Study to Assess the Short- and Long-term Efficacy of Certolizumab Pegol Plus Methotrexate Compared to Adalimumab Plus Methotrexate in Subjects With Moderate to Severe Rheumatoid Arthritis (RA) Inadequately Responding to Methotrexate

July 4, 2018 updated by: UCB Pharma SA

A Multicenter, Single-blind, Randomized Parallel-group Study to Assess the Short- and Long-term Efficacy of Certolizumab Pegol Plus Methotrexate Compared to Adalimumab Plus Methotrexate in Subjects With Moderate to Severe Rheumatoid Arthritis Responding Inadequately to Methotrexate

This study is conducted to evaluate the short (12 Weeks) and long term (104 Weeks) efficacy of Certolizumab Pegol compared with Adalimumab both in combination with Methotrexate (MTX) in the treatment of moderate to severe Rheumatoid Arthritis (RA) that is not responding adequately to MTX.

Study Overview

Study Type

Interventional

Enrollment (Actual)

915

Phase

  • Phase 4

Expanded Access

Available outside the clinical trial. See expanded access record.

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • New South Wales
      • Camperdown, New South Wales, Australia
        • 6
      • Kogarah, New South Wales, Australia
        • 5
    • Queensland
      • Maroochydore, Queensland, Australia
        • 2
    • Tasmania
      • Hobart, Tasmania, Australia
        • 4
    • Victoria
      • Clayton, Victoria, Australia
        • 7
      • Fitzroy, Victoria, Australia
        • 8
      • Malvern, Victoria, Australia
        • 1
    • Western Australia
      • Subiaco, Western Australia, Australia
        • 3
      • Stockerau, Austria
        • 85
      • Wien, Austria
        • 22
      • Pleven, Bulgaria
        • 18
      • Plovdiv, Bulgaria
        • 35
      • Sofia, Bulgaria
        • 21
      • Sofia, Bulgaria
        • 29
      • Sofia, Bulgaria
        • 34
      • Sofia, Bulgaria
        • 46
      • Barrie, Canada
        • 221
      • Quebec, Canada
        • 171
    • Alberta
      • Edmonton, Alberta, Canada
        • 179
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada
        • 168
      • St. John's, Newfoundland and Labrador, Canada
        • 176
    • Nova Scotia
      • Halifax, Nova Scotia, Canada
        • 183
    • Ontario
      • Hamilton, Ontario, Canada
        • 172
      • Hamilton, Ontario, Canada
        • 174
      • Ottawa, Ontario, Canada
        • 177
      • Ottawa, Ontario, Canada
        • 206
      • St. Catharines, Ontario, Canada
        • 175
    • Quebec
      • Rimouski, Quebec, Canada
        • 218
      • Sainte Foy, Quebec, Canada
        • 169
      • Brno, Czechia
        • 103
      • Hradec Kralove, Czechia
        • 61
      • Plzen, Czechia
        • 58
      • Praha, Czechia
        • 49
      • Uherske Hradiste, Czechia
        • 40
      • Brest, France
        • 89
      • Le Mans, France
        • 70
      • Lyon, France
        • 62
      • Montpellier Cedex 5, France
        • 72
      • Orleans, France
        • 90
      • Toulouse Cedex 9, France
        • 105
      • Berlin, Germany
        • 56
      • Fulda, Germany
        • 47
      • Hamburg, Germany
        • 17
      • Heidelberg, Germany
        • 31
      • Herne, Germany
        • 37
      • Köln, Germany
        • 64
      • Osnabrück, Germany
        • 63
      • Ratingen, Germany
        • 11
      • Rheine, Germany
        • 66
      • Rostock, Germany
        • 48
      • Traunstein, Germany
        • 71
      • Zerbst, Germany
        • 44
      • Heraklion, Greece
        • 94
      • Larisa, Greece
        • 95
      • Budapest, Hungary
        • 13
      • Budapest, Hungary
        • 42
      • Gyula, Hungary
        • 68
      • Kistarcsa, Hungary
        • 100
      • Szeged, Hungary
        • 43
      • Veszprem, Hungary
        • 33
      • Dublin, Ireland
        • 23
      • Dublin, Ireland
        • 51
      • Limerick, Ireland
        • 20
      • Bergamo, Italy
        • 80
      • Genova, Italy
        • 38
      • Genova, Italy
        • 88
      • Magenta, Italy
        • 79
      • Napoli, Italy
        • 98
      • Prato, Italy
        • 67
      • Roma, Italy
        • 36
      • Verona, Italy
        • 39
      • Chihuahua, Mexico
        • 194
      • Chihuahua, Mexico
        • 195
      • Guadalajara, Mexico
        • 193
      • Monterrey, Mexico
        • 192
      • San Luis Potosi, Mexico
        • 191
      • Monaco, Monaco
        • 60
      • Bydgoszcz, Poland
        • 107
      • Poznan, Poland
        • 106
      • Warszawa, Poland
        • 113
      • Warszawa, Poland
        • 115
      • Wroclaw, Poland
        • 108
      • Coimbra, Portugal
        • 69
      • Lisboa, Portugal
        • 76
      • Lisbon, Portugal
        • 27
      • Ponte De Lima, Portugal
        • 14
      • Porto, Portugal
        • 81
      • Bacau, Romania
        • 54
      • Braila, Romania
        • 74
      • Bucharest, Romania
        • 25
      • Bucharest, Romania
        • 24
      • Bucharest, Romania
        • 28
      • Bucharest, Romania
        • 32
      • Bucharest, Romania
        • 57
      • Cluj-Napoca, Romania
        • 12
      • Galati, Romania
        • 96
      • Iasi, Romania
        • 26
      • A Coruna, Spain
        • 16
      • A Coruna, Spain
        • 52
      • Madrid, Spain
        • 30
      • Madrid, Spain
        • 83
      • Sabadell, Spain
        • 82
      • Vigo, Spain
        • 65
      • St. Gallen, Switzerland
        • 53
      • Zürich, Switzerland
        • 50
      • Ashford, United Kingdom
        • 86
      • Brighton, United Kingdom
        • 78
      • Leeds, United Kingdom
        • 59
      • London, United Kingdom
        • 19
      • Poole, United Kingdom
        • 77
      • Sheffield, United Kingdom
        • 55
      • Upton, United Kingdom
        • 73
      • Wigan, United Kingdom
        • 99
    • Alabama
      • Birmingham, Alabama, United States
        • 141
      • Tuscaloosa, Alabama, United States
        • 214
    • Arizona
      • Tucson, Arizona, United States
        • 159
    • Arkansas
      • Hot Springs, Arkansas, United States
        • 152
    • California
      • Covina, California, United States
        • 147
      • Fullerton, California, United States
        • 161
      • La Mesa, California, United States
        • 217
      • Los Angeles, California, United States
        • 149
      • Menifee, California, United States
        • 144
      • Roseville, California, United States
        • 185
      • Sacramento, California, United States
        • 208
      • Van Nuys, California, United States
        • 189
      • Whittier, California, United States
        • 148
    • Delaware
      • Lewes, Delaware, United States
        • 220
    • Florida
      • Aventura, Florida, United States
        • 142
      • Fort Lauderdale, Florida, United States
        • 216
      • Gainesville, Florida, United States
        • 162
      • Vero Beach, Florida, United States
        • 209
    • Idaho
      • Coeur d'Alene, Idaho, United States
        • 145
    • Illinois
      • Maywood, Illinois, United States
        • 202
    • Kentucky
      • Lexington, Kentucky, United States
        • 134
    • Maryland
      • Baltimore, Maryland, United States
        • 178
    • Michigan
      • Battle Creek, Michigan, United States
        • 137
      • Detroit, Michigan, United States
        • 153
      • Lansing, Michigan, United States
        • 155
    • Minnesota
      • Eagan, Minnesota, United States
        • 204
      • Rochester, Minnesota, United States
        • 180
      • Saint Louis Park, Minnesota, United States
        • 143
    • Nebraska
      • Omaha, Nebraska, United States
        • 135
    • Nevada
      • Reno, Nevada, United States
        • 170
    • New Jersey
      • Teaneck, New Jersey, United States
        • 201
      • Voorhees, New Jersey, United States
        • 150
    • New Mexico
      • Albuquerque, New Mexico, United States
        • 205
    • New York
      • Albany, New York, United States
        • 154
      • Brooklyn, New York, United States
        • 136
      • Orchard Park, New York, United States
        • 219
      • Plainview, New York, United States
        • 207
      • Syracuse, New York, United States
        • 167
    • Ohio
      • Cincinnati, Ohio, United States
        • 140
    • Oklahoma
      • Oklahoma City, Oklahoma, United States
        • 184
    • Pennsylvania
      • Bethlehem, Pennsylvania, United States
        • 164
      • Duncansville, Pennsylvania, United States
        • 132
      • Wyomissing, Pennsylvania, United States
        • 190
    • South Carolina
      • Charleston, South Carolina, United States
        • 210
      • Myrtle Beach, South Carolina, United States
        • 187
      • Orangeburg, South Carolina, United States
        • 203
    • Tennessee
      • Jackson, Tennessee, United States
        • 133
      • Knoxville, Tennessee, United States
        • 160
    • Texas
      • Austin, Texas, United States
        • 138
      • Corpus Christi, Texas, United States
        • 151
      • Dallas, Texas, United States
        • 131
      • Dallas, Texas, United States
        • 146
      • Dallas, Texas, United States
        • 213
      • Houston, Texas, United States
        • 166
      • Houston, Texas, United States
        • 212
      • San Antonio, Texas, United States
        • 139
      • Sugar Land, Texas, United States
        • 181
      • Victoria, Texas, United States
        • 165
    • Virginia
      • Arlington, Virginia, United States
        • 211
    • Washington
      • Spokane, Washington, United States
        • 157
    • West Virginia
      • Clarksburg, West Virginia, United States
        • 163
    • Wisconsin
      • Glendale, Wisconsin, United States
        • 215

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

14 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Subject must have a diagnosis of Rheumatoid Arthritis (RA) at Screening, as defined by the 2010 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) classification criteria (Aletaha D et al, 2010)
  • Subject must have a positive Rheumatoid Factor (RF) and/or a positive anti-Cyclic Citrullinated Peptide antibody (anti-CCP) as determined by the central laboratory at Screening
  • Subject must have moderate to severe RA disease at Screening and Baseline defined as:

    1. Screening (all criteria required)

      • ≥ 4 swollen joints (of 28 prespecified joints)
      • Disease Activity Score [Erythrocyte Sedimentation Rate] (DAS28[ESR]) > 3.2
      • C-Reactive Protein (CRP) concentration ≥ 10 mg/L (or 1.0 mg/dL) or Erythrocyte Sedimentation Rate (ESR) (Westergren) ≥ 28 mm/hr
    2. Baseline (both criteria required)

      • ≥ 4 swollen joints (of 28 prespecified joints)
      • Disease Activity Score [Erythrocyte Sedimentation Rate] (DAS28[ESR]) > 3.2
  • Subject must have inadequately responded previously to Methotrexate (MTX)
  • Subject is using MTX 15 to 25 mg/week orally or subcutaneously at Screening and has used the same MTX regimen for a minimum of 28 days prior to Baseline

Exclusion Criteria:

  • Subject has previously received any biological Disease Modifying Antirheumatic Drug (DMARD) or has received treatment with cyclophosphamide, chlorambucil, Janus Kinase, phosphodiesterase 4 inhibitors or investigational agents such as spleen tyrosine kinase
  • Diagnosis of any other inflammatory arthritis
  • Infected with Tuberculosis (TB) or high risk of acquiring TB infection
  • Subjects with concurrent acute or chronic viral hepatitis B or C infection
  • Subjects with a history of chronic or recurrent infections or subjects at high risk of infection
  • Use of prohibited medications like nonbiological DMARDs (excluding MTX), biological DMARDs excluding study medications, experimental therapy, IA hyaluronic acid

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Certolizumab Pegol + Methotrexate (CZP + MTX)
  • Active substance: an injectable volume of 1 ml solution for injection CZP
  • Pharmaceutical form: prefilled syringes CZP
  • Concentration: 200 mg/ml CZP
  • Route of Administration: injections will be given subcutaneously: loading dose of CZP 400 mg at Baseline, and Weeks 2 and 4, followed by a maintenance dose of 200 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Cimzia
  • CZP
  • Active substance: Methotrexate
  • Pharmaceutical form: oral tablet
  • Concentration: 15-25 mg/week
  • Route of Administration: MTX orally
Other Names:
  • MTX
Active Comparator: Adalimumab + Methotrexate (ADA + MTX)
  • Active substance: Methotrexate
  • Pharmaceutical form: oral tablet
  • Concentration: 15-25 mg/week
  • Route of Administration: MTX orally
Other Names:
  • MTX
  • Active substance: an injectable volume of 0.8 ml solution for injection ADA
  • Pharmaceutical form: prefilled syringes ADA
  • Concentration: 40 mg/0.8 ml ADA
  • Route of Administration: injections will be given subcutaneously. ADA 40 mg plus an injection with Placebo (to preserve blind) at Baseline, and Weeks 2 and 4, followed by ADA 40 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Humira
  • ADA
Active Comparator: CZP + MTX followed by ADA + MTX
Those subjects who received Certolizumab Pegol (400 mg at Weeks 0, 2, 4 followed by 200 mg every two weeks) + Methotrexate (CZP+ MTX) at Baseline and are Non-Responders at Week 12, switch to Adalimumab (40 mg) + Methotrexate (ADA + MTX) after Week 12.
  • Active substance: an injectable volume of 1 ml solution for injection CZP
  • Pharmaceutical form: prefilled syringes CZP
  • Concentration: 200 mg/ml CZP
  • Route of Administration: injections will be given subcutaneously: loading dose of CZP 400 mg at Baseline, and Weeks 2 and 4, followed by a maintenance dose of 200 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Cimzia
  • CZP
  • Active substance: Methotrexate
  • Pharmaceutical form: oral tablet
  • Concentration: 15-25 mg/week
  • Route of Administration: MTX orally
Other Names:
  • MTX
  • Active substance: an injectable volume of 0.8 ml solution for injection ADA
  • Pharmaceutical form: prefilled syringes ADA
  • Concentration: 40 mg/0.8 ml ADA
  • Route of Administration: injections will be given subcutaneously. ADA 40 mg plus an injection with Placebo (to preserve blind) at Baseline, and Weeks 2 and 4, followed by ADA 40 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Humira
  • ADA
Active Comparator: ADA + MTX followed by CZP + MTX
Those subjects who received Adalimumab (40 mg + Placebo at Weeks 0, 2, 4 followed by 40 mg ADA every two weeks) + Methotrexate (ADA+ MTX) at Baseline and are Non-Responders at Week 12, switch to Certolizumab Pegol (400 mg at Weeks 12, 14, 16 followed by 200 mg every two weeks) + Methotrexate (CZP+ MTX) after Week 12.
  • Active substance: an injectable volume of 1 ml solution for injection CZP
  • Pharmaceutical form: prefilled syringes CZP
  • Concentration: 200 mg/ml CZP
  • Route of Administration: injections will be given subcutaneously: loading dose of CZP 400 mg at Baseline, and Weeks 2 and 4, followed by a maintenance dose of 200 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Cimzia
  • CZP
  • Active substance: Methotrexate
  • Pharmaceutical form: oral tablet
  • Concentration: 15-25 mg/week
  • Route of Administration: MTX orally
Other Names:
  • MTX
  • Active substance: an injectable volume of 0.8 ml solution for injection ADA
  • Pharmaceutical form: prefilled syringes ADA
  • Concentration: 40 mg/0.8 ml ADA
  • Route of Administration: injections will be given subcutaneously. ADA 40 mg plus an injection with Placebo (to preserve blind) at Baseline, and Weeks 2 and 4, followed by ADA 40 mg every 2 weeks through Week 102 or withdrawal.
Other Names:
  • Humira
  • ADA

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Subjects Who Met the American College of Rheumatology 20 % (ACR20) Criteria at Week 12
Time Frame: Week 12
Subjects who met the ACR20 criteria were those subjects with at least 20% improvement from Baseline for Tender Joint Count (TJC), Swollen Joint Count (SJC), and at least 3 of the 5 remaining core set measures: 1) Health Assessment Questionnaire-Disability Index (HAQ-DI), 2) C-reactive Protein (CRP), 3) Patient's Assessment of Arthritis Pain-Visual Analog Scale (PAAP-VAS), 4) Patient's Global Assessment of Disease Activity-Visual Analog Scale (PtGADA-VAS), 5) Physician's Global Assessment of Disease Activity-Visual Analog Scale (PhGA-VAS).
Week 12
Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 104
Time Frame: Week 104
DAS28 [ESR] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x √ (TJC) + 0.28 x √ (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
Week 104

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Week 12 Responders Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 104
Time Frame: Week 104

DAS28 [ESR] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x √ (TJC) + 0.28 x √ (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.

The definition of Week 12 responders was DAS28[ESR] Low Disease Activity (LDA) (ie ≤ 3.2) or an improvement of ≥ 1.2 in DAS28[ESR] relative to Baseline.

Week 104
Percentage of Subjects Who Met the American College of Rheumatology 20 % (ACR20) Criteria at Week 6
Time Frame: Week 6
Subjects who met the ACR20 criteria were those subjects with at least 20% improvement from Baseline for Tender Joint Count (TJC), Swollen Joint Count (SJC), and at least 3 of the 5 remaining core set measures: 1) Health Assessment Questionnaire-Disability Index (HAQ-DI), 2) C-reactive Protein (CRP), 3) Patient's Assessment of Arthritis Pain-Visual Analog Scale (PAAP-VAS), 4) Patient's Global Assessment of Disease Activity-Visual Analog Scale (PtGADA-VAS), 5) Physician's Global Assessment of Disease Activity-Visual Analog Scale (PhGA-VAS).
Week 6
Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 6
Time Frame: Week 6
DAS28 [ESR] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x √ (TJC) + 0.28 x √ (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
Week 6
Percentage of Subjects Who Had a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 12
Time Frame: Week 12
DAS28 [ESR] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x √ (TJC) + 0.28 x √ (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.
Week 12
Percentage of Subjects With a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 104, in Subjects Responding at Both Week 6 and Week 12
Time Frame: Week 104

DAS28 [ESR] was calculated using the Tender Joint Count (TJC), Swollen Joint Count (SJC), Erythrocyte Sedimentation Rate (ESR in mm/hour), and the Patient's Global Assessment of Disease Activity - Visual Analog Scale (PtGADA-VAS in mm) using the following formula: 0.56 x √ (TJC) + 0.28 x √ (SJC) + 0.70 x lognat (ESR) + 0.014 x Patient Global Assessment of Arthritis, where 28 joints were examined and a lower score indicates less disease activity.

The definition of Week 6/12 responders was DAS28[ESR] Low Disease Activity (LDA) (ie ≤ 3.2) or an improvement of ≥ 1.2 in DAS28[ESR] relative to Baseline.

Week 104
Change From Baseline in the Health Assessment Questionnaire-Disability Index (HAQ-DI) at Week 104
Time Frame: From Baseline to Week 104
HAQ-DI was derived based on the mean of individual scores in 8 categories of daily living actives (using 20 questions). Each question was scored 0-3 (0 = without any difficulty, 1 = with some difficulty, 2 = with much difficulty, and 3 = unable to do), and the total HAQ-DI was scored on the scale of 0-3 as well. Change from Baseline was computed as the value at Week 104 minus the Baseline value. A negative value in Change from Baseline indicates an improvement.
From Baseline to Week 104
Kaplan-Meier Estimates of Proportion of Subjects Who Discontinued After Response at Week 12
Time Frame: From Week 12 up to Week 104
Response at Week 12 means that a subject had either a Disease Activity Score 28 [Erythrocyte Sedimentation Rate] (DAS28 [ESR]) ≤ 3.2 at Week 12 or had a reduction of DAS28 [ESR] ≥ 1.2 from Baseline to Week 12. Kaplan-Meier Estimates of Proportion of Subjects Discontinued are presented per study week (days relative to Week 12 visit).
From Week 12 up to Week 104

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2011

Primary Completion (Actual)

November 1, 2015

Study Completion (Actual)

January 1, 2016

Study Registration Dates

First Submitted

December 22, 2011

First Submitted That Met QC Criteria

December 27, 2011

First Posted (Estimate)

December 28, 2011

Study Record Updates

Last Update Posted (Actual)

July 31, 2018

Last Update Submitted That Met QC Criteria

July 4, 2018

Last Verified

July 1, 2017

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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