Ignite Creation Date:
2025-12-25 @ 12:06 AM
Ignite Modification Date:
2025-12-25 @ 10:05 PM
Study NCT ID:
NCT03523858
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2025-12-04
First Post:
2018-04-16
Is NOT Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
A Study to Evaluate Ocrelizumab Treatment in Participants With Progressive Multiple Sclerosis
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24', 'removedCountries': ['Algeria', 'Saudi Arabia']}, 'conditionBrowseModule': {'meshes': [{'id': 'D020528', 'term': 'Multiple Sclerosis, Chronic Progressive'}], 'ancestors': [{'id': 'D009103', 'term': 'Multiple Sclerosis'}, {'id': 'D020278', 'term': 'Demyelinating Autoimmune Diseases, CNS'}, {'id': 'D020274', 'term': 'Autoimmune Diseases of the Nervous System'}, {'id': 'D009422', 'term': 'Nervous System Diseases'}, {'id': 'D003711', 'term': 'Demyelinating Diseases'}, {'id': 'D001327', 'term': 'Autoimmune Diseases'}, {'id': 'D007154', 'term': 'Immune System Diseases'}, {'id': 'D002908', 'term': 'Chronic Disease'}, {'id': 'D020969', 'term': 'Disease Attributes'}, {'id': 'D010335', 'term': 'Pathologic Processes'}, {'id': 'D013568', 'term': 'Pathological Conditions, Signs and Symptoms'}]}, 'interventionBrowseModule': {'meshes': [{'id': 'C533411', 'term': 'ocrelizumab'}]}}, 'protocolSection': {'designModule': {'phases': ['PHASE3'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'NA', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'TREATMENT', 'interventionModel': 'SINGLE_GROUP'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 927}}, 'statusModule': {'overallStatus': 'ACTIVE_NOT_RECRUITING', 'startDateStruct': {'date': '2018-05-28', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2025-12', 'completionDateStruct': {'date': '2026-12-04', 'type': 'ESTIMATED'}, 'lastUpdateSubmitDate': '2025-12-03', 'studyFirstSubmitDate': '2018-04-16', 'studyFirstSubmitQcDate': '2018-05-10', 'lastUpdatePostDateStruct': {'date': '2025-12-04', 'type': 'ESTIMATED'}, 'studyFirstPostDateStruct': {'date': '2018-05-14', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2026-01-15', 'type': 'ESTIMATED'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Proportion of Participants with No Evidence of Progression (NEP)', 'timeFrame': 'From Baseline to Week 96, Week 96 to Week 192 and Baseline to Week 192', 'description': 'NEP is defined as no progression sustained for at least 24 weeks on all of the following three components (confirmed disability progression \\[CDP\\]; ≥20% increase in timed 25-foot walk test \\[T25FWT\\]; ≥20% increase in nine-hole peg test \\[9HPT\\])'}, {'measure': 'Proportion of Participants with no evidence of progression and no active disease (NEPAD)', 'timeFrame': 'From Baseline to Week 96, Week 96 to Week 192 and Baseline to Week 192', 'description': 'NEPAD is defined as no progression sustained for at least 24 weeks on all of the three components of NEP (CDP, T25FWT, 9HPT), no protocol-defined relapse, no enlarging or new T2 lesion, and no T1 gadolinium (Gd+)-enhancing lesion'}], 'secondaryOutcomes': [{'measure': 'Change from Baseline in Cognitive Function, as Measured by the Symbol Digit Modalities Test (SDMT)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change from Baseline in Cognitive Function, as Measured by Brief Visuospatial Memory Test - Revised (BVMT-R)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Mean Change from Baseline in the Expanded Disability Status Scale (EDSS) score over the course of the study', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Time to Onset of First Confirmed Disability Progression (CDP) Sustained for at least 24 and 48 Weeks', 'timeFrame': 'Baseline to onset of first CDP (as measured by EDSS) sustained for at least 24 and 48 weeks'}, {'measure': 'Time to Onset of First >=20% Increase in Timed 25-foot Walk Test (T25FWT) Sustained for at least 24 Weeks', 'timeFrame': 'Baseline to onset of first >=20% increase in T25FWT sustained for at least 24 weeks'}, {'measure': 'Time to Onset of First >=20% Increase in 9 Hole Peg Test (9HPT) Sustained For At Least 24 Weeks', 'timeFrame': 'Baseline to onset of first >=20% increase in 9HPT sustained for at least 24 weeks'}, {'measure': 'Proportion of Participants with NEP', 'timeFrame': 'Week 24 to Week 96, Week 24 to Week 192, and Week 48 to Week 192'}, {'measure': 'Proportion of Participants with NEPAD', 'timeFrame': 'Week 24 to Week 96, Week 24 to Week 192, Week 48 to Week 192'}, {'measure': 'Change from Baseline in Patient-Reported Outcomes (PROs)', 'timeFrame': 'Baseline to end of study (Week 192)', 'description': 'PROs collected in this study will be the Multiple Sclerosis Impact Scale (MSIS-29), the Multiple Sclerosis Walking scale (MSWS-12), the ABILHAND-56 Questionnaire, Fatigue Scale for Motor and Cognitive function (FSMC), SymptoMScreen, 88-item Multiple Sclerosis Spasticity Scale (MSSS-88), Numerical Pain Rating Scale (NPRS), and the Patient Global Impression of Severity (PGIS) for upper limb, lower limb and cognitive function'}, {'measure': 'Change from Baseline in the number of falls and near-falls', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in Whole Brain Volume (Whole, Cerebral White Matter, Cortical Grey Matter, Deep grey matter)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in thalamic volumes', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in whole and regional cerebellar volume (cervical cord grey and white matter area)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in cervical cord cross-sectional area (total, white matter and grey matter)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in number of new/enlarging T2 lesions and total T2 Lesion Volume', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in number of T1 Gadolinium (Gd)+ Lesions and total volume', 'timeFrame': "'Baseline to end of study (Week 192)"}, {'measure': 'Change in number of T1 lesions', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Number in total volume of T1 lesions', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in Slowly Evolving Lesions (SEL)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in normalised T1 intensity/T1 Gd+ enhancement in New Focal T2 Lesions, SELs, Persistent Areas of Non-SEL T2 Lesions, and Normal-Appearing Brain Tissue', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in Gd-enhancing late-Fluid-Attenuated Inversion-Recovery (FLAIR) Meningeal Lesions', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Change in the number/ spatial distribution of lesions in the cervical spinal cord', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Spectroscopic MR: Measure of the Relative Signal Amplitude of N-Acetyl Aspartate (NAA), and Choline to Creatine', 'timeFrame': 'Baseline to end of study (Week 192)', 'description': 'Only in centers with 1.5-Tesla MRI capable to perform it'}, {'measure': 'Measure of phase rim lesions using a Susceptibility-Weighted Imaging [SWI]/T2 sequence', 'timeFrame': 'Baseline to end of study (Week 192)', 'description': 'Only in centers with 3-Tesla MRI capable to perform it, where this sequence would replace the spectroscopic MR in the acquisition flow'}, {'measure': 'Percentage of Participants with Adverse Events (AEs)', 'timeFrame': 'Baseline to end of study (Week 192)'}, {'measure': 'Rates of study treatment discontinuation due to adverse events', 'timeFrame': 'Baseline to Week 192'}]}, 'oversightModule': {'isFdaRegulatedDrug': True, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'conditions': ['Progressive Multiple Sclerosis (PMS)']}, 'referencesModule': {'references': [{'pmid': '40258203', 'type': 'DERIVED', 'citation': 'Kappos L, Yiu S, Dahlke F, Coetzee T, Cutter GR, Yuen S, Bonati U, Lublin FD. Composite Confirmed Disability Worsening/Progression Is a Useful Clinical Endpoint for Multiple Sclerosis Clinical Trials. Neurology. 2025 May 27;104(10):e213558. doi: 10.1212/WNL.0000000000213558. Epub 2025 Apr 21.'}]}, 'descriptionModule': {'briefSummary': 'This study is a prospective, multicenter, open-label, single-arm effectiveness and safety study in participants with progressive multiple sclerosis (PMS).'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'maximumAge': '65 Years', 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': "Inclusion Criteria:\n\n* Have a definite diagnosis of PMS (as per the revised McDonald 2010 criteria for PPMS or Lublin et al. 2014 criteria for PMS)\n* EDSS (Expanded Disability Status Scale) \\</ =6.5 at screening\n* Have a documented evidence of disability progression independent of relapse at any point over the 2 years prior to the screening visit. In case relapse(s) have occurred in the last 2 years, disability progression will have to be considered as independent of relapse activity as per treating physician's judgment\n* Fulfill at least one of the 21 criteria assessing the evidence of disability progression independent of relapse activity in the last 2 years using the pre-baseline disability progression rating system checklist\n* Have experience of having used a smartphone and connecting a smartphone to Wi-Fi network providers\n* For women of childbearing potential: agreement to remain abstinent or use acceptable contraceptive methods during the treatment period and for at least 6 months, or longer if the local label is more stringent after the last dose of study drug\n\nExclusion Criteria:\n\n* Relapsing-remitting multiple sclerosis (RRMS) at screening\n* Inability to complete an MRI\n* Gadolinium (Gd) intolerance\n* Known presence of other neurological disorders\n\nExclusions Related to General Health:\n\n* Pregnancy confirmed by positive serum β human chorionic gonadotropin (hCG) measured at screening\n* Lactation\n* Any concomitant disease that may require chronic treatment of systemic corticosteroids or immunosuppressants during the course of the study\n* History or currently active primary or secondary immunodeficiency\n* Lack of peripheral venous access\n* Significant or uncontrolled somatic disease or any other significant disease that may preclude participant from participating in the study.\n* Active infections must be treated and resolved prior to the first infusion of ocrelizumab\n* Participants in a severely immunocompromised state until the condition resolves\n* Participants with known active malignancies or being actively monitored for recurrence of malignancy\n* Participants who have or have had confirmed progressive multifocal leukoencephalopathy (PML)\n\nExclusions Related to Laboratory Findings:\n\n* Positive screening tests for hepatitis B\n* CD4 count \\<250/μL\n* ANC \\<1.0 × 103/μL\n* AST/SGOT or ALT/SGPT ≥3.0 × ULN in combination with either an elevated total bilirubin (\\>2 X ULN) or clinical jaundice\n\nExclusions Related to Medications:\n\n* Hypersensitivity to ocrelizumab or to any of its excipients\n* Previous treatment with ocrelizumab\n* Previous treatment with B-cell targeted therapies (i.e., atacicept, tabalumab, belimumab, ofatumumab, or obinutuzumab). Note: previous treatment with rituximab is allowed as long as the last dose was administered more than 6 months before the ocrelizumab infusion AND if discontinuation was due to adverse events or immunogenicity AND if Bcell levels are above the lower limit of normal (LLN) prior to screening.\n* Any previous treatment with alemtuzumab (Campath/Mabcampath/Lemtrada), total body irradiation, or bone marrow transplantation\n* Previous treatment with natalizumab where PML has not been excluded according to specific algorithm\n* Contraindications to or intolerance of oral or intravenous (IV) corticosteroids, including methylprednisolone administered IV, according to the country label\n* Systemic corticosteroid therapy within 4 weeks prior to screening\n* All vaccines should be given at least 6 weeks before the first infusion of ocrelizumab, unless the local regulations allow for a shorter interval. Live/live attenuated vaccines should be avoided during treatment and safety follow-up period until B cells are peripherally repleted\n* Previous treatment with daclizumab, ozanimod or figolimod in the last 8 weeks\n* Previous treatment with siponimod in the last 2 weeks\n* Treatment with fampridine/dalfampridine (Fampyra)/Ampyra) or other symptomatic MS treatment unless on stable dose for ≥30 days prior to screening\n* Previous treatment with natalizumab in the last 12 weeks.\n* Previous treatment with teriflunomide in the last 12 weeks. This washout period can be shortened if an accelerated elimination procedure is implemented before screening visit. One of the following elimination procedures can be used:\n* Cholestyramine 8 g administered 3 times daily for a period of at least 7 days (cholestyramine 4 g three times a day can be used, if cholestyramine 8 g three times a day is not well tolerated)\n* Alternatively, 50 g of activated powdered charcoal is administered every 12 hours for a period of at least 7 days.\n* Previous treatment with azathioprine, cyclophosphamide, mycophenolate mofetil or methotrexate in the last 12 weeks\n* Treatment with any investigational agent within 24 weeks of screening (Visit 1) or five half-lives of the investigational drug (whichever is longer) or treatment with any experimental procedures for MS\n* Previous treatment with mitoxantrone, cyclosporine or cladribine in the last 96 weeks\n* Participants previously treated with teriflunomide within the last two years, unless measured plasma concentrations are less than 0.02 mg/l. If above or not known, an accelerated elimination procedure should be implemented before screening visit"}, 'identificationModule': {'nctId': 'NCT03523858', 'acronym': 'CONSONANCE', 'briefTitle': 'A Study to Evaluate Ocrelizumab Treatment in Participants With Progressive Multiple Sclerosis', 'organization': {'class': 'INDUSTRY', 'fullName': 'Hoffmann-La Roche'}, 'officialTitle': 'An Open-Label, Single-Arm 4-Year Study to Evaluate Effectiveness and Safety of Ocrelizumab Treatment in Patients With Progressive Multiple Sclerosis', 'orgStudyIdInfo': {'id': 'MN39159'}, 'secondaryIdInfos': [{'id': '2017-001313-93', 'type': 'EUDRACT_NUMBER'}, {'id': '2023-506429-13-00', 'type': 'CTIS'}]}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Ocrelizumab', 'description': 'Ocrelizumab will be administered via intravenous (IV) infusion.', 'interventionNames': ['Drug: Ocrelizumab']}], 'interventions': [{'name': 'Ocrelizumab', 'type': 'DRUG', 'description': 'Ocrelizumab will be administered via intravenous (IV) infusion at an initial dose of two 300-mg infusions separated by 14 days (on Days 1 and 15), and then 600 mg at every subsequent dose every 24 weeks for the remainder of the study treatment period (approximately 192 weeks)', 'armGroupLabels': ['Ocrelizumab']}]}, 'contactsLocationsModule': {'locations': [{'zip': '92653', 'city': 'Laguna Hills', 'state': 'California', 'country': 'United States', 'facility': 'MS Center of California', 'geoPoint': {'lat': 33.61252, 'lon': -117.71283}}, {'zip': '91105', 'city': 'Pasadena', 'state': 'California', 'country': 'United States', 'facility': 'SC3 Research Group, Inc', 'geoPoint': {'lat': 34.14778, 'lon': -118.14452}}, {'zip': '94158', 'city': 'San Francisco', 'state': 'California', 'country': 'United States', 'facility': 'University of California San Francisco', 'geoPoint': {'lat': 37.77493, 'lon': -122.41942}}, {'zip': '06473', 'city': 'North Haven', 'state': 'Connecticut', 'country': 'United States', 'facility': 'Yale University', 'geoPoint': {'lat': 41.39093, 'lon': -72.85954}}, {'zip': '33613', 'city': 'Tampa', 'state': 'Florida', 'country': 'United States', 'facility': 'University of South Florida', 'geoPoint': {'lat': 27.94752, 'lon': -82.45843}}, {'zip': '60637-1470', 'city': 'Chicago', 'state': 'Illinois', 'country': 'United States', 'facility': 'University of Chicago', 'geoPoint': {'lat': 41.85003, 'lon': -87.65005}}, {'zip': '02114', 'city': 'Boston', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Massachusetts General Hospital', 'geoPoint': {'lat': 42.35843, 'lon': -71.05977}}, {'zip': '02481', 'city': 'Wellesley', 'state': 'Massachusetts', 'country': 'United States', 'facility': 'Dragonfly Research, LLC', 'geoPoint': {'lat': 42.29649, 'lon': -71.29256}}, {'zip': '48210', 'city': 'Detroit', 'state': 'Michigan', 'country': 'United States', 'facility': 'Wayne State University School of Medicine', 'geoPoint': {'lat': 42.33143, 'lon': -83.04575}}, {'zip': '63110', 'city': 'St Louis', 'state': 'Missouri', 'country': 'United States', 'facility': 'Washington University School of Medicine', 'geoPoint': {'lat': 38.62727, 'lon': -90.19789}}, {'zip': '12110', 'city': 'Latham', 'state': 'New York', 'country': 'United States', 'facility': 'The MS Center of Northeastern New York', 'geoPoint': {'lat': 42.74702, 'lon': -73.75901}}, {'zip': '45267', 'city': 'Cincinnati', 'state': 'Ohio', 'country': 'United States', 'facility': 'University of Cincinnati', 'geoPoint': {'lat': 39.12711, 'lon': -84.51439}}, {'zip': '44195', 'city': 'Cleveland', 'state': 'Ohio', 'country': 'United States', 'facility': 'Cleveland Clinic Mellen Center', 'geoPoint': {'lat': 41.4995, 'lon': -81.69541}}, {'zip': '19104', 'city': 'Philadelphia', 'state': 'Pennsylvania', 'country': 'United States', 'facility': 'University of Pennsylvania', 'geoPoint': {'lat': 39.95238, 'lon': -75.16362}}, {'zip': '38018', 'city': 'Cordova', 'state': 'Tennessee', 'country': 'United States', 'facility': 'Neurology Clinic PC', 'geoPoint': {'lat': 35.15565, 'lon': -89.7762}}, {'zip': '78681', 'city': 'Round Rock', 'state': 'Texas', 'country': 'United States', 'facility': 'Central Texas Neurology Consultants', 'geoPoint': {'lat': 30.50826, 'lon': -97.6789}}, {'zip': '78258', 'city': 'San Antonio', 'state': 'Texas', 'country': 'United States', 'facility': 'Lone Star Neurology of San Antonio', 'geoPoint': {'lat': 29.42412, 'lon': -98.49363}}, {'zip': '98122', 'city': 'Seattle', 'state': 'Washington', 'country': 'United States', 'facility': 'Swedish Multiple Sclerosis Center', 'geoPoint': {'lat': 47.60621, 'lon': -122.33207}}, {'zip': '78000', 'city': 'Banja Luka', 'country': 'Bosnia and Herzegovina', 'facility': 'University Clinical Center of the Republic of Srpska', 'geoPoint': {'lat': 44.77879, 'lon': 17.20629}}, {'zip': '88000', 'city': 'Mostar', 'country': 'Bosnia and Herzegovina', 'facility': 'University Hospital Mostar', 'geoPoint': {'lat': 43.34333, 'lon': 17.80806}}, {'zip': '71000', 'city': 'Sarajevo', 'country': 'Bosnia and Herzegovina', 'facility': 'Clinical Center University of Sarajevo', 'geoPoint': {'lat': 43.84864, 'lon': 18.35644}}, {'zip': '75000', 'city': 'Tuzla', 'country': 'Bosnia and Herzegovina', 'facility': 'University Clinical Center Tuzla', 'geoPoint': {'lat': 44.53842, 'lon': 18.66709}}, {'zip': '81210-310', 'city': 'Curitiba', 'state': 'Paraná', 'country': 'Brazil', 'facility': 'Instituto de Neurologia de Curitiba', 'geoPoint': {'lat': -25.42778, 'lon': -49.27306}}, {'zip': '90610-000', 'city': 'Porto Alegre', 'state': 'Rio Grande do Sul', 'country': 'Brazil', 'facility': 'Hospital Sao Lucas - PUCRS', 'geoPoint': {'lat': -30.03283, 'lon': -51.23019}}, {'zip': '14051-140', 'city': 'Ribeirão Preto', 'state': 'São Paulo', 'country': 'Brazil', 'facility': 'Hospital das Clínicas Faculdades Médicas de Ribeirão Preto', 'geoPoint': {'lat': -21.1775, 'lon': -47.81028}}, {'zip': '05403-000', 'city': 'São Paulo', 'state': 'São Paulo', 'country': 'Brazil', 'facility': 'Hospital das Clinicas - FMUSP_X', 'geoPoint': {'lat': -23.5475, 'lon': -46.63611}}, {'zip': 'V5G 2X6', 'city': 'Burnaby', 'state': 'British Columbia', 'country': 'Canada', 'facility': 'Fraser Health Authority - Fraser Health Multiple Sclerosis', 'geoPoint': {'lat': 49.26636, 'lon': -122.95263}}, {'zip': 'V6T 2B5', 'city': 'Vancouver', 'state': 'British Columbia', 'country': 'Canada', 'facility': 'University of British Columbia Hospital', 'geoPoint': {'lat': 49.24966, 'lon': -123.11934}}, {'zip': 'N6A 5A5', 'city': 'London', 'state': 'Ontario', 'country': 'Canada', 'facility': 'London Health Sciences Centre Uni Campus', 'geoPoint': {'lat': 42.98339, 'lon': -81.23304}}, {'zip': 'M5B 1W8', 'city': 'Toronto', 'state': 'Ontario', 'country': 'Canada', 'facility': "St. Michael'S Hospital", 'geoPoint': {'lat': 43.70643, 'lon': -79.39864}}, {'zip': 'J4V 2J2', 'city': 'Greenfield Park', 'state': 'Quebec', 'country': 'Canada', 'facility': 'Recherche Sepmus Inc.', 'geoPoint': {'lat': 45.48649, 'lon': -73.46223}}, {'zip': 'H2L 4M1', 'city': 'Montreal', 'state': 'Quebec', 'country': 'Canada', 'facility': "Hospital Notre-Dame du Centre Hospitalier de l'Universite de Montreal", 'geoPoint': {'lat': 45.50884, 'lon': -73.58781}}, {'zip': 'S7K 0M7', 'city': 'Saskatoon', 'state': 'Saskatchewan', 'country': 'Canada', 'facility': 'Saskatoon City Hospital', 'geoPoint': {'lat': 52.13238, 'lon': -106.66892}}, {'city': 'Bogotá', 'country': 'Colombia', 'facility': 'Organizacion Sanitas Internacional', 'geoPoint': {'lat': 4.60971, 'lon': -74.08175}}, {'city': 'Cali', 'country': 'Colombia', 'facility': 'Fundacion Clinica Valle del Lili', 'geoPoint': {'lat': 3.43054, 'lon': -76.5199}}, {'zip': '10101', 'city': 'San José', 'country': 'Costa Rica', 'facility': 'Hospital Clínica Biblica', 'geoPoint': {'lat': 9.93388, 'lon': -84.08489}}, {'zip': '58633', 'city': 'Jihlava', 'country': 'Czechia', 'facility': 'Nemocnice Jihlava', 'geoPoint': {'lat': 49.3961, 'lon': 15.59124}}, {'zip': '779 00', 'city': 'Olomouc', 'country': 'Czechia', 'facility': 'Fakultní Nemocnice Olomouc', 'geoPoint': {'lat': 49.59552, 'lon': 17.25175}}, {'zip': '708 52', 'city': 'Ostrava-Poruba', 'country': 'Czechia', 'facility': 'Fakultni nemocnice Ostrava'}, {'zip': '128 08', 'city': 'Prague', 'country': 'Czechia', 'facility': 'Vseobecna fakultni nemocnice v Praze', 'geoPoint': {'lat': 50.08804, 'lon': 14.42076}}, {'zip': '8200', 'city': 'Aarhus N', 'country': 'Denmark', 'facility': 'Aarhus Universitetshospital', 'geoPoint': {'lat': 56.20367, 'lon': 10.17317}}, {'zip': '2600', 'city': 'Glostrup Municipality', 'country': 'Denmark', 'facility': 'Rigshospitalet', 'geoPoint': {'lat': 55.6666, 'lon': 12.40377}}, {'zip': '6400', 'city': 'Sønderborg', 'country': 'Denmark', 'facility': 'Hjerne- og nervesygdomme, Ambulatorium, Skleroseklinikken', 'geoPoint': {'lat': 54.90896, 'lon': 9.78917}}, {'zip': '21561', 'city': 'Alexandria', 'country': 'Egypt', 'facility': 'Clinical Research 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