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Study to Evaluate the Efficacy and Safety of Reslizumab Treatment in Patients With Moderate to Severe Asthma

A 16-Week, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Reslizumab (3.0 mg/kg) Treatment in Patients With Moderate to Severe Asthma

The primary objective of the study is to characterize the efficacy of reslizumab treatment, at a dosage of 3.0 milligrams per kilogram (mg/kg) every 4 weeks for a total of 4 doses, in improving pulmonary function in relation to baseline blood eosinophil levels in patients with moderate to severe asthma, as assessed by the change from baseline to week 16 in forced expiratory volume in 1 second (FEV1).

Studieoversigt

Status

Afsluttet

Betingelser

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

511

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Alabama
      • Birmingham, Alabama, Forenede Stater
        • Investigational Site 861
      • Homewood, Alabama, Forenede Stater
        • Investigational Site 842
      • Jasper, Alabama, Forenede Stater
        • Investigational Site 887
    • Arizona
      • Tucson, Arizona, Forenede Stater
        • Investigational Site 809
      • Tucson, Arizona, Forenede Stater
        • Investigational Site 892
    • Arkansas
      • Little Rock, Arkansas, Forenede Stater
        • Investigational Site 846
    • California
      • Anaheim, California, Forenede Stater
        • Investigational Site 828
      • Fresno, California, Forenede Stater
        • Investigational Site 900
      • Huntington Beach, California, Forenede Stater
        • Investigational Site 862
      • Los Angeles, California, Forenede Stater
        • Investigational Site 852
      • Los Angeles, California, Forenede Stater
        • Investigational Site 909
      • Newport Beach, California, Forenede Stater
        • Investigational Site 864
      • Rancho Mirage, California, Forenede Stater
        • Investigational Site 812
      • Riverside, California, Forenede Stater
        • Investigational Site 808
      • Sacramento, California, Forenede Stater
        • Investigational Site 804
    • Colorado
      • Centennial, Colorado, Forenede Stater
        • Investigational Site 837
      • Denver, Colorado, Forenede Stater
        • Investigational Site 851
      • Wheat Ridge, Colorado, Forenede Stater
        • Investigational Site 832
    • Florida
      • Jacksonville, Florida, Forenede Stater
        • Investigational Site 855
      • Miami, Florida, Forenede Stater
        • Investigational Site 865
      • Miami, Florida, Forenede Stater
        • Investigational Site 881
    • Georgia
      • Albany, Georgia, Forenede Stater
        • Investigational Site 805
      • Stockbridge, Georgia, Forenede Stater
        • Investigational Site 870
    • Illinois
      • Chicago, Illinois, Forenede Stater
        • Investigational Site 816
      • Shiloh, Illinois, Forenede Stater
        • Investigational Site 824
    • Indiana
      • Evansville, Indiana, Forenede Stater
        • Investigational Site 883
      • Fort Wayne, Indiana, Forenede Stater
        • Investigational Site 878
    • Kansas
      • Lenexa, Kansas, Forenede Stater
        • Investigational Site 820
    • Kentucky
      • Owensboro, Kentucky, Forenede Stater
        • Investigational Site 873
    • Louisiana
      • Lafayette, Louisiana, Forenede Stater
        • Investigational Site 801
      • Mandeville, Louisiana, Forenede Stater
        • Investigational Site 877
    • Maryland
      • White Marsh, Maryland, Forenede Stater
        • Investigational Site 875
    • Massachusetts
      • Fall River, Massachusetts, Forenede Stater
        • Investigational Site 871
      • North Dartmouth, Massachusetts, Forenede Stater
        • Investigational Site 834
    • Michigan
      • Troy, Michigan, Forenede Stater
        • Investigational Site 889
    • Missouri
      • Rolla, Missouri, Forenede Stater
        • Investigational Site 838
      • St. Louis, Missouri, Forenede Stater
        • Investigational Site 818
      • St. Louis, Missouri, Forenede Stater
        • Investigational Site 841
    • New Mexico
      • Albuquerque, New Mexico, Forenede Stater
        • Investigational Site 857
    • New York
      • Newburgh, New York, Forenede Stater
        • Investigational Site 819
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater
        • Investigational Site 844
    • Ohio
      • Middleburg Heights, Ohio, Forenede Stater
        • Investigational Site 845
    • Oklahoma
      • Tulsa, Oklahoma, Forenede Stater
        • Investigational Site 810
    • Oregon
      • Ashland, Oregon, Forenede Stater
        • Investigational Site 859
      • Portland, Oregon, Forenede Stater
        • Investigational Site 859
    • Pennsylvania
      • Jenkintown, Pennsylvania, Forenede Stater
        • Investigational Site 854
    • Rhode Island
      • Providence, Rhode Island, Forenede Stater
        • Investigational Site 843
    • South Carolina
      • Florence, South Carolina, Forenede Stater
        • Investigational Site 802
      • Orangeburg, South Carolina, Forenede Stater
        • Investigational Site 814
      • Spartanburg, South Carolina, Forenede Stater
        • Investigational Site 821
      • Spartanburg, South Carolina, Forenede Stater
        • Investigational Site 829
    • Tennessee
      • Knoxville, Tennessee, Forenede Stater
        • Investigational Site 850
      • Nashville, Tennessee, Forenede Stater
        • Investigational Site 803
    • Texas
      • Dallas, Texas, Forenede Stater
        • Investigational Site 880
      • Dickinson, Texas, Forenede Stater
        • Investigational Site 858
      • Live Oak, Texas, Forenede Stater
        • Investigational Site 869
      • Plano, Texas, Forenede Stater
        • Investigational Site 879
    • Utah
      • Salt Lake City, Utah, Forenede Stater
        • Investigational Site 847
      • West Jordan, Utah, Forenede Stater
        • Investigational Site 876
    • Virginia
      • Fairfax, Virginia, Forenede Stater
        • Investigational Site 840
      • Richmond, Virginia, Forenede Stater
        • Investigational Site 836
    • Washington
      • Seattle, Washington, Forenede Stater
        • Investigational Site 867
      • Spokane, Washington, Forenede Stater
        • Investigational Site 833
      • Vancouver, Washington, Forenede Stater
        • Investigational Site 904
    • Wisconsin
      • Greenfield, Wisconsin, Forenede Stater
        • Investigational Site 806
      • LaCrosse, Wisconsin, Forenede Stater
        • Investigational Site 823

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion criteria:

Patients are included in the study if all of the following criteria are met:

  • The patient is a man or woman, 18 through 65 years of age, with a diagnosis of asthma.
  • The patient has an ACQ score of at least 1.5.
  • At screening, the patient has airway reversibility of at least 12% to beta-agonist administration.
  • The patient is currently taking fluticasone at a dosage of at least 440 µg daily (or equivalent). Patients' baseline asthma therapy regimens (including but not limited to inhaled corticosteroids, leukotriene antagonists, 5-lipoxygenase inhibitors, cromolyn) must be stable for 30 days before screening and continue without dosage changes throughout study.
  • Female patients must be surgically sterile, 2 years postmenopausal, or must have a negative beta-human chorionic gonadotropin (ßHCG) result for a pregnancy test at screening (serum) and baseline (urine).
  • Female patients of childbearing potential (not surgically sterile or 2 years postmenopausal), must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 30 days after participation in the study. Acceptable methods of contraception include barrier method with spermicide, abstinence, intrauterine device (IUD), or steroidal contraceptive (oral, transdermal, implanted, and injected).
  • Written informed consent is obtained.
  • The patient is in reasonable health (except for diagnosis of asthma) as judged by the investigator, and as determined by a medical history, medical examination, electrocardiogram (ECG) evaluation, serum chemistry, hematology, urinalysis, and serology.
  • The patient must be willing and able to comply with study restrictions and to remain at the clinic for the required duration during the study period, and be willing to return to the clinic for the follow-up evaluation as specified in this protocol.

Exclusion Criteria:

Patients are excluded from participating in this study if 1 or more of the following criteria are met:

  • The patient has another confounding underlying lung disorder (eg, chronic obstructive pulmonary disease, pulmonary fibrosis, lung cancer). The patient has other pulmonary conditions with symptoms of asthma and blood eosinophilia (eg, Churg-Strauss syndrome, allergic bronchopulmonary aspergillosis).
  • The patient has a clinically meaningful comorbidity that would interfere with the study schedule or procedures, or compromise the patient's safety.
  • The patient has known hypereosinophilic syndrome (HES).
  • The patient is a current smoker (ie, has smoked within the last 6 months prior to screening).
  • The patient has a history of use of systemic immunosuppressive or immunomodulating agents (anti-immunoglobulin E [anti-IgE] mAb, methotrexate, cyclosporin, interferon-α, anti-tumor necrosis factor mAb, or omalizumab) within 6 months prior to study entry (randomization).
  • The patient is currently using or has used systemic corticosteroids (includes use of oral corticosteroids) within 30 days prior to the screening visit.
  • The patient is expected to be poorly compliant with study drug administration, study procedures, or visits.
  • The patient has any aggravating factors that are inadequately controlled, and thus would aggravate asthma symptoms (eg, gastroesophageal reflux disease).
  • The patient has participated in any investigative drug or device study within 30 days prior to screening.
  • The patient has participated in any investigative biologics study within 90 days prior to screening.
  • The patient has previously received reslizumab or other anti-hIL-5 mAbs (eg, mepolizumab).
  • The patient is a pregnant or lactating woman. (Any women becoming pregnant during the study will be withdrawn from the study.)
  • The patient has a current infection or disease that may preclude assessment of asthma.
  • The patient has a history of concurrent immunodeficiency (human immunodeficiency, acquired immunodeficiency syndrome, or congenital immunodeficiency).
  • The patient is suspected of current drug or alcohol abuse as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria.
  • The patient has presence of or suspected parasitic infestation/infection.
  • Patients may not have received any live attenuated vaccine within the 12-week period before study entry.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Placebo komparator: Placebo
Placebo intravenous injection every 4 weeks for a total of 4 doses.
Matching placebo administered by intravenous (iv) infusion by qualified study personnel every 4 weeks for 16 weeks (for a total of 4 doses).
Eksperimentel: Reslizumab 3.0 mg/kg
Reslizumab intravenous injection at a dosage of 3.0 mg/kg every 4 weeks for a total of 4 doses.
Reslizumab administered at a dosage of 3.0 mg/kg by intravenous (iv) infusion by qualified study personnel every 4 weeks for 16 weeks (for a total of 4 doses).
Andre navne:
  • Cinquil
  • humaniseret monoklonalt antistof
  • CEP-38072

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Week 16 in Full Analysis Set
Tidsramme: Baseline (Day 1), Week 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry.

Data represent the slope estimate of change from baseline in FEV1 (measured in liters) at Week 16 versus baseline eosinophil count (measured in 10^9/liter) by treatment group.

Baseline (Day 1), Week 16

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Over 16 Weeks Using Mixed Model for Repeated Measures
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.

During study (Weeks 4, 8, 12 and 16) average value was calculated using a mixed effects model for repeated measures (MMRM) with treatment (reslizumab or placebo), blood eosinophil count at baseline, and the interaction of treatment and eosinophil count as a random effect.

Baseline (Day 1), Weeks 4, 8, 12, 16
Change From Baseline in Asthma Control Questionnaire (ACQ) Over 16 Weeks Using Mixed Model for Repeated Measures
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, 16

The ACQ score was measured using the ACQ-7. Six questions are-self assessments; the seventh item is the result of the patient's % predicted FEV1 measurement. Each item has 7 possible answers on a scale of 0 to 6, and the total score is the mean of all responses (the total scale is therefore 0-6). A score of 0 indicates good asthma control; higher scores indicate increasingly poorer asthma control. Negative change from baseline scores indicate improvement in asthma control.

During study (Weeks 4, 8, 12 and 16) average value was calculated from mixed model repeated measures (MMRM) with treatment, visit, treatment by visit interaction, history of asthma exacerbation in the previous year, height, baseline value, and sex as fixed factors, and patient as a random effect.

Baseline (Day 1), Weeks 4, 8, 12, 16
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Week 16 in FEV1 Subpopulation
Tidsramme: Baseline (Day 1), Week 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry.

As with the primary outcome, data represent the slope estimate of change from baseline in FEV1 (measured in liters) at Week 16 versus baseline eosinophil count (measured in 10^9/liter) by treatment group. However the FEV1 subpopulation includes participants with more impaired lung function (% predicted FEV1 <85% at baseline).

Baseline (Day 1), Week 16
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Weeks 4, 8, 12, and 16
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, and 16
FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (% Predicted FEV1) at Weeks 4, 8, 12, 16 and Endpoint
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, and 16
The percent predicted FEV1 is the ratio of the volume of air expired in the first second of a forced expiration to the patient's predicted FEV based on a similar population without asthma. Percent predicted lung function values were transcribed directly from the lung function report to the CRF, without any calculation by Teva. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Forced Vital Capacity (FVC) at Weeks 4, 8, 12, and 16
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, and 16
The FVC is the volume of air that can be forcibly blown out after full inspiration, measured in liters. FV was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in the Forced Expiratory Flow at 25% to 75% of the Forced Vital Capacity (FEF25%-75%) at Weeks 4, 8, 12, and 16
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, and 16
The FEF25%-75% is the forced expiratory flow at 25% to 75% of the forced vital capacity. FEF25%-75% was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Average Daily Use of Short-Acting Beta-Agonist Therapy (SABA) at Weeks 4, 8, 12, and 16
Tidsramme: Baseline (Day -2 to 1), Weeks 4, 8, 12, and 16
SABA are used for quick relief of asthma symptoms. The number of times SABA therapy was used was assessed using 3 day recall at scheduled visits. Participants were asked to recall whether SABAs were used within 3 days of the scheduled visit and, if so, how many puffs were used. Daily use was the average of those 3 days. Negative change from baseline scores indicate improvement in asthma control.
Baseline (Day -2 to 1), Weeks 4, 8, 12, and 16
Change From Baseline in Blood Eosinophil Counts at Weeks 4, 8, 12, 16, Follow-up (Week 28) and Endpoint
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12, 16, Follow-up (Week 28)
Blood eosinophil counts were measured using a standard complete blood count with differential blood test at each scheduled visit. Follow-up was performed approximately 12 weeks after the 16 week treatment period. Endpoint is the last post-baseline assessment.
Baseline (Day 1), Weeks 4, 8, 12, 16, Follow-up (Week 28)
Change From Baseline in Asthma Control Questionnaire (ACQ) at Weeks 4, 8, 12 and 16
Tidsramme: Baseline (Day 1), Weeks 4, 8, 12 and 16
The ACQ score was measured using the ACQ-7. Six questions are self-assessments; the seventh item is the result of the patient's % predicted FEV1 measurement. Each item has 7 possible answers on a scale of 0 to 6, and the total score is the mean of all responses (the total scale is therefore 0-6). A score of 0 indicates good asthma control; higher scores indicate increasingly poorer asthma control. Negative change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12 and 16
Participants With Treatment-Emergent Adverse Events
Tidsramme: Day 1 to Week 28
An adverse event was defined in the protocol as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= an inability to carry out usual activities. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent the previously listed serious outcomes.
Day 1 to Week 28
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Abnormal Lab Values
Tidsramme: Week 4 to Week 16

Data represents participants with potentially clinically significant (PCS) abnormal serum chemistry, hematology, and urinalysis values during any of the lab tests conducted during the treatment period.

Significance criteria:

  • Blood urea nitrogen: >=10.71 mmol/L
  • Creatinine: >=177 μmol/L
  • Uric acid: M>=625, F>=506 μmol/L
  • Aspartate aminotransferase: >=3*upper limit of normal (ULN). Normal range is 10-43 U/L
  • Alanine aminotransferase: >=3*ULN. Normal range is 10-40 U/L
  • GGT = gamma-glutamyl transpeptidase: >= 3*ULN. Normal range is 4-49 U/L.
  • Total bilirubin: >=34.2 μmol/L
  • Creatinine phosphokinase: >5*ULN. Normal range is 24-207 U/L.
  • White blood cells: <=3.0 or >20 10^9/L
  • Hemoglobin: M<=115, F<=95 g/dL
  • Hematocrit: M<0.37, F<0.32 L/L
  • Platelets: <=75 10^9/L
  • Absolute neutrophil count: <=1.0 10^9/L
  • Urinalysis: blood, glucose, ketones and total protein: >=2 unit increase from baseline
Week 4 to Week 16
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Vital Signs Values
Tidsramme: Week 4 to Week 28

Data represents participants with potentially clinically significant (PCS) vital sign values during any of the treatment period exams.

Significance criteria

  • Heart rate - high: >100 and increase of >= 30 beats/minute (bpm)
  • Sitting systolic blood pressure - high: >160 and increase of >=30 mmHg
  • Sitting systolic blood pressure - low: <90 and decrease of >=30 mmHg
  • Sitting diastolic blood pressure - high: >100 and increase of >=12 mmHg
  • Sitting diastolic blood pressure - low: <50 and decrease of >=12 mmHg
  • Body temperature - high: >100.5° Fahrenheit or 38.1° Celsius and increase of >2°
  • Body temperature - low: <96.5° Fahrenheit or <35.8° Celsius
Week 4 to Week 28
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Electrocardiogram (ECG) Abnormalities
Tidsramme: Week 16 or endpoint
Counts represent the number of participants with potentially clinically significant ECG abnormalities as assessed by the investigator.
Week 16 or endpoint
Participants With a Positive Anti-Reslizumab Antibody Status During Study
Tidsramme: Screening (Week -3), Weeks 8 and 16

Counts of participants with a positive anti-drug antibody (ADA) response during treatment is offered for the experimental treatment arm. Blood samples were collected for determination of ADAs before study drug infusion at screening, weeks 8 and 16 or early withdrawal. Serum samples from patients who were treated with reslizumab were analyzed for ADA by Teva (Teva Biopharmaceuticals USA, Rockville, MD) using a validated homogeneous solution-based bridging enzyme-linked immunosorbent assay (ELISA).

Endpoint =week 16 or early withdrawal.

Counts represent the total number of participants at each time point with a positive immunogenicity test, and not 'new' participants with a positive test. An overall status of positive includes participants who had a positive ADA at any time point.

Screening (Week -3), Weeks 8 and 16

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Studieleder: Global Respiratory Clinical Research, M.D., Sponsor's Medical Expert

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. februar 2012

Primær færdiggørelse (Faktiske)

1. august 2013

Studieafslutning (Faktiske)

1. august 2013

Datoer for studieregistrering

Først indsendt

3. januar 2012

Først indsendt, der opfyldte QC-kriterier

10. januar 2012

Først opslået (Skøn)

12. januar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

27. juni 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. maj 2016

Sidst verificeret

1. maj 2016

Mere information

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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