Steroid Treatment for Hypereosinophilic Syndrome
Study Details
Study Description
Brief Summary
Background:
- Hypereosinophilic syndrome (HES) is a disorder in which the body has too many eosinophils (a type of white blood cell). Too many eosinophils in HES can cause damage to the heart, nerves, or skin. Certain drugs can help lower eosinophil counts to prevent tissue damage. Corticosteroids, such as prednisone, are used for initial therapy in this disorder. Although most people respond to prednisone, some people develop side effects from it, or do not respond very well to treatment. Better ways of determining the dose to give could help to decide on the best therapy for HES.
Objectives:
-
To determine whether a single-dose of prednisone can be used to predict which people with hypereosinophilia respond to treatment.
-
To study lack of response to steroid treatment in people with HES.
Eligibility:
Inclusion criteria:
-
Individuals with hypereosinophilic syndrome with high eosinophil counts.
-
Individuals who are willing to have blood drawn before and after getting steroids.
Exclusion criteria:
-
Individuals who are on more than 10mg of prednisone (or similar drug)
-
Individuals with hypereosinophilic syndrome who are on other medications that could interfere with the study
-
Women who are pregnant or breast-feeding
-
Individuals who have a known gene mutation associated with chronic eosinophilic leukemia
-
Children less than 18 years old who weigh less than 48kg or 106lb
Design:
-
Participants will have a screening visit with a physical exam and medical history. Blood and urine samples will be collected.
-
Participants will have a single dose of the steroid prednisone by mouth in the morning. Blood samples will be collected 2, 4, 24 hours after this dose.
-
On the day after the steroid dose, participants will provide another blood sample in the morning.
-
Participants will start to take prednisone daily when they return home. Blood samples will be collected weekly at the participant s doctor s office. The dose of prednisone will be lowered depending on the weekly eosinophil count. We will try to get each person on the lowest dose of prednisone possible that will control the disorder. Participants who do not respond or have severe side effects will be taken off prednisone. Other treatments will be considered for people who do not respond to steroids. The goal is to evaluate the response to prednisone. Our research will try to figure out why some people do not respond to steroids. Most people will complete the study within 6 to 16 weeks, depending on their response to prednisone.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
Phase 4 |
Detailed Description
This study aims to develop a model to determine whether a single, oral, weight-based dose of glucocorticoid (GC) can predict clinical and biologic response to GC s over the long term in subjects with hypereosinophilic syndrome (HES). Subjects with FIP1L1/PDGFRalpha-negative HES, who are symptomatic with eosinophil count >1500/microL and receiving less than or equal to10 mg prednisone daily, will be enrolled. A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) will be administered. Eosinophil count and various laboratory parameters will be assessed at 2 hours, 4 hours and 24 hours following prednisone administration (investigators will be blinded to the results of the eosinophil counts). The subjects will then begin GC therapy at 30 mg prednisone daily followed by a standardized taper. The lowest dose of GC at which symptoms and eosinophilia are controlled will be compared to the change in eosinophil count at 2, 4 and 24 hours post-challenge. Mechanisms and in vitro correlates of GC resistance will also be explored.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Other: Steroid Challenge A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. |
Drug: prednisone
Glucocorticoids (GC) are considered the first- line therapy for hypereosinophilic syndrome.
|
Outcome Measures
Primary Outcome Measures
- Mean Percent Change in Eosinophil Count After Glucocorticoid Challenge [24 hours]
Response to glucocorticoid challenge as assessed by the percentage of the eosinophil count 24 hours post-glucocorticoid challenge relative to the Baseline AEC for each participant. Measure Description (%): Percent of baseline AEC is defined as the Absolute Eosinophil Count at 24 hours divided by the Absolute Eosinophil Count at Baseline *100.
Secondary Outcome Measures
- Participants With Glucocorticoid Responsiveness - IHES Variant [Baseline (Day 1)]
Participants with idiopathic hypereosinophilic syndromes (IHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response.
- Participants With Glucocorticoid Responsiveness - LHES Variant [Baseline (Day 1)]
Participants with lymphoid hypereosinophilic syndromes (LHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response.
- Participants With Glucocorticoid Responsiveness - MHES Variant [Baseline (Day 1)]
Participants with myeloid hypereosinophilic syndromes (MHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response.
- Participants With Glucocorticoid Responsiveness - Overlap HES Subtypes [Baseline (Day 1)]
Participants with overlap hypereosinophilic syndromes that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response.
- Mean Baseline IgE Level [Baseline (Day 1)]
Mean baseline immunoglobulin E (IgE) level in participants prior to initiation of glucocorticoid
- Mean Baseline Absolute Eosinophil Count [Baseline (Day 1)]
Mean baseline absolute eosinophil count in participants prior to initiation of glucocorticoids
- Participants With Glucocorticoid Responsiveness - Cardiac Involvement [Baseline (Day 1)]
Cardiac involvement in participants with hypereosinophilic syndromes (HES)
- Participants With Glucocorticoid Responsiveness - Pulmonary Involvement [Baseline (Day 1)]
Pulmonary involvement in participants with hypereosinophilic syndromes (HES)
Eligibility Criteria
Criteria
- SUBJECT INCLUSION CRITERIA:
Subjects on Protocol #94-I-0079 will be eligible for participation in the study only if all of the following criteria apply:
-
Subjects must be 7 years of age or older to enroll
-
Subject meets diagnostic criteria for HES (AEC >1500/microL, absence of a secondary cause and signs and/or symptoms attributable to the eosinophilia)
-
AEC greater than 1500 microL obtained within 14 days prior to enrollment
-
Willingness to perform the timed steroid challenge
-
Appropriate candidate for GC treatment after challenge
-
Willingness to have samples stored for future research
SUBJECT EXCLUSION CRITERIA:
A subject will not be eligible to participate in the study if any of the following apply:
-
Receiving >10 mg prednisone or equivalent at the time of enrollment.
-
Receiving less than or equal to 10 mg of prednisone or equivalent but have not been on a fixed dose for at least 3 weeks (subjects on a current corticosteroid taper will be excluded).
-
AEC less than or equal to 1500/microl on the day of the steroid challenge
-
Use of immunomodulatory medications, (other than less than or equal to 10 mg/day prednisone) including but not limited to biologics, within the past 6 months.
-
Pregnant at the time of screening.
-
Have a known mutation in the FIP1L1-PDGFR gene.
-
Any condition that, in the opinion of the investigator, places the subject at undue risk by participating in the protocol.
-
Weight less than 48 kg (106 lbs) in subjects less than 18 years of age.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | National Institutes of Health Clinical Center, 9000 Rockville Pike | Bethesda | Maryland | United States | 20892 |
Sponsors and Collaborators
- National Institute of Allergy and Infectious Diseases (NIAID)
Investigators
- Principal Investigator: Paneez Khoury, M.D., National Institute of Allergy and Infectious Diseases (NIAID)
Study Documents (Full-Text)
More Information
Additional Information:
Publications
- Hamilos DL, Leung DY, Muro S, Kahn AM, Hamilos SS, Thawley SE, Hamid QA. GRbeta expression in nasal polyp inflammatory cells and its relationship to the anti-inflammatory effects of intranasal fluticasone. J Allergy Clin Immunol. 2001 Jul;108(1):59-68.
- Ogbogu PU, Bochner BS, Butterfield JH, Gleich GJ, Huss-Marp J, Kahn JE, Leiferman KM, Nutman TB, Pfab F, Ring J, Rothenberg ME, Roufosse F, Sajous MH, Sheikh J, Simon D, Simon HU, Stein ML, Wardlaw A, Weller PF, Klion AD. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009 Dec;124(6):1319-25.e3. doi: 10.1016/j.jaci.2009.09.022.
- Prin L, Lefebvre P, Gruart V, Capron M, Storme L, Formstecher P, Loiseau S, Capron A. Heterogeneity of human eosinophil glucocorticoid receptor expression in hypereosinophilic patients: absence of detectable receptor correlates with resistance to corticotherapy. Clin Exp Immunol. 1989 Dec;78(3):383-9.
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- 12-I-0026
Study Results
Participant Flow
Recruitment Details | |
---|---|
Pre-assignment Detail | 26 participants were consented to protocol but three did not meet the eligibility criteria so did not start study. |
Arm/Group Title | Steroid Challenge |
---|---|
Arm/Group Description | A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. |
Period Title: Overall Study | |
STARTED | 23 |
COMPLETED | 23 |
NOT COMPLETED | 0 |
Baseline Characteristics
Arm/Group Title | Steroid Challenge |
---|---|
Arm/Group Description | A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. |
Overall Participants | 23 |
Age (Count of Participants) | |
<=18 years |
0
0%
|
Between 18 and 65 years |
22
95.7%
|
>=65 years |
1
4.3%
|
Sex: Female, Male (Count of Participants) | |
Female |
12
52.2%
|
Male |
11
47.8%
|
Ethnicity (NIH/OMB) (Count of Participants) | |
Hispanic or Latino |
6
26.1%
|
Not Hispanic or Latino |
17
73.9%
|
Unknown or Not Reported |
0
0%
|
Race (NIH/OMB) (Count of Participants) | |
American Indian or Alaska Native |
0
0%
|
Asian |
2
8.7%
|
Native Hawaiian or Other Pacific Islander |
0
0%
|
Black or African American |
1
4.3%
|
White |
15
65.2%
|
More than one race |
1
4.3%
|
Unknown or Not Reported |
4
17.4%
|
Outcome Measures
Title | Mean Percent Change in Eosinophil Count After Glucocorticoid Challenge |
---|---|
Description | Response to glucocorticoid challenge as assessed by the percentage of the eosinophil count 24 hours post-glucocorticoid challenge relative to the Baseline AEC for each participant. Measure Description (%): Percent of baseline AEC is defined as the Absolute Eosinophil Count at 24 hours divided by the Absolute Eosinophil Count at Baseline *100. |
Time Frame | 24 hours |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the single challenge dose of prednisone |
Arm/Group Title | Steroid Challenge - Responders | Steroid Challenge - Non-responders |
---|---|---|
Arm/Group Description | A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. | A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. |
Measure Participants | 16 | 7 |
Mean (95% Confidence Interval) [percentage of eosinophil count] |
-69.6
|
-13.6
|
Title | Participants With Glucocorticoid Responsiveness - IHES Variant |
---|---|
Description | Participants with idiopathic hypereosinophilic syndromes (IHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response. |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (IHES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
6
26.1%
|
2
NaN
|
2
NaN
|
Title | Participants With Glucocorticoid Responsiveness - LHES Variant |
---|---|
Description | Participants with lymphoid hypereosinophilic syndromes (LHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response. |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily. |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
2
8.7%
|
1
NaN
|
2
NaN
|
Title | Participants With Glucocorticoid Responsiveness - MHES Variant |
---|---|
Description | Participants with myeloid hypereosinophilic syndromes (MHES) that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response. |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
0
0%
|
0
NaN
|
1
NaN
|
Title | Participants With Glucocorticoid Responsiveness - Overlap HES Subtypes |
---|---|
Description | Participants with overlap hypereosinophilic syndromes that achieved glucocorticoid responsiveness, suboptimal responsiveness, or without response. |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
3
13%
|
2
NaN
|
1
NaN
|
Title | Mean Baseline IgE Level |
---|---|
Description | Mean baseline immunoglobulin E (IgE) level in participants prior to initiation of glucocorticoid |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Geometric Mean (95% Confidence Interval) [IU/mL] |
285.2
|
1171.5
|
434.8
|
Title | Mean Baseline Absolute Eosinophil Count |
---|---|
Description | Mean baseline absolute eosinophil count in participants prior to initiation of glucocorticoids |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Geometric Mean (95% Confidence Interval) [10^3 cells per microliter] |
2.81
|
3.85
|
5.90
|
Title | Participants With Glucocorticoid Responsiveness - Cardiac Involvement |
---|---|
Description | Cardiac involvement in participants with hypereosinophilic syndromes (HES) |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
1
4.3%
|
0
NaN
|
4
NaN
|
Title | Participants With Glucocorticoid Responsiveness - Pulmonary Involvement |
---|---|
Description | Pulmonary involvement in participants with hypereosinophilic syndromes (HES) |
Time Frame | Baseline (Day 1) |
Outcome Measure Data
Analysis Population Description |
---|
All participants who received the prednisone challenge and completed dose course post challenge |
Arm/Group Title | Steroid Challenge - Glucocorticoid Responsiveness | Steroid Challenge - Glucocorticoid Suboptimal Responsiveness | Steroid Challenge - Glucocorticoid Unresponsiveness |
---|---|---|---|
Arm/Group Description | Participants with hypereosinophilic syndromes (HES) that achieved glucocorticoid responsiveness defined as final minimally effective dose of prednisone of 0mg-15mg | Participants with hypereosinophilic syndromes (HES) with suboptimal glucocorticoid responsiveness defined as achieving final minimally effective dose of prednisone of 16mg-40mg | Participants with hypereosinophilic syndromes (HES) that were not responsive to prednisone defined as no decline of absolute eosinophil count (AEC) below 1000/mm^3 after one week of prednisone 30 mg daily, followed by 2 days of prednisone 60 mg daily |
Measure Participants | 11 | 5 | 7 |
Count of Participants [Participants] |
4
17.4%
|
3
NaN
|
3
NaN
|
Adverse Events
Time Frame | 20 weeks | |
---|---|---|
Adverse Event Reporting Description | ||
Arm/Group Title | Steroid Challenge | |
Arm/Group Description | A single oral dose of prednisone (1 mg/kg rounded to the nearest 5mg) was administered to all participants. The following day, participant began glucocorticoid therapy of prednisone 30 mg oral daily for one week followed by a standardized taper until a minimally effective dose was achieved or participant tapered to prednisone 5 mg oral daily. | |
All Cause Mortality |
||
Steroid Challenge | ||
Affected / at Risk (%) | # Events | |
Total | 0/23 (0%) | |
Serious Adverse Events |
||
Steroid Challenge | ||
Affected / at Risk (%) | # Events | |
Total | 0/23 (0%) | |
Other (Not Including Serious) Adverse Events |
||
Steroid Challenge | ||
Affected / at Risk (%) | # Events | |
Total | 7/23 (30.4%) | |
Eye disorders | ||
Glaucoma | 1/23 (4.3%) | |
Vitreous floaters | 1/23 (4.3%) | |
General disorders | ||
Swelling face | 1/23 (4.3%) | |
Thirst | 1/23 (4.3%) | |
Investigations | ||
Weight increased | 2/23 (8.7%) | |
Metabolism and nutrition disorders | ||
Fluid retention | 1/23 (4.3%) | |
Increased appetite | 2/23 (8.7%) | |
Nervous system disorders | ||
Dizziness | 1/23 (4.3%) | |
Headache | 1/23 (4.3%) | |
Psychiatric disorders | ||
Insomnia | 1/23 (4.3%) | |
Renal and urinary disorders | ||
Polyuria | 1/23 (4.3%) | |
Skin and subcutaneous tissue disorders | ||
Dermatitis acneiform | 1/23 (4.3%) |
Limitations/Caveats
More Information
Certain Agreements
All Principal Investigators ARE employed by the organization sponsoring the study.
There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
Results Point of Contact
Name/Title | Paneez Khoury |
---|---|
Organization | National Institute of Allergy and Infectious Diseases |
Phone | +1 301 402 3773 |
khouryp@niaid.nih.gov |
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