--- title: Study of the Optimal Protocol for Methotrexate and Adalimumab Combination Therapy in Early Rheumatoid Arthritis nct_id: NCT00420927 overall_status: COMPLETED phase: PHASE4 sponsor: Abbott study_type: INTERVENTIONAL primary_condition: Rheumatoid Arthritis countries: United States, Argentina, Australia, Austria, Belgium, Canada, Czechia, France, Germany, Hungary, Mexico, Netherlands, New Zealand, Norway, Poland, Puerto Rico, Slovakia, South Africa, Spain, Sweden, United Kingdom canonical_url: "https://parkinsonspathways.com/agent/trials/NCT00420927.md" clinicaltrials_gov: "https://clinicaltrials.gov/study/NCT00420927" ct_last_update_post_date: 2012-04-18 last_seen_at: "2026-05-12T06:16:42.785Z" source: ClinicalTrials.gov (mirrored, no enrichment) --- # Study of the Optimal Protocol for Methotrexate and Adalimumab Combination Therapy in Early Rheumatoid Arthritis **Official Title:** A Multicenter, Randomized, Double-Period, Double - Blind Study to Determine the Optimal Protocol for Treatment Initiation With Methotrexate and Adalimumab Combination Therapy in Patients With Early Rheumatoid Arthritis (OPTIMA) **NCT ID:** [NCT00420927](https://clinicaltrials.gov/study/NCT00420927) ## Key Facts - **Status:** COMPLETED - **Phase:** PHASE4 - **Study Type:** INTERVENTIONAL - **Target Enrollment:** 1032 - **Lead Sponsor:** Abbott - **Conditions:** Rheumatoid Arthritis - **Start Date:** 2006-12 - **Completion Date:** 2010-07 - **CT.gov Last Update:** 2012-04-18 ## Brief Summary This study compared the safety and efficacy of combination therapy with adalimumab plus methotrexate (MTX) to that of MTX monotherapy (i.e., placebo plus MTX) in subjects with early rheumatoid arthritis (RA). ## Detailed Description This was a 78-week, multicenter, randomized, double-blind, double-treatment period study designed to compare the safety and efficacy of adalimumab and MTX with placebo and MTX in subjects with early RA. Subjects were randomized to receive adalimumab 40 mg every other week (eow) or placebo subcutaneous injections in combination with orally administered MTX for 26 weeks (Period 1). All subjects in all arms received open-label MTX weekly throughout the study (both Period 1 and Period 2). At Weeks 22 and 26, subjects were assessed for achievement of low disease activity, defined as a DAS28 score below 3.2. DAS28 is a measure of RA disease activity calculated using the number of tender and swollen joints (out of a total of 28), C-reactive protein level (CRP, a blood marker of inflammation), and the patient's global assessment of disease activity (indicated by marking a 10 cm line between very good and very bad). Subjects who achieved low disease activity at Week 22 and 26 in the adalimumab arm at the end of Period 1 were randomized to receive MTX monotherapy (placebo and MTX) or combination therapy (adalimumab and MTX) in a 1:1 ratio for the duration of Period 2 (52 weeks, i.e., to Week 78 of the study). Subjects achieving low disease activity at Week 22 and 26 in the placebo arm (MTX monotherapy) at the end of Period 1 continued to receive MTX monotherapy (and placebo injections in a blinded fashion) for the duration of Period 2. Subjects failing to achieve low disease activity at Week 22 and 26 at the end of Period 1 received open-label combination therapy during Period 2 regardless of treatment assignment in Period 1. ## Eligibility - **Minimum age:** 18 Years - **Sex:** ALL - **Healthy Volunteers:** No ``` Inclusion Criteria * Subject must be 18 or older and in good health * Subject must meet the definition of early rheumatoid arthritis (RA) defined by the 1987-revised American College of Rheumatology (ACR) classification criteria and had disease duration of less than 1 year from diagnosis * Subject must have a Disease Activity Score (DAS28, based on C-reactive protein) greater than 3.2, at least 6 swollen joints out of the 66 assessed, and at least 8 tender joints out of the 68 assessed * Subject must fulfill at least one of the following three criteria: * Rheumatoid factor positive * Greater than 1 joint erosion * Anti-cyclic citrullinated peptide (CCP) antibody positive. Exclusion Criteria * Subject has previously received systemic anti-tumor necrosis factor (TNF) therapy * Subject has received any biologic or investigational therapy within 6 weeks prior to Baseline * Subject has been previously treated with more than 2 disease-modifying antirheumatic drugs (DMARDs) or MTX, had been treated with intra-articular or parenteral administration of corticosteroids in preceding 4 weeks, or had undergone joint surgery within the preceding 2 months at joints to be assessed during the study. ``` ## Arms - **ADA+MTX/PBO+MTX (Arm 1)** (EXPERIMENTAL) — Combination therapy with methotrexate (MTX) and blinded adalimumab (ADA) during Period 1, MTX monotherapy plus blinded placebo (PBO) during Period 2 - **ADA+MTX/ADA+MTX (Arm2)** (EXPERIMENTAL) — Combination therapy with methotrexate (MTX) and blinded adalimumab (ADA) during Period 1 and Period 2 - **ADA+MTX/OL ADA+MTX (Arm 3)** (EXPERIMENTAL) — Combination therapy with methotrexate (MTX) and blinded adalimumab (ADA) during Period 1, open-label combination therapy with ADA + MTX during Period 2 - **PBO+MTX/PBO+MTX (Arm 4)** (EXPERIMENTAL) — Methotrexate (MTX) monotherapy plus blinded placebo (PBO) during Period 1 and Period 2 - **PBO+MTX/OL ADA+MTX (Arm 5)** (EXPERIMENTAL) — Methotrexate (MTX) monotherapy plus blinded placebo (PBO) during Period 1, open-label combination therapy with adalimumab (ADA) and MTX during Period 2. ## Interventions - **adalimumab** (BIOLOGICAL) — Adalimumab 40 mg/0.8 mL prefilled syringe injected subcutaneously (SC) every other week (eow) - **methotrexate** (DRUG) — Methotrexate 2.5 mg tablets administered orally once a week starting at 7.5 mg/week with dose escalation (weekly or every other week) by 2.5 mg intervals to 20 mg/week. - **placebo** (BIOLOGICAL) — Placebo for adalimumab 0.8 mL prefilled syringe injected subcutaneously (SC) every other week (eow) ## Primary Outcomes - **Number of Subjects With Low Disease Activity (DAS28 Less Than 3.2) and No Radiographic Progression From Baseline (Change in mTSS Less Than or Equal to 0.5) at Week 78, Arm 2 vs. Arm 4** _(time frame: Week 78)_ — The Disease Activity Score (DAS28) is calculated using the number of tender and swollen joints (out of 28 counted), C-reactive protein level, and the patient's global assessment of disease activity. The calculated range of DAS28 is 0.49 to 9.07, with scores below 3.2 indicating low disease activity. For the modified Total Sharp score (mTSS), x-rays of hand/wrist and feet joints are scored for erosions (0 to 5) and joint space narrowing (0 to 4). The erosion score and the narrowing score are added to determine the total score, which ranges from 0 (no damage) to 448. ## Secondary Outcomes - **Number of Subjects With Low Disease Activity (DAS28 Less Than 3.2) and No Radiographic Progression From Baseline (Change in mTSS Less Than or Equal to 0.5) at Week 78, Arm 2 vs. Arm 1** _(time frame: Week 78)_ - **Number of Subjects With DAS28 Low Disease Activity (DAS28 Less Than 3.2) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With DAS28 Remission (DAS28 Less Than 2.6) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With No Radiographic Progression (Change From Baseline in mTSS Less Than or Equal to 0.5) at Week 78** _(time frame: Week 78)_ - **Number of Subjects Meeting American College of Rheumatology 20% (ACR20) Response Criteria at Week 78** _(time frame: Week 78)_ - **Number of Subjects Meeting American College of Rheumatology 50% (ACR50) Response Criteria at Week 78** _(time frame: Week 78)_ - **Number of Subjects Meeting American College of Rheumatology 70% (ACR70) Response Criteria at Week 78** _(time frame: Week 78)_ - **Change From Baseline in DAS28 Score at Week 78** _(time frame: Baseline to Week 78)_ - **Number of Subjects With Clinical Disease Activity Index (CDAI) Low Disease Activity (CDAI Less Than or Equal to 10) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With Simplified Disease Activity Index (SDAI) Low Disease Activity (SDAI Less Than or Equal to 11) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With Clinical Disease Activity Index (CDAI) Remission (CDAI Less Than or Equal to 2.8) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With Simplified Disease Activity Index (SDAI) Remission (SDAI Less Than or Equal to 3.3) at Week 78** _(time frame: Week 78)_ - **Change From Baseline in CDAI Score at Week 78** _(time frame: Baseline to Week 78)_ - **Change From Baseline in SDAI Score at Week 78** _(time frame: Baseline to Week 78)_ - **Change From Baseline in Synovitis Score According to the Rheumatoid Arthritis Magnetic Resonance Imaging (RA MRI) Scoring System (RAMRIS) at Week 78** _(time frame: Baseline to Week 78)_ - **Number of Subjects With No Radiographic Progression (Change From Baseline in mTSS of Less Than or Equal to 0.5) and Normal Function (HAQ-DI Less Than 0.5) at Week 78** _(time frame: Week 78)_ - **Number of Subjects With No Radiographic Progression (Change From Baseline in mTSS of Less Than or Equal to 0.5), Normal Function (HAQ-DI Less Than or Equal to 0.5), and ACR70 Response at Week 78** _(time frame: Week 78)_ - **Number of Subjects With No Radiographic Progression (Change From Baseline in mTSS of Less Than or Equal to 0.5), Normal Function (HAQ-DI Less Than 0.5), and DAS28 Remission (DAS28 Less Than 2.6) at Week 78** _(time frame: Week 78)_ ## Locations (170) - Site Reference ID/Investigator# 4560, Birmingham, Alabama, United States - Site Reference ID/Investigator# 4547, Birmingham, Alabama, United States - Site Reference ID/Investigator# 6222, Huntsville, Alabama, United States - Site Reference ID/Investigator# 4537, Mobile, Alabama, United States - Site Reference ID/Investigator# 6758, Tuscaloosa, Alabama, United States - Site Reference ID/Investigator# 9323, Hemet, California, United States - Site Reference ID/Investigator# 4568, La Jolla, California, United States - Site Reference ID/Investigator# 4535, Palm Desert, California, United States - Site Reference ID/Investigator# 4571, Santa Monica, California, United States - Site Reference ID/Investigator# 9271, Torrance, California, United States - Site Reference ID/Investigator# 10746, Victorville, California, United States - Site Reference ID/Investigator# 4559, Denver, Colorado, United States - Site Reference ID/Investigator# 6229, Aventura, Florida, United States - Site Reference ID/Investigator# 10603, Lake Mary, Florida, United States - Site Reference ID/Investigator# 9325, Orange Park, Florida, United States - Site Reference ID/Investigator# 4550, Palm Harbor, Florida, United States - Site Reference ID/Investigator# 4570, Sarasota, Florida, United States - Site Reference ID/Investigator# 4601, Tampa, Florida, United States - Site Reference ID/Investigator# 4552, Vero Beach, Florida, United States - Site Reference ID/Investigator# 10745, Meridian, Idaho, United States - Site Reference ID/Investigator# 4548, Chicago, Illinois, United States - Site Reference ID/Investigator# 4557, Springfield, Illinois, United States - Site Reference ID/Investigator# 4605, Wichita, Kansas, United States - Site Reference ID/Investigator# 10741, Wheaton, Maryland, United States - Site Reference ID/Investigator# 6417, Fall River, Massachusetts, United States - Site Reference ID/Investigator# 4561, Dover, New Hampshire, United States - Site Reference ID/Investigator# 11222, Freehold, New Jersey, United States - Site Reference ID/Investigator# 6228, Passaic, New Jersey, United States - Site Reference ID/Investigator# 4544, Albuquerque, New Mexico, United States - Site Reference ID/Investigator# 4534, Orchard Park, New York, United States - Site Reference ID/Investigator# 9324, Plainview, New York, United States - Site Reference ID/Investigator# 4600, Smithtown, New York, United States - Site Reference ID/Investigator# 12821, The Bronx, New York, United States - Site Reference ID/Investigator# 4549, Mayfield Village, Ohio, United States - Site Reference ID/Investigator# 6227, Bend, Oregon, United States - Site Reference ID/Investigator# 4546, Duncansville, Pennsylvania, United States - Site Reference ID/Investigator# 4564, West Reading, Pennsylvania, United States - Site Reference ID/Investigator# 4558, Wexford, Pennsylvania, United States - Site Reference ID/Investigator# 4533, Charleston, South Carolina, United States - Site Reference ID/Investigator# 7482, Greenville, South Carolina, United States - Site Reference ID/Investigator# 10743, Jackson, Tennessee, United States - Site Reference ID/Investigator# 4562, Nashville, Tennessee, United States - Site Reference ID/Investigator# 4536, Dallas, Texas, United States - Site Reference ID/Investigator# 4538, Houston, Texas, United States - Site Reference ID/Investigator# 6899, San Antonio, Texas, United States - Site Reference ID/Investigator# 6381, Tyler, Texas, United States - Site Reference ID/Investigator# 10744, Seattle, Washington, United States - Site Reference ID/Investigator# 4545, Glendale, Wisconsin, United States - Site Reference ID/Investigator# 4572, Oak Creek, Wisconsin, United States - Site Reference ID/Investigator# 3886, Buenos Aires, Argentina - Site Reference ID/Investigator# 3888, Buenos Aires, Argentina - Site Reference ID/Investigator# 6346, Buenos Aires, Argentina - Site Reference ID/Investigator# 3887, Quilmes, Argentina - Site Reference ID/Investigator# 3889, San Miguel de Tucumán, Argentina - Site Reference ID/Investigator# 8380, Campsie, Sydney, Australia - Site Reference ID/Investigator# 6954, Clayton, Australia - Site Reference ID/Investigator# 6940, Malvern East, Australia - Site Reference ID/Investigator# 3915, Graz, Austria - Site Reference ID/Investigator# 3911, Graz, Austria - Site Reference ID/Investigator# 3880, Vienna, Austria - Site Reference ID/Investigator# 3885, Vienna, Austria - Site Reference ID/Investigator# 3916, Vienna, Austria - Site Reference ID/Investigator# 7792, Vienna, Austria - Site Reference ID/Investigator# 3914, Brussels, Belgium - Site Reference ID/Investigator# 3909, Genk, Belgium - Site Reference ID/Investigator# 3881, Gilly, Belgium - Site Reference ID/Investigator# 3376, Liège, Belgium - Site Reference ID/Investigator# 6720, Mechelen, Belgium - Site Reference ID/Investigator# 6718, Sint-Niklaas, Belgium - Site Reference ID/Investigator# 3910, Yvoir, Belgium - Site Reference ID/Investigator# 6701, Burlington, Canada - Site Reference ID/Investigator# 6834, Edmonton, Canada - Site Reference ID/Investigator# 7197, Halifax, Canada - Site Reference ID/Investigator# 3883, Hamilton, Canada - Site Reference ID/Investigator# 3884, Hamilton, Canada - Site Reference ID/Investigator# 3907, Montreal, Canada - Site Reference ID/Investigator# 3903, Montreal, Canada - Site Reference ID/Investigator# 5178, Ottawa, Canada - Site Reference ID/Investigator# 3904, Richmond, Canada - Site Reference ID/Investigator# 3912, Sainte-Foy, Quebec, Canada - Site Reference ID/Investigator# 3901, Sarnia, Canada - Site Reference ID/Investigator# 3906, St. John's, Canada - Site Reference ID/Investigator# 6542, Toronto, Canada - Site Reference ID/Investigator# 3882, Victoria, Canada - Site Reference ID/Investigator# 5616, Windsor, Canada - Site Reference ID/Investigator# 5847, Winnipeg, Canada - Site Reference ID/Investigator# 3905, Winnipeg, Canada - Site Reference ID/Investigator# 3968, Brno, Czechia - Site Reference ID/Investigator# 3971, Hradec Králové, Czechia - Site Reference ID/Investigator# 5559, Ostrava, Czechia - Site Reference ID/Investigator# 3969, Prague, Czechia - Site Reference ID/Investigator# 5548, Uherské Hradiště, Czechia - Site Reference ID/Investigator# 3982, Amiens, France - Site Reference ID/Investigator# 3979, Le Mans, France - Site Reference ID/Investigator# 3983, Paris, France - Site Reference ID/Investigator# 3918, Strasbourg, France - Site Reference ID/Investigator# 3926, Bad Nauheim, Germany - Site Reference ID/Investigator# 3928, Buch, Germany - Site Reference ID/Investigator# 3978, Damp, Germany - Site Reference ID/Investigator# 3924, Düsseldorf, Germany - Site Reference ID/Investigator# 3965, Frankfurt, Germany - Site Reference ID/Investigator# 3927, Frankfurt am Main, Germany - Site Reference ID/Investigator# 3925, Freiburg im Breisgau, Germany - Site Reference ID/Investigator# 4291, Halle, Germany - Site Reference ID/Investigator# 8489, Hofheim, Germany - Site Reference ID/Investigator# 3923, Munich, Germany - Site Reference ID/Investigator# 8483, Osnabrück, Germany - Site Reference ID/Investigator# 8486, Ratingen, Germany - Site Reference ID/Investigator# 3919, Vogelsang-Gommern, Germany - Site Reference ID/Investigator# 6637, Zerbst, Germany - Site Reference ID/Investigator# 3921, Budapest, Hungary - Site Reference ID/Investigator# 3922, Budapest, Hungary - Site Reference ID/Investigator# 3920, Debrecen, Hungary - Site Reference ID/Investigator# 3824, Aguascallentes, Mexico - Site Reference ID/Investigator# 3822, León, Mexico - Site Reference ID/Investigator# 3825, Mexico City, Mexico - Site Reference ID/Investigator# 3951, Mexico City, Mexico - Site Reference ID/Investigator# 3890, Mexico City, Mexico - Site Reference ID/Investigator# 3823, Mexico City, Mexico - Site Reference ID/Investigator# 3891, Mexico City, Mexico - Site Reference ID/Investigator# 3947, Arnhem, Netherlands - Site Reference ID/Investigator# 3948, Hilversum, Netherlands - Site Reference ID/Investigator# 8485, Auckland, New Zealand - Site Reference ID/Investigator# 8488, Hamilton, New Zealand - Site Reference ID/Investigator# 8496, Timaru, New Zealand - Site Reference ID/Investigator# 8511, Wellington, New Zealand - Site Reference ID/Investigator# 7607, Ålesund, Norway - Site Reference ID/Investigator# 7935, Kristiansand, Norway - Site Reference ID/Investigator# 7506, Levanger, Norway - Site Reference ID/Investigator# 7511, Lillehammer, Norway - Site Reference ID/Investigator# 7500, Trondheim, Norway - Site Reference ID/Investigator# 3963, Bydgoszcz, Poland - Site Reference ID/Investigator# 3962, Katowice, Poland - Site Reference ID/Investigator# 5560, Lublin, Poland - Site Reference ID/Investigator# 3961, Wroclaw, Poland - Site Reference ID/Investigator# 3944, Caguas, Puerto Rico - Site Reference ID/Investigator# 3937, Ponce, Puerto Rico - Site Reference ID/Investigator# 3934, San Juan, Puerto Rico - Site Reference ID/Investigator# 3935, San Juan, Puerto Rico - Site Reference ID/Investigator# 3959, Piešťany, Slovakia - Site Reference ID/Investigator# 3960, Piešťany, Slovakia - Site Reference ID/Investigator# 7177, Berea, Durban, South Africa - Site Reference ID/Investigator# 7175, Cape Town, South Africa - Site Reference ID/Investigator# 7178, Cape Town, South Africa - Site Reference ID/Investigator# 7176, Port Elizabeth, South Africa - Site Reference ID/Investigator# 7172, Pretoria, South Africa - Site Reference ID/Investigator# 7174, Soweto, South Africa - Site Reference ID/Investigator# 3955, A Coruña, Spain - Site Reference ID/Investigator# 13661, Bilbao, Spain - Site Reference ID/Investigator# 3930, Elche (Alicante), Spain - Site Reference ID/Investigator# 8524, Madrid, Spain - Site Reference ID/Investigator# 3956, Madrid, Spain - Site Reference ID/Investigator# 3943, Madrid, Spain - Site Reference ID/Investigator# 3931, Madrid, Spain - Site Reference ID/Investigator# 3957, Oviedo, Spain - Site Reference ID/Investigator# 3954, Santiago de Compostela, Spain - Site Reference ID/Investigator# 3932, Zaragoza, Spain - Site Reference ID/Investigator# 4015, Eskilstuna, Sweden - Site Reference ID/Investigator# 3984, Falun, Sweden - Site Reference ID/Investigator# 4016, Malmö, Sweden - Site Reference ID/Investigator# 4014, Stockholm, Sweden - Site Reference ID/Investigator# 4017, Uppsala, Sweden - Site Reference ID/Investigator# 4012, Bath, United Kingdom - Site Reference ID/Investigator# 8495, Huddersfield, United Kingdom - Site Reference ID/Investigator# 4048, Leeds, United Kingdom - Site Reference ID/Investigator# 4013, London, United Kingdom - Site Reference ID/Investigator# 4046, Newcastle upon Tyne, United Kingdom - Site Reference ID/Investigator# 4047, Oxford, United Kingdom - Site Reference ID/Investigator# 3985, Southampton, United Kingdom - Site Reference ID/Investigator# 7977, York, United Kingdom ## Recent Field Changes (last 30 days) - `design.enrollmentCount` — added _(2026-05-12)_ - `status.overallStatus` — added _(2026-05-12)_ - `status.primaryCompletionDate` — added _(2026-05-12)_ - `status.completionDate` — added _(2026-05-12)_ - `status.lastUpdatePostDate` — added _(2026-05-12)_ - `design.phases` — added _(2026-05-12)_ - `eligibility.criteria` — added _(2026-05-12)_ - `eligibility.minAge` — added _(2026-05-12)_ - `eligibility.sex` — added _(2026-05-12)_ - `outcomes.primary` — added _(2026-05-12)_ - `outcomes.secondary` — added _(2026-05-12)_ - `armsInterventions.arms` — added _(2026-05-12)_ - `armsInterventions.interventions` — added _(2026-05-12)_ - `sponsor.lead` — added _(2026-05-12)_ - `results.hasResults` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4560|birmingham|alabama|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4547|birmingham|alabama|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6222|huntsville|alabama|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4537|mobile|alabama|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6758|tuscaloosa|alabama|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 9323|hemet|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4568|la jolla|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4535|palm desert|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4571|santa monica|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 9271|torrance|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 10746|victorville|california|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4559|denver|colorado|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6229|aventura|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 10603|lake mary|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 9325|orange park|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4550|palm harbor|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4570|sarasota|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4601|tampa|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4552|vero beach|florida|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 10745|meridian|idaho|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4548|chicago|illinois|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4557|springfield|illinois|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4605|wichita|kansas|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 10741|wheaton|maryland|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6417|fall river|massachusetts|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4561|dover|new hampshire|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 11222|freehold|new jersey|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6228|passaic|new jersey|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4544|albuquerque|new mexico|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4534|orchard park|new york|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 9324|plainview|new york|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4600|smithtown|new york|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 12821|the bronx|new york|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 4549|mayfield village|ohio|united states` — added _(2026-05-12)_ - `locations.site reference id/investigator# 6227|bend|oregon|united states` — added _(2026-05-12)_ --- *Canonical: https://parkinsonspathways.com/agent/trials/NCT00420927.md* *Source data (authoritative): https://clinicaltrials.gov/study/NCT00420927* *This page is a raw mirror with no AI summary, no editorial enrichment, and no Parkinson's-specific filtering.*