Evaluation of the Efficacy and Safety of Two Dosing Regimens of Olokizumab (OKZ), Compared to Placebo, in Subjects With Rheumatoid Arthritis (RA) Who Were Taking an Existing Medication Called a Tumour Necrosis Factor Alpha Inhibitor But Had Active Disease

Last updated: September 19, 2023
Sponsor: R-Pharm International, LLC
Overall Status: Completed

Phase

3

Condition

Rheumatoid Arthritis

Musculoskeletal Diseases

Dermatomyositis (Connective Tissue Disease)

Treatment

Olokizumab

Placebo

Clinical Study ID

NCT02760433
CL04041025
2015-005308-27
  • Ages > 18
  • All Genders

Study Summary

The purpose of this study was to determine how effective and safe the study drug Olokizumab was in patients with Rheumatoid Arthritis (RA) who had been already receiving, but not fully responding to treatment with an existing medication called a tumour necrosis factor alpha inhibitor

The primary objective of this study was to evaluate the efficacy of olokizumab (OKZ) 64 mg administered subcutaneously (SC) once every 2 weeks (q2w) or once every 4 weeks (q4w) relative to placebo in subjects with moderately to severely active rheumatoid arthritis (RA) inadequately controlled by TNF-α inhibitor (TNFi) therapy.

Eligibility Criteria

Inclusion

Inclusion Criteria: Subjects may be enrolled in the study only if they meet all of the following criteria.

  • Subjects willing and able to sign informed consent
  • Subjects must have a diagnosis of adult onset RA classified by ACR/EULAR 2010 revisedclassification criteria for RA for at least 24 weeks prior to Screening.

(If the subject was diagnosed according to ACR 1987 criteria previously, the Investigatormay classify the subject per ACR 2010 retrospectively, using available source data.)

  • Treatment with oral, SC, or intramuscular (IM) MTX for at least 12 weeks prior toScreening at a dose of 15 to 25 mg/week (or ≥10 mg/week if there is documentedintolerance to higher doses)
  • The dose and means of administering MTX must have been stable for at least 6weeks prior to Screening.
  • Subjects must be willing to take folic acid or equivalent throughout the study.
  • Subjects must have moderately to severely active RA disease as defined by all of thefollowing:
  • ≥6 tender joints (68 joint count) at Screening and baseline; and
  • ≥6 swollen joints (66 joint count) at Screening and baseline; and
  • C-reactive protein (CRP) above Upper limit of normal (ULN) at Screening based onthe central laboratory results.
  • Subjects must have a documented inadequate response to treatment (i.e., TNFi failure)with ≥1 licensed TNFi following at least 12 weeks of therapy with that agent.Inadequate response to treatment is classified as either:
  • Primary failure: The absence of any documented clinically significant response;or
  • Secondary failure: Documented initial response with subsequent loss of thatresponse or partial response

Exclusion

Exclusion Criteria:

  • Diagnosis of any other inflammatory arthritis or systemic rheumatic disease (e.g.,gout, psoriatic or reactive arthritis, Crohn's disease, Lyme disease, juvenileidiopathic arthritis, or systemic lupus erythematosus) (However, subjects may havesecondary Sjogren's syndrome or hypothyroidism.)
  • Subjects who are Steinbrocker class IV functional capacity (incapacitated, largely orwholly bed-ridden or confined to a wheelchair, with little or no self-care)
  • Prior exposure to any licensed or investigational compound directly or indirectlytargeting Interleukin (IL) 6 or IL 6R (including tofacitinib or other Janus kinasesand spleen tyrosine kinase [SYK] inhibitors)
  • Prior treatment with cell depleting therapies including anti CD20 or investigationalagents (e.g., CAMPATH, anti CD4, anti CD5, anti CD3, and anti CD19) with the exceptionof rituximab, which is allowed if it was discontinued at least 24 weeks prior tobaseline (rituximab should not be discontinued to facilitate a subject's participationin the study, but should instead have been previously discontinued as part of asubject's medical management of RA).
  • Prior use of bDMARDs, within the following windows prior to baseline (bDMARDs shouldnot be discontinued to facilitate a subject's participation in the study, but shouldinstead have been previously discontinued as part of a subject's medical management ofRA):
  1. 4 weeks for etanercept and anakinra
  2. 8 weeks for infliximab
  3. 10 weeks for adalimumab, certolizumab, and golimumab
  4. 12 weeks for abatacept
  • Use of parenteral and/or intra-articular glucocorticoids within 4 weeks prior tobaseline
  • Use of oral glucocorticoids greater than 10 mg/day prednisone (or equivalent) orchange in dosage within 2 weeks prior to baseline
  • Prior documented history of no response to hydroxychloroquine and sulfasalazine
  • Prior use of cDMARDs (other than MTX) within the following windows prior to baseline (cDMARDs should not be discontinued to facilitate a subject's participation in thestudy, but should instead have been previously discontinued as part of a subject'smedical management of RA):
  1. 4 weeks for sulfasalazine, azathioprine, cyclosporine, hydroxychloroquine,chloroquine, gold, penicillamine, minocycline, or doxycycline
  2. 12 weeks for leflunomide unless the subject has completed the followingelimination procedure at least 4 weeks prior to baseline: Cholestyramine at adosage of 8 grams 3 times daily for at least 24 hours, or activated charcoal at adosage of 50 grams 4 times daily for at least 24 hours
  3. 24 weeks for cyclophosphamide
  • Vaccination with live vaccines in the 6 weeks prior to baseline or planned vaccinationwith live vaccines during the study
  • Participation in any other investigational drug study within 30 days or 5 times theterminal half-life of the investigational drug, whichever is longer, prior to baseline
  • Other treatments for RA (e.g., Prosorba Device/Column) within 6 months prior tobaseline
  • Use of intra-articular hyaluronic acid injections within 4 weeks prior to baseline
  • Use of non steroidal anti inflammatory drugs (NSAIDs) on unstable dose or switching ofNSAIDs within 2 weeks prior to baseline
  • Previous participation in this study (randomized) or another study of OKZ
  • Subjects with concurrent acute or chronic viral Hepatitis B or C infection as detectedby blood tests at Screening (e.g., positive for hepatitis B surface antigen [HBsAg],total hepatitis B core antibody [anti-HBc], or hepatitis C virus antibody [HCV Ab]) a) subjects who are positive for hepatitis B surface antibodies (anti-HBs), butnegative for HBsAg and anti-HBc, will be eligible.
  • Subjects with HIV infection
  • Subjects with:
  1. Suspected or confirmed current active tuberculosis (TB) disease or a history ofactive TB disease.
  2. Close contact (i.e., sharing the same household or other enclosed environment,such as a social gathering place, workplace, or facility, for extended periodsduring the day) with an individual with active TB within 1.5 years prior toScreening
  • Concurrent malignancy or a history of malignancy within the last 5 years (with theexception of successfully treated carcinoma of the cervix in situ and successfullytreated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior toScreening [and no more than 3 excised skin cancers within the last 5 years prior toScreening])
  • Subjects with any infection requiring oral antibiotic or antiviral therapy in the 2weeks prior to Screening or at baseline, injectable anti-infective therapy in the last 4 weeks prior to baseline, or serious or recurrent infection with history ofhospitalization in the 6 months prior to baseline
  • Subjects with evidence of disseminated herpes zoster infection, zoster encephalitis,meningitis, or other non-self-limited herpes zoster infections in the 6 months priorto baseline
  • Subjects with planned surgery during the study or surgery ≤ 4 weeks prior to Screeningand from which the subject has not fully recovered, as judged by the Investigator
  • Subjects with diverticulitis or other symptomatic GI conditions that might predisposethe subject to perforations, including subjects with history of such predisposingconditions (e.g., diverticulitis, GI perforation, or ulcerative colitis)
  • Pre-existing central nervous system demyelinating disorders (e.g., multiple sclerosisand optic neuritis)
  • History of chronic alcohol or drug abuse as judged by the Investigator
  • Subjects with a known hypersensitivity to any component of the OKZ drug product orplacebo
  • Subjects with a known hypersensitivity or contraindication to any component of therescue medication
  • History of severe allergic or anaphylactic reactions to human, humanized, or murinemonoclonal antibodies
  • Female subjects who are pregnant, currently lactating, have lactated within the last 12 weeks, or who are planning to become pregnant during the study or within 6 monthsof the last dose of study treatment
  • Female subjects of childbearing potential (unless permanent cessation of menstrualperiods, determined retrospectively after a woman has experienced 12 months of naturalamenorrhea as defined by the amenorrhea with underlying status [e.g., correlative age]or 6 months of natural amenorrhea with documented serum follicle-stimulating hormonelevels >40 mIU/mL and estradiol <20 pg/mL) who are not willing to use a highlyeffective method of contraception during the study and for at least 6 months after thelast administration of study treatment OR Male subjects with partners of childbearing potential not willing to use a highly effectivemethod of contraception during the study and for at least 3 months after the lastadministration of study treatment. The above information was not intended to contain all considerations relevant to aparticipant's potential participation in a clinical trial.

Study Design

Total Participants: 368
Treatment Group(s): 2
Primary Treatment: Olokizumab
Phase: 3
Study Start date:
January 25, 2017
Estimated Completion Date:
October 01, 2019

Study Description

The goal of this Phase III study was to assess the efficacy, safety and tolerability of OKZ in subjects with moderately to severely active RA who had responded inadequately to TNFi therapy. The primary endpoint of the trial was assessed at Week 12. Olokizumab was expected to reduce the disease activity and improve physical function. The study was expected to provide safety information in a large group of subjects over at least a 24 week period.

This was a randomized, double-blind, parallel-group, placebo-controlled, multicenter study. This study included a 4-week Screening Period, a double-blind Treatment Period from Week 0 to Week 24, and a Safety FollowUp Period from Week 24 to Week 44.

A total of 350 subjects were planned to be randomized.Subjects were assessed for eligibility to enter the study during a 4-week Screening Period. Eligible subjects were randomized at Visit 2 in a 2:2:1 ratio in one of 3 treatment groups (planned 140, 140, and 70 subjects per group, respectively) :

  1. Olokizumab 64 mg q4w: SC injection of OKZ 64 mg q4w (alternating with SC injection of placebo OKZ q4w to maintain blinding) + MTX for 24 weeks,

  2. Olokizumab 64 mg q2w: SC injection of OKZ 64 mg q2w + MTX for 24 weeks or

  3. Placebo: SC injection of placebo q2w + MTX for 16 weeks.

Subjects who received placebo were re-randomized at Week 16 to receive 64 mg OKZ q4w + Methotrexate or 64 mg OKZ q2w +Methotrexate for 8 weeks.

Throughout the double-blind Treatment Period, all subjects were required to remain on a stable dose of background MTX with a stable route of administration. Concomitant treatment with folic acid was required for all subjects. The last dose of OKZ was administered at Week 20 for subjects receiving OKZ 64 mg q4w and at Week 22 for subjects receiving OKZ 64 mg q2w.

Following Visit 2 (randomization; Week 0), subjects returned to the study site at least every 2 weeks through Week 24 for response and safety assessments.

At Week 14, subjects who did not improve by at least 20% in both swollen and tender joint counts were classified as nonresponders and were administered sulfasalazine and/or hydroxychloroquine as rescue medication in addition to the assigned treatment.

After completion of the 24-week double-blind Treatment Period, subjects either rolled over into the long-term open-label extension (OLE) study or entered the Safety Follow-Up Period. During the Safety Follow-Up Period, subjects returned for visits +4, +8, and +22 weeks after the last dose of study treatment.

Subjects who discontinued randomized treatment prematurely were required to come for the End of Treatment (EoT) Visit 2 weeks after the last study treatment administration and then continue with the scheduled study visits.

Adverse events (AEs) were assessed throughout the study (starting when the subject signed the informed consent form) and evaluated using the Common Terminology Criteria for Adverse Events Version 4.0. There was ongoing monitoring of safety events, including laboratory findings, by the Sponsor or the Sponsor's designee. In addition, safety was assessed throughout the study by an independent Data Safety Monitoring Board and potential major adverse cardiac events were evaluated by an independent Cardiovascular Adjudication Committee.

The study was conducted at 123 sites across 11 countries globally (in US,EU, Russian Federation, Asia, Latin America)

Connect with a study center

  • Hospital Italiano Regional del Sur

    Bahia Blanca, Buenos Aires B8001HXM
    Argentina

    Site Not Available

  • Centro de Investigaciones Medicas Mar del Plata

    Mar del Plata, Buenos Aires B7600FYK
    Argentina

    Site Not Available

  • Instituto de Investigaciones Clinicas

    Mar del Plata, Buenos Aires B7600FZN
    Argentina

    Site Not Available

  • Instituto de Investigaciones Clinicas-Mar del Plata

    Mar del Plata, Buenos Aires B7600FZ
    Argentina

    Site Not Available

  • Instituto de Asistencia

    Provincia, Buenos Aires B1646DBM
    Argentina

    Site Not Available

  • Instituto de Investigaciones Clinicas Quilmes

    Quilmes, Buenos Aires B1878GEG
    Argentina

    Site Not Available

  • Clinica de Higado y Aparato Digestivo

    Rosario, Santa Fe S2000CFJ
    Argentina

    Site Not Available

  • Sanatorio Delta

    Rosario, Santa Fe S2000BIF
    Argentina

    Site Not Available

  • Sanatorio San Martin

    Venado Tuerto, Santa Fe S2600KUE
    Argentina

    Site Not Available

  • Centro Medico Privado de Reumatologia

    San Miguel de Tucuman, Tucuman T4000AXL
    Argentina

    Site Not Available

  • Centro de Investigaciones Reumatológicas

    San Miguel de Tucuman, Tucuman T4000BRD
    Argentina

    Site Not Available

  • Instituto de Asistencia

    Buenos Aires, B1646DBM
    Argentina

    Site Not Available

  • Atencion Integral en Reumatologia (AIR)

    Ciudad Autonoma Buenos Aires, 1426
    Argentina

    Site Not Available

  • Hospital General de Agudos Dr. J. M. Ramos Mejia

    Ciudad Autonoma Buenos Aires, C1221ADC
    Argentina

    Site Not Available

  • Instituto Centenario

    Ciudad Autonoma Buenos Aires, C1204AAD
    Argentina

    Site Not Available

  • Organizacion Medica de Investigacion (OMI)

    Ciudad Autonoma Buenos Aires, C1015ABO
    Argentina

    Site Not Available

  • APRILLUS

    Ciudad Autonoma Buenos aires, C1046AAQ
    Argentina

    Site Not Available

  • Hospital Privado Centro Medico de Cordoba

    Cordoba, X5016KEH
    Argentina

    Site Not Available

  • Hospital Privado Centro Medico de Cordoba S.A

    Cordoba, 5016
    Argentina

    Site Not Available

  • Instituto DAMIC Fundacion Rusculleda

    Cordoba, X5003DCE
    Argentina

    Site Not Available

  • Centro Polivalente de Asistencia e Inv. Clinica CER

    San Juan, 5400
    Argentina

    Site Not Available

  • HUWC - UFC - Hospital Universitário Walter Cantídio - Universidade Federal do Ceará

    Fortaleza, Ceará 60430-370
    Brazil

    Site Not Available

  • CEDOES - Diagnóstico e Pesquisa

    Vitória, Espírito Santo 29055450
    Brazil

    Site Not Available

  • CIP - Centro Internacional de Pesquisa

    Goiânia, Goiás 74110-120
    Brazil

    Site Not Available

  • CMiP - Centro Mineiro de Pesquisa

    Juiz de Fora, Minas Gerais 36010-570
    Brazil

    Site Not Available

  • CETI - Centro de Estudos em Terapias Inovadoras Ltda.

    Curitiba, Paraná 80030-110
    Brazil

    Site Not Available

  • Clinilive - Clínica do Idoso e Pesquisa Clínica

    Maringá, Paraná 87015-180
    Brazil

    Site Not Available

  • Hospital Bruno Born

    Lajeado, Rio Grande Do Sul 95900-010
    Brazil

    Site Not Available

  • LMK Serviços Médicos S/S Ltda

    Porto Alegre, Rio Grande Do Sul 90480-000
    Brazil

    Site Not Available

  • Faculdade de Medicina do ABC

    Santo André, Sao Paulo 09060-650
    Brazil

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  • Hospital Estadual Mário Covas

    Santo André, Sao Paulo 9190510
    Brazil

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  • Centro Multidisciplinar de Estudos Clínicos - CEMEC

    Sao Bernardo Do Campo, Sao Paulo 09715-090
    Brazil

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  • Hospital São Vicente de Paulo

    Rio Grande, 99010-080
    Brazil

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  • Hospital São Vicente de Paulo

    Rio Grande do Sul, 99010-080
    Brazil

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  • HUCFF-UFRJ - Hospital Universitário Clementino Fraga Filho - Universidade Federal do Rio de Janeiro

    Rio de Janeiro, 21941-913
    Brazil

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  • Clínica de Neoplasias Litoral Ltda.

    Santa Catarina, 88301-215
    Brazil

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  • Associação de Assistência à Criança Deficiente - AACD

    Sao Paulo, 04032-060
    Brazil

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  • Hospital Abreu Sodré - AACD

    Sao Paulo, 04023-000
    Brazil

    Site Not Available

  • CPCLIN - Centro de Pesquisas Clínicas Ltda.

    São Paulo, 01228-200
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  • Centro de Reumatologia y Ortopedia SAS

    Barranquilla, 80020
    Colombia

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  • Fundacion Hospital Universidad del Norte

    Barranquilla, 111211
    Colombia

    Site Not Available

  • Fundacion Instituto de Reumatologia Fernando Chalem

    Bogota, 00000
    Colombia

    Site Not Available

  • Centro de Investigacion en Reumatologia y Especialidades Medicas SAS. CIREEM

    Bogotá, 110221
    Colombia

    Site Not Available

  • Medicity S.A.S.

    Bucaramanga, 680003
    Colombia

    Site Not Available

  • Clinica de Artritis Temprana S.A.

    Cali, 76001
    Colombia

    Site Not Available

  • Hospital Pablo Tobón Uribe

    Medellín, 050034
    Colombia

    Site Not Available

  • CCR Brno S.R.O.

    Brno, 602 00
    Czechia

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  • Revmatologie MUDr. Klara Sirova s.r.o.

    Ostrava - Moravska Ostrava, 70200
    Czechia

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  • CCR Czech, a.s.

    Pardubice, 53002
    Czechia

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  • CCR Pardubice

    Pardubice, 53002
    Czechia

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  • MEDICAL PLUS s.r.o.

    Uherske Hradiste, 68601
    Czechia

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  • PV - Medical, s.r.o.

    Zlin, 760 01
    Czechia

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  • Kerckhoff-Klinik gGmbH

    Bad Nauheim, Hessen 61231
    Germany

    Site Not Available

  • CIRI - Centrum für Innovative Diagnostik und Therapie GmbH

    Frankfurt, Hessen 60590
    Germany

    Site Not Available

  • Rheumazentrum Prof. Dr. G. Neeck

    Bad Doberan, Mecklenburg Vorpommern 18209
    Germany

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  • KH Dresden-Friedrichstadt

    Dresden, Sachsen 01067
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  • SMO.MD GmbH

    Magdeburg, Sachsen Anhalt 39120
    Germany

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  • Rheumapraxis Dr. med. Reiner Kurthen

    Aachen, 52064
    Germany

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  • Charite Universitaetsmedizin Berlin - Campus Charite Mitte

    Berlin, 10117
    Germany

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  • Klin.Forsch. Berlin-Mitt GmbH

    Berlin, 13125
    Germany

    Site Not Available

  • HRF Hamburger Rheuma Forschungszentrum

    Hamburg, 20095
    Germany

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  • Schoen Klinik Hamburg Eilbek

    Hamburg, 22081
    Germany

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  • Clinexpert Egeszsegugyi Szolg. es Ker. Kft.

    Budapest, 1033
    Hungary

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    Budapest, 1036
    Hungary

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  • MAV Korhaz és Rendelointezet

    Szolnok, 5000
    Hungary

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  • Vital Medical Center

    Veszprem, 8200
    Hungary

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  • Ajou University Hospital

    Suwon-si, Gyeonggi-do 443-380
    Korea, Republic of

    Site Not Available

  • Pusan National University Hospital

    Busan, 49241
    Korea, Republic of

    Site Not Available

  • Kangwon National University Hospital

    Chuncheon, 24289
    Korea, Republic of

    Site Not Available

  • Chonbuk National University Hospital

    Chungbuk, 54907
    Korea, Republic of

    Site Not Available

  • Chungnam National University Hospital

    Daejeon, 35015
    Korea, Republic of

    Site Not Available

  • Eulji University Hospital

    Daejeon, 35233
    Korea, Republic of

    Site Not Available

  • Kangwon National University Hospital

    Gangwon Do, 24289
    Korea, Republic of

    Site Not Available

  • Chonnam National University Hospital

    Gwangju, 61469
    Korea, Republic of

    Site Not Available

  • CHA Bundang Medical Center

    Gyeonggi-do, 13496
    Korea, Republic of

    Site Not Available

  • Hallym University Sacred Heart Hospital

    Gyeonggi-do, 431-796
    Korea, Republic of

    Site Not Available

  • Jeju National University Hospital

    Jeju, 63241
    Korea, Republic of

    Site Not Available

  • Jeju National University Hospital

    Jeju Do, 63241
    Korea, Republic of

    Site Not Available

  • Chonbuk National University Hospital

    Jeollabuk-do, 54907
    Korea, Republic of

    Site Not Available

  • Severance Hospital, Yonsei University

    Seoul, 3722
    Korea, Republic of

    Site Not Available

  • The Catholic University of Korea, Seoul St. Mary's Hospital

    Seoul, 06591
    Korea, Republic of

    Site Not Available

  • Centro de Investigacion Clínica GRAMEL S.C

    Mexico, Distrito Federal 03720
    Mexico

    Site Not Available

  • Clinstile, S.A. de C.V.

    Mexico, Distrito Federal 06700
    Mexico

    Site Not Available

  • Comop, A.C.

    Mexico, Distrito Federal 16100
    Mexico

    Site Not Available

  • Clinical Research Institute S.C.

    Tlalnepantla, Estado de Mexico 54055
    Mexico

    Site Not Available

  • Centro de Estudios de Investigacion Basica y Clinica SC

    Guadalajara, Jalisco 44690
    Mexico

    Site Not Available

  • Clinica de Investigacion en Reumatologia y Obesidad S.C.

    Guadalajara, Jalisco 44650
    Mexico

    Site Not Available

  • Accelerium S. de R.L. de C.V.

    Monterrey, Nuevo León 64000
    Mexico

    Site Not Available

  • Hospital y Clinica OCA SA de CV

    Monterrey, Nuevo León 64000
    Mexico

    Site Not Available

  • Universidad Autonoma de Nuevo Leon, Hospital Universitario Dr. Jose Eleuterio Gonzalez

    Monterrey, Nuevo León 64460
    Mexico

    Site Not Available

  • Centro de Alta Especialidad en Reumatología e Investigación del Potosí, S.C.

    San Luis Potosi, San Luis Potos 78213
    Mexico

    Site Not Available

  • Investigacion y Biomedicina de Chihuahua, S.C.

    Chihuahua, 31000
    Mexico

    Site Not Available

  • Szpital Uniwersytecki nr 2 im.dr J. Biziela

    Bydgoszcz, 85-168
    Poland

    Site Not Available

  • Szpital Specjalistyczny nr 1 w

    Bytom, 41902
    Poland

    Site Not Available

  • McBk S.C.

    Grodzisk Mazowiecki, 05-825
    Poland

    Site Not Available

  • Polimedica Centrum Badań, Profilaktyki I Leczenia

    Kielce, 25-355
    Poland

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  • Centrum Medyczne AMED

    Lodz, 91-363
    Poland

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  • Szpital Wojewodzki im. Prymasa Kardynala Stefana Wyszynskiego

    Sieradz, 98-200
    Poland

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  • Samodzielny Publiczny ZOZ Tomaszow Lubelski

    Tomaszow Lubelski, 22-600
    Poland

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  • McM Polimedica

    Warszawa, 02-777
    Poland

    Site Not Available

  • Santa Familia Centrum Badan, Profilaktyki i Leczenia

    Zgierz, 95-100
    Poland

    Site Not Available

  • Medical Center LLC "Maksimum Zdoroviya"

    Kemerovo, Kemerovo oblast 650056
    Russian Federation

    Site Not Available

  • Medical Center n a Almazov

    Saint-Petersburg, Leningrad Oblast 197341
    Russian Federation

    Site Not Available

  • SPb SBHI "Clinical Rheumatological Hospital #25", Fourth Rheumatology Unit

    Saint Petersburg, Leningradskaya oblast 190068
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution of Moscow "City Clinical Hospital #1 n.a. Pirogov" Healthcare Departament of Moscow

    Moscow, Moscovskaya Oblast 119049
    Russian Federation

    Site Not Available

  • Clinical Hospital #1

    Moscow, Moscow Oblast 119992
    Russian Federation

    Site Not Available

  • University hospital #3

    Moscow, Moscow Oblast 119991
    Russian Federation

    Site Not Available

  • University n a Evdokimov

    Moscow, Moscow Oblast 121374
    Russian Federation

    Site Not Available

  • State Budgetary Healthcare Institution "City Clinical Hospital # 15 n.a O.M. Filatov" of Moscow Healtheare Department

    Moscow, Moscow Region 111539
    Russian Federation

    Site Not Available

  • City Clinical Hospital #1

    Novosibirsk, Novosibirsk Oblast 630099
    Russian Federation

    Site Not Available

  • Diagnostic Center Ultramed

    Omsk, Omsk Oblast 644024
    Russian Federation

    Site Not Available

  • SBHI of the Republic of Karelia "Republican Hospital named after V.A.Baranov"

    Petrozavodsk, Republic Of Karelia 185019
    Russian Federation

    Site Not Available

  • Rostov State Medical Unversity

    Rostov-on-Don, Rostov Oblast 344022
    Russian Federation

    Site Not Available

  • Clinical Hosp n a Mirotvorcev

    Saratov, Saratov Oblast 410054
    Russian Federation

    Site Not Available

  • Regional Clinical Hospital

    Saratov, Saratov Oblast 410053
    Russian Federation

    Site Not Available

  • SBHI of Stavropol Region "Stavropol Regional Clinical Hospital"

    Stavropol', Stavropol Region 355030
    Russian Federation

    Site Not Available

  • State Autonomous Healthcare Institution "Republican Clinical Hospital of Ministry of Health of Tatarstan Republic

    Kazan', The Republic of Tatarstan 420064
    Russian Federation

    Site Not Available

  • Siberian Medical University

    Tomsk, Tomsk Oblast 634050
    Russian Federation

    Site Not Available

  • Regional Clinical Hospital

    Vladimir, Vladimir Oblast 600023
    Russian Federation

    Site Not Available

  • University n a Burdenko

    Voronezh, Voronezh Oblast 394066
    Russian Federation

    Site Not Available

  • Clinical Hospital 3

    Yaroslavl, Yaroslavl Oblast 150051
    Russian Federation

    Site Not Available

  • FSBSI "Scientific Research Institute of Rheumatology n.a. V.A. Nasonova"

    Moscow, 115522
    Russian Federation

    Site Not Available

  • Hacettepe University Medical Faculty Hospital, Rheumatology Departament

    Ankara, Altindag 06230
    Turkey

    Site Not Available

  • Istanbul University, Istanbul Medical Faculty Internal Diseases Departament, Rheumatology Discipline

    Istanbul, Fatih 34093
    Turkey

    Site Not Available

  • Rheumatology Associates Of North Alabama- RANA

    Huntsville, Alabama 35801
    United States

    Site Not Available

  • Arizona Arthritis & Rheumatology Associates, P.C.

    Glendale, Arizona 85304
    United States

    Site Not Available

  • AZ Arthritis & Rheum Research

    Mesa, Arizona 85210
    United States

    Site Not Available

  • Sun Valley Arthritis Center Ltd.

    Peoria, Arizona 85381
    United States

    Site Not Available

  • Arizona Arthritis & Rheumatology Associates, P.C.

    Phoenix, Arizona 85032
    United States

    Site Not Available

  • Arizona Arthritis & Rheumatology Research, PLLC

    Phoenix, Arizona 85032-9384
    United States

    Site Not Available

  • Radiant Research, Inc.

    Scottsdale, Arizona 85251
    United States

    Site Not Available

  • Camp Lowell Medical Specialists

    Tucson, Arizona 85712
    United States

    Site Not Available

  • CHI St. Vincent Hot Springs

    Hot Springs, Arkansas 71913
    United States

    Site Not Available

  • Little Rock Diagnostic Clinic, PA

    Little Rock, Arkansas 72205
    United States

    Site Not Available

  • Medvin Clinical Research

    Covina, California 91722
    United States

    Site Not Available

  • TriWest Research Associates, LLC

    El Cajon, California 92020-4124
    United States

    Site Not Available

  • Palomar Medical Center

    Escondido, California 92025
    United States

    Site Not Available

  • Saint Jude Heritage Medical Grp

    Fullerton, California 92835
    United States

    Site Not Available

  • С V Mehta MD Med Corp.

    Hemet, California 92543
    United States

    Site Not Available

  • Advanced Medical Research, LLC

    Lakewood, California 90623
    United States

    Site Not Available

  • Aviva Research

    Orange, California 92866
    United States

    Site Not Available

  • Stanford University School of Medicine

    Palo Alto, California 94304
    United States

    Site Not Available

  • Riverside Medical Clinic

    Riverside, California 92506
    United States

    Site Not Available

  • East Bay Rheumatology Medical Group, Inc.

    San Leandro, California 94578
    United States

    Site Not Available

  • Pacific Arthritis Ctr Med Group

    Santa Maria, California 93454
    United States

    Site Not Available

  • Orrin M Troum and Medical Associates

    Santa Monica, California 90404
    United States

    Site Not Available

  • Stanford University School of Medicine

    Stanford, California 94305
    United States

    Site Not Available

  • Inland Rheumatology Clinical Trials, Inc.

    Upland, California 91786
    United States

    Site Not Available

  • Medvin Clinical Research

    Whittier, California 90602
    United States

    Site Not Available

  • Alpine Clinical Research Center

    Boulder, Colorado 80301
    United States

    Site Not Available

  • Denver Arthritis Clinic

    Denver, Colorado 80230
    United States

    Site Not Available

  • Arthritis & Osteoporosis Center PC

    Hamden, Connecticut 06518
    United States

    Site Not Available

  • New England Research Associates LLC

    Trumbull, Connecticut 06611
    United States

    Site Not Available

  • Javed Rheumatology Associates

    Newark, Delaware 19713
    United States

    Site Not Available

  • RASF - Clinical Research Center

    Boca Raton, Florida 33486
    United States

    Site Not Available

  • Florida Medical center & Research Inc

    Miami, Florida 33142
    United States

    Site Not Available

  • Suncoast Research Group LLC

    Miami, Florida 33135
    United States

    Site Not Available

  • Suncoast Clinical Research Inc.

    New Port Richey, Florida 34652
    United States

    Site Not Available

  • Omega Research Consultants

    Orlando, Florida 32810
    United States

    Site Not Available

  • Family Clinical Trials, LLC.

    Pembroke Pines, Florida 33026
    United States

    Site Not Available

  • AdventHealth Medical Group, PA

    Tampa, Florida 33614
    United States

    Site Not Available

  • McIlwain Medical Group, PA

    Tampa, Florida 33613
    United States

    Site Not Available

  • Atlanta Center for Medical Research

    Atlanta, Georgia 30331
    United States

    Site Not Available

  • DeKalb Medical Center

    Decatur, Georgia 30033
    United States

    Site Not Available

  • Arthritis Center of North Georgia

    Gainesville, Georgia 30501
    United States

    Site Not Available

  • Advanced Clinical Research

    Boise, Idaho 83642
    United States

    Site Not Available

  • Institute of Arthritis Research

    Idaho Falls, Idaho 83404
    United States

    Site Not Available

  • Advanced Clinical Research

    Meridian, Idaho 83642
    United States

    Site Not Available

  • University of Kansas Hospital

    Kansas City, Kansas 66160
    United States

    Site Not Available

  • Graves Gilbert Clinic

    Bowling Green, Kentucky 42101
    United States

    Site Not Available

  • Research Integrity, LLC.

    Owensboro, Kentucky 42303
    United States

    Site Not Available

  • The Arthritis & Diabetes Clinic, Inc.

    Monroe, Louisiana 71203
    United States

    Site Not Available

  • Klein and Associates, M.D., P.A.

    Cumberland, Maryland 21502
    United States

    Site Not Available

  • Klein and Associates, M.D., P.A.

    Hagerstown, Maryland 21740
    United States

    Site Not Available

  • Associates In Cardiology

    Silver Spring, Maryland 20910
    United States

    Site Not Available

  • The Center for Rheumatology and Bone Research

    Wheaton, Maryland 20902
    United States

    Site Not Available

  • Clinical Pharmacology Study Group

    Worcester, Massachusetts 01605
    United States

    Site Not Available

  • Arthritis and Rheumatology Consultants

    Edina, Minnesota 55435
    United States

    Site Not Available

  • Glacier View Research Instutute-Rheumatology

    Kalispell, Montana 59901
    United States

    Site Not Available

  • Westroads Clinical Research

    Omaha, Nebraska 68114
    United States

    Site Not Available

  • Dartmouth-Hitchcock Medical Center

    Lebanon, New Hampshire 03756
    United States

    Site Not Available

  • Summit Medical Group

    Berkeley Heights, New Jersey 07922
    United States

    Site Not Available

  • Arthritis & Osteoporosis Associates, PA

    Freehold, New Jersey 07728
    United States

    Site Not Available

  • Lovelace Scientific Resources, Inc.

    Albuquerque, New Mexico 87114
    United States

    Site Not Available

  • Center for Rheumatology

    Albany, New York 12206
    United States

    Site Not Available

  • Weill Cornell Physicians at Brooklyn Heights

    Brooklyn, New York 11201
    United States

    Site Not Available

  • Winthrop University

    Mineola, New York 11501
    United States

    Site Not Available

  • NYU Langone Ambulatory Care

    New York, New York 11201
    United States

    Site Not Available

  • Medication Management, LLC

    Greensboro, North Carolina 27408
    United States

    Site Not Available

  • PMG Research of Bristol, LLC

    Hickory, North Carolina 28602
    United States

    Site Not Available

  • Cape Fear Arthritis Care

    Leland, North Carolina 28451
    United States

    Site Not Available

  • Carolina Arthritis Associates

    Wilmington, North Carolina 28401
    United States

    Site Not Available

  • Trinity Medical Group

    Minot, North Dakota 58701
    United States

    Site Not Available

  • Cincinnati Rheumatic Disease Study Group

    Cincinnati, Ohio 45242
    United States

    Site Not Available

  • STAT Research, Inc.

    Dayton, Ohio 45417
    United States

    Site Not Available

  • Clinical Research Source, Inc.

    Perrysburg, Ohio 43606
    United States

    Site Not Available

  • Arthritis Group

    Philadelphia, Pennsylvania 19152
    United States

    Site Not Available

  • Low Country Research Center

    Charleston, South Carolina 29486
    United States

    Site Not Available

  • Low Country Rheumatology, PA

    North Charleston, South Carolina 29406
    United States

    Site Not Available

  • Rheumatology Consultants PLLC

    Knoxville, Tennessee 37909-1907
    United States

    Site Not Available

  • Center Inflammatory Disease

    Nashville, Tennessee 37203
    United States

    Site Not Available

  • Amarillo Center for Clinical Research

    Amarillo, Texas 79124
    United States

    Site Not Available

  • Austin Regional Clinic, P.A.

    Austin, Texas 78731
    United States

    Site Not Available

  • Accurate Clinical Research, Inc.

    Baytown, Texas 77521
    United States

    Site Not Available

  • Diagnostic Group of SE Texas

    Beaumont, Texas 77701
    United States

    Site Not Available

  • Precision Comprehensive Clinical Research Solutions

    Grapevine, Texas 76034
    United States

    Site Not Available

  • Accurate Clinical Research, Inc.

    Houston, Texas 77089
    United States

    Site Not Available

  • Pioneer Research Solutions, Inc.

    Houston, Texas 77429
    United States

    Site Not Available

  • Rheumatology Clinic of Houston, P.A.

    Houston, Texas 77065
    United States

    Site Not Available

  • Therapeutic Concepts Rheumatology, LLC

    Houston, Texas 77004
    United States

    Site Not Available

  • Accurate Clinical Research, Inc.

    League City, Texas 77573
    United States

    Site Not Available

  • Endocrinology, Internal Medicine

    Lubbock, Texas 79410
    United States

    Site Not Available

  • Accurate Clinical Research, Inc.

    Nassau Bay, Texas 77058
    United States

    Site Not Available

  • Dr. Alex De Jesus Rheumatology, P.A.

    San Antonio, Texas 78229
    United States

    Site Not Available

  • Diagnostic Group of SE Texas

    Texas, Texas 77701
    United States

    Site Not Available

  • Advanced Rheumatology of Houston

    Woodville, Texas 77382
    United States

    Site Not Available

  • Advanced Research Institute

    Ogden, Utah 84405
    United States

    Site Not Available

  • The Center For Arthritis and Rheumatic Diseases

    Chesapeake, Virginia
    United States

    Site Not Available

  • West Virginia Research Institute

    South Charleston, West Virginia 25309
    United States

    Site Not Available

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