A Study to Evaluate the Efficacy, and Safety Study of Ruxolitinib Cream in Adults With Moderate Atopic Dermatitis
- Registration Number
- NCT06238817
- Lead Sponsor
- Incyte Corporation
- Brief Summary
This study is being conducted to establish the efficacy of ruxolitinib cream in participants with moderate AD who had an inadequate response to, or are intolerant to, or contraindicated to topical corticosteroid (TCS)s and topical calcineurin inhibitor (TCI)s.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 225
- Adults aged ≥ 18 years at screening (Note: Legal adult age for Korea is ≥ 19 years).
- Diagnosis of AD as defined by the Hanifin and Rajka (1980) criteria.
- AD duration of at least 2 years.
- IGA score of 3 at screening and Day 1.
- EASI score > 7 at screening and Day 1.
- Itch NRS score ≥ 4 at Day 1, defined as the average of the 7 days directly before Day 1, with Itch NRS values available for at least 4 of the 7 days.
- %BSA (excluding the scalp) with AD involvement of at least 10% and up to 20% at screening and Day 1.
- DLQI score > 10 at screening and Day 1.
- Documented recent history (within 12 months before the screening visit) of inadequate response, intolerance, or contraindication to TCSs and TCIs.
- Agree to discontinue all agents used to treat AD from screening through the final follow up visit, except as outlined in the protocol.
- Willingness to avoid pregnancy or fathering children based on the criteria as outlined in the protocol.
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Unstable course of AD (spontaneously improving or rapidly deteriorating) as determined by the investigator in the 4 weeks prior to Day 1.
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Concurrent conditions and history of other diseases as follows:
- Immunocompromised (eg, lymphoma, acquired immunodeficiency syndrome, Wiskott-Aldrich syndrome).
- Chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiparasitics, antiprotozoals, or antifungals within 2 weeks before Day 1.
- Active acute bacterial, fungal, or viral skin infection (eg, herpes simplex, herpes zoster, chickenpox) within 1 week before Day 1.
- Any other concomitant skin disorder (eg, generalized erythroderma, such as Netherton syndrome), pigmentation, or extensive scarring that, in the opinion of the investigator, may interfere with the evaluation of AD lesions or compromise participant safety.
- Presence of AD lesions only on the hands or feet without prior history of involvement of other classic areas of involvement such as the face or the flexural folds.
- Other types of eczema within the 6 months prior to screening. Note: Seborrheic dermatitis on the scalp is allowed, as the scalp will not be treated with study cream.
- Current or history of hepatitis B or C virus infection.
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Any serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, would interfere with full participation in the study, including administration of study cream and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data.
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Any of the following clinical laboratory test results at screening:
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Hemoglobin < 10 g/dL.
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Liver function tests:
- AST or ALT ≥ 2 × ULN.
- Alkaline phosphatase > 1.5 × ULN.
- Bilirubin > 1.5 × ULN (isolated bilirubin > 1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin < 35%) with the exception of Gilbert's disease.
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Estimated glomerular filtration rate < 30 mL/min/1.73 m2 (using the Chronic Kidney Disease Epidemiology Collaboration equation).
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Positive serology test results for HIV antibody.
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Any other clinically significant laboratory result that, in the opinion of the investigator, poses a significant risk to the participant.
-
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Use of any of the following treatments within the indicated washout period before Day 1:
- 5 half-lives or 12 weeks, whichever is longer: biologic agents. For biologic agents with washout periods longer than 12 weeks (eg, rituximab), consult the medical monitor.
- 4 weeks: systemic corticosteroids or adrenocorticotropic hormone analogs, cyclosporine, methotrexate, azathioprine, or other systemic immunosuppressive (eg, JAK inhibitors) or immunomodulating agents (eg, mycophenolate or tacrolimus).
- 2 weeks or 5 half-lives, whichever is longer - strong systemic CYP3A4 inhibitors.
- 2 weeks: immunizations with live-attenuated vaccines; sedating antihistamines unless on a long-term stable regimen (nonsedating antihistamines are permitted).
Note: COVID-19 vaccination is allowed.
• 1 week: use of other topical treatments for AD, other than bland emollients (eg, Aveeno creams, ointments, sprays, soap substitutes), such as antipruritics (eg, doxepin cream), corticosteroids, calcineurin inhibitors, PDE4 inhibitors, coal tar (shampoo), antibiotics, or antibacterial cleansing body wash/soap.
Note: Diluted sodium hypochlorite "bleach" baths are allowed as long as they do not exceed 2 baths per week and their frequency remains the same throughout the study.
- History of treatment failure with any systemic or topical JAK inhibitor (eg, ruxolitinib, tofacitinib, baricitinib, abrocitinib, upadacitinib) for AD or any other inflammatory condition.
- Ultraviolet light therapy or prolonged exposure to natural or artificial sources of UV radiation (eg, sunlight or tanning booth) within 2 weeks prior to the baseline visit and/or intention to have such exposure during the study that is thought by the investigator to potentially impact the participant's AD.
- Current treatment or treatment within 30 days or 5 half-lives (whichever is longer) before baseline with another investigational medication or current enrollment in another investigational drug protocol.
- In the opinion of the investigator, are unable or unlikely to comply with the administration schedule, study evaluations, and procedures (eg, eDiary compliance).
Other protocol-defined Inclusion/Exclusion Criteria may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description VC Period: Ruxolitinib 1.5% Cream BID Ruxolitinib Cream Participants received ruxolitinib 1.5% cream, applied topically to the affected areas as a thin film twice daily (BID) from Day 1 to Week 8 during the Vehicle Control (VC) Period. Participants applied cream BID to areas identified at Baseline even if the areas improved. VC Period: Vehicle Cream BID Vehicle Cream Participants received vehicle cream, applied topically to the affected areas as a thin film twice daily (BID) from Day 1 to Week 8 during the VC Period. Participants applied cream BID to areas identified at Baseline even if the areas improved. VC Extension Period/Escape Arm: Vehicle Cream BID Vehicle Cream Participants who applied vehicle cream during the VC Period, continued applying vehicle cream as a thin film twice daily (BID) from Weeks 8 to 24 during the VCE Period. Participants applied cream BID to areas identified at Baseline even if the areas improved. Participants will be eligible to enter the ruxolitinib 1.5% cream open-label escape arm as defined in the protocol. VC Extension Period: Ruxolitinib 1.5% cream open-label escape arm Ruxolitinib Cream Participants received ruxolitinib 1.5% cream, applied topically to the affected areas as a thin film twice daily (BID) during the VCE Period. Participants applied cream BID to areas identified at Baseline even if the areas improved. VC Extension Period/Escape Arm: Ruxolitinib 1.5% Cream BID Ruxolitinib Cream Participants who applied ruxolitinib 1.5% cream during VC Period, continued applying ruxolitinib 1.5% cream topically to the affected areas as a thin film BID from Week 8 to 24 during the Vehicle Control Extension (VCE) Period. Participants stopped treatment 3 days after lesions disappeared and restarted at the first sign of recurrence.
- Primary Outcome Measures
Name Time Method VC Period: Proportion of participants who achieved Investigator's Global Assessment Treatment Success (IGA-TS) Baseline to Week 8 Defined as Investigator's Global Assessment (IGA) score of 0 or 1 with ≥ 2 grade improvement from baseline.
VC Period: Proportion of participants who achieved Eczema Area and Severity Index 75 (EASI75) Baseline to Week 8 Defined as ≥ 75% improvement in Eczema Area and Severity Index (EASI) score.
- Secondary Outcome Measures
Name Time Method VCE period: Time to first re-treatment Week 8 to Week 24 VC Period: Proportion of participants achieving at least a 4-point decrease from baseline in current Itch NRS score at 5, 15, 30, 45, and 60 minutes and 2, 4, and 6 hours post-initial dose on Day 1. Baseline to Day 1 VC Period: Time to achieve a ≥ 4-point improvement in Itch Numeric Rating Scale (NRS) score (ITCH4) Baseline to Week 8 ITCH4 is defined as achieving ≥ 4-point improvement in Itch NRS score.
VC and VCE Periods: Change from baseline in SCORAD score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 SCORing Atopic Dermatitis - tool used to assess extent and severity (intensity) of eczema.
VC and VCE Periods: Time to concurrently meeting all of the following criteria: IGA score ≥ 3, EASI score ≥ 16, Itch NRS score ≥ 4, BSA ≥ 10%, and DLQI score > 10 Baseline to Week 24 VC Period: Proportion of participants who experience a relapse after study treatment discontinuation Week 24 to Follow-up (30 days) Defined as proportion of participants among EASI75 responders who are on study treatment at Week 24 who meet relapse criteria \[loss of EASI50 from baseline\] at the safety follow-up visit.
VC Period: Proportion of participants who achieved Investigator's Global Assessment - Treatment Success (IGA-TS) Baseline to Weeks 2 and 4 Defined as Investigator's Global Assessment (IGA) score of 0 or 1 with ≥ 2 grade improvement from baseline.
VC Period: Change from baseline (pre-study cream application) in current Itch NRS score at 5, 15, 30, 45, and 60 minutes and 2, 4, and 6 hours post-initial dose on Day 1. Baseline to Day 1 VC and VCE Periods: Proportion of participants achieving both EASI75 and IGA-TS Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 Defined as ≥ 75% improvement in Eczema Area and Severity Index (EASI) score and IGA score of 0 or 1 with ≥ 2 grade improvement from baseline.
VCE Period: Time to open-label escape arm Baseline to Week 24 Defined as not achieving 50% improvement in EASI score from baseline at 2 consecutive visits at least 1 week apart.
VC Period: Proportion of participants with a ≥ 4-point improvement in Itch Numeric Rating Scale (NRS) score (ITCH4) Baseline to Weeks 2 and 4 ITCH4 is defined as achieving ≥ 4-point improvement in Itch NRS score.
VC Period: Proportion of participants who achieved Eczema Area and Severity Index 75 (EASI75) Baseline to Weeks 2 and 4 Defined as ≥ 75% improvement in Eczema Area and Severity Index (EASI) score.
VC Period: Time to achieve ≥ 2-point improvement from in Itch Numeric Rating Scale (NRS) score (ITCH2) Baseline to Week 8 ITCH2 is defined as achieving ≥ 2-point improvement from baseline in Itch NRS score.
VC Period: Proportion of participants achieving at least a 2-point decrease from baseline in current Itch NRS score at 5, 15, 30, 45, and 60 minutes and 2, 4, and 6 hours post-initial dose on Day 1. Baseline to Day 1 VC and VCE Periods: Change from baseline in EASI score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 A negative change from Baseline indicates improvement.
VC and VCE Periods: Change from baseline in Skin Pain NRS score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The Skin Pain NRS is a daily participant-reported measure (24-hour or 7-day recall) of the worst level of pain intensity from 0 (no pain) to 10 (worst pain imaginable.
VC and VCE Periods: Change From Baseline in Patient-Oriented Eczema Measure (POEM) Score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The POEM is a 7-question quality-of-life assessment that asks how many days the participant has been bothered by various aspects of their skin condition during the past 7 days. A negative change from Baseline indicates improvement.
VC and VCE Period: Change From Baseline in PROMIS Short Form - Sleep Disturbance (8b) 7-Day Recall Score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The PROMIS Short Form - Sleep Disturbance (8b) questionnaire assesses participant's self-reported perceptions of sleep quality, sleep depth, and restoration associated with sleep. This questionnaire is completed in the morning by the participant where each item asks the participant to rate the severity of the participant's sleep disturbance. It is a 5-point scale with a range in score from 8 to 40, with higher scores indicating greater severity of sleep disturbance. A negative change from Baseline indicates improvement.
VC Period: Number of Treatment Emergent Adverse Events (TEAEs) Up to Week 24, followed by 30 days follow-up An AE is any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug-related. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study treatment. A SAE is defined as any untoward medical occurrence that, at any dose results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect or an important medical event may be considered serious when, based on appropriate medical judgment, the event may jeopardize the participant and may require medical or surgical intervention to prevent one of the outcomes listed above. A TEAE or treatment emergent SAE is any AE or SAE either reported for first time or worsening of a pre-existing event after first dose of study drug.
VC and VCE Periods: Proportion of participants who achieved EASI90 Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 Defined as ≥ 90% improvement in Eczema Area and Severity Index (EASI) score.
VC and VCE Periods: Change from Baseline in Atopic Dermatitis Afflicted Percentage of Body Surface Area (%BSA) Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 A negative change from Baseline indicates improvement.
VC and VCE Periods: Change from baseline in Itch NRS score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The Itch NRS is an instrument for measurement of itch intensity and participant will rate the intensity of their itch on an 11-point scale ranging from 0 (no itch) to 10 (worst itch imaginable).
VC and VCE Periods: Proportion of participants concurrently meeting all of the following criteria: IGA score ≥ 3, EASI score ≥ 16, Itch NRS score ≥ 4, BSA ≥ 10%, and DLQI score > 10 Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 VC and VCE Periods: Proportion of participants who achieve ≥ 4-point improvement in DLQI from baseline Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The DLQI is a 10-question validated questionnaire to measure how much the skin problem has affected the participant over the previous 7 days. The participant will answer the questionnaire with either (1) very much, (2) a lot, (3) a little, or (4) not at all. A negative change from Baseline indicates less impact of the skin problem on participant's life.
VC and VCE Periods: Change From Baseline in EuroQuality of Life Five Dimensions (EQ-5D-5L) Visual Analogue Scale (VAS) Score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 he EQ-5D-5L questionnaire is a standardized, validated instrument for use as a measure of health outcome. The descriptive system comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: Level 1 = no problems, Level 2 = slight problems, Level 3 = moderate problems, Level 4 = severe problems, and Level 5 = extreme problems.
VC and VCE Periods: Proportion of participants who achieved EASI50 Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 Defined as ≥ 50% improvement in Eczema Area and Severity Index (EASI) score.
VC and VCE Periods: Change from baseline in the HADS scores Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The Hospital Anxiety and Depression Scale (HADS) is a 14-item questionnaire to be completed by tablet; the questionnaire assesses the levels of anxiety and depression a person is currently experiencing. There are 7 questions each for measuring anxiety and for measuring depression, with 4 possible responses to each question (responses are scored as 0, 1, 2, or 3). Separate scores are calculated for anxiety and depression. The recall period will be the past 7 days for both the VC and VCE periods.
VCE Period: Proportion of time off study treatment due to lesion clearance Week 8 to Week 24 VCE period: Proportion of time on study treatment Week 8 to Week 24 VC and VCE Periods: Change From Baseline in Dermatology Life Quality Index (DLQI) Score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The DLQI is a 10-question validated questionnaire to measure how much the skin problem has affected the participant over the previous 7 days. The participant will answer the questionnaire with either (1) very much, (2) a lot, (3) a little, or (4) not at all. A negative change from Baseline indicates less impact of the skin problem on participant's life.
VC and VCE Periods: Change from baseline score in Work Productivity and Activity Impairment - Atopic Dermatitis (WPAI-AD) Baseline to Week 8 and Week 24 The WPAI-AD questionnaire is a validated 6-item instrument that measures the effect of overall health and specific symptoms on productivity at work and regular activities outside of it during the past 7 days.
VC and VCE Periods: Change from baseline in PROMIS Short Form - Sleep-Related Impairment (8a) 24-Hour Recall Score Baseline to Weeks 2, 4, 8, 12, 16, 20 and 24 The Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form - Sleep-Related Impairment (8a) questionnaire assesses participant's self-reported perceptions of alertness, sleepiness, and tiredness during usual waking hours and the perceived functional impairments during wakefulness associated with sleep problems or impaired alertness. The questionnaire is filled in the evening where each item asks the participant to rate the severity of the participant's sleep impairment. It has 8 simple questions with a 5-point scale with a range in score from 8 to 40, with higher scores indicating greater severity of sleep-related impairment. A negative change from Baseline indicates improvement.
Trial Locations
- Locations (101)
Irccs Istituto Clinico Humanitas
🇮🇹Rozzano, Italy
Chu de Rouen - Hospital Charles Nicolle
🇫🇷Rouen, France
Universitatsklinikum Munster
🇩🇪Muenster, Germany
Dermatologie Potsdam Mvz Gmbh
🇩🇪Potsdam, Germany
Clinexpert Kft.
🇭🇺Budapest, Hungary
Semmelweis Egyetem
🇭🇺Budapest, Hungary
Dermmedica Sp. Z O.O.
🇵🇱Wrocław, Poland
Universitatsspital Basel
🇨🇭Basel, Switzerland
Bristol Royal Infirmary
🇬🇧Bristol, United Kingdom
Medderm Associates, Inc
🇺🇸San Diego, California, United States
Arlington Dermatology
🇺🇸Rolling Meadows, Illinois, United States
Best Skin Research
🇺🇸Camp Hill, Pennsylvania, United States
International Clinical Research Tennessee Llc
🇺🇸Murfreesboro, Tennessee, United States
Cliniques Universitaires Ucl Saint-Luc
🇧🇪Brussels, Belgium
Ulb Hospital Erasme
🇧🇪Bruxelles, Belgium
Mhat Dr. Tota Venkova Ad
🇧🇬Gabrovo, Bulgaria
Dcc 'Alexandrovska', Eood
🇧🇬Sofia, Bulgaria
Diagnostic Consultative Center Xxviii
🇧🇬Sofia, Bulgaria
Skin Centre For Dermatology
🇨🇦Peterborough, Ontario, Canada
Lynn Institute of the Ozarks
🇺🇸Little Rock, Arkansas, United States
Center For Dermatology Cosmetic and Laser Surgery
🇺🇸Fremont, California, United States
Encore Medical Research, Llc Hollywood
🇺🇸Hollywood, Florida, United States
Revival Research Institute, Llc Troy
🇺🇸Troy, Michigan, United States
Ohio State University-Wexner Medical Center
🇺🇸Gahanna, Ohio, United States
Premier Specialists Pty Ltd
🇦🇺Kogarah, New South Wales, Australia
Australian Clinical Research Network
🇦🇺Maroubra, New South Wales, Australia
Veracity Clinical Research
🇦🇺Woolloongabba, Queensland, Australia
Clinical Trials Sa
🇦🇺Campbelltown, South Australia, Australia
Skin Health Institute Inc.
🇦🇺Carlton, Victoria, Australia
Dermatologie Handelskaai
🇧🇪Kortrijk, Belgium
Medical Center Medconsult Pleven Ood
🇧🇬Pleven, Bulgaria
Ambulatory For Specialized Medical Help - Skin and Venereal Diseases
🇧🇬Sofia, Bulgaria
Lynderm Research Inc
🇨🇦Markham, Ontario, Canada
North Sound Dermatology
🇺🇸Mill Creek, Washington, United States
First Oc Dermatology
🇺🇸Fountain Valley, California, United States
Center For Clinical Studies Webster
🇺🇸Houston, Texas, United States
Rainey and Finklea Dermatology
🇺🇸San Antonio, Texas, United States
Grand Hopital de Charleroi
🇧🇪Gilly, Belgium
Medical Center Assoc. Prof. Vasilev
🇧🇬Sofia, Bulgaria
Wiseman Dermatology Research Inc
🇨🇦Winnipeg, Manitoba, Canada
Entrust Clinical Research
🇺🇸Miami, Florida, United States
Paratus Clinical Research, Woden
🇦🇺Phillip, Australia
Universitair Ziekenhuis Gent (Uz Gent)
🇧🇪Gent, Belgium
Dcc 'Sveti Georgi' Eood
🇧🇬Haskovo, Bulgaria
Medical Center Hera Eood
🇧🇬Sofia, Bulgaria
Dermatology Research Institute Inc.
🇨🇦Calgary, Alberta, Canada
Lane Dermatology and Dermatologic Surgery
🇺🇸Columbus, Georgia, United States
Marietta Dermatology the Skin Cancer Center Marietta
🇺🇸Marietta, Georgia, United States
Northshore University Healthsystem
🇺🇸Skokie, Illinois, United States
Oakland Hills Dermatology Pc
🇺🇸Auburn Hills, Michigan, United States
Texas Dermatology Research Center
🇺🇸Plano, Texas, United States
Universitair Ziekenhuis Antwerpen (Uza)
🇧🇪Edegem, Belgium
Dr. Chih-Ho Hong Medical Inc.
🇨🇦Surrey, British Columbia, Canada
Dr. Irina Turchin Pc Inc.
🇨🇦Fredericton, New Brunswick, Canada
Centre de Recherche Dermatologique Du Quebec Metropolitain
🇨🇦Quebec, Canada
Skincare Studio Dermatology Centre
🇨🇦St. John's, Canada
Centre Hospitalier Du Mans
🇫🇷Le Mans Cedex, France
Ghicl - Hôpital Saint-Vincent de Paul
🇫🇷Lille Cedex, France
Chru de Lille Hopital Claude Huriez
🇫🇷Lille Cedex, France
Centre Hospitalier Universitaire de Nantes (Chu de Nantes) - Hotel-Dieu
🇫🇷Nantes, France
Hospices Civils de Lyon Centre Hospitalier Lyon Sud
🇫🇷Pierre Bénite Cedex, France
University Hospital of Saint Etienne
🇫🇷Saint Etienne Cedex 2, France
Universitaetsklinikum Augsburg Sued
🇩🇪Augsburg, Germany
Fachklinik Bad Bentheim Dermatologie
🇩🇪Bad Bentheim, Germany
Praxis Fuer Haut- Und Geschlechtskrankheiten Dr. Med. Thomas Wildfeuer Und Partner
🇩🇪Berlin, Germany
Obudai Egeszsegugyi Centrum Kft.
🇭🇺Budapest, Hungary
Szegedi Tudomanyegyetem Aok Szent-Gyorgyi Albert Klinikai Kozpont
🇭🇺Szeged, Hungary
Fondazione Irccs Ca Granda Ospedale Maggiore
🇮🇹Milano, Italy
Debreceni Egyetem Klinikai Kozpon Belgyogy Klinika
🇭🇺Debrecen, Hungary
Azienda Ospedaliera Universitaria Federico Ii
🇮🇹Napoli, Italy
Universita Degli Studi Della Campania Luigi Vanvitelli
🇮🇹Napoli, Italy
Fondazione Policlinico Universitario Agostino Gemelli Irccs
🇮🇹Rome, Italy
Konkuk University Medical Center
🇰🇷Seoul, Korea, Republic of
Bravis Ziekenhuis
🇳🇱Bergen Op Zoom, Netherlands
Amphia Ziekenhuis, Molengracht
🇳🇱Breda, Netherlands
Universitair Medisch Centrum Groningen
🇳🇱Groningen, Netherlands
Centrum Badan Klinicznych Pi-House Sp. Z O.O.
🇵🇱Gdansk, Poland
Centrum Medyczne Pratia Katowice
🇵🇱Katowice, Poland
Centrum Medyczne All-Med
🇵🇱Krakow, Poland
Pratia McM Krakow
🇵🇱Kraków, Poland
Santa Sp. Z O.O. Santa Familia Ptg Lodz
🇵🇱Lodz, Poland
Etg Lublin
🇵🇱Lublin, Poland
Dermedic Dr. Zdybski
🇵🇱Ostrowiec Swietokrzyski, Poland
Solumed Centrum Medyczne
🇵🇱Poznan, Poland
Twoja Przychodnia - Szczecinskie Centrum Medyczne
🇵🇱Szczecin, Poland
Centrum Medyczne Evimed
🇵🇱Warszawa, Poland
Klinika Ambroziak Dermatologia
🇵🇱Warszawa, Poland
Ceim Hospital Universitari Germans Trias I Pujol
🇪🇸Badalona, Spain
Hospital de La Santa Creu I Sant Pau
🇪🇸Barcelona, Spain
Hospital Infanta Leonor
🇪🇸Madrid, Spain
Hospital Universitario de La Paz
🇪🇸Madrid, Spain
Hospital de Manises
🇪🇸Manises, Spain
Hospital Marina Baixa
🇪🇸Villajoyosa, Spain
Inselspital Universitatsklinik Fur Medizinische Onkologie
🇨🇭Bern, Switzerland
Dermatology & Skin Care Clinic
🇨🇭Buochs, Switzerland
Universitatsspital Zurich
🇨🇭Zuerich, Switzerland
West Middlesex University Hospital
🇬🇧Isleworth, United Kingdom
Guys Hospital
🇬🇧London, United Kingdom
Northampton General Hospital
🇬🇧Northampton, United Kingdom
University Hospital Plymouth
🇬🇧Plymouth, United Kingdom
Walsall Manor Hospital
🇬🇧Walsall, United Kingdom