A Study to Evaluate the Efficacy, Safety, and Tolerability of Mirabegron in Men With OAB Symptoms While Taking Tamsulosin Hydrochloride for Lower Urinary Tract Symptoms (LUTS) Due to Benign Prostatic Hyperplasia (BPH)

NCT ID: NCT02757768

Last Updated: 2024-11-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

715 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-13

Study Completion Date

2018-09-11

Brief Summary

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The purpose of the study was to assess the efficacy, safety, and tolerability of mirabegron versus placebo in men with overactive bladder (OAB) symptoms while taking tamsulosin hydrochloride for lower urinary tract symptoms (LUTS) due to Benign Prostatic Hyperplasia (BPH).

Detailed Description

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At Screening (Visit 1), participants entered into a 4-week open label tamsulosin hydrochloride 0.4 mg QD run-in period prior to being randomized into the 12-week double-blind treatment period (Visit 2). At conclusion of the 4-week tamsulosin hydrochloride run-in period, participants completed a 3-day diary just prior to Baseline (Visit 2). Approximately 7 days prior to Visit 2 participants received a phone call reminding them about the diary and to answer any questions.

If participants met all entry criteria at the end of the tamsulosin hydrochloride run-in period, participants were randomized to 1 of 2 treatment groups (mirabegron or placebo) for 12 weeks of treatment in addition to the continuation of tamsulosin hydrochloride 0.4 mg QD. Those participants randomized to Mirabegron started at 25 mg and increased to 50 mg after 4 weeks. Those participants randomized to placebo started blinded product matched to the mirabegron 25 mg tablet and increased to blinded product matched to 50 mirabegron after 4 weeks. Once a participant increased dose, the participant remained on that dose for the remainder of the study unless for safety reasons was required to discontinue study drug.

A training diary was completed in the first 2 weeks of the tamsulosin hydrochloride run-in period. During this evaluation period at least one telephone contact took place with the participant. Diaries were completed at home, using the electronic patient-reported outcome (ePRO) device, for 3 consecutive days prior to each visit: Baseline (Visit 2), Week 4 (Visit 3), Week 8 (Visit 4), and Week 12/End of Treatment (Visit 5). Site staff contacted the participant approximately 7 days prior to the scheduled visit to remind the participant to complete the electronic diary, review completion instruction and review changes to concomitant medications and adverse events (if applicable).

Three days before Visits 2 (Baseline), 3 (Week 4), 4 (Week 8), and 5 (Week 12), participants completed a 3-day diary, using the ePRO device in which the participant recorded micturition frequency, urgency (PPIUS), incontinence and volume voided. In addition, the diary captured morning and evening blood pressure and pulse rate measurements via Home Blood Pressure Monitoring (HBPM). At Visit 1, International Prostate Symptom Score (IPSS) was completed. At Visits 2, 3, 4, and 5, participants completed the IPSS, EQ-5D-5L, OAB-q, PPBC, and TS-VAS. Maximum urinary flow (Qmax) was measured at Visit 1 (Screening/tamsulosin hydrochloride run-in) and Visit 5 (Week 12/End of Treatment). Post-void residual volume (PVR) was assessed at Screening/tamsulosin hydrochloride run-in (Visit 1), Baseline (Visit 2) and at Week 4 (Visit 3), Week 8 (Visit 4), and Week 12/End of Treatment (Visit 5). A follow-up phone call (Visit 6) was conducted 4-weeks after End of Treatment (Visit 5). Total study participation was approximately 20 weeks.

Conditions

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Benign Prostatic Hyperplasia Overactive Bladder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Mirabegron

Participants received initial dose of 25 mg of mirabegron which was increased to 50 mg after 4 weeks. In addition to mirabegron participants received 0.4 mg of oral tamsulosin hydrochloride daily throughout the study.

Group Type EXPERIMENTAL

Mirabegron

Intervention Type DRUG

Participants received initial dose of 25 mg of mirabegron (oral tablet) which was increased to 50 mg after 4 weeks.

Tamsulosin Hydrochloride

Intervention Type DRUG

Participants received once daily treatment with tamsulosin hydrochloride 0.4 mg (oral tablet) throughout the study.

Placebo

Participants received matching placebo in addition to oral tamsulosin hydrochloride daily throughout the study.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Participants received initial dose of 25 mg of matching placebo (oral tablet) which was increased to 50 mg after 4 weeks.

Tamsulosin Hydrochloride

Intervention Type DRUG

Participants received once daily treatment with tamsulosin hydrochloride 0.4 mg (oral tablet) throughout the study.

Interventions

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Mirabegron

Participants received initial dose of 25 mg of mirabegron (oral tablet) which was increased to 50 mg after 4 weeks.

Intervention Type DRUG

Placebo

Participants received initial dose of 25 mg of matching placebo (oral tablet) which was increased to 50 mg after 4 weeks.

Intervention Type DRUG

Tamsulosin Hydrochloride

Participants received once daily treatment with tamsulosin hydrochloride 0.4 mg (oral tablet) throughout the study.

Intervention Type DRUG

Other Intervention Names

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Myrbetriq Betmiga YM178 Flomax Omnic

Eligibility Criteria

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Inclusion Criteria

* Men ≥40 years of age with history of overactive bladder (OAB) symptoms (frequency of ≥8 micturitions per day and urgency episodes of ≥2 per day) while taking tamsulosin hydrochloride for at least 2 months to treat LUTS due to BPH.
* Subject has symptoms of OAB (urinary frequency and urgency with or without incontinence) for ≥3 months prior to Screening.
* Subject has an International Prostate Symptom Score (IPSS) score ≥8.
* Subject has Prostate-Specific Antigen (PSA) \<4 ng/mL or ≥4 but \< 10 ng/mL with a prostate biopsy that is negative for cancer in the past 2 years.
* Subject is willing and able to complete the 3-day diary (including urine volumes, vital signs measurements), and Quality of Life questionnaires.
* Subject and the subject's spouses/partners who are of childbearing potential must be using a highly effective birth control, which includes established use of oral, injected or implanted hormonal methods of contraception, placement of an intrauterine device (IUD) or intrauterine system (IUS). Birth control must be practiced from Screening and continue throughout the study and for 30 days after the final study drug administration. In addition, sperm donation will not be allowed throughout the study and for 30 days after the final study drug administration.
* Subject agrees not to participate in another interventional study while on treatment.


* Subject must experience an average of 8 or more micturitions per day over the 3-day diary period.
* Subject must experience an average of 2 episodes of urgency per day (grade 3 or 4) over the 3-diary period

Exclusion Criteria

* Subject has post-void residual volume (PVR) \>200 mL.
* Subject has maximum urinary flow (Qmax) \<5.0 mL/second with a minimum voided volume of 125 mL.
* Subject has hematuria \>3 rbc/hpf that has not been fully evaluated.
* Subject has evidence of Urinary Tract Infection (UTI). Urine culture and sensitivity will be performed for positive leukocytes, nitrites, or turbidity and will be confirmed with a culture greater than 100,000 cfu/mL. If a subject has a UTI, at Screening (Visit 1) the subject may be rescreened after successful treatment of the UTI (confirmed by a laboratory result of negative urine culture).
* Subject has neurogenic bladder (spinal cord injury, multiple sclerosis, Parkinson's, etc.).
* Subject has diabetic neuropathy.
* Previous open, robotic or minimally invasive prostate surgery (including transurethral procedures). Planned (scheduled) pelvic or prostate surgery during the study period.
* Planned (scheduled) cataract surgery.
* Subject with significant stress incontinence
* Subject with clinically significant bladder outlet obstruction.
* Subject has an indwelling catheter or practices intermittent self-catheterization.
* Subject has experienced 3 or more episodes of recurrent urinary tract infection within the last 12 months.
* Subject has a symptomatic urinary tract infection, prostatitis, chronic inflammation such as interstitial cystitis, bladder stones, previous pelvic radiation therapy, or previous or current malignant disease of the pelvic organs (i.e., within the confines of the pelvis including the bladder, prostate and rectum; organs of the lower gastrointestinal tract are not necessarily considered pelvic organs such as the distal ascending colon, the full transverse colon and proximal portion of the descending colon are in the abdomen).
* Subject has received intravesical injection in the past 12 months with botulinum toxin, resiniferatoxin, or capsaicin.
* Subject has ever received electro-stimulation therapy for OAB (e.g. sacral nerve stimulation or Percutaneous Tibial Nerve Stimulation \[PTNS\]).
* Subject began or has changed a bladder training program or pelvic floor exercises less than 30 days prior to Screening.
* Subject has postural hypotension or syncope or postural orthostatic tachycardia.
* Subject has moderate or severe hepatic impairment defined as Child-Pugh Class B or C.
* Subject has severe renal impairment defined as estimated creatinine clearance less than 29 mL/min/1.73 m2 as determined by hospital laboratory calculation of eGFR. A subject with End Stage Renal Disease (ESRD) or undergoing dialysis is also not a candidate for the study.
* Subject has severe uncontrolled hypertension, which is defined as a sitting systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg.
* Subject has baseline resting pulse rate \<60 BPM or \>90 BPM.
* Subject has evidence of QT prolongation on Screening (Visit 1) or Baseline (Visit 2) electrocardiogram (ECG) defined as QTcF \>450 msec.
* Subject has any clinically significant ECG abnormality.
* Subject has AST or ALT \>2x upper limit of normal (ULN), or γ-GT \>3x ULN and considered clinically significant.
* Subject has a hypersensitivity to any components of mirabegron, tamsulosin hydrochloride, or any of the inactive ingredients.
* Subject has a history of angioedema.
* Subject has any clinical significant condition which makes the subject unsuitable for study participation.
* Subject has been treated with an experimental device within 28 days or received an investigational agent within 28 days or 5 half-lives, whichever is longer, prior to Screening.
* Subject has a concurrent malignancy or history of any malignancy (within the past 5 years), except non-metastatic basal or squamous cell carcinoma of the skin that has been treated successfully.
* Subject has ongoing alcohol and/or drug abuse.
* Subject is using prohibited medications within 30 days prior to Screening (Visit 1) through Follow-Up Phone Call (Visit 6).
* Subject has stopped, started or changed the dose of a restricted medication within the 30 days prior to Screening (Visit 1) through Follow-Up Phone Call (Visit 6)
* Subject has participated in an interventional trial within 30 days prior to Screening (Visit 1).
* Subject is involved in the conduct of the study as an employee of the Astellas group, third party associated with the study, or the study site team.
* Subject has previously received mirabegron in the 6 months prior to Screening (Visit 1).


* Subject was non-compliant during the 4-week tamsulosin hydrochloride run-in period, defined as taking less than 80% or greater than 120% of study medication.
* Subject had an average total daily urine volume \>3000 mL as recorded in the 3-day diary.
Minimum Eligible Age

40 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Astellas Pharma Global Development, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Medical Director

Role: STUDY_DIRECTOR

Astellas Pharma Global Development, Inc., Medical Affairs, Americas

Locations

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Site US01009

Homewood, Alabama, United States

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Site US01005

Huntsville, Alabama, United States

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Site US01012

Anchorage, Alaska, United States

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Site US01070

Hawaiian Gardens, California, United States

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Site US01081

Los Angeles, California, United States

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Site US01021

Murrieta, California, United States

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Site US01068

San Diego, California, United States

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Site US01064

Valley Village, California, United States

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Site US01097

Englewood, Colorado, United States

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Site US01026

Pompano Beach, Florida, United States

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Site US01025

St. Petersburg, Florida, United States

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Site US01027

Wellington, Florida, United States

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Site US01034

West Des Moines, Iowa, United States

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Site US01094

Shreveport, Louisiana, United States

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Site US01041

Baltimore, Maryland, United States

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Site US01016

Boston, Massachusetts, United States

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Site US01003

Watertown, Massachusetts, United States

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Site US01060

Kansas City, Missouri, United States

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Site US01067

Billings, Montana, United States

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Site US01061

Omaha, Nebraska, United States

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Site US01029

Edison, New Jersey, United States

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Site US01031

Albuquerque, New Mexico, United States

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Site US01015

Garden City, New York, United States

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Site US01019

Plainview, New York, United States

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Site US01069

Cary, North Carolina, United States

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Site US01079

Maiden, North Carolina, United States

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Site US01072

Bristol, Tennessee, United States

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Site US01042

Clarksville, Tennessee, United States

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Site US01056

Knoxville, Tennessee, United States

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Site US01075

Knoxville, Tennessee, United States

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Site US01078

Knoxville, Tennessee, United States

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Site US01063

Newport News, Virginia, United States

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Site CA15008

Calgary, Alberta, Canada

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Site CA15003

Barrie, Ontario, Canada

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Site CA15001

Brampton, Ontario, Canada

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Site CA15005

Toronto, Ontario, Canada

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Site CA15011

Québec, Quebec, Canada

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Site CA15002

Sherbrooke, Quebec, Canada

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Site CA15009

Sherbrooke, Quebec, Canada

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Site CA15014

Victoriaville, Quebec, Canada

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Site CZ42004

Benešov, , Czechia

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Site CZ42006

Domažlice, , Czechia

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Site CZ42005

Prague, , Czechia

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Site CZ42003

Prague, , Czechia

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Site CZ42001

Sternberk, , Czechia

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Site FR33004

Colmar, , France

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Site FR33002

Pierre-Bénite, , France

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Site DE49002

Duisburg, , Germany

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Site DE49003

Eisleben Lutherstadt, , Germany

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Site DE49001

Hagenow, , Germany

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Site DE49006

Halle, , Germany

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Site DE49004

Hamburg, , Germany

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Site DE49005

Hettstedt, , Germany

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Site DE49007

Sangerhausen, , Germany

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Site IT39002

Avellino, , Italy

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Site IT39003

Catanzaro, , Italy

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Site IT39010

Chieti, , Italy

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Site IT39004

Florence, , Italy

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Site IT39005

Latina, , Italy

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Site IT39006

Pisa, , Italy

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Site IT39001

Treviglio, , Italy

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Site IT39008

Vasto, , Italy

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Site PL48006

Katowice, , Poland

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Site PL48001

Piaseczno, , Poland

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Site PL48004

Warsaw, , Poland

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Site PL48005

Wroclaw, , Poland

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Site PL48007

Wroclaw, , Poland

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Site ES34007

Barcelona, , Spain

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Site ES34009

Lugo, , Spain

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Site ES34001

Madrid, , Spain

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Site ES34003

Miranda de Ebro, , Spain

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Site ES34002

Seville, , Spain

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Site ES34006

Valencia, , Spain

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Site ES34004

Vigo, , Spain

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Site GB44005

Bristol, , United Kingdom

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Site GB44011

Bristol, , United Kingdom

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Site GB44004

Newcastle upon Tyne, , United Kingdom

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Site GB44002

Reading, , United Kingdom

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Site GB44006

York, , United Kingdom

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Countries

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United States Canada Czechia France Germany Italy Poland Spain United Kingdom

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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https://astellasclinicalstudyresults.com/hcp/study.aspx?ID=341

Link to results on the Astellas Clinical Study Results website

Other Identifiers

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2015-004036-36

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

178-MA-1008

Identifier Type: -

Identifier Source: org_study_id

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