CClinicalTrials.gg
CompletedNCT05180240ARCHERUpdated Sep 30, 2026Results posted

Impact of CardiolRx on Myocardial Recovery in Patients With Acute Myocarditis

A Phase 2 interventional study of CardiolRx in Acute Myocarditis, sponsored by Cardiol Therapeutics Inc.. Completed at 37 sites in 5 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2026-09-30.

Sponsored by Cardiol Therapeutics Inc. · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
109
Allocation
Randomized
Ages
18 Years to 75 Years
Sex
All
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Study summary

Multi-center, double-blind, placebo-controlled, parallel group design. Patients with myocarditis will be screened and, if eligible, randomized within 10 days of the diagnostic CMR to CardiolRx or placebo.

CardiolRx is pharmaceutically produced Cannabidiol and is free of tetrahydrocannabinol (THC\<5 ppm). The treatment period is 12 weeks; a last follow-up visit is scheduled one week after the last treatment, 13 weeks after randomization. Study assessments include Cardiac Magnetic Resonance imaging (CMR), ECG monitoring, the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Columbia-Suicide Severity Rating Scale (C-SSRS) as well as physical exams and laboratory tests.

The primary and secondary outcome parameters are measured by CMR. Additional outcomes include clinical endpoints and changes in inflammatory and biomarkers.

Read the detailed description

Rationale:

Myocarditis is an acute inflammatory condition of the myocardium. Presentation of the disease may be fulminant and necessitate cardiac support, or even result in sudden cardiac death; milder cases are usually self-limiting but may progress to dilated cardiomyopathy with eventual end-stage heart failure. Other than treatments for associated heart failure there are no specific indicated treatments for myocarditis. CardiolRxTM (cannabidiol [CBD] solution), which is known to have anti-inflammatory properties, is being investigated to treat the underlying inflammatory process and thereby favorably modify acute myocarditis. The primary endpoints of the trial are cardiac magnetic resonance measures of left ventricular systolic function (ejection fraction and longitudinal strain) and myocardial edema (extra cellular volume) which have been shown to predict long term prognosis of patients with acute myocarditis.

Multi-center, double-blind, randomized, placebo-controlled, parallel group design. 1:1 randomization; treatment will be stratified within sites.

Patients diagnosed with acute myocarditis by a biopsy or a CMR will be screened within 10 days of the diagnostic CMR. Informed consent will be obtained at this point. For patients who have been diagnosed using an EMB, a CMR needs to be performed as well, which will be included in the informed consent form (ICF).Eligible patients will then be randomized within 10 days from the CMR assessment.

Baseline assessments include the following: Clinical assessment, including vital signs, ECG, 24-hr Holter, chest x-ray; Hematology and blood chemistry, NYHA classification, C SSRS and KCCQ. Frozen plasma will be retained for central analysis of hs-troponin, NT-proBNP and inflammatory markers.

Study treatment needs to be taken with food and will be initiated in the evening of Day 1, after all baseline assessments have been completed and the patient has been randomized.

Oral administration is as follows:

  • Week 1 (p.m. dose of Day 1 to a.m. dose of Day 7): 2.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo
  • Week 2 (p.m. dose of Day 7 to a.m. dose of Day 14):

    5 mg/kg of body weight b.i.d. CardiolRxTM or placebo

  • Week 3 (p.m. dose of Day 14 to a.m. dose of Day 21):

7.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo • Week 4 to end of treatment period (p.m. dose of Day 21 to

a.m. dose of last day of treatment period at week 12): 10 mg/kg of body weight b.i.d. CardiolRxTM or placebo

If the next higher dose after each study drug increase is not tolerated, the dose will be reduced to the previous tolerated dose.

Every week (before the next dose increase) the patient will be re-evaluated. This includes ECG monitoring at approximately 5 hours post-morning dose (time of Tmax) to surveil for deleterious effects on ECG intervals (particularly the QTc interval) and rhythm. Drug titration will be dependent on investigator or designate interrogation of the ECGs and the absence of new, clinically significant abnormalities on those ECGs.

Vital signs, concurrent medication and Adverse Events (AEs), including Serious Adverse Events (SAEs) will be recorded, blood chemistry including liver function tests, hematology as well as INR assessments will be carried out.

Final efficacy assessments (including a second CMR) will take place after 12 weeks of study treatment. A final safety assessment will take place after 13 weeks, 1 week after completion of study treatment.

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Conditions studied

  • Acute Myocarditis

Keywords

  • Pharmaceutically produced CBC
  • THC < 5ppm
03

In context

Lead sponsor

Cardiol Therapeutics Inc. is the lead sponsor of 4 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Males and females 18 years of age or older
  2. Diagnosed with acute myocarditis including:

    1. Clinical criteria (symptoms of chest pain, arrhythmia or shortness of breath, or history of viral-like illness), preferably followed by elevated troponin PLUS
    2. CMR diagnosis (Lake Louise Criteria) within 10 days prior to randomization OR
    3. Endomyocardial biopsy (EMB) showing either cellular inflammation and/or immunohistochemistry consistent with inflammation.
  3. Male subjects with partners of childbearing potential who have had a vasectomy or are willing to use double barrier contraception methods during the conduct of the study and for 2 months after the last dose of study drug.
  4. Women of childbearing potential willing to use an acceptable method of contraception starting with study drug administration and for a minimum of 2 months after study completion. Otherwise, women must be post- menopausal.

Exclusion criteria

Exclusion Criteria:

  1. Coronary artery disease (CAD) defined as a stenosis greater than 50% in a major epicardial coronary artery
  2. Severe valvular heart disease
  3. Inability to safely undergo CMR including administration of gadolinium
  4. Estimated glomerular filtration rate (eGFR) \< 30 ml/min
  5. Elevated alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 5 times the upper limit of normal (ULN) or ALT or AST >3x ULN plus bilirubin >2x ULN.
  6. Sepsis, defined as documented bacteremia at the time of presentation or other documented active infection.
  7. Severe left ventricular (LV) dysfunction requiring inotropic support, left ventricular assist device (LVAD) or other circulatory assist devices, or urgent need for transplantation
  8. Documented biopsy evidence of giant cell or eosinophilic myocarditis
  9. Prior history of sustained ventricular arrhythmia
  10. Acute coronary syndrome within 30 days
  11. Percutaneous coronary intervention within 30 days
  12. History of QT interval prolongation or QTc interval > 500 msec
  13. Treated with strong inducers CYP3A4 or CYP2C19, as listed in Appendix 17.8
  14. Treated with digoxin and/or type 1 or 3 antiarrhythmics
  15. Current participation in any research study involving investigational drugs or devices
  16. Inability or unwillingness to give informed consent
  17. Ongoing drug or alcohol abuse
  18. Women who are pregnant or breastfeeding
  19. Current diagnosis of cancer, with the exception of non-melanoma skin cancer
  20. Any factor, which would make it unlikely that the patient can comply with the study procedures
  21. On any cannabinoid during the past month
  22. Body weight > 170 kg
  23. Showing suicidal tendency as per the C-SSRS, administered at screening
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Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
109 participants (actual)

Study arms

  • Experimental
    CardiolRx

    * Week 1 (p.m. dose of Day 1 to a.m. dose of Day 7): 2.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 2 (p.m. dose of Day 7 to a.m. dose of Day 14): 5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 3 (p.m. dose of Day 14 to a.m. dose of Day 21): 7.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 4 to end of treatment period (p.m. dose of Day 21 to a.m. dose of last day of treatment period at week 12): 10 mg/kg of body weight b.i.d. CardiolRxTM or placebo

    Drug: CardiolRx

  • Placebo comparator
    Placebo

    * Week 1 (p.m. dose of Day 1 to a.m. dose of Day 7): 2.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 2 (p.m. dose of Day 7 to a.m. dose of Day 14): 5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 3 (p.m. dose of Day 14 to a.m. dose of Day 21): 7.5 mg/kg of body weight b.i.d. CardiolRxTM or placebo * Week 4 to end of treatment period (p.m. dose of Day 21 to a.m. dose of last day of treatment period at week 12): 10 mg/kg of body weight b.i.d. CardiolRxTM or placebo

    Drug: CardiolRx

Interventions

  • DrugCardiolRx

    Eligible patients will be randomized to receive CardiolRx or placebo. Intervention will be administered orally (via syringe) with food twice daily.

    Also known as: Cannabidiol

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What researchers measure

Primary outcomes

  1. Extracellular Volume (ECV)

    Change of ECV from baseline at 12 weeks, measured by cardiac Cardiac MRI. ECV is measuring the degree of edema and fibrosis. The unit of measure was percentage. It was the percentage of myocardial tissue that is extracellular space (i.e. fraction of the myocardium occupied by extracellular matrix and interstitial fluid).

    Time frame: 12 weeks post randomization

  2. Global Longitudinal Strain (GLS)

    The outcome was the change in GLS from baseline at 12 weeks, measured by cardiac Cardiac MRI. GLS is a predictor of cardiac function. The unit of measure is percentage. It is the percent change in myocardial length relative to its original (end-diastolic) length along the long axis. Longitudinal strain during systole is usually negative, because the ventricle shortens; normal peak GLS in healthy adults is around -20% (i.e., 20% shortening relative to original length)

    Time frame: 12 weeks post randomization

Secondary outcomes

  1. Change in Left-ventricular Ejection Fraction (LVEF) From Baseline at 12 Weeks

    Left-ventricular ejection fraction (LVEF) as measured by Cardiac MRI at 12 weeks. LVEF is a measure of cardiac function. The unit of measure is percentage. It is the percent of end-diastolic blood volume in the left ventricle that is ejected with each systolic contraction. Mathematically, LVEF = (stroke volume/end-diastolic volume) x 100.

    Time frame: 12 weeks post randomization

Other outcomes

  1. Change in Left-ventricular Mass From Baseline at 12 Weeks

    Left-ventricular mass at week 12, measured with cardiac MRI. Unit of measure is grams (g) of myocardium. The mass of left-ventricular myocardial tissue was calculated from lCMR using geometric assumptions (e.g., Devereux/ASE cube formula) and myocardial density.

    Time frame: From baseline to 12 weeks of treatment

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Results

Posted Jun 17, 2026
Limitations and caveats
The reduced number of analyzable CMRs with respect to ECV was the main limitation in this trial.

Participant flow

166 patients signed informed consent between July 28, 2022, and October 31,2024, in 29 centers in Brazil; France; Israel and the United States. There were 57 screening failures and 109 patients were randomized to either CardiolRx™ (N=56) or Placebo (N=53). All randomized patients started the IMP and completed the study as planned - no patient withdrew prematurely from follow-up. In total, 11 patients discontinued the IMP before the Week 12 visit, 6 on CardiolRx and 5 on placebo.

Participant flow — Overall Study
MilestoneCardiolRxPlacebo
Started5653
Completed5653
Not completed00

Outcome measures

PrimaryExtracellular Volume (ECV)

Change of ECV from baseline at 12 weeks, measured by cardiac Cardiac MRI. ECV is measuring the degree of edema and fibrosis. The unit of measure was percentage. It was the percentage of myocardial tissue that is extracellular space (i.e. fraction of the myocardium occupied by extracellular matrix and interstitial fluid).

Time frame:
12 weeks post randomization
Reported as:
Mean · percentage of tissue volume outside cell
Extracellular Volume (ECV)
percentage of tissue volume outside cellCardiolRxPlacebo
Extracellular Volume (ECV)-1.88 ± 3.25-1.60 ± 4.57
Statistical analysis
  • CardiolRx vs Placebo · ANCOVA · p = 0.2609 (Non-adjusted for multiple comparisons) · Mean difference (final values): -0.87 · 95% CI -2.40 to 0.66adjusted for baseline values
PrimaryGlobal Longitudinal Strain (GLS)

The outcome was the change in GLS from baseline at 12 weeks, measured by cardiac Cardiac MRI. GLS is a predictor of cardiac function. The unit of measure is percentage. It is the percent change in myocardial length relative to its original (end-diastolic) length along the long axis. Longitudinal strain during systole is usually negative, because the ventricle shortens; normal peak GLS in healthy adults is around -20% (i.e., 20% shortening relative to original length)

Time frame:
12 weeks post randomization
Reported as:
Mean · % of change in ventricle length
Global Longitudinal Strain (GLS)
% of change in ventricle lengthCardiolRxPlacebo
Global Longitudinal Strain (GLS)-0.68 ± 3.6-0.62 ± 3.68
Statistical analysis
  • CardiolRx vs Placebo · ANCOVA · p = 0.9021 (non-adjusted for multiple comparisons) · Mean difference (final values): -0.07 · 95% CI -1.21 to 1.07
SecondaryChange in Left-ventricular Ejection Fraction (LVEF) From Baseline at 12 Weeks

Left-ventricular ejection fraction (LVEF) as measured by Cardiac MRI at 12 weeks. LVEF is a measure of cardiac function. The unit of measure is percentage. It is the percent of end-diastolic blood volume in the left ventricle that is ejected with each systolic contraction. Mathematically, LVEF = (stroke volume/end-diastolic volume) x 100.

Time frame:
12 weeks post randomization
Reported as:
Mean · percentage
Change in Left-ventricular Ejection Fraction (LVEF) From Baseline at 12 Weeks
percentageCardiolRxPlacebo
Change in Left-ventricular Ejection Fraction (LVEF) From Baseline at 12 Weeks0.65 ± 8.381.75 ± 9.05
Statistical analysis
  • CardiolRx vs Placebo · ANCOVA · p = 0.6520 (non-adjusted for multiple comparisons) · Mean difference (final values): 0.55 · 95% CI -1.85 to 2.94
Other pre-specifiedChange in Left-ventricular Mass From Baseline at 12 Weeks

Left-ventricular mass at week 12, measured with cardiac MRI. Unit of measure is grams (g) of myocardium. The mass of left-ventricular myocardial tissue was calculated from lCMR using geometric assumptions (e.g., Devereux/ASE cube formula) and myocardial density.

Time frame:
From baseline to 12 weeks of treatment
Reported as:
Mean · gram
Change in Left-ventricular Mass From Baseline at 12 Weeks
gramCardiolRxPlacebo
Change in Left-ventricular Mass From Baseline at 12 Weeks-11.11 ± 15.32-2.83 ± 23.39
Statistical analysis
  • CardiolRx vs Placebo · ANCOVA · p = 0.0117 · Mean difference (final values): -9.23 · 95% CI -16.36 to -2.11
Post-hocChange in Extracellular Volume (ECV) in ml From Baseline at 12 Weeks

The total Extracellular Volume (ECV) was calculated in mL using the following formula:Total ECV volume (mL) = ܸECV fraction (%) x LV mass (g)/ 1.05 where 1.05 = the specificgravity of myocardium in g/mL. It is the absolute extracellular volume of the tissue or body compartment, reported as physical volume instead of fraction or percent.

Time frame:
baseline to 12 weeks
Reported as:
Mean · mL
Change in Extracellular Volume (ECV) in ml From Baseline at 12 Weeks
mLCardiolRxPlacebo
Change in Extracellular Volume (ECV) in ml From Baseline at 12 Weeks-5.96 ± 7.35-2.73 ± 9.48
Statistical analysis
  • CardiolRx vs Placebo · ANCOVA · p = 0.0538 (non-adjusted for multiple comparisons) · Mean difference (final values): -3.67 · 95% CI -7.41 to 0.06

Adverse events

Collected over 16 weeks in France and 13 weeks for rest of the world (Brazil, Israel and US). Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cannabidiol, Pharmaceutically Produced With < 5 Ppm THC0/56 (0%)6/56 (10.7%)42/56 (75%)
Placebo0/53 (0%)3/53 (5.7%)35/53 (66%)
Most frequent serious events
Most frequent serious events
EventCannabidiol, Pharmaceutically Produced With < 5 Ppm THCPlacebo
PalpitationCardiac disorders0/561/53
Alanine aminotransferase increasedInvestigations1/561/53
Aspartate aminotransferase increasedInvestigations0/561/53
HypocalcemiaMetabolism and nutrition disorders0/561/53
MyocarditisCardiac disorders1/560/53
Ventricular TachycardiaCardiac disorders1/560/53
GastritisGastrointestinal disorders1/560/53
Chest painGeneral disorders1/560/53
Transaminases increasedInvestigations1/560/53
TremorNervous system disorders1/560/53
Most frequent other events
Most frequent other events
EventCannabidiol, Pharmaceutically Produced With < 5 Ppm THCPlacebo
DiarrheaGastrointestinal disorders18/5611/53
Chest painGeneral disorders9/564/53
AstheniaGeneral disorders1/567/53
NauseaGastrointestinal disorders5/562/53
Alanine aminotransferase increasedInvestigations5/563/53
PalpitationsCardiac disorders1/564/53
NasopharyngitisInfections and infestations0/563/53
RashSkin and subcutaneous tissue disorders3/561/53

Baseline characteristics

modified ITT analysis population

Age, Continuous
Age, Continuous(years)CardiolRxPlaceboTotal
Mean35.8 ± 15.3539.6 ± 15.4737.7 ± 15.45
Sex: Female, Male
Sex: Female, Male(Participants)CardiolRxPlaceboTotal
Female10919
Male394180
Race (NIH/OMB)
Race (NIH/OMB)(Participants)CardiolRxPlaceboTotal
American Indian or Alaska Native000
Asian011
Native Hawaiian or Other Pacific Islander000
Black or African American527
White384179
More than one race011
Unknown or Not Reported6511
Region of Enrollment
Region of Enrollment(participants)CardiolRxPlaceboTotal
United States448
Brazil222850
Israel7714
France161127
Global longitudinal strain (GLS)
Global longitudinal strain (GLS)(%)CardiolRxPlaceboTotal
Mean-15.35 ± 3.10-15.34 ± 4.06-15.35 ± 3.60
Extracellular volume (ECV)
Extracellular volume (ECV)(%)CardiolRxPlaceboTotal
Mean29.74 ± 4.4730.83 ± 4.3130.29 ± 4.40
Left-ventricular ejection fraction (LVEF)
Left-ventricular ejection fraction (LVEF)(%)CardiolRxPlaceboTotal
Mean61.90 ± 8.8859.35 ± 10.7960.61 ± 9.93
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Study locations

37 sites
  • MedStar Heart and Vascular Institute
    Washington D.C., District of Columbia 20010, United States
  • Massachusetts General Hospital site
    Boston, Massachusetts 02114, United States
  • Minneapolis Heart Institute Foundation
    Minneapolis, Minnesota 55407, United States
  • Cleveland Clinic
    Cleveland, Ohio 44195, United States
  • University of Pittsburgh Medical Center
    Pittsburgh, Pennsylvania 15213, United States
  • Virginia Commonwealth University
    Richmond, Virginia 23298, United States
  • Nupec-Orizonti
    Belo Horizonte, Minas Gerais 30210090, Brazil
  • PUC trials
    Curitiba, Paraná 80230-130, Brazil
  • Complexo Hospitalar de Niterói
    Niterói, Rio de Janeiro 24020-096, Brazil
  • Hospital Moinhos de Vento
    Porto Alegre, Rio Grande do Sul 90035-001, Brazil
  • Hospital de Clínicas de Porto Alegre (HCPA)
    Porto Alegre, Rio Grande do Sul 90035-003, Brazil
  • Hospital Nove de Julho
    São Paulo, São Paulo 01409-002, Brazil
  • Hospital Felicio Rocho - Fundação Felice Rosso
    Belo Horizonte, Brazil
  • Hospital Angelina Caron
    Campina Grande do Sul, Brazil
  • Hospital São Lucas
    Porto Alegre, Brazil
  • Instituto D´Or de Pesquisa e Ensino
    Rio de Janeiro, 22281-100, Brazil
  • Hospital Pró-Cardíaco
    Rio de Janeiro, Brazil
  • Hospital Regional de São José
    São José, Brazil
  • Irmandade da Santa Casa de Misericórdia de São Paulo
    São Paulo, 01223-001, Brazil
  • Instituto do Coração - InCor
    São Paulo, Brazil
  • University of Alberta Hospital
    Edmonton, Alberta T6G2B7, Canada
  • McGill University Health Centre
    Montreal, Quebec H4A 3J1, Canada
  • Hopital Louis Pradel Hospices Civils de Lyon
    Bron, 69500, France
  • CHU de Montpellier
    Montpellier, 34295, France
  • Centre Hospitalier Universitaire de Nîmes
    Nîmes, 30029, France
  • Hôpital Lariboisière - Département de Cardiologie
    Paris, 75475, France
  • Hopital Bichat Claude Bernard
    Paris, France
  • Hôpital européen Georges-Pompidou
    Paris, France
  • Institut de Cardiologie hopital Pitié Salpêtrière
    Paris, France
  • Centre Hospitalier Universitaire de Poitiers
    Poitiers, France
  • Hôpital Foch
    Suresnes, 92150, France
  • Chu Rangueil
    Toulouse, France
  • Barzilai Medical Center
    Ashkelon, 7830604, Israel
  • Shaare Zedek Medical Center
    Jerusalem, 9103102, Israel
  • Beilinson Hospital, Rabin medical Center
    Petah Tikva, 4941492, Israel
  • Tel Aviv Sourasky Medical Center (Ichilov)
    Tel Aviv, 6423906, Israel
  • Shamir Medical Center (Assaf Harofeh)
    Zrifin, 70300, Israel
09

References and documents

Publications

  • Lee WS, Erdelyi K, Matyas C, Mukhopadhyay P, Varga ZV, Liaudet L, Hasku G, Cihakova D, Mechoulam R, Pacher P. Cannabidiol Limits T Cell-Mediated Chronic Autoimmune Myocarditis: Implications to Autoimmune Disorders and Organ Transplantation. Mol Med. 2016 Sep;22:136-146. doi: 10.2119/molmed.2016.00007. Epub 2016 Jan 8. PubMed 26772776 ↗
  • McNamara DM, Cooper LT, Friedrich MG, Arbel Y, Bhimaraj A, Bocchi E, Hamer A, Herdy AH, Kerneis M, Liu PP, Parker AB, Pocock SJ, Smith ER, Tang WHW, Torre-Amione G, Tschope C; ARCHER Study Group. Impact of cannabidiol on myocardial recovery in patients with acute myocarditis: primary results of the ARCHER study. ESC Heart Fail. 2026 Feb 3;13(1):xvaf034. doi: 10.1093/eschf/xvaf034. PubMed 41711722 ↗

Study documents

  • Study protocol · Dec 19, 2024
  • Statistical analysis plan · May 9, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Updates

1 registry update since Sep 25, 2026
Minor edits
Nothing that changes what the study is or who can join. Edited: verification date, site details and references
1 update, last Sep 30, 2026
Show all 1 update
  1. Sep 30, 2026
    Minor edits only
    + 3 other changes: verification date, site details and references

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

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Registry details

Key details

Study ID
NCT05180240
Lead sponsor
Cardiol Therapeutics Inc.
Responsible party
Sponsor
First posted
Jan 6, 2022
Start date
Jul 28, 2022
Primary completion
Jan 31, 2025
Completion
Feb 4, 2025
Results posted
Jun 17, 2026
Last update
Sep 30, 2026

Study contacts

Dennis McNamara, MD
study chair · University of Pittsburgh

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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