Level Up: A Study to Evaluate Adverse Events and Change in Disease Activity Comparing Oral Upadacitinib to Subcutaneous Dupilumab in Adolescent and Adult Participants With Moderate to Severe Atopic Dermatitis

Sponsor

AbbVie (Industry)

Overall Status

Recruiting

CT.gov ID

NCT05601882

Collaborator

(none)

880

Enrollment

298

Locations

Arms

33.9

Anticipated Duration (Months)

Patients Per Site

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Atopic dermatitis (AD) is a skin condition that may cause a rash and itching due to inflammation of the skin. Therapies spread over the skin may not be enough to control the AD in trial participants who require systemic anti-inflammatory treatment. This study compares upadacitinib to dupilumab in adolescent and adult participants with moderate to severe AD who have inadequate response to systemic therapies. Adverse events and change in the disease activity will be assessed.

Upadacitinib and dupilumab are approved drugs for the treatment of moderate to severe atopic dermatitis (AD). The study is comprised of a 35-day Screening Period, a 16-week treatment period 1 and a 16-week treatment period 2. During period 1, participants are randomly assigned in 1 of 2 groups, called treatment arms to receive upadacitinib Dose A or dupilumab. In Period 2, participants will receive upadacitinib Dose A or Dose B. Approximately 880 adolescent and adult participants ages 12 to 64 with moderate to severe AD who are candidates for systemic therapy will be enrolled at up to 330 sites worldwide.

Participants will receive upadacitinib oral tablets once daily or dupilumab as per its label for 32 weeks and followed for 30 days.

There may be higher treatment burden for participants in this trial compared to their standard of care . Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Condition or Disease	Intervention/Treatment	Phase
Atopic Dermatitis	Drug: Upadacitinib Drug: Dupilumab	Phase 3

Study Design

Study Type:

Interventional

Anticipated Enrollment :

880 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

A Phase 3b/4 Randomized, Open-label, Efficacy Assessor Blinded Study, Comparing the Safety and Assessor Blinded Efficacy of Upadacitinib to Dupilumab in Subjects With Moderate to Severe Atopic Dermatitis (Level-Up)

Actual Study Start Date :

Nov 28, 2022

Anticipated Primary Completion Date :

May 7, 2025

Anticipated Study Completion Date :

Sep 25, 2025

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Upadacitinib Participants will receive upadacitinib dose A daily in period 1. Eligible participants will receive upadacitinib dose B daily in period 2.	Drug: Upadacitinib Oral Tablets Other Names: RINVOQ
Experimental: Dupilumab followed by Upadacitinib Participants will receive dupilumab as per its label in period 1. Eligible participants will receive upadacitinib dose A in period 2.	Drug: Upadacitinib Oral Tablets Other Names: RINVOQ Drug: Dupilumab Subcutaneous Injection

Arm

Intervention/Treatment

Experimental: Upadacitinib

Participants will receive upadacitinib dose A daily in period 1. Eligible participants will receive upadacitinib dose B daily in period 2.

Drug: Upadacitinib

Oral Tablets

Other Names:

RINVOQ

Experimental: Dupilumab followed by Upadacitinib

Participants will receive dupilumab as per its label in period 1. Eligible participants will receive upadacitinib dose A in period 2.

Drug: Upadacitinib

Oral Tablets

Other Names:

RINVOQ

Drug: Dupilumab

Subcutaneous Injection

Outcome Measures

Primary Outcome Measures

Percentage of Participants Achieving both 90% Eczema Area and Severity Index (EASI 90) and Worst Pruritus Numerical Rating Scale of 0 or 1 (WPNRS 0/1) [At week 16]
The EASI is a validated measure used in clinical practice and clinical trials to assess the severity and extent of AD. The EASI is a composite index with scores ranging from 0 to 72. The WP-NRS is an assessment tool that participants used to report the intensity of their pruritus during a daily recall period. On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst imaginable itch'.

Secondary Outcome Measures

Percentage of Participants Achieving at least 90% of Eczema Area and Severity Index (EASI 90) [Up to week 16]
The EASI is a validated measure used in clinical practice and clinical trials to assess the severity and extent of Atopic Dermatitis (AD). The EASI is a composite index with scores ranging from 0 to 72.
Percentage of Participants Achieving a Worst Pruritus Numerical Rating Scale of 0 or 1 (WP-NRS 0/1) among Participants with Baseline WP-NRS > 1 [Up to week 16]
The WP-NRS is an assessment tool that participants used to report the intensity of their pruritus during a daily recall period. On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst imaginable itch'.
Percentage of Participants Achieving an improvement in Worst Pruritus Numerical Rating Scale (WP-NRS) ≥ 4 among those with Baseline WP-NRS ≥ 4 [At week 16]
The WP-NRS is an assessment tool that participants used to report the intensity of their pruritus during a daily recall period. On a scale of 0 to 10, with 0 being 'no itch' and 10 being the 'worst imaginable itch'.
Percentage of Participants Achieving 75% of Eczema Area and Severity Index (EASI 75) [At week 2]
The EASI is a validated measure used in clinical practice and clinical trials to assess the severity and extent of Atopic Dermatitis (AD). The EASI is a composite index with scores ranging from 0 to 72.
Percentage of Participants Achieving 100% of Eczema Area and Severity Index (EASI 100) [At week 16]
The EASI is a validated measure used in clinical practice and clinical trials to assess the severity and extent of Atopic Dermatitis (AD). The EASI is a composite index with scores ranging from 0 to 72.

Eligibility Criteria

Criteria

Ages Eligible for Study:

12 Years to 64 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Chronic atopic dermatitis (AD) with onset of symptoms at least 3 years prior to baseline and participant meets Hanifin and Rajka criteria.
Eczema area and severity index (EASI) score ≥ 16;validated Investigator´s Global Assessment for AD (vIGA-AD) score ≥ 3 and ≥ 10% Body Surface Area Involvement of Atopic Dermatitis (BSA of AD) involvement at the Baseline Visit.
Baseline weekly average of daily Worst Pruritus Numerical Rating Scale (WP-NRS) ≥ 4.
Documented history of inadequate response to previous systemic treatment defined as documented history of previous inadequate response to at least one prior systemic treatment for AD OR for whom other systemic treatments are otherwise medically inadvisable.

Exclusion Criteria:

History of clinically significant (per investigator's judgment) drug or alcohol abuse within the last 6 months.
History of an organ transplant which requires continued immunosuppression.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Medical Dermatology Specialist /ID# 250212	Phoenix	Arizona	United States	85006-2722
2	Alliance Dermatology and MOH Center, PC /ID# 249671	Phoenix	Arizona	United States	85032
3	Clinical Trials Institute at Northwest Arkansas /ID# 249838	Fayetteville	Arkansas	United States	72703-6245
4	Arkansas Research Trials, LLC /ID# 250722	North Little Rock	Arkansas	United States	72117
5	Encino Research Center /ID# 250211	Encino	California	United States	91436
6	First OC Dermatology Research /ID# 250686	Fountain Valley	California	United States	92708-3701
7	Antelope Valley Clinical Trials /ID# 249946	Lancaster	California	United States	93534
8	Dermatology Research Associates /ID# 249829	Los Angeles	California	United States	90045
9	UC Davis Health /ID# 250044	Sacramento	California	United States	95816-3300
10	Stanford University /ID# 251211	Stanford	California	United States	94305
11	California Dermatology Institute /ID# 250213	Thousand Oaks	California	United States	91320-2130
12	Western States Clinical Res /ID# 250274	Wheat Ridge	Colorado	United States	80033-2896
13	Clearlyderm Dermatology /ID# 250457	Boca Raton	Florida	United States	33428
14	Skin Care Research - Boca Raton /ID# 250458	Boca Raton	Florida	United States	33486-2269
15	Olympian Clinical Research /ID# 250453	Clearwater	Florida	United States	33756
16	Skin Care Research - Hollywood /ID# 250459	Hollywood	Florida	United States	33021-6748
17	Solutions Through Adv Rch /ID# 250455	Jacksonville	Florida	United States	32256
18	GSI Clinical Research, LLC /ID# 250768	Margate	Florida	United States	33063
19	Wellness Clinical Research /ID# 250236	Miami Lakes	Florida	United States	33016
20	D&H National Research Centers /ID# 250734	Miami	Florida	United States	33155-3244
21	Florida International Rsrch cr /ID# 249667	Miami	Florida	United States	33173
22	Tory P Sullivan, MD PA /ID# 251136	North Miami Beach	Florida	United States	33162-4708
23	Precision Clinical Research /ID# 250990	Sunrise	Florida	United States	33351-7311
24	Advanced Clinical Research Institute /ID# 250460	Tampa	Florida	United States	33607-6429
25	Metabolic Research Inst /ID# 250046	West Palm Beach	Florida	United States	33401
26	Treasure Valley Medical Research /ID# 250727	Boise	Idaho	United States	83706
27	Dawes Fretzin, LLC /ID# 250276	Indianapolis	Indiana	United States	46256
28	Randall Dermatology of West Lafayette /ID# 250234	West Lafayette	Indiana	United States	47906-1569
29	Beth Israel Deaconess Medical Center /ID# 251212	Boston	Massachusetts	United States	02215-5400
30	Beacon Clinical Research, LLC /ID# 251412	Quincy	Massachusetts	United States	02169
31	Michigan Center for Research Company /ID# 250225	Clarkston	Michigan	United States	48346
32	Henry Ford Medical Center /ID# 250228	Detroit	Michigan	United States	48202-3046
33	Cleaver Dermatology /ID# 250725	Kirksville	Missouri	United States	63501-5362
34	MediSearch Clinical Trials /ID# 250272	Saint Joseph	Missouri	United States	64506
35	Duplicate_Allergy, Asthma & Immunology Associates, PC /ID# 250616	Lincoln	Nebraska	United States	68505-2343
36	Physician Research Collaboration, LLC /ID# 251099	Lincoln	Nebraska	United States	68516
37	Montefiore Medical Center - Moses Campus /ID# 251214	Bronx	New York	United States	10467
38	Derm of Greater Columbus /ID# 250049	Bexley	Ohio	United States	43209-2422
39	Univ Hosp Cleveland /ID# 250699	Cleveland	Ohio	United States	44106
40	Vital Prospects Clinical Research Institute, PC /ID# 249840	Tulsa	Oklahoma	United States	74136-7049
41	Oregon Dermatology and Research Center /ID# 250726	Portland	Oregon	United States	97210
42	Oregon Medical Res Center PC /ID# 249666	Portland	Oregon	United States	97223
43	Oregon Health and Science University /ID# 250712	Portland	Oregon	United States	97239
44	University of Pittsburgh MC /ID# 251208	Pittsburgh	Pennsylvania	United States	15260
45	MUSC - Rutledge Tower /ID# 251218	Charleston	South Carolina	United States	29425-8903
46	Health Concepts /ID# 250988	Rapid City	South Dakota	United States	57702
47	International Clinical Research - Tennessee LLC /ID# 250724	Murfreesboro	Tennessee	United States	37130-2450
48	Arlington Research Center, Inc /ID# 250468	Arlington	Texas	United States	76011
49	Orion Clinical Research /ID# 250473	Austin	Texas	United States	78759-4100
50	Bellaire Dermatology Associates /ID# 250739	Bellaire	Texas	United States	77401
51	Modern Research Associates, PLLC /ID# 250688	Dallas	Texas	United States	75231
52	University of Texas Health Science Center at Houston /ID# 250736	Houston	Texas	United States	77030-1501
53	Center for Clinical Studies /ID# 250039	Houston	Texas	United States	77065
54	Texas Dermatology and Laser Specialists /ID# 250367	San Antonio	Texas	United States	78218-3128
55	University of Utah Mid Valley Dermatology /ID# 250042	Murray	Utah	United States	84107-7302
56	Virginia Clinical Research, Inc. /ID# 249908	Norfolk	Virginia	United States	23507
57	Framingham Centro Medico /ID# 251031	La Plata	Buenos Aires	Argentina	1902
58	Hospital Universitario Austral /ID# 251030	Pilar	Buenos Aires	Argentina	1629
59	Fundacion CIDEA /ID# 250023	Ciudad Autonoma de Buenos Aire	Ciuadad Autonoma De Buenos Aires	Argentina	1121
60	Instituto de Neumonología y Dermatología /ID# 250088	Ciudad Autonoma de Buenos Aire	Ciuadad Autonoma De Buenos Aires	Argentina	1425
61	Instituto de Diagnostico ABC /ID# 250144	Rosario	Santa Fe	Argentina	2000
62	Centro de Investigaciones Medicas Tucuman /ID# 250024	San Miguel de Tucuman	Tucuman	Argentina	4000
63	Sanatorio 9 de Julio /ID# 250705	San Miguel de Tucuman	Tucuman	Argentina	4000
64	Hospital Italiano /ID# 250182	Caba		Argentina	C1199ABB
65	Parra Dermatologia /ID# 251058	Mendoza		Argentina	5500
66	Premier Specialist /ID# 250572	Kogarah	New South Wales	Australia	2217
67	Veracity Clinical Research /ID# 249943	Woolloongabba	Queensland	Australia	4102
68	Skin Health Institute Inc /ID# 249938	Carlton	Victoria	Australia	3053
69	Sinclair Dermatology /ID# 249937	East Melbourne	Victoria	Australia	3002
70	Fremantle Dermatology /ID# 249941	Fremantle	Western Australia	Australia	6160
71	UCL Saint-Luc /ID# 251403	Woluwe-Saint-Lambert	Bruxelles-Capitale	Belgium	1200
72	Grand Hopital de Charleroi /ID# 251401	Charleroi	Hainaut	Belgium	6000
73	Universitair Ziekenhuis Leuven /ID# 251399	Leuven	Vlaams-Brabant	Belgium	3000
74	CHU de Liege /ID# 251400	Liege		Belgium	4000
75	UMHAT Dr Georgi Stranski EAD /ID# 251268	Pleven		Bulgaria	5800
76	DCC "Pulmed" AD /ID# 251271	Plovdiv		Bulgaria	4001
77	ASMC-IPSMC-Skin and Venereal Diseases /ID# 251272	Sofia		Bulgaria	1407
78	Diagnostic consultative center Aleksandrovska /ID# 251137	Sofia		Bulgaria	1431
79	Diagnostic consultative center Focus-5 /ID# 251269	Sofia		Bulgaria	1463
80	Medical center EuroHealth /ID# 251270	Sofia		Bulgaria	1606
81	Military Medical Academy Multiprofile Hospital /ID# 251187	Sofia		Bulgaria	1606
82	Medical Center Euroderma /ID# 251267	Sofiya		Bulgaria	1606
83	MC Zara-Med EOOD /ID# 251135	Stara Zagora		Bulgaria	6000
84	Dermatology Research Institute Inc. /ID# 251642	Calgary	Alberta	Canada	T2J 7E1
85	Beacon Dermatology Inc /ID# 250336	Calgary	Alberta	Canada	T3E 0B2
86	Alberta DermaSurgery Centre /ID# 250217	Edmonton	Alberta	Canada	T6G 1C3
87	Dr. Chih-ho Hong Medical Inc. /ID# 251643	Surrey	British Columbia	Canada	V3R 6A7
88	Enverus Medical Research /ID# 251645	Surrey	British Columbia	Canada	V3V 0C6
89	UBC Department of Dermatology and Skin Science The Skin Care Centre /ID# 250218	Vancouver	British Columbia	Canada	V5Z 4E8
90	Wiseman Dermatology Research /ID# 250219	Winnipeg	Manitoba	Canada	R3M 3Z4
91	Brunswick Dermatology Center /ID# 250220	Fredericton	New Brunswick	Canada	E3B 1G9
92	LEADER Research /ID# 251647	Hamilton	Ontario	Canada	L8L 3C3
93	DermEffects /ID# 250223	London	Ontario	Canada	N6H 5L5
94	Lynderm Research Inc. /ID# 251854	Markham	Ontario	Canada	L3P 1X2
95	DermEdge Research Inc. /ID# 250216	Mississauga	Ontario	Canada	L4Y 4C5
96	SKIN Centre for Dermatology /ID# 251853	Peterborough	Ontario	Canada	K9J 5K2
97	Toronto Research Centre /ID# 252098	Toronto	Ontario	Canada	M3H 5Y8
98	Research Toronto /ID# 250222	Toronto	Ontario	Canada	M4W 2N4
99	K. Papp Clinical Research /ID# 251644	Waterloo	Ontario	Canada	N2J 1C4
100	Centre de recheche dermatologique du Quebec Metropolitain /ID# 250427	Québec	Quebec	Canada	G1V 4X7
101	Beijing Friendship Hospital /ID# 249399	Beijing	Beijing	China	100032
102	Guangzhou First People's Hospital /ID# 249695	Guangzhou	Guangdong	China	510180
103	The Second Affiliated Hospital of Guangzhou Medical University /ID# 249694	Guangzhou	Guangdong	China	510260
104	The University of Hong Kong- Shenzhen Hospital /ID# 249436	Shenzhen	Guangdong	China	518048
105	Union Hospital Tongji Medical College Huazhong University of Science and Technol /ID# 251485	Wuhan	Hubei	China	430022
106	Wuhan Integrated TCM & Western Medicine Hospital（Wuhan No.1 Hospital) /ID# 250019	Wuhan	Hubei	China	430022
107	The First Hospital of China Medical University /ID# 249638	Shenyang	Liaoning	China	110001
108	Huashan Hospital, Fudan University /ID# 250025	Shanghai	Shanghai	China	200040
109	Shanghai Skin Disease Hospital /ID# 249392	Shanghai	Shanghai	China	200443
110	Tianjin Medical University General Hospital /ID# 250246	Tianjin	Tianjin	China	300052
111	Hangzhou First People's Hospital /ID# 249437	Hangzhou	Zhejiang	China	310003
112	The second Affiliated hospital of Zhejiang University school of Medicine /ID# 249655	Hangzhou	Zhejiang	China	310009
113	Zhejiang Provincial People's Hospital /ID# 249653	Hangzhou	Zhejiang	China	310014
114	The Second Xiangya Hospital of Central South University /ID# 249657	Changsha		China	410011
115	The First Affiliated Hospital of Fujian Medical University /ID# 249674	Fuzhou		China	350005
116	Dermatology Hospital of Southern Medical University /ID# 250121	Guangzhou		China	510091
117	Clinisalud del sur /ID# 251951	Medellin	Antioquia	Colombia	055422
118	Centro Integral de Reumatologia del Caribe Circaribe SAS /ID# 251950	Barranquilla	Atlantico	Colombia	80002
119	Centro de Investigacion en Reumatologia y Especialidades Medicas- CIREEM SAS /ID# 251952	Bogota	Cundinamarca	Colombia	110221
120	Healthy Medical Center SAS /ID# 251953	Zipaquira	Cundinamarca	Colombia	250252
121	Hospital Alma Mater de Antioquia /ID# 252020	Medellin	Distrito Capital De Bogota	Colombia	50010
122	DermaPlus - Poliklinika za dermatologiju i venerologiju /ID# 249591	Zagreb	Grad Zagreb	Croatia	10000
123	Djecja bolnica Srebrnjak /ID# 249594	Zagreb	Grad Zagreb	Croatia	10000
124	Klinicki bolnicki centar Zagreb /ID# 249596	Zagreb	Grad Zagreb	Croatia	10000
125	Klinika za dječje bolesti Zagreb /ID# 249590	Zagreb	Grad Zagreb	Croatia	10000
126	Klinicki bolnicki centar Rijeka /ID# 249593	Rijeka	Primorsko-goranska Zupanija	Croatia	51000
127	Klinicki bolnicki centar Split /ID# 249879	Split	Splitsko-dalmatinska Zupanija	Croatia	21000
128	Poliklinika Solmed /ID# 252138	Grad Zagreb		Croatia	10000
129	Fakultni Nemocnice Brno /ID# 249993	Brno		Czechia	625 00
130	DERMAMEDICA, s.r.o. /ID# 251732	Cerveny Kostelec		Czechia	549 41
131	Nemocnice AGEL Novy Jicin, a.s. /ID# 249873	Novy Jicin		Czechia	741 01
132	CCR Ostrava, s.r.o. /ID# 249872	Ostrava		Czechia	702 00
133	Fakultni Nemocnice v Motole /ID# 251731	Praha		Czechia	150 06
134	Nemocnice Znojmo /ID# 250027	Znojmo		Czechia	669 02
135	Bispebjerg and Frederiksberg Hospital /ID# 248902	Copenhagen NV	Hovedstaden	Denmark	2400
136	Herlev and Gentofte Hospital /ID# 248900	Hellerup	Hovedstaden	Denmark	2900
137	Aarhus University Hospital /ID# 248899	Aarhus N	Midtjylland	Denmark	8200
138	Sjællands Universitetshospital /ID# 248901	Roskilde	Sjælland	Denmark	4000
139	HCL - Hopital Lyon Sud /ID# 251343	Pierre Benite CEDEX	Auvergne-Rhone-Alpes	France	69495
140	Hopital Saint Joseph /ID# 251053	Marseille	Bouches-du-Rhone	France	13008
141	CHU de Nantes, Hotel Dieu -HME /ID# 251347	Nantes	Pays-de-la-Loire	France	44000
142	AP-HP - Hopital Saint-Louis /ID# 251052	Paris		France	75010
143	Hôpital Charles-Nicolle /ID# 251055	Rouen		France	76000
144	CHU Toulouse - Hopital Larrey /ID# 251344	Toulouse		France	31400
145	Universitaetsklinikum Freiburg /ID# 249555	Freiburg	Baden-Wuerttemberg	Germany	79106
146	Universitaetsklinik Heidelberg /ID# 251458	Heidelberg	Baden-Wuerttemberg	Germany	69120
147	Universitaetsklinikum Tuebingen /ID# 249552	Tubingen	Baden-Wuerttemberg	Germany	72076
148	Universitaetsklinikum Frankfurt /ID# 249544	Frankfurt am Main	Hessen	Germany	60590
149	Universitaetsklinikum Muenster /ID# 249404	Muenster	Nordrhein-Westfalen	Germany	48149
150	Universitaetsklinikum Leipzig /ID# 249562	Leipzig	Sachsen	Germany	04103
151	Universitaetsklinikum Schleswig-Holstein Campus Luebeck /ID# 249560	Lübeck	Schleswig-Holstein	Germany	23538
152	Fachklinik Bad Bentheim /ID# 249545	Bad Bentheim		Germany	48455
153	Hautarztpraxis Dr. Niesmann und Dr. Othlinghaus /ID# 251566	Bochum		Germany	44793
154	Universitaetsklinikum Bonn /ID# 250307	Bonn		Germany	53127
155	Studiengesellschaft an der Hase GbR Praxis Weyergraf/Frick/Heiber /ID# 251392	Bramsche		Germany	49565
156	Klinikum Darmstadt /ID# 251391	Darmstadt		Germany	64283
157	Universitaetsklinikum Carl Gustav Carus an der TU Dresden /ID# 251844	Dresden		Germany	01307
158	Derma Study Center Friedrichshafen GmbH /ID# 251460	Friedrichshafen		Germany	88045
159	Universitaetsklinikum Hamburg-Eppendorf (UKE) /ID# 249547	Hamburg		Germany	20246
160	Dermatologikum Hamburg GmbH /ID# 251390	Hamburg		Germany	20354
161	Dermatologische Gemeinschaftspraxis Mahlow /ID# 250306	Mahlow		Germany	15831
162	Universitaetsmedizin der Johannes Gutenberg-Universitaet Mainz /ID# 249549	Mainz		Germany	55131
163	Klinikum rechts der Isar - Technische Universitaet Muenchen /ID# 249548	Munich		Germany	81675
164	Klinikum Oldenburg GmbH /ID# 250344	Oldenburg		Germany	26133
165	401 GSNA - 401 Army General Hospital /ID# 251843	Athens	Attiki	Greece	11527
166	General Hospital Andreas Syggros /ID# 251842	Athens	Attiki	Greece	16121
167	Papageorgiou General Hospital Thessaloniki /ID# 251840	Stavroupoli (Thessalonikis)	Thessaloniki	Greece	55536
168	Thessaloniki hospital for skin and venereal diseases- Ippokrateio Thessaloniki /ID# 252396	Thessaloniki		Greece	54643
169	Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont /ID# 249818	Szeged	Csongrad	Hungary	6725
170	Debreceni Egyetem Klinikai Kozpont /ID# 249849	Debrecen	Hajdu-Bihar	Hungary	4032
171	Bugat Pal Korhaz /ID# 251367	Gyöngyös	Heves	Hungary	3200
172	Somogy Megyei Kaposi Mor Oktato Korhaz /ID# 249848	Kaposvár	Somogy	Hungary	7400
173	Clinexpert Kft /ID# 249822	Budapest		Hungary	1033
174	Semmelweis Egyetem /ID# 251368	Budapest		Hungary	1085
175	Uno Medical Trials Kft /ID# 249820	Budapest		Hungary	1152
176	Derma-B Egeszsegugyi es Szolgaltato Kft. /ID# 249819	Debrecen		Hungary	4031
177	Bács-Kiskun Megyei Kórház Szegedi Tudományegyetem AOK Oktató Kórháza /ID# 249850	Kecskemet		Hungary	6000
178	Pecsi Tudomanyegyetem Klinikai Kozpont /ID# 250419	Pecs		Hungary	7624
179	Allergo-Derm Bakos Kft. /ID# 249821	Szolnok		Hungary	5000
180	Hadassah Medical Center-Hebrew University /ID# 251576	Jerusalem	Yerushalayim	Israel	91120
181	Rabin Medical Center /ID# 251578	Petakh Tikva		Israel	4941492
182	Istituto Clinico Humanitas /ID# 251493	Rozzano	Milano	Italy	20089
183	Fondazione PTV Policlinico Tor Vergata /ID# 250125	Rome	Roma	Italy	00133
184	IRCCS Istituti Fisioterapici Ospitalieri-Istituto Dermatologico San Gallicano /ID# 250558	Rome	Roma	Italy	00144
185	Azienda Ospedaliera di Perugia /ID# 251572	Perugia	Umbria	Italy	06129
186	ASST Spedali civili di Brescia /ID# 250129	Brescia		Italy	25123
187	Azienda Ospedaliero Universitaria di Cagliari- Presidio Ospedaliero /ID# 250130	Cagliari		Italy	09124
188	CAST - Center for Advanced Studies and Technology /ID# 251495	Chieti		Italy	66100
189	Ospedale Piero Palagi /ID# 250206	Florence		Italy	50122
190	Presidio Ospedaliero San Salvatore /ID# 250127	L'Aquila		Italy	67100
191	Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico /ID# 250123	Milan		Italy	20122
192	Azienda Ospedaliero-Universitaria di Modena /ID# 250128	Modena		Italy	41124
193	AOU Universita degli Studi della Campania Luigi Vanvitelli /ID# 251557	Napoli		Italy	80138
194	Azienda Ospedaliero Universitaria Pisana-Stabilimento di Santa Chiara /ID# 250124	Pisa		Italy	56126
195	Fondazione Policlinico Universitario Agostino Gemelli /ID# 251494	Roma		Italy	00168
196	Sapienza University of Rome - Polo Pontino /ID# 251571	Terracina		Italy	04019
197	A.O.U. Citta della Salute e della Scienza di Torino /ID# 250322	Turin		Italy	10126
198	Korea University Ansan Hospital /ID# 249814	Ansan	Gyeonggido	Korea, Republic of	15355
199	Soonchunhyang University Hospital Bucheon /ID# 249812	Bucheon	Gyeonggido	Korea, Republic of	14584
200	Ajou University Hospital /ID# 251491	Suwon	Gyeonggido	Korea, Republic of	16499
201	KonKuk University Medical Center /ID# 249811	Seoul	Seoul Teugbyeolsi	Korea, Republic of	05030
202	Pusan National University Hospital /ID# 249852	Busan		Korea, Republic of	49241
203	Kyungpook National University Hospital /ID# 249855	Daegu		Korea, Republic of	41944
204	Seoul National University Hospital /ID# 251492	Seoul		Korea, Republic of	03080
205	Chung-Ang University Hostipal /ID# 251490	Seoul		Korea, Republic of	06973
206	Hospital Universitario Dr. Jose Eleuterio Gonzalez /ID# 249679	Monterrey	Nuevo Leon	Mexico	64460
207	Eukarya PharmaSite, SC /ID# 249702	Monterrey	Nuevo Leon	Mexico	64718
208	Cryptex Investigación Clínica S.A de C.V /ID# 249994	Mexico City		Mexico	06100
209	Hospital Infantil de Mexico Federico Gomez /ID# 249644	Mexico City		Mexico	06720
210	Centro de Dermatologia de Monterrey /ID# 249126	Monterrey		Mexico	64460
211	Clinical Research Institute SC /ID# 249647	Tlalnepantla de Baz		Mexico	54055
212	Arke SMO, S.A. de C.V. / Veracruz /ID# 250147	Veracruz		Mexico	91910
213	Bravis Ziekenhuis /ID# 251395	Bergen op Zoom	Noord-Brabant	Netherlands	4624 VT
214	Academisch Medisch Centrum /ID# 251397	Amsterdam		Netherlands	1105 AZ
215	MICS Centrum Medyczne Torun /ID# 251433	Torun	Kujawsko-pomorskie	Poland	87-100
216	Dermed Centrum Medyczne Sp. z o.o /ID# 251429	Lodz	Lodzkie	Poland	90-265
217	Lidia Rajzer - Specjalistyczny Gabinet Dermatologiczno-Kosmetyczny /ID# 252082	Cracow	Malopolskie	Poland	30-438
218	Diamond Clinic Sp. z o.o /ID# 249631	Cracow	Malopolskie	Poland	31-559
219	Centrum Nowoczesnych Terapii Dobry Lekarz Sp. z o.o. /ID# 251437	Krakow	Malopolskie	Poland	31-011
220	Klinika Ambroziak Sp. z o.o. /ID# 249406	Warsaw	Mazowieckie	Poland	02-758
221	Royalderm Agnieszka Nawrocka /ID# 251432	Warszawa	Mazowieckie	Poland	02-962
222	Zespol Naukowo-Leczniczy Iwolang Dermatologiczne Centrum Uzdrowiskowe Sp. z o.o /ID# 249598	Iwonicz-Zdrój	Podkarpackie	Poland	38-440
223	INTER CLINIC Piotr Adrian Klimiuk /ID# 251430	Bialystok	Podlaskie	Poland	15-077
224	Centrum Badan Klinicznych PI-House sp. z o.o. /ID# 251431	Gdansk	Pomorskie	Poland	80-546
225	Centrum Kliniczno-Badawcze /ID# 251438	Elblag	Warminsko-mazurskie	Poland	82-300
226	Solumed Centrum Medyczne /ID# 249641	Poznan	Wielkopolskie	Poland	60-529
227	Centrum Medyczne ALL-MED Badania Kliniczne /ID# 249630	Cracow		Poland	30-033
228	Bodyclinic Sp. z o.o. sp.k. /ID# 249599	Warszawa		Poland	03-712
229	Hospital da Senhora da Oliveira Guimaraes, EPE /ID# 249196	Guimaraes	Braga	Portugal	4835-044
230	Hospital Garcia de Orta, EPE /ID# 251455	Almada		Portugal	2805-267
231	CCA Braga - Hospital de Braga /ID# 250480	Braga		Portugal	4710-243
232	Centro Hospitalar de Leiria, EPE /ID# 249194	Leiria		Portugal	2410-197
233	Centro Hospitalar Universitario Lisboa Central, EPE - Hospital dos Capuchos /ID# 249195	Lisboa		Portugal	1169-050
234	Hospital dos Lusíadas Lisboa /ID# 251456	Lisboa		Portugal	1500-458
235	Hospital CUF Descobertas /ID# 249193	Lisboa		Portugal	1998-018
236	Unidade Local de Saúde de Matosinhos, EPE /ID# 249197	Matosinhos		Portugal	4464-513
237	Centro Hospitalar Universitario do Porto, EPE - Hospital Santo Antonio /ID# 249191	Porto		Portugal	4099-001
238	Centro Hospitalar Universitario de Sao Joao, EPE /ID# 249192	Porto		Portugal	4200-319
239	Dr. Samuel Sanchez PSC /ID# 250389	Caguas		Puerto Rico	00727
240	Cruz-Santana, Carolina, PR /ID# 250393	Carolina		Puerto Rico	00985
241	Clinical Research Puerto Rico /ID# 250394	San Juan		Puerto Rico	00909
242	GCM Medical Group PSC /ID# 250391	San Juan		Puerto Rico	00917-3104
243	Bio Terra Med SRL /ID# 249624	Bucharest	Bucuresti	Romania	010701
244	Centrul Medical de Diagnostic si Tratament SRI /ID# 249688	Bucharest	Bucuresti	Romania	011774
245	Cabinet Medical de Dermatovenerologie Dr. Remus Orasan /ID# 249625	Cluj Napoca		Romania	400105
246	Fakultna nemocnica Trnava /ID# 249745	Trnava	Trnavsky Kraj	Slovakia	917 75
247	Poliklinika Bezrucova (Cliniq s.r.o.) /ID# 249746	Bratislava		Slovakia	811 09
248	Derma therapy, spol. s r.o. /ID# 249783	Bratislava		Slovakia	831 03
249	BeneDerma s.r.o. /ID# 251791	Bratislava		Slovakia	841 04
250	Univerzitna nemocnica L. Pasteura Kosice /ID# 251790	Kosice		Slovakia	040 01
251	University of Pretoria /ID# 250208	Pretoria	Gauteng	South Africa	0001
252	Dr Tshegofatso Mabelane /ID# 249697	Pretoria	Gauteng	South Africa	0181
253	Asthma & Allergy Centre /ID# 250103	Westville	Kwazulu-Natal	South Africa	3629
254	Spoke Research Inc /ID# 250091	CAPE TOWN Milnerton	Western Cape	South Africa	7441
255	Allergy & Immunology (AIU) /ID# 249619	Cape Town	Western Cape	South Africa	7700
256	Hospital Universitario Germans Trias i Pujol /ID# 251523	Badalona	Barcelona	Spain	08916
257	Hospital Sant Joan de Deu /ID# 249602	Esplugues de Llobregat	Barcelona	Spain	08950
258	Hospital Universitario Basurto /ID# 249784	Bilbao	Vizcaya	Spain	48013
259	Hospital General Universitario de Alicante Doctor Balmis /ID# 251517	Alicante		Spain	03010
260	Hospital Universitario Virgen de las Nieves /ID# 249785	Granada		Spain	18014
261	Hospital Universitario La Paz /ID# 251518	Madrid		Spain	28046
262	Hospital Universitario Virgen Macarena /ID# 249603	Sevilla		Spain	41009
263	Hospital Universitario y Politecnico La Fe /ID# 251524	Valencia		Spain	46026
264	Skane University hospital /ID# 250332	Malmo	Skane Lan	Sweden	214 28
265	Norrlands University hospital /ID# 250329	Umea	Vasterbottens Lan	Sweden	581 85
266	Malarsjukhuset /ID# 251908	Eskilstuna		Sweden	633 49
267	Karolinska University Hospital /ID# 250328	Stockholm		Sweden	171 76
268	Universitätsspital Basel /ID# 250605	Basel	Basel-Stadt	Switzerland	4031
269	Kantonsspital St. Gallen /ID# 250606	St. Gallen	Sankt Gallen	Switzerland	9007
270	Universitatsspital Zurich /ID# 250607	Zurich	Zuerich	Switzerland	8091
271	Inselspital, Universitätsspital Bern /ID# 250577	Bern		Switzerland	3010
272	Kaohsiung Chang Gung Memorial Hospital /ID# 249260	Kaohsiung City	Kaohsiung	Taiwan	833
273	National Taiwan University Hospital - Hsinchu branch /ID# 249265	Hsinchu City		Taiwan	30059
274	Taipei Medical University Shuang Ho Hospital /ID# 249256	New Taipei City		Taiwan	23561
275	Taichung Veterans General Hospital /ID# 249261	Taichung		Taiwan	40705
276	National Taiwan University Hospital /ID# 249258	Taipei City		Taiwan	100
277	MacKay Memorial Hospital /ID# 249259	Taipei City		Taiwan	10449
278	Taipei Veterans General Hosp /ID# 249263	Taipei City		Taiwan	11217
279	Taipei Municipal Wan Fang Hospital /ID# 251500	Taipei		Taiwan	116
280	Linkou Chang Gung Memorial Hospital /ID# 249257	Taoyuan City		Taiwan	333
281	Erciyes University Medical Fac /ID# 249863	Melikgazi	Kayseri	Turkey	38030
282	Ankara City Hospital /ID# 249870	Ankara		Turkey	06800
283	Akdeniz Universitesi Tip Fakul /ID# 249866	Antalya		Turkey	07059
284	Uludag University Medical Faculty /ID# 249864	Bursa		Turkey	16059
285	Gaziantep University Şahinbey Research and Practice Hospital /ID# 249868	Gaziantep		Turkey	27310
286	Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty /ID# 249862	Istanbul		Turkey	34098
287	Ondokuz Mayis Universitesi Tip /ID# 249865	Samsun		Turkey	55139
288	Victoria Hospital /ID# 251758	Kirkcaldy	Fife	United Kingdom	KY2 5AH
289	Guys and St Thomas NHS Foundation Trust /ID# 250070	London	London, City Of	United Kingdom	SE1 9RT
290	Guys and St Thomas NHS Foundation Trust /ID# 250467	London	London, City Of	United Kingdom	SE1 9RT
291	Great Ormond Street Hospital for Children /ID# 250507	London	London, City Of	United Kingdom	WC1N 3JH
292	The Queen Elizabeth Hospital, Kings Lynn NHS Foundation Trust /ID# 251762	Kings Lynn	Norfolk	United Kingdom	PE30 4ET
293	NHS Greater Glasgow and Clyde /ID# 250068	Glasgow	Scotland	United Kingdom	G12 0XH
294	Epsom & St Helier University Hospital NHS Trust /ID# 250598	Carshalton	Surrey	United Kingdom	SM5 1AA
295	London North West University Healthcare NHS Trust /ID# 250097	Harrow		United Kingdom	HA1 3UJ
296	Whittington Health NHS Trust /ID# 250504	London		United Kingdom	N19 5NF
297	Northern Care Alliance NHS Group /ID# 251236	Salford		United Kingdom	M6 8HD
298	Mid Yorkshire Hospitals NHS Trust /ID# 250508	Wakefield		United Kingdom	WF1 4DG