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A Study to Assess ASP0598 Otic Solution Following Topical Application in the Ear in Subjects With Chronic Tympanic Membrane Perforation (CTMP)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04305184
Recruitment Status : Recruiting
First Posted : March 12, 2020
Last Update Posted : March 29, 2021
Sponsor:
Information provided by (Responsible Party):
Astellas Pharma Inc ( Astellas Pharma Global Development, Inc. )

Brief Summary:
The primary purpose of this study is to evaluate the safety and tolerability of ASP0598 Otic Solution. This study will also evaluate the efficacy of ASP0598 otic solution.

Condition or disease Intervention/treatment Phase
Chronic Tympanic Membrane Perforation Drug: ASP0598 Drug: Matching Placebo Phase 1 Phase 2

Detailed Description:
This study will consist of a dose escalation (single ascending dose - SAD and multiple ascending dose- MAD) and a dose expansion (single dose expansion and multiple dose expansion) phase. Dose escalation will consist of up to 4 cohorts for single ascending dose (SAD) and up to 2 cohorts for multiple ascending dose (MAD) with different dose levels. For SAD, after randomization on Day 1, participants will receive ASP0598 Otic Solution or placebo administration into the affected ear. Participants will return to the site on days 2, 3, 8, 15, 29, and 57 [end of study (EOS)]. For MAD, after randomization on Day 1, participants will receive ASP0598 Otic Solution or placebo administration into the affected ear and will receive additional treatments into the same ear on Days 15 and 29. Participants will return to the investigative site on Days 8, 15, 22, 29, 36, 57, and 85 (EOS). The dose expansion phase will be based on the safety and efficacy results from an interim analysis. The interim analysis will be conducted after completion of after completion of SAD and after completion of MAD. If dose expansion is opened, 2 or 3 treatment groups will be selected. If 3 groups are selected, participants will be randomized in a 1:1:1 ratio of high dose ASP0598 Otic Solution, low dose ASP0598 Otic Solution, and Placebo. If 2 groups are selected, participants will be randomized in a 1:1 ratio of high dose ASP0598 Otic Solution and Placebo. For single dose expansion, after randomization on Day 1, participants will receive ASP0598 otic solution or placebo administration into the affected ear. Participants will return to the investigative site on days 15, 29, 57, and 85 (EOS). For multiple dose expansion, after randomization on Day 1, participants will receive ASP0598 Otic Solution or placebo administration into the affected ear. Participants will receive additional treatment in the same ear on Days 15 and 29. In cases where complete closure is confirmed on Day 15 or Day 29, the participant will not receive the next scheduled dose(s). Participants will return to the investigative site on Days 15, 29, 43, 57, 85 and 113 (EOS).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 114 participants
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 1/2, Randomized, Placebo-controlled Study to Assess the Safety, Tolerability, Efficacy, and Pharmacokinetics of ASP0598 Otic Solution Following Topical Application Into the Ear in Subjects With Chronic Tympanic Membrane Perforation (CTMP)
Actual Study Start Date : September 10, 2020
Estimated Primary Completion Date : January 19, 2023
Estimated Study Completion Date : January 19, 2023

Arm Intervention/treatment
Experimental: ASP0598 SAD
A single topical application of ASP0598 onto the tympanic membrane through the external auditory canal via syringe at up to 4 dose levels.
Drug: ASP0598
Topical Solution

Experimental: ASP0598 MAD
Multiple topical applications of ASP0598 onto the tympanic membrane through the external auditory canal via syringe at up to 2 dose levels with additional treatment days.
Drug: ASP0598
Topical Solution

Experimental: ASP0598 Single Dose Expansion
A single topical application of ASP0598 onto the tympanic membrane through the external auditory canal via syringe at up to 2 dose levels.
Drug: ASP0598
Topical Solution

Experimental: ASP0598 Multiple Dose Expansion
Multiple topical application of ASP0598 onto the tympanic membrane through the external auditory canal via syringe at up to 2 dose levels with additional treatment days.
Drug: ASP0598
Topical Solution

Placebo Comparator: Pooled Placebo in SAD
For each dose level ASP0598 matching placebo onto the tympanic membrane through the external auditory canal via syringe.
Drug: Matching Placebo
Placebo Topical Solution

Placebo Comparator: Pooled Placebo in MAD
For each dose level ASP0598 matching placebo onto the tympanic membrane through the external auditory canal via syringe.
Drug: Matching Placebo
Placebo Topical Solution

Placebo Comparator: Placebo in Single Dose Expansion
ASP0598 matching placebo onto the tympanic membrane through the external auditory canal via syringe.
Drug: Matching Placebo
Placebo Topical Solution

Placebo Comparator: Placebo in Multiple Dose Expansion
ASP0598 matching placebo onto the tympanic membrane through the external auditory canal via syringe.
Drug: Matching Placebo
Placebo Topical Solution




Primary Outcome Measures :
  1. Number of participants with Treatment Emergent Adverse Events (TEAEs) in SAD [ Time Frame: Up to Day 57 ]
    An adverse event (AE) is any untoward medical occurrence in a subject administered an IP, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of investigational product (IP) whether or not considered related to the IP. A TEAE is defined as an AE observed after starting administration of the study drug through end of study visit. A drug-related TEAE is defined as any TEAE with a causal relationship assessed as "yes" by the investigator.

  2. Number of participants with TEAEs of special interest in SAD [ Time Frame: Up to Day 57 ]
    AEs of special interest include cholesteatoma or ear neoplasm, ototoxic symptoms (tinnitus, sensorineural hearing loss, dizziness) and otitis media or otitis externa.

  3. Change from baseline in bone conduction hearing at 1 kHz by pure tone audiometry (PTA) in SAD [ Time Frame: Baseline and Day 57 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems. Pure tone air conduction and bone conduction tests determine whether or not there is any hearing loss; what type of hearing loss it is (conductive, sensorineural or mixed hearing loss); the frequencies that are affected (configuration); magnitude of hearing loss (intensity) and whether hearing loss is unilateral or bilateral. The result is plotted on an audiogram, which is a graph displaying intensity as a function of frequency.

  4. Change from baseline in bone conduction hearing at 2 kHz by pure tone audiometry (PTA) in SAD [ Time Frame: Baseline and Day 57 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  5. Change from baseline in bone conduction hearing at 4 kHz by pure tone audiometry (PTA) in SAD [ Time Frame: Baseline and Day 57 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  6. Change from baseline in Tinnitus Visual Analog Scale (TVAS) in SAD [ Time Frame: Baseline and Day 57 ]
    TVAS is a scale for tinnitus loudness. Participants will be asked to rate their tinnitus on a scale of 0 to 10, where 0 means not at all strong or loud and 10 means extremely strong or loud tinnitus. A lower score means an improvement in tinnitus loudness.

  7. Number of participants with Treatment Emergent Adverse Events (TEAEs) in single dose expansion [ Time Frame: Up to Day 85 ]
    An AE is any untoward medical occurrence in a subject administered an IP, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of investigational product (IP) whether or not considered related to the IP. A TEAE is defined as an AE observed after starting administration of the study drug through end of study visit. A drug-related TEAE is defined as any TEAE with a causal relationship assessed as "yes" by the investigator.

  8. Number of incidences of AEs of special interest in single dose expansion [ Time Frame: Up to Day 85 ]
    AEs of special interest include cholesteatoma or ear neoplasm, ototoxic symptoms (tinnitus, sensorineural hearing loss, dizziness) and otitis media or otitis externa.

  9. Change from baseline in bone conduction hearing at 1 kHz by pure tone audiometry (PTA) in single dose expansion [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems. Pure tone air conduction and bone conduction tests determine whether or not there is any hearing loss; what type of hearing loss it is (conductive, sensorineural or mixed hearing loss); the frequencies that are affected (configuration); magnitude of hearing loss (intensity) and whether hearing loss is unilateral or bilateral. The result is plotted on an audiogram, which is a graph displaying intensity as a function of frequency.

  10. Change from baseline in bone conduction hearing at 2 kHz by pure tone audiometry (PTA) in single dose expansion [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  11. Change from baseline in bone conduction hearing at 4 kHz by pure tone audiometry (PTA) in single dose expansion [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  12. Change from baseline in Tinnitus Visual Analog Scale (TVAS) in single dose expansion [ Time Frame: Baseline and Day 85 ]
    TVAS is a scale for tinnitus loudness. Participants will be asked to rate their tinnitus on a scale of 0 to 10, where 0 means not at all strong or loud and 10 means extremely strong or loud tinnitus. A lower score means an improvement in tinnitus loudness.

  13. Number of participants with Treatment Emergent Adverse Events (TEAEs) in MAD [ Time Frame: Up to Day 85 ]
    AE is any untoward medical occurrence in a subject administered an IP, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of investigational product (IP) whether or not considered related to the IP. A TEAE is defined as an AE observed after starting administration of the study drug through end of study visit. A drug-related TEAE is defined as any TEAE with a causal relationship assessed as "yes" by the investigator.

  14. Number of participants with TEAEs of special interest in MAD [ Time Frame: Up to Day 85 ]
    AEs of special interest include cholesteatoma or ear neoplasm, ototoxic symptoms (tinnitus, sensorineural hearing loss, dizziness) and otitis media or otitis externa.

  15. Change from baseline in bone conduction hearing at 1 kHz by pure tone audiometry (PTA) in MAD [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems. Pure tone air conduction and bone conduction tests determine whether or not there is any hearing loss; what type of hearing loss it is (conductive, sensorineural or mixed hearing loss); the frequencies that are affected (configuration); magnitude of hearing loss (intensity) and whether hearing loss is unilateral or bilateral. The result is plotted on an audiogram, which is a graph displaying intensity as a function of frequency.

  16. Change from baseline in bone conduction hearing at 2 kHz by pure tone audiometry (PTA) in MAD [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  17. Change from baseline in bone conduction hearing at 4 kHz by pure tone audiometry (PTA) in MAD [ Time Frame: Baseline and Day 85 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  18. Change from baseline in Tinnitus Visual Analog Scale (TVAS) in MAD [ Time Frame: Baseline and Day 85 ]
    TVAS is a scale for tinnitus loudness. Participants will be asked to rate their tinnitus on a scale of 0 to 10, where 0 means not at all strong or loud and 10 means extremely strong or loud tinnitus. A lower score means an improvement in tinnitus loudness.

  19. Number of participants with Treatment Emergent Adverse Events (TEAEs) in multiple dose expansion [ Time Frame: Up to Day 113 ]
    An AE is any untoward medical occurrence in a subject administered an IP, and which does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of investigational product (IP) whether or not considered related to the IP. A TEAE is defined as an AE observed after starting administration of the study drug through end of study visit. A drug-related TEAE is defined as any TEAE with a causal relationship assessed as "yes" by the investigator.

  20. Number of incidences of AEs of special interest in multiple dose expansion [ Time Frame: Up to Day 113 ]
    AEs of special interest include cholesteatoma or ear neoplasm, ototoxic symptoms (tinnitus, sensorineural hearing loss, dizziness) and otitis media or otitis externa.

  21. Change from baseline in bone conduction hearing at 1 kHz by pure tone audiometry (PTA) in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems. Pure tone air conduction and bone conduction tests determine whether or not there is any hearing loss; what type of hearing loss it is (conductive, sensorineural or mixed hearing loss); the frequencies that are affected (configuration); magnitude of hearing loss (intensity) and whether hearing loss is unilateral or bilateral. The result is plotted on an audiogram, which is a graph displaying intensity as a function of frequency.

  22. Change from baseline in bone conduction hearing at 2 kHz by pure tone audiometry (PTA) in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  23. Change from baseline in bone conduction hearing at 4 kHz by pure tone audiometry (PTA) in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    PTA is a behavioral test and generally the 1st quantitative hearing test done to assess the nature and degree of hearing loss in adults and in children. This measure involves the peripheral and central auditory systems.

  24. Change from baseline in Tinnitus Visual Analog Scale (TVAS) in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    TVAS is a scale for tinnitus loudness. Participants will be asked to rate their tinnitus on a scale of 0 to 10, where 0 means not at all strong or loud and 10 means extremely strong or loud tinnitus. A lower score means an improvement in tinnitus loudness.


Secondary Outcome Measures :
  1. Proportion of participants with complete closure of Tympanic Membrane Perforation (TMP) in SAD [ Time Frame: Up to Day 57 ]
    Tympanic membrane perforation is a perforation of tympanic membrane in the ear. TMP closure is defined as microscopic TMP closure without presence of pin hole. All images from each visit will be sent to a central imaging vendor for measurement and interpretation.

  2. Change from baseline in the ratio of TMP size per total area of tympanic membrane in SAD [ Time Frame: Baseline and Day 57 ]
    Ratio of TMP size per total area of tympanic membrane will be calculated.

  3. Change from baseline in TMP size in SAD [ Time Frame: Baseline and Day 57 ]
    TMP size calculation will be performed by central imaging vendor.

  4. Proportion of participants with complete closure of TMP in single dose expansion [ Time Frame: Up to Day 85 ]
    Tympanic membrane perforation is a perforation of tympanic membrane in the ear. TMP closure is defined as microscopic TMP closure without presence of pin hole. All images from each visit will be sent to a central imaging vendor for measurement and interpretation.

  5. Change from baseline in the ratio of TMP size per total area of tympanic membrane in single dose expansion [ Time Frame: Baseline and Day 85 ]
    Ratio of TMP size per total area of tympanic membrane will be calculated.

  6. Change from baseline in TMP size in single dose expansion [ Time Frame: Baseline and Day 85 ]
    TMP size calculation will be performed by central imaging vendor.

  7. Proportion of participants with complete closure of TMP in MAD [ Time Frame: Up to Day 85 ]
    Tympanic membrane perforation is a perforation of tympanic membrane in the ear. TMP closure is defined as microscopic TMP closure without presence of pin hole. All images from each visit will be sent to a central imaging vendor for measurement and interpretation.

  8. Change from baseline in TMP size in MAD [ Time Frame: Baseline and Day 85 ]
    TMP size calculation will be performed by central imaging vendor.

  9. Change from baseline in the ratio of TMP size per total area of tympanic membrane in MAD [ Time Frame: Baseline and Day 85 ]
    Ratio of TMP size per total area of tympanic membrane will be calculated.

  10. Proportion of participants with complete closure of TMP in multiple dose expansion [ Time Frame: Up to Day 113 ]
    Tympanic membrane perforation is a perforation of tympanic membrane in the ear. TMP closure is defined as microscopic TMP closure without presence of pin hole. All images from each visit will be sent to a central imaging vendor for measurement and interpretation.

  11. Change from baseline in the ratio of TMP size per total area of tympanic membrane in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    Ratio of TMP size per total area of tympanic membrane will be calculated.

  12. Change from baseline in TMP size in multiple dose expansion [ Time Frame: Baseline and Day 113 ]
    TMP size calculation will be performed by central imaging vendor.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subject has chronic tympanic membrane perforation (CTMP) documented as persisting longer than 3 months.
  • A female subject is eligible to participate if she is not pregnant and at least one of the following conditions applies:

    • Not a woman of childbearing potential (WOCBP) OR
    • WOCBP who agrees to follow the contraceptive guidance starting at screening and for at least 28 days after investigational product (IP) application on Day 1.
  • Female subject must agree not to breastfeed starting at drug application on Day 1 and for at least 28 days after IP application.
  • Female subject must not donate ova starting on Day 1 and for at least 28 days after investigational product (IP) application.
  • A male subject with female partner(s) of child-bearing potential must agree to use contraception starting on Day 1 and for at least 28 days after IP application.
  • A male subject must not donate sperm starting on Day 1 and for at least 28 days after IP application.
  • Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom from Day 1 and for at least 28 days after IP application.
  • Subject must be willing and able to comply with the study requirements including prohibited concomitant medication restrictions.
  • Subject agrees not to participate in another interventional study while receiving IP.

Exclusion Criteria:

  • Subject has one of following conditions that may affect the ipsilateral side of the ear with chronic tympanic membrane perforation (CTMP):

    • Perforation involving 3 or more quadrants.
    • Pin hole perforation (only for the expansion cohort).
    • Presence of tympanosclerosis adjacent to the perforation.
    • Perforation involves malleus erosion.
    • Absent malleus.
    • Marginal perforation (i.e., involving the annulus or exposing the handle of malleus).
    • Tympanic membrane perforation (TMP) caused by electric/slag/blast/burn injury.
    • Post radiated TMP.
    • History of tympanic membrane repair by any type of live tissue.
    • History of otorrhea or active treatment for otorrhea within the last 3 months prior to Screening.
    • Bellucci otorrhea grade 3 or above.
    • Active external ear canal inflammation (otitis externa, dermatitis) or within the last 3 months prior to Screening.
    • Active diagnosis of Eustachian Tube dysfunction or diagnosis within 6 months prior to Screening.
    • Craniofacial abnormalities, History of head and neck surgery within the last 3 months prior to Screening, history of radiation to head and neck.
    • Recent (within 2 weeks) diagnosis of upper respiratory tract infection.
    • Presence or history of cholesteatoma.
    • Presence of pars-flaccida or pars tensa retraction or adhesion.
    • Presence or history of tumors of the middle or external ear.
    • Contraindications to tympanic membrane closure.
    • An audiometric finding indicates a characteristic of Carhart's notch which is an increase in bone conduction threshold with a peak at 2,000 Hz.
    • Only hearing or better hearing ear.
    • Whole circumference of the tympanic membrane perforation is not visible by endoscope.
    • Presence/history of eosinophilic otitis media in either ear.
  • Subject has a presence of adhesive otitis media in the contralateral ear.
  • Subject has a presence of any wound healing systemic condition.
  • Subject has Obstructive Sleep Apnea where the subject is required to use Continuous Positive Airway Pressure (CPAP) during the study period.
  • Subject is exposed in their daily life to high volume of water into the ear canal (e.g., swimmer or surfer).
  • Subject has health conditions that would prevent him/her from fulfilling the study requirements on the basis of medical history and laboratory test (Serum Chemistries, complete blood count [CBC] with Differential, Urinalysis) results at the screening visit.
  • Subject is receiving any other investigational agents during study participation.
  • Subject has any form of substance abuse, or psychiatric illness/social situations that would limit compliance with study requirements, or a condition that could invalidate communication.
  • Subject has a known or suspected hypersensitivity to ASP0598, or any components of the formulation used.
  • Subject has had previous exposure with ASP0598.
  • Subject is unlikely to comply with the visits scheduled in the protocol.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04305184


Contacts
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Contact: Astellas Pharma Global Development, Inc. 800-888-7704; Astellas.registration@astellas.com

Locations
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United States, California
Breathe Clear Institute Recruiting
Torrance, California, United States, 90503
United States, Colorado
Colorado ENT & Allergy Recruiting
Colorado Springs, Colorado, United States, 80909
United States, Florida
ENT and Allergy Associates of Florida Recruiting
Boca Raton, Florida, United States, 33487
Ear Research Foundation Recruiting
Sarasota, Florida, United States, 34329
United States, Illinois
University of Chicago Recruiting
Chicago, Illinois, United States, 60637
United States, Indiana
Advanced ENT Recruiting
New Albany, Indiana, United States, 47150
United States, Kentucky
Advanced ENT Recruiting
Louisville, Kentucky, United States, 40220
United States, Nebraska
Omaha ENT Recruiting
Omaha, Nebraska, United States, 68118
United States, New York
Columbia University Medical Center Recruiting
New York, New York, United States, 10032
United States, North Carolina
Charlotte ENT Associates Recruiting
Matthews, North Carolina, United States, 28105
Piedmont ENT Recruiting
Winston-Salem, North Carolina, United States, 27103
United States, Texas
University of Texas Recruiting
Dallas, Texas, United States, 75235
Sponsors and Collaborators
Astellas Pharma Global Development, Inc.
Investigators
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Study Director: Medical Director Astellas Pharma Global Development, Inc.
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Responsible Party: Astellas Pharma Global Development, Inc.
ClinicalTrials.gov Identifier: NCT04305184    
Other Study ID Numbers: 0598-CL-0101
First Posted: March 12, 2020    Key Record Dates
Last Update Posted: March 29, 2021
Last Verified: March 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Access to anonymized individual participant level data collected during the study, in addition to study-related supporting documentation, is planned for studies conducted with approved product indications and formulations, as well as compounds terminated during development. Studies conducted with product indications or formulations that remain active in development are assessed after study completion to determine if Individual Participant Data can be shared. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Astellas Pharma Inc ( Astellas Pharma Global Development, Inc. ):
ASP0598
Additional relevant MeSH terms:
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Tympanic Membrane Perforation
Ear Diseases
Otorhinolaryngologic Diseases
Wounds and Injuries