- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT03371667
Porovnat účinnost přidání methotrexátu (MTX) k současnému standardnímu akutnímu onemocnění štěpu proti hostiteli (GVHD) první linii léčby kortikosteroidy (MTX-aGVHD)
Multicentrická randomizovaná ve dvojitě zaslepené studii fáze III srovnávající samotnou terapii standardní péče s kortikosteroidy a nízkou dávkou metotrexátu (MTX) pro léčbu první linie akutního onemocnění štěpu proti hostiteli po alogenní transplantaci kmenových buněk
Phase III randomized double-blinded trial designed to compare the efficacy of the addition of MTX to current standard acute GVHD first-line treatment with corticosteroids. The protocol will use a novel endpoint for benchmarking interventions based on a composite primary endpoint of GVHD-free and corticosteroids-free survival.
The primary endpoint of the trial will be the assessment of a composite endpoint of graft-versus-host disease-free and corticosteroids-free survival at 12 months after randomization
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
This is a phase III randomized, multicenter, double blinded controlled study. Patients who develop clinically meaningful acute GVHD and who meet all other entry criteria will be randomized 1:1 to receive either corticosteroids and placebo ("standard of care", control arm) or the combination of low-dose MTX with corticosteroids as first-line therapy for acute GVHD (MTX; "experimental arm").
The primary analysis of this hypothesis generation study is to estimate the composite endpoint of GVHD-free and corticosteroids-free survival at 12 months after randomization in both treatment arms. In fact, it is more and more established that such composite endpoint is a clinically very relevant one because it represents ideal recovery from allo-SCT (Stem Cell transplantation) (at 1 year after acute GVHD diagnosis) and a measure of cure without ongoing morbidity.
Typ studie
Zápis (Aktuální)
Fáze
- Fáze 3
Kontakty a umístění
Studijní místa
-
-
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Paris, Francie, 75012
- Saint Antoine Hospital - Hematology Department
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Adults patients (>=18 years old) with hematological diseases, who develop a first episode of acute GVHD (grade II-IV) requiring systemic therapy
- First allo-SCT, with any type of donor, stem cell source, GVHD prophylaxis or conditioning regimen
- Biopsy of acute GVHD target organ is recommended, but not required. Enrollment should not be delayed awaiting biopsy or pathology results
- The patient must have received no previous systemic immune suppressive therapy for treatment of acute GVHD, except for a maximum 72 hours of prior corticosteroid therapy
- Absolute neutrophil count (ANC) greater than 0.5 G/L
- Platelets count greater than 20 G/L
- Signed informed consent
- Affiliation to a social security system (recipient or assign)
- Women who are of childbearing potential must have a negative serum pregnancy test and agree to use a medically acceptable method of contraception until 6 months after the end of treatment.
Men with a partner of childbearing potential must agree to use a medically acceptable method of contraception until 6 months after the end of treatment.
Exclusion Criteria:
- Hyper-acute GVHD as defined by the MD Anderson's criteria (Saliba, de Lima et al. 2007)
- Flare of GVHD in a patient already on corticosteroid treatment
- Overlap chronic GVHD as defined by the NIH Consensus Criteria (Jagasia, Greinix et al. 2015)
- MTX given within 7 days of enrollment
- Active uncontrolled infection
- Relapsed/persistent malignancy requiring rapid immune suppression withdrawal
- Acute GVHD after donor lymphocytes infusion (DLI)
- Other systemic drugs for GVHD treatment (including extra-corporeal photopheresis)
- If any prior steroid therapy (for indication other than GVHD), treatment at doses > 0.5 mg/kg/day methyl-prednisolone within 7 days prior to onset of acute GVHD
- Patients who are pregnant, breast feeding, or if sexually active, unwilling to use effective birth control for the duration of the study
- Patient on dialysis
- Patients with veno-occlusive disease of the liver or with significant liver abnormalities who in the judgment of the treating physician cannot receive MTX
- Patients requiring after inclusion in the protocol the continuation of one or more of the following medication: probenecide, trimethoprime (alone or in combination with sulfametoxazole), phenylbutazone or yellow fever vaccine
- Patients with a history of intolerance/allergy to MTX
- Hypersensitivity to the active substance or to any of the excipients
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Léčba
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Dvojnásobek
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
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Experimentální: Methotrexate
|
Methotrexate 3 mg/m2 will be given once week for 4 weeks, then 3 mg/m2 every two weeks for 12 weeks. Body surface area will be capped at 2 m2. Methotrexate will be given as an IV infusion over 15 minutes. All patients will received prednisone 2 mg/kg.day PO (or methylprednisolone 1.6 mg/Kg/day) for 3 days. For responding patients between day 4 and 28, the dose of prednisone must be at least 0.25 mg/kg/day prednisone (or 0.2 mg/kg/day methylprednisolone). All patients should receive a folinic acid supplementation 24 hours after each MTX/placebo administration. Lederfoldin 10 mg po or iv will be administered on days 2, 9, 16 and 23. Lederfoldin 10 mg po or iv will be administered on days 37, 51, 65, 79, 93 and 103. |
|
Komparátor placeba: Placebo
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Placebo 3 mg/m2 will be given once week for 4 weeks, then 3 mg/m2 every two weeks for 12 weeks. Body surface area will be capped at 2 m2. Placebo will be given as an IV infusion over 15 minutes. All patients will received prednisone 2 mg/kg.day PO (or methylprednisolone 1.6 mg/Kg/day) for 3 days. For responding patients between day 4 and 28, the dose of prednisone must be at least 0.25 mg/kg/day prednisone (or 0.2 mg/kg/day methylprednisolone). All patients should receive a folinic acid supplementation 24 hours after each MTX/placebo administration. Lederfoldin 10 mg po or iv will be administered on days 2, 9, 16 and 23. Lederfoldin 10 mg po or iv will be administered on days 37, 51, 65, 79, 93 and 103. |
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization.
Časové okno: Evaluation will be performed at time of inclusion
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at time of inclusion
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (1).
Časové okno: Evaluation will be performed before start of MTX at the randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed before start of MTX at the randomization.
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (2).
Časové okno: Evaluation will be performed at Day 8
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 8
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (3).
Časové okno: Evaluation will be performed at Day 15
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 15
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (4).
Časové okno: Evaluation will be performed at Day 22
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 22
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (5).
Časové okno: Evaluation will be performed at Day 28
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 28
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (6).
Časové okno: Evaluation will be performed at Day 36
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 36
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (7).
Časové okno: Evaluation will be performed at Day 50
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 50
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (8).
Časové okno: Evaluation will be performed at Day 56
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 56
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (9).
Časové okno: Evaluation will be performed at Day 64
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 64
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (10)
Časové okno: Evaluation will be performed at Day 78
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 78
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (11).
Časové okno: Evaluation will be performed at Day 92
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 92
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (12).
Časové okno: Evaluation will be performed at Day 102
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 102
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (13).
Časové okno: Evaluation will be performed at 5 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 5 months after randomization.
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (14).
Časové okno: Evaluation will be performed at 6 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 6 months after randomization.
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (17).
Časové okno: Evaluation will be performed at 9 months after randomization .
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 9 months after randomization .
|
|
Assessment of a composite endpoint of graft-versus-host disease-free at 12 months after randomization (18).
Časové okno: Evaluation will be performed at 12 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 12 months after randomization.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (19).
Časové okno: Evaluation will be performed at time of inclusion.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at time of inclusion.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (20).
Časové okno: Evaluation will be performed before start of MTX at the randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed before start of MTX at the randomization.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (21).
Časové okno: Evaluation will be performed at Day 8.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 8.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (20).
Časové okno: Evaluation will be performed at Day 15.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 15.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (21).
Časové okno: Evaluation will be performed at Day 22.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 22.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (22).
Časové okno: Evaluation will be performed at Day 28.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 28.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (23).
Časové okno: Evaluation will be performed at Day 36
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 36
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (24).
Časové okno: Evaluation will be performed at Day 50.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 50.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (25).
Časové okno: Evaluation will be performed at Day 56.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 56.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (26).
Časové okno: Evaluation will be performed at Day 64.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 64.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (27).
Časové okno: Evaluation will be performed at Day 78.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 78.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (28).
Časové okno: Evaluation will be performed at D92.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at D92.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (29).
Časové okno: Evaluation will be performed at Day 102.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at Day 102.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (30).
Časové okno: Evaluation will be performed at 5 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 5 months after randomization.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (31).
Časové okno: Evaluation will be performed at 6 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 6 months after randomization.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (32).
Časové okno: Evaluation will be performed at 9 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 9 months after randomization.
|
|
Assessment of a composite endpoint of corticosteroids-free survival at 12 months after randomization (33).
Časové okno: Evaluation will be performed at 12 months after randomization.
|
GVHD-free survival is defined as absence of initiation of additional GVHD therapy or development of chronic GVHD requiring systemic therapy, and corticosteroids-free survival as absence of continuation of corticosteroids above a dose of 0.15 mg/Kg day. |
Evaluation will be performed at 12 months after randomization.
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Výskyt závažných nežádoucích účinků během prvních 12 měsíců po randomizaci
Časové okno: 12 měsíců po randomizaci
|
12 měsíců po randomizaci
|
|
|
Podíl kompletní remise (CR), velmi dobré částečné odpovědi (VGPR), částečné odpovědi (PR), smíšené odpovědi (MR), žádné odpovědi (NR) a progrese v den 28, den 56 a nejlepší odpověď během prvních 12 měsíců po randomizaci.
Časové okno: v den 28, den 56 a nejlepší odpověď během prvních 12 měsíců po randomizaci.
|
v den 28, den 56 a nejlepší odpověď během prvních 12 měsíců po randomizaci.
|
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Podíl vzplanutí GVHD během prvních 12 měsíců po randomizaci.
Časové okno: 12 měsíců po randomizaci
|
12 měsíců po randomizaci
|
|
|
Kumulativní incidence celkové a závažné chronické GVHD podle NIH Consensus Criteria během prvních 12 měsíců po randomizaci (Jagasia, Greinix et al. 2015, Lee, Wolff et al. 2015).
Časové okno: během prvních 12 měsíců po randomizaci
|
během prvních 12 měsíců po randomizaci
|
|
|
Výskyt systémové infekce a reaktivace CMV (cytomegalovirus) během 3 měsíců po randomizaci
Časové okno: do 3 měsíců po randomizaci
|
do 3 měsíců po randomizaci
|
|
|
Výskyt reaktivace EBV (virus Epstein-Barrové) a potransplantačního lymfoproliferativního onemocnění během 12 měsíců po randomizaci
Časové okno: do 12 měsíců po randomizaci
|
do 12 měsíců po randomizaci
|
|
|
Kumulativní incidence nerecidivující mortality během prvních 12 měsíců po randomizaci.
Časové okno: 12 měsíců po randomizaci
|
12 měsíců po randomizaci
|
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Bez kortikosteroidů, bez onemocnění a celkové přežití během prvních 12 měsíců po randomizaci.
Časové okno: 12 měsíců po randomizaci
|
12 měsíců po randomizaci
|
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Imunitní zotavení a mikroflóra: počet pacientů s kompletním imunitním zotavením (lymfocyty a dendritické buňky) a úpravou dysbiózy mikroflóry během prvních 12 měsíců
Časové okno: 12 měsíců po randomizaci
|
12 měsíců po randomizaci
|
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Quality of Life (QoL)-1
Časové okno: 12 Months
|
Evaluation by 1 questionnaire: EORTC QLQ-C30 (quality of life questionnaire) (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30) |
12 Months
|
|
Quality of Life (QoL)-2
Časové okno: 12 Months
|
Evaluation by 1 questionnaire: FACT-BMT (Functional Assessment of Cancer Therapy - Bone Marrow Transplant) |
12 Months
|
Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Mohamad Mohty, PU-PH, Assistance Publique - Hôpitaux de Paris
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- PHRC-K 16-150
- 2017 (Grant/smlouva NIH USA)
- 2017-002691-98 (Číslo EudraCT)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
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