Trial Outcomes & Findings for A Study of MK-6913 for the Treatment of Hot Flashes in Postmenopausal Women (6913-004) (NCT NCT01015677)

NCT ID: NCT01015677

Last Updated: 2018-08-31

Results Overview

Hot flashes were recorded in real time and hot flashes recorded retrospectively in the morning and evening reports in a diary day via the Hot Flash e-diary were summed to determine the total number of hot flashes over a diary day. The total number of weekly moderate or worse hot flashes were calculated as the sum of the total number of hot flashes that occur over a diary week (non-missing diary day), divided by the number of days of diary completion, and multiplied by 7 (standardized week). At least 4 non-missing diary days were required to define the total number of weekly moderate or worse hot flashes. Hot flash data was excluded for participants whose number of moderate to severe hot flashes per week were in the top 1% of number of hot flashes reported to exclude any outlier effect.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

99 participants

Primary outcome timeframe

Baseline and Week 4

Results posted on

2018-08-31

Participant Flow

Thirty sites in the United States, Canada, France, Belgium, New Zealand, and Australia received IRB/ERC approval. Of the 354 participants screened for inclusion, 255 participants were excluded during screening (235 participants did not meet specific exclusion criteria). Ninety-nine participants were randomized for the study.

The study was terminated at the end of Stage 1 so no participants entered Stage 2 and no participants received MK-6913 25 mg.

Participant milestones

Participant milestones
Measure
MK-6913 75 mg
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Overall Study
STARTED
34
32
33
Overall Study
COMPLETED
33
28
33
Overall Study
NOT COMPLETED
1
4
0

Reasons for withdrawal

Reasons for withdrawal
Measure
MK-6913 75 mg
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Overall Study
Adverse Event
0
1
0
Overall Study
Lack of Efficacy
0
1
0
Overall Study
Protocol Violation
0
1
0
Overall Study
Withdrawal by Subject
1
1
0

Baseline Characteristics

A Study of MK-6913 for the Treatment of Hot Flashes in Postmenopausal Women (6913-004)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
MK-6913 75 mg
n=34 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=32 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Total
n=99 Participants
Total of all reporting groups
Age, Continuous
52.1 Years
STANDARD_DEVIATION 3.9 • n=5 Participants
53.2 Years
STANDARD_DEVIATION 3.9 • n=7 Participants
52.2 Years
STANDARD_DEVIATION 4.2 • n=5 Participants
52.5 Years
STANDARD_DEVIATION 4.0 • n=4 Participants
Sex: Female, Male
Female
34 Participants
n=5 Participants
32 Participants
n=7 Participants
33 Participants
n=5 Participants
99 Participants
n=4 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants

PRIMARY outcome

Timeframe: Baseline and Week 4

Population: The Full Analysis Set (FAS) population consists of all randomized participants who receive at least 1 dose of study treatment, have at least 1 post-randomization observation for the analysis endpoint, and have baseline data for those analyses.

Hot flashes were recorded in real time and hot flashes recorded retrospectively in the morning and evening reports in a diary day via the Hot Flash e-diary were summed to determine the total number of hot flashes over a diary day. The total number of weekly moderate or worse hot flashes were calculated as the sum of the total number of hot flashes that occur over a diary week (non-missing diary day), divided by the number of days of diary completion, and multiplied by 7 (standardized week). At least 4 non-missing diary days were required to define the total number of weekly moderate or worse hot flashes. Hot flash data was excluded for participants whose number of moderate to severe hot flashes per week were in the top 1% of number of hot flashes reported to exclude any outlier effect.

Outcome measures

Outcome measures
Measure
MK-6913 75 mg
n=34 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=31 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Percent Change From Baseline in the Number of Weekly Moderate to Very Severe Hot Flashes (Excluding Outliers) at Week 4
-40.69 Percent change
Interval -54.82 to -26.56
-51.86 Percent change
Interval -66.38 to -37.34
-34.41 Percent change
Interval -48.99 to -19.83

PRIMARY outcome

Timeframe: Up to 6 weeks

Population: The All-Patients-as Treated (APaT) population is all participants who received at least one dose of study drug.

An AE is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Outcome measures

Outcome measures
Measure
MK-6913 75 mg
n=34 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=32 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Number of Participants Who Experienced at Least One or More Adverse Events (AE)
17 Participants
15 Participants
16 Participants

PRIMARY outcome

Timeframe: Up to 4 weeks

Population: The APaT population is all participants who received at least one dose of study drug.

An adverse event (AE) is defined as any unfavorable and unintended sign including an abnormal laboratory finding, symptom or disease associated with the use of a medical treatment or procedure, regardless of whether it is considered related to the medical treatment or procedure, that occurs during the course of the study.

Outcome measures

Outcome measures
Measure
MK-6913 75 mg
n=34 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=32 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Number of Participants Who Discontinued Study Drug Due to an AE
0 Participants
1 Participants
0 Participants

SECONDARY outcome

Timeframe: Baseline and Week 4

Population: The Full Analysis Set (FAS) population consists of all randomized participants who receive at least 1 dose of study treatment, have at least 1 post-randomization observation for the analysis endpoint, and have baseline data for those analyses.

Hot flash severity score is calculated by the sum of: the number of mild hot flashes, 2 times number of moderate hot flashes, 3 times the number of severe hot flashes, and 4 times the number of very severe hot flashes. This sum was standardized to a 7-day week if there were any missing days in the e-diary. The severity of each hot flash was recorded by the Hot Flash e-diary.

Outcome measures

Outcome measures
Measure
MK-6913 75 mg
n=34 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=31 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Percent Change From Baseline in the Weekly Hot Flash Severity Score (Combining Severe and Very Severe Score) at Week 4
-39.92 Percent change
Interval -54.57 to -25.26
-45.09 Percent change
Interval -60.15 to -30.02
-33.87 Percent change
Interval -48.92 to -18.81

SECONDARY outcome

Timeframe: Baseline and Week 4

Population: The Per-Protocol (PP) population excludes participants due to important deviations from the protocol that may substantially affect the results of the primary and key secondary efficacy endpoints.

FSH was measured to assess estrogen receptor (ER) selectivity (a biomarker for ERα activity and a pharmacodynamic endpoint).

Outcome measures

Outcome measures
Measure
MK-6913 75 mg
n=21 Participants
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=21 Participants
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=28 Participants
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Change From Baseline in Follicle-stimulating Hormone (FSH) Level at Week 4
-2.02 mIU/mL
Interval -7.91 to 3.87
-17.48 mIU/mL
Interval -23.08 to -11.89
-2.96 mIU/mL
Interval -8.54 to 2.62

Adverse Events

MK-6913 75 mg

Serious events: 0 serious events
Other events: 17 other events
Deaths: 0 deaths

17-β Estradiol 1 mg

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 16 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
MK-6913 75 mg
n=34 participants at risk
MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
17-β Estradiol 1 mg
n=32 participants at risk
17β-estradiol 1 mg and matching placebo for MK-6913 75 mg once daily for 4 weeks
Placebo
n=33 participants at risk
Matching placebo for MK-6913 75 mg and matching placebo for 17β-estradiol 1 mg once daily for 4 weeks
Gastrointestinal disorders
Abdominal distension
0.00%
0/34 • Up to 6 weeks
6.2%
2/32 • Up to 6 weeks
6.1%
2/33 • Up to 6 weeks
Gastrointestinal disorders
Abdominal pain
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Abdominal pain lower
0.00%
0/34 • Up to 6 weeks
6.2%
2/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Abdominal tenderness
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Constipation
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Gastrointestinal disorders
Diarrhoea
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Dyspepsia
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Gastrointestinal disorders
Faecal incontinence
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Flatulence
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Nausea
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Gastrointestinal disorders
Toothache
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Gastrointestinal disorders
Vomiting
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
General disorders
Chest pain
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
General disorders
Fatigue
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
General disorders
Irritability
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
General disorders
Oedema peripheral
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Immune system disorders
Seasonal allergy
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Infections and infestations
Bronchitis
2.9%
1/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Ear infection
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Fungal infection
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Influenza
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Lower respiratory tract infection
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Infections and infestations
Nasopharyngitis
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Infections and infestations
Oral herpes
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Rhinitis
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
6.1%
2/33 • Up to 6 weeks
Infections and infestations
Sinusitis
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Tooth infection
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Infections and infestations
Upper respiratory tract infection
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
6.1%
2/33 • Up to 6 weeks
Infections and infestations
Urinary tract infection
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Injury, poisoning and procedural complications
Joint sprain
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Injury, poisoning and procedural complications
Muscle strain
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Investigations
Blood glucose increased
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Investigations
Crystal urine
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Investigations
Crystal urine present
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Investigations
Liver function test abnormal
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Investigations
Protein urine
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Investigations
Weight increased
0.00%
0/34 • Up to 6 weeks
6.2%
2/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Metabolism and nutrition disorders
Increased appetite
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Musculoskeletal and connective tissue disorders
Arthralgia
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Musculoskeletal and connective tissue disorders
Back pain
2.9%
1/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Musculoskeletal and connective tissue disorders
Dupuytren's contracture
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Musculoskeletal and connective tissue disorders
Muscle spasms
5.9%
2/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Uterine leiomyoma
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Nervous system disorders
Dizziness
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Nervous system disorders
Headache
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
12.1%
4/33 • Up to 6 weeks
Nervous system disorders
Lethargy
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Nervous system disorders
Migraine
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Nervous system disorders
Poor quality sleep
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Nervous system disorders
Sciatica
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
33.3%
11/33 • Up to 6 weeks
Nervous system disorders
Sinus headache
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Psychiatric disorders
Depression
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Psychiatric disorders
Elevated mood
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Psychiatric disorders
Libido increased
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Renal and urinary disorders
Pollakiuria
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Reproductive system and breast disorders
Breast mass
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Reproductive system and breast disorders
Breast pain
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Reproductive system and breast disorders
Breast tenderness
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Reproductive system and breast disorders
Dysfunctional uterine bleeding
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Reproductive system and breast disorders
Nipple pain
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Reproductive system and breast disorders
Pelvic floor muscle weakness
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Reproductive system and breast disorders
Pelvic pain
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Reproductive system and breast disorders
Vaginal haemorrhage
5.9%
2/34 • Up to 6 weeks
9.4%
3/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Respiratory, thoracic and mediastinal disorders
Nasal congestion
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Respiratory, thoracic and mediastinal disorders
Nasal polyps
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
6.1%
2/33 • Up to 6 weeks
Respiratory, thoracic and mediastinal disorders
Throat irritation
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Respiratory, thoracic and mediastinal disorders
Tonsillar disorder
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Skin and subcutaneous tissue disorders
Acne
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks
Skin and subcutaneous tissue disorders
Dry skin
2.9%
1/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Skin and subcutaneous tissue disorders
Rash
0.00%
0/34 • Up to 6 weeks
3.1%
1/32 • Up to 6 weeks
0.00%
0/33 • Up to 6 weeks
Vascular disorders
Varicose vein
0.00%
0/34 • Up to 6 weeks
0.00%
0/32 • Up to 6 weeks
3.0%
1/33 • Up to 6 weeks

Additional Information

Senior Vice President, Global Clinical Development

Merck Sharp & Dohme Corp.

Phone: 1-800-672-6372

Results disclosure agreements

  • Principal investigator is a sponsor employee The sponsor must have the opportunity to review all proposed abstracts, manuscripts, or presentations regarding this study 60 days prior to submission for publication/presentation. Any information identified by the sponsor as confidential must be deleted prior to submission. Sponsor review can be expedited to meet publication guidelines.
  • Publication restrictions are in place

Restriction type: OTHER