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A Safety and Efficacy Study of Brimonidine Intravitreal Implant in Geographic Atrophy Secondary to Age-related Macular Degeneration (BEACON)

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ClinicalTrials.gov Identifier: NCT02087085
Recruitment Status : Terminated
First Posted : March 14, 2014
Results First Posted : April 23, 2019
Last Update Posted : April 23, 2019
Sponsor:
Information provided by (Responsible Party):
Allergan

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Triple (Participant, Investigator, Outcomes Assessor);   Primary Purpose: Treatment
Conditions Geographic Atrophy
Macular Degeneration
Interventions Drug: 400 µg Brimonidine Implant
Other: Sham
Enrollment 310
Recruitment Details  
Pre-assignment Details  
Arm/Group Title 400 µg Brimonidine Implant Sham
Hide Arm/Group Description 400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21. Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless drug delivery system (DDS) applicator every 3 months from Baseline (Day 1) through Month 21.
Period Title: Overall Study
Started 154 156
Completed 34 40
Not Completed 120 116
Reason Not Completed
Adverse Event             10             14
Lack of Efficacy             4             3
Lost to Follow-up             6             4
Withdrawal by Subject             9             11
Protocol Violation             1             0
Study Terminated by Sponsor             87             80
Other Miscellaneous Reasons             3             4
Arm/Group Title 400 µg Brimonidine Implant Sham Total
Hide Arm/Group Description 400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21. Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless DDS applicator every 3 months from Baseline (Day 1) through Month 21. Total of all reporting groups
Overall Number of Baseline Participants 154 156 310
Hide Baseline Analysis Population Description
All randomized participants.
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 154 participants 156 participants 310 participants
76.9  (7.89) 77.0  (7.24) 76.9  (7.56)
Sex: Female, Male  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 154 participants 156 participants 310 participants
Female
101
  65.6%
91
  58.3%
192
  61.9%
Male
53
  34.4%
65
  41.7%
118
  38.1%
Race/Ethnicity, Customized  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 154 participants 156 participants 310 participants
White
153
  99.4%
156
 100.0%
309
  99.7%
Black or African American
1
   0.6%
0
   0.0%
1
   0.3%
Geographic Atrophy (GA) Lesion Area by Fundus Autofluorescence (FAF)   [1] [2] 
Mean (Standard Deviation)
Unit of measure:  Millimeters squared (mm^2)
Number Analyzed 149 participants 154 participants 303 participants
5.1611  (3.7016) 5.4761  (3.5961) 5.3212  (3.6457)
[1]
Measure Description: GA lesion area was measured in mm^2 by FAF and analysis of FAF images was performed by the central reading center.
[2]
Measure Analysis Population Description: Modified intent-to-treat (mITT) population included all randomized and treated participants with baseline and at least 1 postbaseline assessment for GA lesion area by FAF.
1.Primary Outcome
Title Change From Baseline in Geographic Atrophy (GA) Lesion Area of the Study Eye as Assessed by Fundus Autofluorescence (FAF) at Month 24
Hide Description GA lesion area was measured in mm^2 by FAF in the study eye and was quantified by the central reading center. The study eye was defined as the eye that met inclusion/exclusion criteria with the worst standard Best Correct Visual Acuity (BCVA). If the BCVA in both eyes was similar the right eye was selected as the study eye. A positive change from baseline indicates an increase in size of GA lesion area (worsening; disease progression). Mixed model for repeated measures (MMRM) was used for analysis.
Time Frame Baseline (Day 1) to Month 24
Hide Outcome Measure Data
Hide Analysis Population Description
Participants from the mITT population, all randomized and treated participants with baseline and at least 1 postbaseline assessment for GA lesion area by FAF, with data available for analysis at Month 24.
Arm/Group Title 400 µg Brimonidine Implant Sham
Hide Arm/Group Description:
400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21.
Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless DDS applicator every 3 months from Baseline (Day 1) through Month 21.
Overall Number of Participants Analyzed 86 90
Least Squares Mean (Standard Error)
Unit of Measure: mm^2
3.1455  (0.1377) 3.5044  (0.1359)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 400 µg Brimonidine Implant, Sham
Comments [Not Specified]
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.047
Comments MMRM model included treatment group, study region, analysis visit and treatment-by-visit interaction as factors and baseline value and baseline value-by-analysis visit interaction as covariates.
Method MMRM
Comments [Not Specified]
Method of Estimation Estimation Parameter Least Squares Mean Difference
Estimated Value -0.3589
Confidence Interval (2-Sided) 95%
-0.7132 to -0.0047
Parameter Dispersion
Type: Standard Error of the Mean
Value: 0.1804
Estimation Comments [Not Specified]
2.Secondary Outcome
Title Change From Baseline in Standard Best Corrected Visual Acuity (BCVA) Score as Assessed by Early Treatment Diabetic Retinopathy Study (ETDRS) Chart at Month 24
Hide Description BCVA was measured using an eye chart (ETDRS) and was reported as the number of letters read correctly (ranging from 0 to 100 letters) in the study eye. The lower the number of letters read correctly on the eye chart, the worse the vision (or visual acuity). The study eye was defined as the eye that met inclusion/exclusion criteria with the worst standard BCVA. If the BCVA in both eyes was similar the right eye was selected as the study eye. A positive change from baseline indicates an improvement and a negative change from baseline indicates a worsening. MMRM was used for analysis.
Time Frame Baseline (Day 1) to Month 24
Hide Outcome Measure Data
Hide Analysis Population Description
Participants from the mITT population, all randomized and treated participants with baseline and at least 1 postbaseline assessment for GA lesion area by FAF, with data available for analysis for this outcome measure at Month 24.
Arm/Group Title 400 µg Brimonidine Implant Sham
Hide Arm/Group Description:
400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21.
Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless DDS applicator every 3 months from Baseline (Day 1) through Month 21.
Overall Number of Participants Analyzed 81 82
Least Squares Mean (Standard Error)
Unit of Measure: letters read correctly
-10.9  (1.0) -9.7  (1.0)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 400 µg Brimonidine Implant, Sham
Comments [Not Specified]
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.390
Comments MMRM model included treatment group, study region, analysis visit and treatment-by-visit interaction as factors and baseline value and baseline value-by-analysis visit interaction as covariates.
Method MMRM
Comments [Not Specified]
Method of Estimation Estimation Parameter Least Squares Mean Difference
Estimated Value -1.2
Confidence Interval (2-Sided) 95%
-3.9 to 1.5
Parameter Dispersion
Type: Standard Error of the Mean
Value: 1.4
Estimation Comments [Not Specified]
3.Secondary Outcome
Title Change From Baseline in Low Luminance BCVA Score as Assessed by ETDRS Chart at Month 24
Hide Description Low Luminance BCVA was measured by placing a 2.0 log unit neutral density filter over the best correction for that eye and having the participant read the normally illuminated ETDRS chart and was reported as the number of letters read correctly (ranging from 0 to 100 letters) in the study eye. The lower the number of letters read correctly on the eye chart, the worse the vision (or visual acuity). The study eye was defined as the eye that met inclusion/exclusion criteria with the worst standard BCVA. If the BCVA in both eyes was similar the right eye was selected as the study eye. A positive change from baseline indicates an improvement and a negative change from baseline indicates a worsening. MMRM was used for analysis.
Time Frame Baseline (Day 1) to Month 24
Hide Outcome Measure Data
Hide Analysis Population Description
Participants from the mITT population, all randomized and treated participants with baseline and at least 1 postbaseline assessment for GA lesion area by FAF, with data available for analysis for this outcome measure at Month 24.
Arm/Group Title 400 µg Brimonidine Implant Sham
Hide Arm/Group Description:
400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21.
Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless DDS applicator every 3 months from Baseline (Day 1) through Month 21.
Overall Number of Participants Analyzed 81 82
Least Squares Mean (Standard Error)
Unit of Measure: letters read correctly
-8.1  (1.0) -6.7  (1.0)
Show Statistical Analysis 1 Hide Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection 400 µg Brimonidine Implant, Sham
Comments [Not Specified]
Type of Statistical Test Superiority
Comments [Not Specified]
Statistical Test of Hypothesis P-Value 0.301
Comments MMRM model included treatment group, study region, analysis visit and treatment-by-visit interaction as factors and baseline value and baseline value-by-analysis visit interaction as covariates.
Method MMRM
Comments [Not Specified]
Method of Estimation Estimation Parameter Least Squares Mean Difference
Estimated Value -1.4
Confidence Interval (2-Sided) 95%
-4.2 to 1.3
Parameter Dispersion
Type: Standard Error of the Mean
Value: 1.4
Estimation Comments [Not Specified]
4.Other Pre-specified Outcome
Title Change From Baseline in Retinal Sensitivity in the Study Eye
Hide Description [Not Specified]
Time Frame Baseline (Day 1) to Month 24
Outcome Measure Data Not Reported
Time Frame From first dose of study drug to date of last visit (up to approximately 33 months)
Adverse Event Reporting Description Safety population included all participants who received at least 1 administration of study treatment.
 
Arm/Group Title 400 µg Brimonidine Implant Sham
Hide Arm/Group Description 400 µg brimonidine implant in the study eye, administered by intravitreal injections using the Brimonidine Drug Delivery System (Brimo DDS®) applicator every 3 months from Baseline (Day 1) through Month 21. Sham treatment (control) in the study eye, administered by intravitreal injections using a needleless DDS applicator every 3 months from Baseline (Day 1) through Month 21.
All-Cause Mortality
400 µg Brimonidine Implant Sham
Affected / at Risk (%) Affected / at Risk (%)
Total   5/154 (3.25%)   6/156 (3.85%) 
Show Serious Adverse Events Hide Serious Adverse Events
400 µg Brimonidine Implant Sham
Affected / at Risk (%) Affected / at Risk (%)
Total   48/154 (31.17%)   37/156 (23.72%) 
Blood and lymphatic system disorders     
Iron deficiency anaemia  1  1/154 (0.65%)  0/156 (0.00%) 
Cardiac disorders     
Acute myocardial infarction  1  3/154 (1.95%)  0/156 (0.00%) 
Atrial fibrillation  1  3/154 (1.95%)  1/156 (0.64%) 
Bradycardia  1  3/154 (1.95%)  0/156 (0.00%) 
Cardiac failure congestive  1  3/154 (1.95%)  1/156 (0.64%) 
Coronary artery disease  1  2/154 (1.30%)  1/156 (0.64%) 
Sinus node dysfunction  1  2/154 (1.30%)  0/156 (0.00%) 
Atrioventricular block complete  1  1/154 (0.65%)  0/156 (0.00%) 
Coronary artery stenosis  1  1/154 (0.65%)  0/156 (0.00%) 
Myocardial infarction  1  1/154 (0.65%)  0/156 (0.00%) 
Pericardial effusion  1  1/154 (0.65%)  0/156 (0.00%) 
Angina pectoris  1  0/154 (0.00%)  1/156 (0.64%) 
Cardiopulmonary failure  1  0/154 (0.00%)  1/156 (0.64%) 
Endocrine disorders     
Hypothyroidism  1  1/154 (0.65%)  0/156 (0.00%) 
Eye disorders     
Visual acuity reduced  1  2/154 (1.30%)  0/156 (0.00%) 
Vitreous haemorrhage  1  2/154 (1.30%)  0/156 (0.00%) 
Retinal tear  1  1/154 (0.65%)  0/156 (0.00%) 
Retinal vein occlusion  1  1/154 (0.65%)  0/156 (0.00%) 
Anterior capsule contraction  1  0/154 (0.00%)  1/156 (0.64%) 
Cataract  1  0/154 (0.00%)  1/156 (0.64%) 
Gastrointestinal disorders     
Diarrhoea  1  1/154 (0.65%)  0/156 (0.00%) 
Pancreatitis  1  1/154 (0.65%)  0/156 (0.00%) 
Abdominal hernia  1  0/154 (0.00%)  1/156 (0.64%) 
Gastrointestinal haemorrhage  1  0/154 (0.00%)  1/156 (0.64%) 
Hiatus hernia  1  0/154 (0.00%)  1/156 (0.64%) 
Inguinal hernia  1  0/154 (0.00%)  1/156 (0.64%) 
Intestinal obstruction  1  0/154 (0.00%)  1/156 (0.64%) 
Spigelian hernia  1  0/154 (0.00%)  1/156 (0.64%) 
Vomiting  1  0/154 (0.00%)  1/156 (0.64%) 
General disorders     
Systemic inflammatory response syndrome  1  1/154 (0.65%)  0/156 (0.00%) 
Hernia  1  0/154 (0.00%)  1/156 (0.64%) 
Hepatobiliary disorders     
Cholecystitis  1  1/154 (0.65%)  1/156 (0.64%) 
Cholecystitis chronic  1  1/154 (0.65%)  0/156 (0.00%) 
Cholangitis  1  0/154 (0.00%)  1/156 (0.64%) 
Infections and infestations     
Pneumonia  1  3/154 (1.95%)  3/156 (1.92%) 
Arthritis bacterial  1  1/154 (0.65%)  0/156 (0.00%) 
Bacterial pyelonephritis  1  1/154 (0.65%)  0/156 (0.00%) 
Bronchitis  1  1/154 (0.65%)  1/156 (0.64%) 
Cellulitis  1  1/154 (0.65%)  0/156 (0.00%) 
Septic shock  1  1/154 (0.65%)  0/156 (0.00%) 
Urinary tract infection  1  1/154 (0.65%)  1/156 (0.64%) 
Diverticulitis  1  0/154 (0.00%)  1/156 (0.64%) 
Erysipelas  1  0/154 (0.00%)  1/156 (0.64%) 
Gastroenteritis  1  0/154 (0.00%)  1/156 (0.64%) 
Pneumonia viral  1  0/154 (0.00%)  1/156 (0.64%) 
Sepsis  1  0/154 (0.00%)  1/156 (0.64%) 
Staphylococcal bacteraemia  1  0/154 (0.00%)  1/156 (0.64%) 
Upper respiratory tract infection  1  0/154 (0.00%)  1/156 (0.64%) 
Injury, poisoning and procedural complications     
Fall  1  2/154 (1.30%)  2/156 (1.28%) 
Fractured sacrum  1  1/154 (0.65%)  0/156 (0.00%) 
Hip fracture  1  1/154 (0.65%)  0/156 (0.00%) 
Pelvic fracture  1  1/154 (0.65%)  1/156 (0.64%) 
Procedural intestinal perforation  1  1/154 (0.65%)  0/156 (0.00%) 
Upper limb fracture  1  1/154 (0.65%)  0/156 (0.00%) 
Ankle fracture  1  0/154 (0.00%)  1/156 (0.64%) 
Flail chest  1  0/154 (0.00%)  1/156 (0.64%) 
Laceration  1  0/154 (0.00%)  1/156 (0.64%) 
Rib fracture  1  0/154 (0.00%)  1/156 (0.64%) 
Spinal compression fracture  1  0/154 (0.00%)  2/156 (1.28%) 
Tendon rupture  1  0/154 (0.00%)  1/156 (0.64%) 
Thoracic vertebral fracture  1  0/154 (0.00%)  2/156 (1.28%) 
Traumatic haemothorax  1  0/154 (0.00%)  1/156 (0.64%) 
Investigations     
C-reactive protein increased  1  1/154 (0.65%)  0/156 (0.00%) 
Haemoglobin decreased  1  0/154 (0.00%)  1/156 (0.64%) 
Metabolism and nutrition disorders     
Dehydration  1  1/154 (0.65%)  1/156 (0.64%) 
Lactic acidosis  1  1/154 (0.65%)  0/156 (0.00%) 
Hypokalaemia  1  0/154 (0.00%)  1/156 (0.64%) 
Musculoskeletal and connective tissue disorders     
Bursitis  1  2/154 (1.30%)  0/156 (0.00%) 
Acquired claw toe  1  1/154 (0.65%)  0/156 (0.00%) 
Arthritis  1  1/154 (0.65%)  0/156 (0.00%) 
Foot deformity  1  1/154 (0.65%)  0/156 (0.00%) 
Joint range of motion decreased  1  1/154 (0.65%)  0/156 (0.00%) 
Osteoarthritis  1  1/154 (0.65%)  2/156 (1.28%) 
Arthralgia  1  0/154 (0.00%)  1/156 (0.64%) 
Back pain  1  0/154 (0.00%)  1/156 (0.64%) 
Osteoporosis  1  0/154 (0.00%)  1/156 (0.64%) 
Spondylolisthesis  1  0/154 (0.00%)  1/156 (0.64%) 
Neoplasms benign, malignant and unspecified (incl cysts and polyps)     
Basal cell carcinoma  1  2/154 (1.30%)  2/156 (1.28%) 
Squamous cell carcinoma  1  2/154 (1.30%)  0/156 (0.00%) 
Squamous cell carcinoma of skin  1  2/154 (1.30%)  1/156 (0.64%) 
Adenocarcinoma gastric  1  1/154 (0.65%)  0/156 (0.00%) 
Desmoplastic melanoma  1  1/154 (0.65%)  0/156 (0.00%) 
Gastrointestinal melanoma  1  1/154 (0.65%)  0/156 (0.00%) 
Lip neoplasm malignant stage unspecified  1  1/154 (0.65%)  0/156 (0.00%) 
Metastases to peritoneum  1  1/154 (0.65%)  0/156 (0.00%) 
Renal cell carcinoma  1  1/154 (0.65%)  0/156 (0.00%) 
Small intestine adenocarcinoma  1  1/154 (0.65%)  0/156 (0.00%) 
Adrenal gland cancer  1  0/154 (0.00%)  1/156 (0.64%) 
B-cell lymphoma  1  0/154 (0.00%)  1/156 (0.64%) 
Breast cancer  1  0/154 (0.00%)  1/156 (0.64%) 
Malignant neoplasm of unknown primary site  1  0/154 (0.00%)  1/156 (0.64%) 
Nervous system disorders     
Brain stem ischaemia  1  1/154 (0.65%)  0/156 (0.00%) 
Presyncope  1  1/154 (0.65%)  0/156 (0.00%) 
Cerebral infarction  1  0/154 (0.00%)  1/156 (0.64%) 
Cerebrovascular accident  1  0/154 (0.00%)  1/156 (0.64%) 
Dementia alzheimer's type  1  0/154 (0.00%)  1/156 (0.64%) 
Encephalopathy  1  0/154 (0.00%)  1/156 (0.64%) 
Product Issues     
Device dislocation  1  0/154 (0.00%)  1/156 (0.64%) 
Psychiatric disorders     
Alcohol withdrawal syndrome  1  1/154 (0.65%)  0/156 (0.00%) 
Delirium  1  0/154 (0.00%)  1/156 (0.64%) 
Renal and urinary disorders     
Renal impairment  1  1/154 (0.65%)  0/156 (0.00%) 
Bladder outlet obstruction  1  0/154 (0.00%)  1/156 (0.64%) 
Renal failure  1  0/154 (0.00%)  1/156 (0.64%) 
Reproductive system and breast disorders     
Benign prostatic hyperplasia  1  0/154 (0.00%)  2/156 (1.28%) 
Uterine prolapse  1  0/154 (0.00%)  1/156 (0.64%) 
Vaginal prolapse  1  0/154 (0.00%)  1/156 (0.64%) 
Respiratory, thoracic and mediastinal disorders     
Chronic obstructive pulmonary disease  1  1/154 (0.65%)  2/156 (1.28%) 
Acute respiratory failure  1  0/154 (0.00%)  1/156 (0.64%) 
Asthma  1  0/154 (0.00%)  1/156 (0.64%) 
Pulmonary oedema  1  0/154 (0.00%)  1/156 (0.64%) 
Respiratory failure  1  0/154 (0.00%)  2/156 (1.28%) 
Skin and subcutaneous tissue disorders     
Intertrigo  1  0/154 (0.00%)  1/156 (0.64%) 
Skin ulcer  1  0/154 (0.00%)  1/156 (0.64%) 
Vascular disorders     
Hypertensive crisis  1  1/154 (0.65%)  1/156 (0.64%) 
Hypotension  1  1/154 (0.65%)  0/156 (0.00%) 
Peripheral artery aneurysm  1  1/154 (0.65%)  0/156 (0.00%) 
Thrombophlebitis superficial  1  1/154 (0.65%)  0/156 (0.00%) 
Varicose vein  1  1/154 (0.65%)  1/156 (0.64%) 
1
Term from vocabulary, MedDRA Version 20.1
Indicates events were collected by systematic assessment
Show Other (Not Including Serious) Adverse Events Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
400 µg Brimonidine Implant Sham
Affected / at Risk (%) Affected / at Risk (%)
Total   79/154 (51.30%)   61/156 (39.10%) 
Eye disorders     
Vitreous floaters  1  29/154 (18.83%)  1/156 (0.64%) 
Conjunctival haemorrhage  1  21/154 (13.64%)  11/156 (7.05%) 
Visual impairment  1  12/154 (7.79%)  6/156 (3.85%) 
Eye pain  1  11/154 (7.14%)  9/156 (5.77%) 
Visual acuity reduced  1  9/154 (5.84%)  6/156 (3.85%) 
Dry eye  1  8/154 (5.19%)  6/156 (3.85%) 
Ocular discomfort  1  8/154 (5.19%)  1/156 (0.64%) 
Infections and infestations     
Nasopharyngitis  1  12/154 (7.79%)  12/156 (7.69%) 
Urinary tract infection  1  3/154 (1.95%)  15/156 (9.62%) 
Injury, poisoning and procedural complications     
Fall  1  5/154 (3.25%)  10/156 (6.41%) 
Nervous system disorders     
Headache  1  8/154 (5.19%)  4/156 (2.56%) 
Vascular disorders     
Hypertension  1  8/154 (5.19%)  11/156 (7.05%) 
1
Term from vocabulary, MedDRA Version 20.1
Indicates events were collected by systematic assessment
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS 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.
A disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is less than or equal to 90 days from the time submitted to the sponsor for review. The sponsor cannot require changes to the communication and cannot extend the embargo.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: Therapeutic Area, Head
Organization: Allergan
Phone: 714-246-4500
EMail: clinicaltrials@allergan.com
Layout table for additonal information
Responsible Party: Allergan
ClinicalTrials.gov Identifier: NCT02087085     History of Changes
Other Study ID Numbers: 190342-038
2013-003320-36 ( EudraCT Number )
First Submitted: March 12, 2014
First Posted: March 14, 2014
Results First Submitted: March 29, 2019
Results First Posted: April 23, 2019
Last Update Posted: April 23, 2019