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Childhood-onset Lupus Nephritis Initial Glucocorticoid-dose Harmonization Trial (LIGHT Trial) (LIGHT)

17 luglio 2026 aggiornato da: Hongmei Song, Peking Union Medical College Hospital

Low- Versus High-Dose Initial Glucocorticoid Therapy for Childhood-Onset Proliferative Lupus Nephritis: a Multicenter Open-Label Noninferiority Randomized Controlled Trial

Childhood-onset systemic lupus erythematosus (cSLE) is a severe chronic autoimmune disease with a high burden of major-organ involvement. Lupus nephritis (LN) affects more than half of children with SLE, and proliferative LN-including class III, IV, III+V, and IV+V disease-is associated with acute kidney injury, progression to end-stage kidney disease, and poor long-term outcomes.

Glucocorticoids remain a cornerstone of induction therapy for proliferative LN. However, the optimal initial dose in children is uncertain. Although recent adult SLE and LN guidelines increasingly recommend lower-dose glucocorticoid regimens with rapid tapering, pediatric guidelines still commonly recommend high initial prednisone doses of 1.5-2.0 mg/kg/day. Adult trials and comparative observational studies suggest that lower-dose glucocorticoid regimens may preserve efficacy while reducing treatment-related toxicity.

Because cumulative glucocorticoid exposure in children may impair growth, development, psychosocial well-being, and medication adherence, this trial will compare low-dose versus high-dose initial glucocorticoid regimens for induction treatment of pediatric proliferative LN. The objective is to determine whether a lower-dose regimen is non-inferior in efficacy while reducing glucocorticoid-related adverse effects and improving quality of life.

Panoramica dello studio

Tipo di studio

Interventistico

Iscrizione (Stimato)

198

Fase

  • Fase 4

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

    • Beijing Municipality
      • Beijing, Beijing Municipality, Cina, 100730
        • Reclutamento
        • Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
        • Contatto:
        • Investigatore principale:
          • Hongmei Song, MD, PhD
      • Beijing, Beijing Municipality, Cina
        • Reclutamento
        • Beijing Children's Hospital, Capital Medical University
        • Contatto:
          • Huawei Mao, MD, PhD
          • Numero di telefono: 86-10-59616318
          • Email: maohwei@qq.com
        • Investigatore principale:
          • Huawei Mao, MD, PhD
    • Chongqing Municipality
      • Chongqing, Chongqing Municipality, Cina
        • Non ancora reclutamento
        • Chidren's Hospital of Chongqing Medical University
        • Contatto:
        • Investigatore principale:
          • Xuemei Tang, MD
    • Guangdong
      • Shenzhen, Guangdong, Cina
        • Non ancora reclutamento
        • Shenzhen Children's Hospital
        • Contatto:
        • Investigatore principale:
          • Jun Yang, MD
    • Hunan
      • Changsha, Hunan, Cina
        • Non ancora reclutamento
        • The Second Xiangya Hospital of Central South University
        • Contatto:
        • Investigatore principale:
          • Xiaochuan Wu, MD
    • Jiangsu
      • Nanjing, Jiangsu, Cina
        • Non ancora reclutamento
        • Children's Hospital of Nanjing Medical University
        • Contatto:
        • Investigatore principale:
          • Haiguo Yu, MD
    • Jilin
      • Changchun, Jilin, Cina
        • Non ancora reclutamento
        • Jilin University
        • Contatto:
        • Investigatore principale:
          • Sirui Yang, MD
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, Cina
        • Non ancora reclutamento
        • Children's Hospital of Fudan University
        • Investigatore principale:
          • Li SUN, MD
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Bambino
  • Adulto

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Age ≥6 years and <18 years, with body weight ≥20 kg
  • Meets the 2019 European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) classification criteria for Systemic Lupus Erythematosus (SLE)
  • Renal biopsy confirming Lupus Nephritis class III, IV, III+V, or IV+V according to the International Society of Nephrology / Renal Pathology Society (ISN/RPS) classification
  • At screening: 24-hour urinary protein ≥1.0 g (or ≥25 mg/kg), or urine protein-to-creatinine ratio (UPCR) ≥1.0 g/g
  • White blood cell count ≥3.0 × 10⁹/L and lymphocyte count ≥1.0 × 10⁹/L
  • No prior intravenous methylprednisolone pulse therapy before enrollment, and glucocorticoid exposure ≤2 weeks before enrollment, with a maximum prednisone-equivalent dose ≤30 mg/day (or ≤1 mg/kg/day)
  • Written informed consent obtained and good treatment compliance expected

Exclusion Criteria:

  • Uncertain diagnosis of SLE, genetically confirmed monogenic lupus, or a history of immunodeficiency
  • Severe infection, including hepatitis C, active hepatitis B, HIV infection, tuberculosis infection, severe fungal infection, etc.
  • Severe neuropsychiatric lupus
  • Peripheral blood hemoglobin <60 g/L, platelet count <10 × 10⁹/L, or concomitant aplastic anemia
  • Severe cardiac insufficiency (NYHA functional class ≥ II)
  • Severe pulmonary involvement, including pulmonary hemorrhage, respiratory failure, pulmonary embolism, or other conditions requiring respiratory support
  • Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m²
  • Severe gastrointestinal bleeding, pancreatitis, or hepatic lesions
  • Patients deemed by the investigator to be unsuitable for participation in this trial

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: Control group (High-dose group)
Standard high-dose glucocorticoid therapy

All participants will receive two courses of intravenous methylprednisolone pulse therapy (10-30 mg/kg/day for 3 consecutive days per course; maximum 500 mg/day). Participants will then be randomized in a 1:1 ratio to the two treatment groups.

In the standard-dose (control) group, oral prednisone will be initiated at 1.4-1.6 mg/kg/day (maximum 60 mg/day), followed by gradual tapering according to the predefined schedule. For participants weighing <40 kg, doses will be adjusted in proportion to body weight using the following formula: Individual dose = standard dose × body weight (kg) × 0.025.

All participants will receive background therapy with oral hydroxychloroquine, mycophenolate mofetil, and intravenous belimumab at standard doses.

Sperimentale: Intervention group (Low-dose group)
Low-dose glucocorticoid therapy

All participants will receive two courses of intravenous methylprednisolone pulse therapy (10-30 mg/kg/day for 3 consecutive days per course; maximum 500 mg/day). Participants will then be randomized in a 1:1 ratio to the two treatment groups.

Participants in the intervention group will receive oral prednisone at an initial dose of 0.6-0.8 mg/kg/day, with a maximum dose of 30 mg/day, followed by gradual tapering according to the predefined schedule. For participants weighing <40 kg, doses will be adjusted in proportion to body weight using the following formula: Individual dose = standard dose × body weight (kg) × 0.025. The estimated cumulative prednisone dose over 24 weeks will be approximately 50% of that in the control group.

All participants will receive background therapy with oral hydroxychloroquine, mycophenolate mofetil, and intravenous belimumab at standard doses.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Total Renal Response at Week 24
Lasso di tempo: Week 24

Total renal response (TRR) is defined as achievement of complete renal response (CRR), primary efficacy renal response (PERR), or partial renal response (PRR).

Complete renal response (CRR) is defined as meeting both of the following criteria:

  1. Proteinuria <0.5 g/1.73 m², or 24-hour urinary protein excretion <300 mg/m², or urine protein-to-creatinine ratio (UPCR) <0.5 g/g; and
  2. Estimated glomerular filtration rate (eGFR) within the normal range, or eGFR ≥85% of baseline, or a normal serum creatinine level with an increase of no more than 25% from baseline.

Primary efficacy renal response (PERR) is defined as meeting both of the following criteria:

  1. UPCR <0.7 g/g; and
  2. eGFR ≥80% of baseline or eGFR ≥60 mL/min/1.73 m².

Partial renal response (PRR) is defined as meeting both of the following criteria:

  1. A ≥50% reduction in proteinuria from baseline and UPCR <3 g/g; and
  2. eGFR ≥85% of baseline.
Week 24

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Complete Renal Response at Week 12 and 24
Lasso di tempo: Week 12, 24
CRR is defined as meeting both of the following criteria: (1) Urine protein <0.5 g/1.73 m², or 24-hour urine protein <300 mg/m², or urine protein-to-creatinine ratio (UPCR) <0.5 g/g; AND (2) Estimated glomerular filtration rate (eGFR) within the normal range; or eGFR at least 85% of baseline; or normal serum creatinine with an increase of no more than 25% from baseline.
Week 12, 24
Primary Efficacy Renal Response at Week 12 and 24
Lasso di tempo: Week 12, 24
PERR is defined as meeting both of the following criteria: (1) UPCR <0.7 g/g; AND (2) eGFR at least 80% of baseline or eGFR ≥60 mL/min/1.73 m².
Week 12, 24
Partial Renal Response at Week 12 and 24
Lasso di tempo: Week 12, 24
PRR is defined as meeting both of the following criteria: (1) Urine protein reduced by ≥50% from baseline and UPCR <3 g/g; AND (2) eGFR at least 85% of baseline.
Week 12, 24
Time to TRR
Lasso di tempo: Week 0-24
Total renal response (TRR) is defined as achievement of complete renal response (CRR), primary efficacy renal response (PERR), or partial renal response (PRR). Complete renal response (CRR) is defined as meeting both of the following criteria: 1. Proteinuria <0.5 g/1.73 m², or 24-hour urinary protein excretion <300 mg/m², or urine protein-to-creatinine ratio (UPCR) <0.5 g/g; and 2. Estimated glomerular filtration rate (eGFR) within the normal range, or eGFR ≥85% of baseline, or a normal serum creatinine level with an increase of no more than 25% from baseline. Primary efficacy renal response (PERR) is defined as meeting both of the following criteria: 1. UPCR <0.7 g/g; and 2. eGFR ≥80% of baseline or eGFR ≥60 mL/min/1.73 m². Partial renal response (PRR) is defined as meeting both of the following criteria: 1. A ≥50% reduction in proteinuria from baseline and UPCR <3 g/g; and 2. eGFR ≥85% of baseline.
Week 0-24
Time to CRR
Lasso di tempo: Week 0-24
Complete renal response (CRR) is defined as meeting both of the following criteria: (1) Urine protein <0.5 g/1.73 m², or 24-hour urine protein <300 mg/m², or urine protein-to-creatinine ratio (UPCR) <0.5 g/g; (2) Estimated glomerular filtration rate (eGFR) within the normal range; or eGFR at least 85% of baseline; or normal serum creatinine with an increase of no more than 25% from baseline.
Week 0-24
Time to PERR
Lasso di tempo: Week 0-24
Primary efficacy renal response (PERR) is defined as meeting both of the following criteria: (1) UPCR <0.7 g/g; (2) eGFR at least 80% of baseline or eGFR ≥60 mL/min/1.73 m².
Week 0-24
Time to PRR
Lasso di tempo: Week 0-24
Partial renal response (PRR) is defined as meeting both of the following criteria: (1) Urine protein reduced by ≥50% from baseline and UPCR <3 g/g; (2) eGFR at least 85% of baseline.
Week 0-24
Change of C3 from baseline to Week 24
Lasso di tempo: Week 0, 24
To assess the improvement of SLE serum activity
Week 0, 24
Changes of C4 from baseline to Week 24
Lasso di tempo: Week 0, 24
To assess the improvement of SLE serum activity
Week 0, 24
Change of anti-dsDNA titer from baseline to Week 24
Lasso di tempo: Week 0, 24
To assess the improvement of SLE disease activity
Week 0, 24
Change of anti-dsDNA value from baseline to Week 24
Lasso di tempo: Week 0, 24
To assess the improvement of SLE disease activity
Week 0, 24
Change of SLEDAI-2K from baseline to Week 24
Lasso di tempo: Week 0, 24
To assess the level of disease activity improvement by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score.
Week 0, 24
Change of PGA from baseline to Week 24
Lasso di tempo: Week 0, 24
Physician Global Assessment (PGA) is a clinical tool utilizing a 0 to 3 visual analogue scale to measure overall disease activity by experienced rheumatologists.
Week 0, 24
Change of ParentGA from baseline to Week 24
Lasso di tempo: Week 0, 24
Parental Global Assessment (ParentGA) is a parent-reported outcome measure used to quantify a caregiver's perception of their child's overall disease impact and well-being. ParentGA consists of a horizontal line containing 21 circles numbered from 0 to 10. The scale moves in 0.5 increments. The score of 0 indicates "very well" (best possible health status/disease activity) and 10 indicates "very poor" (worst possible health status/disease activity).
Week 0, 24
Change of PedsQL from baseline to Week 24
Lasso di tempo: Week 0, 24
The Pediatric Quality of Life Inventory (PedsQL) is a modular assessment tool used to measure health-related quality of life in children, evaluating physical, emotional, social, and school functioning to generate an overall health score.
Week 0, 24
Change of serum creatinine from baseline to Week 24
Lasso di tempo: Week 0, 24
To measure renal function levels
Week 0, 24
Change of eGFR from baseline to Week 24
Lasso di tempo: Week 0, 24

eGFR (estimated Glomerular Filtration Rate) is a calculated value used to assess kidney filtration function. Pediatric eGFR [mL/(min·1.73m2)] = K × 88.4 × Height (cm)/Serum Creatinine (μmol/L).

When serum creatinine is measured using the Jaffe method, the K coefficient is proportional to an individual's muscle mass and varies with age. In adolescents, it varies according to sex:

Children and adolescent females: K = 0.55; Adolescent males: K = 0.77. When creatinine is measured using an enzymatic assay: K = 0.413

Week 0, 24
Change of 24-hour urine protein from baseline to Week 24
Lasso di tempo: Week 0, 24
A 24-hour urine protein test measures kidney function by quantifying how much protein the body excretes in a full day.
Week 0, 24
Changes of UPCR from baseline to Week 24
Lasso di tempo: Week 0, 24
A UPCR (Urine Protein Creatinine Ratio) test measures the amount of protein relative to creatinine in a single urine sample. It is a highly accurate, convenient alternative to 24-hour urine test.
Week 0, 24
Rate of LN treatment failure at Week 24
Lasso di tempo: Week 24

LN treatment failure is defined as the occurrence of any of the following:

  1. Death;
  2. New-onset end-stage renal disease (ESRD), or the need for dialysis or kidney transplantation;
  3. Doubling of serum creatinine (compared with the baseline level);
  4. Renal flare, defined by either (a) or (b):

    1. Proteinuric flare: after excluding secondary causes such as infection, 24-hour urinary protein excretion or the urine protein-to-creatinine ratio (UPCR) increased to at least twice the baseline level; or
    2. Nephritic flare: after excluding secondary causes such as infection, serum creatinine increased by 25% from baseline, together with any of the following:

      • 24-hour urinary protein increased to at least twice the baseline level and exceeded 2 g/24 h, or the equivalent UPCR;
      • New-onset hematuria graded as 2+ or more;
      • New-onset cellular casts.
Week 24
Rate of renal flare at Week 24
Lasso di tempo: Week 24

Renal flare, defined by either (a) or (b):

  1. Proteinuric flare: after excluding secondary causes such as infection, 24-hour urinary protein excretion or the urine protein-to-creatinine ratio (UPCR) increased to at least twice the baseline level; or
  2. Nephritic flare: after excluding secondary causes such as infection, serum creatinine increased by 25% from baseline, together with any of the following:

    • 24-hour urinary protein increased to at least twice the baseline level and exceeded 2 g/24 h, or the equivalent UPCR;
    • New-onset hematuria graded as 2+ or more;
    • New-onset cellular casts.
Week 24
Rate of SLE flare at Week 24
Lasso di tempo: Week 24

SLE flare is defined according to SELENA-SLEDAI definitions:

  1. An increase in the SLEDAI score of ≥3 points compared with the previous assessment;
  2. New-onset or worsening manifestations of lupus activity, including cutaneous lesions, oral or nasal ulcers, pleuritis, pericarditis, arthritis, fever, neuropsychiatric lupus, vasculitis, nephritis, myositis, platelet count <60 × 10⁹/L, hemolytic anemia (hemoglobin <70 g/L or a decrease of >30 g/L), lupus myocarditis, or lupus pneumonitis;
  3. Initiation or dose escalation of medications because of disease activity, including NSAIDs, glucocorticoids, cyclophosphamide, methotrexate, or azathioprine;
  4. A Physician Global Assessment (PGA; range, 0-3) score of ≥1.
Week 24
Rate of LLDAS at Week 24
Lasso di tempo: Week 24

LLDAS was defined as meeting all of the following criteria:

  1. SLEDAI-2K score ≤4, with no activity in major organ systems (renal, neuropsychiatric, cardiopulmonary, vasculitic, or constitutional activity), no hemolytic anemia, and no gastrointestinal activity;
  2. No new manifestations of SLE disease activity compared with baseline;
  3. SELENA-SLEDAI Physician Global Assessment score (range, 0-3) ≤1;
  4. Prednisone dose, or equivalent glucocorticoid dose, ≤7.5 mg/day.
Week 24
Rate of DORIS remission at Week 24
Lasso di tempo: Week 24

DORIS remission is defined as meeting all of the following criteria:

  1. Clinical SLEDAI score = 0;
  2. Physician Global Assessment score (range, 0-3) <0.5, irrespective of serological activity;
  3. Treatment with antimalarial agents was permitted, as was prednisone at a dose of ≤5 mg/day (or an equivalent glucocorticoid dose) and/or stable immunosuppressive therapy, including biologic agents.
Week 24
PRINTO/ACR cSLE response rate at Week 24
Lasso di tempo: Week 24

Response was defined as improvement of at least 50% from baseline in any two of the five core outcome measures, with no more than one of the remaining measures worsening by more than 30%.

The five core outcome measures were Physician Global Assessment of overall disease activity (PGA), Parent Global Assessment of disease activity (ParentGA), proteinuria, the SLE Disease Activity Index 2000 (SLEDAI-2K), and the physical functioning domain of the Pediatric Quality of Life Inventory (PedsQL).

Week 24
Changes of Childhood Lupus Improvement Index (CHILI) from baseline to Week 24
Lasso di tempo: Week 0, 24
The Childhood Lupus Improvement Index (CHILI) is a validated measure of treatment response in childhood-onset SLE that primarily captures clinically meaningful improvement. The score is calculated using five core outcome measures: Physician Global Assessment of overall disease activity (PGA), Parent Global Assessment of disease activity (ParentGA), proteinuria assessed by the urine protein-to-creatinine ratio (UPCR) or 24-hour urinary protein excretion, the SLE Disease Activity Index 2000 (SLEDAI-2K), and the physical functioning domain of the Pediatric Quality of Life Inventory (PedsQL). (PMID: 30680946)
Week 0, 24
Rate of clinical, minor, moderate and major improvement in cSLE at Week 24
Lasso di tempo: Week 0, 24
Using the CHILI absolute-change definition, clinical improvement is defined as a CHILI score ≥54; minor improvement as CHILI ≥15; moderate improvement as CHILI ≥68; and major improvement as CHILI ≥92.
Week 0, 24
Scores and changes of pGTI from baseline to Week 12 and 24
Lasso di tempo: Week 0, 12, 24

The pediatric glucocorticoid toxicity index (pGTI) is a composite index including 10 glucocorticoid toxicity domains: body mass index, growth and development, glucose tolerance, lipid metabolism, systolic blood pressure, bone mineral density, glucocorticoid-induced myopathy, skin toxicity, neuropsychiatric effects, and infection.

(PMID: 35917759)

Week 0, 12, 24
SLICC/ACR Damage Index at Week 24
Lasso di tempo: Week 24
The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR Damage Index, SDI) is designed to assess cumulative, irreversible organ damage occurring since the onset of SLE. It encompasses 39 types of chronic, irreversible damage across 12 organ systems, irrespective of ongoing inflammatory disease activity. (PMID: 8607884)
Week 24
Category, incidence and severity of adverse events
Lasso di tempo: Week 0-24

Adverse events should be assessed at each study visit, including the event name, timing, management, severity, and outcome.

Adverse event grading:

Grade 1 (mild): Asymptomatic or mild symptoms; clinical or diagnostic findings only; no treatment required.

Grade 2 (moderate): Requires minor or local treatment and limits instrumental activities of daily living.

Grade 3 (severe): Medically significant but not immediately life-threatening; hospitalization may be required; limits self-care activities of daily living.

Grade 4 (life-threatening): Requires urgent intervention. Grade 5 (death): Death related to the adverse event.

Week 0-24
Change of blood pressure from baseline to Week 24
Lasso di tempo: Week 0, 24
To measure improvement of kidney function, and monitor the side effect by glucocorticoids.
Week 0, 24
Change of fasting blood glucose from baseline to Week 24
Lasso di tempo: Week 0, 24
To evaluate adverse events of glucocorticoids
Week 0, 24
Changes of serum triglycerides from baseline to Week 24
Lasso di tempo: Week 0, 24
To monitor adverse effects of glucocorticoids
Week 0, 24
Changes of height from baseline to Week 24
Lasso di tempo: Week 0, 24
To measure the growth velocity of children, and monitor the adverse events of glucocorticoids
Week 0, 24
Changes of bone marrow density from baseline to Week 24
Lasso di tempo: Week 0, 24
To monitor the side effects of glucocorticoids, bone mineral density (BMD) is measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine.
Week 0, 24

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Pubblicazioni generali

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 luglio 2026

Completamento primario (Stimato)

1 settembre 2028

Completamento dello studio (Stimato)

1 marzo 2029

Date di iscrizione allo studio

Primo inviato

13 luglio 2026

Primo inviato che soddisfa i criteri di controllo qualità

17 luglio 2026

Primo Inserito (Effettivo)

22 luglio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

22 luglio 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

17 luglio 2026

Ultimo verificato

1 luglio 2026

Maggiori informazioni

Termini relativi a questo studio

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Descrizione del piano IPD

For privacy concerns, individual participant data will not be shared. Summary data will be available with publication and upon reasonable request.

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

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 .

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