- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT04089579
hCT-MSC chez les enfants atteints de troubles du spectre autistique (IMPACT)
Une étude de phase II sur hCT-MSC, un produit de cellules stromales mésenchymateuses dérivées du cordon ombilical, chez des enfants atteints de troubles du spectre autistique
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Le but de cette étude de phase II en double aveugle est de déterminer l'efficacité des cellules stromales mésenchymateuses dérivées du tissu du cordon ombilical humain (hCT-MSC), administrées selon deux stratégies de dosage différentes, chez les enfants atteints de troubles du spectre autistique (TSA).
Cette étude recrutera des enfants atteints de TSA âgés de 4 à 11 ans. Les sujets éligibles subiront une évaluation neuropsychologique, des tests EEG, un suivi oculaire, des évaluations CVA et une perfusion du produit de l'étude. Les sujets seront randomisés dans l'un des deux bras de l'étude ; 1) une perfusion unique de 6,0 x 106 cellules/kg au départ, suivie d'une perfusion de placebo en aveugle à six mois ou 2) une perfusion de placebo au départ, suivie d'une dose intraveineuse de 6 x 106 cellules/kg à six mois.
Le critère d'évaluation principal de cette étude est le changement des compétences en communication sociale entre le départ et six mois. Les risques potentiels associés à la perfusion de CSM comprennent une réaction au produit (éruption cutanée, essoufflement, respiration sifflante, difficulté à respirer, hypotension, gonflement autour de la bouche, de la gorge ou des yeux, tachycardie, diaphorèse), la transmission d'infections et la sensibilisation au HLA.
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
-
-
North Carolina
-
Durham, North Carolina, États-Unis, 27705
- Duke University Medical Center
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
La description
Critère d'intégration
- Âge ≥ 4 ans à < 12 ans (11 ans, 364 jours) au moment du consentement
- Diagnostic clinique DSM-5 confirmé de trouble du spectre autistique à l'aide de la liste de contrôle DSM-5, conformément à la brève observation des symptômes de l'autisme (BOSA) et à l'entretien diagnostique de l'autisme révisé (ADI-R)
- Test X fragile effectué et négatif ; CMA et/ou séquençage de l'exome entier effectué et résultats non liés au diagnostic d'autisme
- Stable sur le régime de médicaments psychiatriques actuel (dose et schéma posologique) pendant au moins 2 mois avant la perfusion du produit à l'étude
- Numération lymphocytaire absolue normale (≥1200/uL pour les participants afro-américains et ≥1500/uL pour tous les autres participants)
- GAI ≥ 65 via des tests cognitifs par le personnel de l'étude
- Le participant et le parent/tuteur parlent anglais
- Capable de se rendre à l'Université Duke deux fois (baseline, six mois), et le parent/tuteur est en mesure de participer à des enquêtes et entretiens intermédiaires
- Consentement parental/tuteur d'au moins un parent/tuteur
Critère d'exclusion
Général:
- L'examen des dossiers médicaux et/ou des évaluations de dépistage indique un diagnostic de TSA et/ou un GAI > 65 pas confiant
- Diagnostic connu de l'un des troubles psychiatriques coexistants suivants : dépression, trouble bipolaire, schizophrénie, trouble obsessionnel-compulsif associé au trouble bipolaire, syndrome de Tourette
- Les données de dépistage suggèrent que le participant ne serait pas en mesure de se conformer aux exigences des procédures de l'étude telles qu'évaluées par l'équipe de l'étude
- La famille ne veut pas ou ne peut pas s'engager à participer à toutes les évaluations liées à l'étude, y compris le suivi du protocole
- Un frère ou une sœur est inscrit à cette étude (Duke IMPACT)
Génétique:
- Les dossiers indiquent que l'enfant a un syndrome génétique connu tel que (mais sans s'y limiter) le syndrome de l'X fragile, la neurofibromatose, le syndrome de Rett, la sclérose tubéreuse, la mutation PTEN, la fibrose kystique, la dystrophie musculaire ou une anomalie génétique définitivement connue pour être associée au TSA
- Mutation pathogène connue ou variation du nombre de copies (CNV) associée au TSA (par exemple, 16p11.2, 15q13.2, 2q13.3)
Infectieux:
- Infection active connue du SNC
- Preuve d'une infection non contrôlée basée sur les dossiers ou l'évaluation clinique
- Positivité connue pour le VIH
- Exposition au COVID-19 au cours des 14 jours précédents ou test COVID-19 positif au cours des 28 jours précédents. Les sujets ayant des antécédents d'infection par le COVID-19 doivent être asymptomatiques pendant 14 jours avant la visite initiale.
Médical:
- Trouble métabolique connu
- Dysfonctionnement mitochondrial connu
- Antécédents d'épilepsie instable ou de trouble convulsif incontrôlé, de spasmes infantiles, de syndrome de Lennox Gastaut, de syndrome de Dravet ou d'un autre trouble convulsif chronique similaire
- Malignité active ou malignité antérieure traitée par chimiothérapie
- Antécédents d'un trouble d'immunodéficience primaire
- Antécédents de cytopénies auto-immunes (c'est-à-dire ITP, AIHA)
- Condition médicale coexistante qui exposerait l'enfant à un risque accru de complications des procédures d'étude
- Maladie génétique ou acquise concomitante ou comorbidité(s) pouvant nécessiter une future greffe de cellules souches
- Déficience sensorielle (par exemple, cécité, surdité, déficience auditive non corrigée) ou motrice (par exemple, paralysie cérébrale) importante
- Insuffisance rénale ou hépatique telle que déterminée par la créatinine sérique> 1,5 mg / dL ou la bilirubine totale> 1,3 mg / dL, sauf chez les patients atteints de la maladie de Gilbert connue
- Anomalies hématologiques significatives définies comme : hémoglobine <10,0 g/dL, plaquettes <150 x 10e9/uL, WBC <3 000 cellules/mL, ALC <1 200/uL pour les Afro-Américains ou <1 500/uL pour tous les autres participants.
- Preuve d'une dysmorphologie physique cliniquement pertinente indiquant un syndrome génétique telle qu'évaluée par les IP ou d'autres chercheurs, y compris un généticien médical et des psychiatres formés à l'identification des caractéristiques dysmorphiques associées aux conditions neurodéveloppementales.
Thérapie actuelle/antérieure :
un. Disponibilité d'une unité de sang de cordon autologue qualifiée en banque ou les parents ont reporté l'utilisation d'une unité de sang de cordon autologue qualifiée b. Antécédents de thérapie cellulaire c. Utilisation actuelle ou antérieure d'IgIV ou d'autres médicaments anti-inflammatoires à l'exception des AINS d. Traitement immunosuppresseur actuel ou antérieur i. Aucun traitement stéroïdien systémique qui a duré> 2 semaines et aucun stéroïde systémique dans les 3 mois précédant l'inscription. Les stéroïdes topiques et inhalés sont autorisés.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: MSC
Une dose de 6x10e6 cellules/kg administrée par voie intraveineuse.
|
Cellules stromales mésenchymateuses dérivées de tissu de cordon ombilical humain (hCT-MSC), isolées et développées à partir de tissu de cordon ombilical provenant de donneurs non apparentés allogéniques.
Une dose de 6x10e6 cellules/kg administrée par voie intraveineuse.
|
|
Comparateur placebo: Perfusion placebo
|
Perfusion comparative placebo
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change on the Average Socialization and Communication Subscale Standard Scores on the Vineland Behavior Scales (VABS-3)
Délai: Baseline, 6 months
|
The primary outcome measure is the mean of the Socialization and Communication Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form.
The primary endpoint is the change in this outcome measure from baseline to six months before the second infusion.
A positive change in the scores indicates an improvement in socialization and communication.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in VABS-3 (Vineland Adaptive Behavior Scales) Socialization Standard Score
Délai: Baseline, 6 months
|
The change in the Socialization Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months.
Higher Socialization Standard scores indicate greater socialization.
A positive change in the scores indicates an improvement in socialization.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
|
Change in VABS-3 Communication Standard Score
Délai: Baseline, 6 months
|
The change in the Communication Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion.
Higher scores indicate greater communication.
A positive change in the scores indicates an improvement in communication.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
|
CGI-S (Clinical Global Impression - Severity of Illness) Overall Score
Délai: 6 months
|
The CGI-S Overall Score is a 7-point scale that requires the clinician to rate the severity of the participant's overall functioning and symptoms of autism at the time of assessment, relative to the clinician's experience with participants who have the same diagnosis.
The clinician rates the severity of autism symptoms - 1, normal, no symptoms; 2, borderline level of symptoms; 3, mild symptoms; 4, moderate symptoms; 5, marked symptoms; 6, severe symptoms; or 7, extremely severe symptoms.
The higher ratings indicate greater severity of overall functioning impairment.
|
6 months
|
|
CGI-I (Clinical Global Impression - Improvement) Overall Score
Délai: 6 months
|
The CGI-I Overall Score is a 7-point scale that requires the clinician to assess how much the participant's autism overall functioning and symptoms have improved or worsened relative to a baseline assessment.
The symptoms are rated as: 1, very much improved; 2, much improved; 3, minimally improved; 4, no change; 5, minimally worse; 6, much worse; or 7, very much worse.
The lower scores indicate greater improvement.
|
6 months
|
|
Change in the Pediatric Quality of Life (PedsQL) Total Scale Score
Délai: Baseline, 6 months
|
The PedsQL 4.0 Generic Core Scales is a 5-minute parent questionnaire that measures the child's functioning in the dimensions of physical, emotional, social, and school.
The items use a Likert rating scale from 0 (Never) to 4 (Almost Always).
This 0-4 scale is then transformed to 0=100, 1=75, 2=50, 3=25, and 4=0 for a reverse score.
The Total Scale Score is then computed as the sum of all the items over the number of items answered on all the Scales for a total score range of 0 to 100.
Higher scores indicate a better quality of life.
|
Baseline, 6 months
|
Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Number of Participants Experiencing an Infusion Reaction
Délai: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not what they were randomized.
Patients received the infusion to which they were randomized at baseline and the alternate treatment at 6 months.
Therefore, adverse events are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
|
up to 12 months
|
|
Number of Participants Experiencing Product-related Infections
Délai: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
|
up to 12 months
|
|
Evidence of Formation of Anti-HLA Antibodies
Délai: Baseline, 6 months, 12 months
|
Assess for anti-HLA antibodies
|
Baseline, 6 months, 12 months
|
|
Number of Participants Experiencing Graft Versus Host Disease (GVHD)
Délai: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
|
up to 12 months
|
|
Number of Participants Experiencing Unexpected Adverse Events Related to the Study Product
Délai: up to 12 months
|
To assess safety, participants were considered according to the treatment received at each time point, not to what they were randomized.
Patients received the infusion to which they are randomized at baseline, and the alternate treatment at 6 months.
AEs are reported by randomized treatment arm broken into periods: 0-6 months (post-baseline infusion, pre-six month infusion) and 6-12 months (post-six month infusion).
6-12 month evaluation time points are further broken into whether or not the participant received a second infusion, since three MSC patients and one Placebo patient did not receive the 6-month incentive infusion but were still evaluated.
|
up to 12 months
|
|
Change on the Adaptive Behavior Composite Subscale Standard Score on the Vineland Behavior Scales (VABS-3)
Délai: Baseline, 6 months
|
The change in the Vineland Adaptive Behavior Scales (VABS-3) Adaptive Behavior Composite Subscale from baseline to 6 months before the second infusion.
Higher Adaptive Behavior Composite Standard scores indicate greater adaptive behavior.
A positive change in the scores indicates an improvement in adaptive behavior.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
|
Change in VABS-3 (Vineland Adaptive Behavior Scales) Daily Living Skills Standard Score
Délai: Baseline, 6 months
|
The change in the Daily Living Skills Subscale Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from baseline to six months before the second infusion.
Higher Daily Living Skills Standard scores indicate greater daily living skills.
A positive change in the scores indicates an improvement in daily living skills.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
|
Change in VABS-3 Motor Skills Standard Score
Délai: Baseline, 6 months
|
The change in the Motor Skills Standard Scores on the Vineland Adaptive Behavior Scales (VABS-3) from the Comprehensive Interview form from baseline to six months before the second infusion.
Higher scores indicate greater motor skills.
A positive change in the scores indicates an improvement in motor skills.
A standard score of 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Domain scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
|
Baseline, 6 months
|
|
Change in Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal
Délai: Baseline, 6 months
|
The change in the Aberrant Behavior Checklist-Community (ABC-C) Social Withdrawal scale from baseline to six months before the second infusion.
Higher scores indicate greater problems with social withdrawal.
A positive change in the scores indicates a worsening in social withdrawal.
This scale has 16 items that are scored on a 4-point Likert scale: 0 = not a problem, 1 = slight problem, 2 = moderately serious problem, 3 = severe problem.
The individual items are added together to calculate the Social Withdrawal scale score.
|
Baseline, 6 months
|
|
Change in Pervasive Developmental Disorder Behavior Inventory (PDDBI) Total Score
Délai: Baseline, 6 months
|
The change in the Pervasive Developmental Disorder Behavior Inventory (PDDBI) from baseline to 6 months before the second infusion.
The PDDBI is a measure of problem behaviors and social, language, and learning or memory skills of children who have been diagnosed with autism spectrum disorder.
Raw scores are converted to T-scores.
The T-score has a mean of 50 with a standard deviation of 10 points with a range of 10-100.
Higher scores indicate greater behavioral issues and a positive change in score indicates worsening.
|
Baseline, 6 months
|
|
Change in the Autism Impact Measure (AIM)
Délai: Baseline, 6 months
|
The change in the Autism Impact Measure (AIM) from baseline to 6 months before second infusion.
AIM is a measure of core Autism Spectrum Disorder Symptoms.
It is a parent-report questionnaire that includes 41 core-symptom items rated on two corresponding 5-point scales: frequency (ranging from "never" to "always") and impact (ranging from "not at all" to "severely") over the previous two weeks.
Frequency and impact ratings are combined, yielding a total score range of 82 to 410.
Higher scores indicate greater symptom severity; a positive change in score indicates worsening of symptoms.
|
Baseline, 6 months
|
|
Change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control Subscale
Délai: Baseline, 6 months
|
The change in the Behavior Rating Inventory of Executive Function (BRIEF) Emotional Control subscale from baseline to month 6 before the second infusion.
BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
|
Baseline, 6 months
|
|
Change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory Subscale
Délai: Baseline, 6 months
|
The change in the Behavior Rating Inventory of Executive Function (BRIEF) Working Memory subscale from baseline to month 6 before the second infusion.
The BREIF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
|
Baseline, 6 months
|
|
Change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit Subscale
Délai: Baseline, 6 months
|
The change in the Behavior Rating Inventory of Executive Function (BRIEF) Inhibit subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
|
Baseline, 6 months
|
|
Change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization Subscale
Délai: Baseline, 6 months
|
The change in the Behavior Rating Inventory of Executive Function (BRIEF) Plan/Organization subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
|
Baseline, 6 months
|
|
Change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift Subscale
Délai: Baseline, 6 months
|
The change in the Behavior Rating Inventory of Executive Function (BRIEF) Shift subscale from baseline to month 6 before the second infusion.
The BRIEF is a survey that assesses executive function and self-regulation with the following subscales: Inhibit, Shift, Emotional Control, Working Memory, and Planning and Organization.
Higher scores indicate greater levels of dysfunction each respective domain.
A positive change in score indicates worsening the respective domain.
Raw scores for each domain are converted to t-scores (Mean = 50, SD = 10) and percentiles.
T scores 60-64 are considered to be mildly elevated, 65-69 are considered to be potentially clinically elevated, and >= 70 are considered to be clinically elevated.
|
Baseline, 6 months
|
|
Change in the Expressive Vocabulary Test (Third Edition, EVT-3)
Délai: Baseline, 6 months
|
The change in the Expressive Vocabulary Test (Third Edition, EVT-3) from baseline to 6 months before the second infusion.
The EVT-3 is a measure of a participant's ability to match a spoken word with an image of an object, action, or concept.
The number of words that are retrieved is converted to a Standard Score, where 100 is the mean with a standard deviation of 15 points.
A score of 100 should be understood as being similar to the typical population of the same age.
Scores greater than or equal to 86 are considered adequate or above adequate.
Scores less than or equal to 85 are considered moderately low to low and indicate the patient has a significant skill deficit when compared with similarly aged peers.
A positive change in EVT-3 score indicates improvement.
|
Baseline, 6 months
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Lauren Franz, MBChB, Duke University
- Chercheur principal: Beth Shaz, MD, Duke University
Publications et liens utiles
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- Pro00113011
- Pro00102894 (Autre identifiant: Duke IRB)
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Étudie un produit d'appareil réglementé par la FDA américaine
produit fabriqué et exporté des États-Unis.
Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .