Ignite Creation Date:
2025-12-25 @ 5:08 AM
Ignite Modification Date:
2025-12-26 @ 4:12 AM
Study NCT ID:
NCT05814627
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-12-23
First Post:
2023-04-04
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Study to Assess Change in Disease Activity and Adverse Events of Oral Upadacitinib Compared to Subcutaneous Adalimumab in Adult Participants With Moderate to Severe Rheumatoid Arthritis
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D001172', 'term': 'Arthritis, Rheumatoid'}], 'ancestors': [{'id': 'D001168', 'term': 'Arthritis'}, {'id': 'D007592', 'term': 'Joint Diseases'}, {'id': 'D009140', 'term': 'Musculoskeletal Diseases'}, {'id': 'D012216', 'term': 'Rheumatic Diseases'}, {'id': 'D003240', 'term': 'Connective Tissue Diseases'}, {'id': 'D017437', 'term': 'Skin and Connective Tissue Diseases'}, {'id': 'D001327', 'term': 'Autoimmune Diseases'}, {'id': 'D007154', 'term': 'Immune System Diseases'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C000613732', 'term': 'upadacitinib'}, {'id': 'D000068879', 'term': 'Adalimumab'}], 'ancestors': [{'id': 'D061067', 'term': 'Antibodies, Monoclonal, Humanized'}, {'id': 'D000911', 'term': 'Antibodies, Monoclonal'}, {'id': 'D000906', 'term': 'Antibodies'}, {'id': 'D007136', 'term': 'Immunoglobulins'}, {'id': 'D007162', 'term': 'Immunoproteins'}, {'id': 'D001798', 'term': 'Blood Proteins'}, {'id': 'D011506', 'term': 'Proteins'}, {'id': 'D000602', 'term': 'Amino Acids, Peptides, and Proteins'}, {'id': 'D012712', 'term': 'Serum Globulins'}, {'id': 'D005916', 'term': 'Globulins'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'QUADRUPLE', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 487}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2023-06-15', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-12', 'completionDateStruct': {'date': '2026-07', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-12-20', 'studyFirstSubmitDate': '2023-04-04', 'studyFirstSubmitQcDate': '2023-04-04', 'lastUpdatePostDateStruct': {'date': '2025-12-23', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2023-04-18', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2026-07', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Percentage of Participants Achieving Disease Activity Score 28 C-reactive Protein [DAS28-CRP]) <= 3.2', 'timeFrame': 'Week 12', 'description': "The DAS28-CRP is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (NRS), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28-CRP range from 0 to approximately 10, where higher scores indicate more disease activity. Low Disease Activity (LDA) based on DAS28 (CRP) is defined as achieving a DAS28 (CRP) of less than or equal to 3.2."}, {'measure': 'Number of Participants with Adverse Events', 'timeFrame': 'From first dose of study drug until 70 days following last dose of study drug (up to approximately 58 weeks)', 'description': 'An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not the event is considered causally related to the use of the product.'}], 'secondaryOutcomes': [{'measure': 'Percentage of Participants Achieving American College of Rheumatology 50 % (ACR50) Response', 'timeFrame': 'Week 12', 'description': "Participants who met the following 3 conditions for improvement from baseline were classified as meeting the ACR50 response criteria:\n\n* 50% improvement in tender joint count (TJC68);\n* 50% improvement in swollen joint count (SJC66); and\n* 50% improvement in at least 3 of the 5 following parameters:\n\n * Physician's Global Assessment of Disease Activity measured on a Numerical Rating Scale of 0 to 10 (NRS)\n * Patient's Global Assessment of Disease Activity (NRS)\n * Patient's Assessment of Pain (NRS)\n * Health Assessment Questionnaire - Disability Index (HAQ-DI)\n * High-sensitivity C-reactive protein (hsCRP)."}, {'measure': 'Percentage of Participants Achieving Disease Activity Score 28 C-reactive Protein [DAS28-CRP]) < 2.6', 'timeFrame': 'Week 12', 'description': "The DAS28-CRP is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (NRS), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28-CRP range from 0 to approximately 10, where higher scores indicate more disease activity. Clinical remission (CR) based on DAS28 (CRP) is defined as achieving a DAS28 (CRP) of less than 2.6."}, {'measure': 'Change from Baseline in Disease Activity Score 28 C-reactive Protein [DAS28-CRP])', 'timeFrame': 'Week 12', 'description': "The DAS28-CRP is a composite index used to assess rheumatoid arthritis disease activity, calculated based on the tender joint count (out of 28 evaluated joints), swollen joint count (out of 28 evaluated joints), Patient's Global Assessment of Disease Activity (NRS), and high-sensitivity C-reactive protein (hsCRP; in mg/L). Scores on the DAS28-CRP range from 0 to approximately 10, where higher scores indicate more disease activity."}, {'measure': 'Change from Baseline in Participants Assessment of Pain', 'timeFrame': 'Week 12', 'description': "Participants indicated their level of pain over the last 7 days using the Patient's Global Assessment Pain NRS. The range is 0 to 10 with no activity being indicated by 0 and severe activity by 10."}, {'measure': 'Change from Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI) Score', 'timeFrame': 'Week 12', 'description': 'The HAQ-DI assesses physical function in RA. The HAQ-DI score is the average of the highest score in each of eight categories. The total score is between 0-3.0, in 0.125 increments. Increasing scores indicate worse functioning with 0 indicating no functional impairment and 3 indicating complete impairment.'}]}, 'oversightModule': {'isUsExport': True, 'oversightHasDmc': False, 'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Rheumatoid Arthritis', 'RA', 'Upadacitinib', 'Adalimumab', 'Methotrexate', 'MTX', 'TNF Inhibitor'], 'conditions': ['Rheumatoid Arthritis']}, 'referencesModule': {'seeAlsoLinks': [{'url': 'https://www.abbvieclinicaltrials.com/study/?id=M23-700', 'label': 'Related Info'}]}, 'descriptionModule': {'briefSummary': 'Rheumatoid Arthritis (RA) is a chronic inflammatory disease causing pain, stiffness, swelling and loss of joint function. This study will assess how safe and effective upadacitinib is in treating RA when compared to adalimumab in adult participants with inadequate response or intolerance to one TNF-inhibitor who are on a stable dose of methotrexate (MTX). Adverse events and change in disease activity will be assessed.\n\nUpadacitinib is an approved drug for the treatment of RA. This study is double-blinded means that neither the participants nor the study doctors will know who will be given upadacitinib and who will be given adalimumab. Study doctors put the participants in 1 of the 2 groups, called treatment arms randomly, to receive either upadacitinib or adalimumab. There is 1 in 2 chance that participants will receive adalimumab. Each group consists of 2 periods. Approximately 480 participants diagnosed with RA will be enrolled in approximately 250 sites across the world.\n\nParticipants will receive the oral upadacitinib once daily and matching adalimumab placebo every other week, or the subcutaneous adalimumab every other week and matching upadacitinib placebo once daily during Period 1. Eligible participants will continue to receive same study treatment in Period 2 as assigned in Period 1 and will be followed for 30 days and 70 days.\n\nThere may be higher treatment burden for participants in this trial compared to their standard of care. Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, checking for side effects and completing questionnaires.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Diagnosis of Rheumatoid Arthritis (RA) for \\>= 3 months based on the 2010 American College of Rheumatology/European Alliance of Associations for Rheumatology (ACR/EULAR) classification criteria for RA.\n* Treated for \\>= 3 consecutive months prior to screening with 1 tumor necrosis factor inhibitor (TNFi) (only 1 of originator or biosimilar certolizumab pegol, etanercept, golimumab or infliximab) for RA, but continue to exhibit active RA, or had to discontinue due to intolerability or toxicity, irrespective of treatment duration. Up to 15% of participants who were intolerant to 1 TNFi will be allowed to enroll. Prior administration of different biosimilar versions for the same originator TNFi or switching between originator and biosimilar version of the same originator TNFi are acceptable. Cycling between biosimilars of different originator TNF inhibitors is not acceptable.\n* On oral or parenteral methotrexate (MTX) therapy \\>= 3 consecutive months and on a stable prescription of 15 to 25 mg/week (or \\>= 10 mg/week in participants intolerant of MTX at doses \\>= 15 mg/week) for \\>= 4 weeks prior to the first dose of study drug. In addition, all participants should take a dietary supplement of folic acid or folinic acid throughout the study participation.\n\n * For a Chinese, Japanese, Korean, or Taiwanese participant, a stable dose of MTX \\>= 7.5 mg/week is acceptable.\n * Additional local requirements for MTX may apply.\n* Meets both of the following disease activity criteria:\n\n * \\>= 6 swollen joint (based on 66 joint counts) and \\>= 6 tender joints (based on 68 joint counts) at screening and baseline;\n * High-sensitivity C-reactive protein (hsCRP) \\>= 3 mg/L (central lab, upper limit of normal \\[ULN\\] 2.87 mg/L) at screening.\n\nExclusion Criteria:\n\n* History of any arthritis with onset prior to age 17 years or current diagnosis of inflammatory joint disease other than Rheumatoid Arthritis (RA).\n* Prior exposure to any janus kinase (JAK) inhibitor.\n* Prior exposure to adalimumab (original or biosimilar) or to any approved or investigational TNF inhibitor other than infliximab, etanercept, certolizumab pegol and golimumab.\n* Prior exposure to an approved or investigational non-TNFi biologic disease modifying anti-rheumatic drug (bDMARD) or targeted synthetic disease modifying antirheumatic drug (tsDMARD).'}, 'identificationModule': {'nctId': 'NCT05814627', 'acronym': 'SELECT- SWITCH', 'briefTitle': 'Study to Assess Change in Disease Activity and Adverse Events of Oral Upadacitinib Compared to Subcutaneous Adalimumab in Adult Participants With Moderate to Severe Rheumatoid Arthritis', 'organization': {'class': 'INDUSTRY', 'fullName': 'AbbVie'}, 'officialTitle': 'A Phase 3b/4 Randomized, Double-Blind, Double Dummy, Active Comparator-Controlled Study, Comparing the Efficacy and Safety of Upadacitinib Versus Adalimumab in Subjects With Moderate to Severe Rheumatoid Arthritis on a Stable Background of MTX and Who Had an Inadequate Response or Intolerance to a Single TNF Inhibitor (SELECT- SWITCH)', 'orgStudyIdInfo': {'id': 'M23-700'}, 'secondaryIdInfos': [{'id': '2022-502578-18-00', 'type': 'OTHER', 'domain': 'EU CT'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Upadacitinib+ Adalimumab matching Placebo', 'description': 'Participants will receive upadacitinib once a day along with matching placebo for adalimumab at eow (every other week) in Period 1. Eligible participants will continue to receive same study treatment in Period 2 as assigned in Period 1.', 'interventionNames': ['Drug: Upadacitinib', 'Drug: Adalimumab Matching Placebo']}, {'type': 'EXPERIMENTAL', 'label': 'Adalimumab + Upadacitinib matching Placebo', 'description': 'Participants will receive adalimumab at eow (every other week) along with matching placebo for upadacitinib once a day in Period 1. Eligible participants will continue to receive same study treatment in Period 2 as assigned in Period 1.', 'interventionNames': ['Drug: Adalimumab', 'Drug: Upadacitinib Matching Placebo']}], 'interventions': [{'name': 'Upadacitinib', 'type': 'DRUG', 'otherNames': ['RINVOQ'], 'description': 'Oral Tablets', 'armGroupLabels': ['Upadacitinib+ Adalimumab matching Placebo']}, {'name': 'Adalimumab', 'type': 'DRUG', 'otherNames': ['Humira'], 'description': 'Subcutaneous Injection', 'armGroupLabels': ['Adalimumab + Upadacitinib matching Placebo']}, {'name': 'Upadacitinib Matching Placebo', 'type': 'DRUG', 'description': 'Oral Tablets', 'armGroupLabels': ['Adalimumab + Upadacitinib matching Placebo']}, {'name': 'Adalimumab Matching Placebo', 'type': 'DRUG', 'description': 'Subcutaneous Injection', 'armGroupLabels': ['Upadacitinib+ Adalimumab matching Placebo']}]}, 'contactsLocationsModule': {'locations': [{'zip': '86001-6299', 'city': 'Flagstaff', 'state': 'Arizona', 'country': 'United States', 'facility': 'AZ Arthritis and Rheumotology Research, PLLC - Flagstaff /ID# 253431', 'geoPoint': {'lat': 35.19807, 'lon': -111.65127}}, {'zip': '85306-9802', 'city': 'Glendale', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Arthritis and Rheumatology Research - Glendale Office /ID# 255018', 'geoPoint': {'lat': 33.53865, 'lon': -112.18599}}, {'zip': '85381', 'city': 'Peoria', 'state': 'Arizona', 'country': 'United States', 'facility': 'Sun Valley Arthritis Center Ltd. /ID# 254654', 'geoPoint': {'lat': 33.5806, 'lon': -112.23738}}, {'zip': '85032', 'city': 'Phoenix', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Arthritis & Rheumatology Associates - East Bell Road /ID# 253432', 'geoPoint': {'lat': 33.44838, 'lon': -112.07404}}, {'zip': '85032', 'city': 'Phoenix', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Arthritis & Rheumatology Associates - East Bell Road /ID# 255021', 'geoPoint': {'lat': 33.44838, 'lon': -112.07404}}, {'zip': '85704', 'city': 'Tucson', 'state': 'Arizona', 'country': 'United States', 'facility': 'Arizona Arthritis & Rheumatology Associates - Tucson /ID# 255017', 'geoPoint': {'lat': 32.22174, 'lon': -110.92648}}, {'zip': '72401-6251', 'city': 'Jonesboro', 'state': 'Arkansas', 'country': 'United States', 'facility': 'Arthritis and Rheumatism Associates /ID# 254013', 'geoPoint': {'lat': 35.8423, 'lon': -90.70428}}, {'zip': '92835', 'city': 'Fullerton', 'state': 'California', 'country': 'United States', 'facility': 'Providence - St. Jude Medical Center /ID# 252690', 'geoPoint': {'lat': 33.87029, 'lon': -117.92534}}, {'zip': '92648-5994', 'city': 'Huntington Beach', 'state': 'California', 'country': 'United States', 'facility': 'Newport Huntington Medical Group /ID# 252687', 'geoPoint': {'lat': 33.6603, 'lon': -117.99923}}, {'zip': '91942', 'city': 'La Mesa', 'state': 'California', 'country': 'United States', 'facility': 'Purushotham & Akther Kotha MD, Inc /ID# 252704', 'geoPoint': {'lat': 32.76783, 'lon': -117.02308}}, {'zip': '90720-5402', 'city': 'Los Alamitos', 'state': 'California', 'country': 'United States', 'facility': 'Valerius Medical Group & Research Center of Greater Long Beach, Inc /ID# 252692', 'geoPoint': {'lat': 33.80307, 'lon': -118.07256}}, {'zip': '92128-2549', 'city': 'San Diego', 'state': 'California', 'country': 'United States', 'facility': 'Rheumatology Center of San Diego /ID# 255038', 'geoPoint': {'lat': 32.71571, 'lon': -117.16472}}, {'zip': '91360-3951', 'city': 'Thousand Oaks', 'state': 'California', 'country': 'United States', 'facility': 'Millennium Clinical Trials /ID# 252689', 'geoPoint': {'lat': 34.17056, 'lon': -118.83759}}, {'zip': '90502', 'city': 'Torrance', 'state': 'California', 'country': 'United States', 'facility': 'The Lundquist Institute at Harbor-UCLA Medical Center /ID# 252691', 'geoPoint': {'lat': 33.83585, 'lon': -118.34063}}, {'zip': '91364', 'city': 'Woodland Hills', 'state': 'California', 'country': 'United States', 'facility': 'Comprehensive Rheumatology Center /ID# 252688', 'geoPoint': {'lat': 34.16834, 'lon': -118.60592}}, {'zip': '80045', 'city': 'Aurora', 'state': 'Colorado', 'country': 'United States', 'facility': 'University of Colorado Hospital /ID# 254617', 'geoPoint': {'lat': 39.72943, 'lon': -104.83192}}, {'zip': '80230', 'city': 'Denver', 'state': 'Colorado', 'country': 'United States', 'facility': 'Denver Arthritis Clinic /ID# 254058', 'geoPoint': {'lat': 39.73915, 'lon': -104.9847}}, {'zip': '80528', 'city': 'Fort Collins', 'state': 'Colorado', 'country': 'United States', 'facility': 'Tekton Research - Fort Collins - East Harmony Road /ID# 255036', 'geoPoint': {'lat': 40.58526, 'lon': -105.08442}}, {'zip': '33180', 'city': 'Aventura', 'state': 'Florida', 'country': 'United States', 'facility': 'Arthritis and Rheumatic Disease Specialties /ID# 260583', 'geoPoint': {'lat': 25.95648, 'lon': -80.13921}}, {'zip': '33486', 'city': 'Boca Raton', 'state': 'Florida', 'country': 'United States', 'facility': 'Rheumatology Associates of South Florida (RASF) - Clinical Research /ID# 253733', 'geoPoint': {'lat': 26.35869, 'lon': -80.0831}}, {'zip': '33511', 'city': 'Brandon', 'state': 'Florida', 'country': 'United States', 'facility': 'Bay Area Arthritis and Osteo /ID# 254046', 'geoPoint': {'lat': 27.9378, 'lon': -82.28592}}, {'zip': '33065', 'city': 'Coral Springs', 'state': 'Florida', 'country': 'United States', 'facility': 'Believe Clinical Trial /ID# 262355', 'geoPoint': {'lat': 26.27119, 'lon': -80.2706}}, {'zip': '32117', 'city': 'Daytona Beach', 'state': 'Florida', 'country': 'United States', 'facility': 'International Medical Research /ID# 254651', 'geoPoint': {'lat': 29.21081, 'lon': -81.02283}}, {'zip': '32713-2260', 'city': 'DeBary', 'state': 'Florida', 'country': 'United States', 'facility': 'Omega Research Debary, LLC /ID# 253735', 'geoPoint': {'lat': 28.88305, 'lon': -81.30868}}, {'zip': '33016-1897', 'city': 'Hialeah', 'state': 'Florida', 'country': 'United States', 'facility': 'Neoclinical Research /ID# 254622', 'geoPoint': {'lat': 25.8576, 'lon': -80.27811}}, {'zip': '33024', 'city': 'Hollywood', 'state': 'Florida', 'country': 'United States', 'facility': 'Gnp Research - Hollywood /ID# 273563', 'geoPoint': {'lat': 26.0112, 'lon': -80.14949}}, {'zip': '33063', 'city': 'Margate', 'state': 'Florida', 'country': 'United States', 'facility': 'Life Clinical Trials /ID# 256061', 'geoPoint': {'lat': 26.24453, 'lon': -80.20644}}, {'zip': '33014', 'city': 'Miami', 'state': 'Florida', 'country': 'United States', 'facility': 'Lakes Research, LLC /ID# 255023', 'geoPoint': {'lat': 25.77427, 'lon': -80.19366}}, {'zip': '32819', 'city': 'Orlando', 'state': 'Florida', 'country': 'United States', 'facility': 'HMD Research LLC /ID# 253732', 'geoPoint': {'lat': 28.53834, 'lon': -81.37924}}, {'zip': '32174', 'city': 'Ormond Beach', 'state': 'Florida', 'country': 'United States', 'facility': 'Millennium Research /ID# 253744', 'geoPoint': {'lat': 29.28581, 'lon': -81.05589}}, {'zip': '33410', 'city': 'Palm Beach Gardens', 'state': 'Florida', 'country': 'United States', 'facility': 'Vitalia Research /ID# 274213', 'geoPoint': {'lat': 26.82339, 'lon': -80.13865}}, {'zip': '33705', 'city': 'St. Petersburg', 'state': 'Florida', 'country': 'United States', 'facility': 'BayCare Medical Group /ID# 253799', 'geoPoint': {'lat': 27.77086, 'lon': -82.67927}}, {'zip': '33606', 'city': 'Tampa', 'state': 'Florida', 'country': 'United States', 'facility': 'Clinical Research Of West Florida - Tampa - North Howard Avenue /ID# 254649', 'geoPoint': {'lat': 27.94752, 'lon': -82.45843}}, {'zip': '33606', 'city': 'Tampa', 'state': 'Florida', 'country': 'United States', 'facility': 'Clinical Research Of West Florida - Tampa - North Howard Avenue /ID# 255264', 'geoPoint': {'lat': 27.94752, 'lon': -82.45843}}, {'zip': '33613', 'city': 'Tampa', 'state': 'Florida', 'country': 'United States', 'facility': 'University of South Florida- Neuroscience Institute /ID# 253745', 'geoPoint': {'lat': 27.94752, 'lon': -82.45843}}, {'zip': '33614', 'city': 'Tampa', 'state': 'Florida', 'country': 'United States', 'facility': 'Baycare Medical Group - Tampa /ID# 255268', 'geoPoint': {'lat': 27.94752, 'lon': -82.45843}}, {'zip': '30060', 'city': 'Marietta', 'state': 'Georgia', 'country': 'United States', 'facility': 'Atlanta Research Center For Rheumatology - Marietta /ID# 254623', 'geoPoint': {'lat': 33.9526, 'lon': -84.54993}}, {'zip': '60616', 'city': 'Chicago', 'state': 'Illinois', 'country': 'United States', 'facility': 'Next Innovative Clinical Research - Chicago /ID# 273453', 'geoPoint': {'lat': 41.85003, 'lon': -87.65005}}, {'zip': '60048', 'city': 'Libertyville', 'state': 'Illinois', 'country': 'United States', 'facility': 'Deerbrook Medical Associates /ID# 254008', 'geoPoint': {'lat': 42.28308, 'lon': -87.95313}}, {'zip': '61114-4937', 'city': 'Rockford', 'state': 'Illinois', 'country': 'United States', 'facility': 'OrthoIllinois /ID# 254057', 'geoPoint': {'lat': 42.27113, 'lon': -89.094}}, {'zip': '60195-3106', 'city': 'Schaumburg', 'state': 'Illinois', 'country': 'United States', 'facility': 'Greater Chicago Specialty Physicians /ID# 254000', 'geoPoint': {'lat': 42.03336, 'lon': -88.08341}}, {'zip': '60076', 'city': 'Skokie', 'state': 'Illinois', 'country': 'United States', 'facility': 'Clinic Of Dr. Robert Hozman/Clinical Investigation Specialists, Inc /ID# 253999', 'geoPoint': {'lat': 42.03336, 'lon': -87.73339}}, {'zip': '60527', 'city': 'Willowbrook', 'state': 'Illinois', 'country': 'United States', 'facility': 'Willow Rheumatology and Wellness, PLLC /ID# 254712', 'geoPoint': {'lat': 41.76975, 'lon': -87.93589}}, {'zip': '47715-2813', 'city': 'Evansville', 'state': 'Indiana', 'country': 'United States', 'facility': 'Qualmedica Research - Evansville /ID# 254005', 'geoPoint': {'lat': 37.97476, 'lon': -87.55585}}, {'zip': '42240', 'city': 'Hopkinsville', 'state': 'Kentucky', 'country': 'United States', 'facility': 'Western KY Rheumatology /ID# 255026', 'geoPoint': {'lat': 36.86561, 'lon': -87.49117}}, {'zip': '40504', 'city': 'Lexington', 'state': 'Kentucky', 'country': 'United States', 'facility': 'Bluegrass Community Research /ID# 254653', 'geoPoint': {'lat': 37.98869, 'lon': -84.47772}}, {'zip': '70836', 'city': 'Baton Rouge', 'state': 'Louisiana', 'country': 'United States', 'facility': 'Ochsner Health Center - The Grove /ID# 254059', 'geoPoint': {'lat': 30.44332, 'lon': -91.18747}}, {'zip': '71203', 'city': 'Monroe', 'state': 'Louisiana', 'country': 'United States', 'facility': 'The Arthritis & Diabetes Clinic, Inc. /ID# 254014', 'geoPoint': {'lat': 32.50931, 'lon': -92.1193}}, {'zip': '04102-2643', 'city': 'Portland', 'state': 'Maine', 'country': 'United States', 'facility': 'Rheumatology Associates PA - Portland /ID# 255014', 'geoPoint': {'lat': 43.65737, 'lon': -70.2589}}, {'zip': '02149-4903', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Beth Israel Deaconess Medical Center - 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