- ICH GCP
- Registro degli studi clinici negli Stati Uniti
- Sperimentazione clinica NCT04801420
Studio di fase 2 su VLA15, un candidato vaccino contro la borreliosi di Lyme, in una popolazione di studio pediatrica e adulta sana
Studio sulla sicurezza e l'immunogenicità di VLA15, un candidato vaccino ricombinante multivalente a base di OspA contro la borreliosi di Lyme: uno studio di fase 2 randomizzato, controllato, in cieco per l'osservatore in una popolazione di studio pediatrica e adulta sana
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
Tipo di studio
Iscrizione (Effettivo)
Fase
- Fase 2
Contatti e Sedi
Luoghi di studio
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Connecticut
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Bridgeport, Connecticut, Stati Uniti, 06606
- New England Research Associates
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Stamford, Connecticut, Stati Uniti, 06905
- Stamford Therapeutics Consortium
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Waterbury, Connecticut, Stati Uniti, 06708
- Chase Medical Research, LLC
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Waterbury, Connecticut, Stati Uniti, 06708
- Pediatric Associates of Conn. PC
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Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55402
- Clinical Research Institute, Inc.
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New Jersey
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East Orange, New Jersey, Stati Uniti, 07018
- Foundation Pediatrics
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Irvington, New Jersey, Stati Uniti, 07111
- Med Clinical Research Partners, LLC
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New York
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Binghamton, New York, Stati Uniti, 13905
- Meridian Clinical Research LLC
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Rochester, New York, Stati Uniti, 14609
- Rochester Clinical Research, Inc.
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Staten Island, New York, Stati Uniti, 10314
- Richmond Behavioral Associates
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The Bronx, New York, Stati Uniti, 10467
- Advantage Clinical Trials
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Ohio
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Cleveland, Ohio, Stati Uniti, 44122
- Velocity Clinical Research, Inc.
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Pennsylvania
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Erie, Pennsylvania, Stati Uniti, 16506
- Allegheny Health and Wellness Pavilion
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Erie, Pennsylvania, Stati Uniti, 16508
- Liberty Family Practice
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Fort Washington, Pennsylvania, Stati Uniti, 19034
- Lockman & Lubell Pediatric Associates
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Rhode Island
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Providence, Rhode Island, Stati Uniti, 02906
- The Miriam Hospital
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Providence, Rhode Island, Stati Uniti, 02903
- Rhode Island Hospital
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Providence, Rhode Island, Stati Uniti, 02903
- Hasbro Children's Hospital
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Warwick, Rhode Island, Stati Uniti, 02886
- Velocity Clinical Research Providence
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Descrizione
Criterio di inclusione:
- Il soggetto ha un'età compresa tra 5 e 65 anni al giorno dello screening (Visita 0)
- Il soggetto gode di buona salute generale
Il/i genitore/i/rappresentante/i legale/i e il soggetto comprendono lo studio e le sue procedure, accettano le sue disposizioni
- per soggetti di età compresa tra 18 e 65 anni: consenso informato scritto prima di qualsiasi procedura correlata allo studio
- per soggetti di età compresa tra 5 e 17 anni: consenso informato scritto da parte del/i rappresentante/i legale/i del soggetto, in base ai requisiti locali, e assenso informato scritto del soggetto, se applicabile, prima di qualsiasi procedura correlata allo studio.
Se il soggetto è in età fertile: Il soggetto ha un test di gravidanza su siero negativo allo screening (Visita 0) e accetta di impiegare adeguate misure di controllo delle nascite secondo le seguenti tempistiche:
- Fase di studio principale: durata dell'intero studio
- Fase di richiamo: fino al mese 23 (ovvero 5 mesi dopo la dose di richiamo)
- - Il soggetto è disposto e in grado di rispettare le visite programmate, il piano di trattamento e altre procedure dello studio
- Il soggetto è disponibile per la durata dello studio e può essere contattato telefonicamente durante la partecipazione allo studio
Criteri di esclusione:
- - Il soggetto ha una malattia cronica correlata alla borreliosi di Lyme (LB), un LB sintomatico attivo o ha ricevuto un trattamento per LB negli ultimi 3 mesi prima del Giorno 1;
- Il soggetto ha ricevuto una precedente vaccinazione contro LB;
- Il soggetto ha avuto una puntura di zecca entro 4 settimane prima del giorno 1;
- Il soggetto ha una storia medica o ha attualmente una malattia clinicamente rilevante;
- Il soggetto ha una storia medica o ha attualmente una malattia neuroinfiammatoria o autoimmune;
- - Il soggetto ha una trombocitopenia nota, disturbi della coagulazione o ha ricevuto anticoagulanti nelle 3 settimane precedenti al Giorno 1;
- Il soggetto ha ricevuto un'immunizzazione attiva o passiva entro 4 settimane prima del giorno 1;
- Il soggetto ha ricevuto qualsiasi altro medicinale registrato o non registrato in un altro studio clinico entro 4 settimane prima della vaccinazione al giorno 1;
- - Il soggetto ha un difetto noto o sospetto del sistema immunitario o ha ricevuto una terapia immunosoppressiva entro 4 settimane prima del Giorno 1;
- - Il soggetto ha una storia di anafilassi da causa sconosciuta o gravi reazioni allergiche di causa sconosciuta o ha una nota ipersensibilità o reazioni allergiche a uno dei componenti del vaccino;
- Il soggetto ha avuto tumori maligni negli ultimi 5 anni;
- - Il soggetto è incinta, ha intenzione di rimanere incinta durante il corso dello studio o sta allattando al momento dell'arruolamento;
- Il soggetto ha donato o prevede di donare sangue o emoderivati 4 settimane prima del Giorno 1;
- - Il soggetto presenta qualsiasi condizione che possa comprometterne il benessere, interferire con la valutazione degli endpoint dello studio o limitare la capacità del soggetto di completare lo studio;
- Il soggetto è in una relazione di dipendenza;
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Prevenzione
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Quadruplicare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
|---|---|
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Sperimentale: Parte A+B - Gruppo 1
Parte A: VLA15 ai mesi 0, 2 e 6 Parte B: VLA15 ai mesi 18, 30 e 42
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un candidato vaccino ricombinante multivalente a base di Outer Surface Protein A (OspA).
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Sperimentale: Parte A+B - Gruppo 2
Parte A: VLA15 al mese 0 e 6, placebo al mese 2 Parte B: VLA15 al mese 18, 30 e 42
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un candidato vaccino ricombinante multivalente a base di Outer Surface Protein A (OspA).
PBS (soluzione salina tamponata con fosfato)
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Comparatore placebo: Parte A+B - Gruppo 3
Parte A: Placebo ai mesi 0, 2 e 6 Parte B: Placebo ai mesi 18, 30 e 42
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PBS (soluzione salina tamponata con fosfato)
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Percentage of Participants With Solicited Local and Solicited Systemic Adverse Events (AEs) Within 7 Days After Vaccination 1
Lasso di tempo: From Day 1 to Day 7 after vaccination 1 at Month 0
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Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness meeting grading scale (MGS), swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 1 at Month 0
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Vaccination 2
Lasso di tempo: From Day 1 to Day 7 after vaccination 2 at Month 2
|
Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 2 at Month 2
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Vaccination 3
Lasso di tempo: From Day 1 to Day 7 after vaccination 3 at Month 6
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Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 3 at Month 6
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Any Vaccination During the Main Study Phase
Lasso di tempo: From Day 1 to Day 7 after any vaccination 1, 2 or 3 at Month 0, 2 and 6, respectively
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Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after any vaccination 1, 2 or 3 at Month 0, 2 and 6, respectively
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Geometric Mean Titers (GMTs) for Immunoglobulin G (IgG) Against Each Outer Surface Protein A (OspA) Serotype (ST1 to ST6) at Day 208 During the Main Study Phase
Lasso di tempo: At Day 208 (Month 7)
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GMTs for IgG against each OspA serotype ST1 to ST6, determined by an IgG binding assay at Day 208 was presented in this outcome measure.
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At Day 208 (Month 7)
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Vaccination 1 Booster Dose
Lasso di tempo: From Day 1 to Day 7 after vaccination 1 booster dose at Month 18
|
Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 1 booster dose at Month 18
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Vaccination 2 Booster Dose
Lasso di tempo: From Day 1 to Day 7 after vaccination 2 booster dose at Month 30
|
Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 2 booster dose at Month 30
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Percentage of Participants With Solicited Local and Solicited Systemic AEs Within 7 Days After Vaccination 3 Booster Dose
Lasso di tempo: From Day 1 to Day 7 after vaccination 3 booster dose at Month 42
|
Participants or their legal guardians were required to record any solicited local and systemic AEs in the electronic diary.
Solicited symptoms were pre-defined symptoms which were collected via an electronic diary.
Solicited local AEs included pain, tenderness, erythema/redness MGS, swelling MGS and induration/hardening MGS.
Solicited systemic AEs included headache, muscle pain, joint pain, nausea, vomiting, fatigue and fever.
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From Day 1 to Day 7 after vaccination 3 booster dose at Month 42
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Percentage of Participants With Serious Adverse Events (SAEs)
Lasso di tempo: From Day 1 of vaccination 1 up to 6 months following the last booster dose (up to Month 48)
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A SAE was any untoward medical occurrence that at any dose: resulted in death; required inpatient hospitalization or prolongation of existing hospitalization; was life-threatening; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect; was another medically important condition.
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From Day 1 of vaccination 1 up to 6 months following the last booster dose (up to Month 48)
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Percentage of Participants With Adverse Events of Special Interest (AESIs)
Lasso di tempo: From Day 1 of vaccination 1 up to 6 months following the last booster dose (up to Month 48)
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An AESI (serious or non-serious) was one of scientific and medical concern specific to the sponsor's product or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor were appropriate.
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From Day 1 of vaccination 1 up to 6 months following the last booster dose (up to Month 48)
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Percentage of Participants With Unsolicited AE
Lasso di tempo: Up to 28 Days after vaccination 1, 2 or 3 at Month 0, 2 and 6, respectively, and up to 28 Days after vaccination 1, 2 or 3 booster dose at Month 18, 30 and 42, respectively
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An AE was any untoward medical occurrence in a participant administered an investigational product, whether or not related to this treatment.
Unsolicited AEs were defined as any solicited local or systemic AE if it had an onset date more than 6 days after vaccination or any other symptom or untoward medical event.
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Up to 28 Days after vaccination 1, 2 or 3 at Month 0, 2 and 6, respectively, and up to 28 Days after vaccination 1, 2 or 3 booster dose at Month 18, 30 and 42, respectively
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Percentage of Participants With SAEs, AESIs, Solicited and Unsolicited AEs Stratified by Age Group
Lasso di tempo: SAEs & AESIs: From Day 1 of vaccination up to Month 48; Solicited AEs: from Day 1 to Day 7 after vaccination 1, 2, 3, 4, 5 and 6; Unsolicited AEs: up to 28 Days after vaccination 1, 2, 3, 4, 5 and 6
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Percentage of participants with SAEs, AESIs, solicited and unsolicited AEs stratified by age group 5-11, 12-17 and 18-65 years were reported.
SAE: any untoward medical occurrence that at any dose: resulted in death; required inpatient hospitalization or prolongation of existing hospitalization; was life-threatening; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect; was another medically important condition.
AESI: scientific and medical concern specific to the sponsor's product or program.
Solicited AE: predefined reactions at injection site or systemic reactions after each vaccination.
Unsolicited AEs: any solicited local or systemic AE if it had an onset date more than 6 days after vaccination or any other symptom or untoward medical event.
|
SAEs & AESIs: From Day 1 of vaccination up to Month 48; Solicited AEs: from Day 1 to Day 7 after vaccination 1, 2, 3, 4, 5 and 6; Unsolicited AEs: up to 28 Days after vaccination 1, 2, 3, 4, 5 and 6
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GMTs for IgG Against Each OspA Serotype (ST1 to ST6) at Baseline, Days 85, 180, 365 and Month 18
Lasso di tempo: Baseline; Days 85, 180 and 365; Month 18
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GMTs for IgG against each OspA serotype ST1 to ST6, determined by an IgG binding assay were evaluated.
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Baseline; Days 85, 180 and 365; Month 18
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Seroconversion Rate (SCR) at Days 85, 180, 208, 365 and Month 18
Lasso di tempo: Days 85, 180, 208 and 365; Month 18
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Seroconversion for enzyme linked immunosorbent assay (ELISA) was defined as a change from seronegative at baseline to seropositive at a measured time point.
For participants who were OspA seropositive at baseline, seroconversion was defined as a greater than or equal to (>=) 4-fold rise in IgG antibody titer from baseline.
SCR was percentage of participants with seroconversion reported for each OspA serotype specific IgG ST1 to ST6, as determined by ELISA.
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Days 85, 180, 208 and 365; Month 18
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Geometric Mean of the Fold Rise (GMFR) for IgG When Compared to Baseline Against Each OspA Serotype (ST1 to ST6) at Days 85 and 208
Lasso di tempo: Days 85 and 208
|
GMFR for IgG when compared to baseline against each OspA serotype ST1 to ST6, determined by IgG binding assay at Day 85 and Day 208 were evaluated.
|
Days 85 and 208
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GMTs for IgG Against Each OspA Serotype (ST1 to ST6) Stratified by Age Group at Baseline, Days 85, 180, 194, 365 and Month 18
Lasso di tempo: Baseline; Days 85, 180, 194 (18 to 65 years only) and 365; Month 18
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GMTs for IgG against each OspA serotype ST1 to ST6, determined by an IgG binding assay stratified by age group (5-11, 12-17 and 18-65 years) were evaluated.
Day 194 data was reported for adult participants only as pre-specified in protocol.
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Baseline; Days 85, 180, 194 (18 to 65 years only) and 365; Month 18
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SCR Stratified by Age Group at Days 85, 180, 194, 208, 365 and Month 18
Lasso di tempo: Days 85, 180, 194 (18 to 65 years only), 208 and 365; Month 18
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Seroconversion for ELISA was defined as a change from seronegative at baseline to seropositive at a measured time point.
For participants who were OspA seropositive at baseline, seroconversion was defined as a >=4-fold rise in IgG antibody titer from baseline.
SCR was percentage of participants with seroconversion reported for each OspA serotype specific IgG ST1 to ST6, as determined by ELISA.
Day 194 data was reported for adult participants only as pre-specified in protocol.
|
Days 85, 180, 194 (18 to 65 years only), 208 and 365; Month 18
|
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GMFR for IgG When Compared to Baseline Against Each OspA Serotype (ST1 to ST6) Stratified by Age Group at Days 85 and 208
Lasso di tempo: Days 85 and 208
|
GMFR for IgG when compared to baseline against each OspA serotype ST1 to ST6, stratified by age group (5-11, 12-17 and 18-65 years) determined by IgG binding assay at Day 85 and Day 208 were evaluated.
|
Days 85 and 208
|
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GMTs for IgG Against Each OspA Serotype (ST1 to ST6) at Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
Lasso di tempo: Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
GMTs for IgG against each OspA serotype ST1 to ST6, determined by an IgG binding assay were evaluated.
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Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
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SCR at Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
Lasso di tempo: Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
Seroconversion for ELISA was defined as a change from seronegative at baseline to seropositive at a measured time point.
For participants who were OspA seropositive at baseline, seroconversion was defined as a >=4-fold rise in IgG antibody titer from baseline.
SCR was percentage of participants with seroconversion reported for each OspA serotype specific IgG ST1 to ST6, as determined by ELISA.
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Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
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GMFR for IgG Against Each OspA Serotype (ST1 to ST6) at Months 19, 31 and 43 During the Booster Phase
Lasso di tempo: Months 19, 31 and 43
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GMFRs for IgG were determined by IgG binding assay for each OspA serotype (ST1-ST6) at Months 19, 31, and 43 relative to the corresponding pre-booster timepoints Months 18, 30, and 42, respectively.
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Months 19, 31 and 43
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GMTs for IgG Against Each OspA Serotype (ST1 to ST6) Stratified by Age Group at Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
Lasso di tempo: Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
GMTs for IgG against each OspA serotype ST1 to ST6, determined by an IgG binding assay stratified by age group (5-11, 12-17 and 18-65 years) were evaluated.
|
Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
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SCR Stratified by Age Group at Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
Lasso di tempo: Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
|
Seroconversion for ELISA was defined as a change from seronegative at baseline to seropositive at a measured time point.
For participants who were OspA seropositive at baseline, seroconversion was defined as a >=4-fold rise in IgG antibody titer from baseline.
SCR was percentage of participants with seroconversion reported for each OspA serotype specific IgG ST1 to ST6, as determined by ELISA.
|
Months 18, 19, 23, 26, 30, 31, 39, 42, 43 and 48
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GMFR for IgG Against Each OspA Serotype (ST1 to ST6) Stratified by Age Group at Months 19, 31 and 43 During the Booster Phase
Lasso di tempo: Months 19, 31 and 43
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GMFRs for IgG were determined by IgG binding assay for each OspA serotype (ST1-ST6), stratified by age group (5-11, 12-17 and 18-65 years) at Months 19, 31, and 43 relative to the corresponding pre-booster timepoints Months 18, 30, and 42, respectively.
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Months 19, 31 and 43
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Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Direttore dello studio: Pfizer CT.gov Call Center, Pfizer
Pubblicazioni e link utili
Pubblicazioni generali
- Wagner L, Obersriebnig M, Kadlecek V, Hochreiter R, Ghadge SK, Larcher-Senn J, Hegele L, Maguire JD, Derhaschnig U, Jaramillo JC, Eder-Lingelbach S, Bezay N. Immunogenicity and safety of different immunisation schedules of the VLA15 Lyme borreliosis vaccine candidate in adults, adolescents, and children: a randomised, observer-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis. 2025 Sep;25(9):986-999. doi: 10.1016/S1473-3099(25)00092-1. Epub 2025 Apr 25.
- Wagner L, Obersriebnig M, Hochreiter R, Kadlecek V, Larcher-Senn J, Hegele L, Maguire JD, Murphy T, Derhaschnig U, Bezay N, Jaramillo JC, Eder-Lingelbach S, Messier M. Immunogenicity and safety of an 18-month booster dose of the VLA15 Lyme borreliosis vaccine candidate after primary immunisation in children, adolescents, and adults in the USA: a randomised, observer-blind, placebo-controlled, phase 2 trial. Lancet Infect Dis. 2026 Mar;26(3):314-328. doi: 10.1016/S1473-3099(25)00541-9. Epub 2025 Nov 7.
- Wagner L, Kadlecek V, Skaroupkova J, Scharnagl N, Hochreiter R, Messier M, Jaramillo JC, Larcher-Steiner J, Hegele L, Lamberth E, Murphy T, Maguire JD, Clarkin C, Derhaschnig U, Eder-Lingelbach S. A second yearly booster dose of the VLA15 Lyme borreliosis vaccine candidate in healthy individuals. Nat Commun. 2026 Aug 4;17(1):9386. doi: 10.1038/s41467-026-75871-3.
Collegamenti utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Effettivo)
Completamento dello studio (Effettivo)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- VLA15-221
- C4601008 (Altro identificatore: Alias Study Number)
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .