Clinical trial NCT01173939: Primary Prevention of Major Adverse Cardiac Events (MACE) With Standard and Intensive Statin Treatment in Patients With Diabetes: Survival and Cardiovascular Event Assessments
Official title: Primary Prevention of MACE With Standard and Intensive Statin Treatment in Hypercholesterolemia Patients With Concomitant Diabetes and Hypertension
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Hypercholesterolemia
Type 2 Diabetes
Hypertension
Keywords: Hypercholesterolemia with concomitant type 2 diabetes and hypertension
Lead sponsor: Positive Trial Group
Sponsor class: OTHER
First posted: 2010-08-02
Enrollment: 10000
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: PREVENTION

Brief summary: The study is being conducted to compare the effect of standard treatment (target LDL-C level: \<120 mg/dL (JASGL 2007 target level)) and intensive treatment (target LDL-C level: \<70 mg/dL) in the prevention of major adverse cardiac events (MACE) in hypercholesterolemia patients with concomitant type 2 diabetes and hypertension.


Eligibility criteria: Inclusion Criteria:

Patients meeting the following inclusion criteria will be included in the study:

1. Patients giving voluntary written consent to participate in the study
2. Male or female patients 50 years of age or older (at informed consent)
3. Hypercholesterolemia patients (Untreated patients: LDL-C level ≥140 mg/dL; treated patients: LDL-C level ≥120 mg/dL)
4. Type 2 diabetes patients (HbA1c level ≥6.1% (JDS criteria), with or without history of drug therapy)
5. Hypertension patients (SBP ≥130 mmHg or DBP ≥80 mmHg, with or without history of drug therapy)
6. Patients with two or more of the following risk factors

   * Male
   * 65 years of age or older
   * Smoker
   * L/H ratio: ≥3.0 •HbA1c level: ≥8.0%
   * Left ventricular hypertrophy
   * First- or second-degree family history of MACE
   * Microalbuminuria (quantitative testing: ≥30 mg/dL), proteinuria (qualitative testing: + or higher) or eGFR (\<60 mL/min/1.73 m2)

Exclusion Criteria:

Patients meeting the following criteria will be excluded from the study:

1. Patients receiving rosuvastatin, pitavastatin, or atorvastatin therapy within one month prior to informed consent
2. Patients judged to have familial hypercholesterolemia
3. Patients with a serum triglyceride level of ≥400 mg/dL
4. Patients with a history of myocardial infarction
5. Patients with a history of coronary revascularization (PCI or CABG)
6. Patients with a history of treatment of unstable angina
7. Patients with a history of cerebrovascular accident (excluding asymptomatic lacunar infarction)
8. Heart failure patients
9. Patients with a history of hypersensitivity to statins
10. Patients with a history of drug-induced myopathy
11. Patients with poorly controlled arrhythmia
12. Patients with severe liver or kidney disease
13. Patients with serious concurrent disease, such as malignancy, or patients with severely limited lifespan
14. Patients who are or may be pregnant
15. Patients judged by the investigators to be ineligible for participation in the study for any other reason

Primary outcomes:
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: At baseline
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: 1 month after treatment initiation
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: 3 month after treatment initiation
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: 6 month after treatment initiation
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: 12 month after treatment initiation
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: 36 month after treatment initiation
measure: MACE (time to event): MACE (time to event): myocardial infarction, unstable angina, cardiovascular death, revascularization, fatal/nonfatal cerebrovascular accident, peripheral arteriopathy, aortic event
timeFrame: At the end of the study or discontinuation up to 4 years
Secondary outcomes:
measure: Prevention of individual MACE
timeFrame: At baseline
measure: Prevention of MACE(combination of each category)
timeFrame: At baseline
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: At baseline
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: At baseline
measure: Frequency and distribution of type of deaths during the study period
timeFrame: At baseline
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: At baseline
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: At baseline
measure: Frequency and type of adverse events
timeFrame: At baseline
measure: Prevention of individual MACE
timeFrame: 1 month after treatment initiation
measure: Prevention of individual MACE
timeFrame: 3 month after treatment initiation
measure: Prevention of individual MACE
timeFrame: 6 month after treatment initiation
measure: Prevention of individual MACE
timeFrame: 12 month after treatment initiation
measure: Prevention of individual MACE
timeFrame: 36 month after treatment initiation
measure: Prevention of individual MACE
timeFrame: At the end of the study (or discontinuation)
measure: Prevention of MACE(combination of each category)
timeFrame: 1 month after treatment initiation
measure: Prevention of MACE(combination of each category)
timeFrame: 3 month after treatment initiation
measure: Prevention of MACE(combination of each category)
timeFrame: 6 month after treatment initiation
measure: Prevention of MACE(combination of each category)
timeFrame: 12 month after treatment initiation
measure: Prevention of MACE(combination of each category)
timeFrame: 36 month after treatment initiation
measure: Prevention of MACE(combination of each category)
timeFrame: At the end of the study (or discontinuation)
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: 1 month after treatment initiation
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: 3 month after treatment initiation
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: 6 month after treatment initiation
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: 12 month after treatment initiation
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: 36 month after treatment initiation
measure: Prevention, frequency and distribution of type of the following non-MACE cardiac and cerebrovascular events during the study period: heart failure requiring hospitalization, transient ischemic attack (TIA), abnormal ankle-brachial index (abnormal ABI)
timeFrame: At study completion up to 4 years
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: 1 month after treatment initiation
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: 3 month after treatment initiation
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: 6 month after treatment initiation
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: 12 month after treatment initiation
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: 36 month after treatment initiation
measure: Frequency and distribution of type of MACE during the study period Including correlation with LDL-C, HDL-C and LDL-C/HDL-C ratio (hereafter referred to as "L/H ratio")
timeFrame: At the end of the study or discontinuation up to 4 years
measure: Frequency and distribution of type of deaths during the study period
timeFrame: 1 month after treatment initiation
measure: Frequency and distribution of type of deaths during the study period
timeFrame: 3 month after treatment initiation
measure: Frequency and distribution of type of deaths during the study period
timeFrame: 6 month after treatment initiation
measure: Frequency and distribution of type of deaths during the study period
timeFrame: 12 month after treatment initiation
measure: Frequency and distribution of type of deaths during the study period
timeFrame: 36 month after treatment initiation
measure: Frequency and distribution of type of deaths during the study period
timeFrame: At the end of the study or discontinuation up to 4 years
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: 1 month after treatment initiation
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: 3 month after treatment initiation
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: 6 month after treatment initiation
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: 12 month after treatment initiation
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: 36 month after treatment initiation
measure: Frequency and distribution of type of hospitalizations during the study period
timeFrame: At the end of the study or discontinuation up to 4 years
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: 1 month after treatment initiation
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: 3 month after treatment initiation
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: 6 month after treatment initiation
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: 12 month after treatment initiation
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: 36 month after treatment initiation
measure: Frequency of other events (malignancy, dementia, need of nursing care)
timeFrame: At the end of the study or discontinuation up to 4 years
measure: Frequency and type of adverse events
timeFrame: 1 month after treatment initiation
measure: Frequency and type of adverse events
timeFrame: 3 month after treatment initiation
measure: Frequency and type of adverse events
timeFrame: 6 month after treatment initiation
measure: Frequency and type of adverse events
timeFrame: 12 month after treatment initiation
measure: Frequency and type of adverse events
timeFrame: 36 month after treatment initiation
measure: Frequency and type of adverse events
timeFrame: At the end of the study or discontinuation up to 4 years
Other outcomes:
Locations:
city: Nagoya city
country: Japan
facility: Hiramitsu Heart Clinic
state: Aichi pref.
city: Nagoya city
country: Japan
facility: Medical Dock&Clinic
state: Aichi pref.
city: Iyo gun
country: Japan
facility: Matsuno Medical Clinic
state: Ehime pref.
city: Matsuyama city
country: Japan
facility: Ishite Matsumoto Naika Junkanki Clinic
state: Ehime pref.
city: Niihama city
country: Japan
facility: Ehime Medical CO-OP Izumigawa Clinic
state: Ehime pref.
city: Echizen city
country: Japan
facility: Tsugawa Internal Medicine Clinic
state: Fukui pref.
city: Fukui city
country: Japan
facility: Fukui Chuo Clinic
state: Fukui pref.
city: Sakai city
country: Japan
facility: Koshino Clinic
state: Fukui pref.
city: Chikushino city
country: Japan
facility: Fukuoka University Chikushi Hospital
state: Fukuoka pref.
city: Chikushino city
country: Japan
facility: Saiseikai Futsukaichi Hospital
state: Fukuoka pref.
city: Fukuoka city
country: Japan
facility: Abies Clinic
state: Fukuoka pref.
city: Fukuoka city
country: Japan
facility: Hirano Medical Clinic
state: Fukuoka pref.
city: Fukuoka city
country: Japan
facility: Naitoh Clinic
state: Fukuoka pref.
city: Fukuoka city
country: Japan
facility: Saku Hospital
state: Fukuoka pref.
city: Kasuga city
country: Japan
facility: Fukuoka Tokushukai Medical Center
state: Fukuoka pref.
city: Kitakyusyu city
country: Japan
facility: Morizono Naika
state: Fukuoka pref.
city: Gifu city
country: Japan
facility: Kawai Naika Clinic
state: Gifu pref.
city: Hiroshima city
country: Japan
facility: Hiroshima General Hospital of West Japan Railway Company
state: Hiroshima pref.
city: Date city
country: Japan
facility: Hijirigaoka Hospital
state: Hokkaido pref.
city: Hakodate city
country: Japan
facility: Kyoaikai Hospital
state: Hokkaido pref.
city: Kato-gun
country: Japan
facility: Miyazawa Cardiovascular And Internal Medicine Clinic
state: Hokkaido pref.
city: Obihiro city
country: Japan
facility: Jiyugaoka Yamada Clinic
state: Hokkaido pref.
city: Sapporo city
country: Japan
facility: Chikama Clinic
state: Hokkaido pref.
city: Sapporo city
country: Japan
facility: Hiro Clinic
state: Hokkaido pref.
city: Sapporo city
country: Japan
facility: Medical and Radiology Clinic Caress Sapporo Hokko Memorial Hospital
state: Hokkaido pref.
city: Sapporo city
country: Japan
facility: Seiwa Memorial Hospital
state: Hokkaido pref.
city: Yubari city
country: Japan
facility: Medical Treatment Corporate Foundation Yubari Kibounomori Yubari City Clinic
state: Hokkaido pref.
city: Himeji city
country: Japan
facility: Ino Hospital
state: Hyogo pref.
city: Amagasaki city
country: Japan
facility: Katsuya Clinic
state: Hyogo pref
city: Kobe city
country: Japan
facility: Kotani Diabetes Clinic
state: Hyogo pref
city: Kobe city
country: Japan
facility: Shimizu Clinic
state: Hyogo pref
city: Nishinomiya city
country: Japan
facility: Dr. Kodama's Office of Internal Medicine
state: Hyogo pref
city: Koga city
country: Japan
facility: Koga Hospital
state: Ibaraki pref.
city: Hakusan city
country: Japan
facility: Imura Internal Medicine Clinic
state: Ishikawa pref.
city: Hakusan city
country: Japan
facility: Yanagi Medical Clinic
state: Ishikawa pref.
city: Ishikawa gun
country: Japan
facility: Okyozuka Clinic
state: Ishikawa pref.
city: Kahoku gun
country: Japan
facility: Koni Clinic
state: Ishikawa pref.
city: Kahoku gun
country: Japan
facility: Murata Clinic
state: Ishikawa pref.
city: Kanazawa city
country: Japan
facility: Arai Naika Clinic
state: Ishikawa pref.
city: Kanazawa city
country: Japan
facility: Dr. Hayakawa's Family Clinic
state: Ishikawa pref.
city: Kanazawa city
country: Japan
facility: Wakasa Medical Clinic
state: Ishikawa pref.
city: Komatsu city
country: Japan
facility: Morita Hospital
state: Ishikawa pref.
city: Ichinoseki
country: Japan
facility: Kawasaki Family Clinic
state: Iwate pref.
city: Iwate gun
country: Japan
facility: Sugie Clinic
state: Iwate pref.
city: Morioka city
country: Japan
facility: Katsura General Clinic
state: Iwate pref.
city: Shiwa gun
country: Japan
facility: Takamiya General Clinic
state: Iwate pref.
city: Marugame city
country: Japan
facility: Hayashi Clinic
state: Kagawa pref.
city: Marugame city
country: Japan
facility: Otsuka Internal Medicine Clinic
state: Kagawa pref.
city: Takamatsu city
country: Japan
facility: Center for Preventive Medical Treatment, NTT West Takamatsu Hospital
state: Kagawa pref.
city: Takamatsu city
country: Japan
facility: Hananomiya Clinic
state: Kagawa pref.
city: Takamatsu city
country: Japan
facility: Hasegawa Outpatients Clinic for Cardiovascular Disease
state: Kagawa pref.
city: Takamatsu city
country: Japan
facility: Kojima Clinic
state: Kagawa pref.
city: Takamatsu city
country: Japan
facility: Matsuoka Clinic
state: Kagawa pref.
city: Kanoya city
country: Japan
facility: Osumi-Kanoya Hospital
state: Kagoshima pref.
city: Kumage gun
country: Japan
facility: Yakushima Tokushukai Hospital
state: Kagoshima pref.
city: Ashigara-kami gun
country: Japan
facility: Nemoto G.I.M. Clinic
state: Kanagawa pref.
city: Ashigarakami gun
country: Japan
facility: Magokoro Internal Medicine and Orthopedic Clinic
state: Kanagawa pref.
city: Atsugi City
country: Japan
facility: Kasuya Clinic
state: Kanagawa pref.
city: Fujisawa city
country: Japan
facility: Kuboshima Clinic
state: Kanagawa pref.
city: Fujisawa city
country: Japan
facility: Takahashi Clinic
state: Kanagawa pref.
city: Isehara city
country: Japan
facility: Akizawa Clinic
state: Kanagawa pref.
city: Isehara city
country: Japan
facility: Medical Corp Takeda Clinic
state: Kanagawa pref.
city: Kamakura city
country: Japan
facility: Hashimoto Clinic
state: Kanagawa pref.
city: Kamakura city
country: Japan
facility: Iroden Clinic
state: Kanagawa pref.
city: Kamakura city
country: Japan
facility: Kamakura Naika Shinryosyo
state: Kanagawa pref.
city: Kamakura city
country: Japan
facility: Shohei Clinic
state: Kanagawa pref.
city: Kawasaki city
country: Japan
facility: Hatori Medical Clinic
state: Kanagawa pref.
city: Kawasaki city
country: Japan
facility: Hirayasu Iin
state: Kanagawa pref.
city: Kawasaki city
country: Japan
facility: Kamegaya Medical Clinic
state: Kanagawa pref.
city: Kawasaki city
country: Japan
facility: Kirimura Iin
state: Kanagawa pref.
city: Odawara city
country: Japan
facility: Kojima Clinic
state: Kanagawa pref.
city: Sagamihara city
country: Japan
facility: Hakuai Iin
state: Kanagawa pref.
city: Sagamihara city
country: Japan
facility: Sato Clinic
state: Kanagawa pref.
city: Sagamihara city
country: Japan
facility: Toshiba Rinkan Hospital
state: Kanagawa pref.
city: Sagamihara city
country: Japan
facility: Yamamoto Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Fukumura Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Fukushi Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: International Goodwill Hospital
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Kikuchi Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Matsuo Naika Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Miho-cho Cardiovascular Medical Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Minamisawa Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Miyoshi-Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Paula's Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Shimokurata Heart Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Shinwakai Fukuda Iin
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Shinyoshida Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Suzuki Orthopedic Clinic
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Yokohama City University Medical Center
state: Kanagawa pref.
city: Yokohama city
country: Japan
facility: Yokohama Sotetsu bldg. clinic of internal medicine
state: Kanagawa pref.
city: Yokosuka City
country: Japan
facility: Hara Clinic
state: Kanagawa pref.
city: Kochi city
country: Japan
facility: Ueta Medical Clinic
state: Kochi pref.
city: Amakusa city
country: Japan
facility: Nakayama Cardiovascular Clinic
state: Kumamoto pref.
city: Amakusa city
country: Japan
facility: Yamashita Clinic
state: Kumamoto pref.
city: Aso city
country: Japan
facility: National Health Insurance Central Hospital Aso
state: Kumamoto pref.
city: Aso city
country: Japan
facility: Sakanashi Heart Clinic
state: Kumamoto pref.
city: Kamimashiki gun
country: Japan
facility: Koyasako iin
state: Kumamoto pref.
city: Kikuchi city
country: Japan
facility: Kawaguchi Hospital
state: Kumamoto pref.
city: Kikuchi city
country: Japan
facility: Miyamoto Internal Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Doi Cardiovascular Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Doi Naika-ichoka Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Haraguchi Circular&Internal Medical Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Jinnouchi Clinic Diabetes Care Center
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Kiyota Junkanki Naika Iin
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Maki Cardiovascular Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Nozuhara Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Ootsuka Hospital
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Shono Heart Clinic
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Suefuji Naika Junkankika
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Suizenji Tohya Hospital
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Terao Hospital
state: Kumamoto pref.
city: Kumamoto city
country: Japan
facility: Yi Medical Clinic
state: Kumamoto pref.
city: Shimomashiki gun
country: Japan
facility: Munakata Clinic
state: Kumamoto pref.
city: Tamana city
country: Japan
facility: Higashi Diabetes and Cardiovascular Clinic
state: Kumamoto pref.
city: Tamana city
country: Japan
facility: Yoshimura Jyunnkannkika Naika Iinn
state: Kumamoto pref.
city: Tamana gun
country: Japan
facility: Universal Shipbuilding Co. Ariake Shipyard Ariake Infirmary
state: Kumamoto pref.
city: Yatsushiro city
country: Japan
facility: Miyagi Clinic Cardiovascular Medicine
state: Kumamoto pref.
city: Kizugawa-city
country: Japan
facility: Koide Iin
state: Kyoto pref.
city: Kyotanabe city
country: Japan
facility: Sawai medical Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Asamoto Clinic of Internal Medicine
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Gotoh Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Higashiyama Takeda Hospital
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Isoda Internal Medical Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Omoto Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Sakazaki Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Shinya Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Takagi Cardiology Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Takenaka Clinic
state: Kyoto pref.
city: Kyoto city
country: Japan
facility: Tegoshi Clinic
state: Kyoto pref.
city: Yosa gun
country: Japan
facility: Kimura Naika Clinic
state: Kyoto pref.
city: Ise city
country: Japan
facility: Shimizu Clinic
state: Mie pref.
city: Nabari city
country: Japan
facility: Horii Clinic Kiodai
state: Mie pref.
city: Higashi matsushima city
country: Japan
facility: Yamoto-naika Clinic
state: Miyagi pref.
city: Kurokawa gun
country: Japan
facility: Seisuikai Yoshioka QQ Clinic
state: Miyagi pref.
city: Tome City
country: Japan
facility: Ohtomo Clinic
state: Miyagi pref.
city: Shimoina gun
country: Japan
facility: Shimoina Kosei Hospital
state: Nagano pref.
city: Shiojiri city
country: Japan
facility: Yokoyama Medical Clinic
state: Nagano pref.
city: Suzaka city
country: Japan
facility: Sato Clinic
state: Nagano pref.
city: Nagasaki city
country: Japan
facility: Hoshiko Clinic
state: Nagasaki pref.
city: Nagasaki city
country: Japan
facility: Shinagawa Clinic
state: Nagasaki pref.
city: Nishisonogi gun
country: Japan
facility: Iryohojin Yamamoto Naika
state: Nagasaki pref.
city: Gojo city
country: Japan
facility: Yamada Clinic
state: Nara pref.
city: Ikoma city
country: Japan
facility: Uyama Naika Clinic
state: Nara pref.
city: Kahihara city
country: Japan
facility: Clinic Jinguumae
state: Nara pref.
city: Kahihara city
country: Japan
facility: Kasahara Clinic
state: Nara pref.
city: Kashiba city
country: Japan
facility: Sawada Clinic
state: Nara pref.
city: Kashihara city
country: Japan
facility: Doi Clinic
state: Nara pref.
city: Kashihara city
country: Japan
facility: Medical Corporation Kiriyama Clinic
state: Nara pref.
city: Kashihara city
country: Japan
facility: Miyamoto Clinic
state: Nara pref.
city: Kashihara city
country: Japan
facility: Oosumi Naika Iin
state: Nara pref.
city: Kitakatsuragi gun
country: Japan
facility: Kondo Clinic Mamigaoka Purified Center
state: Nara pref.
city: Kitakatsuragi gun
country: Japan
facility: Matsuoka Clinic
state: Nara pref.
city: Kitakatsuragi gun
country: Japan
facility: Nakahori Iin
state: Nara pref.
city: Kitakatsuragi gun
country: Japan
facility: Seiwadai Clinic
state: Nara pref.
city: Nara city
country: Japan
facility: Saiseikai Nara Hospital
state: Nara pref.
city: Nara city
country: Japan
facility: Takanohara Central Hospital
state: Nara pref.
city: Nara city
country: Japan
facility: Takanohara Suzuran-naika
state: Nara pref.
city: Sakurai city
country: Japan
facility: Ote Clinic of Internal Medicine
state: Nara pref.
city: Sakurai city
country: Japan
facility: Sakaguchi Clinic
state: Nara pref.
city: Shiki gun
country: Japan
facility: Kokuho Central Hospital
state: Nara pref.
city: Yamatokoriyama city
country: Japan
facility: Makiura Naika
state: Nara pref.
city: Yamatokoriyama city
country: Japan
facility: Matsuta Heart Clinic
state: Nara pref.
city: Yamatotakada city
country: Japan
facility: Nakatani Clinic
state: Nara pref.
city: Murakami city
country: Japan
facility: Sano Clinic
state: Niigata pref.
city: Nagaoka city
country: Japan
facility: Kawaguchi Clinic
state: Niigata pref.
city: Niigata city
country: Japan
facility: Maeda Medical Clinic
state: Niigata pref.
city: Beppu city
country: Japan
facility: Watanabe NJ Clinic
state: Oiat pref.
city: Oita city
country: Japan
facility: Hirata Clinic
state: Oiat pref.
city: Oita city
country: Japan
facility: Ninomiya Clinic
state: Oiat pref.
city: Oita city
country: Japan
facility: Sumi Cardiology Clinic
state: Oiat pref.
city: Oita city
country: Japan
facility: Tokumaru Digestive Internal Medicine Clinic
state: Oiat pref.
city: Oita city
country: Japan
facility: Tsuzaki Clinic
state: Oiat pref.
city: Usa city
country: Japan
facility: Ishida Medical Clinic
state: Oiat pref.
city: Kurashiki city
country: Japan
facility: Hachiouji Naika Clinic
state: Okayama pref.
city: Kurashiki city
country: Japan
facility: Inada Clinic
state: Okayama pref.
city: Okayama city
country: Japan
facility: Hisamatsu Medical Clinic
state: Okayama pref.
city: Okayama city
country: Japan
facility: Yuhara Naika Clinic
state: Okayama pref.
city: Setouchi city
country: Japan
facility: Hattori Clinic
state: Okayama pref.
city: Fujiidera city
country: Japan
facility: Nishimura Clinic
state: Osaka pref.
city: Higashiosaka city
country: Japan
facility: Ikeda Clinic
state: Osaka pref.
city: Higashiosaka city
country: Japan
facility: Ogawa Clinic
state: Osaka pref.
city: Hirakata city
country: Japan
facility: Taisei Clinic
state: Osaka pref.
city: Ibaraki city
country: Japan
facility: Ishiga Clinic
state: Osaka pref.
city: Ibaraki city
country: Japan
facility: Masuda Clinic
state: Osaka pref.
city: Izumi city
country: Japan
facility: Kanazawa Clinic
state: Osaka pref.
city: Kaizuka city
country: Japan
facility: Misugi Clinic
state: Osaka pref.
city: Kaizuka city
country: Japan
facility: Yoshida Clinic
state: Osaka pref.
city: Kishiwada city
country: Japan
facility: Mori Iin
state: Osaka pref.
city: Moriguchi city
country: Japan
facility: Medical Corporation Joukokai Teranishi-geka naika
state: Osaka pref.
city: Osaka city
country: Japan
facility: Iryouhoujin Suisyoukai Murata Hospital
state: Osaka pref.
city: Osaka city
country: Japan
facility: Izuoka Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Keiju Hospital
state: Osaka pref.
city: Osaka city
country: Japan
facility: Kondo Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Kubota Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Matsushita Medical Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Nishizawa Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Osaka General Medical Center
state: Osaka pref.
city: Osaka city
country: Japan
facility: Senpuku Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Tai Internal Medicin Clinic
state: Osaka pref.
city: Osaka city
country: Japan
facility: Ueda Clinic
state: Osaka pref.
city: Sakai city
country: Japan
facility: Ohta Iin
state: Osaka pref.
city: Suita city
country: Japan
facility: Ban Clinic
state: Osaka pref.
city: Suita city
country: Japan
facility: Iryohojin Nogi Naika Iin
state: Osaka pref.
city: Suita city
country: Japan
facility: Kobayashi Clinic
state: Osaka pref.
city: Takaishi city
country: Japan
facility: Ichida Internal Clinic
state: Osaka pref.
city: Takaishi city
country: Japan
facility: Yada Clinic
state: Osaka pref.
city: Takatsuki city
country: Japan
facility: Ryo Clinic
state: Osaka pref.
city: Yao city
country: Japan
facility: Matsuo Clinic
state: Osaka pref.
city: Ageo city
country: Japan
facility: Enomoto Clinic
state: Saitama pref.
city: Hanyu city
country: Japan
facility: Medimo Hanyu Clinic
state: Saitama pref.
city: Kawagoe city
country: Japan
facility: Hirose Hospital
state: Saitama pref.
city: Kawaguchi city
country: Japan
facility: Iryohojin Hogi Shinryojo
state: Saitama pref.
city: Kawaguchi city
country: Japan
facility: Tokutake Iin
state: Saitama pref.
city: Koshigaya city
country: Japan
facility: Gamo Tenjinbashi Clinic
state: Saitama pref.
city: Koshigaya city
country: Japan
facility: Matsumoto Clinic
state: Saitama pref.
city: Kumagaya city
country: Japan
facility: Medical Corporation Shibuya Clinic
state: Saitama pref.
city: Saitama city
country: Japan
facility: Akimoto Clinic
state: Saitama pref.
city: Saitama city
country: Japan
facility: Iwatsuki-minami Hospital
state: Saitama pref.
city: Saitama city
country: Japan
facility: Suzuhiro Clinic
state: Saitama pref.
city: Tokorozawa City
country: Japan
facility: Nashida naika clinic
state: Saitama pref.
city: Shimoda city
country: Japan
facility: Shizuoka Medical Alliance Shirahama Chuou Clinic
state: Shizuoka pref.
city: Shizuoka city
country: Japan
facility: Akiyama Clinic
state: Shizuoka pref.
city: Shizuoka city
country: Japan
facility: Aoshima Clinic
state: Shizuoka pref.
city: Shizuoka city
country: Japan
facility: Eguchi Clinic
state: Shizuoka pref.
city: Shizuoka city
country: Japan
facility: Shizuoka Hospital
state: Shizuoka pref.
city: Yaizu city
country: Japan
facility: Ueno Clinic
state: Shizuoka pref.
city: Ohtawara city
country: Japan
facility: Takahashi Medical Clinic
state: Tochigi pref.
city: Oyama city
country: Japan
facility: Iryouhoujin Yuukoukai Morioka Naika Shonika
state: Tochigi pref.
city: Tochigi city
country: Japan
facility: Takada Clinic
state: Tochigi pref.
city: Utsunomiya city
country: Japan
facility: Masuda Naika
state: Tochigi pref.
city: Anan city
country: Japan
facility: Murakami Clinic
state: Tokushima pref.
city: Itano gun
country: Japan
facility: Fukushima Clinic
state: Tokushima pref.
city: Itano gun
country: Japan
facility: Yamamoto Naika Ityoka
state: Tokushima pref.
city: Kaifu gun
country: Japan
facility: Yuki National Health Insurance Hospital Of Minami Town
state: Tokushima pref.
city: Komatsushima city
country: Japan
facility: Sekishinkan Hospital
state: Tokushima pref.
city: Myozai gun
country: Japan
facility: Ueta Clinic
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Kensei Uchimachi Clinic
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Kitagawa Naika Ityoka
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Kitasako Clinic
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Limbs Tokushima Clinic
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Matsumura Internal, Gastrointestial Medicine
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Okagawa Clinic
state: Tokushima pref.
city: Tokushima city
country: Japan
facility: Yokoi Internal Medicine
state: Tokushima pref.
city: Yoshinokawa city
country: Japan
facility: Kimura Internal Medicine Clinic
state: Tokushima pref.
city: Yoshinokawa city
country: Japan
facility: Yata Clinic
state: Tokushima pref.
city: Akishima city
country: Japan
facility: Okubo Clinic
state: Tokyo
city: Bunkyo ku
country: Japan
facility: Juntendo University Hospital
state: Tokyo
city: Edogawa ku
country: Japan
facility: Choei Clinic
state: Tokyo
city: Edogawa ku
country: Japan
facility: Shiraishi Iin
state: Tokyo
city: Hachioji city
country: Japan
facility: Hattori Clinic
state: Tokyo
city: Hachioji city
country: Japan
facility: Toyoizumi Hospital
state: Tokyo
city: Hachioji City
country: Japan
facility: Utsugidai Tajima Clinic
state: Tokyo
city: Itabashi ku
country: Japan
facility: Mochizuki Naika Clinic
state: Tokyo
city: Itabashi ku
country: Japan
facility: Nishio Clinic
state: Tokyo
city: Koto ku
country: Japan
facility: Ono Heart Clinic
state: Tokyo
city: Minato-ku
country: Japan
facility: Shiba Palace Clinic
state: Tokyo
city: Mitaka city
country: Japan
facility: Kamada Clinic
state: Tokyo
city: Mitaka city
country: Japan
facility: Tenjinmae Clinic
state: Tokyo
city: Mitaka-shi
country: Japan
facility: Takayama Iin
state: Tokyo
city: Nerima ku
country: Japan
facility: Sugawara Clinic
state: Tokyo
city: Ota-ku
country: Japan
facility: Yamada Clinic
state: Tokyo
city: Setagaya ku
country: Japan
facility: Matsumura Gastroenterological Clinic
state: Tokyo
city: Shinjuku ku
country: Japan
facility: Magari Clinic
state: Tokyo
city: Shinjuku ku
country: Japan
facility: Yotsuya Internal Medicine Clinic
state: Tokyo
city: Shinjuku ku
country: Japan
facility: Yotsuya-Murakami Internal Medicine Clinic
state: Tokyo
city: Sumida city
country: Japan
facility: Obayashi Clinic
state: Tokyo
city: Sumida ku
country: Japan
facility: Sumidagawa Clinic
state: Tokyo
city: Tachikawa-shi
country: Japan
facility: ISHII Medical Clinic
state: Tokyo
city: Murayama city
country: Japan
facility: Takahashi Ko Minako Clinic
state: Yamagata pref.
city: Obanazawa city
country: Japan
facility: Obanazawa City Clinic
state: Yamagata pref.
city: Obanazawa city
country: Japan
facility: Okuyama Clinic
state: Yamagata pref.
city: Obanazawa city
country: Japan
facility: Sakae Clinic
state: Yamagata pref.
city: Sakata city
country: Japan
facility: Honma Clinic
state: Yamagata pref.
city: Yamagata city
country: Japan
facility: Isoda Clinic
state: Yamagata pref.
city: Yamagata city
country: Japan
facility: Nihei Clinic
state: Yamagata pref.
city: Yamagata city
country: Japan
facility: Shimasaki Clinic
state: Yamagata pref.
city: Yamagata city
country: Japan
facility: Yamagata Tokushukai Hospital
state: Yamagata pref.
city: Iwakuni city
country: Japan
facility: Iwasaki Naika Iin
state: Yamaguchi pref.
city: Iwakuni city
country: Japan
facility: Kuwahara Clinic
state: Yamaguchi pref.
city: Shimonoseki city
country: Japan
facility: Ayame Medical Clinic
state: Yamaguchi pref.
city: Shimonoseki city
country: Japan
facility: Johno Clinic
state: Yamaguchi pref.
city: Shimonoseki city
country: Japan
facility: Matsuda Medical Clinic
state: Yamaguchi pref.
city: Shimonoseki city
country: Japan
facility: Mizumachi Medical Clinic
state: Yamaguchi pref.
city: Shimonoseki city
country: Japan
facility: Noda Clinic
state: Yamaguchi pref.
city: Ube City
country: Japan
facility: Fujii Clinic
state: Yamaguchi pref.
city: Ube City
country: Japan
facility: Shakaiiryouhoujin Onaka Hospital
state: Yamaguchi pref.
city: Ube city
country: Japan
facility: Watada-naika Hospital
state: Yamaguchi pref.
city: Yamaguchi city
country: Japan
facility: Ouchi Clinic
state: Yamaguchi pref.
city: Chuo city
country: Japan
facility: Yoshizaki Clinic
state: Yamanashi pref.
city: Nishi Yatsushiro gun
country: Japan
facility: Takahashi Clinic
state: Yamanashi pref.
city: Tsuru city
country: Japan
facility: Higashikatsura Medical Clinic
state: Yamanashi pref.
city: Aomori city
country: Japan
facility: Fukushi Clinic
city: Ayase city
country: Japan
facility: Kashiwagi Clinic
city: Chigasaki city
country: Japan
facility: Hayashi Diabetes Clinic
city: Joetsu city
country: Japan
facility: Uchiyama Clinic
city: Kamiinagun
country: Japan
facility: Nitta Medical Clinic
city: Kawasaki city
country: Japan
facility: Imai Clinic
city: Kitakyusyu City
country: Japan
facility: Tani Clinic
city: Koganei city
country: Japan
facility: Marumo Clinic
city: Kyoto city
country: Japan
facility: Ihara Clinic
city: Matsudo city
country: Japan
facility: Goko-Hospital
city: Moka city
country: Japan
facility: Satou Clinic
city: Nirasaki city
country: Japan
facility: Iino Clinic
city: Osaka City
country: Japan
facility: Miura Clinic
city: Otsuki City
country: Japan
facility: Kuroda Iin
city: Sendai city
country: Japan
facility: Sasaki Clinic
city: Shiki city
country: Japan
facility: Kamata Clinic of Internal Medicine
city: Shimoda city
country: Japan
facility: Nishikawa Clinic
city: Shimoinagun
country: Japan
facility: Satou Iin
city: Shinshiro city
country: Japan
facility: Kumagai Clinic
city: Toyokawa city
country: Japan
facility: Suzuki Clinic
city: Yamagata city
country: Japan
facility: Benibana Clinic
city: Yokohama city
country: Japan
facility: Fujimi Clinic
city: Yokohama city
country: Japan
facility: Hongo Clinic
city: Yokohama city
country: Japan
facility: Jiyukai Yamada Naika
city: Yokohama city
country: Japan
facility: Shonan Ochanomizu Clinic
city: Yokohama city
country: Japan
facility: Tani Clinic Internal Medicine, Allergology & Rheumatology
Study officials:
References: