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
NCT ID: NCT02760433
Last Updated: 2023-09-21
Study Results
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View full resultsBasic Information
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COMPLETED
PHASE3
368 participants
INTERVENTIONAL
2017-01-25
2019-10-01
Brief Summary
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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.
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Detailed Description
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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)
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
DOUBLE
Study Groups
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Arm 1: Olokizumab q4w
Olokizumab 64mg subcutaneous q4w + placebo + Methotrexate
Olokizumab 64 mg subcutaneous q4w + placebo+ concomitant background therapy (Methotrexate) at a stable dose with a stable route of administration (oral, subcutaneous, or intramuscular) in order to maintain the blind, subjects randomized to receive OKZ q4w received placebo injections at the alternate q4w interval (e.g., Week 2, Week 6, etc.)
Olokizumab
160 mg/mL sterile solution for SC injection in a 2 mL clear Type I glass vial
Placebo
sodium chloride 0.9% solution provided as either a 10 mL vial or ampoule, depending on market availability. Each placebo will be packed into a cardboard carton to contain 1 vial or ampoule
Arm 2: Olokizumab q2w
Olokizumab 64mg subcutaneous q2w + Methotrexate
64 mg Olokizumab administered subcutaneously once every 2 weeks + concomitant background therapy (Methotrexate) at a stable dose with a stable route of administration (oral, subcutaneous, or intramuscular)
Olokizumab
160 mg/mL sterile solution for SC injection in a 2 mL clear Type I glass vial
Arm 3: Placebo q2w
Placebo q2w subcutaneous + Methotrexate
Placebo administered subcutaneously once every 2 weeks + concomitant background therapy (Methotrexate) at a stable dose with a stable route of administration (oral, subcutaneous, or intramuscular)
Starting at Week 16, all subjects in the placebo group were randomized in a blinded fashion to receive either OKZ 64 mg q2w or OKZ 64 mg q4w; equal numbers of subjects were planned to be assigned to each OKZ treatment group.
Placebo
sodium chloride 0.9% solution provided as either a 10 mL vial or ampoule, depending on market availability. Each placebo will be packed into a cardboard carton to contain 1 vial or ampoule
Interventions
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Olokizumab
160 mg/mL sterile solution for SC injection in a 2 mL clear Type I glass vial
Placebo
sodium chloride 0.9% solution provided as either a 10 mL vial or ampoule, depending on market availability. Each placebo will be packed into a cardboard carton to contain 1 vial or ampoule
Eligibility Criteria
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Inclusion Criteria
* Subjects willing and able to sign informed consent
* Subjects must have a diagnosis of adult onset RA classified by ACR/EULAR 2010 revised classification criteria for RA for at least 24 weeks prior to Screening.
(If the subject was diagnosed according to ACR 1987 criteria previously, the Investigator may 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 to Screening at a dose of 15 to 25 mg/week (or ≥10 mg/week if there is documented intolerance to higher doses)
* The dose and means of administering MTX must have been stable for at least 6 weeks 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 the following:
* ≥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 on the 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 that response or partial response
Exclusion Criteria
* Subjects who are Steinbrocker class IV functional capacity (incapacitated, largely or wholly bed-ridden or confined to a wheelchair, with little or no self-care)
* Prior exposure to any licensed or investigational compound directly or indirectly targeting Interleukin (IL) 6 or IL 6R (including tofacitinib or other Janus kinases and spleen tyrosine kinase \[SYK\] inhibitors)
* Prior treatment with cell depleting therapies including anti CD20 or investigational agents (e.g., CAMPATH, anti CD4, anti CD5, anti CD3, and anti CD19) with the exception of rituximab, which is allowed if it was discontinued at least 24 weeks prior to baseline (rituximab should not be discontinued to facilitate a subject's participation in the study, but should instead have been previously discontinued as part of a subject's medical management of RA).
* Prior use of bDMARDs, within the following windows prior to baseline (bDMARDs should not be discontinued to facilitate a subject's participation in the study, but should instead have been previously discontinued as part of a subject's medical management of RA):
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 to baseline
* Use of oral glucocorticoids greater than 10 mg/day prednisone (or equivalent) or change 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 the study, but should instead have been previously discontinued as part of a subject's medical 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 following elimination procedure at least 4 weeks prior to baseline: Cholestyramine at a dosage of 8 grams 3 times daily for at least 24 hours, or activated charcoal at a dosage 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 vaccination with live vaccines during the study
* Participation in any other investigational drug study within 30 days or 5 times the terminal 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 to baseline
* 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 of NSAIDs 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 detected by 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), but negative 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 of active 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 periods during the day) with an individual with active TB within 1.5 years prior to Screening
* Concurrent malignancy or a history of malignancy within the last 5 years (with the exception of successfully treated carcinoma of the cervix in situ and successfully treated basal cell carcinoma and squamous cell carcinoma not less than 1 year prior to Screening \[and no more than 3 excised skin cancers within the last 5 years prior to Screening\])
* Subjects with any infection requiring oral antibiotic or antiviral therapy in the 2 weeks 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 of hospitalization 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 prior to baseline
* Subjects with planned surgery during the study or surgery ≤ 4 weeks prior to Screening and from which the subject has not fully recovered, as judged by the Investigator
* Subjects with diverticulitis or other symptomatic GI conditions that might predispose the subject to perforations, including subjects with history of such predisposing conditions (e.g., diverticulitis, GI perforation, or ulcerative colitis)
* Pre-existing central nervous system demyelinating disorders (e.g., multiple sclerosis and 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 or placebo
* Subjects with a known hypersensitivity or contraindication to any component of the rescue medication
* History of severe allergic or anaphylactic reactions to human, humanized, or murine monoclonal 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 months of the last dose of study treatment
* Female subjects of childbearing potential (unless permanent cessation of menstrual periods, determined retrospectively after a woman has experienced 12 months of natural amenorrhea as defined by the amenorrhea with underlying status \[e.g., correlative age\] or 6 months of natural amenorrhea with documented serum follicle-stimulating hormone levels \>40 mIU/mL and estradiol \<20 pg/mL) who are not willing to use a highly effective method of contraception during the study and for at least 6 months after the last administration of study treatment
OR
Male subjects with partners of childbearing potential not willing to use a highly effective method of contraception during the study and for at least 3 months after the last administration of study treatment.
The above information was not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
18 Years
ALL
No
Sponsors
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Quintiles, Inc.
INDUSTRY
OCT Clinical Trials
OTHER
Mene Research
OTHER
R-Pharm International, LLC
INDUSTRY
Responsible Party
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Principal Investigators
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Mikhail Samsonov
Role: STUDY_DIRECTOR
R-Pharm
Locations
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Arizona Arthritis & Rheumatology Associates, P.C.
Phoenix, Arizona, United States
CHI St. Vincent Hot Springs
Hot Springs, Arkansas, United States
Medvin Clinical Research
Covina, California, United States
TriWest Research Associates, LLC
El Cajon, California, United States
Saint Jude Heritage Medical Grp
Fullerton, California, United States
С V Mehta MD Med Corp.
Hemet, California, United States
Advanced Medical Research, LLC
Lakewood, California, United States
Stanford University School of Medicine
Palo Alto, California, United States
Riverside Medical Clinic
Riverside, California, United States
East Bay Rheumatology Medical Group, Inc.
San Leandro, California, United States
Inland Rheumatology Clinical Trials, Inc.
Upland, California, United States
Denver Arthritis Clinic
Denver, Colorado, United States
Javed Rheumatology Associates
Newark, Delaware, United States
RASF - Clinical Research Center
Boca Raton, Florida, United States
Suncoast Research Group LLC
Miami, Florida, United States
Omega Research Consultants
Orlando, Florida, United States
Family Clinical Trials, LLC.
Pembroke Pines, Florida, United States
AdventHealth Medical Group, PA
Tampa, Florida, United States
Institute of Arthritis Research
Idaho Falls, Idaho, United States
University of Kansas Hospital
Kansas City, Kansas, United States
Graves Gilbert Clinic
Bowling Green, Kentucky, United States
The Arthritis & Diabetes Clinic, Inc.
Monroe, Louisiana, United States
Klein and Associates, M.D., P.A.
Hagerstown, Maryland, United States
The Center for Rheumatology and Bone Research
Wheaton, Maryland, United States
Clinical Pharmacology Study Group
Worcester, Massachusetts, United States
Glacier View Research Instutute-Rheumatology
Kalispell, Montana, United States
Arthritis & Osteoporosis Associates, PA
Freehold, New Jersey, United States
Lovelace Scientific Resources, Inc.
Albuquerque, New Mexico, United States
NYU Langone Ambulatory Care
New York, New York, United States
Medication Management, LLC
Greensboro, North Carolina, United States
Cape Fear Arthritis Care
Leland, North Carolina, United States
Carolina Arthritis Associates
Wilmington, North Carolina, United States
Trinity Medical Group
Minot, North Dakota, United States
Cincinnati Rheumatic Disease Study Group
Cincinnati, Ohio, United States
STAT Research, Inc.
Dayton, Ohio, United States
Clinical Research Source, Inc.
Perrysburg, Ohio, United States
Arthritis Group
Philadelphia, Pennsylvania, United States
Low Country Research Center
Charleston, South Carolina, United States
Amarillo Center for Clinical Research
Amarillo, Texas, United States
Austin Regional Clinic, P.A.
Austin, Texas, United States
Accurate Clinical Research, Inc.
Baytown, Texas, United States
Precision Comprehensive Clinical Research Solutions
Grapevine, Texas, United States
Therapeutic Concepts Rheumatology, LLC
Houston, Texas, United States
Rheumatology Clinic of Houston, P.A.
Houston, Texas, United States
Accurate Clinical Research, Inc.
Houston, Texas, United States
Pioneer Research Solutions, Inc.
Houston, Texas, United States
Accurate Clinical Research, Inc.
League City, Texas, United States
Endocrinology, Internal Medicine
Lubbock, Texas, United States
Dr. Alex De Jesus Rheumatology, P.A.
San Antonio, Texas, United States
Advanced Rheumatology of Houston
Woodville, Texas, United States
Centro de Investigaciones Medicas Mar del Plata
Mar del Plata, Buenos Aires, Argentina
Instituto de Investigaciones Clinicas
Mar del Plata, Buenos Aires, Argentina
Instituto de Investigaciones Clinicas Quilmes
Quilmes, Buenos Aires, Argentina
Clinica de Higado y Aparato Digestivo
Rosario, Santa Fe Province, Argentina
Sanatorio San Martin
Venado Tuerto, Santa Fe Province, Argentina
Centro Medico Privado de Reumatologia
San Miguel de Tucumán, Tucumán Province, Argentina
Centro de Investigaciones Reumatológicas
San Miguel de Tucumán, Tucumán Province, Argentina
Atencion Integral en Reumatologia (AIR)
Ciudad Autonoma Buenos Aires, , Argentina
Organizacion Medica de Investigacion (OMI)
Ciudad Autonoma Buenos Aires, , Argentina
APRILLUS
Ciudad Autonoma Buenos Aires, , Argentina
Instituto Centenario
Ciudad Autonoma Buenos Aires, , Argentina
Hospital Privado Centro Medico de Cordoba S.A
Córdoba, , Argentina
Centro Polivalente de Asistencia e Inv. Clinica CER
San Juan, , Argentina
HUWC - UFC - Hospital Universitário Walter Cantídio - Universidade Federal do Ceará
Fortaleza, Ceará, Brazil
CEDOES - Diagnóstico e Pesquisa
Vitória, Espírito Santo, Brazil
CIP - Centro Internacional de Pesquisa
Goiânia, Goiás, Brazil
CMiP - Centro Mineiro de Pesquisa
Juiz de Fora, Minas Gerais, Brazil
CETI - Centro de Estudos em Terapias Inovadoras Ltda.
Curitiba, Paraná, Brazil
Hospital Bruno Born
Lajeado, Rio Grande do Sul, Brazil
LMK Serviços Médicos S/S Ltda
Porto Alegre, Rio Grande do Sul, Brazil
Faculdade de Medicina do ABC
Santo André, São Paulo, Brazil
Centro Multidisciplinar de Estudos Clínicos - CEMEC
São Bernardo do Campo, São Paulo, Brazil
Clínica de Neoplasias Litoral Ltda.
Santa Catarina, , Brazil
CPCLIN - Centro de Pesquisas Clínicas Ltda.
São Paulo, , Brazil
Associação de Assistência à Criança Deficiente - AACD
São Paulo, , Brazil
Centro de Reumatologia y Ortopedia SAS
Barranquilla, , Colombia
Centro de Investigacion en Reumatologia y Especialidades Medicas SAS. CIREEM
Bogotá, , Colombia
Medicity S.A.S.
Bucaramanga, , Colombia
Clinica de Artritis Temprana S.A.
Cali, , Colombia
Revmatologie MUDr. Klara Sirova s.r.o.
Ostrava - Moravska Ostrava, , Czechia
CCR Czech, a.s.
Pardubice, , Czechia
MEDICAL PLUS s.r.o.
Uherské Hradiště, , Czechia
PV - Medical, s.r.o.
Zlín, , Czechia
Kerckhoff-Klinik gGmbH
Bad Nauheim, Hesse, Germany
SMO.MD GmbH
Magdeburg, Saxony-Anhalt, Germany
HRF Hamburger Rheuma Forschungszentrum
Hamburg, , Germany
Clinexpert Egeszsegugyi Szolg. es Ker. Kft.
Budapest, , Hungary
Obudai Egeszsegugyi Centrum
Budapest, , Hungary
MAV Korhaz és Rendelointezet
Szolnok, , Hungary
Vital Medical Center
Veszprém, , Hungary
Clinica de Investigacion en Reumatologia y Obesidad S.C.
Guadalajara, Jalisco, Mexico
Centro de Estudios de Investigacion Basica y Clinica SC
Guadalajara, Jalisco, Mexico
Centro de Investigacion Clínica GRAMEL S.C
Mexico City, Mexico City, Mexico
Clinstile, S.A. de C.V.
Mexico City, Mexico City, Mexico
Accelerium S. de R.L. de C.V.
Monterrey, Nuevo León, Mexico
Universidad Autonoma de Nuevo Leon, Hospital Universitario Dr. Jose Eleuterio Gonzalez
Monterrey, Nuevo León, Mexico
Centro de Alta Especialidad en Reumatología e Investigación del Potosí, S.C.
San Luis Potosí City, San Luis Potos, Mexico
Investigacion y Biomedicina de Chihuahua, S.C.
Chihuahua City, , Mexico
Szpital Uniwersytecki nr 2 im.dr J. Biziela
Bydgoszcz, , Poland
McBk S.C.
Grodzisk Mazowiecki, , Poland
Centrum Medyczne AMED
Lodz, , Poland
Szpital Wojewodzki im. Prymasa Kardynala Stefana Wyszynskiego
Sieradz, , Poland
Samodzielny Publiczny ZOZ Tomaszow Lubelski
Tomaszów Lubelski, , Poland
McM Polimedica
Warsaw, , Poland
State Budgetary Healthcare Institution "City Clinical Hospital # 15 n.a O.M. Filatov" of Moscow Healtheare Department
Moscow, Moscow Oblast, Russia
City Clinical Hospital #1
Novosibirsk, Novosibirsk Oblast, Russia
Diagnostic Center Ultramed
Omsk, Omsk Oblast, Russia
SBHI of the Republic of Karelia "Republican Hospital named after V.A.Baranov"
Petrozavodsk, Republic of Karelia, Russia
Rostov State Medical Unversity
Rostov-on-Don, Rostov Oblast, Russia
SBHI of Stavropol Region "Stavropol Regional Clinical Hospital"
Stavropol, Stavropol Kray, Russia
Regional Clinical Hospital
Vladimir, Vladimirskaya Oblast’, Russia
FSBSI "Scientific Research Institute of Rheumatology n.a. V.A. Nasonova"
Moscow, , Russia
Ajou University Hospital
Suwon, Gyeonggi-do, South Korea
Chonnam National University Hospital
Gwangju, , South Korea
Hallym University Sacred Heart Hospital
Gyeonggi-do, , South Korea
Severance Hospital, Yonsei University
Seoul, , South Korea
Countries
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References
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Feist E, Fatenejad S, Grishin S, Korneva E, Luggen ME, Nasonov E, Samsonov M, Smolen JS, Fleischmann RM. Olokizumab, a monoclonal antibody against interleukin-6, in combination with methotrexate in patients with rheumatoid arthritis inadequately controlled by tumour necrosis factor inhibitor therapy: efficacy and safety results of a randomised controlled phase III study. Ann Rheum Dis. 2022 Dec;81(12):1661-1668. doi: 10.1136/ard-2022-222630. Epub 2022 Sep 15.
Provided Documents
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Document Type: Study Protocol and Statistical Analysis Plan
Other Identifiers
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2015-005308-27
Identifier Type: EUDRACT_NUMBER
Identifier Source: secondary_id
CL04041025
Identifier Type: -
Identifier Source: org_study_id
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