- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01500278
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
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
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 4
Expanded Access
Contacts and Locations
Study Locations
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New South Wales
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Camperdown, New South Wales, Australia
- 6
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Kogarah, New South Wales, Australia
- 5
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Queensland
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Maroochydore, Queensland, Australia
- 2
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Tasmania
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Hobart, Tasmania, Australia
- 4
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Victoria
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Clayton, Victoria, Australia
- 7
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Fitzroy, Victoria, Australia
- 8
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Malvern, Victoria, Australia
- 1
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Western Australia
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Subiaco, Western Australia, Australia
- 3
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Stockerau, Austria
- 85
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Wien, Austria
- 22
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Pleven, Bulgaria
- 18
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Plovdiv, Bulgaria
- 35
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Sofia, Bulgaria
- 21
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Sofia, Bulgaria
- 29
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Sofia, Bulgaria
- 34
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Sofia, Bulgaria
- 46
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Barrie, Canada
- 221
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Quebec, Canada
- 171
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Alberta
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Edmonton, Alberta, Canada
- 179
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Newfoundland and Labrador
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St. John's, Newfoundland and Labrador, Canada
- 168
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St. John's, Newfoundland and Labrador, Canada
- 176
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Nova Scotia
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Halifax, Nova Scotia, Canada
- 183
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Ontario
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Hamilton, Ontario, Canada
- 172
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Hamilton, Ontario, Canada
- 174
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Ottawa, Ontario, Canada
- 177
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Ottawa, Ontario, Canada
- 206
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St. Catharines, Ontario, Canada
- 175
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Quebec
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Rimouski, Quebec, Canada
- 218
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Sainte Foy, Quebec, Canada
- 169
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Brno, Czechia
- 103
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Hradec Kralove, Czechia
- 61
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Plzen, Czechia
- 58
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Praha, Czechia
- 49
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Uherske Hradiste, Czechia
- 40
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Brest, France
- 89
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Le Mans, France
- 70
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Lyon, France
- 62
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Montpellier Cedex 5, France
- 72
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Orleans, France
- 90
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Toulouse Cedex 9, France
- 105
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Berlin, Germany
- 56
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Fulda, Germany
- 47
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Hamburg, Germany
- 17
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Heidelberg, Germany
- 31
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Herne, Germany
- 37
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Köln, Germany
- 64
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Osnabrück, Germany
- 63
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Ratingen, Germany
- 11
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Rheine, Germany
- 66
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Rostock, Germany
- 48
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Traunstein, Germany
- 71
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Zerbst, Germany
- 44
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Heraklion, Greece
- 94
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Larisa, Greece
- 95
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Budapest, Hungary
- 13
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Budapest, Hungary
- 42
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Gyula, Hungary
- 68
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Kistarcsa, Hungary
- 100
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Szeged, Hungary
- 43
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Veszprem, Hungary
- 33
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Dublin, Ireland
- 23
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Dublin, Ireland
- 51
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Limerick, Ireland
- 20
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Bergamo, Italy
- 80
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Genova, Italy
- 38
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Genova, Italy
- 88
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Magenta, Italy
- 79
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Napoli, Italy
- 98
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Prato, Italy
- 67
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Roma, Italy
- 36
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Verona, Italy
- 39
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Chihuahua, Mexico
- 194
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Chihuahua, Mexico
- 195
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Guadalajara, Mexico
- 193
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Monterrey, Mexico
- 192
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San Luis Potosi, Mexico
- 191
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Monaco, Monaco
- 60
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Bydgoszcz, Poland
- 107
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Poznan, Poland
- 106
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Warszawa, Poland
- 113
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Warszawa, Poland
- 115
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Wroclaw, Poland
- 108
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Coimbra, Portugal
- 69
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Lisboa, Portugal
- 76
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Lisbon, Portugal
- 27
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Ponte De Lima, Portugal
- 14
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Porto, Portugal
- 81
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Bacau, Romania
- 54
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Braila, Romania
- 74
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Bucharest, Romania
- 25
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Bucharest, Romania
- 24
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Bucharest, Romania
- 28
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Bucharest, Romania
- 32
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Bucharest, Romania
- 57
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Cluj-Napoca, Romania
- 12
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Galati, Romania
- 96
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Iasi, Romania
- 26
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A Coruna, Spain
- 16
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A Coruna, Spain
- 52
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Madrid, Spain
- 30
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Madrid, Spain
- 83
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Sabadell, Spain
- 82
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Vigo, Spain
- 65
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St. Gallen, Switzerland
- 53
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Zürich, Switzerland
- 50
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Ashford, United Kingdom
- 86
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Brighton, United Kingdom
- 78
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Leeds, United Kingdom
- 59
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London, United Kingdom
- 19
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Poole, United Kingdom
- 77
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Sheffield, United Kingdom
- 55
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Upton, United Kingdom
- 73
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Wigan, United Kingdom
- 99
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Alabama
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Birmingham, Alabama, United States
- 141
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Tuscaloosa, Alabama, United States
- 214
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Arizona
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Tucson, Arizona, United States
- 159
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Arkansas
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Hot Springs, Arkansas, United States
- 152
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California
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Covina, California, United States
- 147
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Fullerton, California, United States
- 161
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La Mesa, California, United States
- 217
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Los Angeles, California, United States
- 149
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Menifee, California, United States
- 144
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Roseville, California, United States
- 185
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Sacramento, California, United States
- 208
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Van Nuys, California, United States
- 189
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Whittier, California, United States
- 148
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Delaware
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Lewes, Delaware, United States
- 220
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Florida
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Aventura, Florida, United States
- 142
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Fort Lauderdale, Florida, United States
- 216
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Gainesville, Florida, United States
- 162
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Vero Beach, Florida, United States
- 209
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Idaho
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Coeur d'Alene, Idaho, United States
- 145
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Illinois
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Maywood, Illinois, United States
- 202
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Kentucky
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Lexington, Kentucky, United States
- 134
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Maryland
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Baltimore, Maryland, United States
- 178
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Michigan
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Battle Creek, Michigan, United States
- 137
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Detroit, Michigan, United States
- 153
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Lansing, Michigan, United States
- 155
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Minnesota
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Eagan, Minnesota, United States
- 204
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Rochester, Minnesota, United States
- 180
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Saint Louis Park, Minnesota, United States
- 143
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Nebraska
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Omaha, Nebraska, United States
- 135
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Nevada
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Reno, Nevada, United States
- 170
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New Jersey
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Teaneck, New Jersey, United States
- 201
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Voorhees, New Jersey, United States
- 150
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New Mexico
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Albuquerque, New Mexico, United States
- 205
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New York
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Albany, New York, United States
- 154
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Brooklyn, New York, United States
- 136
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Orchard Park, New York, United States
- 219
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Plainview, New York, United States
- 207
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Syracuse, New York, United States
- 167
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Ohio
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Cincinnati, Ohio, United States
- 140
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Oklahoma
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Oklahoma City, Oklahoma, United States
- 184
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Pennsylvania
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Bethlehem, Pennsylvania, United States
- 164
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Duncansville, Pennsylvania, United States
- 132
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Wyomissing, Pennsylvania, United States
- 190
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South Carolina
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Charleston, South Carolina, United States
- 210
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Myrtle Beach, South Carolina, United States
- 187
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Orangeburg, South Carolina, United States
- 203
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Tennessee
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Jackson, Tennessee, United States
- 133
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Knoxville, Tennessee, United States
- 160
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Texas
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Austin, Texas, United States
- 138
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Corpus Christi, Texas, United States
- 151
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Dallas, Texas, United States
- 131
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Dallas, Texas, United States
- 146
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Dallas, Texas, United States
- 213
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Houston, Texas, United States
- 166
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Houston, Texas, United States
- 212
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San Antonio, Texas, United States
- 139
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Sugar Land, Texas, United States
- 181
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Victoria, Texas, United States
- 165
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Virginia
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Arlington, Virginia, United States
- 211
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Washington
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Spokane, Washington, United States
- 157
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West Virginia
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Clarksburg, West Virginia, United States
- 163
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Wisconsin
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Glendale, Wisconsin, United States
- 215
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
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:
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
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
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)
|
Other Names:
Other Names:
|
|
Active Comparator: Adalimumab + Methotrexate (ADA + MTX)
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Other Names:
Other Names:
|
|
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.
|
Other Names:
Other Names:
Other Names:
|
|
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.
|
Other Names:
Other Names:
Other Names:
|
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
Sponsor
Collaborators
Publications and helpful links
General Publications
- Smolen JS, Burmester GR, Combe B, Curtis JR, Hall S, Haraoui B, van Vollenhoven R, Cioffi C, Ecoffet C, Gervitz L, Ionescu L, Peterson L, Fleischmann R. Head-to-head comparison of certolizumab pegol versus adalimumab in rheumatoid arthritis: 2-year efficacy and safety results from the randomised EXXELERATE study. Lancet. 2016 Dec 3;388(10061):2763-2774. doi: 10.1016/S0140-6736(16)31651-8. Epub 2016 Nov 15. Erratum In: Lancet. 2017 Feb 4;389(10068):e2.
- Paul S, Marotte H, Kavanaugh A, Goupille P, Kvien TK, de Longueville M, Mulleman D, Sandborn WJ, Vande Casteele N. Exposure-Response Relationship of Certolizumab Pegol and Achievement of Low Disease Activity and Remission in Patients With Rheumatoid Arthritis. Clin Transl Sci. 2020 Jul;13(4):743-751. doi: 10.1111/cts.12760. Epub 2020 Apr 1.
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Immune System Diseases
- Autoimmune Diseases
- Joint Diseases
- Musculoskeletal Diseases
- Rheumatic Diseases
- Connective Tissue Diseases
- Arthritis
- Arthritis, Rheumatoid
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Dermatologic Agents
- Reproductive Control Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Folic Acid Antagonists
- Adalimumab
- Methotrexate
- Certolizumab Pegol
Other Study ID Numbers
- RA0077
- 2011-002067-20 (EudraCT Number)
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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