A Study to Assess the Efficacy, Safety, and Tolerability of Brensocatib in Participants With Non-Cystic Fibrosis Bronchiectasis

Phase 3

Completed

• Conditions: Non-Cystic Fibrosis Bronchiectasis
• Interventions: Drug: Placebo; Drug: Brensocatib 10 mg; Drug: Brensocatib 25 mg

• Registration Number: NCT04594369
• Lead Sponsor: Insmed Incorporated

Brief Summary

The primary objective of this study is to evaluate the effect of brensocatib at 10 mg and 25 mg compared with placebo on the rate of pulmonary exacerbations (PEs) over the 52-week treatment period.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2020-10-14
• Study First Submitted QC: 2020-10-14
• Study First Posted: 2020-10-20
• Study Start: 2020-12-01
• Primary Completion: 2024-10-28
• Study Completion: 2024-10-28
• Status Verified: 2024-11
• Last Update Submitted: 2024-11-11
• Last Update Posted: 2024-11-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 1767

Inclusion Criteria

1. Provide their signed study informed consent to participate.

   a. Adolescent participants must have signed study assent form to participate, and the adolescent's parent or legal guardian must have provided signed informed consent for the adolescent to participate.

2. Clinical history consistent with non-cystic fibrosis bronchiectasis (NCFBE) (cough, chronic sputum production and/or recurrent respiratory infections) that is confirmed by chest computerized tomography (CT) scan.

3. At least 2 PEs defined by need for antibiotic prescription by a physician for the signs and symptoms of respiratory infections in the past 12 months before the Screening Visit.

   a. Adolescent participants are required to have at least 1 pulmonary exacerbation in the prior 12 months.

4. Women must be postmenopausal (defined as no menses for 12 months without an alternative medical cause), surgically sterile, or using highly effective contraception (ie, methods that can achieve a failure rate <1% per year when used consistently and correctly) from Day 1 to at least 90 days after the last dose.

5. Male participants with female partners of childbearing potential must be using effective contraception from Day 1 to at least 90 days after the last dose.

6. Male participants with pregnant or non-pregnant women of child-bearing potential partners must use condoms to avoid potential exposure to the embryo/fetus.

Exclusion Criteria

1. A primary diagnosis of chronic obstructive pulmonary disease (COPD) or asthma as judged by the Investigator.
2. Bronchiectasis due to cystic fibrosis.
3. Current smokers as defined per Centers for Disease Control (CDC).
4. Known or suspected immunodeficiency disorder, including history of invasive opportunistic infections.
5. Known history of human immunodeficiency virus (HIV) infection.
6. Currently being treated for nontuberculous mycobacteria (NTM) lung infection, allergic bronchopulmonary aspergillosis, or tuberculosis (TB).
7. Active and current symptomatic infection by 2019 corona virus disease (COVID-19).
8. Inability to follow the procedures of the study (eg, due to language problems or psychological disorders).
9. Receiving medications or therapy that are prohibited as concomitant medications.
10. Previously participated in a clinical trial for brensocatib.
11. Received any live attenuated vaccine within 4 weeks prior to the first administration of brensocatib.
12. Suffering an exacerbation 4 weeks before Screening or during the Screening period.
13. Adult participants only: Have compliance issues with completion of electronic diary entries during the Screening Period and in the opinion of the Investigator, compliance is unlikely to improve during the study.
14. Participated in any other interventional clinical studies within 3 months before Screening Visit.
15. History of alcohol or drug abuse within 6 months prior to the Screening Visit.
16. Is the Investigator or any Sub-Investigator, research assistant, pharmacist, study coordinator, other staff or relative thereof directly involved in the conduct of the study.
17. Known history of hypersensitivity to brensocatib or any of its excipients.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo	Placebo	Participants will receive a brensocatib-matching placebo, tablets orally, once daily, for 52 weeks.
Brensocatib 10 mg	Brensocatib 10 mg	Participants will receive brensocatib 10 mg, tablets orally, once daily, for 52 weeks.
Brensocatib 25 mg	Brensocatib 25 mg	Participants will receive brensocatib 25 mg, tablets orally, once daily, for 52 weeks.

Primary Outcome Measures

Name	Time	Method
Rate of Adjudicated Pulmonary Exacerbations (PEs)	52 Weeks

Secondary Outcome Measures

Name	Time	Method
Percentage of Participants who are Pulmonary Exacerbation (PE) Free	52 Weeks
Rate of Severe Adjudicated Pulmonary Exacerbations (PEs)	52 Weeks
Plasma Concentration of Brensocatib at Select Time Points	Pre-dose and post-dose at multiple time points up to Week 52
Time to First Adjudicated Pulmonary Exacerbation (PE)	52 Weeks
Change From Baseline in Postbronchodilator Forced Expiratory Volume in 1 Second (FEV1)	Baseline, at Week 52
Change from Baseline to Week 52 in Quality of Life Questionnaire - Bronchiectasis (QOL-B) Respiratory Symptoms Domain Score in Adult Participants	Baseline to Week 52
Number of Participants who Experience at Least one Treatment-Emergent Adverse Events (TEAEs)	56 Weeks

Trial Locations

Locations (373)

USA039; 🇺🇸 Kissimmee, Florida, United States

USA029; 🇺🇸 Newport Beach, California, United States

USA103; 🇺🇸 Plantation, Florida, United States

USA046; 🇺🇸 Philadelphia, Pennsylvania, United States

BRA009; 🇧🇷 Passo Fundo, Rio Grande Do Sul, Brazil

IRL002; 🇮🇪 Dublin, Ireland

IRL001; 🇮🇪 Limerick, Ireland

POL017; 🇵🇱 Krakow, Poland

USA015; 🇺🇸 Clearwater, Florida, United States

USA076; 🇺🇸 Gainesville, Florida, United States

USA082; 🇺🇸 Jacksonville, Florida, United States

USA089; 🇺🇸 Saint Petersburg, Florida, United States

USA079; 🇺🇸 Boston, Massachusetts, United States

USA110; 🇺🇸 Lincoln, Nebraska, United States

USA065; 🇺🇸 Toms River, New Jersey, United States

USA041; 🇺🇸 Franklin, Tennessee, United States

USA036; 🇺🇸 Rock Hill, South Carolina, United States

ARG027; 🇦🇷 Bahia Blanca, Buenos Aires, Argentina

ARG022; 🇦🇷 Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

ARG001; 🇦🇷 Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

ARG006; 🇦🇷 la Plata, Buenos Aires, Argentina

ARG013; 🇦🇷 Mar del Plata, Buenos Aires, Argentina

ARG017; 🇦🇷 Mar Del Plata, Buenos Aires, Argentina

ARG012; 🇦🇷 Ciudad Autónoma de Buenos Aires, Ciudad Autónoma De BuenosAires, Argentina

ARG009; 🇦🇷 Villa Vatteone, Buenos Aires, Argentina

ARG023; 🇦🇷 Río Cuarto, Córdoba, Argentina

ARG015; 🇦🇷 San Miguel De Tucumán, Tucumán, Argentina

ARG025; 🇦🇷 San Miguel de Tucumán, Tucumán, Argentina

ARG005; 🇦🇷 Córdoba, Argentina

ARG007; 🇦🇷 Mendoza, Argentina

ARG011; 🇦🇷 Rosario, Argentina

ARG019; 🇦🇷 Santa Fe, Argentina

AUS013; 🇦🇺 Kogarah, New South Wales, Australia

AUS008; 🇦🇺 New Lambton Heights, New South Wales, Australia

AUS007; 🇦🇺 Westmead, New South Wales, Australia

AUS012; 🇦🇺 Cairns North, Queensland, Australia

AUS001; 🇦🇺 Chermside, Queensland, Australia

AUS010; 🇦🇺 Greenslopes, Queensland, Australia

AUS017; 🇦🇺 Bedford Park, South Australia, Australia

AUS011; 🇦🇺 Adelaide, South Australia, Australia

AUS009; 🇦🇺 Woodville South, South Australia, Australia

AUS014; 🇦🇺 Clayton, Victoria, Australia

AUS005; 🇦🇺 Nedlands, Western Australia, Australia

AUS003; 🇦🇺 Concord, Australia

AUT002; 🇦🇹 Linz, Austria

AUS015; 🇦🇺 Spearwood, Australia

BEL002; 🇧🇪 Gent, Oost-Vlaanderen, Belgium

BEL001; 🇧🇪 Leuven, Belgium

BEL007; 🇧🇪 Liège, Belgium

BEL008; 🇧🇪 Sint-Niklaas, Belgium

BRA001; 🇧🇷 Blumenau, Santa Catarina, Brazil

BRA006; 🇧🇷 Santo André, São Paulo, Brazil

BRA003; 🇧🇷 Botucatu, Brazil

BRA004; 🇧🇷 São Bernardo do Campo, Brazil

BRA011; 🇧🇷 São Paulo, Brazil

BGR009; 🇧🇬 Sofia, Sofia-Grad, Bulgaria

BGR002; 🇧🇬 Sofia, Sofia-Grad, Bulgaria

BGR005; 🇧🇬 Blagoevgrad, Bulgaria

BGR014; 🇧🇬 Kozloduy, Bulgaria

BGR018; 🇧🇬 Pazardzhik, Bulgaria

BGR007; 🇧🇬 Montana, Bulgaria

BGR019; 🇧🇬 Pleven, Bulgaria

BGR008; 🇧🇬 Ruse, Bulgaria

BGR010; 🇧🇬 Sofia, Bulgaria

BGR013; 🇧🇬 Vidin, Bulgaria

BGR016; 🇧🇬 Vratsa, Bulgaria

CAN004; 🇨🇦 Toronto, Ontario, Canada

CAN002; 🇨🇦 Montreal, Quebec, Canada

CHL005; 🇨🇱 Curicó, Maule, Chile

CHL001; 🇨🇱 Providencia, Región-MetropolitanadeSantiago, Chile

CHL002; 🇨🇱 Providencia, Región-MetropolitanadeSantiago, Chile

COL006; 🇨🇴 Zipaquira, Cundinamarca, Colombia

CHL008; 🇨🇱 Providencia, Región-MetropolitanadeSantiago, Chile

COL003; 🇨🇴 Cali, Valle Del Cauca, Colombia

DNK005; 🇩🇰 Odense C, South Denmark, Denmark

DNK007; 🇩🇰 Aarhus, Denmark

FRA002; 🇫🇷 Strasbourg, Bas-Rhin, France

FRA005; 🇫🇷 Montpellier, Hérault, France

FRA004; 🇫🇷 Amiens cedex 1, France

FRA011; 🇫🇷 Creteil, France

FRA003; 🇫🇷 Nantes, France

FRA009; 🇫🇷 Nice, France

FRA010; 🇫🇷 Paris, France

DEU009; 🇩🇪 Heidelberg, Baden-Württemberg, Germany

FRA006; 🇫🇷 Toulouse, France

DEU025; 🇩🇪 München, Bayern, Germany

DEU027; 🇩🇪 Potsdam, Brandenburg, Germany

DEU013; 🇩🇪 Essen, Nordrhein-Westfalen, Germany

DEU031; 🇩🇪 Hannover, Niedersachsen, Germany

DEU016; 🇩🇪 Halle, Sachsen-Anhalt, Germany

DEU003; 🇩🇪 Leipzig, Sachsen, Germany

DEU020; 🇩🇪 Geesthacht, Schleswig-Holstein, Germany

DEU002; 🇩🇪 Berlin, Germany

DEU006; 🇩🇪 Berlin, Germany

DEU015; 🇩🇪 Hannover, Germany

DEU023; 🇩🇪 Mainz, Germany

GRC003; 🇬🇷 Alexandroupoli, Evros, Greece

DEU029; 🇩🇪 Muenster, Germany

HUN005; 🇭🇺 Tatabánya, Komárom-Esztergom, Hungary

IRL003; 🇮🇪 Dublin, Ireland

ISR010; 🇮🇱 Beer Sheva, Israel

ISR001; 🇮🇱 Ashkelon, Israel

ISR006; 🇮🇱 Jerusalem, Israel

ISR008; 🇮🇱 Haifa, Israel

ISR009; 🇮🇱 Kefar-Sava, Israel

ISR011; 🇮🇱 Petach Tikva, Israel

ISR007; 🇮🇱 Ramat Gan, Israel

ISR003; 🇮🇱 Rehovot, Israel

ISR004; 🇮🇱 Zerifin, Israel

ITA008; 🇮🇹 Ferrara, Emilia-Romagna, Italy

ITA010; 🇮🇹 Bologna, Emilia-Romagna, Italy

ITA012; 🇮🇹 Milano, Lombardia, Italy

ITA002; 🇮🇹 Reggio Emilia, Emilia-Romagna, Italy

ITA006; 🇮🇹 Milano, Lombardia, Italy

ITA011; 🇮🇹 Rozzano, Lombardia, Italy

ITA004; 🇮🇹 Siena, Toscana, Italy

ITA003; 🇮🇹 Milano, Italy

ITA001; 🇮🇹 Palermo, Italy

ITA007; 🇮🇹 Pavia, Italy

JPN029; 🇯🇵 Toyoake, Aiti, Japan

ITA009; 🇮🇹 Roma, Italy

JPN023; 🇯🇵 Iizuka-Shi, Hukuoka, Japan

JPN027; 🇯🇵 Fukuoka-Shi, Hukuoka, Japan

JPN031; 🇯🇵 Toon-Shi, Ehime, Japan

JPN009; 🇯🇵 Kobe-City, Hyôgo, Japan

JPN022; 🇯🇵 Takamatsu-Shi, Kagawa, Japan

JPN020; 🇯🇵 Kasama-Shi, Ibaraki, Japan

JPN001; 🇯🇵 Naka-gun, Ibaraki, Japan

JPN028; 🇯🇵 Yokohama-Shi Konan-Ku, Kanagawa, Japan

JPN005; 🇯🇵 Koshi shi, Kumamoto, Japan

JPN008; 🇯🇵 Matsusaka-shi, Mie, Japan

JPN011; 🇯🇵 Tsu, Mie, Japan

JPN013; 🇯🇵 Nagasaki-Shi, Nagasaki, Japan

JPN034; 🇯🇵 Sendai-shi, Miyagi, Japan

JPN012; 🇯🇵 Chuo-ku, Niigata, Japan

JPN015; 🇯🇵 Matsue, Simane, Japan

JPN007; 🇯🇵 Kiyose, Tokyo, Japan

JPN014; 🇯🇵 Ota-Ku, Tokyo, Japan

JPN017; 🇯🇵 Shinagawa-ku, Tokyo, Japan

JPN002; 🇯🇵 Shinjuku-ku, Tokyo, Japan

JPN032; 🇯🇵 Shinjuku-ku, Tokyo, Japan

JPN019; 🇯🇵 Shimonoseki-Shi, Yamaguti, Japan

JPN003; 🇯🇵 Hamamatsu-Shi, Japan

JPN004; 🇯🇵 Kita Kyushu-shi, Japan

JPN010; 🇯🇵 Meguro-ku, Japan

JPN018; 🇯🇵 Toyonaka-shi, Japan

KOR007; 🇰🇷 Seongnam-si, Gyeonggido, Korea, Republic of

KOR008; 🇰🇷 Bucheon-si, Gyeonggido, Korea, Republic of

KOR003; 🇰🇷 Seoul, Seoul Teugbyeolsi, Korea, Republic of

KOR009; 🇰🇷 Seoul, Korea, Republic of

KOR013; 🇰🇷 Seoul, Korea, Republic of

KOR010; 🇰🇷 Seoul, Korea, Republic of

KOR005; 🇰🇷 Seoul, Korea, Republic of

LVA002; 🇱🇻 Daugavpils, Daugavpils Aprinkis, Latvia

MYS003; 🇲🇾 Kota Bahru, Malaysia

MYS004; 🇲🇾 Kuantan, Pahang, Malaysia

MEX007; 🇲🇽 Guadalajara, Jalisco, Mexico

MEX008; 🇲🇽 Guadalajara, Jalisco, Mexico

MEX005; 🇲🇽 Guadalajara, Jalisco, Mexico

MEX001; 🇲🇽 Monterrey, Mexico

MEX003; 🇲🇽 Monterrey, Nuevo León, Mexico

NLD001; 🇳🇱 Alkmaar, Noord-Holland, Netherlands

MEX006; 🇲🇽 Durango, Mexico

MEX002; 🇲🇽 Oaxaca, Mexico

NLD002; 🇳🇱 Amsterdam, Noord-Holland, Netherlands

NLD003; 🇳🇱 Arnhem, Gelderland, Netherlands

NLD006; 🇳🇱 Rotterdam, Netherlands

NZL006; 🇳🇿 Otahuhu, Auckland, New Zealand

NZL005; 🇳🇿 Christchurch, South Island, New Zealand

NZL009; 🇳🇿 Hastings, Hawkes's Bay, New Zealand

NZL002; 🇳🇿 Hamilton, Waikato, New Zealand

NZL003; 🇳🇿 Auckland, New Zealand

NZL001; 🇳🇿 Dunedin, South Island, New Zealand

NZL011; 🇳🇿 Paraparaumu, Wellington, New Zealand

NZL008; 🇳🇿 Auckland, New Zealand

NZL007; 🇳🇿 Tauranga, New Zealand

NZL010; 🇳🇿 Wellington, New Zealand

PER003; 🇵🇪 Lima, Peru

PER001; 🇵🇪 Lima, Peru

PER005; 🇵🇪 Chancay, Peru

PER002; 🇵🇪 Lima, Peru

PER006; 🇵🇪 Piura, Peru

POL012; 🇵🇱 Ostrowiec Swietokrzyski, Swietokrzyskie, Poland

POL005; 🇵🇱 Bialystok, Poland

POL006; 🇵🇱 Bielsko Biala, Poland

POL016; 🇵🇱 Katowice, Poland

POL018; 🇵🇱 Ksawerow, Poland

POL001; 🇵🇱 Sucha Beskidzka, Poland

POL008; 🇵🇱 Rabka-Zdroj, Poland

POL010; 🇵🇱 Siedlce, Poland

POL014; 🇵🇱 Szczecin, Poland

POL011; 🇵🇱 Rzeszów, Poland

POL007; 🇵🇱 Sosnowiec, Poland

POL009; 🇵🇱 Tarnow, Poland

PRT005; 🇵🇹 Aveiro, Portugal

PRT006; 🇵🇹 Guarda, Portugal

PRT009; 🇵🇹 Braga, Portugal

PRT002; 🇵🇹 Guimaraes, Portugal

PRT003; 🇵🇹 Lisboa, Portugal

SRB001; 🇷🇸 Belgrade, Serbia

SRB003; 🇷🇸 Belgrade, Serbia

SRB014; 🇷🇸 Sombor, Serbia

SRB007; 🇷🇸 Nis, Serbia

SRB010; 🇷🇸 Uzice, Serbia

SVK002; 🇸🇰 Bardejov, Slovakia

ESP009; 🇪🇸 Santiago de Compostela, A Coruña, Spain

SVK003; 🇸🇰 Spisská Nová Ves, Slovakia

ESP008; 🇪🇸 Oviedo, Asturias, Spain

ESP013; 🇪🇸 Badalona, Barcelona, Spain

ESP012; 🇪🇸 Santander, Cantabria, Spain

ESP003; 🇪🇸 Barcelona, Spain

ESP016; 🇪🇸 Barcelona, Spain

ESP015; 🇪🇸 Pozuelo de Alarcon, Madrid, Spain

ESP011; 🇪🇸 Pamplona, Navarra, Spain

ESP006; 🇪🇸 L´Hospitalet de Llobregat, Spain

ESP007; 🇪🇸 Madrid, Spain

ESP001; 🇪🇸 Girona, Spain

ESP002; 🇪🇸 Madrid, Spain

TWN003; 🇨🇳 Kaohsiung City, Taiwan

TWN002; 🇨🇳 Kaohsiung, Taiwan

TWN001; 🇨🇳 Kaohsiung, Taiwan

TWN006; 🇨🇳 Taipei City, Taiwan

TWN007; 🇨🇳 Taipei, Taiwan

TWN004; 🇨🇳 Taipei, Taiwan

TUR006; 🇹🇷 Atakum, Samsun, Turkey

THA004; 🇹🇭 Nakhonnayok, Nakhon Nayok, Thailand

THA002; 🇹🇭 Muang, Nonthaburi, Thailand

THA003; 🇹🇭 Khon Kaen, Thailand

TUR011; 🇹🇷 Ankara, Turkey

TUR003; 🇹🇷 Canakkale, Turkey

TUR005; 🇹🇷 Konya, Turkey

TUR009; 🇹🇷 Kocaeli, Turkey

TUR001; 🇹🇷 Mersin, Turkey

UKR001; 🇺🇦 Kharkiv, Kharkivs'ka Oblast, Ukraine

UKR005; 🇺🇦 Poltava, Poltavs'ka Oblast, Ukraine

UKR007; 🇺🇦 Kherson, Khersons'ka Oblast, Ukraine

UKR012; 🇺🇦 Dnipro, Ukraine

UKR009; 🇺🇦 Ivano-Frankivsk, Ukraine

UKR008; 🇺🇦 Kyiv, Ukraine

UKR004; 🇺🇦 Kyiv, Ukraine

UKR010; 🇺🇦 Vinnytsia, Ukraine

UKR003; 🇺🇦 Odesa, Ukraine

GBR015; 🇬🇧 Exeter, Devon, United Kingdom

GBR013; 🇬🇧 Llandough, Penarth, Vale Of Glamorgan, The, United Kingdom

GBR016; 🇬🇧 Bradford, Yorkshire, United Kingdom

GBR006; 🇬🇧 Birmingham, United Kingdom

GBR002; 🇬🇧 Chertsey, United Kingdom

GBR004; 🇬🇧 Liverpool, United Kingdom

GBR007; 🇬🇧 Dundee, United Kingdom

GBR009; 🇬🇧 London, United Kingdom

GBR008; 🇬🇧 Manchester, United Kingdom

GBR011; 🇬🇧 Manchester, United Kingdom

GBR003; 🇬🇧 Newcastle upon Tyne, United Kingdom

GBR018; 🇬🇧 Southampton, United Kingdom

GBR012; 🇬🇧 Salford, United Kingdom

GBR010; 🇬🇧 Swansea, United Kingdom

USA109; 🇺🇸 Nashville, Tennessee, United States

CHL010; 🇨🇱 Talca, Maule, Chile

BRA005; 🇧🇷 Porto Alegre, Rio Grande Do Sul, Brazil

AUS018; 🇦🇺 Murdoch, Western Australia, Australia

USA031; 🇺🇸 Kansas City, Kansas, United States

USA104; 🇺🇸 Fresno, California, United States

USA055; 🇺🇸 Los Angeles, California, United States

USA102; 🇺🇸 Northridge, California, United States

USA022; 🇺🇸 Palm Springs, California, United States

USA078; 🇺🇸 Santa Barbara, California, United States

USA035; 🇺🇸 San Diego, California, United States

USA027; 🇺🇸 Ventura, California, United States

USA012; 🇺🇸 Atlanta, Georgia, United States

USA053; 🇺🇸 Augusta, Georgia, United States

USA061; 🇺🇸 Maywood, Illinois, United States

USA073; 🇺🇸 Chicago, Illinois, United States

USA006; 🇺🇸 Chesterfield, Missouri, United States

USA063; 🇺🇸 Iowa City, Iowa, United States

USA115; 🇺🇸 Hammond, Indiana, United States

USA059; 🇺🇸 Saint Louis, Missouri, United States

USA066; 🇺🇸 New Hyde Park, New York, United States

USA021; 🇺🇸 New York, New York, United States

USA085; 🇺🇸 New York, New York, United States

USA033; 🇺🇸 Gastonia, North Carolina, United States

USA096; 🇺🇸 Huntersville, North Carolina, United States

USA067; 🇺🇸 Cincinnati, Ohio, United States

USA093; 🇺🇸 Cleveland, Ohio, United States

USA038; 🇺🇸 DuBois, Pennsylvania, United States

USA097; 🇺🇸 Dallas, Texas, United States

USA050; 🇺🇸 McKinney, Texas, United States

USA011; 🇺🇸 San Antonio, Texas, United States

USA002; 🇺🇸 Tyler, Texas, United States

USA034; 🇺🇸 Williamsburg, Virginia, United States

USA088; 🇺🇸 Vancouver, Washington, United States

BGR015; 🇧🇬 Lovech, Bulgaria

USA017; 🇺🇸 Farmington, Connecticut, United States

USA003; 🇺🇸 Baltimore, Maryland, United States

USA074; 🇺🇸 Saint Petersburg, Florida, United States

ARG026; 🇦🇷 Recoleta, Ciudad Autónoma De BuenosAires, Argentina

AUS006; 🇦🇺 South Brisbane, Queensland, Australia

USA080; 🇺🇸 Conway, Arkansas, United States

AUS022; 🇦🇺 North Adelaide, South Australia, Australia

USA037; 🇺🇸 Miami, Florida, United States

ARG003; 🇦🇷 Ciudad Autónoma de BuenosAires, Buenos Aires, Argentina

BGR012; 🇧🇬 Veliko Tarnovo, Bulgaria

USA044; 🇺🇸 Little Rock, Arkansas, United States

USA064; 🇺🇸 Springfield, Massachusetts, United States

USA049; 🇺🇸 Naples, Florida, United States

ARG002; 🇦🇷 Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

ARG004; 🇦🇷 Ciudad Autónoma de BuenosAires, Buenos Aires, Argentina

ARG018; 🇦🇷 Ciudad Autónoma de Buenos Aires, Ciudad Autónoma De BuenosAires, Argentina

USA001; 🇺🇸 Washington, District of Columbia, United States

BGR004; 🇧🇬 Plovdiv, Bulgaria

KOR011; 🇰🇷 Seoul, Korea, Republic of

ARG021; 🇦🇷 Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina

BEL009; 🇧🇪 Gent, Oost-Vlaanderen, Belgium

BEL004; 🇧🇪 Roeselare, West-Vlaanderen, Belgium

BGR006; 🇧🇬 Gabrovo, Bulgaria

CHL004; 🇨🇱 Quillota, Chile

USA084; 🇺🇸 Sarasota, Florida, United States

COL004; 🇨🇴 Santiago de Cali, Colombia

ARG010; 🇦🇷 Rosario, Santa Fe, Argentina

DEU011; 🇩🇪 Berlin, Germany

BGR011; 🇧🇬 Sofia, Sofia-Grad, Bulgaria

COL002; 🇨🇴 Bogota DC, Colombia

USA019; 🇺🇸 Miami Lakes, Florida, United States

DEU014; 🇩🇪 Dresden, Germany

DEU021; 🇩🇪 Frankfurt, Germany

AUS019; 🇦🇺 South Brisbane, Queensland, Australia

USA072; 🇺🇸 Leesburg, Florida, United States

COL005; 🇨🇴 Floridablanca, Santander, Colombia

ARG014; 🇦🇷 Vistalba, Mendoza, Argentina

DEU008; 🇩🇪 Frankfurt am Main, Hessen, Germany

DEU005; 🇩🇪 Marburg, Hessen, Germany

ISR002; 🇮🇱 Jerusalem, Israel

JPN030; 🇯🇵 Fukuoka-shi, Japan

JPN016; 🇯🇵 Matsue-shi, Japan

KOR004; 🇰🇷 Incheon, Korea, Republic of

AUS002; 🇦🇺 Box Hill, Victoria, Australia

DEU019; 🇩🇪 Berlin, Germany

BEL003; 🇧🇪 Mechelen, Belgium

MYS001; 🇲🇾 Kuala Lumpur, WilayahPersekutuan KualaLumpur, Malaysia

GBR017; 🇬🇧 Norwich, Norfolk, United Kingdom

CHL007; 🇨🇱 Valdivia, Los Ríos, Chile

COL001; 🇨🇴 Bogotá, Distrito Capital De Bogotá, Colombia

GBR001; 🇬🇧 Cambridge, Cambridgeshire, United Kingdom

MYS005; 🇲🇾 Kuala Lumpur, Malaysia

POL015; 🇵🇱 Kielce, Poland

KOR012; 🇰🇷 Seoul, Korea, Republic of

KOR015; 🇰🇷 Ansan-si, Gyeonggido, Korea, Republic of

LVA005; 🇱🇻 Jurmala, Latvia

MEX004; 🇲🇽 Guadalajara, Jalisco, Mexico

TWN005; 🇨🇳 New Taipei City, Taiwan

TUR010; 🇹🇷 Ankara, Turkey

TUR008; 🇹🇷 Izmir, Turkey

TUR004; 🇹🇷 Izmir, Turkey

DNK008; 🇩🇰 Copenhagen O, Capital, Denmark

DNK001; 🇩🇰 Hvidovre, Capital, Denmark

DNK006; 🇩🇰 Vejle, South Denmark, Denmark

DNK004; 🇩🇰 Hellerup, Denmark

DNK002; 🇩🇰 Roskilde, Denmark

USA013; 🇺🇸 Birmingham, Alabama, United States

USA075; 🇺🇸 Denver, Colorado, United States

USA023; 🇺🇸 Portland, Oregon, United States

DNK003; 🇩🇰 Aalborg, Denmark

GRC006; 🇬🇷 Thessaloniki, Greece

BGR017; 🇧🇬 Sliven, Bulgaria

GRC007; 🇬🇷 Herakleion, Greece

USA010; 🇺🇸 Rochester, Minnesota, United States

USA120; 🇺🇸 Tampa, Florida, United States

USA024; 🇺🇸 Sacramento, California, United States

USA026; 🇺🇸 Winston-Salem, North Carolina, United States

JPN006; 🇯🇵 Shinagawa-ku, Tokyo, Japan

USA052; 🇺🇸 Orlando, Florida, United States

USA020; 🇺🇸 New Orleans, Louisiana, United States

USA051; 🇺🇸 New Orleans, Louisiana, United States

USA005; 🇺🇸 Charleston, South Carolina, United States