A Study to Evaluate the Efficacy and Safety of Pimodivir in Combination With the Standard-of-Care Treatment in Adolescent, Adult, and Elderly Non-Hospitalized Participants With Influenza A Infection Who Are at Risk of Developing Complications
- Conditions
- Influenza A
- Interventions
- Registration Number
- NCT03381196
- Lead Sponsor
- Janssen Research & Development, LLC
- Brief Summary
The purpose of this study is to evaluate the clinical and virologic benefit of pimodivir in combination with Standard-of-Care (SOC) treatment compared to placebo in combination with SOC treatment.
- Detailed Description
This double-blind (neither researchers nor participants know what treatment participant is receiving) study will evaluate efficacy/safety of pimodivir in combination with SOC treatment versus placebo in combination with SOC treatment in adolescent (13 to 17 years), adult (18 to 65 years), and elderly (greater than \[\>\] 65 but less than or equal to \[\<=\] 85 years) non-hospitalized participants with influenza A infection who are at risk of developing complications. The study will be conducted in 3 phases: screening phase, double-blind treatment period (5 days), a post treatment follow-up period (23 days). Study evaluations include efficacy, clinical and virological outcomes, pharmacokinetics (PK), PK/pharmacodynamics, biomarkers, safety and tolerability. The duration of participation in the study for each participant is 28 days.
Recruitment & Eligibility
- Status
- TERMINATED
- Sex
- All
- Target Recruitment
- 553
- Present to the clinic with symptoms suggestive of a diagnosis of acute influenza and have at least 1 respiratory symptom and at least 1 systemic symptom, both scored as at least "moderate" if the symptom did not pre-exist before influenza onset, or scored worse than usual if the symptom pre-existed as determined by subject's ratings on Module 1 of the Flu-iiQ and the Pre-existing Symptom Questionnaire in the ePRO device. Symptoms must include the following by category: a) Respiratory symptoms: cough, sore throat, nasal congestion b) Systemic symptoms: headache, body aches or pain, feverishness, fatigue
- Tested positive for influenza A infection after the onset of symptoms, using a rapid influenza diagnostic test (RIDT) or, if available, a polymerase chain reaction (PCR)-based or other rapid molecular diagnostic assay
- Not be in need of hospitalized medical care at screening. Emergency room or hospital observation status for an anticipated duration of less than (<)24 hours is not considered hospitalization as long as a determination of the need for hospitalization has not been made
- Enrollment and initiation of study drug treatment less than or equal to (<=)72 hours after onset of influenza symptoms
- Participants 13 to 65 years of age, inclusive must also have at least 1 of the following: a) Cardiovascular or cerebrovascular disease (including congenital heart disease, chronic heart failure, coronary artery disease, or stroke; excluding isolated hypertension); b) Chronic lung disease (for example, asthma, chronic obstructive lung disease [COPD] or cystic fibrosis); c) Weakened immune system due to disease or medication (for example, participants with human immunodeficiency virus [HIV], cancer, or chronic liver or kidney disease [presence of kidney damage for >3 months, defined by structural or functional abnormalities of the kidney, with or without decreased GFR manifested by: pathological abnormalities; OR markers of kidney damage, including abnormalities in the composition of the blood or urine or abnormalities in imaging tests], or participants taking chronic systemic steroids)
- Received more than (>)1 dose of influenza antiviral medication (for example, oseltamivir [OST] or zanamivir), or any dose of ribavirin within 2 weeks, prior to first study drug intake, or received intravenous (IV) peramivir >1 day prior to screening
- Unstable angina pectoris or myocardial infarction within 30 days prior to screening (inclusive)
- Presence of clinically significant heart arrhythmias, uncontrolled, unstable atrial arrhythmia, or sustained ventricular arrhythmia, or risk factors for Torsade de Pointes syndrome
- Known severe hepatic impairment (Child Pugh C cirrhosis) or chronic hepatitis C infection undergoing hepatitis C antiviral therapy
- Severely immunocompromised in the opinion of the investigator (for example, known cluster of differentiation 4 plus [CD4+] count <200 cells per cubic millimeter [cells/mm^3], absolute neutrophil count <750/mm^3, first course of chemotherapy completed within 2 weeks prior to screening, history of stem cell transplant within 1 year prior to screening, history of a lung transplant)
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Treatment Arm 1 (pimodivir + SOC treatment) Pimodivir 600 mg Participants will receive pimodivir 600 milligram (mg), orally, twice daily, for 5 days (on Days 1 through 5; for participants who will receive only 1 dose of pimodivir on Day 1 \[evening\], dosing will continue until the morning of Day 6) along with Standard-of-Care (SOC) treatment. The SOC treatment is determined by the investigator based on local practice, and may include influenza antivirals and/or supportive care only. The choice to use influenza antivirals as part of the SOC should be made before randomization. The influenza antiviral should be started no later than Day 2 morning (up to noon). An influenza antiviral as part of the SOC cannot be changed (for example, switching one influenza antiviral for another) during the treatment period, with the exception that an influenza antiviral may be discontinued in the case of a suspected adverse event (AE). Treatment Arm 1 (pimodivir + SOC treatment) SOC Treatment Participants will receive pimodivir 600 milligram (mg), orally, twice daily, for 5 days (on Days 1 through 5; for participants who will receive only 1 dose of pimodivir on Day 1 \[evening\], dosing will continue until the morning of Day 6) along with Standard-of-Care (SOC) treatment. The SOC treatment is determined by the investigator based on local practice, and may include influenza antivirals and/or supportive care only. The choice to use influenza antivirals as part of the SOC should be made before randomization. The influenza antiviral should be started no later than Day 2 morning (up to noon). An influenza antiviral as part of the SOC cannot be changed (for example, switching one influenza antiviral for another) during the treatment period, with the exception that an influenza antiviral may be discontinued in the case of a suspected adverse event (AE). Treatment Arm 2 (placebo + SOC treatment) Placebo Participants will receive placebo matching to pimodivir orally, twice daily, for 5 days (on Days 1 through 5; for participants who will receive only 1 dose of placebo on Day 1 \[evening\], dosing will continue until the morning of Day 6) along with SOC treatment. The SOC treatment is determined by the investigator based on local practice, and may include influenza antivirals and/or supportive care only. The choice to use influenza antivirals as part of the SOC should be made before randomization. The influenza antiviral should be started no later than Day 2 morning (up to noon). An influenza antiviral as part of the SOC cannot be changed (for example, switching one influenza antiviral for another) during the treatment period, with the exception that an influenza antiviral may be discontinued in the case of a suspected AE. Treatment Arm 2 (placebo + SOC treatment) SOC Treatment Participants will receive placebo matching to pimodivir orally, twice daily, for 5 days (on Days 1 through 5; for participants who will receive only 1 dose of placebo on Day 1 \[evening\], dosing will continue until the morning of Day 6) along with SOC treatment. The SOC treatment is determined by the investigator based on local practice, and may include influenza antivirals and/or supportive care only. The choice to use influenza antivirals as part of the SOC should be made before randomization. The influenza antiviral should be started no later than Day 2 morning (up to noon). An influenza antiviral as part of the SOC cannot be changed (for example, switching one influenza antiviral for another) during the treatment period, with the exception that an influenza antiviral may be discontinued in the case of a suspected AE.
- Primary Outcome Measures
Name Time Method Time to Resolution of 7 Primary Influenza-related Symptoms as Assessed by the Patient-Reported Outcome (PRO) Measure Flu-Intensity and Impact Questionnaire (Flu-iiQ) Up to Day 28 The Flu-iiQ is a PRO that measures influenza symptom intensity (none, mild, moderate, or severe) on a 4 point Likert response rating scale ranging from 0 to 3, where "0" represents the absence of symptom and "3" represents the severe symptom. The resolution of influenza-related symptoms is defined as the beginning of the 24-hour period that 7 influenza symptoms (cough, sore throat, headache, nasal congestion, feeling feverish, body aches and pains, fatigue) are at most mild or at least back to previous level of symptom severity in case the participant reported the symptom as pre-existing.
- Secondary Outcome Measures
Name Time Method Number of Participants Hospitalized After Treatment Initiation Up to Day 28 The number of participants hospitalized after treatment initiation were reported.
Viral Load Over Time Baseline, Day 3, 6, 10, 14 Viral load over time was measured by quantitative real time polymerase chain reaction (qRT-PCR) and viral culture in the mid-turbinate (MT) nasal swabs and endotracheal samples.
Plasma Concentration of Pimodivir Day 3, 6, 7 Plasma concentration of Pimodivir was reported.
Number of Participants With Clinically Significant Changes in Electrocardiogram (ECG) Up to Day 28 Number of participants with clinically significant changes in Electrocardiogram (ECG) were reported.
Number of Participants With Clinically Significant Changes in Vital Signs Up to Day 28 Number of participants with clinically significant changes in vital signs (temperature, pulse rate, respiratory rate and blood pressure) were reported.
Number of Participants With Emergence of Viral Resistance to Pimodivir Up to Day 28 Emergence of viral resistance to pimodivir was detected by genotyping and/or phenotyping. Nasal MT swabs and endotracheal samples were used for sequence analysis of the polymerase basic protein (PB)2 region of the influenza polymerase gene, and of neuraminidase (NA) genes for participants using an NA inhibitor (NAI) as part of their Standard of Care (SOC).
Number of Participants With Adverse Events as a Measure of Safety and Tolerability Up to Day 28 An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Number of Participants With Clinically Significant Changes in Laboratory Tests Up to Day 28 Number of participants with clinically significant changes in laboratory tests were reported. Blood samples for hematology, serum chemistry, and urinalysis was collected at predefined time points for clinical laboratory testing.
Trial Locations
- Locations (421)
Centre Hospitalier Intercommunal de Créteil
🇫🇷Creteil cedex, France
Centre Hospitalier Départemental
🇫🇷La Roche S/ Yon Cedex 9, France
CHU de Grenoble Hopital Albert Michallon
🇫🇷La Tronche, France
CHU Nantes - Hotel Dieu
🇫🇷Nantes Cedex 1, France
Centro de Estudos ClÃnicos do Interior Paulista - CECIP
🇧🇷Jau, Brazil
CMIP - Centro Mineiro de Pesquisa Ltda
🇧🇷Juiz de Fora, Brazil
Botho ke Bontle Health Services
🇿🇦Pretoria, South Africa
Into Research
🇿🇦Pretoria, South Africa
Jongaie Research
🇿🇦Pretoria, South Africa
Queenswood Clinical Trial Centre
🇿🇦Pretoria, South Africa
Engelbrecht, I
🇿🇦Pretoria, South Africa
Johese Clinical Research
🇿🇦Pretoria, South Africa
Wits Clinical Research
🇿🇦Soweto, South Africa
Limpopo Clinical Research Initiative
🇿🇦Thabazimbi, South Africa
Clinteam Vaal Clinical Trial Centre
🇿🇦Van Der Bijl, South Africa
Welkom Clinical Trial Centre
🇿🇦Welkom, South Africa
Hosp. Gral. Univ. de Elche
🇪🇸Elche, Spain
Hosp. Univ. San Cecilio
🇪🇸Granada, Spain
Hosp. Univ. Virgen de Las Nieves
🇪🇸Granada, Spain
Hosp. Univ. de La Princesa
🇪🇸Madrid, Spain
Hosp. Clinico San Carlos
🇪🇸Madrid, Spain
Hosp. Univ. 12 de Octubre
🇪🇸Madrid, Spain
Hosp. Univ. La Paz
🇪🇸Madrid, Spain
Hosp. Univ. Hm Monteprincipe
🇪🇸Madrid, Spain
Hosp. Clinico Univ. de Santiago
🇪🇸Santiago de Compostela, Spain
Hosp. Alvaro Cunqueiro
🇪🇸Vigo, Spain
Department for Heart Failure and Valvular Disease
🇸🇪Malmö, Sweden
City Diabetes
🇸🇪Stockholm, Sweden
Norrlands Universitetssjukhus
🇸🇪Umeå, Sweden
Akademiska Sjukhuset
🇸🇪Uppsala, Sweden
Taipei Medical University Shuang-Ho Hospital
🇨🇳New Taipei City, Taiwan
Kuang Tien General Hospital, Shalu
🇨🇳Taichung, Taiwan
Srinagarind Hospital
🇹ðŸ‡Muang, Thailand
Bamrasnaradura Infectious Disease Institute
🇹ðŸ‡Nonthaburi, Thailand
Northenden Group Practice
🇬🇧Northenden, United Kingdom
Bach Mai Hospital
🇻🇳Hanoi, Vietnam
National Hospital for Tropical Diseases
🇻🇳Hanoi, Vietnam
Nguyen Tri Phuong Hospital
🇻🇳Ho Chi Minh, Vietnam
Kasturba Medical College Hospital
🇮🇳Manipal, India
Suretech Hospital and Research Centre Limited
🇮🇳Nagpur, India
Siddhi Hospital
🇮🇳Nashik, India
BLK Super Specialty Hospital
🇮🇳New Delhi, India
Sir Ganga Ram Hospital
🇮🇳New Delhi, India
Sahyadri Speciality Hospital
🇮🇳Pune, India
Lifepoint Multispecialty Hospital
🇮🇳Pune, India
Hospital of Lithuanian University of Health Sciences Kaunas Clinics
🇱🇹Kaunas, Lithuania
Siriraj Hospital
🇹ðŸ‡Bangkok, Thailand
Bugat Pal Korhaz
ðŸ‡ðŸ‡ºGyongyos, Hungary
Futurenest Klinikai Kutato Kft.
ðŸ‡ðŸ‡ºMiskolc, Hungary
Mohacsi Korhaz
ðŸ‡ðŸ‡ºMohacs, Hungary
Borbanya Praxis Eu. Kft.
ðŸ‡ðŸ‡ºNyiregyhaza, Hungary
Medifarma-98 Kft.
ðŸ‡ðŸ‡ºNyiregyhaza, Hungary
DRC Szentendre
ðŸ‡ðŸ‡ºSzentendre, Hungary
Tudogyogyintezet Torokbalint
ðŸ‡ðŸ‡ºTorokbalint, Hungary
DRC Zamardi
ðŸ‡ðŸ‡ºZamardi, Hungary
DRC Zirc
ðŸ‡ðŸ‡ºZirc, Hungary
Rajiv Gandhi Institute of Medical Sciences
🇮🇳Balaga, India
M S Ramaiah Memorial Hospital
🇮🇳Bangalore, India
S. R. Kalla Memorial General Hospital
🇮🇳Jaipur, India
Midland Healthcare & Research Center
🇮🇳Lucknow, India
Vee Family Doctor's Center OY
🇪🇪Paide, Estonia
OU Innomedica
🇪🇪Tallinn, Estonia
Merelahe Family Doctors Center
🇪🇪Tallinn, Estonia
Pirita Family Doctors Centre
🇪🇪Tallinn, Estonia
Family Doctors Pullerits & Gavronski
🇪🇪Tartu, Estonia
Centre Hospitalier d'Agen
🇫🇷Agen cedex 9, France
S. Boreiko Doctor's Practice
🇱🇻Ogre, Latvia
Children's Clinical University Hospital
🇱🇻Riga, Latvia
Clinic of GP A.Lasmanis 'ALMA'
🇱🇻Riga, Latvia
Health Centre 4
🇱🇻Riga, Latvia
Inese Petrova General Practitioner Practice
🇱🇻Tukums, Latvia
Medical Practice BINI
🇱🇻Ventspils, Latvia
Auki Sveikas
🇱🇹Kaunas, Lithuania
Silainiai Family Health Center, JSC
🇱🇹Kaunas, Lithuania
Saules Seimos Medicinos Centras, JSC
🇱🇹Kaunas, Lithuania
The Hospital for Tropical Diseases
🇹ðŸ‡Bangkok, Thailand
Emmed Research
🇿🇦Pretoria, South Africa
Azienda Socio Sanitaria Territoriale di Monza Presidio San Gerardo
🇮🇹Monza, Italy
Siauliai Republican Hospital, Public Institution
🇱🇹Siauliai, Lithuania
Inlita, JSC, Lazdynai KTC clinical trial site
🇱🇹Vilnius, Lithuania
Central Outpatient Clinic
🇱🇹Vilnius, Lithuania
Inlita, JSC
🇱🇹Vilnius, Lithuania
Vilnius University Hospital Santaros Klinikos, Public Institution
🇱🇹Vilnius, Lithuania
Klinik Kesihatan Cheras Baru
🇲🇾Cheras Baru, Malaysia
Klinik Kesihatan Kuang
🇲🇾Kuang, Malaysia
Hospital Miri
🇲🇾Miri, Malaysia
Hospital Taiping
🇲🇾Taiping, Malaysia
Hospital Cardiologica Aguascalientes
🇲🇽Aguascalientes, Mexico
Hospital Infantil de Mexico Federico Gomez
🇲🇽Ciudad De Mexico, Mexico
Dr AA Mahomed Medical Centre
🇿🇦Moloto, South Africa
Newtown Clinical Research
🇿🇦Newtown, South Africa
Pillay, SR
🇿🇦Ottawa, South Africa
Smartmed Research Centre
🇿🇦Port Elizabeth, South Africa
Private GP Ilme Last
🇪🇪Paide, Estonia
CHU De Nice Hopital De l'Archet
🇫🇷Nice Cedex 3, France
Hôpital Bichat - Claude Bernard
🇫🇷Paris, France
MECS GmbH Cottbus
🇩🇪Cottbus, Germany
Jung, Thomas
🇩🇪Deggingen, Germany
Universitaetsklinik Erlangen
🇩🇪Erlangen, Germany
Universitaetsklinikum Koelnt
🇩🇪Koeln, Germany
Universitaetsklinikum Giessen und Marburg GmbH
🇩🇪Giessen, Germany
Gemeinschaftspraxis Dr. Klein/ Minnich
🇩🇪Kuenzing, Germany
Gemeinschaftspraxis Dr. Taeschner / Dr. Bonigut
🇩🇪Leipzig, Germany
DRC Gyogyszervizsgalo Kozpont Kft
ðŸ‡ðŸ‡ºBalatonfured, Hungary
Clinexpert Kft
ðŸ‡ðŸ‡ºBudapest, Hungary
Obudai Egeszsegugyi Centrum Kft
ðŸ‡ðŸ‡ºBudapest, Hungary
AOU Policlinico di Modena
🇮🇹Modena, Italy
LLC 'ArsVite'
🇷🇺Stavropol, Russian Federation
Nebraska Medical Center
🇺🇸Omaha, Nebraska, United States
Next Phase Research Alliance
🇺🇸Las Vegas, Nevada, United States
Saint Michaels Medical Center
🇺🇸Newark, New Jersey, United States
Accellacare Research of Cary
🇺🇸Cary, North Carolina, United States
Onsite Clinical Solutions
🇺🇸Clemmons, North Carolina, United States
Carolina Institute for Clinical Research
🇺🇸Fayetteville, North Carolina, United States
clinical research of Gastonia
🇺🇸Gastonia, North Carolina, United States
Hickory Research Center.
🇺🇸Hickory, North Carolina, United States
Monroe Biomedical Research
🇺🇸Monroe, North Carolina, United States
Burke Primary Care
🇺🇸Morganton, North Carolina, United States
PMG Research of Rocky Mount, LLC
🇺🇸Rocky Mount, North Carolina, United States
PMG Research of Wilmington, LLC
🇺🇸Wilmington, North Carolina, United States
Clinical Trials of America
🇺🇸Winston-Salem, North Carolina, United States
Southeastern Research Center LLC
🇺🇸Winston-Salem, North Carolina, United States
Dayton Clinical Research
🇺🇸Dayton, Ohio, United States
Buckeye Health and Research, LLC
🇺🇸Hilliard, Ohio, United States
Lancaster General Hospital
🇺🇸Lancaster, Pennsylvania, United States
Detweiler Family Medicine and Associates
🇺🇸Lansdale, Pennsylvania, United States
Albert Einstein Healthcare Network
🇺🇸Philadelphia, Pennsylvania, United States
Preferred Primary Care Physicians Research
🇺🇸Uniontown, Pennsylvania, United States
Frontier Clinical Research
🇺🇸Smithfield, Pennsylvania, United States
AAPRI Clinical Research Institute
🇺🇸Warwick, Rhode Island, United States
Spectrum Medical Research
🇺🇸Gaffney, South Carolina, United States
DeGarmo Institute of Medical Research
🇺🇸Greer, South Carolina, United States
PMG Research of Charleston, LLC
🇺🇸Mount Pleasant, South Carolina, United States
Encore Medical Research, LLC
🇺🇸Hollywood, Florida, United States
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
Fusion Clinical Research of Spartanburg
🇺🇸Spartanburg, South Carolina, United States
Invocare Clinical Research Center
🇺🇸West Columbia, South Carolina, United States
Health Concepts
🇺🇸Rapid City, South Dakota, United States
PMG Research of Bristol
🇺🇸Bristol, Tennessee, United States
PMG Research of Knoxville
🇺🇸Knoxville, Tennessee, United States
Infection Control Ltda
🇧🇷Brasil, Brazil
HIRG, LLC dba Health Innovation Research Group
🇺🇸Arlington, Texas, United States
ACRC Trials
🇺🇸Austin, Texas, United States
Family Medicine Associates of Texas
🇺🇸Carrollton, Texas, United States
University of Texas Southwestern Medical Center
🇺🇸Dallas, Texas, United States
WR-Global Medical Research, LLC
🇺🇸DeSoto, Texas, United States
University Of Texas Medical Branch At Galveston
🇺🇸Galveston, Texas, United States
San Gabriel Clinical Research, LLC
🇺🇸Georgetown, Texas, United States
BI Research Center
🇺🇸Houston, Texas, United States
West Houston Clinical Research Service
🇺🇸Houston, Texas, United States
Northwest Med Care,P.A.
🇺🇸Houston, Texas, United States
Southwest Clinical Trials
🇺🇸Houston, Texas, United States
Dairy Ashford Family Practice
🇺🇸Houston, Texas, United States
JM Research.PLLC
🇺🇸Houston, Texas, United States
PCP for Life
🇺🇸Houston, Texas, United States
SMS Clinical Research LLC
🇺🇸Mesquite, Texas, United States
Village Health Partners
🇺🇸Plano, Texas, United States
Tekton Research Inc.
🇺🇸San Antonio, Texas, United States
CCBR Brasil Centro de Pesquisas e Análises ClÃnicas Ltda.
🇧🇷Rio de Janeiro, Brazil
The First Affiliated Hospital of NanChang University
🇨🇳NanChang, China
Hopital Cochin
🇫🇷Paris 75, France
Alabama Clinical Therapeutics, LLC
🇺🇸Birmingham, Alabama, United States
Cahaba Research Inc
🇺🇸Birmingham, Alabama, United States
Scottsboro Quick Care Clinic
🇺🇸Scottsboro, Alabama, United States
SC Clinical Research Inc.
🇺🇸California City, California, United States
Research Center of Fresno Inc
🇺🇸Fresno, California, United States
Allied Clinical Research
🇺🇸Gold River, California, United States
Innovative Clinical Research Inc
🇺🇸Harbor City, California, United States
Om Research LLC
🇺🇸Lancaster, California, United States
Ark Clinical Research
🇺🇸Long Beach, California, United States
Miller Children's Hospital
🇺🇸Long Beach, California, United States
Downtown LA Research Center, Inc
🇺🇸Los Angeles, California, United States
California Allergy & Asthma Medical Group Inc.
🇺🇸Los Angeles, California, United States
Adam D. Karns, MD
🇺🇸Los Angeles, California, United States
Lucita M. Cruz Md Inc
🇺🇸Norwalk, California, United States
Asclepes Research
🇺🇸Weeki Wachee, Florida, United States
Center for Clinical Trials LLC
🇺🇸Paramount, California, United States
Benchmark Research
🇺🇸Sacramento, California, United States
Medical Associates Research Group, Inc.
🇺🇸San Diego, California, United States
San Diego Sports Medicine & Family Health Center
🇺🇸San Diego, California, United States
West Coast Clinical Research, LLC
🇺🇸San Ramon, California, United States
Stanford University
🇺🇸Stanford, California, United States
Lynn Institute
🇺🇸Colorado Springs, Colorado, United States
Complete Family Care
🇺🇸Northglenn, Colorado, United States
Paradigm Clinical Research Centers, Inc.
🇺🇸Wheat Ridge, Colorado, United States
Chase Medical Research, LLC
🇺🇸Waterbury, Connecticut, United States
Emerson Clinical Research Institute
🇺🇸Washington, District of Columbia, United States
Moonshine Research Center, Inc
🇺🇸Doral, Florida, United States
Best Quality Research Inc
🇺🇸Hialeah, Florida, United States
Floridian Clinical Research LLC
🇺🇸Hialeah, Florida, United States
The community Research of South Florida
🇺🇸Hialeah, Florida, United States
Hrpc Ulbratech - Ulbra
🇧🇷Canoas, Brazil
Homestead Associates in Research Inc
🇺🇸Homestead, Florida, United States
Care Partners Clinical Research
🇺🇸Jacksonville, Florida, United States
Premier Medical Group
🇺🇸Lady Lake, Florida, United States
Crystal Biomedical Research
🇺🇸Miami Lakes, Florida, United States
Sima Research Clinic
🇺🇸Miami, Florida, United States
Universal Clinical Research Associates
🇺🇸Miami, Florida, United States
South Florida Research Center Inc.
🇺🇸Miami, Florida, United States
A Plus Research
🇺🇸Miami, Florida, United States
Nuren Medical & Research Center
🇺🇸Miami, Florida, United States
Coral Research Clinic Corp
🇺🇸Miami, Florida, United States
New Horizon Research Center
🇺🇸Miami, Florida, United States
Vista Health Research, LLC
🇺🇸Miami, Florida, United States
Combined Research Orlando
🇺🇸Orlando, Florida, United States
Clinical NeuroScience Solutions Inc
🇺🇸Orlando, Florida, United States
DM Clinical Research
🇺🇸San Antonio, Texas, United States
Renovatio Clinical
🇺🇸The Woodlands, Texas, United States
ClinPoint Trials
🇺🇸Waxahachie, Texas, United States
Val Hansen
🇺🇸Bountiful, Utah, United States
Ericksen Research and Development
🇺🇸Clinton, Utah, United States
J. Lewis research Inc./ Foothill Family Clinic South
🇺🇸Salt Lake City, Utah, United States
Advanced Research Institute
🇺🇸Ogden, Utah, United States
Granger Medical Clinic-Riverton
🇺🇸Riverton, Utah, United States
J. Lewis research Inc./ Foothill Family Care
🇺🇸Salt Lake City, Utah, United States
J. Lewis Research Inc/ FirstMed East
🇺🇸Salt Lake City, Utah, United States
J. Lewis Research Inc./Jordan River Family Medicine
🇺🇸South Jordan, Utah, United States
Millennium Clinical Trials LLC
🇺🇸Arlington, Virginia, United States
Hospital Interzonal General de Agudos Dr. Jose Penna
🇦🇷Bahia Blanca, Argentina
CEMIC Saavedra
🇦🇷Ciudad de Buenos Aires, Argentina
Hospital Nuestra Señora de la Misericordia
🇦🇷Cordoba, Argentina
Sanatorio Allende
🇦🇷Cordoba, Argentina
Hospital Cordoba
🇦🇷Cordoba, Argentina
Hospital Privado Centro Medico de Cordoba
🇦🇷Cordoba, Argentina
Hospital Rawson
🇦🇷Córdoba, Argentina
Hospital San Roque
🇦🇷Córdoba, Argentina
Sanatorio Juan XXIII
🇦🇷General Roca, Argentina
Sanatorio del Oeste Ituzaingo
🇦🇷Ituzaingo, Argentina
Hospital Italiano de La Plata
🇦🇷La Plata Lpl Lpl, Argentina
Wuxi People s Hospital
🇨🇳Wuxi, China
Omega Research Consultants
🇺🇸Orlando, Florida, United States
Pines Care Research Center Inc
🇺🇸Pembroke Pines, Florida, United States
South Broward Research, LLC
🇺🇸Pembroke Pines, Florida, United States
Destin Pulmonary Critical Care, PLLS.
🇺🇸Santa Rosa Beach, Florida, United States
Vita Health and Medical center
🇺🇸Tamarac, Florida, United States
Axcess Medical Research, LLC
🇺🇸Wellington, Florida, United States
Cozy Research, Llc
🇺🇸Zephyrhills, Florida, United States
Snake River Research, PLLC
🇺🇸Idaho Falls, Idaho, United States
Saltzer Medical Group
🇺🇸Nampa, Idaho, United States
Ann & Robert H. Lurie Children's Hospital of Chicago
🇺🇸Chicago, Illinois, United States
Investigators Research Group, LLC
🇺🇸Brownsburg, Indiana, United States
Medisphere Medical Research Center, Llc
🇺🇸Evansville, Indiana, United States
Hutchinson Clinic
🇺🇸Hutchinson, Kansas, United States
The Research Group of Lexington, LLC
🇺🇸Lexington, Kentucky, United States
Strázsahegy Medicina Bt
ðŸ‡ðŸ‡ºBudapest, Hungary
Clinical Trials Management, LLC
🇺🇸Metairie, Louisiana, United States
Medpharmics, LLC
🇺🇸Metairie, Louisiana, United States
Instituto Medico Platense
🇦🇷La Plata, Argentina
Sanatorio Britanico S.A.
🇦🇷Rosario, Argentina
Instituto Del Buen Aire
🇦🇷Santa Fe, Argentina
Northside Health
🇦🇺Coffs Harbour, Australia
Mater Hospital Brisbane
🇦🇺South Brisbane, Australia
AKH - Medizinische Universitat Wien
🇦🇹Wien, Austria
SMZ Süd - Kaiser Franz Josef Spital Wien
🇦🇹Wien, Austria
Hopital Erasme
🇧🇪Brussel, Belgium
Pesquisare Saude
🇧🇷Santo André, Brazil
Henan Provincial Peoples Hospital
🇨🇳Zhengzhou, China
ADMED s.r.o.
🇨🇿Ceske Budejovice, Czechia
Sanare, s.r.o.
🇨🇿Ceské Budejovice, Czechia
North Star Clinical Research, LLC
🇺🇸Shreveport, Louisiana, United States
University Of Maryland Medical Center
🇺🇸Baltimore, Maryland, United States
Johns Hopkins University School of Medicine
🇺🇸Baltimore, Maryland, United States
CHU Saint-Pierre
🇧🇪Bruxelles, Belgium
Institut Jules Bordet
🇧🇪Bruxelles, Belgium
De Meulemeester, Marc
🇧🇪Gozée, Belgium
Jaak Mortelmans
🇧🇪Ham, Belgium
Quartier du Furgy 4
🇧🇪Herbeumont, Belgium
Research Link
🇧🇪Linkebeek, Belgium
BVBA Dr. Luc Capiau
🇧🇪Massemen, Belgium
Testumed
🇧🇪Tessenderlo, Belgium
Santa Casa de Misericordia de Belo Horizonte
🇧🇷Belo Horizonte, Brazil
Associacao Hospitalar Beneficente Sao Vicente de Paulo - Hospital Sao Vicente de Paulo
🇧🇷Passo Fundo, Brazil
Irmandade Santa Casa de Misericordia de Sao Paulo
🇧🇷Sao Paulo, Brazil
Fundacao Jose Luiz Egydio Setubal
🇧🇷Sao Paulo, Brazil
CEMEC - Centro Multidisciplinar de Estudos ClÃnicos
🇧🇷São Bernardo do Campo, Brazil
SHATPPD - Ruse Ltd.
🇧🇬Ruse, Bulgaria
MHAT Knyaginya Klementina
🇧🇬Sofia, Bulgaria
MHAT 'Lyulin' EAD
🇧🇬Sofia, Bulgaria
Acibadem City Clinic Tokuda Hospital
🇧🇬Sofia, Bulgaria
DCC II- Sofia EOOD
🇧🇬Sofia, Bulgaria
Nemocnice Kyjov, p.o.
🇨🇿Kyjov, Czechia
Praktik Pb s.r.o
🇨🇿Pribram, Czechia
Centennial Medical Group
🇺🇸Elkridge, Maryland, United States
Massachusetts General Hospital
🇺🇸Boston, Massachusetts, United States
Wayne State Univ School of Medicine
🇺🇸Detroit, Michigan, United States
Wayne State University
🇺🇸Detroit, Michigan, United States
William Beaumont Hospital
🇺🇸Troy, Michigan, United States
Tri County Research, Inc.
🇺🇸Sterling Heights, Michigan, United States
Arcturus Healthcare PLC
🇺🇸Troy, Michigan, United States
Hospital das Clinicas de Porto Alegre
🇧🇷Porto Alegre, Brazil
Uniao Brasileira de Educacao e Assistencia Hospital Sao Lucas da PUCRS
🇧🇷Porto Alegre, Brazil
Medical Center 'N. I. Pirogov', EOOD
🇧🇬Sofia, Bulgaria
Medical Center Excelsior OOD
🇧🇬Sofia, Bulgaria
Military Medical Academy - Sofia
🇧🇬Sofia, Bulgaria
MHAT Dr Stefan Cherkezov
🇧🇬Veliko Tarnovo, Bulgaria
MC 'Sv. Ivan Rilski', OOD
🇧🇬Vidin, Bulgaria
The Bailey Clinic
🇨🇦Red Deer, Alberta, Canada
Commonwealth Medical Clinic
🇨🇦Mount Pearl, Newfoundland and Labrador, Canada
Aggarwal and associates Ltd
🇨🇦Brampton, Ontario, Canada
SKDS Research Inc.
🇨🇦NewMarket, Ontario, Canada
Bluewater Clinical Research Group Inc.
🇨🇦Sarnia, Ontario, Canada
Dr. Anil K Gupta Medicine Professional Corporation
🇨🇦Toronto, Ontario, Canada
Recherche Clinique Sigma Inc.
🇨🇦Quebec, Canada
Hospital El Pino
🇨🇱San Bernardo, Chile
Centro de Investigacion del Maule
🇨🇱Talca, Chile
Hospital de Niños y Cunas
🇨🇱Viña, Chile
Chinese PLA General Hospital
🇨🇳Beijing, China
SARKAMED s.r.o.
🇨🇿Slany, Czechia
Prakticky lekar
🇨🇿Sokolov, Czechia
Craig A. Spiegel, MD
🇺🇸Bridgeton, Missouri, United States
Mercury Street Medical Group, PLLC
🇺🇸Butte, Montana, United States
Montana Medical Research
🇺🇸Missoula, Montana, United States
Barrett Clinic P.C.
🇺🇸La Vista, Nebraska, United States
Pestszentimrei Gyermekrendelő
ðŸ‡ðŸ‡ºBudapest, Hungary
Fuzhou General Hospital of Nanjing Military Command
🇨🇳Fuzhou, China
Eszak Kozep budai Centrum Uj Szent Janos Korhaz es Szakrendelo Budai Csaladkozpontu
ðŸ‡ðŸ‡ºBudapest, Hungary
Shree Giriraj Multispeciality Hospital
🇮🇳Rajkot, India
Unique Hospital
🇮🇳Surat, India
BAPS Pramukhswami Hospital
🇮🇳Surat, India
Barzilai Medical Center
🇮🇱Ashkelon, Israel
Bnai Zion Medical Center
🇮🇱Haifa, Israel
Galilee Medical Center
🇮🇱Nahariya, Israel
Chaim Sheba Medical Center
🇮🇱Ramat Gan, Israel
Kaplan Medical Center
🇮🇱Rechovot, Israel
Ziv Medical Center
🇮🇱Safed, Israel
ASST Grande Ospedale Metropolitano Niguarda
🇮🇹Milano, Italy
Azienda Ospedaliera Universitaria Integrata Verona
🇮🇹Verona, Italy
Chungbuk National University Hospital
🇰🇷Cheongju-si, Korea, Republic of
Yonsei University Wonju Severance Christian Hospital
🇰🇷Gangwon-do, Korea, Republic of
Korea University Ansan Hospital
🇰🇷Gyeonggi-do, Korea, Republic of
Hallym University Dongtan Sacred Heart Hospital
🇰🇷Hwaseong-si, Korea, Republic of
Inha University Hospital
🇰🇷Incheon, Korea, Republic of
The Catholic University of Korea, Incheon St. Mary's Hospital
🇰🇷Incheon, Korea, Republic of
Dong-A University Hospital
🇰🇷Pusan, Korea, Republic of
Korea University Anam Hospital
🇰🇷Seoul, Korea, Republic of
Konkuk University Medical Center
🇰🇷Seoul, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Hallym University Kangnam Sacred Heart Hospital
🇰🇷Seoul, Korea, Republic of
Korea University Guro Hospital
🇰🇷Seoul, Korea, Republic of
The Catholic university of Korea ST Vincent Hospital
🇰🇷Suwon si, Korea, Republic of
Liga Kozlovska family doctor practice
🇱🇻Balvi, Latvia
OLVI Medical Centre
🇱🇻Daugavpils, Latvia
Baiba Bake GP practice
🇱🇻Jelgava, Latvia
Ruta Eglite's Private Practice
🇱🇻Kuldiga, Latvia
Inese Cebere GP practice
🇱🇻Liepaja, Latvia
Centro para el Desarrollo de la Medicina y de Asistencia Médica Especializada S.C.
🇲🇽Culiacan, Mexico
Centro de Investigacion Medico Biologica y Terapia Avanzada CIMBYTA
🇲🇽Guadalajara, Mexico
Hospital Civil de Guadalajara Fray Antonio Alcalde
🇲🇽Guadalajara, Mexico
Hospital Civil de Guadalajara Dr. Juan I. Menchaca
🇲🇽Guadalajara, Mexico
Centro Medico Jojutla
🇲🇽Jojutla De Juárez, Mexico
Hospital Universitario de Nuevo Leon 'Dr Jose Eleuterio Gonzalez'
🇲🇽Monterrey, Mexico
Clinical Trials Mexico S.A. de C.V.
🇲🇽Pahucha, Mexico
Huisartsenpraktijk Mangal
🇳🇱Den Haag, Netherlands
Huisartsenpraktijk Zijtregtop
🇳🇱Rotterdam, Netherlands
Huisartsenpraktijk Top
🇳🇱Zwijndrecht, Netherlands
Southern Clinical Trials Ltd
🇳🇿Auckland, New Zealand
Culloden Research Ltd
🇳🇿Papamoa, New Zealand
Lakeland Family Medical Services Ltd
🇳🇿Rotorua, New Zealand
Wellington Hospital
🇳🇿Wellington, New Zealand
Complejo Hospitalario San Pablo
🇵🇪Lima, Peru
ClÃnica Sanna San Borja
🇵🇪Lima, Peru
ClÃnica Internacional
🇵🇪Lima, Peru
Hospital Maria Auxiliadora
🇵🇪Lima, Peru
Clinica Peruano Americana S.A
🇵🇪Trujillo, Peru
Malopolskie Centrum Alergologii
🇵🇱Krakow, Poland
Centrum Medyczne w Lancucie Sp.z o.o.
🇵🇱Lancut, Poland
ETG Lodz
🇵🇱Lodz, Poland
Powiatowe Centrum Medyczne w Wolowie Sp z o o
🇵🇱Specjalistyczna W Brzegu Dolnym, Poland
Gabinet Lekarski Pediatryczno-Alergologiczny
🇵🇱Sucha Beskidzka, Poland
NZOZ Centrum Badan Klinicznych Piotr Napora Lekarze Spolka Partnerska
🇵🇱Wroclaw, Poland
Institute Of Epidimiology And Microbiology
🇷🇺Kazan, Russian Federation
Limited Liability company 'MSMC' Euromed
🇷🇺Omsk, Russian Federation
LLC Outpatient department of Private Security Guards and Detectives
🇷🇺Saint-Petersburg, Russian Federation
LLC Institute of Medical Examinations
🇷🇺Saint-Petersburg, Russian Federation
FSBI 'Scientific and Research Institute of Flu' of the MoH of the RF
🇷🇺Saint-Petersburg, Russian Federation
LLC Kurator
🇷🇺St. Petersburg, Russian Federation
Siberian State Medical University
🇷🇺Tomsk, Russian Federation
Clinical Hospital #3
🇷🇺Yaroslavl, Russian Federation
SBEI HPE 'Yaroslavl State Medical University' of the MoH of the RF
🇷🇺Yaroslavl, Russian Federation
Alersa, S.R.O.
🇸🇰Kosice, Slovakia
Nemocnica s poliklinikou S. Kukuru Michalovce, a.s.
🇸🇰Michalovce, Slovakia
Plucna ambulancia Hrebenar, s.r.o.
🇸🇰Spisska Nova Ves, Slovakia
Nemocnica arm. generala L. Svobodu Svidnik, a.s.,
🇸🇰Svidnik, Slovakia
Cardiology Clinical Research
🇿🇦Alberton, South Africa
Josha Research
🇿🇦Bloemfontein, South Africa
Moriana Clinical Research
🇿🇦Brandfort, South Africa
Dr Dindar & Partner
🇿🇦Breyten, South Africa
Endocare Research
🇿🇦Cape Town, South Africa
Uhuru Clinical Trial Centre
🇿🇦Cape Town, South Africa
Dr EL Janari Private Practice
🇿🇦Cape Town, South Africa
Precise Clinical Solutions
🇿🇦Chatsworth, South Africa
Global Clinical Research SA
🇿🇦Durban North, South Africa
Abdullah, IA
🇿🇦Durban, South Africa
Sebastian, Peter
🇿🇦Durban, South Africa
Pillai, P
🇿🇦Durban, South Africa
Govind, U
🇿🇦Durban, South Africa
Jeevren Reddy, MD
🇿🇦Durban, South Africa
CRISMO Bertha Gxowa Research Centre
🇿🇦Johannesburg, South Africa
Peermed Clinical Trial Centre
🇿🇦Kempton Park, South Africa
DJW Research
🇿🇦Krugersdorp, South Africa
Aliwal Shoal Medical Centre
🇿🇦KwaZulu-Natal, South Africa
Dr A Jacovides Clinical Trials Inc.
🇿🇦Midrand, South Africa
Taipei Medical University
🇨🇳Taipei City, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Taipei Medical University-Wan Fang Hospital
🇨🇳Taipei, Taiwan
Bumrungrad Hospital
🇹ðŸ‡Wattana, Thailand
Hacettepe University Medical Faculty
🇹🇷Samanpazari, Turkey
Adnan Menderes University
🇹🇷Aydin, Turkey
Uludag University Medical Faculty
🇹🇷Bursa, Turkey
Diyarbakir University Medical Faculty
🇹🇷Diyarbakir, Turkey
Kocaeli University Medical Faculty
🇹🇷Kocaeli, Turkey
Karadeniz Teknik University Medical Faculty
🇹🇷Trabzon, Turkey
Med San Unit OJSC Kharkiv S.OrdzhonikidzeTractor Plant Dept of Ther KMA PGE
🇺🇦Kharkiv, Ukraine
Kyiv Oleksandrivska Clinical Hospital
🇺🇦Kyiv, Ukraine
Odesa City Municipal Institution Polyclinic #20
🇺🇦Odesa, Ukraine
Poltava Regional Clinical Hospital HSEI of Ukraine Ukrainian Medical Stomatological Academy
🇺🇦Poltava, Ukraine
CCH #1 Vinnytsia M.I. Pyrogov NMU Ch of Propaedeutics of IM
🇺🇦Vinnytsia, Ukraine
Swan Lane Medical Centre
🇬🇧Bolton, United Kingdom
Bodey Medical Centre
🇬🇧Manchester, United Kingdom
Barlow Medical Centre
🇬🇧Manchester, United Kingdom
West Timperley Medical Centre
🇬🇧Manchester, United Kingdom