A Phase 3 Study to Compare Upadacitinib to Abatacept in Subjects With Rheumatoid Arthritis on Stable Dose of Conventional Synthetic Disease- Modifying Antirheumatic Drugs (csDMARDs) Who Have an Inadequate Response or Intolerance to Biologic DMARDs
- Conditions
- Rheumatoid Arthritis (RA)
- Interventions
- Registration Number
- NCT03086343
- Lead Sponsor
- AbbVie
- Brief Summary
The study objective of Period 1 was to compare the safety and efficacy of upadacitinib 15 mg once daily (QD) to abatacept on a background of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) for the treatment of signs and symptoms of rheumatoid arthritis (RA) in biologic disease-modifying antirheumatic drug (bDMARD)-inadequate response or bDMARD-intolerant participants with moderately to severely active RA. The study objective of Period 2 is to evaluate the long-term safety, tolerability, and efficacy of upadacitinib 15 mg QD in participants with RA who had completed Period 1.
- Detailed Description
This is a Phase 3 multicenter study with 2 periods. Period 1 was a 24-week, randomized, double-blind, parallel-group, active-controlled period designed to compare the safety and efficacy of upadacitinib 15 mg and abatacept for the treatment of signs and symptoms of participants with moderately to severely active RA who had an inadequate response to or intolerance to bDMARD therapy and were currently on a stable dose of csDMARD(s) and had never received abatacept. Period 2 is an open-label, long-term extension study to evaluate the long-term safety, tolerability, and efficacy of upadacitinib 15 mg once a day (QD) in participants with RA who had completed Period 1.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 657
- Diagnosis of rheumatoid arthritis (RA) for ≥ 3 months who also fulfill the 2010 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) classification criteria for RA
- Participants have been treated for ≥ 3 months prior to the screening visit with ≥ 1 bDMARD therapy, but continue to exhibit active RA or had to discontinue due to intolerability or toxicity, irrespective of treatment duration and have never received abatacept prior to the first dose of study drug
- Participants have been receiving csDMARD therapy ≥ 3 months and on a stable dose for ≥ 4 weeks prior to the first dose of study drug. The following csDMARDs are allowed: methotrexate (MTX), sulfasalazine, hydroxychloroquine, chloroquine, and leflunomide. A combination of up to two background csDMARDs is allowed except the combination of MTX and leflunomide
- Meets the following criteria: ≥ 6 swollen joints (based on 66 joint counts) and ≥ 6 tender joints (based on 68 joint counts) at Screening and Baseline Visits and high-sensitivity C-reactive protein (hsCRP) ≥ 3 mg/L at Screening
Main
- Prior exposure to any Janus kinase (JAK) inhibitor (including but not limited to upadacitinib, tofacitinib, baricitinib and filgotinib)
- Prior exposure to abatacept
- History of any arthritis with onset prior to age 17 years or current diagnosis of inflammatory joint disease other than RA. Current diagnosis of secondary Sjogren's Syndrome is permitted
- Laboratory values meeting the following criteria within the Screening period prior to the first dose of study drug: serum aspartate transaminase > 2 × upper limit of normal (ULN); serum alanine transaminase > 2 × ULN; estimated glomerular filtration rate by simplified 4-variable Modification of Diet in Renal Disease formula < 40 mL/minute/1.73 meter (m)^2; total white blood cell count < 2,500/ μL; absolute neutrophil count < 1,500/μL; platelet count < 100,000/μL; absolute lymphocyte count < 800/μL; and hemoglobin < 10 g/dL
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Primary Cohort: Abatacept/Upadacitinib 15 mg QD Placebo for upadacitinib Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 15 mg QD for 192 weeks. Primary Cohort: Upadacitinib 15 mg QD/Upadacitinib 15 mg QD Placebo for abatacept (0.9% Sodium Chloride Injection or Solution for Infusion) Period 1: One 15 mg upadacitinib oral tablet QD for 24 weeks. Period 2: open label upadacitinib 15 mg QD for 192 weeks. 30 mg Cohort: Upadacitinib 30 mg QD/Upadacitinib 30 mg QD Placebo for abatacept (0.9% Sodium Chloride Injection or Solution for Infusion) Period 1: One upadacitinib 30 mg oral tablet QD for 24 weeks. Period 2: open label upadacitinib 30 mg (reduced to 15 mg per Amendment 5) QD for 192 weeks. 30 mg Cohort: Abatacept/Upadacitinib 30 mg QD Placebo for upadacitinib Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 30 mg (reduced to 15 mg per Amendment 5) QD for 192 weeks. Primary Cohort: Abatacept/Upadacitinib 15 mg QD Abatacept Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 15 mg QD for 192 weeks. Primary Cohort: Abatacept/Upadacitinib 15 mg QD Upadacitinib Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 15 mg QD for 192 weeks. 30 mg Cohort: Upadacitinib 30 mg QD/Upadacitinib 30 mg QD Upadacitinib Period 1: One upadacitinib 30 mg oral tablet QD for 24 weeks. Period 2: open label upadacitinib 30 mg (reduced to 15 mg per Amendment 5) QD for 192 weeks. Primary Cohort: Upadacitinib 15 mg QD/Upadacitinib 15 mg QD Upadacitinib Period 1: One 15 mg upadacitinib oral tablet QD for 24 weeks. Period 2: open label upadacitinib 15 mg QD for 192 weeks. 30 mg Cohort: Abatacept/Upadacitinib 30 mg QD Abatacept Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 30 mg (reduced to 15 mg per Amendment 5) QD for 192 weeks. 30 mg Cohort: Abatacept/Upadacitinib 30 mg QD Upadacitinib Period 1: 500 mg (for body weight \<60 kg); 750 mg (for body weight 60-100 kg); and 1000 mg (for body weight \>100 kg) IV infusion at Baseline, Week 2, Week 4, Week 8, Week 12, Week 16 and Week 20. Period 2: open label upadacitinib 30 mg (reduced to 15 mg per Amendment 5) QD for 192 weeks.
- Primary Outcome Measures
Name Time Method Change From Baseline in Disease Activity Score (DAS) 28 C-Reactive Protein (CRP) at Week 12 (Non-inferiority) Baseline and Week 12 The Disease Activity Score (DAS) 28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A negative change from Baseline indicates improvement in disease activity.
- Secondary Outcome Measures
Name Time Method Change From Baseline in Disease Activity Score (DAS) 28 C-Reactive Protein (CRP) at Week 12 (Superiority) Baseline and Week 12 The Disease Activity Score (DAS) 28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A negative change from Baseline indicates improvement in disease activity.
Percentage of Participants Achieving Clinical Remission (CR) Based on Disease Activity Score (DAS) 28 C-Reactive Protein (CRP) at Week 12 (Superiority) At Week 12 The Disease Activity Score (DAS) 28 is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (0-100 mm), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28 range from 0 to approximately 10, where higher scores indicate more disease activity. A DAS 28 score less than 2.6 indicates clinical remission.
Trial Locations
- Locations (161)
SunValley Arthritis Center, Lt /ID# 154558
🇺🇸Peoria, Arizona, United States
AZ Arthritis & Rheum Research /ID# 156539
🇺🇸Sun City, Arizona, United States
CHI St. Vincent Medical Group /ID# 154561
🇺🇸Hot Springs, Arkansas, United States
Saint Jude Heritage /ID# 158833
🇺🇸Fullerton, California, United States
Arthritis and Rheum Clin N. CO /ID# 155673
🇺🇸Fort Collins, Colorado, United States
Kotha and Kotha /ID# 154573
🇺🇸La Mesa, California, United States
Scientia Medical Research /ID# 159189
🇺🇸Lakewood, Colorado, United States
Advanced Clin Res of Orlando /ID# 154580
🇺🇸Ocoee, Florida, United States
Clinical Res of West FL, Inc. /ID# 154576
🇺🇸Clearwater, Florida, United States
Jefrey D. Lieberman, MD, P.C. /ID# 157178
🇺🇸Decatur, Georgia, United States
Lovelace Scientific Resources /ID# 154600
🇺🇸Venice, Florida, United States
Gulf Region Clinical Res Inst /ID# 154597
🇺🇸Pensacola, Florida, United States
W. Broward Rheum Assoc Inc. /ID# 158835
🇺🇸Tamarac, Florida, United States
PMG Research of Christie Clini /ID# 154569
🇺🇸Champaign, Illinois, United States
Four Rivers Clinical Research /ID# 154606
🇺🇸Paducah, Kentucky, United States
Advanced Rheumatology, PC /ID# 154589
🇺🇸Lansing, Michigan, United States
The Center for Rheumatology & Bone Research /ID# 158723
🇺🇸Wheaton, Maryland, United States
West Michigan Rheumatology /ID# 154551
🇺🇸Grand Rapids, Michigan, United States
Clinvest Research LLC /ID# 154554
🇺🇸Springfield, Missouri, United States
Ocean Rheumatology, PA /ID# 162980
🇺🇸Toms River, New Jersey, United States
Arthritis and Osteo Assoc /ID# 154560
🇺🇸Las Cruces, New Mexico, United States
Atlantic Coast Research /ID# 155234
🇺🇸Toms River, New Jersey, United States
The Center for Rheumatology /ID# 162979
🇺🇸Albany, New York, United States
NYU Langone Rheum Assoc /ID# 155236
🇺🇸Lake Success, New York, United States
NYU Langone Medical Center /ID# 158829
🇺🇸New York, New York, United States
PMG Research of Salisbury /ID# 154605
🇺🇸Salisbury, North Carolina, United States
Physicians East, PA /ID# 154565
🇺🇸Greenville, North Carolina, United States
PMG Research of Wilmington LLC /ID# 154584
🇺🇸Wilmington, North Carolina, United States
University of Pittsburgh MC /ID# 157434
🇺🇸Pittsburgh, Pennsylvania, United States
East Penn Rheumatology Assoc /ID# 159193
🇺🇸Bethlehem, Pennsylvania, United States
Altoona Ctr Clinical Res /ID# 154572
🇺🇸Duncansville, Pennsylvania, United States
West Tennessee Research Inst /ID# 158721
🇺🇸Jackson, Tennessee, United States
Adriana Pop-Moody MD Clinic PA /ID# 154607
🇺🇸Corpus Christi, Texas, United States
P&I Clinical Research /ID# 159191
🇺🇸Lufkin, Texas, United States
DM Clinical Research /ID# 158722
🇺🇸Tomball, Texas, United States
Aprillus Asistencia e Investig /ID# 159173
🇦🇷Capital Federal, Buenos Aires, Argentina
Atencion Integral en Reuma /ID# 155696
🇦🇷Buenos Aires, Argentina
Ctr Privado Med Familiar /ID# 158814
🇦🇷Buenos Aires, Argentina
Hospital General de Agudos /ID# 167117
🇦🇷Buenos Aires, Argentina
Inst. de Rehab. Psicofisica /ID# 167768
🇦🇷Caba, Argentina
Inst. Rheumatologic Strusberg /ID# 159021
🇦🇷Cordoba, Argentina
Instituto Medico DAMIC /ID# 167770
🇦🇷Cordoba, Argentina
Instituto CAICI SRL /ID# 159022
🇦🇷Rosario, Santa FE, Argentina
Rheumatology Research Unit /ID# 159174
🇦🇺Maroochydore, Queensland, Australia
The Queen Elizabeth Hospital /ID# 159175
🇦🇺Woodville, South Australia, Australia
Western Health Footscray Hospi /ID# 157968
🇦🇺Footscray, Victoria, Australia
Ceti - Centro de Estudos Em Terapias Inovadoras Ltda /Id# 154634
🇧🇷Curitiba, Parana, Brazil
MHAT Trimontsium /ID# 155226
🇧🇬Plovdiv, Bulgaria
CEPIC - Centro Paulista de Investigação Clínica e Serviços Médicos Ltda /ID# 159587
🇧🇷São Paulo, Sao Paulo, Brazil
Diag Consult Ctr 17 Sofia EOOD /ID# 169298
🇧🇬Sofia, Bulgaria
UMHAT Sv. Ivan Rilski /ID# 155000
🇧🇬Sofia, Bulgaria
Medical Centre Synexus Sofia /ID# 201807
🇧🇬Sofia, Bulgaria
The Waterside Clinic /ID# 159178
🇨🇦Barrie, Ontario, Canada
Medical Plus, s.r.o. /ID# 155230
🇨🇿Uherské Hradište, Czechia
Adachi Medicine Prof. Corp /ID# 158024
🇨🇦Hamilton, Ontario, Canada
Revmatologicky ustav Praha /ID# 154612
🇨🇿Prague 2, Praha 2, Czechia
Uniklinik Koln /ID# 156047
🇩🇪Köln, Nordrhein-Westfalen, Germany
Rheumaforschungszentrum II /ID# 157177
🇩🇪Hamburg, Germany
Praxis fuer Rheumatologie /ID# 156156
🇩🇪Berlin, Germany
Welcker, Planegg, DE /ID# 160185
🇩🇪Planegg, Germany
University General Hospital of Heraklion "PA.G.N.I" /ID# 163916
🇬🇷Heraklion, Greece
Budai Irgalmasrendi Korhaz /ID# 154457
🇭🇺Budapest, Hungary
Debreceni Egyetem Kenezy Gyula Egyetemi Korhaz /ID# 159183
🇭🇺Debrecen, Hungary
Obudai Egeszsegugyi Centrum Kft. /ID# 156159
🇭🇺Budapest, Hungary
Markhot Ferenc Oktatokorhaz es Rendelointezet /ID# 159689
🇭🇺Eger, Hungary
MAV Korhaz ess Rendelointezet /ID# 154455
🇭🇺Szolnok, Hungary
Our Lady's Hospital /ID# 161149
🇮🇪Manorhamilton, Ireland
The Lady Davis Carmel MC /ID# 161686
🇮🇱Haifa, Israel
Sheba Medical Center /ID# 163154
🇮🇱Ramat Gan, Israel
Meir Medical Center /ID# 162774
🇮🇱Kfar Saba, Israel
Istituto Clinico Humanitas /ID# 154999
🇮🇹Rozzano, Milano, Italy
SMG-SNU Boramae Medical Center /ID# 155788
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Asan Medical Center /ID# 154639
🇰🇷Seoul, Korea, Republic of
Riga East Clinical Univ Hosp /ID# 155024
🇱🇻Riga, Latvia
Morales Vargas Centro de Investigacion S.C. /ID# 200800
🇲🇽Leon, Guanajuato, Mexico
Centro Integral en Reumatología S.A de C.V /ID# 204493
🇲🇽Guadalajara, Jalisco, Mexico
Medisch Centrum Leeuwarden /ID# 156043
🇳🇱Leeuwarden, Netherlands
Wellington Hospital (Capital and Coast District Health Board) /ID# 154591
🇳🇿Wellington, New Zealand
Spaarne Gasthuis /ID# 161003
🇳🇱Haarlem, Netherlands
Timaru Medical Specialists Ltd /ID# 159184
🇳🇿Timaru, New Zealand
ClinicMed Daniluk, Nowak Sp.j. /ID# 202998
🇵🇱Białystok, Podlaskie, Poland
Synexus Polska Sp. z o.o. Oddzial w Gdyni /ID# 202472
🇵🇱Gdynia, Pomorskie, Poland
Medyczne Centrum Hetmanska /ID# 155746
🇵🇱Poznań, Wielkopolskie, Poland
Instituto Portugues De Reumatologia /ID# 155698
🇵🇹Lisbon, Lisboa, Portugal
Centrum Med Amed Oddzial Lodzi /ID# 154458
🇵🇱Lodz, Poland
Centro Hospitalar Lisboa Ocidental, EPE /ID# 200035
🇵🇹Lisbon, Lisboa, Portugal
Hospital Garcia de Orta, E.P.E /ID# 164056
🇵🇹Almada, Setubal, Portugal
Centro Hospitalar Lisboa Norte, EPE /ID# 200037
🇵🇹Lisboa, Portugal
Unidade Local De Saude Do Alto Minho /ID# 200036
🇵🇹Viana Do Castelo, Portugal
Centro Hosp de Tondela-Viseu /ID# 155699
🇵🇹Viseu, Portugal
GCM Medical Group /ID# 156158
🇵🇷San Juan, Puerto Rico
Dr. Ramon L. Ortega-Colon, MD /ID# 158097
🇵🇷Carolina, Puerto Rico
Spitalul Clinic Dr. I. Cantacuzino /ID# 155893
🇷🇴Bucharest, Bucuresti, Romania
Family Outpatient clinic#4 LLC /ID# 203524
🇷🇺Korolev, Moskva, Russian Federation
State Budget Healthcare Instit /ID# 154593
🇷🇺Moscow, Russian Federation
LLC Medical Center /ID# 203523
🇷🇺Novosibirsk, Novosibirskaya Oblast, Russian Federation
Novamed,spol.s.r.o. /ID# 157928
🇸🇰Banska Bystrica, Slovakia
Univerzitna Nemocnica Bratislava /ID# 161143
🇸🇰Bratislava, Slovakia
Hospital Universitario Reina S /ID# 155701
🇪🇸Cordoba, Spain
Narodny ustav reumatickych chorob Piestany /ID# 156864
🇸🇰Pieštany, Slovakia
Hospital General Univ de Elche /ID# 158825
🇪🇸Elche, Spain
Hospital Universitario La Paz /ID# 163636
🇪🇸Madrid, Spain
Corp Sanitaria Parc Tauli /ID# 163634
🇪🇸Sabadell, Barcelona, Spain
Hospital Infanta Luisa /ID# 154641
🇪🇸Sevilla, Spain
Complejo Hospitalario /ID# 155700
🇪🇸Santiago de Compostela, Spain
Skanes Universitetssjukhus /ID# 165133
🇸🇪Malmö, Skane Lan, Sweden
Sahlgrenska University Hosp /ID# 162775
🇸🇪Goteborg, Sweden
Vastmanlands Sjukhus /ID# 159186
🇸🇪Vasteras, Sweden
University Hospital of Basel /ID# 160860
🇨🇭Basel, Switzerland
Ankara Univ Medical Faculty /ID# 162691
🇹🇷Ankara, Turkey
Akdeniz University Faculty /ID# 163153
🇹🇷Antalya, Turkey
Istanbul Fizik Tedavi Rehabilitasyon Egitim ve Arastırma Hastanesi /ID# 169479
🇹🇷Istanbul, Turkey
Ninewells Hospital /ID# 156050
🇬🇧Dundee, United Kingdom
Lancashire Care NHS Foundation /ID# 156042
🇬🇧Preston, United Kingdom
Royal Cornwall Hospital /ID# 157785
🇬🇧Truro, United Kingdom
Altnagelvin Area Hospital /ID# 156540
🇬🇧Londonderry, United Kingdom
CMiP - Centro Mineiro de Pesquisa Ltda - ME /ID# 154564
🇧🇷Juiz de Fora, Minas Gerais, Brazil
LMK Sevicos Medicos S/S /ID# 159176
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Hospital de Clinicas de Porto Alegre /ID# 161211
🇧🇷Porto Alegre, Rio Grande Do Sul, Brazil
Santa Casa de Belo Horizonte /ID# 154631
🇧🇷Belo Horizonte, Minas Gerais, Brazil
Ochsner Clinic Foundation /ID# 154585
🇺🇸Baton Rouge, Louisiana, United States
Advanced Clinical Research /ID# 154603
🇺🇸Meridian, Idaho, United States
AZ Arth & Rheum Res /ID# 167161
🇺🇸Tucson, Arizona, United States
DIM Clinica Privada /ID# 167769
🇦🇷Ramos Mejía, Argentina
CHU UCL Namur /ID# 157628
🇧🇪Namur, Belgium
Centro Especializado en Diabetes, Obesidad y Prevención de Enfermedades Cardiova /ID# 160126
🇲🇽Mexico City, Mexico
Overlook Medical Center /ID# 154794
🇺🇸Summit, New Jersey, United States
A.O. Univ. Ospedali Riuniti /ID# 161707
🇮🇹Ancona, Marche, Italy
Spitalul Clinic Sf. Maria /ID# 167245
🇷🇴Bucuresti, Romania
Institut de Rhum. de Montreal /ID# 155001
🇨🇦Montreal, Quebec, Canada
Barzilai Medical Center /ID# 161685
🇮🇱Ashkelon, Israel
D.Saulites-Kandevicas PP /ID# 154578
🇱🇻Liepaja, Latvia
CINTRE, Centro de Investigación y Tratamiento Reumatológico SC /ID# 154579
🇲🇽Mexico City, Ciudad De Mexico, Mexico
RM Pharma Specialists S.A de C.V /ID# 159588
🇲🇽Mexico City, Mexico
Salve Medica Sp. z o.o. S.K. /ID# 202473
🇵🇱Lodz, Lodzkie, Poland
Kantonsspital St. Gallen /ID# 155232
🇨🇭St. Gallen, Sankt Gallen, Switzerland
Groupe de Recherche en Maladies Osseuses /ID# 154601
🇨🇦Sainte-foy, Quebec, Canada
Hopitaux Universitaires de Geneve /ID# 159083
🇨🇭Genève, Geneve, Switzerland
HFR Fribourg - Hopital Canton /ID# 160970
🇨🇭Fribourg, Switzerland
Reade /ID# 161002
🇳🇱Amsterdam, Netherlands
Antonius Ziekenhuis /ID# 155737
🇳🇱Sneek, Fryslan, Netherlands
Gabinet Internistyczno Reum. /ID# 157433
🇵🇱Białystok, Podlaskie, Poland
Malopolskie Centrum Kliniczne /ID# 157180
🇵🇱Cracow, Malopolskie, Poland
Centrum Medyczne AMED Warszawa Targowek /ID# 159589
🇵🇱Warszawa, Mazowieckie, Poland
Alliance Biomedical Ural Group /ID# 154609
🇷🇺Izhevsk, Udmurtskaya Respublika, Russian Federation
Nort-Western State Medical Uni /ID# 154610
🇷🇺St. Petersburg, Russian Federation
AOU Citta della Salute Scienza /ID# 154577
🇮🇹Turin, Piemonte, Italy
Presidio Columbus, Fondazione Policlinico Gemelli Universita Cattolica S. Cuore /ID# 162252
🇮🇹Rome, Roma, Italy
Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele /ID# 161172
🇮🇹Catania, Italy
ASST G. Pini /ID# 162223
🇮🇹Milan, Italy
Hacettepe University Medical Faculty /ID# 167995
🇹🇷Ankara, Turkey
Denver Arthritis Clinic /ID# 159195
🇺🇸Denver, Colorado, United States
Oregon Health and Science University /ID# 163822
🇺🇸Portland, Oregon, United States
Care Access Research /ID# 158098
🇺🇸Salt Lake City, Utah, United States
Whipps Cross Univ Hospital /ID# 205985
🇬🇧London, London, City Of, United Kingdom
Akademiskt specialistcentrum Centrum for reumatologi /ID# 156046
🇸🇪Stockholm, Stockholms Lan, Sweden
CEDOES-Centro de Diagnóstico e Pesquisa da Osteoporose do Espírito Santo LTDA /ID# 155228
🇧🇷Vitoria, Espirito Santo, Brazil
CEMEC - Centro Multidisciplinar de Estudos Clínicos /ID# 154632
🇧🇷Santo André, Sao Paulo, Brazil
The Catholic University of Korea, Yeouido St. Mary's Hospital /ID# 155231
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Wake Forest Baptist Medical Center /ID# 154586
🇺🇸Winston-Salem, North Carolina, United States
Bluegrass Community Research /ID# 154604
🇺🇸Lexington, Kentucky, United States