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Efficacy & Safety of Resatorvid in Adults With Severe Sepsis

Primary Purpose

Sepsis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Resatorvid
Resatorvid
Placebo
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sepsis focused on measuring Shock, Septic, Sepsis Syndrome, Respiratory Insufficiency, SIRS (Systemic Inflammatory Response Syndrome), Respiratory Failure, Drug Therapy

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Has clinical evidence of infection defined as the presence of a known or probable source of infection requiring the initiation of parenteral antimicrobial therapy. Must meet at least 3 of the following 4 criteria for SIRS: A core temperature greater than 38°C or less than 36°C. A heart rate greater than 90 beats per minute. A respiratory rate greater than 20 breaths/min or partial pressure of carbon dioxide in arterial blood less than 32 mm Hg or mechanical ventilation for an acute process. A total white blood cell absolute count greater than 12,000 cells/mm3 or less than 4,000 cells/mm3, or a white blood cell differential count that showed greater than 10% immature (band) forms. Must have sepsis with shock and/or respiratory failure. Exclusion Criteria If female, the subject is pregnant, nursing and the milk is intended to be ingested by the infant, or the participant plans to become pregnant, or nurse and the milk is intended to be ingested by the infant. Is receiving immunosuppressive therapy such as cyclosporine, azathioprine, or cancer-related chemotherapy. Has a granulocyte count of less than 1000/mm3 except if the decreased count was believed to be due to sepsis. Has documented or suspected acute myocardial infarction within the last 6 weeks prior to Pretreatment Period. Has a documented history of moderate to severe chronic heart failure as defined by New York Heart Association Functional Classification III or IV. Is known to be positive for human immunodeficiency virus with known CD4 count less than or equal to 50/mm3 or had known end-stage processes. Has a known history of glucose-6-phosphate dehydrogenase deficiency. Has a methemoglobin level greater than 5% at Pretreatment Period or had a known history of methemoglobinemia. Is moribund and death was considered imminent. Is classified as "Do Not Resuscitate", or "Do Not Treat", or the participant's family has not committed to aggressive management of the participant's condition. Is not expected to survive for 28 days and was not likely be given life support due to a pre-existing, uncorrectable medical condition. Has a known esophageal varices, chronic jaundice, cirrhosis, or chronic ascites. Is in a chronic vegetative state or has a similar long-term neurological condition. Has known portal hypertension or Child-Pugh hepatic impairment class C. Has acute third degree burns involving more than 30% of body surface within 120 hours prior to Pretreatment Period. Has known hypersensitivity to sulfonamides. Has known hypersensitivity to components of resatorvid. Has participated in any other investigational study (drug or device) and/or taken any investigational drug within 30 days or 5 half-lives of the drug.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Resatorvid 1.2 mg/kg/day

Resatorvid 2.4 mg/kg/day

Placebo

Arm Description

Outcomes

Primary Outcome Measures

28-day All-cause Mortality.

Secondary Outcome Measures

Change from Baseline in Organ Failure Assessment
Mean Systemic Inflammatory Response
Mean Vasopressor-free days
Mean Ventilator-free days
Mean Intensive Care Unit free days
Mean Discharge Status.

Full Information

First Posted
August 31, 2005
Last Updated
January 31, 2012
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT00143611
Brief Title
Efficacy & Safety of Resatorvid in Adults With Severe Sepsis
Official Title
A Pivotal, Multicenter, Multinational, Randomized, Double-Blind, Placebo-Controlled Study To Evaluate The Efficacy And Safety of TAK-242 in Adults With Severe Sepsis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
September 2005 (undefined)
Primary Completion Date
February 2007 (Actual)
Study Completion Date
February 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the optimal dose of Resatorvid for reducing 28-day all-cause mortality in subjects with severe sepsis.
Detailed Description
Severe sepsis, defined as sepsis associated with acute organ dysfunction, remains a serious medical problem worldwide. In the United States alone, approximately 750,000 cases of severe sepsis occur each year, with the mortality rate ranging between 30% and 50% for severe sepsis patients with concomitant organ dysfunction. As the population ages, these numbers are expected to increase. The pathophysiology of severe sepsis is thought to involve the activation of a variety of inflammatory and procoagulant host responses to infection, which if unchecked, can lead to diffuse endovascular injury, multi-organ dysfunction, and ultimately death. The host response to infection with microorganism and microorganism-derived molecules is characterized by the synthesis and release of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) and interleukins 1, 6 and 8 (IL-1, IL-6, and IL-8), by inflammatory cells, and by other markers of inflammation such as C-reactive protein. Inflammatory cells, such as macrophages, release these cytokines by signals transmitted from the surface of these cells after binding of pathogen-associated molecules to cell surface pattern recognition receptors known as toll-like receptors. TAK-242 (resatorvid) is a small molecule suppressor of pathogen-induced release of inflammatory cytokines and acts by inhibiting TLR-4 mediated signaling. Because of its inhibitory effect on suppressing cytokine levels, resatorvid is being developed as a treatment for severe sepsis. The study was ended after the DSMB determined there was insufficient cytokine suppression in the 150-subject analysis within Stage 1 of the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sepsis
Keywords
Shock, Septic, Sepsis Syndrome, Respiratory Insufficiency, SIRS (Systemic Inflammatory Response Syndrome), Respiratory Failure, Drug Therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
277 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Resatorvid 1.2 mg/kg/day
Arm Type
Experimental
Arm Title
Resatorvid 2.4 mg/kg/day
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Resatorvid
Other Intervention Name(s)
TAK-242
Intervention Description
Resatorvid 1.2 mg/kg, injection, subcutaneously for thirty minutes; then resatorvid 0.05 mg/kg/h (1.2 mg/kg/day), injection, subcutaneously over 96 hours.
Intervention Type
Drug
Intervention Name(s)
Resatorvid
Other Intervention Name(s)
TAK-242
Intervention Description
Resatorvid 1.2 mg/kg, injection, subcutaneously for thirty minutes; then resatorvid 0.1 mg/kg/h (2.4 mg/kg/day), injection, subcutaneously over 96 hours.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Resatorvid placebo-matching injection, subcutaneously for thirty minutes; then resatorvid placebo-matching injection, subcutaneously over 96 hours.
Primary Outcome Measure Information:
Title
28-day All-cause Mortality.
Time Frame
Day 28
Secondary Outcome Measure Information:
Title
Change from Baseline in Organ Failure Assessment
Time Frame
Day 28
Title
Mean Systemic Inflammatory Response
Time Frame
Day 28
Title
Mean Vasopressor-free days
Time Frame
Day 28
Title
Mean Ventilator-free days
Time Frame
Day 28
Title
Mean Intensive Care Unit free days
Time Frame
Day 28
Title
Mean Discharge Status.
Time Frame
Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Has clinical evidence of infection defined as the presence of a known or probable source of infection requiring the initiation of parenteral antimicrobial therapy. Must meet at least 3 of the following 4 criteria for SIRS: A core temperature greater than 38°C or less than 36°C. A heart rate greater than 90 beats per minute. A respiratory rate greater than 20 breaths/min or partial pressure of carbon dioxide in arterial blood less than 32 mm Hg or mechanical ventilation for an acute process. A total white blood cell absolute count greater than 12,000 cells/mm3 or less than 4,000 cells/mm3, or a white blood cell differential count that showed greater than 10% immature (band) forms. Must have sepsis with shock and/or respiratory failure. Exclusion Criteria If female, the subject is pregnant, nursing and the milk is intended to be ingested by the infant, or the participant plans to become pregnant, or nurse and the milk is intended to be ingested by the infant. Is receiving immunosuppressive therapy such as cyclosporine, azathioprine, or cancer-related chemotherapy. Has a granulocyte count of less than 1000/mm3 except if the decreased count was believed to be due to sepsis. Has documented or suspected acute myocardial infarction within the last 6 weeks prior to Pretreatment Period. Has a documented history of moderate to severe chronic heart failure as defined by New York Heart Association Functional Classification III or IV. Is known to be positive for human immunodeficiency virus with known CD4 count less than or equal to 50/mm3 or had known end-stage processes. Has a known history of glucose-6-phosphate dehydrogenase deficiency. Has a methemoglobin level greater than 5% at Pretreatment Period or had a known history of methemoglobinemia. Is moribund and death was considered imminent. Is classified as "Do Not Resuscitate", or "Do Not Treat", or the participant's family has not committed to aggressive management of the participant's condition. Is not expected to survive for 28 days and was not likely be given life support due to a pre-existing, uncorrectable medical condition. Has a known esophageal varices, chronic jaundice, cirrhosis, or chronic ascites. Is in a chronic vegetative state or has a similar long-term neurological condition. Has known portal hypertension or Child-Pugh hepatic impairment class C. Has acute third degree burns involving more than 30% of body surface within 120 hours prior to Pretreatment Period. Has known hypersensitivity to sulfonamides. Has known hypersensitivity to components of resatorvid. Has participated in any other investigational study (drug or device) and/or taken any investigational drug within 30 days or 5 half-lives of the drug.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
VP Clinical Science
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
City
Birmingham
State/Province
Alabama
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United States
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Mobile
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Alabama
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United States
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Phoenix
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Scottsdale
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Arizona
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Escondido
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Los Angeles
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Orange
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Poway
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San Diego
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Colorado Springs
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Colorado
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New Haven
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Newark
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Delaware
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Atlantis
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Bay Pines
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Jacksonville
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Miami
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Orlando
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Sarasota
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Atlanta
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Augusta
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Chicago
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Illinois
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Peoria
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Indianapolis
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Des Moines
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Louisville
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Kentucky
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Shreveport
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Portland
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Baltimore
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Springfield
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Kalamazoo
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Kansas City
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St. Louis
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Butte
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Englewood
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Buffalo
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New York
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Rochester
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Greensboro
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Winston-Salem
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Akron
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Columbus
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Oklahoma City
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Greenville
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Galveston
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Houston
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Lubbock
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Bellevue
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Adelaide
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Australia
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Fremantle
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Australia
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Heidelberg
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Australia
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Linz
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Austria
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Wien
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Austria
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Aalst
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Belgium
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Antwerpen
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Belgium
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Brussel
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Belgium
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Bruxelles
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Belgium
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Genk
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Belgium
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Gent
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Belgium
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Liege
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Belgium
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Ottignies
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Belgium
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Yvoir
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Belgium
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Calgary
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Vancouver
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Canada
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Victoria
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Winnipeg
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Halifax
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London
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Ontario
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Brno
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Havlickuv Brod
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Hradec Kralove
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Opava
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Pilsen
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Prague
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Helsinki
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Finland
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Joensuu
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Finland
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Kokkola
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Finland
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Kuopio
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Finland
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Lappeenranta
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Finland
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Oulu
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Finland
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Seinajoki
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Finland
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Tampere
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Finland
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Turku
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Finland
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Berlin
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Germany
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Dresden
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Germany
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Erfurt
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Germany
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Jena
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Germany
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Krefeld
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Germany
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Ludwigshafen
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Germany
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Mannheim
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Germany
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Munchen
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Germany
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Wuppertal
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Germany
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Afula
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Israel
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Ashkelon
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Israel
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Haifa
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Israel
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Holon
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Israel
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Jerusalem
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Israel
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Kfar Saba
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Israel
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Petach-Tikva
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Israel
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Zerifin
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Israel
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Lecco
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Italy
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Monza
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Italy
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Pavia
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Italy
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Chiba
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Japan
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Fukuoka
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Japan
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Hiroshima
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Japan
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Hokkaido
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Japan
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Iwate
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Japan
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Kumamoto
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Japan
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Kyoto
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Japan
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Osaka
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Japan
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Shizuoka
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Japan
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Tokyo
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Japan
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Yamaguchi
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Japan
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Apeldoorn
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Netherlands
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Groningen
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Netherlands
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Leeuwarden
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Netherlands
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Nijmegen
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Netherlands
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Rotterdam
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Netherlands
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s-Hertogenbosch
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Netherlands
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Tilburg
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Netherlands
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Auckland
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New Zealand
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Christchurch
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New Zealand
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Hastings
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New Zealand
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Tauranga
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New Zealand
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San Juan
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Puerto Rico
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Barcelona
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Spain
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Getafe
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Spain
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Madrid
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Spain
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Valladolid
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Spain
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Vitoria
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Spain
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Gavle
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Sweden
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Goteborg
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Sweden
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Karlstad
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Sweden
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Kristianstad
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Sweden
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Linkoping
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Sweden
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Lund
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Sweden
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Stockholm
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Sweden
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Uppsala
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Sweden
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Brighton
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United Kingdom
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Glasgow
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United Kingdom
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Leeds
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United Kingdom
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Livingston
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United Kingdom
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London
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
20562702
Citation
Rice TW, Wheeler AP, Bernard GR, Vincent JL, Angus DC, Aikawa N, Demeyer I, Sainati S, Amlot N, Cao C, Ii M, Matsuda H, Mouri K, Cohen J. A randomized, double-blind, placebo-controlled trial of TAK-242 for the treatment of severe sepsis. Crit Care Med. 2010 Aug;38(8):1685-94. doi: 10.1097/CCM.0b013e3181e7c5c9.
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Efficacy & Safety of Resatorvid in Adults With Severe Sepsis

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