A Study To Assess The Efficacy And Safety Of PF-04236921 In Subjects With Crohn's Disease Who Failed Anti-TNF Therapy
- Conditions
- Crohn's Disease
- Interventions
- Drug: PF-04236921 SC injection
- Registration Number
- NCT01287897
- Lead Sponsor
- Pfizer
- Brief Summary
This is a proof of concept study to determine the efficacy and safety of a monoclonal antibody with three doses versus placebo. Subjects will be randomized to a treatment and the dose will be delivered subcutaneously twice, 4 weeks apart. All subjects will have moderate to severe refractory Crohn's Disease.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 250
- Subjects must have failed or are intolerant to anti TNFs
- hsCRP greater or equal to 5.0 mg/L
- Ulcerations demonstrated by colonoscopy as defined by SES CD assessment performed within 8 weeks of study entry (screening) and able to retrospectively complete the SES-CD or colonoscopy performed during screening
- Pregnant or breastfeeding women
- Crohn's Disease with active fistulae or abscess
- History of diverticulitis or symptomatic diverticulosis
- Abnormality in hematology or chemistry profiles at screening
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo- SC injection PF-04236921 SC injection - Drug Dose level 1 - SC injection PF-04236921 SC injection - Drug Dose level 2 - SC injection PF-04236921 SC injection -
- Primary Outcome Measures
Name Time Method The Crohn's Disease Activity Index (CDAI)-70 Response Rate at Week 8 in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Week 8 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response at Week 8 were compared between placebo and PF-04236921 10 mg/50 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score greater than or equal to (\>=) 0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
The CDAI-70 Response Rate at Week 8 in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Week 8 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response at Week 8 were compared between placebo and PF-04236921 200 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 1, that will yield different estimates for placebo for the two different models.
The CDAI-70 Response Rate at Week 12 in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Week 12 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response at Week 12 were compared between placebo and and PF-04236921 10 mg/50 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
The CDAI-70 Response Rate at Week 12 in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Week 12 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response at Week 12 were compared between placebo and PF-04236921 200 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 3, that will yield different estimates for placebo for the two different models.
- Secondary Outcome Measures
Name Time Method The CDAI-70 Response Rate Over Time in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Weeks 2, 4, 6, and 10 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response were compared between placebo and PF-04236921 200 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 5, that will yield different estimates for placebo for the two different models.
The CDAI-100 Response Rate Over Time in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI-100 response was defined as a decrease in CDAI score of 100 or greater from baseline. The proportions of participants with CDAI-100 response at Week 12 were compared between placebo and PF-04236921 10 mg/50 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
The CDAI-100 Response Rate Over Time in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI-100 response was defined as a decrease in CDAI score of 100 or greater from baseline. The proportions of participants with CDAI-100 response at Week 12 were compared between placebo and PF-04236921 200 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 9, that will yield different estimates for placebo for the two different models.
The CDAI-70 Response Rate Over Time in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Weeks 2, 4, 6, and 10 CDAI-70 response was defined as a decrease in CDAI score of 70 or greater from baseline. The proportions of participants with CDAI-70 response were compared between placebo and PF-04236921 10 mg/50 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
The CDAI Remission Rate Over Time in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI remission rate was defined as an absolute CDAI score less than (\<) 150. The proportions of participants with CDAI remission were compared between placebo and PF-04236921 10 mg/50 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
The CDAI Remission Rate Over Time in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI remission rate was defined as an absolute CDAI score \<150. The proportions of participants with CDAI remission were compared between placebo and PF-04236921 200 mg. CDAI is used to quantify the symptoms of patients with Crohn's Disease. CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit. Many clinical trials use the endpoint for response as a 70 or greater point decrease in CDAI and clinical remission is often defined as a CDAI score below 150. The Outcome included a Generalized linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 7, that will yield different estimates for placebo for the two different models.
Change From Baseline in CDAI Score Over Time in Participants Who Received Placebo, PF-04236921 10 mg and PF-04236921 50 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit, and higher score indicate more severe disease. The Outcome included a Linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference).
Change From Baseline in CDAI Score Over Time in Participants Who Received Placebo and PF-04236921 200 mg Baseline and Weeks 2, 4, 6, 8, 10, and 12 CDAI evaluates 8 Crohn's disease-related variables during a 1-week assessment period, yielding a composite score \>=0 and without an upper limit, and higher score indicate more severe disease. The Outcome included a Linear mixed model analyses which incorporated longitudinal data for each subject, and the same model is used for estimate (least squares mean) and statistical analysis (mean difference). Since the inputs in the model included different Analysis Population than in Outcome Measure 11, that will yield different estimates for placebo for the two different models.
Percentages of Participants With Confirmed Positive Anti-drug Antibodies (ADAs) At baseline (Day 1) and at Weeks 4, 8, 12, 16, 24, 32 and 40 The percentage of participants with confirmed positive ADA was summarized for each treatment arm. ADA positive was defined as ADA titer defined as ADA titer (ie, the reciprocal of the highest dilution that gives a value equivalent to the cut point of the assay) \>= 4.32.
Percentages of Participants With Confirmed Positive Neutralizing Antibodies (NAbs) At baseline (Day 1) and at Weeks 4, 8, 12, 16, 24, 32 and 40 The percentage of participants with confirmed positive NAbs was summarized for each treatment arm. Only ADA positive samples were analyzed for Nab. A multi-tiered approach was utilized to detect NAbs. NAb serum samples were screened at tier one, and those found presumptively NAb positive was further tested with the confirmatory assay (tier two). The percentage of subjects with confirmed positive NAbs was summarized for each treatment.
Serum PF-04236921 Concentration Over Time Day 1 (predose), and at Weeks 2, 4 (Day 28, predose), 8, 10, 12, 16, 20, 24, 28, 32, 36, and 40 Number of Participants Who Withdrew From the Study Due to Treatment-emergent Adverse Events (AEs) Induction period: from Week 0 (Day 1) through Week 12; follow-up period: from Week 12 (or discontinuation from the induction period) through last subject visit (up to 28 weeks after completion of or discontinuation from the 12-week induction period) An AE was any untoward medical occurrence without regard to causality in a participant who received study drug. Treatment-emergent were events between first dose of treatment and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state.
Trial Locations
- Locations (190)
Digestive Disorders Associates
🇺🇸Annapolis, Maryland, United States
An Spiessens H.-Hartziekenhuis Roeselare-Menen vzw
🇧🇪Roeselare, Belgium
Hepato-Gastroenterologie HK, s.r.o.
🇨🇿Hradec Kralove, Czech Republic
Medial Pharma s.r.o.,
🇨🇿Hradec Kralove, Czech Republic
The University of Chicago Medical Center
🇺🇸Chicago, Illinois, United States
University of California - San Francisco
🇺🇸San Francisco, California, United States
University of California San Francisco at Mount Zion
🇺🇸San Francisco, California, United States
The University of Chicago Medical Center (Ucmc)
🇺🇸Chicago, Illinois, United States
Houston Hospital for Specialized Surgery (Endoscopy Only)
🇺🇸Houston, Texas, United States
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States
Baylor Clinic (Drug Storage)
🇺🇸Houston, Texas, United States
Memorial Hermann Hospital
🇺🇸Houston, Texas, United States
The University of Texas Health Science Center at Houston
🇺🇸Houston, Texas, United States
The University of Texas Medical School at Houston
🇺🇸Houston, Texas, United States
Physicians Endoscopy Center (Colonoscopy)
🇺🇸Houston, Texas, United States
Mount Sinai Hospital
🇨🇦Toronto, Ontario, Canada
Kirurgisk Afdeling 0143
🇩🇰Hilleroed, Denmark
Aarhus Universitetshospital, Aarhus Sygehus Aarhus University Hospital
🇩🇰Aarhus C, Denmark
Gastroenheden
🇩🇰Herlev, Denmark
Azienda Ospedaliero Universitaria di Bologna Policlinico Sant'Orsola Malpighi
🇮🇹Bologna, Italy
Colonoscopy and X-rays: OU Physicians Building
🇺🇸Oklahoma City, Oklahoma, United States
Hospital Nossa Senhora das Gracas
🇧🇷Curitiba, Brazil
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
Rocky Mountain Clinical Research, LLC
🇺🇸Denver, Colorado, United States
Shaare Zedek Medical Center
🇮🇱Jerusalem, Israel
Dept of Gastroenterology & Hepatology
🇮🇱Kfar Saba, Israel
P3 Research Limited
🇳🇿Wellington, New Zealand
Radiology Ltd
🇺🇸Tucson, Arizona, United States
UCSF Endoscopy Unit at Mount Zion
🇺🇸San Francisco, California, United States
Digestive Health Research Unit
🇺🇸Scottsdale, Arizona, United States
UAB Hospital
🇺🇸Birmingham, Alabama, United States
Rocky Mountain Gastroenterology
🇺🇸Lakewood, Colorado, United States
Medical Research Center of Connecticut, LLC
🇺🇸Hamden, Connecticut, United States
Clinical Research of West Florida, Inc.
🇺🇸Clearwater, Florida, United States
Atlanta Endoscopy Center
🇺🇸Decatur, Georgia, United States
Advanced Research Institute, Inc.
🇺🇸New Port Richey, Florida, United States
Glenbrook Hospital
🇺🇸Glenview, Illinois, United States
Decatur Health Imaging
🇺🇸Decatur, Georgia, United States
Illinois Gastroenterology Group, LLC
🇺🇸Arlington Heights, Illinois, United States
Disgestive Disorders Associates
🇺🇸Annapolis, Maryland, United States
Utica Park Clinic X-Ray
🇺🇸Tulsa, Oklahoma, United States
East Valley Endoscopy
🇺🇸Grand Rapids, Michigan, United States
Weill Cornell Medical College of Cornell University-Greenberg
🇺🇸New York, New York, United States
University Of Utah HSC
🇺🇸Salt Lake City, Utah, United States
UZ Leuven Pharmacy
🇧🇪Leuven, Belgium
Hospital Sao Lucas da PUCRS
🇧🇷Porto Alegre, RS, Brazil
Aalborg Sygehus
🇩🇰Aalborg, Denmark
Rigshospitalet
🇩🇰Koebenhavn, Denmark
Medizinische Hochschule Hannover
🇩🇪Hannover, Niedersachsen, Germany
Hopital de Brabois
🇫🇷Vandoeuvre Les Nancy, France
Debreceni Egyetem Orvos- es Egeszsegtudomanyi Centrum
ðŸ‡ðŸ‡ºDebrecen, Hungary
New Cross Hospital
🇬🇧Wolverhampton, United Kingdom
Royal Victoria Hospital
🇬🇧Newcastle-upon-Tyne, United Kingdom
Hadassah Medical Center
🇮🇱Jerusalem, Israel
Universitaetsspital Zuerich
🇨ðŸ‡Zuerich, Switzerland
Institute of Gastroenterology
🇮🇱Haifa, Israel
Hull and East Yorkshire Hospitals NHS Trust
🇬🇧Hull, East Yorkshire, United Kingdom
Pharmacy Department
🇬🇧Hull, United Kingdom
Rabin Medical Center, Beilinson Hospital
🇮🇱Petach Tikva, Israel
Barts and The London NHS Trust
🇬🇧London, United Kingdom
Royal Free Hospital (Royal Free London NHS Foundation Trust)
🇬🇧London, United Kingdom
Addenbrooke's Hospital, Department of Gastroenterology
🇬🇧Cambridge, United Kingdom
Casa Sollievo della Sofferenza/Div.Gastroenterologia Endoscopia Digestiva
🇮🇹San Giovanni Rotondo Fg, Foggia, Italy
Newcross Hospital-The Royal Wolverhampton Hospitals NHS Trust
🇬🇧Wolverhampton, United Kingdom
Glasgow Royal Infirmary
🇬🇧Glasgow, United Kingdom
Policlinico Tor Vergata
🇮🇹Roma, Italy
Atlanta Center for Gastroenterology, P.C.
🇺🇸Decatur, Georgia, United States
GI Diagnostics
🇺🇸Marietta, Georgia, United States
Gastroenterology Associates
🇺🇸Crystal River, Florida, United States
Nature Coast Clinical Research
🇺🇸Inverness, Florida, United States
Commonwealth Clinical Studies
🇺🇸Brockton, Massachusetts, United States
The University of Chicago Medical
🇺🇸Chicago, Illinois, United States
The University Of Chicago
🇺🇸Chicago, Illinois, United States
Adobe Clinical Research, Llc
🇺🇸Tucson, Arizona, United States
Gastroenterology Center of Connecticut, PC
🇺🇸Hamden, Connecticut, United States
Suncoast Endoscopy Center
🇺🇸Inverness, Florida, United States
International Clinical Research - US, LLC
🇺🇸Sanford, Florida, United States
Investigative Clinical Research
🇺🇸Annapolis, Maryland, United States
St. Joseph Mercy Hospital
🇺🇸Ypsilanti, Michigan, United States
Maryland Diagnostics & Therapeutic Endo Center
🇺🇸Annapolis, Maryland, United States
Prima CARE, PC
🇺🇸Fall River, Massachusetts, United States
Metro Health Hospital Endoscopy Unit
🇺🇸Wyoming, Michigan, United States
Gastroenterology Associates of Western Michigan
🇺🇸Wyoming, Michigan, United States
Huron Gastroenterology Associates
🇺🇸Ypsilanti, Michigan, United States
Minnesota Gastroenterology, PA
🇺🇸Plymouth, Minnesota, United States
Weill Cornell Medical College of Cornell University
🇺🇸New York, New York, United States
New York Presbyterian Hospital - Weill Cornell Medical College Investigational Pharmacy
🇺🇸New York, New York, United States
Present Chapman, Steinlauf and Marion
🇺🇸New York, New York, United States
Mount Sinai School of Medicine
🇺🇸New York, New York, United States
Arthur asher Kornbluth, MD PC
🇺🇸New York, New York, United States
Weill Cornell Imaging at New York Presbyterian Hospital
🇺🇸New York, New York, United States
New York Presbyterian Hospital
🇺🇸New York, New York, United States
Oklahoma Foundation for Digestive Research
🇺🇸Oklahoma City, Oklahoma, United States
Hillcrest Medical Center Endoscopy
🇺🇸Tulsa, Oklahoma, United States
Hillcrest Medical Center
🇺🇸Tulsa, Oklahoma, United States
Options Health Research, LLC
🇺🇸Tulsa, Oklahoma, United States
Pittsburgh Gastroenterology Associates
🇺🇸Pittsburgh, Pennsylvania, United States
Omega Medical Research
🇺🇸Warwick, Rhode Island, United States
Baylor College of Medicine - Baylor Medical Center
🇺🇸Houston, Texas, United States
Ertan Digestive Disease Center
🇺🇸Houston, Texas, United States
One Step Diagnostic (X-Ray)
🇺🇸Sugar Land, Texas, United States
Texas Digestive Disease Consultants
🇺🇸Southlake, Texas, United States
Pioneer Research Solutions, Inc.
🇺🇸SugarLand, Texas, United States
Digestive Health Specialists of Tyler
🇺🇸Tyler, Texas, United States
Nepean Public Hospital
🇦🇺Kingswood, New South Wales, Australia
Monash Medical Centre
🇦🇺Clayton, Victoria, Australia
Mater Health Services
🇦🇺South Brisbane, Queensland, Australia
Royal Brisbane and Women's Hospital
🇦🇺Herston, Brisbane, Queensland, Australia
Eastern Health, Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
The Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
St. Vincent's Hospital Melbourne
🇦🇺Fitzroy, Australia
CHU Saint-Pierre
🇧🇪Bruxelles, Belgium
University Hospital Leuven
🇧🇪Leuven, Vlaams Brabant, Belgium
Clinica do Coracao Samaritano
🇧🇷Goiania, GO, Brazil
Center X Diagnosticos
🇧🇷Goiania, GO, Brazil
Hospital Universitário Fraga Filho da UFRJ
🇧🇷Rio de Janeiro, RJ, Brazil
Instituto Goiano de Gastroenterologia e Endoscopia Digestiva Ltda.
🇧🇷Goiania, GO, Brazil
Hospital Israelita Albert Einstein
🇧🇷São Paulo, SP, Brazil
Faculdade de Medicina do ABC
🇧🇷Santo Andre, SP, Brazil
Klinicke centrum ISCARE I.V.F. - gastroenterologie
🇨🇿Prague, Czech Republic
London Health Science Centre - University Hospital
🇨🇦London, Ontario, Canada
McGill University Health Centre - Royal Victoria Hospital
🇨🇦Montreal, Quebec, Canada
Institut klinicke a experimentalni mediciny
🇨🇿Praha 4, Czech Republic
Fakultni nemocnice Olomouc
🇨🇿Olomouc, Czech Republic
Fakultni nemocnice Kralovske Vinohrady
🇨🇿Praha 10, Czech Republic
IBD Clinical and Research centre
🇨🇿Praha 7, Czech Republic
Krajska zdravotni, a.s.
🇨🇿Usti nad Labem, Czech Republic
Afdeling I, Gastroenterologisk Sektion
🇩🇰Koebenhavn NV, Denmark
Hvidovre Hospital
🇩🇰Hvidovre, Denmark
Medicinsk Afdeling, Gastroenterologisk Sektion
🇩🇰Koege, Denmark
Hopital Saint-Antoine - Service De Gastroenterologie
🇫🇷Paris Cedex 12, France
University General Hospital "Attikon"
🇬🇷Athens, Greece
Praxis Dr. Howaldt
🇩🇪Hamburg, Germany
Gastroenterologische Gemeinschaftspraxis Minden
🇩🇪Minden, Germany
Universitaetsklinik Regensburg
🇩🇪Regensburg, Germany
Universitaetsklinikum Schleswig-Holstein
🇩🇪Kiel, Germany
General Hospital of Athens "Evangelismos",1st Gastroenterology Department
🇬🇷Kolonaki Athens, Greece
Semmelweis Egyetem II. Sz. Belgyogyaszati Klinika
ðŸ‡ðŸ‡ºBudapest, Hungary
Szegedi Tudomanyegyetem Altalanos Orvostudomanyi Kar / I. sz. Belgyogyaszati Klinika
ðŸ‡ðŸ‡ºSzeged, Hungary
Pannonia Maganorvosi Centrum Kft.
ðŸ‡ðŸ‡ºBudapest, Hungary
Clinfan Kft.
ðŸ‡ðŸ‡ºSzekszard, Hungary
National Virus Reference Laboratory
🇮🇪Dublin, Ireland
Beaumont Hospital
🇮🇪Dublin, Ireland
Mater Misericordiae Hospital, Department of Clinical Chemistry and Clinical Haematology
🇮🇪Dublin, Ireland
The Institute Of Gastroenterology & Liver Diseases
🇮🇱Tel Hashomer, Ramat Gan, Israel
The E. Wolfson Medical Center
🇮🇱Holon, Israel
University Hospital Galway
🇮🇪Galway, Ireland
Assaf Harofeh Medical Center
🇮🇱Zerifin, Israel
Azienda Ospedaliera - Universita di Padova
🇮🇹Padova, Italy
Istituto Clinico Humanitas IRCCS
🇮🇹Rozzano, Milano, Italy
A. Gemelli University Hospital-Department of Medical Sciences - Division of Internal Medicine and
🇮🇹Rome, Province of Rome, Italy
Università Campus Biomedico
🇮🇹Roma, Italy
Department of Gastroenterology Research
🇳🇿Hamilton, Waikato, New Zealand
Shakespeare Specialist Group
🇳🇿Milford, Auckland, New Zealand
Azienda Ospedaliera San Camillo Forlanini
🇮🇹Roma, Italy
Spitalul Clinic Colentina
🇷🇴Bucuresti, Sector 2, Romania
Christchurch Hospital
🇳🇿Christchurch, Canterbury, New Zealand
Glenbrook Hospital Outpatient Pharmacy
🇺🇸Glenview, Illinois, United States
NorthShore University Health System
🇺🇸Evanston, Illinois, United States
Advanced Imaging
🇺🇸Tulsa, Oklahoma, United States
Simon Medical Imaging
🇺🇸Scottsdale, Arizona, United States
Metro Health Hospital
🇺🇸Wyoming, Michigan, United States
Rocky Mountain Gastroenterology Associates
🇺🇸Lakewood, Colorado, United States
Endoscopy Center of Connecticut, LLC
🇺🇸Hamden, Connecticut, United States
Arapahoe Gastroenterology, PC
🇺🇸Littleton, Colorado, United States
Central Indiana Gastroenterology Group
🇺🇸Anderson, Indiana, United States
Gastrointestinal Specialists of Georgia, PC
🇺🇸Marietta, Georgia, United States
Pharmacy: Wheeler and Stuckey, Inc.
🇺🇸Oklahoma City, Oklahoma, United States
University of Kentucky
🇺🇸Lexington, Kentucky, United States
Saint John's Research Institute
🇺🇸Anderson, Indiana, United States
Hopital Huriez, CHRU de Lille
🇫🇷Lille Cedex, France
Research Protocol Management Specialists
🇺🇸Pittsburgh, Pennsylvania, United States
Pharma Resource
🇺🇸East Providence, Rhode Island, United States
Diagnostic Clinic of Houston, PA
🇺🇸Houston, Texas, United States
Gastro One
🇺🇸Germantown, Tennessee, United States
Heritage Medical Research Clinic - University of Calgary
🇨🇦Calgary, Alberta, Canada
"Charite - Campus Benjamin Franklin
🇩🇪Berlin, Germany
Pioneer Research Solutions, Inc. (Admin. Office)
🇺🇸Sugar Land, Texas, United States
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Szent Janos Korhaz es Eszak-budai Egyesitett Korhazak./I. Belgyogyaszati-Gasztroenterologiai
ðŸ‡ðŸ‡ºBudapest, Hungary
Tel Aviv Sourasky Medical Center
🇮🇱Tel Aviv, Israel
St. Vincents University Hospital
🇮🇪Dublin 4, Ireland
Pathology, Haematology and Biochemistry Laboratories, St Vincent's Healthcare Group
🇮🇪Dublin, Ireland
University Of Louisville Healthcare Outpatient Center
🇺🇸Louisville, Kentucky, United States
University of Louisville Research Foundation
🇺🇸Louisville, Kentucky, United States
University Of Louisville
🇺🇸Louisville, Kentucky, United States
PMG Research of Winston-Salem
🇺🇸Winston-Salem, North Carolina, United States
Professional Quality Research, Inc.
🇺🇸Austin, Texas, United States
Virginia Commonwealth University
🇺🇸Richmond, Virginia, United States
VCU Medical Investigational Drug Service (IDS)
🇺🇸Richmond, Virginia, United States