- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT05825417
폐고혈압: 조합 Rx의 강화 및 개인화 (PHoenix)
폐동맥 압력 및 심장 박동 모니터링 장치(CardioMEMS/ConfirmRx)를 이식한 폐동맥 고혈압(PAH) 환자의 질병 특정 치료에 대한 다기관 무작위 교차 시험
연구 개요
상태
정황
상세 설명
연구 유형
등록 (추정된)
단계
- 4단계
연락처 및 위치
연구 장소
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Sheffield, 영국, S10 2JF
- Sheffield Teaching Hospitals NHS FT
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참여기준
자격 기준
공부할 수 있는 나이
- 성인
- 고령자
건강한 자원 봉사자를 받아들입니다
설명
포함 기준:
- 정보에 입각한 동의를 제공할 수 있음
- 18-80세
- 특발성, 유전성 또는 약물, 독소 또는 결합 조직 질환과 관련된 PAH
- 스크리닝 전 최소 1개월 동안 ERA 및 PDE5i의 임의의 조합을 포함하는 안정적인 PAH 치료 체제(치료를 견딜 수 없는 경우 제외)
- WHO 기능 등급 III
- 안정 시 mPAP ≥20mmHg, 폐모세혈관 쐐기압 ≤15mmHg, 폐혈관 저항 ≥2 Wood Units 진단 시 우심장 카테터 삽입으로 측정
- 6MWT > 입구에서 50m
- 예상 사구체 여과율(eGFR)>30 ml/min/1.73 입장 시 m²(부록 C)
- 부적절한 치료 반응(임상적으로 결정됨)
제외 기준:
- 정보에 입각한 동의를 제공할 수 없음
- 임신
- 이유 없는 폐색전증(언제든지)
- 스크리닝 시 급성 감염(재스크리닝 허용)
- 인간 면역결핍 바이러스로 인한 PAH, 문맥 고혈압, 주혈흡충증, 선천성 심장병
- 좌심장, 폐, 혈전색전성 또는 불분명/다인자성 질환으로 인한 폐고혈압(II-V군)
- 아스피린 또는 P2Y12 억제제를 견딜 수 없음
- selexipag 또는 riociguat에 과민증
- 임상적으로 중요한 신장 질환(eGFR≤30 ml/min/1.73m2)
- 빈혈(헤모글로빈 <10g/dl)
- 좌심장 질환 및/또는 임상적으로 유의미한 심장 질환(다음 중 하나를 포함하나 이에 국한되지 않음): 경미한 대동맥 부전 이상의 대동맥 또는 승모판 질환; 가벼운 대동맥 협착증; 가벼운 승모판 협착; 또는 중등도의 승모판 역류
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 크로스오버 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
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활성 비교기: A군(셀렉시팍/리오시구아트)
기준선 - 확립된 PDE/ERA 요법 1주 - OPA(PDE/ERA/OPA 요법) 시작 2-12주 - OPA를 최대 요법으로 상향 조정(PDE/ERA/OPA 요법) 13-14주 - OPA 감소(PDE/ERA) /OPA 요법) 15주 - OPA 세척(PDE/OPA 요법) 16주 - PDE 세척(ERA 요법) 17주 - sGCS 시작(ERA/sGCS 요법) 18-27주 - 최대 요법으로 sGCS의 상향 조정(ERA/sGCS) 요법)
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A군인 경우 - 최대 허용 용량으로 상향 적정한 후 단계적 축소 Arm B인 경우 - 최대 허용 용량으로 상향 적정한 후 필요한 경우 담당 치료 팀의 재량에 따라 관찰, 수정 또는 전환.
다른 이름들:
A군인 경우 - 최대 허용 용량으로 상향 적정한 후 단계적 축소 Arm B인 경우 - 최대 허용 용량으로 상향 적정한 후 필요한 경우 담당 치료 팀의 재량에 따라 관찰, 수정 또는 전환.
다른 이름들:
환자가 시작한 일일 판독값으로 이식 및 원격 모니터링 설정
자동 일일 판독/다운로드로 이식 및 원격 모니터링 설정
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활성 비교기: 팔 B(리오시구아트/셀렉시팍)
기준선 - 확립된 PDE/ERA 요법 1주차 - 휴약 PDE(ERA 요법만) 2주차 - sGCS 시작(ERA/sGCS 요법) 3-12주차 - sGCS를 최대 요법으로 상향 조정(ERA/sGCS 요법) 13주차 - sGCS 감소 (ERA/sGCS 요법) 14주차 - sGCS 감소 및 제거(ERA 요법) 15주차 - PDE 시작(PDE/ERA 요법) 16주차 - OPA 시작(PDE/ERA/OPA 요법) 17-27주차 - OPA의 상향 조정 최대 요법(PDE/ERA/OPA 요법)
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A군인 경우 - 최대 허용 용량으로 상향 적정한 후 단계적 축소 Arm B인 경우 - 최대 허용 용량으로 상향 적정한 후 필요한 경우 담당 치료 팀의 재량에 따라 관찰, 수정 또는 전환.
다른 이름들:
A군인 경우 - 최대 허용 용량으로 상향 적정한 후 단계적 축소 Arm B인 경우 - 최대 허용 용량으로 상향 적정한 후 필요한 경우 담당 치료 팀의 재량에 따라 관찰, 수정 또는 전환.
다른 이름들:
환자가 시작한 일일 판독값으로 이식 및 원격 모니터링 설정
자동 일일 판독/다운로드로 이식 및 원격 모니터링 설정
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활성 비교기: Arm C : Sotatercept
Baseline - established background therapy; initiate sotatercept 0.3 mg/kg Week 3 - evaluate safety parameters (Hb/platelets) & uptitrate sotatercept to target dose 0.7 mg/kg . Weeks 6, 9, 12, 15, 18, 21 - maintenance sotatercept 0.7 mg/kg every 3 weeks with safety monitoring Week 24 - final maintenance dose and endpoint assessments |
환자가 시작한 일일 판독값으로 이식 및 원격 모니터링 설정
자동 일일 판독/다운로드로 이식 및 원격 모니터링 설정
Subcutaneous injection of sotatercept administered once every 3 weeks for 24 weeks.
Treatment is initiated at a starting dose of 0.3 mg/kg at Week 0 and escalated at Week 3 to a target maintenance dose of 0.7 mg/kg, contingent on body weight, clinical response, and pre-dose safety parameters (haematoglobin and platelet counts).
Maintenance dosing at 0.7 mg/kg continues every 3 weeks through Week 21, alongside continuous daily remote hemodynamic and physiological monitoring via implanted CardioMEMS and cardiac rhythm devices.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Right Ventricular Stroke Volume (RVSV) flow on each therapy measured by MRI RSVS (flow) on each therapy measured by MRI
기간: Baseline to Week 12 of each crossover period
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This provides a robust, objective assessment of clinical efficacy which, if met, will mean that a change in therapy has provided a clinically meaningful change in physiology
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Baseline to Week 12 of each crossover period
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Daily Hemodynamic Detection of Treatment Response During Sotatercept Escalation
기간: Baseline (Week 0) through Week 24
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Within-patient changes in continuous, remote-monitored Total Pulmonary Resistance (TPR), mean Pulmonary Artery Pressure (mPAP), Cardiac Output (CO), Stroke Volume (SV), and Heart Rate (HR) detected by the CardioMEMS sensor following treatment escalation with sotatercept, correlated with end-of-treatment RVSV measured by cardiac MRI.
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Baseline (Week 0) through Week 24
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
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Haemodynamics - Total Pulmonary Resistance (TPR)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change in TPR (Woods Units) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Haemodynamics - mean Pulmonary Artery Pressure (mPAP)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change in mPAP (mmHg) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Haemodynamics - Cardiac Output (CO)
기간: Part 1 : From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change in CO (L/min) on each therapy to determine clinical efficacy
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Part 1 : From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Haemodynamics - Cardiac Index
기간: Part 1 : From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change in cardiac index (L/min/m^2) on each therapy to determine clinical efficacy
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Part 1 : From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Haemodynamics - Stroke Volume (SV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change in SV (mL) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Haemodynamics - Heart Rate (HR)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change in HR (bpm) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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6 Minute Walk Test
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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NTpro-BNP
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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Change on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks.
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MRI - Right Ventricular Ejection Fraction (RVEF)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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RVEF (%) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Right Ventricular End Systolic Volume (RVESV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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RVESV (mL/m^2) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Right Ventricular End Diastolic Volume (RVEDV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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RVEDV (mL/m^2) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Right Ventricular Stroke Volume (RVSV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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RVSV (mL) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Left Ventricular Volume Fraction (LVEF)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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LVEF (%) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Left Ventricular End Systolic Volume (LVESV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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LVESV (mL/m^2) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Left Ventricular End Diastolic Volume LVEDV
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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LVEDV (mL/m^2) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Left Ventricular Stroke Volume (LVSV)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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LVSV (mL) on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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MRI - Left Ventricular Stroke Volume (LVSV) flow
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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LVSV flow on each therapy to determine clinical efficacy
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Patient Reported Outcomes (PRO) - Quality of Life (QoL) (EmPHasis-10)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change of QoL score on each therapy to determine clinical efficacy.
This will be done using EmPHasis-10 questionnaire (10 questions using a 0 (poor) - 5 (good) scale)
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Patient Reported Outcomes (PRO) - Medication Compliance (PHoenix PRO)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks
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Change of medication compliance score on each therapy to determine clinical efficacy.
This will be done using PHoenix PRO questionnaire (10 questions using a 0 (poor) - 5 (good) scale)
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks
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Patient Reported Outcomes (PRO) - Medication Side Effects
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change of medication side effects on each therapy to determine clinical efficacy.
This will be done using PHoenix Medication side effects questionnaires (4 Yes/No or Better/Worse style questions)
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Patient Reported Outcomes (PRO) - Depression symptoms (GAD-2/7)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change of depression symptoms on each therapy to determine clinical efficacy.
This will be done using the GAD-2/7 questionnaire (2 screening questions to determine if symptoms present.
If present, 7 additional questions to determine level of depression using a 0 (not at all) - 3 (nearly every day) scale)
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Patient Reported Outcomes (PRO) - Anxiety symptoms (PHQ-2/9)
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change of anxiety symptoms on each therapy to determine clinical efficacy.
This will be done using the PHQ-2/9 questionnaire (2 screening questions to determine if symptoms present.
If present, 9 additional questions to determine level of anxiety using a 0 (not at all) - 3 (nearly every day) scale)
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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WHO functional class
기간: Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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Change on each therapy to determine clinical efficacy.
Functional assessment of PAH will be made according to the WHO classification system: Class I - Patients with PAH without limitation of physical activity.
Ordinary physical activity does not cause increased dyspnoea or fatigue, chest pain, or near syncope / Class II - Patients with PAH resulting in slight limitation of physical activity.
No discomfort at rest.
Normal physical activity causes increased dyspnoea or fatigue, chest pain, or near syncope / Class III - Patients with PAH resulting in marked limitation of physical activity.
There is no discomfort at rest.
Less than ordinary activity causes increased dyspnoea or fatigue, chest pain, or near syncope / Class IV - Patients with PAH with inability to carry out any physical activity without discomfort.
Indications of manifest right heart failure.
Dyspnoea and/or fatigue may even be present at rest.
Discomfort is increased by the least physical activity.
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Part 1: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks Part 2: From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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EuroQoL-5D-5L
기간: Part 2 only : From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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The EuroQoL-5D-5L is included for future health economic evaluation of sotatercept.
(free for non-commercial use
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Part 2 only : From baseline and area under the curve to 3 weeks, 6 weeks, 12 weeks, 18 weeks, and 24 weeks
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PHoenix UTAUT questionnaire
기간: Part 1 only: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks
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Evaluation of remote monitoring technology and devices.
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Part 1 only: From baseline and area under the curve to 4 weeks, 8 weeks and 12 weeks
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공동 작업자 및 조사자
협력자
수사관
- 수석 연구원: Alexander Rothman, MD / PhD, University of Sheffield
간행물 및 유용한 링크
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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기타 연구 ID 번호
- STH21653
- MR/W026279/1 (기타 보조금/기금 번호: UKRI Medical Research Council)
- 325120 (기타 식별자: IRAS)
- MISP 102663 (기타 보조금/기금 번호: MERCK SHARP & DOHME(UK) LIMITED [MSD])
개별 참가자 데이터(IPD) 계획
개별 참가자 데이터(IPD)를 공유할 계획입니까?
IPD 계획 설명
연구 샘플은 식별 가능한 개인 데이터 없이 Sheffield Biorepository로 전송됩니다.
데이터는 University of Oxford(데이터 공급자)에서 수집, 호스팅 및 처리합니다. 승인된 데이터 작성자는 PI 및 위임된 직원을 포함하되 이에 국한되지 않습니다. 참가자들; 및 코어 이미징 연구실. 시험 관리자는 데이터 검증 프로세스를 이끌 것입니다. 원격 모니터링 데이터는 Merlin.net을 통해 관리됩니다. 시스템(기기 공급업체 - Abbott). 가명 처리된 데이터는 글래스고 대학교(프로세서)에서 안전하게 전송, 보유, 분석 및 보관됩니다. 데이터는 또한 연구 분석을 위해 University of Sheffield 및 Newcastle University(프로세서)로 전송됩니다.
University of Sheffield는 University of Sheffield Data에 대한 모든 권리, 소유권 및 이권을 소유합니다. 데이터 보호법의 목적상 Sheffield Teaching Hospitals(스폰서)가 데이터 컨트롤러입니다.
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
미국에서 제조되어 미국에서 수출되는 제품
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .