<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04497597</url>
  </required_header>
  <id_info>
    <org_study_id>P20-095</org_study_id>
    <nct_id>NCT04497597</nct_id>
  </id_info>
  <brief_title>A Study of Oral Upadacitinib Tablets to Assess Treatment Patterns, Achievement of Treatment Targets and Maintenance of Response in Adult Participants With Moderate to Severe Rheumatoid Arthritis</brief_title>
  <acronym>UPHOLD</acronym>
  <official_title>Upadacitinib Treatment Patterns, Achievement of Treatment Targets and Maintenance of Response in Moderate to Severe Rheumatoid Arthritis Patients in Real-World Practice (UPHOLD)</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>AbbVie</agency>
      <agency_class>Industry</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>AbbVie</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>No</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      Rheumatoid Arthritis (RA) is an inflammatory disease of the joints causing pain, stiffness,&#xD;
      swelling and loss of joint function. Despite the range of treatment options for RA steadily&#xD;
      increasing, many patients remain sub-optimally managed, with sustained clinical remission&#xD;
      rarely achieved. This study will assess the treatment patterns, achievement of treatment&#xD;
      targets and maintenance of response.&#xD;
&#xD;
      Upadacitinib is a drug approved for the treatment of moderately to severely active rheumatoid&#xD;
      arthritis. Adult participants with moderate to severe RA who have been prescribed&#xD;
      upadacitinib by their physicians will be enrolled. Approximately, 1660 participants will be&#xD;
      enrolled this study, worldwide.&#xD;
&#xD;
      Participants will not receive Upadacitinib as part of this study, but will be followed for&#xD;
      response to treatment for up to 24 months.&#xD;
&#xD;
      There may be higher burden for participants in this trial compared to their standard of care.&#xD;
      Participants will attend regular visits, every 3 months, during the course of the study at a&#xD;
      hospital or clinic and will be asked to provide additional information by questionnaire at&#xD;
      each visit.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Active, not recruiting</overall_status>
  <start_date type="Actual">October 16, 2020</start_date>
  <completion_date type="Anticipated">May 15, 2024</completion_date>
  <primary_completion_date type="Anticipated">May 15, 2024</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>Percentage of Participants Who Achieve Remission</measure>
    <time_frame>At Month 6</time_frame>
    <description>Remission is defined as Disease Activity Score at 28 joints (DAS28) C-reactive Protein (CRP)&lt;2.6.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission</measure>
    <time_frame>At Month 12</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission</measure>
    <time_frame>At Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieve Low Disease Activity (LDA) at 6 months that maintain LDA</measure>
    <time_frame>Through Month 24</time_frame>
    <description>LDA is defined as DAS28-CRP≤3.2. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieve Remission at 3 Months and Maintain Remission</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission Grouped by Glucocorticoid Dose</measure>
    <time_frame>At Month 12</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieve LDA at 3 months that maintain LDA Grouped by Glucocorticoid Dose</measure>
    <time_frame>Through Month 6</time_frame>
    <description>LDA is defined as DAS28-CRP≤3.2. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants in LDA that Achieve Glucocorticoid Dose &lt;5 mg/Day Per Visit</measure>
    <time_frame>Through Month 24</time_frame>
    <description>LDA is defined as DAS28-CRP&lt;3.2.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants in Remission that Achieve Glucocorticoid Dose &lt;5 mg/Day Per Visit</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Achieved a Glucocorticoid Dose &lt;5 mg/Day Without Conventional Synthetic Disease Modifying Anti Rheumatic Drug (csDMARD) Intensification</measure>
    <time_frame>At Month 6</time_frame>
    <description>Percentage of participants who achieved a glucocorticoid dose &lt;5 mg/day without csDMARD intensification.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Initiated Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) That Moved to Monotherapy (+/- Glucocorticoids)</measure>
    <time_frame>Through Week 24</time_frame>
    <description>Percentage of participants who initiated Upadacitinib as combination therapy (csDMARD +/- Glucocorticoids) that moved to monotherapy (+/- glucocorticoids).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Of the Participants Initiating Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) and Achieve Remission at 6 months, the Percentage of Participants that Maintain Remission Grouped by Maintenance of Combination Therapy Strategy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Of the Participants Initiating Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) and Achieve LDA at 6 months, the Percentage of Participants that Maintain LDA Grouped by Maintenance of Combination Therapy Strategy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>LDA is defined as DAS28-CRP&lt;3.2.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Of the Participants Initiating Upadacitinib as Monotherapy Therapy (+/- Glucocorticoids) and Achieve Remission at 6 months, the Percentage of Participants that Maintain Remission Grouped by Maintenance of Monotherapy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Of the Participants Initiating Upadacitinib as Monotherapy Therapy (+/- Glucocorticoids) and Achieve LDA at 6 months, the Percentage of Participants that Maintain LDA Grouped by Maintenance of Monotherapy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>LDA is defined as DAS28-CRP&lt;3.2.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Who Do Not Achieve Remission at Any Point in the Study</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to the Discontinuation of Upadacitinib</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Time to the discontinuation of Upadacitinib.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Time to First Treatment Adjustment</measure>
    <time_frame>Baseline (Month 0) Through Month 24</time_frame>
    <description>Treatment Adjustment is defined as treatment escalation/de-escalation/ addition/withdrawal.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Achieving LDA Grouped by Therapy Strategy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>LDA is defined as DAS28-CRP&lt;3.2, Simplified Disease Activity Index (SDAI) ≤11 and Clinical Disease Activity Index (CDAI) ≤10.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Percentage of Participants Achieving Remission Grouped by Therapy Strategy</measure>
    <time_frame>Through Month 24</time_frame>
    <description>Remission is defined as DAS28-CRP&lt;2.6, SDAI≤3.3 and CDAI ≤2.8.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Medication Burden Treatment Burden Questionnaire (TBQ) in Participants, Grouped by Therapy Strategy</measure>
    <time_frame>Through Week 24</time_frame>
    <description>The TBQ is composed of 13 items rated on a Likert scale ranging from 0 (not a problem), to 10 (big problem). scores can be summed into a global score, ranging from 0 to 130.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Physical Function Health Assessment Questionnaire - Disability Index (HAQ-DI) in Participants, Grouped by Therapy Strategy</measure>
    <time_frame>Baseline (Month 0) Through Month 24</time_frame>
    <description>HAQ is a widely accepted, validated, rheumatology specific instrument to assess physical function in Rheumatoid Arthritis. It consists of 20 questions, covering eight types of activities. For each question, scores range from 0 to 3 (0 = without any difficulty; 1 = with some difficulty; 2 = with much difficulty or with assistance; 3 = unable to do). HAQ Disability Index (HAQ-DI) score is the average of the highest score in each of the eight categories.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Pain Visual Analogue Scale (VAS) in participants, Grouped by Therapy Strategy</measure>
    <time_frame>Baseline (Month 0) Through Month 24</time_frame>
    <description>A VAS is used to assess worst joint pain in the past 7 days.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Morning Stiffness in Participants, Grouped by Therapy Strategy</measure>
    <time_frame>Baseline (Month 0) Through Month 24</time_frame>
    <description>A numeric rating scale (NRS) is used to assess severity and length of morning stiffness in the past 7 days.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) in Participants, Grouped by Therapy Strategy</measure>
    <time_frame>Baseline (Month 0) Through Month 24</time_frame>
    <description>The FACIT Fatigue Scale is a short, 13-item, easy to administer tool that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four-point Likert scale (0 = not at all fatigued to 4 = very much fatigued).</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Actual">1532</enrollment>
  <condition>Rheumatoid Arthritis (RA)</condition>
  <arm_group>
    <arm_group_label>Participants receiving Upadacitinib</arm_group_label>
    <description>Participants receiving Upadacitinib for moderate to severe rheumatoid arthritis (RA).</description>
  </arm_group>
  <eligibility>
    <study_pop>
      <textblock>
        Adults receiving Upadacitinib according to the product prescribing information, for&#xD;
        moderate to severe active Rheumatoid Arthritis (RA).&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Confirmed diagnosis of moderate to severe active Rheumatoid Arthritis (RA).&#xD;
&#xD;
          -  Physician decision on patient treatment with upadacitinib must have been reached prior&#xD;
             to and independently of recruitment in the study.&#xD;
&#xD;
          -  Upadacitinib prescribed in accordance to the applicable approved label and local&#xD;
             regulatory and reimbursement policies.&#xD;
&#xD;
          -  French Participants Only: Taking oral glucocorticoids ≥5 mg/day of prednisone or&#xD;
             equivalent for at least 3 months prior to study start.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        - Prior treatment with Upadacitinib.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>ABBVIE INC.</last_name>
    <role>Study Director</role>
    <affiliation>AbbVie</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hospital Italiano La Plata /ID# 222190</name>
      <address>
        <city>La Plata</city>
        <state>Buenos Aires</state>
        <zip>1902</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CER Instituto Medico /ID# 222193</name>
      <address>
        <city>Quilmes</city>
        <state>Buenos Aires</state>
        <zip>1878</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Organizacion Medica de Investigacion (OMI) /ID# 222187</name>
      <address>
        <city>Ciudad Autonoma de Buenos Aire</city>
        <state>Ciuadad Autonoma De Buenos Aires</state>
        <zip>1015</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CIER Centro de Investigaciones en Enfermedades Reumaticas /ID# 231769</name>
      <address>
        <city>Ciudad Autonoma de Buenos Aire</city>
        <state>Ciuadad Autonoma De Buenos Aires</state>
        <zip>1055</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>DOM Centro de Reumatologia /ID# 222194</name>
      <address>
        <city>Ciudad Autonoma de Buenos Aire</city>
        <state>Ciuadad Autonoma De Buenos Aires</state>
        <zip>1111</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto CAICI S.R.L /ID# 222191</name>
      <address>
        <city>Rosario</city>
        <state>Santa Fe</state>
        <zip>2000</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto Medico Strusberg /ID# 222189</name>
      <address>
        <city>Cordoba</city>
        <zip>5000</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cimer /Id# 222188</name>
      <address>
        <city>San Miguel de Tucuman</city>
        <zip>4000</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Instituto de Cardiologia /ID# 226634</name>
      <address>
        <city>Santiago Del Estero</city>
        <zip>4200</zip>
        <country>Argentina</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Genesis Research Services /ID# 224060</name>
      <address>
        <city>Broadmeadow</city>
        <state>New South Wales</state>
        <zip>2292</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>BJC Health /ID# 223884</name>
      <address>
        <city>Paramatta</city>
        <state>New South Wales</state>
        <zip>2150</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Emeritus Research /ID# 223883</name>
      <address>
        <city>Camberwell</city>
        <state>Victoria</state>
        <zip>3124</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Joint West Rheumatology /ID# 223886</name>
      <address>
        <city>Murdoch</city>
        <state>Western Australia</state>
        <zip>6150</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Private Practice - Scott Walter Graf /ID# 223958</name>
      <address>
        <city>Adelaide</city>
        <zip>5000</zip>
        <country>Australia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Klinikum Klagenfurt am Woerthersee /ID# 239628</name>
      <address>
        <city>Klagenfurt Am Woerthersee</city>
        <state>Kaernten</state>
        <zip>9020</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ordination Dr. Leeb /ID# 224293</name>
      <address>
        <city>Hollabrunn</city>
        <state>Niederoesterreich</state>
        <zip>2020</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dr. Georg Kurtz /ID# 225477</name>
      <address>
        <city>Gleisdorf</city>
        <state>Steiermark</state>
        <zip>8200</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dr. Maya Thun /ID# 224299</name>
      <address>
        <city>Vienna</city>
        <state>Wien</state>
        <zip>1010</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ordination Doz. Grisar /ID# 224298</name>
      <address>
        <city>Vienna</city>
        <state>Wien</state>
        <zip>1090</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rheuma-Zentrum Wien-Oberlaa GmbH /ID# 227853</name>
      <address>
        <city>Vienna</city>
        <state>Wien</state>
        <zip>1100</zip>
        <country>Austria</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Saint Pierre /ID# 223041</name>
      <address>
        <city>Bruxelles</city>
        <state>Bruxelles-Capitale</state>
        <zip>1000</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rhumaconsult SPRL /ID# 221825</name>
      <address>
        <city>Charleroi</city>
        <state>Hainaut</state>
        <zip>6000</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU UCL Namur - site Godinne /ID# 222797</name>
      <address>
        <city>Godinne</city>
        <state>Namur</state>
        <zip>5530</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Algemeen Stedelijk Ziekenhuis /ID# 224121</name>
      <address>
        <city>Aalst</city>
        <state>Oost-Vlaanderen</state>
        <zip>9300</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Onze Lieve Vrouw Hospital /ID# 223042</name>
      <address>
        <city>Aalst</city>
        <zip>9300</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AZ Sint-Jan Brugge /ID# 223713</name>
      <address>
        <city>Brugge</city>
        <zip>8000</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AZ Sint Lucas /ID# 223093</name>
      <address>
        <city>Brugge</city>
        <zip>8310</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Reumacentrum /ID# 222799</name>
      <address>
        <city>Genk</city>
        <zip>3600</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ReumaClinic /ID# 221353</name>
      <address>
        <city>Genk</city>
        <zip>3600</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Maertens, Gistel, BE /ID# 221823</name>
      <address>
        <city>Gistel</city>
        <zip>8470</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Reuma Instituut Hasselt /ID# 221822</name>
      <address>
        <city>Hasselt</city>
        <zip>3500</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de Liege /ID# 222201</name>
      <address>
        <city>Liege</city>
        <zip>4000</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AZ Alma Campus Sijsele /ID# 222214</name>
      <address>
        <city>Sijsele</city>
        <zip>8340</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Private practice Sint-Niklaas /ID# 224123</name>
      <address>
        <city>Sint-Niklaas</city>
        <zip>9100</zip>
        <country>Belgium</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Cannes - les Broussailles /ID# 226160</name>
      <address>
        <city>Cannes CEDEX</city>
        <state>Alpes-Maritimes</state>
        <zip>06414</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>HCL - Hopital Lyon Sud /ID# 222447</name>
      <address>
        <city>Pierre Benite CEDEX</city>
        <state>Auvergne-Rhone-Alpes</state>
        <zip>69495</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Strasbourg - Hopital de Hautepierre /ID# 222450</name>
      <address>
        <city>Strasbourg</city>
        <state>Bas-Rhin</state>
        <zip>67200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hopital Saint Joseph /ID# 227221</name>
      <address>
        <city>Marseille</city>
        <state>Bouches-du-Rhone</state>
        <zip>13008</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Dijon /ID# 223799</name>
      <address>
        <city>Dijon</city>
        <state>Cote-d Or</state>
        <zip>21000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Georges Renon /ID# 225197</name>
      <address>
        <city>Niort CEDEX</city>
        <state>Deux-Sevres</state>
        <zip>79028</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de Besancon - Jean Minjoz /ID# 222463</name>
      <address>
        <city>Besancon</city>
        <state>Doubs</state>
        <zip>25030</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Limoges - Dupuytren 1 /ID# 222457</name>
      <address>
        <city>Limoges CEDEX 1</city>
        <state>Franche-Comte</state>
        <zip>87042</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Toulouse - Hopital Purpan /ID# 223150</name>
      <address>
        <city>TOULOUSE Cedex 9</city>
        <state>Haute-Garonne</state>
        <zip>31059</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Bigorre - Site de la Gespe /ID# 225141</name>
      <address>
        <city>Tarbes CEDEX 9</city>
        <state>Hautes-Pyrenees</state>
        <zip>65013</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Roubaix - Hopital Victor Provo /ID# 225032</name>
      <address>
        <city>Roubaix Cedex 1</city>
        <state>Hauts-de-France</state>
        <zip>59100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Montpellier - Hôpital Saint Eloi /ID# 222452</name>
      <address>
        <city>Montpellier Cedex 5</city>
        <state>Herault</state>
        <zip>34295</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Montpellier - Hôpital Saint Eloi /ID# 223394</name>
      <address>
        <city>Montpellier Cedex 5</city>
        <state>Herault</state>
        <zip>34295</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hopital Avicenne - APHP /ID# 224248</name>
      <address>
        <city>Bobigny</city>
        <state>Ile-de-France</state>
        <zip>93000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHR Orleans - Hopital de la Source /ID# 223591</name>
      <address>
        <city>Orleans CEDEX 2</city>
        <state>Loiret</state>
        <zip>45067</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de SAINT ETIENNE - Hopital Nord /ID# 222456</name>
      <address>
        <city>St. Priest En Jarez</city>
        <state>Loire</state>
        <zip>42270</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de Nantes, Hotel Dieu -HME /ID# 225787</name>
      <address>
        <city>Nantes</city>
        <state>Pays-de-la-Loire</state>
        <zip>44000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Nice -Hopital Pasteur /ID# 222460</name>
      <address>
        <city>Nice CEDEX 1</city>
        <state>Provence-Alpes-Cote-d Azur</state>
        <zip>06002</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Infirmerie Protestante /ID# 222438</name>
      <address>
        <city>Caluire Et Cuire</city>
        <state>Rhone</state>
        <zip>69300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Amiens-Picardie Site Sud /ID# 222444</name>
      <address>
        <city>Amiens CEDEX 1</city>
        <state>Somme</state>
        <zip>80054</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet libéral du Dr PAUPIERE /ID# 238723</name>
      <address>
        <city>Peronne</city>
        <state>Somme</state>
        <zip>80200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH du Pays d'AIX /ID# 229561</name>
      <address>
        <city>Aix En Provence Cedex 1</city>
        <zip>13616</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet medical /ID# 225366</name>
      <address>
        <city>Aix les Bains</city>
        <zip>73100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet medical /ID# 224850</name>
      <address>
        <city>Albi</city>
        <zip>81000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier d'Angouleme /ID# 226064</name>
      <address>
        <city>Angouleme CEDEX 9</city>
        <zip>16959</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet Novel d'Annecy /ID# 232310</name>
      <address>
        <city>Annecy</city>
        <zip>74000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier d'Arras /ID# 223172</name>
      <address>
        <city>Arras</city>
        <zip>62022</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Bordeaux - Hopital Pellegrin /ID# 224837</name>
      <address>
        <city>Bordeaux</city>
        <zip>33000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier de Boulogne Sur Mer /ID# 222991</name>
      <address>
        <city>Boulogne sur Mer</city>
        <zip>62200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hopital de la Cavale Blanche /ID# 222462</name>
      <address>
        <city>Brest</city>
        <zip>29200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>cabinet liberal- Dr CORNILLE /ID# 227869</name>
      <address>
        <city>Caen</city>
        <zip>14000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier Jean Rougie /ID# 224242</name>
      <address>
        <city>Cahors</city>
        <zip>46005</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHRU Tours - Hopital Trousseau /ID# 222445</name>
      <address>
        <city>Chambray Les Tours</city>
        <zip>37170</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier de CHOLET /ID# 222455</name>
      <address>
        <city>Cholet</city>
        <zip>49300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hia Percy /Id# 225642</name>
      <address>
        <city>Clamart</city>
        <zip>92190</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Clermont Ferand - Hopital Gabriel Montpied /ID# 223801</name>
      <address>
        <city>Clermont Ferrand</city>
        <zip>63000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet liberal - Compiegne - Dr Banse /ID# 227099</name>
      <address>
        <city>Compiegne</city>
        <zip>60200</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>C. H. Sud Francilien /ID# 222446</name>
      <address>
        <city>Corbeil Essonnes</city>
        <zip>91106</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet medical /ID# 225142</name>
      <address>
        <city>Haguenau</city>
        <zip>67500</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHD Vendée- La Roche-sur-Yon - Les Oudairies /ID# 229086</name>
      <address>
        <city>La Roche Sur Yon</city>
        <zip>85000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH La Rochelle - Hopital Saint Louis /ID# 224240</name>
      <address>
        <city>La Rochelle</city>
        <zip>17019</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Grenoble - Hopital Michallon /ID# 223211</name>
      <address>
        <city>La Tronche</city>
        <zip>38700</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre Hospitalier de Laon /ID# 224857</name>
      <address>
        <city>Laon CEDEX</city>
        <zip>02001</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Emile Roux Le Puy en Velay /ID# 223688</name>
      <address>
        <city>Le Puy en Velay</city>
        <zip>43000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet médical /ID# 225000</name>
      <address>
        <city>Les Abrets En Dauphine</city>
        <zip>38490</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU Lille - Hôpital Roger Salengro /ID# 223170</name>
      <address>
        <city>Lille</city>
        <zip>59037</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinique de la Sauvegarde /ID# 223424</name>
      <address>
        <city>Lyon</city>
        <zip>69009</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet de rhumatologie /ID# 227740</name>
      <address>
        <city>Mennecy</city>
        <zip>91540</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Princesse Grace /ID# 222451</name>
      <address>
        <city>Monaco</city>
        <zip>98000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ch Montauban /Id# 231854</name>
      <address>
        <city>Montauban</city>
        <zip>82000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ELSAN - Clinique du Pont de Chaume /ID# 224898</name>
      <address>
        <city>Montauban</city>
        <zip>82000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinique Beau Soleil /ID# 224238</name>
      <address>
        <city>Montpellier</city>
        <zip>34070</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH des Pays de Morlaix /ID# 223795</name>
      <address>
        <city>Morlaix</city>
        <zip>29600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Polyclinique saint Odilon /ID# 225576</name>
      <address>
        <city>Moulins</city>
        <zip>03000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ch Mulhouse /Id# 223442</name>
      <address>
        <city>Mulhouse</city>
        <zip>68100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AP-HP - Hopital Saint-Antoine /ID# 222441</name>
      <address>
        <city>Paris</city>
        <zip>75012</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hopital Pitie Salpetriere /ID# 222443</name>
      <address>
        <city>Paris</city>
        <zip>75013</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AP-HP - Hopital Cochin /ID# 222986</name>
      <address>
        <city>Paris</city>
        <zip>75014</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet medical /ID# 224855</name>
      <address>
        <city>Paris</city>
        <zip>75014</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centre de Soins Osteoarticulaires Ambulatoires /ID# 224737</name>
      <address>
        <city>Paris</city>
        <zip>75015</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AP-HP - Hopital Bichat - Claude-Bernard /ID# 222449</name>
      <address>
        <city>Paris</city>
        <zip>75018</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>GH Diaconesses Croix Saint-Simon /ID# 229126</name>
      <address>
        <city>Paris</city>
        <zip>75020</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet médical /ID# 225321</name>
      <address>
        <city>Reims</city>
        <zip>51100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHU de Rennes - Hospital Sud /ID# 222458</name>
      <address>
        <city>Rennes CEDEX 2</city>
        <zip>35203</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Roanne /ID# 224729</name>
      <address>
        <city>Roanne</city>
        <zip>42300</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinique Saint-Hilaire /ID# 223833</name>
      <address>
        <city>Rouen</city>
        <zip>76000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hôpital Charles-Nicolle /ID# 223589</name>
      <address>
        <city>Rouen</city>
        <zip>76000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hôpital d'instruction des armées Bégin /ID# 222440</name>
      <address>
        <city>Saint-Mandé cedex</city>
        <zip>94163</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet rhumatologie Dr NECTOUX /ID# 225828</name>
      <address>
        <city>Sainte Maxime</city>
        <zip>83120</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet Rhumatologie St Michel Sur Orge /ID# 225176</name>
      <address>
        <city>St Michel Sur Orge</city>
        <zip>91240</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CH Saint Nazaire /ID# 225750</name>
      <address>
        <city>St Nazaire</city>
        <zip>44600</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Groupe Médical Spécialisé - Le Premium /ID# 223719</name>
      <address>
        <city>Strasbourg</city>
        <zip>67000</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cabinet de Rhumatologie Poincare /ID# 224755</name>
      <address>
        <city>Thionville</city>
        <zip>57100</zip>
        <country>France</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rheumatologische-Immunologische Praxis Templin /ID# 226924</name>
      <address>
        <city>Templin</city>
        <state>Brandenburg</state>
        <zip>17268</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ACURA Rheumazentrum Baden-Bade /ID# 225225</name>
      <address>
        <city>Baden-baden</city>
        <zip>76530</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rheumapraxis Prof Dr Karin Manger /ID# 224086</name>
      <address>
        <city>Bamberg</city>
        <zip>96047</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Praxis fuer Rheumatologie und Innere Medizin /ID# 225222</name>
      <address>
        <city>Berlin</city>
        <zip>12163</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Eisterhues, Braunschweig, DE /ID# 225186</name>
      <address>
        <city>Braunschweig</city>
        <zip>38100</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rheumatologie in Veedel /ID# 224999</name>
      <address>
        <city>Cologne</city>
        <zip>50825</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dres. Karger/Baerlecken /ID# 224809</name>
      <address>
        <city>Cologne</city>
        <zip>50996</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Praxis Dilltal /ID# 226925</name>
      <address>
        <city>Ehringshausen</city>
        <zip>35630</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MVZ Ambulantes Rheumazentrum Erfurt /ID# 224812</name>
      <address>
        <city>Erfurt</city>
        <zip>99096</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Helios Fachklinik Vogelsang-Gommern /ID# 222949</name>
      <address>
        <city>Gommern</city>
        <zip>39245</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Heilig, Heidelberg, DE /ID# 225223</name>
      <address>
        <city>Heidelberg</city>
        <zip>69120</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Praxis internistische Rheumatologie /ID# 239226</name>
      <address>
        <city>Leipzig</city>
        <zip>04129</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Dres. Teipel/Toussaint/Saech /ID# 226923</name>
      <address>
        <city>Leverkusen</city>
        <zip>51373</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Aurich &amp; Sieburg, Magdeburg /ID# 230701</name>
      <address>
        <city>Magdeburg</city>
        <zip>39104</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Die Fachaerzte im Rottal - Nephrologie, Rheumatologie /ID# 223866</name>
      <address>
        <city>Pfarrkirchen</city>
        <zip>84347</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>MVZ für Rheumatologie Dr. M. Welcker GmbH /ID# 226926</name>
      <address>
        <city>Planegg</city>
        <zip>82152</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Knappschaftsklinikum Saar /ID# 225224</name>
      <address>
        <city>Puettlingen</city>
        <zip>66346</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Krankenhaus der Barmherzigen Brueder Trier /ID# 226927</name>
      <address>
        <city>Trier</city>
        <zip>54292</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Praxis Dr. Haas /ID# 225187</name>
      <address>
        <city>Tuebingen</city>
        <zip>72072</zip>
        <country>Germany</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>251 Airforce General Hospital /ID# 225065</name>
      <address>
        <city>Athens</city>
        <state>Attiki</state>
        <zip>11525</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>General Hospital of Athens Gennimatas /ID# 225064</name>
      <address>
        <city>Athens</city>
        <state>Attiki</state>
        <zip>11527</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>General Hospital of Athens Ippokratio /ID# 224164</name>
      <address>
        <city>Athens</city>
        <state>Attiki</state>
        <zip>11527</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University General Hospital Attikon /ID# 224136</name>
      <address>
        <city>Athens</city>
        <state>Attiki</state>
        <zip>12462</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>General Hospital Asklepieio Voulas /ID# 224131</name>
      <address>
        <city>Athens</city>
        <state>Attiki</state>
        <zip>16673</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University General Hospital of Alexandroupolis /ID# 224880</name>
      <address>
        <city>Alexandroupoli</city>
        <state>Evros</state>
        <zip>68100</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>University General Hospital of Heraklion PA.G.N.I /ID# 224133</name>
      <address>
        <city>Heraklion</city>
        <state>Kriti</state>
        <zip>71500</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Naval Hospital of Athens /ID# 224135</name>
      <address>
        <city>Athens</city>
        <zip>11521</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>General Hospital of Patras Agios Andreas /ID# 224132</name>
      <address>
        <city>Patras</city>
        <zip>26335</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Olympion General Clinic SA /ID# 224130</name>
      <address>
        <city>Patras</city>
        <zip>26443</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Bioclinic Thessaloniki /ID# 224879</name>
      <address>
        <city>Thessaloniki</city>
        <zip>54622</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>General Hospital of Thessaloniki Hippokrateio /ID# 229965</name>
      <address>
        <city>Thessaloniki</city>
        <zip>54642</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Euromedica General Clinic /ID# 224134</name>
      <address>
        <city>Thessaloniki</city>
        <zip>54645</zip>
        <country>Greece</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hermitage Medical Clinic /ID# 239556</name>
      <address>
        <city>Dublin 20</city>
        <state>Dublin</state>
        <zip>D20 W722</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St James Hospital /ID# 224201</name>
      <address>
        <city>Dublin 8</city>
        <state>Dublin</state>
        <zip>D08 NHY1</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>St Vincent's University Hospital /ID# 224200</name>
      <address>
        <city>Elm Park</city>
        <state>Dublin</state>
        <zip>D04 T6F4</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tallaght University Hospital /ID# 231260</name>
      <address>
        <city>Tallaght</city>
        <state>Dublin</state>
        <zip>D24 NR0A</zip>
        <country>Ireland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The Chaim Sheba Medical Center /ID# 222034</name>
      <address>
        <city>Ramat Gan</city>
        <state>Tel-Aviv</state>
        <zip>5265601</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tel Aviv Sourasky Medical Center /ID# 222117</name>
      <address>
        <city>Tel Aviv-Yafo</city>
        <state>Tel-Aviv</state>
        <zip>6423906</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>HaEmek Medical Center /ID# 222138</name>
      <address>
        <city>Afula</city>
        <zip>1834111</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hillel Yaffe Medical Center /ID# 222170</name>
      <address>
        <city>Hadera</city>
        <zip>38100</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rambam Health Care Campus /ID# 222118</name>
      <address>
        <city>Haifa</city>
        <zip>3109601</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>The Lady Davis Carmel Medical Center /ID# 223851</name>
      <address>
        <city>Haifa</city>
        <zip>34362</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Meir Medical Center /ID# 222116</name>
      <address>
        <city>Kfar Saba</city>
        <zip>4428164</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Galilee Medical Center /ID# 222113</name>
      <address>
        <city>Nahariya</city>
        <zip>2210001</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rabin Medical Center /ID# 222694</name>
      <address>
        <city>Petakh Tikva</city>
        <zip>4941492</zip>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero-Universitaria di Ferrara-Arcispedale Sant Anna /ID# 228788</name>
      <address>
        <city>Cona</city>
        <state>Ferrara</state>
        <zip>44124</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ASL 3 Genovese - Ospedale la Colletta /ID# 228892</name>
      <address>
        <city>Arenzano</city>
        <state>Genova</state>
        <zip>16011</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fondazione Policlinico Universitario Campus Bio-Medico di Roma /ID# 229063</name>
      <address>
        <city>Rome</city>
        <state>Lazio</state>
        <zip>00128</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero-Universitaria Policlinico Umberto I /ID# 228014</name>
      <address>
        <city>Rome</city>
        <state>Lazio</state>
        <zip>00161</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fondazione Policlinico Universitario Agostino Gemelli IRCCS-Università Cattolica /ID# 229061</name>
      <address>
        <city>Rome</city>
        <state>Lazio</state>
        <zip>00168</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ospedale San Raffaele IRCCS /ID# 229059</name>
      <address>
        <city>Milan</city>
        <state>Milano</state>
        <zip>20132</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Istituto Clinico Humanitas /ID# 227943</name>
      <address>
        <city>Rozzano</city>
        <state>Milano</state>
        <zip>20089</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo /ID# 228889</name>
      <address>
        <city>Alessandria</city>
        <zip>15121</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona /ID# 229440</name>
      <address>
        <city>Ancona</city>
        <zip>60126</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria Consorziale Policlinico /ID# 228580</name>
      <address>
        <city>Bari</city>
        <zip>70124</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII (Presidio Papa Giovanni /ID# 228967</name>
      <address>
        <city>Bergamo</city>
        <zip>24127</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ASST Spedali civili di Brescia /ID# 228970</name>
      <address>
        <city>Brescia</city>
        <zip>25123</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ospedale Ss. Annunziata /ID# 228809</name>
      <address>
        <city>Chieti</city>
        <zip>66100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ASST Grande Ospedale Metropolitano Niguarda /ID# 228807</name>
      <address>
        <city>Milano</city>
        <zip>20162</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>ASST Gaetano Pini/Presidio Ospedaliero Pini /ID# 228556</name>
      <address>
        <city>Milan</city>
        <zip>20122</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero-Universitaria di Modena /ID# 228554</name>
      <address>
        <city>Modena</city>
        <zip>41124</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>AOU Universita degli Studi della Campania Luigi Vanvitelli /ID# 229057</name>
      <address>
        <city>Napoli</city>
        <zip>80138</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ospedale San Giovanni Bosco /ID# 228552</name>
      <address>
        <city>Napoli</city>
        <zip>80144</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Civico Di Cristina Benfratelli- P.O. Civico /ID# 228912</name>
      <address>
        <city>Palermo</city>
        <zip>90127</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria Paolo Giaccone /ID# 228160</name>
      <address>
        <city>Palermo</city>
        <zip>90127</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Fondazione IRCCS Policlinico /ID# 227937</name>
      <address>
        <city>Pavia</city>
        <zip>27100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero Universitaria Pisana-Stabilimento di Santa Chiara /ID# 228550</name>
      <address>
        <city>Pisa</city>
        <zip>56126</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Regionale San Carlo /ID# 228648</name>
      <address>
        <city>Potenza</city>
        <zip>85100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero-Universitaria Sant'Andrea /ID# 227942</name>
      <address>
        <city>Rome</city>
        <zip>00189</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria &quot;San Giovanni di Dio e Ruggi d'Aragona /ID# 229065</name>
      <address>
        <city>Salerno</city>
        <zip>84131</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliero-Universitaria Senese-Ospedale Santa Maria delle Scotte /ID# 227938</name>
      <address>
        <city>Siena</city>
        <zip>53100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>A.0.Ordine Mauriziano/Ospedale Umberto I di Torino /ID# 228888</name>
      <address>
        <city>Turin</city>
        <zip>10128</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria Friuli Centrale/Presidio Ospedaliero Universit /ID# 228551</name>
      <address>
        <city>Udine</city>
        <zip>33100</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Azienda Ospedaliera Universitaria di Verona/Ospedale Borgo Trento /ID# 228553</name>
      <address>
        <city>Verona</city>
        <zip>37126</zip>
        <country>Italy</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Mubarak Hospital /ID# 224139</name>
      <address>
        <city>Hawalli</city>
        <zip>46300</zip>
        <country>Kuwait</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ameeri Hospital /ID# 224140</name>
      <address>
        <city>Kuwait City</city>
        <zip>35002</zip>
        <country>Kuwait</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>KOC Hospital /ID# 224138</name>
      <address>
        <city>Kuwait</city>
        <zip>60000</zip>
        <country>Kuwait</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>RM Pharma Specialists S.A de C.V. /ID# 224359</name>
      <address>
        <city>Mexico City</city>
        <state>Ciudad De Mexico</state>
        <zip>03100</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CINTRE, Centro de Investigación y Tratamiento Reumatológico SC /ID# 240836</name>
      <address>
        <city>Mexico City</city>
        <state>Ciudad De Mexico</state>
        <zip>11850</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Integral en Reumatologia S.A de C.V /ID# 224363</name>
      <address>
        <city>Guadalajara</city>
        <state>Jalisco</state>
        <zip>44160</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinica de Investigacion en Reumatologia y Obesidad S.C. /ID# 224361</name>
      <address>
        <city>Guadalajara</city>
        <state>Jalisco</state>
        <zip>44650</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Private Office Dr. Orozco /ID# 243257</name>
      <address>
        <city>Guadalajara</city>
        <state>Jalisco</state>
        <zip>44650</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro de Estudios de Investigación Básica y Clínica, S.C. /ID# 224364</name>
      <address>
        <city>Guadalajara</city>
        <state>Jalisco</state>
        <zip>44690</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Consultorio Medico Privado - Miryam Eguia Bernal /Id# 243255</name>
      <address>
        <city>Monterrey</city>
        <state>Nuevo Leon</state>
        <zip>64000</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Centro Especializado en Diabetes, Obesidad y Prevencion de Enfermedades Cardiova /ID# 224360</name>
      <address>
        <city>Mexico City</city>
        <zip>11650</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Consultorio Privado Jorge Rojas Serrano /Id# 243258</name>
      <address>
        <city>Puebla</city>
        <zip>72550</zip>
        <country>Mexico</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>LLC MC RevmaMed /ID# 239162</name>
      <address>
        <city>Syktyvkar</city>
        <state>Komi, Respublika</state>
        <zip>167031</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Moscow Regional Research and Clinical Institute n.a. Vladimirskiy (MONIKI) /ID# 224852</name>
      <address>
        <city>Moscow</city>
        <state>Moskovskaya Oblast</state>
        <zip>129110</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Samara Regional Clinical Hospital n.a. V. D. Seredavin /ID# 227852</name>
      <address>
        <city>Samara</city>
        <state>Samarskaya Oblast</state>
        <zip>443095</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nort-Western State Medical University n.a. Mechnikov /ID# 223419</name>
      <address>
        <city>St. Petersburg</city>
        <state>Sankt-Peterburg</state>
        <zip>193015</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>GBUZ TO Regional Clinical Hospital No. 1 /ID# 241113</name>
      <address>
        <city>Tyumen</city>
        <state>Tyumenskaya Oblast</state>
        <zip>625032</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>District clinical hospital /ID# 227662</name>
      <address>
        <city>Khanty-Mansyisk</city>
        <zip>628011</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>City Clinical Hospital #52 /ID# 242947</name>
      <address>
        <city>Moscow</city>
        <zip>123182</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Omsk Regional Clinic Hospital /ID# 232029</name>
      <address>
        <city>Omsk</city>
        <zip>644111</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Orenburg State Medical University /ID# 243615</name>
      <address>
        <city>Orenburg</city>
        <zip>460000</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Republican hospital named after V.A. Baranov /ID# 227661</name>
      <address>
        <city>Petrozavodsk</city>
        <zip>185019</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinic of Samara State Medical University /ID# 241168</name>
      <address>
        <city>Samara</city>
        <zip>443079</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Clinical Rheumatologic Hospital No 25 /ID# 242475</name>
      <address>
        <city>St. Petersburg</city>
        <zip>190068</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Military Medical Academy n.a. Kirov /ID# 242351</name>
      <address>
        <city>St. Petersburg</city>
        <zip>194044</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Budgetary Institution of the Khanty-Mansiysk Autonomous Okrug-Yugra &quot;Surgut Dist /ID# 243313</name>
      <address>
        <city>Surgut</city>
        <zip>628400</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Nebbiolo Clinical Research Center /ID# 224900</name>
      <address>
        <city>Tomsk</city>
        <zip>634009</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Ulyanovsk Regional Clinical Hospital /ID# 239164</name>
      <address>
        <city>Ulyanovsk</city>
        <zip>432017</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Voronezh State Medical Univers /ID# 224854</name>
      <address>
        <city>Voronezh</city>
        <zip>394036</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Yaroslavl State Medicat University /ID# 224851</name>
      <address>
        <city>Yaroslavl</city>
        <zip>150000</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saudi German Hospital Jeddah /ID# 243234</name>
      <address>
        <city>Jeddah</city>
        <zip>22236</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>King Abdulaziz University Hospital /ID# 222724</name>
      <address>
        <city>Jeddah</city>
        <zip>22252</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>International Medical Center /ID# 243235</name>
      <address>
        <city>Jeddah</city>
        <zip>22382</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Saudi German Hospital /ID# 224137</name>
      <address>
        <city>Mushait</city>
        <zip>61961</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>King Fahad Medical City /ID# 222917</name>
      <address>
        <city>Riyadh</city>
        <zip>11525</zip>
        <country>Saudi Arabia</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital de Mérida /ID# 231826</name>
      <address>
        <city>Mérida</city>
        <state>Badajoz</state>
        <zip>06800</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Mutua Terrassa /ID# 231822</name>
      <address>
        <city>Terrasa</city>
        <state>Barcelona</state>
        <zip>08221</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital de Viladecans /ID# 231823</name>
      <address>
        <city>Viladecans</city>
        <state>Barcelona</state>
        <zip>08840</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Virgen del Puerto /ID# 240149</name>
      <address>
        <city>Plasencia</city>
        <state>Caceres</state>
        <zip>10600</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario de Jerez de la Frontera /ID# 231844</name>
      <address>
        <city>Jerez de la Frontera</city>
        <state>Cadiz</state>
        <zip>11407</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario de Getafe /ID# 231825</name>
      <address>
        <city>Getafe</city>
        <state>Madrid</state>
        <zip>28905</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital General Universitario Santa Lucia /ID# 238780</name>
      <address>
        <city>Cartagena</city>
        <state>Murcia</state>
        <zip>30202</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Clinico Universitario Virgen de la Arrixaca /ID# 231847</name>
      <address>
        <city>El Palmar</city>
        <state>Murcia</state>
        <zip>30120</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Rafael Mendez /ID# 231846</name>
      <address>
        <city>Lorca</city>
        <state>Murcia</state>
        <zip>30817</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Xeral Cies (CHUVI) /ID# 231819</name>
      <address>
        <city>Vigo</city>
        <state>Pontevedra</state>
        <zip>36204</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Canarias /ID# 231848</name>
      <address>
        <city>San Cristóbal de La Laguna</city>
        <state>Santa Cruz De Tenerife</state>
        <zip>38320</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Ernest Lluch Martin /ID# 238779</name>
      <address>
        <city>Calatayud</city>
        <state>Zaragoza</state>
        <zip>50299</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario A Coruna - CHUAC /ID# 231818</name>
      <address>
        <city>A Coruna</city>
        <zip>15006</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Torrecardenas /ID# 241931</name>
      <address>
        <city>Almeria</city>
        <zip>04009</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Perpetuo Socorro /ID# 231827</name>
      <address>
        <city>Badajoz</city>
        <zip>06010</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Parc de Salut del Mar /ID# 240000</name>
      <address>
        <city>Barcelona</city>
        <zip>08003</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Santa Creu i Sant Pau /ID# 231821</name>
      <address>
        <city>Barcelona</city>
        <zip>08041</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital General de Granollers /ID# 238778</name>
      <address>
        <city>Barcelona</city>
        <zip>08042</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Reina Sofia /ID# 231843</name>
      <address>
        <city>Cordoba</city>
        <zip>14004</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen de las Nieves /ID# 231841</name>
      <address>
        <city>Granada</city>
        <zip>18014</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Juan Ramon Jimenez /ID# 231840</name>
      <address>
        <city>Huelva</city>
        <zip>21005</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario de Jaen /ID# 231842</name>
      <address>
        <city>Jaen</city>
        <zip>23007</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Ramon y Cajal /ID# 241901</name>
      <address>
        <city>Madrid</city>
        <zip>28034</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen de la Victoria /ID# 240150</name>
      <address>
        <city>Malaga</city>
        <zip>29010</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen Macarena /ID# 231837</name>
      <address>
        <city>Sevilla</city>
        <zip>41009</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen del Rocio /ID# 231836</name>
      <address>
        <city>Sevilla</city>
        <zip>41013</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Universitario Virgen de Valme /ID# 231838</name>
      <address>
        <city>Sevilla</city>
        <zip>41014</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Hospital Royo Villanova /ID# 231824</name>
      <address>
        <city>Zaragoza</city>
        <zip>50015</zip>
        <country>Spain</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kantonsspital Aarau AG /ID# 222354</name>
      <address>
        <city>Aarau</city>
        <state>Aargau</state>
        <zip>5001</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Universitätsspital Basel /ID# 224160</name>
      <address>
        <city>Basel</city>
        <state>Basel-Stadt</state>
        <zip>4031</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kantonsspital St. Gallen /ID# 224158</name>
      <address>
        <city>St. Gallen</city>
        <state>Sankt Gallen</state>
        <zip>9007</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Rheumatologisches Versorgungszentrum Weinfelden /ID# 222346</name>
      <address>
        <city>Weinfelden</city>
        <state>Thurgau</state>
        <zip>8570</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>CHUV, Centre hospitalier universitaire vaudois /ID# 224161</name>
      <address>
        <city>Lausanne</city>
        <state>Vaud</state>
        <zip>1011</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Inselspital, Universitätsspital Bern /ID# 224951</name>
      <address>
        <city>Bern</city>
        <zip>3010</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>HFR Fribourg - Hôpital cantonal /ID# 224163</name>
      <address>
        <city>Fribourg</city>
        <zip>1708</zip>
        <country>Switzerland</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Kaohsiung Medical University Chung-Ho Memorial Hospital /ID# 241052</name>
      <address>
        <city>Kaohsiung</city>
        <zip>807</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>China Medical University Hospital /ID# 241051</name>
      <address>
        <city>Taichung City</city>
        <zip>40447</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Chi-Mei Medical Center /ID# 241745</name>
      <address>
        <city>Tainan</city>
        <zip>71004</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>National Taiwan University Hospital /ID# 241050</name>
      <address>
        <city>Taipei City</city>
        <zip>100</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Tri-Service General Hospital /ID# 241746</name>
      <address>
        <city>Taipei City</city>
        <zip>11490</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Linkou Chang Gung Memorial Hospital /ID# 241053</name>
      <address>
        <city>Taoyuan City</city>
        <zip>333</zip>
        <country>Taiwan</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Cleveland Clinic Abu Dhabi /ID# 223176</name>
      <address>
        <city>Abu Dhabi</city>
        <country>United Arab Emirates</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Integrated Rheumatology and Arthritis Center /ID# 223177</name>
      <address>
        <city>Dubai</city>
        <zip>334224</zip>
        <country>United Arab Emirates</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Departnent of Medicine-Rheumatology Al Baraha Hospital and Al Qasmi Hospital Min /ID# 223178</name>
      <address>
        <city>Dubai</city>
        <country>United Arab Emirates</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Drt Sulaiman Al Habib Hospital /ID# 226575</name>
      <address>
        <city>Dubai</city>
        <country>United Arab Emirates</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Asociacion Española /ID# 222009</name>
      <address>
        <city>Montevideo</city>
        <zip>11200</zip>
        <country>Uruguay</country>
      </address>
    </facility>
  </location>
  <location>
    <facility>
      <name>Medica Uruguaya /ID# 222008</name>
      <address>
        <city>Montevideo</city>
        <zip>11600</zip>
        <country>Uruguay</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Argentina</country>
    <country>Australia</country>
    <country>Austria</country>
    <country>Belgium</country>
    <country>France</country>
    <country>Germany</country>
    <country>Greece</country>
    <country>Ireland</country>
    <country>Israel</country>
    <country>Italy</country>
    <country>Kuwait</country>
    <country>Mexico</country>
    <country>Russian Federation</country>
    <country>Saudi Arabia</country>
    <country>Spain</country>
    <country>Switzerland</country>
    <country>Taiwan</country>
    <country>United Arab Emirates</country>
    <country>Uruguay</country>
  </location_countries>
  <link>
    <url>https://www.rxabbvie.com/</url>
    <description>Related Info.</description>
  </link>
  <verification_date>January 2023</verification_date>
  <study_first_submitted>July 30, 2020</study_first_submitted>
  <study_first_submitted_qc>July 30, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">August 4, 2020</study_first_posted>
  <last_update_submitted>January 25, 2023</last_update_submitted>
  <last_update_submitted_qc>January 25, 2023</last_update_submitted_qc>
  <last_update_posted type="Actual">January 26, 2023</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Rheumatoid Arthritis</keyword>
  <keyword>Upadacitinib</keyword>
  <keyword>RINVOQ</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Arthritis</mesh_term>
    <mesh_term>Arthritis, Rheumatoid</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04497597
org study id: P20-095
nct id: NCT04497597
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
is us export: No
Rheumatoid Arthritis (RA) is an inflammatory disease of the joints causing pain, stiffness,
      swelling and loss of joint function. Despite the range of treatment options for RA steadily
      increasing, many patients remain sub-optimally managed, with sustained clinical remission
      rarely achieved. This study will assess the treatment patterns, achievement of treatment
      targets and maintenance of response.

      Upadacitinib is a drug approved for the treatment of moderately to severely active rheumatoid
      arthritis. Adult participants with moderate to severe RA who have been prescribed
      upadacitinib by their physicians will be enrolled. Approximately, 1660 participants will be
      enrolled this study, worldwide.

      Participants will not receive Upadacitinib as part of this study, but will be followed for
      response to treatment for up to 24 months.

      There may be higher burden for participants in this trial compared to their standard of care.
      Participants will attend regular visits, every 3 months, during the course of the study at a
      hospital or clinic and will be asked to provide additional information by questionnaire at
      each visit.
observational model: Cohort
time perspective: Prospective
measure: Percentage of Participants Who Achieve Remission
time frame: At Month 6
description: Remission is defined as Disease Activity Score at 28 joints (DAS28) C-reactive Protein (CRP)<2.6.
measure: Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission
time frame: At Month 12
description: Remission is defined as DAS28-CRP<2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission
time frame: At Month 24
description: Remission is defined as DAS28-CRP<2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants Who Achieve Low Disease Activity (LDA) at 6 months that maintain LDA
time frame: Through Month 24
description: LDA is defined as DAS28-CRP≤3.2. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants Who Achieve Remission at 3 Months and Maintain Remission
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants Who Achieve Remission at 6 Months and Maintain Remission Grouped by Glucocorticoid Dose
time frame: At Month 12
description: Remission is defined as DAS28-CRP<2.6. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants Who Achieve LDA at 3 months that maintain LDA Grouped by Glucocorticoid Dose
time frame: Through Month 6
description: LDA is defined as DAS28-CRP≤3.2. Maintaining remission is defined as no more than 0.6 point increase in DAS28-CRP.
measure: Percentage of Participants in LDA that Achieve Glucocorticoid Dose <5 mg/Day Per Visit
time frame: Through Month 24
description: LDA is defined as DAS28-CRP<3.2.
measure: Percentage of Participants in Remission that Achieve Glucocorticoid Dose <5 mg/Day Per Visit
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6.
measure: Percentage of Participants Who Achieved a Glucocorticoid Dose <5 mg/Day Without Conventional Synthetic Disease Modifying Anti Rheumatic Drug (csDMARD) Intensification
time frame: At Month 6
description: Percentage of participants who achieved a glucocorticoid dose <5 mg/day without csDMARD intensification.
measure: Percentage of Participants Who Initiated Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) That Moved to Monotherapy (+/- Glucocorticoids)
time frame: Through Week 24
description: Percentage of participants who initiated Upadacitinib as combination therapy (csDMARD +/- Glucocorticoids) that moved to monotherapy (+/- glucocorticoids).
measure: Of the Participants Initiating Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) and Achieve Remission at 6 months, the Percentage of Participants that Maintain Remission Grouped by Maintenance of Combination Therapy Strategy
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6.
measure: Of the Participants Initiating Upadacitinib as Combination Therapy (csDMARD +/- Glucocorticoids) and Achieve LDA at 6 months, the Percentage of Participants that Maintain LDA Grouped by Maintenance of Combination Therapy Strategy
time frame: Through Month 24
description: LDA is defined as DAS28-CRP<3.2.
measure: Of the Participants Initiating Upadacitinib as Monotherapy Therapy (+/- Glucocorticoids) and Achieve Remission at 6 months, the Percentage of Participants that Maintain Remission Grouped by Maintenance of Monotherapy
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6.
measure: Of the Participants Initiating Upadacitinib as Monotherapy Therapy (+/- Glucocorticoids) and Achieve LDA at 6 months, the Percentage of Participants that Maintain LDA Grouped by Maintenance of Monotherapy
time frame: Through Month 24
description: LDA is defined as DAS28-CRP<3.2.
measure: Percentage of Participants Who Do Not Achieve Remission at Any Point in the Study
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6.
measure: Time to the Discontinuation of Upadacitinib
time frame: Through Month 24
description: Time to the discontinuation of Upadacitinib.
measure: Time to First Treatment Adjustment
time frame: Baseline (Month 0) Through Month 24
description: Treatment Adjustment is defined as treatment escalation/de-escalation/ addition/withdrawal.
measure: Percentage of Participants Achieving LDA Grouped by Therapy Strategy
time frame: Through Month 24
description: LDA is defined as DAS28-CRP<3.2, Simplified Disease Activity Index (SDAI) ≤11 and Clinical Disease Activity Index (CDAI) ≤10.
measure: Percentage of Participants Achieving Remission Grouped by Therapy Strategy
time frame: Through Month 24
description: Remission is defined as DAS28-CRP<2.6, SDAI≤3.3 and CDAI ≤2.8.
measure: Change in Medication Burden Treatment Burden Questionnaire (TBQ) in Participants, Grouped by Therapy Strategy
time frame: Through Week 24
description: The TBQ is composed of 13 items rated on a Likert scale ranging from 0 (not a problem), to 10 (big problem). scores can be summed into a global score, ranging from 0 to 130.
measure: Change in Physical Function Health Assessment Questionnaire - Disability Index (HAQ-DI) in Participants, Grouped by Therapy Strategy
time frame: Baseline (Month 0) Through Month 24
description: HAQ is a widely accepted, validated, rheumatology specific instrument to assess physical function in Rheumatoid Arthritis. It consists of 20 questions, covering eight types of activities. For each question, scores range from 0 to 3 (0 = without any difficulty; 1 = with some difficulty; 2 = with much difficulty or with assistance; 3 = unable to do). HAQ Disability Index (HAQ-DI) score is the average of the highest score in each of the eight categories.
measure: Change in Pain Visual Analogue Scale (VAS) in participants, Grouped by Therapy Strategy
time frame: Baseline (Month 0) Through Month 24
description: A VAS is used to assess worst joint pain in the past 7 days.
measure: Change in Morning Stiffness in Participants, Grouped by Therapy Strategy
time frame: Baseline (Month 0) Through Month 24
description: A numeric rating scale (NRS) is used to assess severity and length of morning stiffness in the past 7 days.
measure: Change in Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) in Participants, Grouped by Therapy Strategy
time frame: Baseline (Month 0) Through Month 24
description: The FACIT Fatigue Scale is a short, 13-item, easy to administer tool that measures an individual's level of fatigue during their usual daily activities over the past week. The level of fatigue is measured on a four-point Likert scale (0 = not at all fatigued to 4 = very much fatigued).
arm group label: Participants receiving Upadacitinib
description: Participants receiving Upadacitinib for moderate to severe rheumatoid arthritis (RA).
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: ABBVIE INC.
role: Study Director
affiliation: AbbVie
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country: Argentina
country: Australia
country: Austria
country: Belgium
country: France
country: Germany
country: Greece
country: Ireland
country: Israel
country: Italy
country: Kuwait
country: Mexico
country: Russian Federation
country: Saudi Arabia
country: Spain
country: Switzerland
country: Taiwan
country: United Arab Emirates
country: Uruguay
url: https://www.rxabbvie.com/
description: Related Info.
responsible party type: Sponsor
mesh term: Arthritis
mesh term: Arthritis, Rheumatoid
sharing ipd: Undecided