Treatment Resistance in Psychiatric Disorders: the Search for Biological Markers Predictive of Response to Treatment (BIO-INM)
The disruption of immune system is a key candidate in the pathogenesis of psychiatric disorders, especially those resistant to traditional treatments. Involving complex processes within the brain and peripheral immune system, inflammation may lead to imbalance of neurotransmitter systems and synaptic plasticity and directly contribute to the psychiatric symptoms observed in conditions such as depression, bipolar disorder (BD) and schizophrenia (SCZ).
Studies show that treatment-resistant depression (TRD) is associated with elevated levels of inflammatory markers in the blood, which are linked to a lower response to conventional antidepressants. Interventions that modulate this inflammatory response, such as immunomodulatory treatments or therapies targeting pro-inflammatory cytokines, have demonstrated beneficial effects by reducing symptoms and improving patients' quality of life.
A thorough understanding of the links between inflammation and treatment resistance therefore paves the way for innovative therapeutic strategies. These approaches could transform current practices by offering more personalized and effective solutions for patients suffering from chronic and resistant psychiatric disorders.
A tanulmány áttekintése
Állapot
Állapot
Körülmények
Körülmények
Beavatkozás / kezelés
Beavatkozás / kezelés
Tanulmány típusa
Tanulmány típusa
Beiratkozás (Becsült)
Beiratkozás
Fázis
Fázis
- Nem alkalmazható
Kapcsolatok és helyek
Tanulmányi kapcsolat
Tanulmányi kapcsolat
- Név: Iolanda PALIMARU, MD
- Telefonszám: +33145658798
- E-mail: iolanda.palimaru@ghu-paris.fr
Tanulmányi helyek
-
-
-
Paris, Franciaország, 75014
- GHU Paris - Psychiatrie et Neurosciences
-
Kapcsolatba lépni:
- Cécile MICHEL
- Telefonszám: +331 80 52 70 19
- E-mail: cecile.bultez@ghu-paris.fr
-
-
Részvételi kritériumok
Jogosultsági kritériumok
Jogosultsági kritériumok
Tanulmányozható életkorok
- Felnőtt
- Idősebb felnőtt
Egészséges önkénteseket fogad
Leírás
Inclusion Criteria:
- Patient aged ≥ 18 years old;
- Patient suffering from a psychiatric disorder according to DSM-5 criteria;
- Patient with drug-resistant disease according to the definition of the protocol
- Patient starting a new treatment for his pathology;
- Patient informed and having signed an informed consent;
- Patient covered by the social security system.
Exclusion Criteria:
- Patient with major neurocognitive disorder diagnosed (dementia syndrome)
- Pregnant, laboring, or breastfeeding female patients
- Patient deprived of liberty by judicial or administrative decision. Patient in psychiatric care under constraints may be included.
- For patients accepting the lumbar punction: patients who are unable to control themselves and are likely to engage in physical or violent behavior.
Tanulási terv
Hogyan készül a tanulmány?
Tervezési részletek
- Elsődleges cél: Egyéb
- Kiosztás: Nem véletlenszerű
- Beavatkozó modell: Párhuzamos hozzárendelés
- Maszkolás: Nincs (Open Label)
Fegyverek száma
Fegyverek és beavatkozások
Résztvevő csoport / karRésztvevő csoport / kar |
Beavatkozás / kezelésBeavatkozás / kezelés |
|---|---|
|
Egyéb: OCD cohort
Patients suffering from OCD resistant to treatments
|
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
|
|
Egyéb: Catatonia cohort
Patients suffering from resistant catatonia
|
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
|
|
Egyéb: TRD cohort
Patients suffering from treatment resistant depression (TRD)
|
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
|
|
Egyéb: BD cohort
Patients suffering from treatment resistant bipolar disorders (BD)
|
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
|
|
Egyéb: Schizophrenia cohort
Patients suffering from schizophrenia resistant to treatments
|
the biomarker research involves different biological sampling : blood, stool, cerebrospinal fluid, skin
|
Mit mér a tanulmány?
Elsődleges eredményintézkedések
Elsődleges eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for Schizophrenia patients.
The minimal score is 30.
The maximal score is 210.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for depression.
The minimal score is 0. The maximal score is 60.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for bipolar troubles.
The minimal score is 0. The maximal score is 60.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for obsessive compulsive disorder.
The minimal score is 0. The maximal score is 72.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for obsessive compulsive disorder.
The minimal score is 0 mm.
The maximal score is 100 mm.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in disease scale scores at the end of acute phase therapy (V3)
Időkeret: Up to 10 weeks
|
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and the end of acute phase therapy (V3).
The scale will be used to assess disease severity for catatonia.
The minimal score is 0 mm.
The maximal score is 69.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : White blood cells, neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets in G/L
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : C3, C4, fibrinogen in g/L.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : Vitamin B12, IL-1β, IL-6, IL-18 in pg/mL.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : Folate, Vitamin B1, B6, D, cortisol in nmol/L.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : TSH, prolactin in mUI/L
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : CRPus, β2 microglobulin, C1q in mg/L.
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in biological parameters at the end of acute phase therapy (V3).
Időkeret: Up to 10 weeks
|
Changes in biological parameters measured between inclusion (V1) and the end of acute phase therapy (V3).
The dosages are : anti-TPO Ab, anti-TG Ab, CH50 in UI/mL.
|
Up to 10 weeks
|
Másodlagos eredményintézkedések
Másodlagos eredményintézkedések
Eredménymérő |
Intézkedés leírása |
Időkeret |
|---|---|---|
|
Changes in CRPus from inclusion (V1) to Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Variation in CRPus between inclusion (V1) and Day 2 (V2) in mg/L.
|
From enrollment to Day 2
|
|
Changes in immunity markers from inclusion (V1) to Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Variation in IL-1β, IL-6, and IL-18 between inclusion (V1) and Day 2 (V2) in pg/mL.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and Day 2 (V2).
The scale will be used to assess disease severity for catatonia.
The minimal score is 0 mm.
The maximal score is 69.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and Day 2 (V2).
The scale will be used to assess disease severity for Schizophrenia patients.
The minimal score is 30.
The maximal score is 210.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and day 2 (V2).
The scale will be used to assess disease severity for depression.
The minimal score is 0. The maximal score is 60.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and Day 2 (V2).
The scale will be used to assess disease severity for bipolar troubles.
The minimal score is 0. The maximal score is 60.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and Day 2 (V2).
The scale will be used to assess disease severity for obsessive compulsive disorder.
The minimal score is 0 mm.
The maximal score is 100 mm.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) in standardized clinical disease scale scores at Day 2 (V2)
Időkeret: From enrollment to Day 2
|
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and Day 2 (V2).
The scale will be used to assess disease severity for obsessive compulsive disorder.
The minimal score is 0. The maximal score is 72.
|
From enrollment to Day 2
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Changes in Positive and Negative Syndrome Scale (PANSS) scores between inclusion (V1) and the end of study EOS (M24).
The scale will be used to assess disease severity for Schizophrenia patients.
The minimal score is 30.
The maximal score is 210.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Changes in Montgomery-Åsberg Depression Rating Scale (MADRS) scores between inclusion (V1) and the end of study (M24).
The scale will be used to assess disease severity for depression.
The minimal score is 0. The maximal score is 60.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Variation in standardized clinical disease scale scores between inclusion (V1) and EOS (M24). Changes in Young Mania Rating Scale (YMRS) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for bipolar troubles. The minimal score is 0. The maximal score is 60. |
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Changes in Obsessive-Compulsive Inventory-Revised (OCI-R) scores between inclusion (V1) and the end of study (M24).
The scale will be used to assess disease severity for obsessive compulsive disorder.
The minimal score is 0. The maximal score is 72.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Variation in standardized clinical disease scale scores between inclusion (V1) and EOS (M24). Changes in Visual analogic scale for obsessive compulsive disorder (VAS-OCD) scores between inclusion (V1) and the end of study (M24). The scale will be used to assess disease severity for obsessive compulsive disorder. The minimal score is 0 mm. The maximal score is 100 mm. |
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in standardized clinical disease scale scores
Időkeret: through study completion, an average of 2 years
|
Changes in Bush-Francis Catatonia Rating Scale (BFCRS) scores between inclusion (V1) and the end of study (M24).
The scale will be used to assess disease severity for catatonia.
The minimal score is 0 mm.
The maximal score is 69.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in CBC components
Időkeret: through study completion, an average of 2 years
|
Variation in Complete Blood Count components between inclusion (V1) and End Of Study (M24) : White blood cells, neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets in G/L.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in Folates, Vitamin B6, Vitamin B1, Vitamin D
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24).
The dosages are : Folates, Vitamins B1, B6, D in nmol/L.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in Vitamin B12
Időkeret: through study completion, an average of 2 years
|
Changes in Vitamin B12 measured between inclusion (V1) and the End Of Study (M24) in pg/mL.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in TSH, prolactin
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and End Of Study (M24).
The dosages are : TSH, prolactin in mUI/L
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to end of study (M24) in drug dosage
Időkeret: through study completion, an average of 2 years
|
Variation in drug dosage between inclusion (V1) and End Of Study (M24).
Unit could be different according to the drug.
|
through study completion, an average of 2 years
|
|
Changes from inclusion in levels of pro-inflammatory cytokines and other immune biomarkers in cerebrospinal fluid, skin biopsies and/or stool, at end of acute treatment (V3), 6-month follow-up (V4), 12-month follow-up (V5) and 24-month follow-up (V6)
Időkeret: At inclusion (V1), 10 weeks, 6 months-, 12 months- and 24 months after end of acute treatment
|
Change in levels of pro-inflammatory cytokines and other immune biomarkers in other biological samples (cerebrospinal fluid (CSF), skin biopsies, stool) between inclusion (V1) , end of acute treatment (V3), 6-month follow-up (V4), 12-month follow-up (V5) and 24-month follow-up (V6).
This will enable direct assessment of the efficacy of interventions on immune processes.
|
At inclusion (V1), 10 weeks, 6 months-, 12 months- and 24 months after end of acute treatment
|
|
Changes from inclusion (V1) in functional (Clinical Global Impression, CGI-S and CGI-I) scores to end of acute treatment (V3)
Időkeret: Up to 10 weeks
|
Variation in Clinical Global Impression (CGI-S and CGI-I) questionnaire scores between inclusion (V1) and end of acute treatment (V3):
|
Up to 10 weeks
|
|
Changes from inclusion (V1) in quality of life (by WHOQOL-BREF questionnaire) scores to end of acute treatment (V3)
Időkeret: Up to 10 weeks
|
Variation in WHOQOL-BREF questionnaire scores between inclusion (V1) and end of acute treatment (V3).
The minimum score is 16 and the maximum is 80.
The higher the score, the better the perceived quality of life in the relevant area.
|
Up to 10 weeks
|
|
Changes from inclusion in quality of life (by WHOQOL-BREF scores), to End Of Study (M24)
Időkeret: through study completion, an average of 2 years
|
Variation in quality-of-life questionnaire scores (WHOQOL-BREF) between inclusion (V1) and End Of Study (M24).
The minimal score is 16 and the maximal is 80.
The higher the score, the better the perceived quality of life in the relevant area.
|
through study completion, an average of 2 years
|
|
Changes from inclusion in functional score (by Clinical Global Impression scale), to End Of Study (M24)
Időkeret: through study completion, an average of 2 years
|
Variation in Clinical Global Impression (CGI-S and CGI-I) questionnaire scores between inclusion (V1) and end of study (M24):
|
through study completion, an average of 2 years
|
|
Number of side-effects (type, intensity, severity) in total population and by cohort between study inclusion (V1) and end of study (M24)
Időkeret: through study completion, an average of 2 years
|
Side-effects (type, intensity, severity) in total population and by cohort between study inclusion and End Of Study (M24)
|
through study completion, an average of 2 years
|
|
Number and characteristics of biomarkers identified in the retrospectively and prospectively included populations
Időkeret: through study completion, an average of 2 years
|
The number and characteristics of biomarkers identified in the retrospectively and prospectively included populations throughout the study
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) in fibrinogen, C3, C4 to End Of Study (M24)
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and the end of study (M24).
The dosages are : C3, C4, fibrinogen in g/L.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in IL-1β, IL-6, IL-18
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24).
The dosages are : IL-1β, IL-6, IL-18 in pg/mL.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in cortisol dosage
Időkeret: through study completion, an average of 2 years
|
Changes in cortisol measured between inclusion (V1) and the end of study (M24) in nmol/L.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in CRPus, β2 microglobulin, C1q
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and End Of Study (M24).
The dosages are : CRPus, β2 microglobulin, C1q in mg/L.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in anti-TPO Ab, anti-TG Ab, CH50
Időkeret: through study completion, an average of 2 years
|
Changes in biological parameters measured between inclusion (V1) and the End Of Study (M24).
The dosages are : anti-Peroxidase Antibodies, anti-thyroglobulin Antibodies, Hemolytic Complement 50 in UI/mL.
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in anti-TRAK Ab
Időkeret: through study completion, an average of 2 years
|
Variation in anti TSH receptor specific Antibodies (anti-TRAK Ab) between inclusion (V1) and End Of Study (M24)
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in neuronal Ab
Időkeret: through study completion, an average of 2 years
|
Number of positive neuronal antibodies between inclusion (V1) and End Of Study (M24)
|
through study completion, an average of 2 years
|
|
Changes from inclusion (V1) to End Of Study (M24) in interferon signature score
Időkeret: through study completion, an average of 2 years
|
Variation in interferon signature score between inclusion (V1) and End Of Study (M24)
|
through study completion, an average of 2 years
|
Együttműködők és nyomozók
Szponzor
Szponzor
Együttműködők
Együttműködők
Nyomozók
Nyomozók
- Tanulmányi igazgató: Anne-Cécile PETIT, MD, PhD, GHU Paris Psychiatry & Neurosciences
Tanulmányi rekorddátumok
Tanulmány főbb dátumok
Tanulmány kezdete (Becsült)
Tanulmány kezdete
Elsődleges befejezés (Becsült)
Elsődleges befejezés
A tanulmány befejezése (Becsült)
A tanulmány befejezése
Tanulmányi regisztráció dátumai
Először benyújtva
Először benyújtva
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Először nyújtották be, amely megfelel a minőségbiztosítási kritériumoknak
Első közzététel (Tényleges)
Első közzététel
Tanulmányi rekordok frissítései
Utolsó frissítés közzétéve (Tényleges)
Utolsó frissítés közzétéve
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Az utolsó frissítés elküldve, amely megfelel a minőségbiztosítási kritériumoknak
Utolsó ellenőrzés
Utolsó ellenőrzés
Több információ
A tanulmányhoz kapcsolódó kifejezések
Kulcsszavak
További vonatkozó MeSH feltételek
- Bipoláris és kapcsolódó rendellenességek
- Neurológiai megnyilvánulások
- Idegrendszeri betegségek
- Skizofrénia spektrum és egyéb pszichotikus rendellenességek
- Mentális zavarok
- Viselkedési tünetek
- Neuroviselkedési megnyilvánulások
- Hangulati zavarok
- Szorongásos zavarok
- Depressziós rendellenesség
- Kóros állapotok, jelek és tünetek
- Viselkedés
- Jelek és tünetek
- Skizofrénia
- Bipoláris zavar
- Depressziós zavar, kezelésnek ellenálló
- Catatonia
- Obszesszív-kompulzív zavar
- Nyomozási technikák
- Terápiás kezelés
- Minta kezelése
- Klinikai laboratóriumi technikák
- Diagnosztikai technikák és eljárások
- Diagnózis
- Lyukasztás
- Műtéti eljárások, operatív
- Biopszia
- Diagnosztikai technikák, neurológiai
- Gerincvelő
- Vérminta gyűjteménye
Egyéb vizsgálati azonosító számok
Egyéb vizsgálati azonosító számok
- D25-P041
- N°ID-RCB: 2026-A00433-48 (Egyéb azonosító: ANSM)
Terv az egyéni résztvevői adatokhoz (IPD)
Tervezi megosztani az egyéni résztvevői adatokat (IPD)?
Gyógyszer- és eszközinformációk, tanulmányi dokumentumok
Egy amerikai FDA által szabályozott gyógyszerkészítményt tanulmányoz
Egy amerikai FDA által szabályozott eszközterméket tanulmányoz
Ezt az információt közvetlenül a clinicaltrials.gov webhelyről szereztük be, változtatás nélkül. Ha bármilyen kérése van vizsgálati adatainak módosítására, eltávolítására vagy frissítésére, kérjük, írjon a következő címre: register@clinicaltrials.gov. Amint a változás bevezetésre kerül a clinicaltrials.gov oldalon, ez a webhelyünkön is automatikusan frissül. .