Fenofibrate for Patients With COVID-19 Requiring Hospitalization (FENOC)

April 17, 2022 updated by: Yaakov Nahmias

A Study of a 10-days Fenofibrate Treatment, or Until Discharge From Hospital, Among COVID-19 Infected Patients Requiring Hospitalization

This is an open-label run-in followed by a randomized, double-blind drug treatment study of COVID-19 infected patients requiring inpatient hospital admission.

Study Overview

Detailed Description

This is an open-label run-in followed by a randomized, double-blind drug treatment study of COVID-19 infected patients requiring inpatient hospital admission. Open-label patients will be matched at least 1:10 with observational retrospective Propensity score-matched (PSM) patients' medical files. The double-blinded step will be randomized 2:1 to daily Fenofibrate or placebo for 10 days or hospital discharge.

Study Type

Interventional

Enrollment (Anticipated)

55

Phase

  • Phase 3

Contacts and Locations

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

Study Contact

Study Contact Backup

Study Locations

      • Ashkelon, Israel, 7830604
        • Recruiting
        • Barzilai Medical Center
        • Contact:
          • Shlomo Maayan, MD
      • Haifa, Israel
        • Recruiting
        • Rambam Health Care Campus
        • Contact:
        • Principal Investigator:
          • Shadi Hamoud, Prof. MD.
      • Nazareth, Israel
        • Recruiting
        • Nazareth Hospital EMMS
        • Contact:
          • Amir Alimi, MD
        • Principal Investigator:
          • Amir Alimi, MD

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

16 years to 83 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Presumptive positive laboratory test for SARS-CoV-2 based on local laboratory standard
  • Age greater than or equal to 18 years of age
  • Severe COVID-19, defined by:

    • A disease severity score of 3 (Hospitalized, on non-invasive ventilation or high flow oxygen devices) to 4 (Hospitalized, requiring supplemental oxygen).

AND o A respiratory SOFA >=1 and increased oxygen requirement compared to baseline among those on home O2, a blood oxygen saturation of 93% or less on room air, a ratio of the partial pressure of oxygen to the fraction of inspired oxygen (PaO2/FiO2) of less than 300 mm Hg, respiratory rate >30 breaths/min, or lung infiltrates >50% on chest CT

• Enrollment within 72 hours of presentation of hospital admission or within 72 hours of a positive test result, whichever is later

Exclusion Criteria:

  • Enrollment > 72 hours of admission order or positive test result, whichever is later
  • Admission to the hospital with a respiratory SOFA >=5 , Critical COVID-19, or Disease Severity Score >5 (requiring extracorporeal membrane oxygenation (ECMO), invasive mechanical ventilation, or all)
  • Known hypersensitivity to fenofibrate
  • For female subjects:

    1. Pregenant, determined by a human chorionic gonadotropin (HCG) rapid detection kit or a blood test
    2. Breastfeeding
    3. Undergoing fertility treatments
  • Patient-reported history or electronic medical record history of kidney disease, defined as:

    1. Any history of dialysis
    2. History of chronic kidney disease stage IV
    3. Estimated Glomerular Filtration Rate (eGFR) of < 30ml/min/1.73 m2 at the time of enrollment
  • Acute pre-renal azotemia at the time of enrollment in the opinion of the investigator or bedside clinician
  • Most recent mean arterial blood pressure prior to enrollment <65 mmHg
  • Patient-reported history or electronic medical record history of severe liver disease, defined as:

    1. Cirrhosis
    2. History of hepatitis B or C
    3. Documented AST or ALT > 10 times the upper limit of normal measured within 24 hours prior to enrollment
  • Patient-reported history or electronic medical record history of gallbladder disease
  • Potassium >5.0 within 24 hours prior to enrollment unless a repeat value was <=5.0
  • Treatment with coumarin anticoagulants (e.g., Warfarin), immunosuppressants (e.g. cisplatin), bile acid resins, or sulfonylurea.
  • Inability to obtain informed consent from participant or legally authorized representative
  • Enrollment in another blinded randomized clinical trial for COVID

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: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Fenofibrate + Usual Care
Participants in this arm will receive the study drug, Fenofibrate, in combination with usual care.
All participants will otherwise receive usual medical care
Fenofibrate; 145 mg daily (1/day); oral administration; 10 days
Other Names:
  • Lipanthyl NT 145mg tablets
Placebo Comparator: Placebo + Usual Care
Participants in this arm will receive placebo treatment, in combination with usual care.
Placebo (microcrystalline methylcellulose, gelatin capsule); oral administration
All participants will otherwise receive usual medical care
No Intervention: Usual Care (Observetional)
Participants in this arm will receive the usual care and be compared by their medical records and laboratory results

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Therapeutic Oxygen-Free Days
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm did not require therapeutic oxygen usage during an in-patient hospital admission.
14 days
Length of Hospital Stay
Time Frame: 14 days
Outcome reported as the mean length of in-patient hospital stay (in days) for participants in each arm
14 days
Viral Clearance by Nasopharyngeal Swab
Time Frame: 14 days
Nasopharyngeal swabs will be collected every second day for the duration of study participation. Viral clearance is measured as fold change in viral genetic copies per mL
14 days
Difference in Estimated P/F Ratio at 14 days
Time Frame: 14 days
Outcome calculated from the partial pressure of oxygen or peripheral saturation of oxygen by pulse oximetry divided by the fraction of inspired oxygen (PaO2 or SaO2 : FiO2 ratio). PaO2 is preferentially used if available.
14 days
Difference in Plasma Neutrophils at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma Lymphocytes at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma Monocytes at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma C-Reactive Protein (CRP) at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma IL-6 at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma Procalcitonin (PCT) at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Plasma Ferritin at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in NLR (Neutrophils to Lymphocytes Ratio) at 14 days
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
28-Day Mortality
Time Frame: 28 days
Outcome reported as the number of participants who have expired at 28 days post enrollment.
28 days
90-Day Mortality
Time Frame: 90 days
Outcome reported as the number of participants who have expired at 90 days post enrollment.
90 days
14-Day Mortality
Time Frame: 14 days
Outcome reported as the number of participants who have expired at 14 days post enrollment.
14 days
Difference in Organ Injury Plasma markers at 14 days - Lactate
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - Cardiac Troponin (TRO)
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - Creatine Kinase (CK)
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - Alanine Aminotransferase (ALT)
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - Alkaline Phosphatase (ALP)
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - D-dimer
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Difference in Organ Injury Plasma markers at 14 days - Platelets (PLT)
Time Frame: 14 days
Blood will be collected every second day for the duration of study participation. Difference will be calculated based on the first measurement after admission to the study.
14 days
Number of Abnormal Biomarker Days - D-dimer
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Neutrophils
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Lymphocytes
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Platelets (PLT)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Monocytes
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - C-Reactive Protein (CRP)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - IL-6
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had 2 or more abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Procalcitonin (PCT)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Lactate
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Cardiac Troponin (TRO)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Creatine Kinase (CK)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Alanine Aminotransferase (ALT)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Alkaline Phosphatase (ALP)
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Number of Abnormal Biomarker Days - Ferritin
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
14 days
Difference in Oxygenation at 14 days
Time Frame: 14 days
PaO2 or SaO2 and FiO2. Partial pressure of oxygen or peripheral saturation of oxygen by pulse oximetry. FiO₂ is estimated from oxygen flow/delivery rates
14 days
Difference in Estimated PEEP adjusted P/F Ratio at 14 days
Time Frame: 14 days
Outcome calculated from the partial pressure of oxygen or peripheral saturation of oxygen by pulse oximetry divided by the fraction of inspired oxygen (PaO2 or SaO2 : FiO2 ratio) and Expiratory Pressure.
14 days
Daily Hypotensive Episodes
Time Frame: 14 days
Outcome reported as the mean number of daily hypotensive episodes (MAP < 65 mmHg) prompting intervention (indicated by a fluid bolus >=500 mL, new treatment with pressures, increase in 50% pressure or fluid rate) per participant in each arm.
14 days
Hypotension Requiring Vasopressors
Time Frame: 14 days
Outcome reported as the number of participants in each arm requiring the use of vasopressors for hypotension.
14 days
Acute Kidney Injury
Time Frame: 14 days
Outcome reported as the number of participants in each arm who experience acute kidney injury as defined by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines: Increase in serum creatinine by 0.3mg/dL or more within 48 hours OR Increase in serum creatinine to 1.5 times baseline or more within the last 7 days OR Urine output less than 0.5 mL/kg/h for 6 hours.
14 days
Sequential Organ Failure Assessment (SOFA) Total Score
Time Frame: 14 days
The SOFA assessment is used to track a person's risk status during stay in the Intensive Care Unit (ICU). The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Each organ system is assigned a point value from 0 (normal) to 4 (high degree of dysfunction/failure). Total score is calculated by entering patient data into a SOFA calculator, a widely available software. Total scores range from 0-24, with higher scores indicating greater risk of mortality.
14 days
Oxygen Saturation / Fractional Inhaled Oxygen (F/S)
Time Frame: 14 days
Oxygen saturation (percent) is measured by pulse oximeter. Fraction of inspired oxygen (FiO2) (unitless) is the volumetric fraction of oxygen to other gases in respiratory support. The F/S ratio is unitless.
14 days
ICU Admission
Time Frame: 14 days
Outcome reported as the number of participants in each arm who require admission to the Intensive Care Unit (ICU).
14 days
Number of Ventilator-Free Days
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm did not require mechanical ventilation during an in-patient hospital admission.
14 days
Number of Vasopressor-Free Days
Time Frame: 14 days
Outcome reported as the mean number of days participants in each arm did not require vasopressor usage during an in-patient hospital admission.
14 days
Length of ICU Stay
Time Frame: 14 days
Outcome reported as the mean length of stay (in days) in the Intensive Care Unit (ICU) for participants in each arm.
14 days
Incidence of Respiratory Failure
Time Frame: 14 days
Outcome reported as the number of participants requiring BiPAP OR high flow nasal cannula OR mechanical ventilation OR extracorporeal membranous oxygenation (ECMO) utilization during in-patient hospital care in each arm.
14 days
Change in PROMIS Dyspnea Functional Limitations
Time Frame: 14 days
The PROMIS Dyspnea (shortness of breath) item banks and pools assess self-reported Functional Limitations, Severity, Activity Motivation, Activity Requirements, Airborne Exposure, Assistant Devices Resources, Characteristics, Emotional Response, Task Avoidance and Time Extension as they related to dyspnea. In the 33-item Functional Limitations bank, 33 daily activities are rated in terms of degree of difficulty while engaging in the activity over the past 7 days (0 = no difficulty, 1 = a little difficulty, 2 = some difficulty, 3 = much difficulty). Total scores range from 0 to 99, with higher scores reflecting greater functional limitations.
14 days
Change in PROMIS Dyspnea Severity
Time Frame: 14 days
The PROMIS Dyspnea (shortness of breath) item banks and pools assess self-reported Functional Limitations, Severity, Activity Motivation, Activity Requirements, Airborne Exposure, Assistant Devices Resources, Characteristics, Emotional Response, Task Avoidance and Time Extension as they related to dyspnea. The 33-item Severity bank assesses the severity of difficulty breathing during various specific activities (the same 33 activities assessed in Dyspnea Functional Limitations). Each activity is rated in terms of degree of dyspnea (0 = no shortness of breath, 1 = mildly short of breath, 2 = moderately short of breath, 3 = severely short of breath) while engaging in the activity over the past 7 days. Total scores range from 0 to 99 with higher scores reflecting greater levels of dyspnea during daily activity.
14 days
Disease Severity Rating
Time Frame: 14 days
Outcome reported as the number of participants in each arm who fall into each of 7 categories. Lower scores indicate greater condition severity. The ordinal scale is an assessment of the clinical status at the first assessment of a given study day. The scale is as follows: 1) Death; 2) Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO); 3) Hospitalized, on non-invasive ventilation or high flow oxygen devices; 4) Hospitalized, requiring supplemental oxygen; 5) Hospitalized, not requiring supplemental oxygen; 6) Not hospitalized, limitation on activities; 7) Not hospitalized, no limitations on activities.
14 days
Viral Load by Nasopharyngeal Swab
Time Frame: 14 days
Nasopharyngeal swabs will be collected every fourth day for the duration of study participation. Viral load is measured as number of viral genetic copies per mL.
14 days
Viral Load by Blood
Time Frame: 14 days
Blood will be collected every third day for viral load assessment for the duration of study participation. Viral load is measured as number of viral genetic copies per mL.
14 days
Viral Clearance by Blood
Time Frame: 14 days
Blood will be collected every third day for viral load assessment for the duration of study participation. clearance is measured as fold change in viral genetic copies per mL.
14 days
Abnormal Biomarkers after recovery - D-dimer
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Neutrophils
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Lymphocytes
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Platelets (PLT)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Monocytes
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - C-Reactive Protein (CRP)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - IL-6
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Procalcitonin (PCT)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Lactate
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Cardiac Troponin (TRO)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Creatine Kinase (CK)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Alanine Aminotransferase (ALT)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Alkaline Phosphatase (ALP)
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Biomarkers after recovery - Ferritin
Time Frame: 1 day
Outcome reported as the mean number of days participants in each arm had abnormal plasma levels.
1 day
Abnormal Oxygenation after recovery
Time Frame: 1 day
Outcome reported as the mean number of participants in each arm had abnormal PaO2 or SaO2 and FiO2 levels at the end of quarantine period. Partial pressure of oxygen or peripheral saturation of oxygen by pulse oximetry. FiO₂ is estimated from oxygen flow/delivery rates
1 day
PROMIS Dyspnea Functional Limitations after recovery
Time Frame: 1 day
The PROMIS Dyspnea (shortness of breath) item banks and pools assess self-reported Functional Limitations, Severity, Activity Motivation, Activity Requirements, Airborne Exposure, Assistant Devices Resources, Characteristics, Emotional Response, Task Avoidance and Time Extension as they related to dyspnea. In the 33-item Functional Limitations bank, 33 daily activities are rated in terms of degree of difficulty while engaging in the activity over the past 7 days (0 = no difficulty, 1 = a little difficulty, 2 = some difficulty, 3 = much difficulty). Total scores range from 0 to 99, with higher scores reflecting greater functional limitations. Measured at the end of quarantine period.
1 day
PROMIS Dyspnea Severity after recovery
Time Frame: 1 day
The PROMIS Dyspnea (shortness of breath) item banks and pools assess self-reported Functional Limitations, Severity, Activity Motivation, Activity Requirements, Airborne Exposure, Assistant Devices Resources, Characteristics, Emotional Response, Task Avoidance and Time Extension as they related to dyspnea. The 33-item Severity bank assesses the severity of difficulty breathing during various specific activities (the same 33 activities assessed in Dyspnea Functional Limitations). Each activity is rated in terms of degree of dyspnea (0 = no shortness of breath, 1 = mildly short of breath, 2 = moderately short of breath, 3 = severely short of breath) while engaging in the activity over the past 7 days. Total scores range from 0 to 99 with higher scores reflecting greater levels of dyspnea during daily activity. Measured at the end of quarantine period.
1 day

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Significant post-acute incident diagnoses after recovery at 28-days
Time Frame: 1 day
Incident rate per 1000 at 28-days in hospitalized COVID-19 is ascertained from hospital admission until 28-days or end of follow-up.
1 day
Significant post-acute incident diagnoses after recovery at 90-days
Time Frame: 1 day
Incident rate per 1000 at 90-days in hospitalized COVID-19 is ascertained from hospital admission until 90-days or end of follow-up.
1 day
Significant post-acute incident diagnoses after recovery at 6-months
Time Frame: 1 day
Incident rate per 1000 at 6-months in hospitalized COVID-19 is ascertained from hospital admission until 6-months or end of follow-up.
1 day

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Shlomo Mayaan, MD, Barzilai Medical Center
  • Study Director: Mahram Nassar, MD, Barzilai Medical Center
  • Principal Investigator: Yaakov Nahmias, PhD, Hebrew University of Jerusalem

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.

General Publications

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 (Actual)

January 1, 2021

Primary Completion (Anticipated)

May 1, 2022

Study Completion (Anticipated)

July 1, 2022

Study Registration Dates

First Submitted

December 9, 2020

First Submitted That Met QC Criteria

December 9, 2020

First Posted (Actual)

December 10, 2020

Study Record Updates

Last Update Posted (Actual)

April 19, 2022

Last Update Submitted That Met QC Criteria

April 17, 2022

Last Verified

April 1, 2022

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

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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