A Study of the Efficacy and Safety of MK-5475 in Participants With Pulmonary Arterial Hypertension (INSIGNIA-PAH: Phase 2/3 Study of an Inhaled sGC Stimulator in PAH) (MK-5475-007)

Study Purpose

This is a two-part (Phase 2/Phase 3) study of MK-5475, an inhaled soluble guanylate cyclase stimulator, in participants with pulmonary arterial hypertension (PAH). The first part (Phase 2) will assess three different doses of MK-5475 compared to placebo in a base period of 12 weeks, followed by comparison of three different doses of MK-5475 during an optional 24 month extension period. The treatment dose with the best efficacy and safety profile in the phase 2 cohort base period will be selected for use in the second part (Phase 3) of the study. The primary hypothesis of Phase 2 is that at least one MK-5475 dose is superior to placebo in reducing pulmonary vascular resistance (PVR) from baseline at week 12. The purpose of the second part (Phase 3) of the study is to confirm the efficacy, safety, and tolerability of MK-5475 at the selected dose compared to placebo during a 12 week base period followed by an extension period of up to 5 years. The primary hypothesis of Phase 3 is that MK-5475 is superior to placebo in increasing 6-minute walk distance (6MWD) from baseline at week 12.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years - 75 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Pulmonary arterial hypertension (PAH) in one of the following groups: - Idiopathic PAH.
  • - Heritable PAH.
  • - Drug and toxin-induced PAH.
  • - PAH associated with connective tissue disease, HIV infection, or congenital heart disease.
  • - Diagnosis of PAH documented by right heart catheterization (RHC).
  • - Eligibility RHC meeting all of the following criteria: - Mean pulmonary artery pressure (mPAP) ≥25 mmHg.
  • - Pulmonary vascular resistance (PVR) of ≥3 Wood units.
  • - Pulmonary capillary wedge pressure (PCWP) or left ventricular end diastolic pressure (LVEDP) ≤15 mmHg.
  • - World Health Organization functional class (WHO-FC) symptoms between Class II and IV.
  • - Two 6-Minute walk distance (6MWD) measurements between 150 and 500 meters, one at screening and one at randomization.
  • - Stable concomitant background PAH-specific therapy.
  • - Body Mass Index (BMI) between 18.5 kg/m² and 40 kg/m² .
  • - Agree to be abstinent from heterosexual intercourse or use contraception during the intervention period and for at least 14 days after the last dose of study intervention.
  • - Female participants may not be pregnant or breastfeeding.

Exclusion Criteria:

  • - Group 2 to 5 pulmonary hypertension.
  • - PAH in one of the following groups: - Long term responders to calcium channel blockers.
  • - Overt features of venous/capillary involvement.
  • - Evidence of more-than-mild obstructive lung disease.
  • - Evidence of more-than-mild parenchymal lung disease.
  • - Evidence of more-than-mild obstructive sleep apnea (OSA) that is untreated.
  • - Evidence or history of left heart disease, including any of the following: - Left ventricular ejection fraction (LVEF) ≤45% - Moderate or severe left-sided valvular disease (aortic or mitral valve stenosis or regurgitation) - Significant left ventricular diastolic dysfunction on echocardiographic evaluation.
  • - Presence of 3 or more of the following risk factors for heart failure with preserved ejection fraction: BMI>30 kg/m², essential systemic hypertension, diabetes mellitus of any type, or coronary artery disease.
  • - Oxygen saturation measured by pulse oximetry (SpO₂) <90%, despite supplemental oxygen therapy.
  • - Chronic renal insufficiency (eGFR <30 mL/min) - Chronic liver disease (i.e., Child-Pugh B or C), portal hypertension, cirrhosis, or significant hepatic laboratory abnormalities.
  • - Current smoker or currently uses electronic cigarettes (vapes).
  • - History of cancer, except: nonmelanomatous skin carcinoma or carcinoma in situ of the cervix or other malignancies which have been successfully treated, with appropriate follow up, and unlikely to recur for the duration of the study.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT04732221
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2/Phase 3
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Merck Sharp & Dohme LLC
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Medical Director
Principal Investigator Affiliation Merck Sharp & Dohme LLC
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Active, not recruiting
Countries Argentina, Australia, Belgium, Canada, Colombia, France, Germany, Greece, Israel, Italy, Mexico, New Zealand, Poland, Russian Federation, Sweden, Turkey, United Kingdom, United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Pulmonary Arterial Hypertension, Hypertension, Pulmonary
Study Website: View Trial Website
Arms & Interventions

Arms

Experimental: Phase 2 Cohort MK-5475 380 µg

Participants receive MK-5475 380 µg via oral inhalation once daily for 12 week base period and for optional 24 month extension period.

Experimental: Phase 2 Cohort MK-5475 100 µg

Participants receive MK-5475 100 µg via oral inhalation once daily for 12 week base period and for optional 24 month extension period.

Experimental: Phase 2 Cohort MK-5475 32 µg

Participants receive MK-5475 32 µg via oral inhalation once daily for 12 week base period and for optional 24 month extension period.

Placebo Comparator: Phase 2 Cohort Placebo

Participants receive placebo via oral inhalation once daily for 12 week base period, and one of the MK-5475 doses (380, 100, or 32 µg) for the optional 24 month extension period.

Experimental: Phase 3 Cohort MK-5475

Participants receive one of 3 MK-5475 doses (380, 100 or 32 µg) to be selected at end of the Phase 2 Cohort, administered via oral inhalation once daily for 12-week base period and up to 60 months in the extension period

Placebo Comparator: Phase 3 Cohort Placebo

Participants receive placebo via oral inhalation once daily for 12 week base period and up to 60 months in the extension period.

Interventions

Drug: - MK-5475

MK-5475 (soluble guanylate cyclase stimulator) 380 µg, 100 µg or 32 µg administered as dry powder inhalation

Drug: - Placebo to MK-5475

Placebo administered as dry powder inhalation

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

La Jolla, California

Status

Address

University of California San Diego Health-Pulmonary Critical Care ( Site 0061)

La Jolla, California, 92037-7381

Sacramento, California

Status

Address

University of California Davis Health-Internal Medicine: Pulmonary, Critical Care and Sleep Medicine

Sacramento, California, 95817

San Francisco, California

Status

Address

UCSF Helen Diller Medical Center at Parnassus Heights ( Site 0063)

San Francisco, California, 94143

Aurora, Colorado

Status

Address

University of Colorado - Denver ( Site 0003)

Aurora, Colorado, 80045

Greeley, Colorado

Status

Address

Cardiovascular Institute of North Colorado - Banner Health ( Site 0013)

Greeley, Colorado, 80631

Washington, District of Columbia

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Address

Georgetown University Hospital ( Site 0025)

Washington, District of Columbia, 20007

Miami, Florida

Status

Address

University of Miami Hospital-Division of Pulmonary & Critical Care ( Site 0053)

Miami, Florida, 33136

AdventHealth Orlando ( Site 0040), Orlando, Florida

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Address

AdventHealth Orlando ( Site 0040)

Orlando, Florida, 32803

Tampa General Hospital ( Site 0058), Tampa, Florida

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Tampa General Hospital ( Site 0058)

Tampa, Florida, 33606

Indianapolis, Indiana

Status

Address

Indiana University Health Methodist Hospital ( Site 0045)

Indianapolis, Indiana, 46202-1239

Iowa City, Iowa

Status

Address

University of Iowa Hospital and Clinics ( Site 0009)

Iowa City, Iowa, 52242

Kansas City, Kansas

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University of Kansas Medical Center ( Site 0038)

Kansas City, Kansas, 66160

University of Kentucky ( Site 0006), Lexington, Kentucky

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Address

University of Kentucky ( Site 0006)

Lexington, Kentucky, 40536

Louisville, Kentucky

Status

Address

Norton Pulmonary Specialists ( Site 0048)

Louisville, Kentucky, 40202

University of Maryland ( Site 0032), Baltimore, Maryland

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Address

University of Maryland ( Site 0032)

Baltimore, Maryland, 21201

Saint Louis, Missouri

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Washington University School of Medicine ( Site 0066)

Saint Louis, Missouri, 63110

Omaha, Nebraska

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Address

University of Nebraska Medical Center ( Site 0041)

Omaha, Nebraska, 68198

Albuquerque, New Mexico

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Address

University of New Mexico, Health Sciences Center ( Site 0028)

Albuquerque, New Mexico, 87131

Chapel Hill, North Carolina

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Address

Clinical Trials Unit at Eastowne Medical Office Building ( Site 0019)

Chapel Hill, North Carolina, 27514

AnMed Health ( Site 0033), Anderson, South Carolina

Status

Address

AnMed Health ( Site 0033)

Anderson, South Carolina, 29621

Knoxville, Tennessee

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Address

Statcare Pulmonary Consultants ( Site 0067)

Knoxville, Tennessee, 37934

Dallas, Texas

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University of Texas Southwestern Medical Center at Dallas ( Site 0012)

Dallas, Texas, 75390

Houston, Texas

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Houston Methodist Research Institute ( Site 0036)

Houston, Texas, 77030

Houston, Texas

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Address

The University of Texas Health Science Center at Houston ( Site 0054)

Houston, Texas, 77030

Norfolk, Virginia

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Sentara Norfolk General Hospital ( Site 0014)

Norfolk, Virginia, 23507

Morgantown, West Virginia

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West Virginia University-WVU Heart and Vascular Institute ( Site 0051)

Morgantown, West Virginia, 26506

International Sites

Cardiologia Palermo ( Site 0140), Ciudad Autonoma de Buenos Aires, Buenos Aires, Argentina

Status

Address

Cardiologia Palermo ( Site 0140)

Ciudad Autonoma de Buenos Aires, Buenos Aires, C1425BNG

Florencio Varela, Buenos Aires, Argentina

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Address

Hospital El Cruce Nestor Carlos Kirchner ( Site 0132)

Florencio Varela, Buenos Aires, 1888

Centro Medico Capital ( Site 0131), La Plata, Buenos Aires, Argentina

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Address

Centro Medico Capital ( Site 0131)

La Plata, Buenos Aires, B1904AAW

Pilar, Buenos Aires, Argentina

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Address

Hospital Universitario Austral ( Site 0138)

Pilar, Buenos Aires, B1629ODT

Quilmes, Buenos Aires, Argentina

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Address

Instituto de Investigaciones Clinicas Quilmes ( Site 0141)

Quilmes, Buenos Aires, B1878GEG

Buenos Aires, Caba, Argentina

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Address

Sanatorio de la Trinidad Mitre ( Site 0130)

Buenos Aires, Caba, 1039

Rosario, Santa Fe, Argentina

Status

Address

Instituto Cardiovascular de Rosario ( Site 0128)

Rosario, Santa Fe, S2000DSR

Cordoba, Argentina

Status

Address

Hospital Privado Universitario de Córdoba ( Site 0137)

Cordoba, , X5016KEH

Nepean Hospital ( Site 0184), Kingswood, New South Wales, Australia

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Address

Nepean Hospital ( Site 0184)

Kingswood, New South Wales, 2747

Macquarie University ( Site 0180), Macquarie University, New South Wales, Australia

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Address

Macquarie University ( Site 0180)

Macquarie University, New South Wales, 2109

John Hunter Hospital ( Site 0185), Newcastle, New South Wales, Australia

Status

Address

John Hunter Hospital ( Site 0185)

Newcastle, New South Wales, 2305

Brussels, Bruxelles-Capitale, Region De, Belgium

Status

Address

Université Libre de Bruxelles - Hôpital Erasme ( Site 0601)

Brussels, Bruxelles-Capitale, Region De, 1070

UZ Leuven ( Site 0600), Leuven, Vlaams-Brabant, Belgium

Status

Address

UZ Leuven ( Site 0600)

Leuven, Vlaams-Brabant, 3000

Peter Lougheed Centre ( Site 0107), Calgary, Alberta, Canada

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Address

Peter Lougheed Centre ( Site 0107)

Calgary, Alberta, T1Y 6J4

Toronto, Ontario, Canada

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Address

University Health Network - Toronto General Hospital ( Site 0104)

Toronto, Ontario, M5G 2N2

IUCPQ ( Site 0111), Quebec, Canada

Status

Address

IUCPQ ( Site 0111)

Quebec, , G1V 4G5

Medellín, Antioquia, Colombia

Status

Address

Centro Cardiovascular Colombiano Clínica Santa María ( Site 0154)

Medellín, Antioquia, 050034

Bogota, Distrito Capital De Bogota, Colombia

Status

Address

Hospital Universitario San Ignacio ( Site 0152)

Bogota, Distrito Capital De Bogota, 110231

Piedecuesta, Santander, Colombia

Status

Address

Fundacion Cardiovascular de Colombia ( Site 0155)

Piedecuesta, Santander, 681017

Brest, Finistere, France

Status

Address

CHRU Brest - Hopital Cavale Blanche ( Site 0254)

Brest, Finistere, 29609

Toulouse, Haute-Garonne, France

Status

Address

CHU de Toulouse - Hopital Larrey ( Site 0258)

Toulouse, Haute-Garonne, 31059

Lille Cedex, Nord-Pas-de-Calais, France

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Address

Institut Coeur Poumon - CHRU de Lille ( Site 0252)

Lille Cedex, Nord-Pas-de-Calais, 59037

Rouen, Seine-Maritime, France

Status

Address

Centre Hospitalier Universitaire de Rouen ( Site 0253)

Rouen, Seine-Maritime, 76031

CHU - Hopital de Bicetre ( Site 0251), Le Kremlin-Bicetre, Val-de-Marne, France

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Address

CHU - Hopital de Bicetre ( Site 0251)

Le Kremlin-Bicetre, Val-de-Marne, 94275

Heidelberg, Baden-Wurttemberg, Germany

Status

Address

Thoraxklinik Heidelberg gGmbH am Universitaetsklinikum Heidelberg ( Site 0276)

Heidelberg, Baden-Wurttemberg, 69126

Wuerzburg, Bayern, Germany

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Address

Klinikum Würzburg Mitte-Medizinische Klinik - Schwerpunkt Pneumologie & Beatmungsmedizin ( Site 0280

Wuerzburg, Bayern, 97074

UKGM Gießen/Marburg ( Site 0279), Gießen, Hessen, Germany

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Address

UKGM Gießen/Marburg ( Site 0279)

Gießen, Hessen, 35392

Hannover, Niedersachsen, Germany

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Address

Medizinische Hochschule Hannover ( Site 0284)

Hannover, Niedersachsen, 30625

Uniklinikum Dresden ( Site 0283), Dresden, Sachsen, Germany

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Address

Uniklinikum Dresden ( Site 0283)

Dresden, Sachsen, 01307

Leipzig, Sachsen, Germany

Status

Address

Universitaetsklinikum Leipzig ( Site 0285)

Leipzig, Sachsen, 04103

Thessaloniki, Greece

Status

Address

AHEPA University General Hospital of Thessaloniki ( Site 0577)

Thessaloniki, , 54636

Soroka Medical Center ( Site 0330), Beer Sheva, Israel

Status

Address

Soroka Medical Center ( Site 0330)

Beer Sheva, , 8410101

Rambam Medical Center ( Site 0335), Haifa, Israel

Status

Address

Rambam Medical Center ( Site 0335)

Haifa, , 3109601

Holon, Israel

Status

Address

Wolfson Medical Center [Holon, Israel] ( Site 0333)

Holon, , 5810000

Shaare Zedek Medical Center ( Site 0331), Jerusalem, Israel

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Address

Shaare Zedek Medical Center ( Site 0331)

Jerusalem, , 9103102

Rabin Medical Center ( Site 0327), Petah Tikva, Israel

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Address

Rabin Medical Center ( Site 0327)

Petah Tikva, , 4941492

Naples, Campania, Italy

Status

Address

University of Naples Federico II ( Site 0308)

Naples, Campania, 80100

Roma, Lazio, Italy

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Address

Azienda Ospedaliera Policlinico Umberto I ( Site 0301)

Roma, Lazio, 00161

Monza, Monza E Brianza, Italy

Status

Address

Ospedale San Gerardo - ASST Monza ( Site 0304)

Monza, Monza E Brianza, 20900

Milano, Italy

Status

Address

Centro Cardiologico Monzino IRCCS ( Site 0306)

Milano, , 20138

Pavia, Italy

Status

Address

Fondazione IRCCS Policlinico San Matteo ( Site 0302)

Pavia, , 27100

Xalapa, Veracruz, Mexico

Status

Address

Consultorio 1020 Hospital Angeles Xalapa ( Site 0654)

Xalapa, Veracruz, 91193

Huixquilucan, Mexico

Status

Address

Operadora de Hospitales Angeles. S.A. de C.V. -Sucursal Lomas ( Site 0653)

Huixquilucan, , 52763

Mexico D.F, Mexico

Status

Address

Instituto Nacional de Cardiología -Ignacio Chavez ( Site 0651)

Mexico D.F, , 14080

Christchurch Hospital ( Site 0201), Christchurch, Canterbury, New Zealand

Status

Address

Christchurch Hospital ( Site 0201)

Christchurch, Canterbury, 8011

Greenlane Clinical Centre ( Site 0203), Auckland, New Zealand

Status

Address

Greenlane Clinical Centre ( Site 0203)

Auckland, , 1051

Walbrzych, Dolnoslaskie, Poland

Status

Address

Specjalistyczny Szpital im. Dr Alfreda Sokolowskiego w Walbrzychu ( Site 0351)

Walbrzych, Dolnoslaskie, 58-309

Lublin, Lubelskie, Poland

Status

Address

Samodzielny Publiczny Szpital Kliniczny nr 4 w Lublinie ( Site 0352)

Lublin, Lubelskie, 20-954

Krakow, Malopolskie, Poland

Status

Address

Krakowski Szpital Specjalistyczny im. Jana Pawa II-Oddzial Kliniczny Chorob Serca i Naczyn z Pododd

Krakow, Malopolskie, 31-202

Kemerovo, Kemerovskaya Oblast, Russian Federation

Status

Address

Scientific Research Institute Complex Problems Cardiovascular Disease ( Site 0403)

Kemerovo, Kemerovskaya Oblast, 650002

Saint Petersburg, Sankt-Peterburg, Russian Federation

Status

Address

Almazov National Medical Research Centre of the Ministry of Health ( Site 0402)

Saint Petersburg, Sankt-Peterburg, 197341

Akademiska sjukhuset ( Site 0453), Uppsala, Uppsala Lan, Sweden

Status

Address

Akademiska sjukhuset ( Site 0453)

Uppsala, Uppsala Lan, 751 85

Gothenburg, Vastra Gotalands Lan, Sweden

Status

Address

Sahlgrenska Universitetssjukhuset-Cardiology Research Unit ( Site 0452)

Gothenburg, Vastra Gotalands Lan, 413 45

Bornova, Izmir, Turkey

Status

Address

Ege Universitesi Hastanesi-Cardilogy Department ( Site 0504)

Bornova, Izmir, 35100

Ankara, Turkey

Status

Address

Hacettepe Universitesi Tip Fakultesi Hastanesi ( Site 0510)

Ankara, , 06100

Antalya, Turkey

Status

Address

Akdeniz Uni.Tip Fakultesi Saglik Uygulama ve Arastirma Merkezi ( Site 0508)

Antalya, , 07059

Eskisehir, Turkey

Status

Address

Eskisehir Osmangazi Uni. Tip Fakultesi Hastanesi ( Site 0506)

Eskisehir, , 26040

Istanbul, Turkey

Status

Address

Istanbul Uni. Kardiyoloji Enstitusu ( Site 0502)

Istanbul, , 34096

Istanbul, Turkey

Status

Address

Istanbul Universitesi Istanbul Tip Fakultesi ( Site 0509)

Istanbul, , 34390

Istanbul, Turkey

Status

Address

Marmara Universitesi Pendik Egitim ve Arastirma Hastanesi ( Site 0501)

Istanbul, , 34899

Izmir, Turkey

Status

Address

Dokuz Eylul University Faculty of Medicine ( Site 0505)

Izmir, , 35330

Glasgow, Glasgow City, United Kingdom

Status

Address

Golden Jubilee National Hospital ( Site 0556)

Glasgow, Glasgow City, G81 4DY

London, London, City Of, United Kingdom

Status

Address

Royal Brompton and Harefield NHS Trust ( Site 0553)

London, London, City Of, SW3 6NP

London, London, City Of, United Kingdom

Status

Address

Imperial College Healthcare NHS Trust - Hammersmith Hospital ( Site 0554)

London, London, City Of, W12 0HS

Newcastle-upon-Tyne, Newcastle Upon Tyne, United Kingdom

Status

Address

The Freeman Hosp.Newcastle upon Tyne Hosp NHS Trust ( Site 0552)

Newcastle-upon-Tyne, Newcastle Upon Tyne, NE7 7DN

For more information, please contact PHA at Research@PHAssociation.org and refer to the terms of service below.

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