MSB11022 in Moderate to Severe Chronic Plaque Psoriasis

Phase 3

Completed

Conditions: Moderate to Severe Plaque Psoriasis
Plaque Type Psoriasis
Psoriasis

Interventions: Drug: Humira®
Drug: MSB11022

Registration Number: NCT02660580

Lead Sponsor: Fresenius Kabi SwissBioSim GmbH

Brief Summary: The purpose of this study was to compare the efficacy, safety and immunogenicity of MSB11022 and Humira® in adult subjects with moderate to severe chronic plaque type psoriasis.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 443

Inclusion Criteria

Male or female participants greater than or equal to (>=) 18 years old with a clinical diagnosis of stable moderate to severe plaque psoriasis (defined by Psoriasis Area and Severity Index [PASI] score >=12, Physician Global Assessment [PGA] score >=3, and >=10% of body surface area affected at Screening and Baseline [Day 1 of Week 1]) who have a history of receipt of or are candidates for systemic therapy or phototherapy for active plaque-type psoriasis despite topical therapy
Participants must not have received more than 1 biologic therapy
Other protocol-defined inclusion criteria could apply

Exclusion Criteria

Participants was excluded if they have erythrodermic, pustular, guttate, or medication-induced forms of psoriasis or other active skin diseases/infections that may interfere with the evaluation of plaque psoriasis
Participants must not have received adalimumab or an investigational or licensed biosimilar of adalimumab; topical therapies for the treatment of psoriasis or ultraviolet B phototherapy within 2 weeks of investigational medicinal product (IMP) administration or plan to take such treatment during the trial; or psoralen combined with ultraviolet A phototherapy or nonbiological systemic therapies for psoriasis within 4 weeks prior to IMP administration
Participants was excluded if they have a history of an ongoing, chronic, or recurrent infectious disease (except for latent tuberculosis [TB]); history of active TB; or a history of hypersensitivity to any component of the IMP formulation, comparable drugs, or latex
Other protocol-defined exclusion criteria could apply

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
EU-Humira	Humira®	Participants received EU-Humira subcutaneously at an initial dose of 80 mg on Day 1 of Week 1 followed by 40 mg every other week starting at Week 2 up to and including Week 14 in Core Treatment Period.
EU-Humira/EU-Humira	Humira®	Participants who had achieved PASI 50 and received EU-Humira in Core Treatment Period and continued to receive EU-Humira subcutaneously at dose of 40 mg every other week starting at Week 16 up to and including Week 50 after re-randomization in extended treatment period.
EU-Humira/MSB11022	Humira®	Participants who had achieved PASI 50 and received EU-Humira in Core Treatment Period were re-randomized to receive MSB11022 subcutaneously at dose of 40 mg every other week starting at Week 16 up to and including Week 50 in extended treatment period.
EU-Humira/MSB11022	MSB11022	Participants who had achieved PASI 50 and received EU-Humira in Core Treatment Period were re-randomized to receive MSB11022 subcutaneously at dose of 40 mg every other week starting at Week 16 up to and including Week 50 in extended treatment period.
MSB11022 (Core Treatment Period)	MSB11022	Participants received MSB11022 subcutaneously at an initial dose of 80 milligram (mg) on Day 1 of Week 1 followed by 40 mg every other week starting at Week 2 up to and including Week 14 in Core Treatment Period.
MSB11022 (Extended Treatment Period)	MSB11022	Participants who had achieved PASI 50 and received MSB11022 during Core Treatment Period continued to receive MSB11022 subcutaneously at dose of 40 mg every other week starting at Week 16 up to and including Week 50 in extended treatment period.

Primary Outcome Measures

Name	Time	Method
Percentage of Participants Who Achieved Psoriasis Area and Severity Index 75 (PASI 75) at Week 16	Week 16	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72 with higher scores reflecting more disease severity. The PASI-75 response is defined as the percentage of participants who achieved at least a 75% improvement in PASI score from Baseline.

Secondary Outcome Measures

Name	Time	Method
Observed Serum Concentration at Week 24 and 52	Week 24 and 52	Observed serum concentrations at week 24 and 52 were reported.
Percent Change From Baseline in PASI at Week 16	Baseline (Day 1 of Core Treatment Period), Week 16	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity. Percent change from Baseline in PASI score was reported.
Percentage of Participants Who Achieved PASI 50, 90 and 100 at Week 16	Week 16	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72 with higher scores reflecting more disease severity. The PASI 50, 90 and 100 response rate at Week 16 is measured as the percentage of participants who achieved at least 50, 90 and 100% improvement from baseline PASI score at Week 16.
Percentage of Participants Who Achieved PASI 50, 75, 90 and 100 at Week 24	Week 24	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72 with higher scores reflecting more disease severity. The PASI response rate at Week 24 is measured as the percentage of participants who achieved at least 50, 75, 90 and 100% improvement from baseline PASI at Week 24.
Percentage of Participants Who Achieved PASI 50, 75, 90 and 100 at Week 52	Week 52	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72 with higher scores reflecting more disease severity. The PASI response rate at Week 52 is measured as the percentage of participants who achieved at least 50, 75, 90 and 100% improvement from baseline PASI at Week 52.
Percent Change From Baseline in PASI at Week 24 and 52	Baseline (Day 1 of Extended Treatment Period), Weeks 24 and 52	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity.
Number of Participants With Change From Baseline in Physician's Global Assessment (PGA) Score to "Clear" or "Almost Clear" at Week 16	Baseline (Day 1 of Core Treatment Period), Week 16	PGA was assessed relative to baseline condition based on a scale ranged from 0 to 4, where 0 indicates Clear condition (no signs of psoriasis, post-inflammatory hyperpigmentation may be present), 1 indicates Almost clear condition (normal to pink coloration of lesion, no thickening and no to minimal \[focal\] scaling), 2 indicates Mild condition (pink to light red coloration, just detectable to mild thickening and predominantly fine scaling), 3 indicates Moderate condition (dull bright red, clearly distinguishable erythema, clearly distinguishable to moderate thickening and moderate scaling), and 4 indicates Severe condition (bright to deep dark red coloration, severe thickening with hard edges and severe/coarse scaling covering almost all or all lesions).
Number of Participants With Change From Baseline in Physician's Global Assessment (PGA) Score to "Clear" or "Almost Clear" at Week 24 and 52	Baseline (Day 1 of Extended Treatment Period), Week 24 and 52	PGA was assessed relative to baseline condition based on a scale ranged from 0 to 4, where 0 indicates clear condition (no signs of psoriasis, post-inflammatory hyperpigmentation may be present), 1 indicates Almost clear condition (normal to pink coloration of lesion, no thickening and no to minimal \[focal\] scaling), 2 indicates mild condition (pink to light red coloration, just detectable to mild thickening and predominantly fine scaling), 3 indicates moderate condition (dull bright red, clearly distinguishable erythema, clearly distinguishable to moderate thickening and moderate scaling), and 4 indicates severe condition (bright to deep dark red coloration, severe thickening with hard edges and severe/coarse scaling covering almost all or all lesions).
Time to Achieve PASI 50	Baseline (Day 1 of Core Treatment Period) up to Month 4	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity. Time to achieve at least 50% improvement in PASI from baseline was measured.
Time to Achieve PASI 75	Baseline (Day 1 of Core Treatment Period) up to Month 4	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity. Time to achieve at least 75% improvement in PASI from baseline was measured.
Time to Achieve PASI 90	Baseline (Day 1 of Core Treatment Period) up to Month 4	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity. Time to achieve at least 90% improvement in PASI from baseline was measured.
Time to Achieve PASI 100	Baseline (Day 1 of Core Treatment Period) up to Month 13.5	PASI correlates to the physician's assessment of psoriasis symptoms including redness of lesions, thickness of lesions, scaliness of lesions and extent of disease. Each parameter is graded from 0-4, 0 refers to no disease and 4 to severe involvement. The body is divided into 4 areas for scoring (head, arms, trunk to groin, legs to top of buttocks), and the final score ranges from 0-72, with higher scores reflecting more disease severity. Time to achieve at least 100% improvement in PASI from baseline was measured.
Number of Participants With Change in Physician's Global Assessment (PGA) From Baseline at Week 16	Baseline (Day 1 of Core Treatment Period), Week 16	PGA was assessed relative to baseline condition based on a scale ranged from 0 to 4, where 0 indicates clear condition (no signs of psoriasis, post-inflammatory hyperpigmentation may be present), 1 indicates Almost clear condition (normal to pink coloration of lesion, no thickening and no to minimal \[focal\] scaling), 2 indicates mild condition (pink to light red coloration, just detectable to mild thickening and predominantly fine scaling), 3 indicates moderate condition (dull bright red, clearly distinguishable erythema, clearly distinguishable to moderate thickening and moderate scaling), and 4 indicates severe condition (bright to deep dark red coloration, severe thickening with hard edges and severe/coarse scaling covering almost all or all lesions).
Number of Participants With Change in Physician's Global Assessment (PGA) From Baseline at Week 24	Baseline (Day 1 of Extended Treatment Period), Week 24	PGA was assessed relative to baseline condition based on a scale ranged from 0 to 4, where 0 indicates clear condition (no signs of psoriasis, post-inflammatory hyperpigmentation may be present), 1 indicates Almost clear condition (normal to pink coloration of lesion, no thickening and no to minimal \[focal\] scaling), 2 indicates mild condition (pink to light red coloration, just detectable to mild thickening and predominantly fine scaling), 3 indicates moderate condition (dull bright red, clearly distinguishable erythema, clearly distinguishable to moderate thickening and moderate scaling), and 4 indicates severe condition (bright to deep dark red coloration, severe thickening with hard edges and severe/coarse scaling covering almost all or all lesions).
Number of Participants With Clinically Meaningful Differences in Vital Signs	Core Treatment Period: Baseline up to 16; Extended Treatment Period: Baseline up to Week 54	Number of participants with clinically meaningful abnormalities in vital signs were reported. Clinical meaningful was determined by the investigator.
European Quality of Life 5-Dimensions and 5-Levels Questionnaire (EQ5D-5L) Based on VAS Score at Week 24 and 52	Week 24 and 52	The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no problems, slight problems, moderate problems, severe problems and extreme problems) that reflect increasing levels of difficulty. The participant was asked to indicate his/her current health state by selecting the most appropriate level on a visual analog scale, where the participant was asked to rate current health status on a scale of 0 to 100, with 0 being the worst imaginable health state.
Number of Participants With Change in Physician's Global Assessment (PGA) From Baseline at Week 52	Baseline (Day 1 of Extended Treatment Period), Week 52	PGA was assessed relative to baseline condition based on a scale ranged from 0 to 4, where 0 indicates clear condition (no signs of psoriasis, post-inflammatory hyperpigmentation may be present), 1 indicates Almost clear condition (normal to pink coloration of lesion, no thickening and no to minimal \[focal\] scaling), 2 indicates mild condition (pink to light red coloration, just detectable to mild thickening and predominantly fine scaling), 3 indicates moderate condition (dull bright red, clearly distinguishable erythema, clearly distinguishable to moderate thickening and moderate scaling), and 4 indicates severe condition (bright to deep dark red coloration, severe thickening with hard edges and severe/coarse scaling covering almost all or all lesions).
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs of Special Interest and TEAEs Leading to Death up to Week 16	Baseline (Day 1 of Core Treatment Period) up to Week 16	Adverse event(AE) was defined as any untoward medical occurrence in participants which does not necessarily have causal relationship with treatment. AE was any unfavorable and unintended sign(including abnormal laboratory finding), symptom/disease temporally associated with use of medicinal product, whether/not considered related to medicinal product. A serious adverse event(SAE) was AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial/prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Term TEAE is defined as AEs starting/worsening after first intake of the study drug. TEAEs included both Serious TEAEs and non-serious TEAEs.
Number of Participants With Treatment Emergent Adverse Events (TEAEs), Serious TEAEs, TEAEs of Special Interest and TEAEs Leading to Death up to Week 54	Baseline (Day 1 of Extended Treatment Period) up to Week 54	Adverse event(AE) was defined as any untoward medical occurrence in participants which does not necessarily have causal relationship with treatment. AE was any unfavorable and unintended sign(including abnormal laboratory finding), symptom/disease temporally associated with use of medicinal product, whether/not considered related to medicinal product. A serious adverse event(SAE) was AE that resulted in any of the following outcomes: death; life threatening; persistent/significant disability/incapacity; initial/prolonged inpatient hospitalization; congenital anomaly/birth defect or was otherwise considered medically important. Term TEAE is defined as AEs starting/worsening after first intake of the study drug. TEAEs included both Serious TEAEs and non-serious TEAEs.
Number of Participants With Clinically Meaningful Differences in Laboratory Values	Core Treatment Period: Baseline up to 16; Extended Treatment Period: Baseline up to Week 54	Based on categories of low, normal, or high according to the laboratory normal ranges, there were no clinically meaningful differences across the treatment groups in the numbers of participants with shifts in Laboratory parameters including hematology, chemistry and urinalysis from normal at Core Baseline to either low or high during the overall treatment period. Clinical meaningful was determined by the investigator.
Number of Participants With Anti-nuclear Antibodies (ANA) and Anti-double-stranded Deoxyribonucleic Acid (Anti-dsDNA) Assessments at Week 16	Week 16	Number of participants ANA and anti-ds DNA values were reported. For ANA, positivity is defined as any participants with ANA titer greater than (\>) 1:160 and negativity is defined as ANA titer less than (\<) 1:160. For anti-ds DNA, positivity is defined as any participants with adsDNA \> 15 units per milliliter (U/mL), intermediate category is defined as value between 10 U/mL to 15 U/mL and negativity is defined as adsDNA \< 10 U/mL.
Number of Participants With Anti-nuclear Antibodies (ANA) and Anti-double-stranded Deoxyribonucleic Acid (Anti-dsDNA) Assessments at Week 24, 32, 40 and 52	Week 24, 32, 40 and 52	Number of participants ANA and anti-ds DNA values were reported. For ANA, positivity is defined as any participants with ANA titer greater than (\>) 1:160 and negativity is defined as ANA titer less than (\<) 1:160. For anti-ds DNA, positivity is defined as any participants with adsDNA \> 15 units per milliliter (U/mL), intermediate category is defined as value between 10 U/mL to 15 U/mL and negativity is defined as adsDNA \< 10 U/mL.
Dermatology Life Quality Index (DLQI) at Week 24 and 52	Week 24 and 52	The DLQI is a 10-item validated quality-of-life questionnaire that covers 6 domains: symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment. The DLQI measures how much participant's skin problems has affected his life. Responses range from 0=Not at all to 3=Very much. The DLQI total score is the sum of individual 10 items and could range from 0 to 30 (higher score indicated greater negative impact on life).
European Quality of Life 5-Dimensions and 5-Levels Questionnaire (EQ5D-5L) Descriptive Score at Week 24 and 52	Week 24 and 52	The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no problems, slight problems, moderate problems, severe problems and extreme problems) that reflect increasing levels of difficulty. The participant was asked to indicate his/her current health state by selecting the most appropriate level in each of the 5 dimensions. The responses are converted into a single index value, with scores ranging from -0.594 to 1 (a higher score indicates better health state).
European Quality of Life 5-Dimensions and 5-Levels Questionnaire (EQ5D-5L) Based on Visual Analogue Scale (VAS) Score at Week 16	Week 16	The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no problems, slight problems, moderate problems, severe problems and extreme problems) that reflect increasing levels of difficulty. The participant was asked to indicate his/her current health state by selecting the most appropriate level on a visual analog scale, where the participant was asked to rate current health status on a scale of 0 to 100, with 0 being the worst imaginable health state.
Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 16	Week 16	HAQ-DI: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; and common activities over past week. Each item scored on 4-point scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.
Anti-Drug Antibodies (ADAs) Titers for Adalimumab at Week 16	Week 16	Anti-Drug Antibodies (ADAs) Titers for adalimumab at week 16 was reported. Data was collected using validated bioanalytical method.
Number of Participants With Clinically Significant Abnormalities in 12-Electrocardiogram (12-ECG)	Core Treatment Period: Baseline up to 16; Extended Treatment Period: Baseline up to Week 54	Number of participants with clinically significant abnormalities in 12-ECG were reported. Clinical significance was determined by the investigator.
Dermatology Life Quality Index (DLQI) at Week 16	Weeks 16	The DLQI is a 10-item validated quality-of-life questionnaire that covers 6 domains: symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment. The DLQI measures how much participant's skin problems has affected his life. Responses range from 0=Not at all to 3=Very much. The DLQI total score is the sum of individual 10 items and could range from 0 to 30 (higher score indicated greater negative impact on life).
European Quality of Life 5-Dimensions and 5-Levels Questionnaire (EQ5D-5L) Descriptive Score at Week 16	Week 16	The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no problems, slight problems, moderate problems, severe problems and extreme problems) that reflect increasing levels of difficulty. The participant was asked to indicate his/her current health state by selecting the most appropriate level in each of the 5 dimensions. The responses are converted into a single index value, with scores ranging from -0.594 to 1 (a higher score indicates better health state).
Health Assessment Questionnaire Disability Index (HAQ-DI) at Week 24, and 52	Week 24 and 52	HAQ-DI: participant-reported assessment of ability to perform tasks in 8 categories of daily living activities: dress/groom; arise; eat; walk; reach; grip; hygiene; and common activities over past week. Each item scored on 4-point scale from 0 to 3: 0=no difficulty; 1=some difficulty; 2=much difficulty; 3=unable to do. Overall score was computed as the sum of domain scores and divided by the number of domains answered. Total possible score range 0-3 where 0 = least difficulty and 3 = extreme difficulty.
Number of Participants With Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) to Adalimumab at Week 24, 32, 40 and 52	Week 24, 32, 40 and 52	Number of participants With positive treatment emergent Anti-Drug Antibodies (ADAs) and positive Neutralizing Antibodies (NAbs) to Adalimumab were reported. Data was collected using validated bioanalytical method.
Patient Global Assessment for Joints on Visual Analog Scale (PJA-VAS) at Week 16	Week 16	Patient global assessment for joints was measured on a 100 millimeter (mm) VAS scale, where 0 = no pain and 100 = worst possible pain.
Patient Global Assessment for Joints on Visual Analog Scale (PJA-VAS) at Week 24 and 52	Week 24 and 52	Patient global assessment for joints was measured on a 100 millimeter (mm) VAS scale, where 0 = no pain and 100 = worst possible pain.
Number of Participants With Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) to Adalimumab at Week 16	Week 16	Number of participants with treatment emergent Anti-Drug Antibodies (ADAs) and Neutralizing Antibodies (NAbs) to Adalimumab were reported from baseline to week 16. Data was collected using validated bioanalytical method.
Anti-Drug Antibodies (ADAs) Titers for Adalimumab at Week 24, 32, 40 and 52	Week 24, 32, 40 and 52	Anti-Drug Antibodies (ADAs) Titers for adalimumab at Week 24, 32, 40 and 50 was reported. Data was collected using validated bioanalytical method.
Observed Serum Concentration at Week 16	Week 16	Observed serum concentrations at week 16 were reported.

Trial Locations

Locations (76): NZOZ ALL-MED Centrum Medyczne Specjalistyczne Gabinety Lekarskie
🇵🇱
Lodz, Poland
Centrum Medyczne ADAMAR
🇵🇱
Wroclaw, Poland
MC "Robert Koch", EOOD
🇧🇬
Sofia, Bulgaria
Unidad de Investigacion de las Enfermedades Reumaticas
🇲🇽
Cuauhtemoc, Distrito Federal, Mexico
Diagnostic Consultative Center II - Sofia OOD
🇧🇬
Sofia, Bulgaria
Centrum Badan Klinicznych S.C.
🇵🇱
Poznan, Poland
Royal Stoke University Hospital
🇬🇧
Stoke on Trent, Staffordshire, United Kingdom
DCC "Alexandrovska", EOOD
🇧🇬
Sofia, Bulgaria
UMHAT "Alexandrovska" EAD
🇧🇬
Sofia, Bulgaria
ALLERGO-DERM BAKOS Kft.
🇭🇺
Szolnok, Hungary
Clinical Research Institute S.C.
🇲🇽
Tlalnepantla, Estado De Mexico, Mexico
Dr. Lorne E. Albrecht, Inc.
🇨🇦
Surrey, British Columbia, Canada
Medical Center "Excelsior", OOD
🇧🇬
Sofia, Bulgaria
Niepubliczny Zaklad Opieki Zdrowotnej "Nasz Lekarz" Praktyka Grupowa Lekarzy Rodzinnych z
🇵🇱
Torun, Poland
SBEI HPE "Kazan State Medical University" of the MoH of the RF
🇷🇺
Kazan, Russian Federation
Clinica de Investigacion en Reumatologia y Obesidad S.C.
🇲🇽
Guadalajara, Jalisco, Mexico
Dermatology Clinical Research Center of San Antonio
🇺🇸
San Antonio, Texas, United States
DermEdge Research
🇨🇦
Mississauga, Ontario, Canada
Centro de Dermatologia de Monterrey
🇲🇽
Monterrey, Nuevo León, Mexico
Military Medical Academy - MHAT - Sofia
🇧🇬
Sofia, Bulgaria
MC "Synexus - Sofia", EOOD
🇧🇬
Sofia, Bulgaria
DCC 'Sveti Georgi' EOOD
🇧🇬
Haskovo, Bulgaria
Dermatology Treatment and Research Center
🇺🇸
Dallas, Texas, United States
Modern Research Associates
🇺🇸
Dallas, Texas, United States
UMHAT 'Dr. Georgi Stranski', EAD
🇧🇬
Pleven, Bulgaria
DCC "Sv. Georgi", EOOD
🇧🇬
Plovdiv, Bulgaria
Dr Melinda Gooderham Medicine Professional Corporation
🇨🇦
Peterborough, Ontario, Canada
Fakultni nemocnice Kralovske Vinohrady
🇨🇿
Praha 10, Czechia
Stratica Medical
🇨🇦
Edmonton, Alberta, Canada
DCC 3 - Varna, EOOD
🇧🇬
Varna, Bulgaria
Gupta, Aditya K. MD
🇨🇦
London, Ontario, Canada
Nemocnice Novy Jicin a.s.
🇨🇿
Novy Jicin, Czechia
Vahlberg & Pild OÜ
🇪🇪
Tallinn, Estonia
East Tallinn Central Hospital
🇪🇪
Tallinn, Estonia
Fakultni nemocnice Olomouc
🇨🇿
Olomouc, Czechia
Tartu University Hospital
🇪🇪
Tartu, Estonia
Clintrial, s.r.o.
🇨🇿
Praha 10, Czechia
Dermatovenerologická klinika
🇨🇿
Praha 8 - Liben, Czechia
Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad Labem
🇨🇿
Usti nad Labem, Czechia
Groupe Hospitalier Sud - Hôpital Haut-Lévêque - Maison du Haut Lévêque
🇫🇷
Bordeaux, Gironde, France
Hôpital de Brabois Adultes
🇫🇷
Vandoeuvre les Nancy, Meurthe Et Moselle, France
CHU Nice - Hôpital de l'Archet 2
🇫🇷
Nice cedex 3, Alpes Maritimes, France
Hôpital de la Timone
🇫🇷
Marseille cedex 5, France
Licca
🇩🇪
Augsburg, Bayern, Germany
Clinical Research Hamburg GmbH
🇩🇪
Hamburg, Germany
Universitaetsklinikum Bonn AoeR
🇩🇪
Bonn, Nordrhein Westfalen, Germany
Praxis fuer Dermatologie und Venerologie
🇩🇪
Dresden, Sachsen, Germany
Debreceni Egyetem Klinikai Kozpont
🇭🇺
Debrecen, Hungary
SzSzB Megyei Korhazak es Egyetemi Oktatokorhaz
🇭🇺
Nyiregyhaza, Hungary
Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont
🇭🇺
Szeged, Hungary
Ambrozia Gondozohaz Szolg. Nonprofit Kft.
🇭🇺
Budapest, Hungary
Köhler & Milstein Research S.A de C.V.
🇲🇽
Merida, Yucatán, Mexico
Centro Multidisciplinario para el Desarrollo Especializado de la Investigacion Clinica en Yucatan
🇲🇽
Merida, Yucatán, Mexico
Gdanskie Centrum Zdrowia Sp. z o.o.
🇵🇱
Gdansk, Poland
Centrum Medyczne Medyk
🇵🇱
Rzeszow, Poland
Derma Norte del Bajio S.C.
🇲🇽
Aguascalientes, Mexico
Centrum Kliniczno - Badawcze J. Brzezicki, B. Górnikiewicz-Brzezicka Lekarze Spółka Partnerska
🇵🇱
Elblag, Poland
Centrum Medyczne Plejady
🇵🇱
Krakow, Poland
Grazyna Pulka Specjalistyczny Osrodek "ALL-MED"
🇵🇱
Krakow, Poland
Centrum Terapii Wspolczesnej J.M. Jasnorzewska sp. komandytowo-akcyjna
🇵🇱
Lodz, Poland
Niepubliczny Zaklad Opieki Zdrowotnej "Med-Laser"
🇵🇱
Lublin, Poland
LLC "Alliance Biomedical - Russian Group"
🇷🇺
Saint-Petersburg, Russian Federation
Clinic of skin and veneral diseases
🇷🇺
Saratov, Russian Federation
SBEI HPE "Yaroslavl State Medical University" of the MoH of the RF
🇷🇺
Yaroslavl, Russian Federation
Russells Hall Hospital
🇬🇧
Dudley, West Midlands, United Kingdom
York Dermatology Center
🇨🇦
Richmond Hill, Ontario, Canada
K. Papp Clinical Research
🇨🇦
Waterloo, Ontario, Canada
Palm Beach Research Center
🇺🇸
West Palm Beach, Florida, United States
San Luis Dermatology & Laser Clinic, Inc.
🇺🇸
San Luis Obispo, California, United States
Florida Academic Centers Research and Education
🇺🇸
Coral Gables, Florida, United States
Lynderm Research Inc.
🇨🇦
Markham, Ontario, Canada
Nemocnice Jihlava
🇨🇿
Jihlava, Czechia
Centre de Recherche Dermatologique du Quebec Metropolitain
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Ste-Foy, Quebec, Canada
Clinical Research Centre
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Tartu, Estonia
Klinikum der Johann Wolfgang Goethe-Universitaet
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Frankfurt, Hessen, Germany
SP Szpital Kliniczny Nr 1 we Wroclawiu
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Wroclaw, Poland