A Study of Lebrikizumab in Participants With Idiopathic Pulmonary Fibrosis (IPF)

Phase 2

Completed

Conditions: Idiopathic Pulmonary Fibrosis

Interventions: Drug: Lebrikizumab
Drug: Pirfenidone
Drug: Placebo

Registration Number: NCT01872689

Lead Sponsor: Hoffmann-La Roche

Brief Summary: This randomized, multicenter, double-blind, placebo-controlled, parallel-group study will evaluate the efficacy and safety of lebrikizumab as monotherapy in the absence of background IPF therapy and as combination therapy with pirfenidone background therapy in participants with IPF. Participants will be randomized to receive either lebrikizumab or placebo subcutaneously every 4 weeks.

Detailed Description: Not available

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 505

Inclusion Criteria

Have a diagnosis of IPF within the previous 5 years from time of screening and confirmed at baseline
FVC >/=40 percent (%) and </=100% of predicted at screening
Stable baseline lung function as evidenced by a difference of less than (<) 10% in FVC (in liters) measurements between screening and Day 1, Visit 2 prior to randomization
DLco >/=25% and </=90% of predicted at screening
Ability to walk >/=100 meters unassisted in 6 minutes
Cohort A: No background IPF therapy for >/=4 weeks allowed prior to randomization and throughout the placebo-controlled study period
Cohort B: Tolerated dose of pirfenidone </=2403 milligrams once daily (mg/day) for >/=4 weeks required prior to randomization and throughout the placebo-controlled study period

Exclusion Criteria

History of severe allergic reaction or anaphylactic reaction to a biologic agent or known hypersensitivity to any component of the lebrikizumab injection
Evidence of other known causes of interstitial lung disease
Lung transplant expected within 12 months of screening
Evidence of clinically significant lung disease other than IPF
Post-bronchodilator forced expiratory volume in 1 second (FEV1)/FVC ratio <0.7 at screening
Positive bronchodilator response, evidenced by an increase of >/=12% predicted and 200 milliliters increase in FEV1 or FVC
Class IV New York Heart Association chronic heart failure or historical evidence of left ventricular ejection fraction <35%
Hospitalization due to an exacerbation of IPF within 4 weeks prior to or during screening
Known current malignancy or current evaluation for potential malignancy
Listeria monocytogenes infection or active parasitic infection within 6 months prior to Day 1, Visit 2
Active tuberculosis requiring treatment within 12 months of screening
Known immunodeficiency, including but not limited to human immunodeficiency virus infection
Past use of any anti-interleukin (IL)-13 or anti-IL-4/IL-13 therapy, including lebrikizumab
Evidence of acute or chronic hepatitis or known liver cirrhosis

Exclusions Criteria Limited to Cohort B:

Known achalasia, esophageal stricture, or esophageal dysfunction sufficient to limit the ability to swallow oral medication
Tobacco smoking or use of tobacco-related products within 3 months of screening or unwillingness to avoid smoking throughout the study period
Known or suspected peptic ulcer
Any condition that, as assessed by the investigator, might be significantly exacerbated by the known side effects associated with pirfenidone
Creatinine clearance <40 milliliters/minute, calculated using the Cockcroft-Gault formula
Use of following therapies within 4 weeks of randomization (Day 1, Visit 2) or during the study: Strong inhibitors of CYP1A2 (Cytochrome P450 Family 1 Subfamily A Member 2) (example: fluvoxamine or enoxacin); Moderate inducers of CYP1A2 (limited to tobacco smoking and tobacco-related products)

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Monotherapy (Cohort A): Placebo	Lebrikizumab	Participants will receive monotherapy with placebo matched to lebrikizumab administered via subcutaneous (SC) injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period. Participants will be allowed to receive treatment with lebrikizumab at a dose of 250 mg administered via SC injection once every 4 weeks up to additional 52 weeks (that is, up to Week 104) in the open-label period.
Monotherapy (Cohort A): Lebrikizumab	Lebrikizumab	Participants will receive monotherapy with lebrikizumab at a dose of 250 milligrams (mg) administered via SC injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period. Participants will be allowed to receive treatment with lebrikizumab at a dose of 250 mg administered via SC injection once every 4 weeks up to additional 52 weeks (that is, up to Week 104) in the open-label period.
Combination Therapy (Cohort B): Placebo + Pirfenidone	Placebo	Participants will receive pirfenidone at a stable dose of 2403 mg per day (three 267 mg capsules three times a day \[9 capsules daily\] for a total of 2403 mg/day) or at maximum tolerated dose (MTD) administered orally along with placebo matched to lebrikizumab administered via SC injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period.
Monotherapy (Cohort A): Placebo	Placebo	Participants will receive monotherapy with placebo matched to lebrikizumab administered via subcutaneous (SC) injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period. Participants will be allowed to receive treatment with lebrikizumab at a dose of 250 mg administered via SC injection once every 4 weeks up to additional 52 weeks (that is, up to Week 104) in the open-label period.
Combination Therapy (Cohort B): Placebo + Pirfenidone	Pirfenidone	Participants will receive pirfenidone at a stable dose of 2403 mg per day (three 267 mg capsules three times a day \[9 capsules daily\] for a total of 2403 mg/day) or at maximum tolerated dose (MTD) administered orally along with placebo matched to lebrikizumab administered via SC injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period.
Combination Therapy (Cohort B): Lebrikizumab + Pirfenidone	Lebrikizumab	Participants will receive pirfenidone at a stable dose of 2403 mg per day (three 267 mg capsules three times a day \[9 capsules daily\] for a total of 2403 mg/day) or at MTD administered orally along with lebrikizumab at a dose of 250 mg administered via SC injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period.
Combination Therapy (Cohort B): Lebrikizumab + Pirfenidone	Pirfenidone	Participants will receive pirfenidone at a stable dose of 2403 mg per day (three 267 mg capsules three times a day \[9 capsules daily\] for a total of 2403 mg/day) or at MTD administered orally along with lebrikizumab at a dose of 250 mg administered via SC injection once every 4 weeks up to 52 weeks during the placebo-controlled treatment period.

Primary Outcome Measures

Name	Time	Method
Annualized Rate of Decrease in Percent Predicted Forced Vital Capacity (FVC) Over 52 Weeks	Baseline up to Week 52 (assessed at Baseline, Weeks 1, 4, 12, 24, 36, 44, and 52)	Annualized rates of decrease (slope throughout time from baseline to Week 52) for percent predicted FVC was assessed and reported. FVC is a standard pulmonary function test. FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position, measured in liters. Predicted FVC is based on sex, age, and height of a person. Percent predicted FVC (in %) = \[(observed FVC)/(predicted FVC)\]\*100.

Secondary Outcome Measures

Name	Time	Method
Annualized Rate of Decline in 6-Minute Walk Test (6MWT) Distance Over 52 Weeks	Baseline up to Week 52 (assessed at Baseline, Weeks 1, 4, 12, 24, 36, 44, and 52)	Annualized rates of decline (slope throughout time from baseline to Week 52) in 6MWT was assessed and reported. 6MWT was the distance (in meters \[m\]) that a participant could walk in 6 minutes.
Annualized Rate of Decrease in FVC Over 52 Weeks	Baseline up to Week 52 (assessed at Baseline, Weeks 1, 4, 12, 24, 36, 44, and 52)	Annualized rates of decrease (slope throughout time from baseline to Week 52) in FVC (in milliliters per year \[mL/year\]) was assessed and reported. FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position.
Progression-Free Survival (PFS)	Baseline up to the event of death from any cause, all cause hospitalization, or a decrease from baseline of >/=10% in FVC, whichever occurred first (up to Week 122)	FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position, measured in liters. Predicted FVC is based on sex, age, and height of a person. Percent predicted FVC = \[(observed FVC)/(predicted FVC)\]\*100. PFS was defined as time from randomization to death from any cause, all cause hospitalization, or a decrease from baseline of \>/=10% in FVC, whichever occurred first. Participants without an event were censored at the last assessment during the double-blind treatment period. Any participant who underwent lung transplantation was censored at the date of the transplant. The median PFS was estimated using Kaplan-Meier method. 95% CI for median was computed using the method of Brookmeyer and Crowley.
Time to First Occurrence of SGRQ Total Score Worsening or Death From Any Cause	Baseline up to the event of SGRQ total score worsening or death from any cause, whichever occurred first (up to Week 122)	The SGRQ is a 50-item health-related QoL instrument that measured health impairment. The questionnaire contains 3 domains: symptoms, activity, and impacts. Items were assessed on various response scales, including a 5-point Likert scale and True/False scale. The SGRQ had a recall specification of 4 weeks. The SGRQ total score (summed weights) ranged from 0 to 100 with a lower score denoting a better health status. Time from randomization to first occurrence of an event of SGRQ total score worsening (defined as reaching minimal important difference \[MID\], that is, an increase in total score of \>/=7) or death from any cause was reported. The median time to event was estimated using Kaplan-Meier method. 95% CI for median was computed using the method of Brookmeyer and Crowley.
Percentage of Participants With Event of Greater Than or Equal to (>/=) 10% Absolute Decline in Percent Predicted FVC or Death From Any Cause	Baseline up to the event of >/=10% absolute decline in percent predicted FVC or death from any cause, whichever occurred first (up to Week 122)	FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position, measured in liters. Predicted FVC is based on sex, age, and height of a person. Percent predicted FVC (in %) = \[(observed FVC)/(predicted FVC)\]\*100.
Time to First Occurrence of a >/=10% Absolute Decline in Percent Predicted FVC or Death From Any Cause	Baseline up to the event of >/=10% absolute decline in percent predicted FVC or death from any cause, whichever occurred first (up to Week 122)	FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position, measured in liters. Predicted FVC is based on sex, age, and height of a person. Percent predicted FVC (in %) = \[(observed FVC)/(predicted FVC)\]\*100. Time from randomization to first occurrence of an event of \>/=10% absolute decline in percent predicted FVC or death from any cause was reported. Participants without an event were censored at the last assessment during the double-blind treatment period. Any participant who underwent lung transplantation was censored at the date of the transplant. The median time to event was estimated using Kaplan-Meier method. 95% confidence interval (CI) for median was computed using the method of Brookmeyer and Crowley.
Annualized Rate of Decrease in Diffusion Capacity of the Lung for Carbon Monoxide (DLco) Over 52 Weeks	Baseline up to Week 52 (assessed at Baseline, Weeks 1, 4, 12, 24, 36, 44, and 52)	Annualized rates of decrease (slope throughout time from baseline to Week 52) in DLco was assessed and reported. DLco (in milliliters per minute/millimeters of mercury \[mL/min/mmHg\]) is a measure of the gas transfer.
Minimum Observed Serum Concentration (Cmin) of Lebrikizumab at Week 52	Predose (Hour 0) at Week 52	Participants who received lebrikizumab were only included in the analysis.
Elimination Half-Life (t1/2) of Lebrikizumab	Pre-dose (Hour 0) at Weeks 1, 4, 12, 24, 36, 64, 76, 88, 104; and at 4, 12, and 18 weeks post-last dose (last dose = Week 104)	Elimination half-life is the time measured for the plasma drug concentration to decrease by one-half during the elimination phase of the drug. Analysis was performed on PK-Evaluable Population. Participants who received lebrikizumab were only included in the analysis.
Percentage of Participants With Event of Death, All Cause Hospitalization, or a Decrease From Baseline of >/=10% in FVC	Baseline up to the event of death from any cause, all cause hospitalization, or a decrease from baseline of >/=10% in FVC, whichever occurred first (up to Week 122)	FVC is defined as the volume of air that can forcibly be blown out after full inspiration in the upright position, measured in liters. Predicted FVC is based on sex, age, and height of a person. Percent predicted FVC = \[(observed FVC)/(predicted FVC)\]\*100.
Annualized Rate of Decrease in A Tool to Assess Quality of Life in IPF (ATAQ-IPF) Questionnaire Total Score Over 52 Weeks	Baseline up to Week 52 (assessed at Baseline, Weeks 1, 4, 12, 24, 36, 44, and 52)	The ATAQ-IPF Version 3 was utilized that included 31 items within 5 domains: cough (6 items), dyspnea (7 items), exhaustion (6 items), emotional well-being (6 items), and independence (6 items). Each item was assessed on a scale ranging from 1 (Strongly disagree) to 4 (Strongly agree). The ATAQ-IPF had a recall specification of 2 weeks. Simple summation scoring was used to derive individual domain scores as well as a total score. ATAQ-IPF total score ranged from 31 to 124 with lower score indicating better quality of life (QoL). Annualized rates of decrease (slope throughout time from baseline to Week 52) in ATAQ-IPF questionnaire total score was assessed and reported.
Percentage of Participants With an Event of Acute Idiopathic Pulmonary Fibrosis (IPF) Exacerbation	Baseline up to the event of acute IPF exacerbation (up to Week 122)	IPF exacerbation was defined as an event that met all of the following criteria as determined by the investigator: Unexplained worsening or development of dyspnea within the previous 30 days; And radiologic evidence of new bilateral ground-glass abnormality or consolidation, superimposed on a reticular or honeycomb background pattern, that is consistent with usual interstitial pneumonitis; And absence of alternative causes, such as left heart failure, pulmonary embolism, pulmonary infection (on the basis of endotracheal aspirate or bronchoalveolar lavage if available, or investigator judgment), or other events leading to acute lung injury (for example, sepsis, aspiration, trauma, reperfusion pulmonary edema).
Percentage of Participants With Respiratory-Related Hospitalization	Baseline up to the event of respiratory-related hospitalization (up to Week 122)
Percentage of Participants With an Event of St. George's Respiratory Questionnaire (SGRQ) Total Score Worsening or Death From Any Cause	Baseline up to the event of SGRQ total score worsening or death from any cause, whichever occurred first (up to Week 122)	The SGRQ is a 50-item health-related QoL instrument that measured health impairment. The questionnaire contains 3 domains: symptoms, activity, and impacts. Items were assessed on various response scales, including a 5-point Likert scale and True/False scale. The SGRQ had a recall specification of 4 weeks. The SGRQ total score (summed weights) ranged from 0 to 100 with a lower score denoting a better health status. Percentage of participants with an event of SGRQ total score worsening (defined as reaching minimal important difference \[MID\], that is, an increase in total score of \>/=7) or death from any cause was reported.
Time to First Event of Acute IPF Exacerbation	Baseline up to the event of acute IPF exacerbation (up to Week 122)	Time from randomization to first occurrence of an event of IPF exacerbation was reported. IPF exacerbation was defined as an event that met all of the following criteria as determined by the investigator: Unexplained worsening or development of dyspnea within the previous 30 days; And radiologic evidence of new bilateral ground-glass abnormality or consolidation, superimposed on a reticular or honeycomb background pattern, that is consistent with usual interstitial pneumonitis; And absence of alternative causes, or other events leading to acute lung injury. The median time to event was estimated using Kaplan-Meier method. 95% CI for median was computed using the method of Brookmeyer and Crowley.
Time to Respiratory-Related Hospitalization	Baseline up to the event of respiratory-related hospitalization (up to Week 122)	Time from randomization to first occurrence of an event of respiratory-related hospitalization was reported. Participants without an event were censored at the last known alive day, study Day 368, or the last date during the double-blind period. The median time to event was estimated using Kaplan-Meier method. 95% CI for median was computed using the method of Brookmeyer and Crowley.
Percentage of Participants With Anti-therapeutic Antibody (ATA) to Lebrikizumab	Baseline and Post-Baseline (assessed at multiple time points: Weeks 4, 12, 24, 36, 52, 56, 64, 76, and at safety follow-up up to Week 122)	ATA to lebrikizumab was tested using a validated immunoassay. A positive ATA result was defined as one in which the presence of detectable ATAs could be confirmed by competitive binding with lebrikizumab. Percentage of participants with positive results for ATA at Baseline and at post-baseline time points were reported. Only participants who received lebrikizumab were included in the analysis.
Percentage of Participants With an Event of >/=15% Absolute Decrease in Percentage of Predicted DLco or Death From Any Cause	Baseline up to the event of >/=15% absolute decrease in percentage of predicted DLco or death from any cause (up to Week 122)	DLco (in mL/min/mmHg) is a measure of the gas transfer. Predicted DLco is based on sex, age, and height of a person. Percent of predicted DLco (in %) = \[(observed DLco)/(predicted DLco)\]\*100.
Time to First Event of >/=15% Absolute Decrease in Percentage of Predicted DLco or Death From Any Cause	Baseline up to the event of >/=15% absolute decrease in percentage of predicted DLco or death from any cause (up to Week 122)	DLco is a measure of the gas transfer. Predicted DLco is based on sex, age, and height of a person. Percent of predicted DLco (in %) = \[(observed DLco)/(predicted DLco)\]\*100. Time from randomization to first occurrence of \>/=15% absolute decrease in percentage of predicted DLco or death from any cause was reported. The median time to event was estimated using Kaplan-Meier method. 95% CI for median was computed using the method of Brookmeyer and Crowley.
Minimum Observed Serum Concentration (Cmin) of Lebrikizumab	Predose (Hour 0) at Weeks 4, 12, 24, and 36	Participants who received lebrikizumab were only included in the analysis.

Trial Locations

Locations (112): Pulmonary Consultants
🇺🇸
Tacoma, Washington, United States
Box Hill Hospital; Eastern Clinical Research Unit
🇦🇺
Box Hill, Victoria, Australia
Hopital Bichat Claude Bernard ; Service de Pneumologie
🇫🇷
Paris, France
Thoraxklinik Heidelberg gGmbH
🇩🇪
Heidelberg, Germany
Clinica San Pablo
🇵🇪
Lima, Peru
Lawson Health Research Institute a joint venture of LHSC Research Inc and Lawson Research Institute
🇨🇦
London, Ontario, Canada
CHU UCL Mont-Godinne
🇧🇪
Mont-godinne, Belgium
Penn State University College Medical Allergy And Care Med
🇺🇸
Hershey, Pennsylvania, United States
Lovelace Scientific Resources, Inc.
🇺🇸
Albuquerque, New Mexico, United States
Medical University of South Carolina
🇺🇸
Charleston, South Carolina, United States
Mt Sinai School Medical Pulmo And Critical Care Med
🇺🇸
New York, New York, United States
Royal Prince Alfred Hospital; Department of Respiratory Medicine
🇦🇺
Camperdown, New South Wales, Australia
Hospital Erasme; Neurologie
🇧🇪
Bruxelles, Belgium
Cardiopulmonary Associates LLC Cardiopulmonary Research
🇺🇸
Chesterfield, Missouri, United States
A.O.U. Policlinico Vittorio Emanuele; Centro per la cura delle Malattie Rare del Polmone
🇮🇹
Catania, Sicilia, Italy
Fachklinik für Lungenerkrankungen
🇩🇪
Immenhausen, Germany
Ruhrlandklinik Lungenzentrum der UNI Essen Abt.Pneumologie-Allergologie
🇩🇪
Essen, Germany
A.O. Univ. Senese Policlinico S. Maria alle Scotte; UOC Malattie Resepiratorie e Trapianto Polmonare
🇮🇹
Siena, Toscana, Italy
Hopital Avicenne; Pneumologie
🇫🇷
Bobigny, France
Inova Transplant Center Fairfax Hospital
🇺🇸
Falls Church, Virginia, United States
Alfred Hospital; Allergy Immuno Resp
🇦🇺
Melbourne, Victoria, Australia
Universitätsklinikum Standort Gießen Medizinische Klinik II u. Poliklinik Innere Med./Pneumologie
🇩🇪
Gießen, Germany
Ospedale Morgagni-Pierantoni; U.O. Pneumologia
🇮🇹
Forlì, Emilia-Romagna, Italy
Hopital de Pontchaillou; Service de Pneumologie
🇫🇷
Rennes, France
Highland Hospital-University of Rochester Medical Center
🇺🇸
Rochester, New York, United States
ST VINCENT'S HOSPITAL; Thoracic Medicine
🇦🇺
Darlinghurst, New South Wales, Australia
CPC Comprehensive Pneumology Center / Forschungsambulanz, Helmholtz Zentrum
🇩🇪
München, Germany
Weill Medical College of Cornell University
🇺🇸
New York, New York, United States
Ms Clinsearch Specjalistyczny Niepubliczny Zaklad Opieki Zdrowotnej
🇵🇱
Lublin, Poland
Institut universitaire de cardiologie et de pneumologie de Québec (Hôpital Laval)
🇨🇦
Ste. Foy, Quebec, Canada
Ospedale San Giuseppe; U.O. di Pneumologia
🇮🇹
Milano, Lombardia, Italy
Hopital Louis Pradel; Pneumologie
🇫🇷
Bron, France
Hopital Calmette; Pneumologie
🇫🇷
Lille, France
Hospital Universitario La Princesa; Servicio de Neumologia
🇪🇸
Madrid, Spain
LungenClinic Großhansdorf
🇩🇪
Großhansdorf, Germany
Papworth Hospital NHS Foundation Trust; Respiratory Department
🇬🇧
Cambridge, United Kingdom
Kanagawa Cardiovascular and Respiratory Center; Respiratory Medicine
🇯🇵
Kanagawa, Japan
Unidad de Investigacion Clinica En Medicina (Udicem) S.C.
🇲🇽
Monterrey, Mexico
A.O. Universitaria San Luigi Gonzaga di Orbassano; Ambulatorio per le Malattie Rare del Polmone
🇮🇹
Orbassano (TO), Piemonte, Italy
Southmead Hospital; Respiratory Department
🇬🇧
Bristol, United Kingdom
St James University Hospital; Respiratory Department
🇬🇧
Leeds, United Kingdom
Hospital Universitario Virgen del Rocio; Servicio de Neumologia
🇪🇸
Sevilla, Spain
Southampton General Hospital; Respiratory Department
🇬🇧
Hampshire, United Kingdom
Respiratory research department clinical science building
🇬🇧
Liverpool, United Kingdom
Hospital General Universitario De Valencia; Servicio de Neumologia
🇪🇸
Valencia, Spain
Royal Brompton Hospital; Respiratory Department
🇬🇧
London, United Kingdom
Hospital Clínico San Carlos - Servicio de Neumologia
🇪🇸
Madrid, Spain
North Manchester Hospital; Respiratory Department
🇬🇧
Manchester, United Kingdom
Case Western Research University; University Hospitals Case Medical Center
🇺🇸
Cleveland, Ohio, United States
Ohio State University
🇺🇸
Columbus, Ohio, United States
Temple Lung Center, Temple Universtiy-Of the Commomwealth System of Higher Education
🇺🇸
Philadelphia, Pennsylvania, United States
University of Pittsburgh Med Cen; Dorothy P And Richard P Simmons Cen For Interstitial Lung Disease
🇺🇸
Pittsburgh, Pennsylvania, United States
Tufts Medical Center
🇺🇸
Boston, Massachusetts, United States
Southern Arizona Veterans Administration Healthcare Systems
🇺🇸
Tucson, Arizona, United States
UCSD Medical Center
🇺🇸
La Jolla, California, United States
Rocky Mountain Center For Clinical Research
🇺🇸
Wheat Ridge, Colorado, United States
Cleveland Clinic Florida
🇺🇸
Weston, Florida, United States
Research Alliance Inc
🇺🇸
Clearwater, Florida, United States
Mayo Clinic-Jacksonville
🇺🇸
Jacksonville, Florida, United States
Southeastern Lung Care
🇺🇸
Decatur, Georgia, United States
Loyola University Med Center
🇺🇸
Maywood, Illinois, United States
Piedmont Healthcare Pulmonary and Critical Care Research
🇺🇸
Austell, Georgia, United States
University of Chicago; Pulmonary and Critical Care
🇺🇸
Chicago, Illinois, United States
Uni of Kansas Medical Center
🇺🇸
Kansas, Kansas, United States
Univ of Iowa Hosp & Clinics; Pulmonary
🇺🇸
Iowa City, Iowa, United States
University of Maryland Medical Center
🇺🇸
Baltimore, Maryland, United States
Johns Hopkins Bayview Medical Center - Johns Hopkins Asthma & Allergy Center
🇺🇸
Baltimore, Maryland, United States
Via Christi Hospital Inc. DBA Via Christi Research; Research Dept.
🇺🇸
Wichita, Kansas, United States
Institute for Respiratory Health Inc
🇦🇺
Nedlands, Western Australia, Australia
University Alabama At Birmingham
🇺🇸
Birmingham, Alabama, United States
University of California, San Francisco
🇺🇸
San Francisco, California, United States
National Jewish Health
🇺🇸
Denver, Colorado, United States
University Miami
🇺🇸
Miami, Florida, United States
University of Minnesota Hospital & Clinic
🇺🇸
Minneapolis, Minnesota, United States
Mayo Clinic Rochester
🇺🇸
Rochester, Minnesota, United States
University of Nebraska
🇺🇸
Omaha, Nebraska, United States
University of Cincinnati
🇺🇸
Cincinnati, Ohio, United States
Oklahoma University Health Sciences Center
🇺🇸
Oklahoma City, Oklahoma, United States
The Oregon Clinic.
🇺🇸
Portland, Oregon, United States
Vanderbilt University Medical Center
🇺🇸
Nashville, Tennessee, United States
Baylor College Med
🇺🇸
Houston, Texas, United States
Houston Methodist Hospital
🇺🇸
Houston, Texas, United States
Audie Murphy Va Hospital
🇺🇸
San Antonio, Texas, United States
University of Utah Health Sciences Center, Lung Health Research Center
🇺🇸
Salt Lake City, Utah, United States
Clinica Internacional, Sede San Borja; Unidad de Investigacion de Clínica Internacional
🇵🇪
Lima, Peru
Uniwersytecki Szpital Kliniczny Nr 1 im.N.Barlickiego Oddzial Kliniczny Pneumonologii i Alergologii
🇵🇱
Lodz, Poland
Klinika Chorob Pluc i Gruzlicy w Zabrzu; Slaski Uniwersytet Medyczny
🇵🇱
Zabrze, Poland
Central Florida Pulmonary Group, PA
🇺🇸
Orlando, Florida, United States
University Wisconsin Hospitals and Clinics
🇺🇸
Madison, Wisconsin, United States
USF Tampa General Hospital
🇺🇸
Tampa, Florida, United States
Policlinico Tor Vergata; UO Mal. Respiratorie; Centro Malattie rare polmone
🇮🇹
Roma, Lazio, Italy
Klinika Pulmonologii, Alergologii i Onkologii Pulmonologicznej Uniwersytet Medyczny w Poznaniu
🇵🇱
Poznan, Poland
Hospital Universitari de Bellvitge ; Servicio de Neumologia
🇪🇸
Hospitalet de Llobregat, Barcelona, Spain
University Vermont College Medicine Fletcher Allen Health Care
🇺🇸
Colchester, Vermont, United States
University of British Columbia - Vancouver Coastal Health Authority
🇨🇦
Vancouver, British Columbia, Canada
Cliniques Universitaires St-Luc
🇧🇪
Bruxelles, Belgium
UZ Leuven Gasthuisberg
🇧🇪
Leuven, Belgium
Hospital General Del Estado De Sonora "Dr. Ernesto Ramos Bours"; Servicio De Neumologia
🇲🇽
Hermosillo, Mexico
Dr. Georges-L. Dumont Regional Hospital
🇨🇦
Moncton, New Brunswick, Canada
University of Arizona
🇺🇸
Tucson, Arizona, United States
Medical College of Wisconsin
🇺🇸
Milwaukee, Wisconsin, United States
Instituto Nacional De Enfermedades Respiratorias;Unidad de Investigación
🇲🇽
Mexico City, Mexico
Universidad Autonoma De Nuevo Leon, Hospital Universitario Doctor Jose Eleuterio Gonzalez
🇲🇽
Monterrey, Mexico
Clinica San Borja; NEUMOCARE
🇵🇪
Lima, Peru
Yale New Haven Hospital
🇺🇸
New Haven, Connecticut, United States
Maine Medical Center -Division of Pulmomary and Critical Care Medicine
🇺🇸
Portland, Maine, United States
Tosei General Hospital
🇯🇵
Seto-shi, Japan
Instytut Gruzlicy i Chorob Płuc
🇵🇱
Warszawa, Poland
Mayo Clinic- Scottsdale
🇺🇸
Scottsdale, Arizona, United States
Kinki-Chuo Chest Medical Center
🇯🇵
Osaka, Japan
Rhode Island Hospital
🇺🇸
Providence, Rhode Island, United States
St. Joseph's Healthcare Hamilton
🇨🇦
Hamilton, Ontario, Canada