiba, Japan
State Institution "Institute of Gastroenterology of AMS of Ukraine"
🇺🇦
Dnipropetrovsk, Ukraine
Shands Hospital at the University of Florida
🇺🇸
Gainesville, Florida, United States
Internal Medicine Specialists
🇺🇸
Orlando, Florida, United States
Shands Medical Plaza and Cancer Center
🇺🇸
Gainesville, Florida, United States
East Ann Arbor Health and Geriatrics Center
🇺🇸
Ann Arbor, Michigan, United States
University of Michigan Health Systems
🇺🇸
Ann Arbor, Michigan, United States
FQL Research, LLC
🇺🇸
Miramar, Florida, United States
Clinical Research Of The Rockies
🇺🇸
Lafayette, Colorado, United States
Cotton-O'Neil Clinical Research Center, Digestive Health
🇺🇸
Topeka, Kansas, United States