Safety and Efficacy of Efavaleukin Alfa in Participants With Moderately to Severely Active Ulcerative Colitis
- Registration Number
- NCT04987307
- Lead Sponsor
- Amgen
- Brief Summary
The main purpose of this study is to evaluate the effect of efavaleukin alfa on induction of clinical remission in participants with moderately to severely active ulcerative colitis (UC).
Participants will be randomized to receive 1 of 3 efavaleukin alfa doses or placebo during a 12-week induction period. Participants who complete the 12-week induction period will have the option to enter an exploratory long-term treatment period for up to 40 weeks (total of up to 52 weeks of treatment) if, in the opinion of the investigator, they may benefit from continued treatment. During the long-term period, participants randomized to efavaleukin alfa will remain on the same efavaleukin alfa blinded dose; participants randomized to placebo who achieved clinical response at week 12 will remain on placebo; and placebo non-responders (ie, participants randomized to placebo who did not achieve clinical response at week 12) will receive efavaleukin alfa in a blinded manner during continued treatment. All participants will complete a safety follow-up visit 6 weeks after their last dose of investigational product.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 224
-
Participant has provided informed consent prior to initiation of any study specific activities or procedures.
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Men and women aged ≥ 18 to < 80 years at screening visit (≥ 19 to < 80 in South Korea).
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Diagnosis of UC established ≥ 3 months prior to enrollment by clinical and endoscopic evidence and corroborated by a histopathology report. If a histopathology report is not available at screening, then additional biopsies may be taken during the screening period for local histopathology analysis to corroborate.
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Moderately to severely active UC as defined by a modified Mayo score of 5 to 9, with a centrally read endoscopy subscore ≥ 2.
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Has documentation of:
- A surveillance colonoscopy (performed according to local standard) within 12 months of day 1 visit for participants with pancolitis of > 8 years duration, or participants with left-sided colitis of > 12 years duration, or participants with primary sclerosing cholangitis.
- At the discretion of the investigator, a colonoscopy (instead of a rectosigmoidoscopy) may be performed as the screening endoscopy for this study.
- For all other participants, up-to-date colorectal cancer surveillance (performed according to local standard). Participants who do not have a colonoscopy report available in source documentation will have a colonoscopy instead of rectosigmoidoscopy performed as the screening endoscopy for the study.
-
Participants must have demonstrated inadequate response, loss of response, or intolerance to at least 1 conventional therapy, biologic therapy, or targeted small molecule therapy (ie, Janus kinase [JAK]-inhibitor or or S1P modulators), as follows:
-
Conventional therapy failed participants:
- Corticosteroids (corticosteroid-refractory colitis, defined as signs and/or symptoms of active UC despite oral prednisone [or equivalent] at doses of at least 30 mg/day for a minimum of 2 weeks; or corticosteroid-dependent colitis, defined as: an inability to reduce corticosteroids below the equivalent of prednisone 10 mg/day within 3 months of starting corticosteroids without a return of signs and/or symptoms of active UC; or a relapse within 3 months of completing a course of corticosteroids).
- History of intolerance of corticosteroids (including, but not limited to, Cushing's syndrome, osteopenia/ osteoporosis, hyperglycemia, or neuropsychiatric side-effects, including insomnia, associated with corticosteroid treatment).
- Immunomodulators: signs and/or symptoms of persistently active disease despite at least 3 months treatment with one of the following at locally approved doses: oral azathioprine (eg, ≥ 1.5 mg/kg/day) or 6-mercaptopurine (eg, ≥ 0.75 mg/kg/day), or oral azathioprine or 6-mercatopurine within a therapeutic range as judged by thioguanine metabolite testing, or a combination of a thiopurine and allopurinol within a therapeutic range as judged by thioguanine metabolite testing.
- History of intolerance to at least 1 immunomodulator (including but not limited to nausea/vomiting, abdominal pain, pancreatitis, liver function test abnormalities, and lymphopenia) and have neither failed nor demonstrated an intolerance to a biological medication (anti-tumor necrosis factor [TNF] antibody, anti-integrin antibody, or interleukin [IL]-12/23 antagonists) that is indicated for the treatment of UC.
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Biologic or targeted small molecule therapy failed participants: those who demonstrated inadequate response or loss of response or intolerance to biologic therapy for UC (eg, anti-TNF antibodies or IL-12/23 antagonists, anti-integrin antibodies) or targeted small molecules (eg, JAK inhibitors or S1P modulators). The therapy used to qualify the participant for entry into this category must be approved for the treatment of UC in the country of use, at the time of use. Participants must fulfil one of the following criteria:
- Inadequate response: signs and symptoms of persistently active disease despite induction treatment at the approved induction dosing that was indicated in the product label at the time of use.
- Loss of response: recurrence of signs and symptoms of active disease during approved maintenance dosing following prior clinical benefit (discontinuation despite clinical benefit does not quality as having failed or being intolerant to UC biological therapy, JAK inhibitor, or S1P modulators).
- Intolerance: history of intolerance to infliximab, adalimumab, golimumab, vedolizumab, ustekinumab, tofacitinib or other approved biologicals, JAK inhibitors or S1P modulators (including but not limited to infusion-related event, demyelination, congestive heart failure, or any other drug-related adverse event that led to a reduction in dose or discontinuation of the medication).
-
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If receiving any of the following therapies, participants must have stable dosage for the specified duration:
- 5-aminosalicylates (ASAs), stable dosage for ≥ 2 weeks prior to screening endoscopy.
- Oral corticosteroids: prednisone ≤ 20 mg/day or its equivalent, stable dose for ≥ 2 weeks prior to screening endoscopy.
- Budesonide: extended release tablets 9 mg/day [budensonide MMX], stable dose for ≥ 2 weeks prior to screening endoscopy.
- Beclomethasone dipropionate: gastro-resistant prolonged-release tablet 5 mg/day, stable dose for >= 2 weeks prior to screening endoscopy.
- Conventional immunomodulators: azathioprine, 6-mercaptopurine, methotrexate, stable dosage for ≥ 12 weeks prior to screening endoscopy.
Key
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Diagnosis of Crohn's disease, inflammatory bowel disease unclassified (indeterminate colitis), microscopic colitis, ischemic colitis, or clinical findings suggestive of Crohn's disease.
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Evidence of toxic megacolon, fulminant colitis, intra-abdominal abscess, or stricture/stenosis within the small bowel or colon.
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Participant has had extensive surgery for UC (for example, subtotal colectomy), or is likely to require surgery for the treatment of UC during the study.
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Currently receiving or had treatment within 12 months prior to screening with T cell depleting agents (eg, antithymocyte globulin, Campath).
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Participant has received any of the following prescribed medication or therapy within the specified time period:
- Anti TNF antibodies (eg, infliximab, adalimumab, golimumab) < 8 weeks prior to screening rectosigmoidoscopy.
- Anti integrin antibodies (eg, vedolizumab) < 8 weeks prior to screening rectosigmoidoscopy.
- IL 12/23 antagonist (eg, ustekinumab) < 8 weeks prior to screening rectosigmoidoscopy.
- JAK inhibitors (eg, tofacitinib) < 4 weeks prior to screening rectosigmoidoscopy.
- Any other commercially approved biologic agent or targeted small molecule < 8 weeks prior to screening rectosigmoidoscopy or < 5 half lives prior to screening rectosigmoidoscopy, whichever is longer
- Immunomodulatory medications, including oral cyclosporine, intravenous cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, thalidomide < 4 weeks prior to screening rectosigmoidoscopy.
- Any investigational biologic therapy within 8 weeks prior to screening rectosigmoidoscopy or < 5 half-lives prior to screening rectosigmoidoscopy, whichever is longer.
- Has used apheresis (eg, Adacolumnâ apheresis) < 2 weeks prior to screening rectosigmoidoscopy.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Arm D: Placebo Placebo Placebo Q2W Arm B: Efavaleukin alfa Efavaleukin alfa Efavaleukin alfa Dose 2 administered by SC injection Q2W Arm C: Efavaleukin alfa Efavaleukin alfa Efavaleukin alfa Dose 3 administered by SC injection Q2W Arm A: Efavaleukin alfa Efavaleukin alfa Efavaleukin alfa Dose 1 administered by SC injection once every two weeks (Q2W)
- Primary Outcome Measures
Name Time Method Number of Participants with Clinical Remission at Week 12 Week 12
- Secondary Outcome Measures
Name Time Method Number of Participants with Endoscopic Remission at Week 12 Week 12 Number of Participants with Symptomatic Remission at Week 12 Week 12 Number of Participants with Combined Endoscopic Remission and Histologic Remission of the Colon Tissue at Week 12 Week 12 Number of Participants with a Clinically Significant Change from Baseline in Histological Score at Week 12 as Measured by Geboes Score Baseline to Week 12 Number of Participants who Experience One or More Treatment-emergent Adverse Events Up to 56 weeks Number of Participants with Clinical Response at Week 12 Week 12
Trial Locations
- Locations (200)
Digestive Health Specialists of the Southeast
🇺🇸Dothan, Alabama, United States
Birmingham Digestive Health Research, LLC
🇺🇸Homewood, Alabama, United States
Arizona Health Research
🇺🇸Mesa, Arizona, United States
Arizona Arthritis and Rheumatology Research, PLLC
🇺🇸Phoenix, Arizona, United States
Southern California Research Center
🇺🇸Coronado, California, United States
United Medical Doctors
🇺🇸Los Alamitos, California, United States
Biopharma Informatic Incorporated
🇺🇸Los Angeles, California, United States
Gastrointestinal Biosciences Clinical Trials Limited Liability Company
🇺🇸Los Angeles, California, United States
University of California Irvine
🇺🇸Orange, California, United States
Santa Maria Gastroenterology Medical Group
🇺🇸Santa Maria, California, United States
Clinical Trials Management Services LLC
🇺🇸Thousand Oaks, California, United States
Gastroenterology Center of Connecticut, PC
🇺🇸Hamden, Connecticut, United States
West Central Gastroenterology
🇺🇸Clearwater, Florida, United States
Homestead Associates In Research Inc
🇺🇸Homestead, Florida, United States
Indian Health Service Health Research
🇺🇸Kissimmee, Florida, United States
Lake Center for Clinical Research
🇺🇸Lady Lake, Florida, United States
Auzmer Research
🇺🇸Lakeland, Florida, United States
University of Miami Hospital and Clinic
🇺🇸Miami, Florida, United States
Ocala Gastrointestinal Research, LLC
🇺🇸Ocala, Florida, United States
AdventHealth Medical Group Gastroenterology and Hepatology
🇺🇸Orlando, Florida, United States
Infigo Clinical Research
🇺🇸Sanford, Florida, United States
Atlanta Gastroenterology Associates
🇺🇸Atlanta, Georgia, United States
Columbus Regional Research Institute, LLC
🇺🇸Columbus, Georgia, United States
Grand Teton Research Group
🇺🇸Idaho Falls, Idaho, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Digestive Research Alliance of Michiana
🇺🇸South Bend, Indiana, United States
University of Kansas Medical Center
🇺🇸Kansas City, Kansas, United States
Mid-Atlantic GI Research, LLC
🇺🇸Greenbelt, Maryland, United States
Harvard Medical School - Brigham and Womens Hospital
🇺🇸Boston, Massachusetts, United States
University of Massachusetts Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
University of Michigan
🇺🇸Ann Arbor, Michigan, United States
Clinical Research Institute of Michigan
🇺🇸Troy, Michigan, United States
West Michigan Clinical Research Center
🇺🇸Wyoming, Michigan, United States
Southern Therapy and Advanced Research LLC - Jackson
🇺🇸Jackson, Mississippi, United States
Gastrointestinal Associates Research, LLC
🇺🇸Columbia, Missouri, United States
Bvl Clinical Research
🇺🇸Liberty, Missouri, United States
Interspond - Las Vegas Medical Research
🇺🇸Las Vegas, Nevada, United States
Sanmora Bespoke Clinical Research Solutions
🇺🇸East Orange, New Jersey, United States
Aga Clinical Research Associates LLC
🇺🇸Egg Harbor Township, New Jersey, United States
Affiliates in Gastroenterology Digestive Disease Research
🇺🇸Florham Park, New Jersey, United States
Atlantic Digestive Health Institute
🇺🇸Morristown, New Jersey, United States
Premier Health Research LLC
🇺🇸Sparta, New Jersey, United States
University of New Mexico
🇺🇸Albuquerque, New Mexico, United States
New York University Grossman School of Medicine and New York University Langone Hospitals
🇺🇸Lake Success, New York, United States
Consultants for Clinical Research
🇺🇸Cincinnati, Ohio, United States
Digestive Specialists Inc Research, LLC
🇺🇸Springboro, Ohio, United States
Hightower Clinical
🇺🇸Oklahoma City, Oklahoma, United States
Options Health Research, LLC
🇺🇸Tulsa, Oklahoma, United States
Guthrie Robert Packer Hospital
🇺🇸Sayre, Pennsylvania, United States
Medical University of South Carolina
🇺🇸Charleston, South Carolina, United States
Columbia Digestive Health Research LLC
🇺🇸Columbia, South Carolina, United States
Wake Research-ClinSearch, LLC
🇺🇸Chattanooga, Tennessee, United States
Digestive Health Research, LLC
🇺🇸Hermitage, Tennessee, United States
Great Lakes Research Insititute El Paso Research
🇺🇸El Paso, Texas, United States
Digestive Health Associates
🇺🇸Houston, Texas, United States
Digestive Research of Central Texas, LLC
🇺🇸Waco, Texas, United States
Digestive Health Research of North Texas LLC
🇺🇸Wichita Falls, Texas, United States
Emeritas Research Group
🇺🇸Lansdowne Town Center, Virginia, United States
Blue Ridge Medical Research
🇺🇸Lynchburg, Virginia, United States
North Richmond Health Research
🇺🇸Richmond, Virginia, United States
GI Select Health Research LLC
🇺🇸Richmond, Virginia, United States
Hunter Holmes McGuire Veterans Affairs Medical Center
🇺🇸Richmond, Virginia, United States
Wisconsin Center for Advanced Research
🇺🇸Milwaukee, Wisconsin, United States
Centro de Investigaciones Medicas Mar del Plata
🇦🇷Mar del Plata, Buenos Aires, Argentina
Clinica Independencia
🇦🇷Munro, Buenos Aires, Argentina
Cer Instituto Medico
🇦🇷Quilmes, Buenos Aires, Argentina
CardioAlem Investigaciones
🇦🇷San Isidro, Buenos Aires, Argentina
Hospital Privado Centro Medico de Cordoba SA
🇦🇷Cordoba, Córdoba, Argentina
Fundacion Estudios Clinicos
🇦🇷Rosario, Santa Fe, Argentina
Medizinische Universitaet Innsbruck
🇦🇹Innsbruck, Austria
Landeskrankenhaus Salzburg
🇦🇹Salzburg, Austria
Universitaetsklinikum Allgemeines Krankenhaus Wien
🇦🇹Wien, Austria
Universitair Ziekenhuis Antwerpen
🇧🇪Edegem, Belgium
Universitair Ziekenhuis Leuven - Campus Gasthuisberg
🇧🇪Leuven, Belgium
Centre Hospitalier Universitaire de Liege - Sart Tilman
🇧🇪Liège, Belgium
Second Multiprofile Hospital for Active Treatment - Sofia EAD
🇧🇬Sofia, Bulgaria
Diagnostic-Consultative Center Convex EOOD
🇧🇬Sofia, Bulgaria
Acibadem City Clinic University Multiprofile Hospital for Active Treatment Mladost EOOD
🇧🇬Sofia, Bulgaria
South Edmonton Gastroenterology
🇨🇦Edmonton, Alberta, Canada
London Health Sciences Centre, University Hospital
🇨🇦London, Ontario, Canada
TIDHI Innovation Incorporated
🇨🇦Toronto, Ontario, Canada
Hepato-Gastroenterologie HK sro
🇨🇿Hradec Kralove, Czechia
Nemocnice Pardubickeho kraje as, Pardubicka nemocnice
🇨🇿Pardubice, Czechia
Nemocnice Milosrdnych sester sv Karla Boromejskeho v Praze
🇨🇿Praha, Czechia
Axon Clinical sro
🇨🇿Praha, Czechia
Krajska zdravotni as - Masarykova nemocnice Usti nad Labem oz
🇨🇿Usti nad Labem, Czechia
Aalborg Universitetshospital
🇩🇰Aalborg, Denmark
Herlev Hospital
🇩🇰Herlev, Denmark
Hvidovre Hospital
🇩🇰Hvidovre, Denmark
Bispebjerg Hospital
🇩🇰Kobenhavn NV, Denmark
Helsinki University Central Hospital
🇫🇮Helsinki, Finland
Centre Hospitalier Universitaire Amiens Picardie
🇫🇷Amiens cedex 1, France
Centre Hospitalier Universitaire de Montpellier - Hopital Saint Eloi
🇫🇷Montpellier cedex 5, France
Centres Medicaux Chirurgicaux Ambroise Pare Hartmann
🇫🇷Neuilly sur seine, France
Centre Hospitalier Universitaire Archet 2
🇫🇷Nice cedex 3, France
Centre Hospitalier Universitaire Nord de Saint Etienne - Hopital Nord
🇫🇷Saint Priest en Jarez, France
Centre Hospitalier Universitaire de Nancy - Hôpital de Brabois
🇫🇷Vandoeuvre les Nancy Cedex, France
Gastro-Studien GbR Studienzentrum
🇩🇪Berlin, Germany
Universitaetsklinikum Essen
🇩🇪Essen, Germany
Universitaetsklinikum Frankfurt
🇩🇪Frankfurt am Main, Germany
Universitaetsklinikum Schleswig-Holstein
🇩🇪Kiel, Germany
Universitaetsklinikum Tuebingen
🇩🇪Tuebingen, Germany
Universitaetsklinikum Ulm
🇩🇪Ulm, Germany
University General Hospital of Alexandroupolis
🇬🇷Alexandroupoli, Greece
General Hospital Evangelismos
🇬🇷Athens, Greece
Laiko General Hospital of Athens
🇬🇷Athens, Greece
University Hospital Attikon
🇬🇷Haidari, Greece
Venizeleio General Hospital
🇬🇷Heraklion, Greece
University Hospital of Heraklion
🇬🇷Heraklion, Greece
University General Hospital of Ioannina
🇬🇷Ioannina, Greece
General University Hospital of Patras Panagia i Voithia
🇬🇷Patras, Greece
Bekes Varmegyei Kozponti Korhaz Dr Rethy Pal Tagkorhaz
🇭🇺Bekescsaba, Hungary
MIND Klinika Kft
🇭🇺Budapest, Hungary
Clinexpert Kft
🇭🇺Budapest, Hungary
Obudai Egeszsegugyi Centrum Kft
🇭🇺Budapest, Hungary
Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont Altalanos Orvostudomanyi Kar
🇭🇺Szeged, Hungary
Clinfan Kft
🇭🇺Szekszard, Hungary
Komarom-Esztergom Varmegyei Szent Borbala Korhaz
🇭🇺Tatabanya, Hungary
Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
🇮🇹Brescia, Italy
Azienda Ospedaliera Universitaria Renato Dulbecco
🇮🇹Catanzaro, Italy
Azienda Ospedaliero Universitaria Careggi
🇮🇹Firenze, Italy
Ospedale Policlinico San Martino IRCCS
🇮🇹Genoa, Italy
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
🇮🇹Milano, Italy
IRCCS Ospedale San Raffaele
🇮🇹Milano, Italy
Ospedale Sacro Cuore Don Calabria
🇮🇹Negrar VR, Italy
Ospedale Sandro Pertini
🇮🇹Roma, Italy
Tsujinaka Hospital Kashiwanoha
🇯🇵Kashiwa-shi, Chiba, Japan
Toho University Sakura Medical Center
🇯🇵Sakura-shi, Chiba, Japan
Kitakyushu Municipal Medical Center
🇯🇵Kitakyushu-shi, Fukuoka, Japan
Gifu University Hospital
🇯🇵Gifu-shi, Gifu, Japan
Matsunami General Hospital
🇯🇵Hashima-gun, Gifu, Japan
Hakodate Central General Hospital
🇯🇵Hakodate-shi, Hokkaido, Japan
Sapporo Tokushukai Hospital
🇯🇵Sapporo-shi, Hokkaido, Japan
Aoyama Clinic GI Endoscopy and IBD Center
🇯🇵Kobe-shi, Hyogo, Japan
Gokeikai Ofuna Chuo Hospital
🇯🇵Kamakura-shi, Kanagawa, Japan
Takagi Clinic
🇯🇵Sendai-shi, Miyagi, Japan
Miyazaki Prefectural Miyazaki Hospital
🇯🇵Miyazaki-shi, Miyazaki, Japan
Nagasaki University Hospital
🇯🇵Nagasaki-shi, Nagasaki, Japan
Nara Medical University Hospital
🇯🇵Kashihara-shi, Nara, Japan
National Hospital Organization Okayama Medical Center
🇯🇵Okayama-shi, Okayama, Japan
Osaka Metropolitan University Hospital
🇯🇵Osaka-shi, Osaka, Japan
Tokyo Medical and Dental University Hospital
🇯🇵Bunkyo-ku, Tokyo, Japan
Kitasato University Kitasato Institute Hospital
🇯🇵Minato-ku, Tokyo, Japan
Kyorin University Hospital
🇯🇵Mitaka-shi, Tokyo, Japan
Ome Medical Center
🇯🇵Ome-shi, Tokyo, Japan
Medical Corporation ENEXT Ikebukuro West Gate Hospital
🇯🇵Toshima-ku, Tokyo, Japan
Yamanashi Prefectural Central Hospital
🇯🇵Kofu-shi, Yamanashi, Japan
Inje University Haeundae Paik Hospital
🇰🇷Busan, Korea, Republic of
Yeungnam University Medical Center
🇰🇷Daegu, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
The Catholic University of Korea Seoul St Marys Hospital
🇰🇷Seoul, Korea, Republic of
Wonju Severance Christian Hospital
🇰🇷Wonju-si, Gangwon-do, Korea, Republic of
Pauls Stradins Clinical University Hospital
🇱🇻Riga, Latvia
Gastro Centrs
🇱🇻Riga, Latvia
Clinicos Asociados BOCM SC
🇲🇽Ciudad de Mexico, Distrito Federal, Mexico
Clinica de Investigacion en Reumatologia y Obesidad SC
🇲🇽Guadalajra, Jalisco, Mexico
Investigacion Biomedica para el Desarrollo de Farmacos SA de CV
🇲🇽Zapopan, Jalisco, Mexico
CRI Centro Regiomontano de Investigacion SC
🇲🇽Monterrey, Nuevo León, Mexico
Hospital San Jose Tec Salud Fundacion Santos y de la Garza Evia IBP
🇲🇽Monterrey, Nuevo León, Mexico
Centro para el Desarrollo de la Medicina y de Asistencia Medica Especializada SC
🇲🇽Culiacan, Sinaloa, Mexico
Leids Universitair Medisch Centrum
🇳🇱Leiden, Netherlands
Elisabeth TweeSteden Ziekenhuis
🇳🇱Tilburg, Netherlands
Universitair Medisch Centrum Utrecht
🇳🇱Utrecht, Netherlands
NZOZ Twoje Zdrowie EL Spzoo
🇵🇱Elblag, Poland
Centrum Medyczne Med-Gastr Sp zoo
🇵🇱Lodz, Poland
Centrum Badawcze Panaceum Agnieszka Brzezicka Magdalena Lenkiewicz Spzoo
🇵🇱Malbork, Poland
Oleg Tyszkiwski Centrum Gastrologiczne Gorczyn Oleg Tyszkiwski
🇵🇱Poznan, Poland
Centrum Medyczne Pratia Poznan
🇵🇱Skorzewo, Poland
BodyClinic spolka z ograniczona odpowiedzialnoscia
🇵🇱Warszawa, Poland
Centrum Medyczne Melita Medical
🇵🇱Wroclaw-Krzyki, Poland
EuroMediCare Przychodnia Specjalistyczna we Wroclawiu
🇵🇱Wroclaw, Poland
Institutul Clinic Fundeni
🇷🇴Bucharest, Romania
Spitalul Universitar de Urgenta Militar Central Dr Carol Davila
🇷🇴Bucuresti, Romania
Clinica Medicum
🇷🇴Bucuresti, Romania
Memorial Healthcare International SRL
🇷🇴Bucuresti, Romania
Spitalul Clinic Colentina
🇷🇴Bucuresti, Romania
Spitalul Clinic Pelican
🇷🇴Oradea, Romania
Fakultna Nemocnica s poliklinikou FD Roosevelta Banska Bystrica
🇸🇰Banska Bystrica, Slovakia
Endomed, sro
🇸🇰Kosice, Slovakia
Gastro I, sro
🇸🇰Presov, Slovakia
Hospital de la Santa Creu i Sant Pau
🇪🇸Barcelona, Cataluña, Spain
Hospital Universitario de La Princesa
🇪🇸Madrid, Spain
Hospital General Universitario Gregorio Marañon
🇪🇸Madrid, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Inselspital Bern
🇨🇭Bern, Switzerland
Intesto BE
🇨🇭Bern, Switzerland
Kantonsspital St Gallen
🇨🇭Sankt Gallen, Switzerland
Universitaetsspital Zuerich
🇨🇭Zuerich, Switzerland
China Medical University Hospital
🇨🇳Taichung, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Taipei Veterans General Hospital
🇨🇳Taipei, Taiwan
Ankara Bilkent Sehir Hastanesi
🇹🇷Ankara, Turkey
Antalya Egitim ve Arastirma Hastanesi
🇹🇷Antalya, Turkey
Uludag Universitesi Tip Fakultesi Hastanesi
🇹🇷Bursa, Turkey
Gaziantep Universitesi Tip Fakultesi Hastanesi
🇹🇷Gaziantep, Turkey
Istanbul Universitesi Istanbul Tip Fakultesi Hastanesi
🇹🇷Istanbul, Turkey
Ege Universitesi Tip Fakultesi Hastanesi
🇹🇷Izmir, Turkey
Dokuz Eylul Universitesi Tip Fakultesi Hastanesi
🇹🇷Izmir, Turkey
Kocaeli Universitesi Tip Fakultesi Hastanesi
🇹🇷Kocaeli, Turkey
Mersin Universitesi Tip Fakultesi Hastanesi
🇹🇷Mersin, Turkey