MedPath

A Safety and Efficacy Study of Relamorelin in Diabetic Gastroparesis 01

Phase 3
Terminated
Conditions
Gastroparesis
Diabetes Mellitus
Interventions
Drug: Placebo
Registration Number
NCT03285308
Lead Sponsor
Allergan
Brief Summary

This study will evaluate the safety and efficacy of relamorelin compared to placebo in participants with diabetic gastroparesis. Participants will report daily severity scores of their diabetic gastroparesis symptoms.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
336
Inclusion Criteria
  • Diagnosis of Type 1 or Type 2 diabetes mellitus
  • Meet the per protocol criteria of diabetic gastroparesis
  • Compliance with diary
  • Compliance with the per protocol study treatment dosing instructions
Exclusion Criteria
  • Currently receiving nutrition intravenously, by nasogastric tube, or other feeding tube
  • Actively experiencing anorexia nervosa, binge-eating, bulimia, or other eating disorder at the time of Screening (Visit 1)
  • Diagnosis of Celiac Disease, also a history of non-celiac gluten sensitivity
  • History of gastrointestinal disorders that may be similar to gastroparesis
  • Functional dyspepsia diagnosed before the diagnosis of diabetes mellitus

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboFollowing a 2-week placebo run-in, participants received placebo-matching relamorelin injected subcutaneously twice daily for up to 12 weeks.
Relamorelin 10 μgRelamorelinFollowing a 2-week placebo run-in, participants received relamorelin 10 μg injected subcutaneously twice daily for up to 12 weeks.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants Meeting the Vomiting Responder Criterion During Each of the Last 6 Weeks of the 12-week Treatment PeriodWeek 6 to Week 12

The number of vomiting episodes in the previous 24 hours were assessed daily by the participant using the DGSSD and were recorded in the e-diary. A Vomiting Responder was defined as a participant with zero weekly vomiting episodes during each of the last 6 weeks of the 12-week Treatment Period.

Change From Baseline to Week 12 in the Weekly Diabetic Gastroparesis Symptom Severity Score (DGSSS)Baseline (Day-14 to Day-1) to Week 12

Participants assessed the severity of diabetic gastroparesis symptoms daily using the Diabetic Gastroparesis Symptom Severity Diary (DGSSD), recorded in an electronic diary (e-diary). The DGSSS was derived as the sum of the weekly averages of the 4 DGSSD items: nausea, abdominal pain, postprandial fullness and bloating. Each symptom was scored using an 11-point ordinal scale where: 0=no or not at all uncomfortable to 10=worst possible or most uncomfortable for a total possible DGSSS of 0 (best) to 40 (worst). A negative change from Baseline indicates improvement. Baseline was defined as the average of the 2 weekly DGSSS from the Run-in Period.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants Meeting the Abdominal Pain Responder Criterion During Each of the Last 6 Weeks of the 12-week Treatment PeriodBaseline (Day-14 to Day-1) to (Week 6 to Week 12)

An Abdominal Pain Responder was defined as a participant with an improvement (decrease) of at least 2-points in the weekly symptom scores for abdominal pain at each of the last 6 weeks of the 12-week Treatment Period. Abdominal pain was one of the items of the DGSSD assessed daily and recorded in the e-diary by the participant using an 11-point ordinal scale where: 0=no abdominal pain to 10=the worst possible abdominal pain and was recorded in an e-diary.

Percentage of Participants Meeting the Bloating Responder Criterion During Each of the Last 6 Weeks of the 12-week Treatment PeriodBaseline (Day-14 to Day-1) to (Week 6 to Week 12)

A Bloating Responder was defined as a participant with an improvement (decrease) of at least 2-points in the weekly symptom scores for bloating at each of the last 6 weeks of the 12-week Treatment Period. Bloating was one of the items of the DGSSD assessed daily and recorded by the participant in the e-diary using an 11-point ordinal scale where: 0=no bloating and 10=the worst possible bloating and was recorded in the e-diary.

Number of Participants With Clinically Meaningful Trends for Vital SignsUp to 12 weeks

Vital Signs included assessments of heart rate, respiratory rate, systolic and diastolic blood pressure, and body temperature. The investigator determined if the results were clinically significant.

Percentage of Participants Meeting the Nausea Responder Criterion During Each of the Last 6 Weeks of the 12-week Treatment PeriodBaseline (Day-14 to Day-1) to (Week 6 to Week 12)

A Nausea Responder was defined as a participant with improvement (decrease) of at least 2-points in the weekly symptom scores for nausea at each of the last 6 weeks of the 12-week Treatment Period. Nausea was one of the items of the DGSSD assessed daily and recorded in the e-diary by the participant using an 11-point ordinal scale where: 0=no nausea to 10=worst possible nausea.

Number of Participants With Anti-relamorelin Antibody Testing Results by VisitBaseline (Day 1), Day 14, Day 28, Day 84, and End of Treatment (Up to Day 84)

A blood sample was collected that was sent to a laboratory for an anti-relamorelin antibody screening test. A positive screening test was confirmed by an immunodepletion assay. The number of participants in each of the following categories are reported: Negative Screening Test, Positive Screening Test, Negative Confirmatory Test, and Positive Confirmatory Test at each time point.

Percentage of Participants Meeting the Postprandial Fullness Responder Criterion During Each of the Last 6 Weeks of the 12-week Treatment PeriodBaseline (Day-14 to Day-1) to (Week 6 to Week 12)

A Postprandial Fullness Responder was defined as a participant with an improvement (decrease) of at least 2-points in the weekly symptom scores for Postprandial Fullness at each of the last 6 weeks of the 12-week Treatment Period. Postprandial Fullness was one of the items of the DGSSD assessed daily and recorded by the participant in the e-diary using an 11-point ordinal scale where: 0=no feeling of fullness until finishing a meal (best) to 10=feeling full after only a few bites (worst).

Number of Participants Who Experienced One or More Treatment-Emergent Adverse Events (TEAE)Up to approximately 16 weeks

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study treatment, whether or not considered related to the study treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. A TEAE is an AE that begins or worsens after receiving study drug.

Number of Participants With Potential Clinically Significant (PCS) Clinical Laboratory ResultsUp to 12 weeks

Clinical Laboratory tests included Hematology, Chemistry and Urinalysis tests. The investigator determined if the results were clinically significant. Only those categories where at least 1 person had a non-PCS value at Baseline and met the PCS criterion at least once during postbaseline are reported.

Number of Participants With a ≥1% Increase in Glycosylated Hemoglobin A1c (HBA1c)Baseline (Day 1) up to 12 weeks

HbA1c is also known as glycosylated hemoglobin. It is the concentration of glucose bound to hemoglobin as a percentage of the absolute maximum that can be bound.

Number of Participants With Clinically Significant Abnormal Electrocardiogram (ECG) ResultsUp to 12 weeks

A standard 12-lead ECG was performed. The investigator determined if the abnormal results were clinically significant.

Trial Locations

Locations (205)

Digestive Health Specialist of the South East

🇺🇸

Dothan, Alabama, United States

Aurora Care Clinic, LLC

🇺🇸

Costa Mesa, California, United States

Savin Medical Group LLC

🇺🇸

Miami Lakes, Florida, United States

Southwest Gastroenterology

🇺🇸

Oak Lawn, Illinois, United States

MNGI Digestive Health

🇺🇸

Coon Rapids, Minnesota, United States

Montana Medical Research

🇺🇸

Missoula, Montana, United States

Long Island Gastrointestinal Research Group LLP

🇺🇸

Great Neck, New York, United States

Asheville Gastroenterology Associates

🇺🇸

Asheville, North Carolina, United States

Endocrinology Research Associates, Inc.

🇺🇸

Columbus, Ohio, United States

Preferred Primary Care Physicians, Inc.

🇺🇸

Pittsburgh, Pennsylvania, United States

Amir Ali Hassan, MD, PA

🇺🇸

Houston, Texas, United States

West Virginia University

🇺🇸

Morgantown, West Virginia, United States

Advanced Clinical Research

🇺🇸

West Jordan, Utah, United States

Verity Research Inc.

🇺🇸

Fairfax, Virginia, United States

Royal Adelaide Hospital - Central Adelaide Local Health Network Incorporated

🇦🇺

Adelaide, South Australia, Australia

Bhatia Hospital

🇮🇳

Mumbai, Maharashtra, India

B. J. Government Medical College and Sassoon General Hospitals

🇮🇳

Pune, Maharashtra, India

Universal Hospital

🇮🇳

Pune, Maharashtra, India

Noble Hospital Pvt. Ltd

🇮🇳

Pune, Maharashtra, India

Diabetic Thyroid and Endocrine Centre

🇮🇳

Jaipur, Rajasthan, India

Marudhar Hospital

🇮🇳

Jaipur, Rajasthan, India

Eternal Hospital - Diabetology

🇮🇳

Jaipur, Rajasthan, India

APF Research LLC

🇺🇸

Miami, Florida, United States

AMPM Research Clinic

🇺🇸

Miami, Florida, United States

Advanced Medical Research Institute

🇺🇸

Miami, Florida, United States

Florida Research Center, Inc.

🇺🇸

Miami, Florida, United States

Indiana University Health University Hospital

🇺🇸

Indianapolis, Indiana, United States

Medical Associates Research Group, Inc

🇺🇸

San Diego, California, United States

Clinical Applications Laboratories, Inc.

🇺🇸

San Diego, California, United States

Excel Clinical Research

🇺🇸

Las Vegas, Nevada, United States

Advanced Biomedical Research of America

🇺🇸

Las Vegas, Nevada, United States

Palm Research Center

🇺🇸

Las Vegas, Nevada, United States

Clinical Research of South Nevada

🇺🇸

Las Vegas, Nevada, United States

Digestive Disease Specialists

🇺🇸

Las Vegas, Nevada, United States

Vinnytsia Regional Clinical highly specialized Endocrinology Centre

🇺🇦

Vinnytsia, Ukraine

Denver Esophageal and Stomach Center

🇺🇸

Englewood, Colorado, United States

S R Kalla (SRK) Memorial Gastro & General Hospital

🇮🇳

Jaipur, Rajasthan, India

M.V. Hospital for Diabetes & Diabetes Research Centre

🇮🇳

Chennai, Tamil Nadu, India

Cotton-O'Neil Clinical Research Center - Digestive Health

🇺🇸

Topeka, Kansas, United States

SMS Hospital

🇮🇳

Jaipur, Rajasthan, India

Sagact Pllc

🇺🇸

San Antonio, Texas, United States

Clinical Trials of Texas, Inc.

🇺🇸

San Antonio, Texas, United States

Phoenix Clinical LLC

🇺🇸

Phoenix, Arizona, United States

Memorial Clinical Research

🇺🇸

Oklahoma City, Oklahoma, United States

Quality Medical Research

🇺🇸

Nashville, Tennessee, United States

University of Alabama at Birmingham

🇺🇸

Birmingham, Alabama, United States

Northwest Gastroenterology Clinic, LLC

🇺🇸

Portland, Oregon, United States

University of South Florida

🇺🇸

Tampa, Florida, United States

West Central Gastroenterology

🇺🇸

Tampa, Florida, United States

Del Sol Research Management, LLC

🇺🇸

Tucson, Arizona, United States

University of Colorado, Denver

🇺🇸

Aurora, Colorado, United States

University of Louisville

🇺🇸

Louisville, Kentucky, United States

The Center for Clinical Research

🇺🇸

Winston-Salem, North Carolina, United States

Synexus Clinical Research US, Inc.

🇺🇸

Murray, Utah, United States

Avant Research Associates

🇺🇸

Huntsville, Alabama, United States

Preferred Research Partners, Inc.

🇺🇸

Little Rock, Arkansas, United States

Kindred Medical Institute for Clinical Trials, LLC

🇺🇸

Corona, California, United States

Citrus Valley Gastroenterology Clinic

🇺🇸

Covina, California, United States

University of California San Diego

🇺🇸

La Jolla, California, United States

Hope Clinical Research

🇺🇸

Canoga Park, California, United States

VVCRD Research

🇺🇸

Garden Grove, California, United States

Synexus Clinical Research, US, Santa Rosa

🇺🇸

Santa Rosa, California, United States

Om Research LLC

🇺🇸

Lancaster, California, United States

Upland Clinical Research

🇺🇸

Upland, California, United States

Connecticut Clinical Research Foundation

🇺🇸

Bristol, Connecticut, United States

Innovative Research of West FL, Inc.

🇺🇸

Clearwater, Florida, United States

Medical Research Center of Connecticut, LLC

🇺🇸

Hamden, Connecticut, United States

TrialSpark, Inc.

🇺🇸

Washington, District of Columbia, United States

American Research Institute, Inc

🇺🇸

Cutler Bay, Florida, United States

Top Medical Research

🇺🇸

Cutler Bay, Florida, United States

Nature Coast Clinical Research

🇺🇸

Inverness, Florida, United States

Cfagi Llc

🇺🇸

Maitland, Florida, United States

Sensible Healthcare

🇺🇸

Ocoee, Florida, United States

Gulf Region Clinical Research Institute

🇺🇸

Pensacola, Florida, United States

Infinite Clinical Trials

🇺🇸

Riverdale, Georgia, United States

Summit Clinical Research, LLC

🇺🇸

Carnesville, Georgia, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

MediSphere Medical Research Center, LLC

🇺🇸

Evansville, Indiana, United States

Cronola LLC

🇺🇸

Houma, Louisiana, United States

Delta Research Partners

🇺🇸

Bastrop, Louisiana, United States

New Orleans Research Institute - Metropolitan Gastroenterology Associates

🇺🇸

Metairie, Louisiana, United States

Gastro Center of Maryland

🇺🇸

Columbia, Maryland, United States

Frederick Gastroenterology Associates, PA an Elligo Health Research Site

🇺🇸

Frederick, Maryland, United States

Vida Clinical Studies

🇺🇸

Dearborn, Michigan, United States

Boston VA Healthcare System

🇺🇸

West Roxbury, Massachusetts, United States

National Clinical, LLC

🇺🇸

Hamtramck, Michigan, United States

Henry Ford Health System

🇺🇸

Novi, Michigan, United States

Gastroenterology Associates of Western Michigan

🇺🇸

Wyoming, Michigan, United States

Synexus Clinical Research

🇺🇸

Greer, South Carolina, United States

Garden State Endocrinology

🇺🇸

Brick, New Jersey, United States

CHEAR Center, LLC

🇺🇸

Bronx, New York, United States

AGA Clinical Research Associates LLC

🇺🇸

Egg Harbor Township, New Jersey, United States

United Health Services Hospitals, Inc.

🇺🇸

Johnson City, New York, United States

Carolinas Healthcare-Charlotte

🇺🇸

Charlotte, North Carolina, United States

Carolina Digestive Health Associates

🇺🇸

Concord, North Carolina, United States

Cumberland Research Associates, LLC

🇺🇸

Fayetteville, North Carolina, United States

PMG Research Salisbury

🇺🇸

Salisbury, North Carolina, United States

Triad Clinical Trials

🇺🇸

Greensboro, North Carolina, United States

Hometown Urgent Care and Research

🇺🇸

Columbus, Ohio, United States

Dayton Gastroenterology,Inc.

🇺🇸

Beavercreek, Ohio, United States

Premier Clinical Research d.b.a. STAT Research

🇺🇸

Franklin, Ohio, United States

Family Practice Center of Wadsworth, Inc.

🇺🇸

Wadsworth, Ohio, United States

Digestive Disease Specialists Inc

🇺🇸

Oklahoma City, Oklahoma, United States

Family Medical Associates, Research Department

🇺🇸

Levittown, Pennsylvania, United States

Montgomery Medical, Inc.

🇺🇸

Smithfield, Pennsylvania, United States

Carolina Medical Research

🇺🇸

Clinton, South Carolina, United States

Gastroenterology Associates, PA

🇺🇸

Greenville, South Carolina, United States

Advanced Research Institute, Inc.

🇺🇸

Ogden, Utah, United States

Nepean Hospital

🇦🇺

Kingswood, New South Wales, Australia

Cardinal Internal Medicine

🇺🇸

Woodbridge, Virginia, United States

The Alfred Hospital

🇦🇺

Melbourne, Victoria, Australia

UMHAT - Kaspela- EOOD

🇧🇬

Plovdiv, Bulgaria

Royal Melbourne Hospital

🇦🇺

Parkville, Victoria, Australia

MHAT Yuliya Vrevska Byala

🇧🇬

Byala, Ruse, Bulgaria

Alexandrovska University Hospital

🇧🇬

Sofia, Bulgaria

Medical Center Asklepion - Humane Medicine Research EOOD

🇧🇬

Sofia, Bulgaria

CHU Nantes

🇫🇷

Nantes Cedex 1, France

Kumudini Devi Diabetes Research Center; Ramdevrao Hospital

🇮🇳

Hyderabad, Andhra Pradesh, India

Hopital Charles Nicolle

🇫🇷

Rouen Cedex, France

King George Hospital

🇮🇳

Visakhapatnam, Andhra Pradesh, India

Dr. Jivraj Mehta Smarak Health Foundation Bakeri Medical Research Centre - Gasterentrology

🇮🇳

Ahmedabad, Gujarat, India

Victoria Hospital

🇮🇳

Bangalore, Karnataka, India

Life Care Hospital & Research Centre

🇮🇳

Bangalore, Karnataka, India

Diacon Hospital and research Center - Diabetology

🇮🇳

Bengaluru, Karnataka, India

Rajalakshmi Hospital

🇮🇳

Bengaluru, Karnataka, India

Vinaya Hospital & Research Centre

🇮🇳

Mangalore, Karnataka, India

M V Hospital & Research Centre

🇮🇳

Lucknow, Uttar Pradesh, India

Arthur Asirvatham Hospital

🇮🇳

Madurai, India

Sir Ganga Ram Hospital

🇮🇳

New Delhi, India

Bnai Zion Medical Center

🇮🇱

Haifa, Israel

E. Wolfson Medical Center

🇮🇱

Holon, Israel

Digestive Diseases Institute

🇮🇱

Jerusalem, Israel

Gastroenterology Institute

🇮🇱

Tel Aviv, Israel

Chonbuk National University Hospital

🇰🇷

Jeonju, Jeollabuk-Do, Korea, Republic of

Sanggye Paik Hospital, Inje University College of Medicine

🇰🇷

Seoul, Nowon-gu, Korea, Republic of

Endocrinology & Diabetes Center

🇮🇱

Safed, Israel

Hospital Sultanah Bahiyah

🇲🇾

Alor Setar, Kedah, Malaysia

University Malaya Medical Centre

🇲🇾

Kuala Lumpur, Malaysia

Hospital Taiping

🇲🇾

Taiping, Malaysia

Universiti Sains Malaysia

🇲🇾

Kubang Kerian, Malaysia

Manila Doctors Hospital

🇵🇭

Ermita, Manila, Philippines

San Juan De Dios Educational Foundation, Inc.

🇵🇭

Pasay, Metro Manila, Philippines

Perpetual Succor Hospital

🇵🇭

Cebu City, Philippines

Cardinal Santos Medical Center

🇵🇭

San Juan City, Metro Manila, Philippines

Ospital ng Makati

🇵🇭

Makati City, NCR, Philippines

West Visayas State University Medical Center

🇵🇭

IloIlo City, Philippines

St. Luke's Medical Center

🇵🇭

Quezon City, Philippines

Synexus Polska Sp.z o.o.

🇵🇱

Pomorskie, Gdansk, Poland

Endoskopia Sp. Z O.O.

🇵🇱

Sopot, Pomorskie, Poland

CenterMed Krakow Ltd

🇵🇱

Krakow, Malopolska, Poland

Centrum Medyczne Pratia S.A. Warsaw, Poland

🇵🇱

Warsaw, Mazowian, Poland

Wojewodzki Szpital Specjalistyczny w Olsztynie

🇵🇱

Olsztyn, Warmia-Mazury, Poland

NZOZ Vita Diabetica - Malgorzata Buraczyk

🇵🇱

Bialystok, Poland

Centrum Medyczne Lukamed

🇵🇱

Chojnice, Poland

Specjalistyczny Gabinet Neurologiczny Marta Banach

🇵🇱

Kraków, Poland

Synexus Polska Sp. z o.o. Oddzial w Warszawie

🇵🇱

Warszawa, Poland

Centrum Badan Klinicznych Piotr Napora Lekarze Spolka Partnerska

🇵🇱

Wroclaw, Poland

DRS Wroclaw

🇵🇱

Wroclaw, Poland

National University Hospital

🇸🇬

Singapore, Singapore

Changi General Hospital

🇸🇬

Singapore, Singapore

Hospital Universitario Principe de Asturias

🇪🇸

Madrid, Spain

Singapore General Hospital

🇸🇬

Singapore, Singapore

Maharaj Nakorn Chiang Mai Hospital

🇹🇭

Chiang Mai, Thailand

Hospital Universitario De Salamanca

🇪🇸

Salamanca, Spain

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

Phramongkutklao Hospital

🇹🇭

Bangkok, Thailand

Faculty of Medicine, Siriraj Hospital, Mahidol University

🇹🇭

Bangkok, Thailand

Limited Liability Company "Medical Center "Salutem"

🇺🇦

Vinnitsa, Vinnyts'ka Oblast', Ukraine

Communal Institution "Odesa Regional Clinical Hospital", Out-patient department

🇺🇦

Odesa, Odesa Region, Ukraine

Municipal Institution City Hospital No. 7

🇺🇦

Zaporizhzhia, Zaporizhzhia Region, Ukraine

Regional municipal institution "Chernivtsi's regional clinical hospital", gastroenterological department, Higher state educational establishment of Ukraine "Bukovinian state medical university", department of internal medicine and infectious diseases, c.C

🇺🇦

Chernivtsi, Ukraine

Regional Public Organization Chernivtsi Regional Endocrinology Center

🇺🇦

Chernivtsi, Ukraine

Ivano-Frankivsk Central City Clinical Hospital

🇺🇦

Ivano-Frankivsk, Ukraine

Municipal nonprofit entity of Kharkiv municipal council

🇺🇦

Kharkiv, Ukraine

State Institution Ukrainian State Research Institute of Medical and Social Problems of Disability of the Ministry of Health of Ukraine

🇺🇦

Dnipro, Ukraine

Ivano-Frankivsk National Medical University

🇺🇦

Ivano-Frankivsk, Ukraine

AS PVNZ

🇺🇦

Kyiv, Ukraine

Kyiv municipal clinical endocrinological center

🇺🇦

Kyiv, Ukraine

L.T.Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine

🇺🇦

Kharkiv, Ukraine

Clinical Endocrinology of SI "V.Danilevsky Institute for endocrine pathology problems National Academy of Medical sciences of Ukraine"

🇺🇦

Kharkiv, Ukraine

Communal Institution Kherson City Clinical Hospital

🇺🇦

Kherson, Ukraine

Medical Center Universal Clinic Oberig

🇺🇦

Kyiv, Ukraine

AS Medbud Clinic

🇺🇦

Kyiv, Ukraine

Limited Liability Company "Medical and Diagnostic Center "ADONIS Plus", outpatient department, c. Kyiv

🇺🇦

Kyiv, Ukraine

Polyclinic of medical services and rehabilitation department of State Joint-Stock Holding Company Artem, day-patient unit

🇺🇦

Kyiv, Ukraine

Odessa Railway Clinical Hospital of Branch of HC JSC Ukrzaliznytsia, Odessa National Medical University

🇺🇦

Odesa, Ukraine

Poltava Regional Clinical Hospital

🇺🇦

Poltava, Ukraine

Ternopil University Hospital

🇺🇦

Ternopil, Ukraine

6th City Clinical Hospital, c. Zaporizhzhia

🇺🇦

Zaporizhzhia, Ukraine

Municipal nonprofit entity "Vinnytsia's city clinical hospital #1", c. Vinnytsia

🇺🇦

Vinnytsia, Ukraine

Peak Gastroenterology Associates

🇺🇸

Colorado Springs, Colorado, United States

Asan Medical Center

🇰🇷

Seoul, Korea, Republic of

University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

Synexus Polska Sp. z o.o.Oddzial w Poznaniu

🇵🇱

Poznan, Poznañ, Poland

Synexus Polska sp.z.o.o oddzial Czestochowa

🇵🇱

Czestochowa, Poland

Central Arizona Medical Associates

🇺🇸

Mesa, Arizona, United States

Soroka University Medical Center

🇮🇱

Beer Sheba, Israel

Synexus Polska Sp. z o.o. Oddzial w Lodzi

🇵🇱

Lodz, Poland

Sanitas Centrum Medyczne

🇵🇱

Lublin, Poland

Kyiv Railway hospital on the railway transport #2 of the branch "health

🇺🇦

Kyiv, Ukraine

Arkansas Gastorenterology

🇺🇸

North Little Rock, Arkansas, United States

Private Small-Scale Enterprise Medical Centre Pulse

🇺🇦

Vinnytsia, Ukraine

Avant Research Associates,LLC

🇺🇸

Austin, Texas, United States

Kovai Diabetes Speciality Centre

🇮🇳

Coimbatore, Tamil Nadu, India

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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