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    Clinical Trial Results:
    Long-term extension, multi-centre, multi-national study to evaluate the safety and tolerability of oral BAY63-2521(1 mg, 1.5 mg, 2 mg, or 2.5 mg tid) in patients with Chronic Thromboembolic Pulmonary Hypertension (CTEPH).

    Summary
    EudraCT number
    2008-003539-19
    Trial protocol
    DE   NL   FR   AT   IT   IE   ES   BE   CZ   PT   DK   SK   GB  
    Global end of trial date
    18 Aug 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Sep 2020
    First version publication date
    02 Sep 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BAY 63-2521/11349
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00910429
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Bayer AG
    Sponsor organisation address
    Kaiser-Wilhelm-Allee, Leverkusen, Germany, D-51368
    Public contact
    Therapeutic Area Head, Bayer AG, clinical-trials-contact@bayer.com
    Scientific contact
    Therapeutic Area Head, Bayer AG, clinical-trials-contact@bayer.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    18 Aug 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    18 Aug 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Aug 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To assess the long-term safety and tolerability of BAY63-2521 in patients with inoperable Chronic Thromboembolic Pulmonary Hypertension (CTEPH) or recurrent or persisting pulmonary hypertension after surgical treatment.
    Protection of trial subjects
    The conduct of this clinical study met all local legal and regulatory requirements. The study was conducted in accordance with ethical principles that have their origin in the Declaration of Helsinki and the International Council for Harmonization guideline E6: Good Clinical Practice. Before entering the study, the informed consent was read by and explained to all the subjects. Participating subjects signed informed consent form and could withdraw from the study at any time without any disadvantage and without having to provide a reason for this decision. Only investigators qualified by training and experience were selected as appropriate experts to investigate the study drug.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Jun 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 2
    Country: Number of subjects enrolled
    Japan: 14
    Country: Number of subjects enrolled
    Korea, Republic of: 5
    Country: Number of subjects enrolled
    Taiwan: 4
    Country: Number of subjects enrolled
    China: 30
    Country: Number of subjects enrolled
    Austria: 1
    Country: Number of subjects enrolled
    Belgium: 3
    Country: Number of subjects enrolled
    Czech Republic: 23
    Country: Number of subjects enrolled
    Denmark: 7
    Country: Number of subjects enrolled
    France: 9
    Country: Number of subjects enrolled
    Germany: 51
    Country: Number of subjects enrolled
    Italy: 13
    Country: Number of subjects enrolled
    Poland: 11
    Country: Number of subjects enrolled
    Portugal: 2
    Country: Number of subjects enrolled
    Russian Federation: 3
    Country: Number of subjects enrolled
    Spain: 3
    Country: Number of subjects enrolled
    Slovakia: 2
    Country: Number of subjects enrolled
    Swaziland: 2
    Country: Number of subjects enrolled
    Turkey: 5
    Country: Number of subjects enrolled
    United Kingdom: 3
    Country: Number of subjects enrolled
    Canada: 9
    Country: Number of subjects enrolled
    United States: 14
    Country: Number of subjects enrolled
    Argentina: 1
    Country: Number of subjects enrolled
    Brazil: 12
    Country: Number of subjects enrolled
    Mexico: 8
    Worldwide total number of subjects
    237
    EEA total number of subjects
    128
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    141
    From 65 to 84 years
    96
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Study was conducted at 71 centers in 25 countries or regions, between 01-JUL-2009 (first subject first visit) and 19-AUG-2019 (last subject last visit)

    Pre-assignment
    Screening details
    Of the 243 subjects who completed CHEST-1, 237 entered CHEST-2. 155 subjects were from the former riociguat treatment group, and 82 were from the former placebo group.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    Study titration phase was from week 1 to week 8, in titration phase, blinded with respect to the riociguat dose. Study main phase wass starting from week 12 to the end of study. In study main phase, unblinded with respect to riociguat dose.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Riociguat-Former Riociguat 1.0-2.5 mg
    Arm description
    Subjects were from the former riociguat (BAY 63-2521) treatment group of CHEST-1 (2007-000072-16)
    Arm type
    Experimental

    Investigational medicinal product name
    Riociguat
    Investigational medicinal product code
    BAY63-2521
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects from the riociguat 1.0-2.5mg group of CHEST-1 entered the extension study (CHEST-2) on the same dose as they received on the last day of CHEST-1 (Visit7). If the investigator requested a dose increase above that level via the IVRS, the subject received a sham titration. However, if the investigator requested a dose decrease (e.g. for safety reasons), dose modifications were possible, but without a subsequent re-increase before Visit5.

    Arm title
    Riociguat-Former Placebo
    Arm description
    ‌Subjects were from the former placebo group of CHEST-1
    Arm type
    Experimental

    Investigational medicinal product name
    Riociguat
    Investigational medicinal product code
    BAY63-2521
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    For subjects from the CHEST-1 placebo arm, the starting dose in CHEST-2 was 1.0 mg riociguat tid. The individual riociguat dose was titrated every 2weeks according to the peripheral SBP measured at trough before intake of the next morning dose. At the end of the titration phase (Visit5), subjects reached riociguat doses between 0.5mg tid and 2.5mg tid.

    Number of subjects in period 1
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Started
    155
    82
    Completed
    116
    61
    Not completed
    39
    21
         Consent withdrawn by subject
    3
    2
         Drug non-compliance
    1
    -
         Adverse event, non-fatal
    10
    5
         Death
    18
    12
         Lost to follow-up
    2
    1
         Protocol deviation
    1
    -
         Lack of efficacy
    4
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Riociguat-Former Riociguat 1.0-2.5 mg
    Reporting group description
    Subjects were from the former riociguat (BAY 63-2521) treatment group of CHEST-1 (2007-000072-16)

    Reporting group title
    Riociguat-Former Placebo
    Reporting group description
    ‌Subjects were from the former placebo group of CHEST-1

    Reporting group values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo Total
    Number of subjects
    155 82 237
    Age Categorical
    Units: Subjects
        Adults (18-64 years)
    91 50 141
        From 65-84 years
    64 32 96
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    59 ( 13.8 ) 59.2 ( 12.4 ) -
    Gender Categorical
    Units: Subjects
        Female
    104 49 153
        Male
    51 33 84
    Race / Ethnicity
    Units: Subjects
        White
    105 60 165
        Black or African American
    7 1 8
        Asian
    34 19 53
        Hispanic or Latino
    8 2 10
        Multiple races
    1 0 1

    End points

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    End points reporting groups
    Reporting group title
    Riociguat-Former Riociguat 1.0-2.5 mg
    Reporting group description
    Subjects were from the former riociguat (BAY 63-2521) treatment group of CHEST-1 (2007-000072-16)

    Reporting group title
    Riociguat-Former Placebo
    Reporting group description
    ‌Subjects were from the former placebo group of CHEST-1

    Subject analysis set title
    Long-term safety analysis set(SAF)
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All 237 subjects who completed 16 weeks of treatment in the double-blind CHEST-1 study entered long term extension CHEST-2 study. Baseline of CHEST-2 was Week 0 of CHEST-1. All 237 subjects were included in the long-term safety set

    Primary: Number of subjects with treatment-emergent adverse events (TEAE)

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    End point title
    Number of subjects with treatment-emergent adverse events (TEAE) [1]
    End point description
    Analyses of drug-related TEAEs were based on the assessment of causal relationship to study medication.
    End point type
    Primary
    End point timeframe
    From administration of first dose of study medication up to 2 days after end of treatment with study medication.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive statistics were done, no inferential statistical analyses were performed.
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Subjects
        Any TEAE
    153
    82
        Any drug-related TEAE
    77
    44
        Any serious TEAE
    96
    56
        Any drug-related serious TEAE
    14
    7
        Any TEAT leading to death
    22
    13
    No statistical analyses for this end point

    Primary: Number of subjects with death

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    End point title
    Number of subjects with death [2]
    End point description
    Analyses of deaths were based on the assessment of causal relationship to study medication. The safety follow-up visit was to be performed 30 days after the last dose of riociguat.
    End point type
    Primary
    End point timeframe
    From baseline to safety follow-up visit
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Descriptive statistics were done, no inferential statistical analyses were performed.
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Subjects
        Death
    22
    13
    No statistical analyses for this end point

    Secondary: Percentage of subjects with treatment-emergent high laboratory abnormalities in Hematology and Coagulation

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    End point title
    Percentage of subjects with treatment-emergent high laboratory abnormalities in Hematology and Coagulation
    End point description
    Percentage of subjects with a treatment-emergent shift in hematology and coagulation parameters from normal or low at baseline to a high value at a timepoint after the start of treatment. The percentage was calculated by comparing the number of subjects with a normal or low value at baseline who had at least one high value after the start of treatment with the number of subjects with a normal or low value at baseline who also had at least one valid value after start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Percentage
    number (not applicable)
        Activated partial thromboplastin time (sec)
    97.1
    90.5
        Basophils (Giga/L)
    1.4
    0.0
        Basophils / Leukocytes (%)
    18.4
    16.4
        Eosinophils (Giga/L)
    0.7
    5.4
        Eosinophils / Leukocytes (%)
    3.7
    9.7
        Erythrocytes (T/L)
    18.0
    24.2
        Hematocrit (%)
    41.2
    38.0
        Hemoglobin (g/dL)
    12.5
    10.8
        Leukocytes (Giga/L)
    8.0
    16.4
        Lymphocytes (Giga/L)
    0.0
    1.4
        Lymphocytes / Leukocytes (%)
    8.8
    7.4
        Monocytes (Giga/L)
    3.7
    8.6
        Monocytes / Leukocytes (%)
    15.6
    16.4
        Neutrophils (Giga/L)
    11.3
    23.3
        Neutrophils / Leukocytes (%)
    31.7
    32.9
        Platelets (Giga/L)
    17.2
    20.6
        Prothrombin international normalized ratio
    92.3
    75
    No statistical analyses for this end point

    Secondary: Percentage of subjects with treatment-emergent low laboratory abnormalities in Hematology and coagulation

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    End point title
    Percentage of subjects with treatment-emergent low laboratory abnormalities in Hematology and coagulation
    End point description
    Percentage of subjects with a treatment-emergent shift in hematology and coagulation parameters from normal or high at baseline to a low value at a timepoint after the start of treatment.The percentage was calculated by comparing the number of subjects with a normal or high value at baseline who had at least one low value after the start of treatment with the number of subjects with a normal or high value at baseline who also had at least one valid value after start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Percentage
    number (not applicable)
        Activated partial thromboplastin time (sec)
    2.9
    2.7
        Erythrocytes (T/L)
    21.1
    29.7
        Hematocrit (%)
    9.3
    17.6
        Hemoglobin (g/dL)
    30.0
    36.2
        Leukocytes (Giga/L)
    25.4
    25.4
        Lymphocytes (Giga/L)
    30.0
    22.4
        Lymphocytes / Leukocytes (%)
    39.3
    42.9
        Monocytes (Giga/L)
    0.7
    0.0
        Monocytes / Leukocytes (%)
    3.6
    2.7
        Neutrophils (Giga/L)
    10.8
    5.6
        Neutrophils / Leukocytes (%)
    5.8
    10.1
        Platelets (Giga/L)
    19.8
    19.4
        Prothrombin INR
    0.0
    0.0
    No statistical analyses for this end point

    Secondary: Change from baseline of hemoglobin in Hematology and coagulation

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    End point title
    Change from baseline of hemoglobin in Hematology and coagulation
    End point description
    Hemoglobin is a standard Hematology and coagulation parameter. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [3]
    82 [4]
    Units: gram/deciliter (g/dL)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    14.49 ( 1.82 )
    14.36 ( 1.70 )
        Change from baseline to Termination visit
    1.04 ( 1.58 )
    -1.37 ( 1.71 )
    Notes
    [3] - Baseline: N=140 Termination Visit: N=5
    [4] - Baseline: N=76 Termination visit: N=3
    No statistical analyses for this end point

    Secondary: Percentage of subjects with treatment-emergent high laboratory abnormalities in Clinical chemistry

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    End point title
    Percentage of subjects with treatment-emergent high laboratory abnormalities in Clinical chemistry
    End point description
    Percentage of subjects per treatment group with a treatment-emergent shift in clinical chemistry parameters from normal or low at baseline to a high value at a timepoint after the start of treatment. The percentage was calculated by comparing the number of subjects with a normal or low value at baseline who had at least one high value after the start of treatment with the number of subjects with a normal or low value at baseline who also had at least one valid value after start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Percentage
    number (not applicable)
        Alanine aminotransferase (U/L)
    11.5
    13.7
        Albumin (g/dL)
    0.0
    0.0
        Alkaline phosphatase (U/L)
    22.0
    19.4
        Aspartate aminotransferase (U/L)
    16.4
    14.1
        Bilirubin (mg/dL)
    17.2
    15.6
        Calcium (mg/dL)
    2.6
    0.0
        Creatine kinase (U/L)
    28.4
    30.3
        Creatinine (mg/dL)
    32.5
    31.0
        Gamma glutamyltransferase (U/L)
    22.3
    24.1
        Glutamate dehydrogenase (U/L)
    43.0
    34.0
        Phosphate (mg/dL)
    7.9
    5.0
        Potassium (mmol/L)
    4.3
    6.7
        Protein (g/dL)
    2.7
    0.0
        Pseudocholinesterase (U/mL)
    2.1
    0.0
        Sodium (mmol/L)
    1.4
    3.9
        Triacylglycerol lipase (U/L)
    18.8
    18.8
        Urate (mg/dL)
    13.6
    35.7
        Urea (mg/dL)
    22.9
    36.7
        eGFR MDRD method(mL/min/1.73 m2)
    0.0
    0.0
        Creatinine clearance (mL/min)
    11.5
    8.6
    No statistical analyses for this end point

    Secondary: Percentage of subjects with treatment-emergent low laboratory abnormalities in Clinical chemistry

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    End point title
    Percentage of subjects with treatment-emergent low laboratory abnormalities in Clinical chemistry
    End point description
    Percentage of subjects per treatment group with a treatment-emergent shift in clinical chemistry parameters from normal or high at baseline to a low value at a timepoint after the start of treatment. The percentage was calculated by comparing the number of subjects with a normal or high value at baseline who had at least one low value after the start of treatment with the number of subjects with a normal or high value at baseline who also had at least one valid value after start of treatment. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Percentage
    number (not applicable)
        Albumin (g/dL)
    2.0
    0.0
        Alkaline phosphatase (U/L)
    2.1
    0.0
        Bilirubin (mg/dL)
    0.0
    0.0
        Calcium (mg/dL)
    14.3
    6.3
        Creatine kinase (U/L)
    6.4
    6.8
        Creatinine (mg/dL)
    4.1
    3.9
        Gamma glutamyltransferase (U/L)
    0.0
    0.0
        Phosphate (mg/dL)
    10.5
    9.5
        Potassium (mmol/L)
    18.4
    18.9
        Protein (g/dL)
    6.3
    2.8
        Pseudocholinesterase (U/mL)
    10.0
    14.7
        Sodium (mmol/L)
    4.3
    6.6
        Triacylglycerol lipase (U/L)
    0.0
    0.0
        Urate (mg/dL)
    2.7
    2.6
        Urea (mg/dL)
    0.0
    1.3
        eGFR MDRDmethod (mL/min/1.73 m2)
    26.7
    22.4
        Creatinine clearance (mL/min)
    29.2
    40.6
    No statistical analyses for this end point

    Secondary: Change from baseline of urate in Clinical chemistry.

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    End point title
    Change from baseline of urate in Clinical chemistry.
    End point description
    Urate is a standard clinical chemistry parameter. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Secondary
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [5]
    82 [6]
    Units: milligram/deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    6.767 ( 1.859 )
    6.999 ( 2.193 )
        Change from baseline to Termination visit
    0.310 ( 2.916 )
    -1.290 ( 1.120 )
    Notes
    [5] - Baseline: N=147 Termination visit: N=5
    [6] - Baseline: N=77 Termination visit: N=3
    No statistical analyses for this end point

    Other pre-specified: Change of Systolic blood pressure (SBP)

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    End point title
    Change of Systolic blood pressure (SBP)
    End point description
    SBP was measured after the subject had been at rest for 10 minutes in a supine position. Low SBP was defined as SBP <95 mmHg, normal SBP as SBP 95–140mmHg, and high SBP as SBP >140 mmHg. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [7]
    82 [8]
    Units: millimetre(s) of mercury (mmHg)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    118.81 ( 14.96 )
    124.26 ( 16.14 )
        Change from baseline to Termination visit
    -3.96 ( 17.34 )
    -5.02 ( 14.79 )
    Notes
    [7] - Baseline: N=155 Termination visit: N=126
    [8] - Baseline: N=82 Termination visit: N=65
    No statistical analyses for this end point

    Other pre-specified: Change of Diastolic blood pressure (DBP)

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    End point title
    Change of Diastolic blood pressure (DBP)
    End point description
    DBP was measured after the subject had been at rest for 10 minutes in a supine position. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [9]
    82 [10]
    Units: mmHg
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    75.34 ( 9.75 )
    78.55 ( 9.46 )
        Change from baseline to Termination visit
    -6.16 ( 13.77 )
    -7.26 ( 11.09 )
    Notes
    [9] - Baseline: N=155 Termination visit: N=126
    [10] - Baseline: N=82 Termination visit: N=66
    No statistical analyses for this end point

    Other pre-specified: Change of Heart rate

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    End point title
    Change of Heart rate
    End point description
    Heart rate was measured after the subject had been at rest for 10 minutes in a supine position. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [11]
    82 [12]
    Units: beats/minute (BPM)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    77.66 ( 12.12 )
    76.11 ( 12.10 )
        Change from baseline to Termination visit
    -0.89 ( 13.85 )
    3.77 ( 14.69 )
    Notes
    [11] - Baseline: N=155 Termination visit: N=126
    [12] - Baseline: N=82 Termination visit: N=65
    No statistical analyses for this end point

    Other pre-specified: Change of Weight

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    End point title
    Change of Weight
    End point description
    Weight was evaluated for safety. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [13]
    82 [14]
    Units: kilogram (kg)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    74.01 ( 18.76 )
    77.29 ( 16.42 )
        From baseline to Termination visit
    -0.87 ( 5.86 )
    -2.97 ( 7.27 )
    Notes
    [13] - Baseline: N=155 Termination visit: N=123
    [14] - Baseline: N=82 Termination visit: N=64
    No statistical analyses for this end point

    Other pre-specified: Change of oxygen saturation (SaO2)

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    End point title
    Change of oxygen saturation (SaO2)
    End point description
    SaO2 is one parameters of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [15]
    82 [16]
    Units: Percentage
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    93.9 ( 2.7 )
    93.6 ( 2.4 )
        From baseline to Termination visit
    0.0 ( 2.6 )
    -2.3 ( 5.5 )
    Notes
    [15] - Baseline: N=154 Termination visit: N=3
    [16] - Baseline: N=81 Termination visit: N=3
    No statistical analyses for this end point

    Other pre-specified: Change of arterial partial oxygen pressure (PaO2)

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    End point title
    Change of arterial partial oxygen pressure (PaO2)
    End point description
    PaO2 is one parameter of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [17]
    82 [18]
    Units: mmHg
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    69.66 ( 11.90 )
    69.19 ( 10.96 )
        From baseline to Termination visit
    -1.67 ( 8.02 )
    2.00 ( 24.73 )
    Notes
    [17] - Baseline: N=154 Termination visit: N=3
    [18] - Baseline: N=81 Termination visit: N=4
    No statistical analyses for this end point

    Other pre-specified: Change of arterial partial pressure of carbon dioxide (PaCO2)

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    End point title
    Change of arterial partial pressure of carbon dioxide (PaCO2)
    End point description
    PaCO2 is one parameter of blood gas. The sample was obtained with the participant resting in a sitting or supine position for at least 10 minutes. A termination visit was only to be performed in the case of premature termination of study medication or if the sponsor announced the official end of the study.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Termination visit, up to 10 years
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [19]
    82 [20]
    Units: mmHg
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    33.20 ( 4.61 )
    33.52 ( 4.60 )
        From baseline to Termination visit
    -0.33 ( 1.53 )
    -2.25 ( 4.50 )
    Notes
    [19] - Baseline: N=154 Termination visit: N=3
    [20] - Baseline: N=81 Termination visit: N=4
    No statistical analyses for this end point

    Other pre-specified: Change of RR duration from Electrocardiogram (ECG)

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    End point title
    Change of RR duration from Electrocardiogram (ECG)
    End point description
    Heart rate from ECG is derived from the RR duration, unless arrhythmias such as atrial fibrillation or ventricular extra beats require additional calculations. ECGs were recorded after the subject had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set. "99999" denotes that value was not calculated due to very low number of subjects.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Month 48
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [21]
    82 [22]
    Units: millisecond (msec)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    812.90 ( 144.31 )
    828.47 ( 147.54 )
        Change rom baseline to Month 48
    152.00 ( 236.17 )
    99999 ( 99999 )
    Notes
    [21] - Baseline: N=149 Month 48: N=2
    [22] - Baseline: N=75 Month 48: N=0
    No statistical analyses for this end point

    Other pre-specified: Change of PR duration from ECG

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    End point title
    Change of PR duration from ECG
    End point description
    PR duration was evaluated as part of ECG. ECGs were recorded after the subject had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set. "99999" denotes that value was not calculated due to very low number of subjects.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Month 48
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [23]
    82 [24]
    Units: msec
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    173.22 ( 26.49 )
    174.92 ( 24.35 )
        Change from baseline to Month 48
    -10.00 ( 11.31 )
    99999 ( 99999 )
    Notes
    [23] - Baseline: N=147 Month 48: N=2
    [24] - Baseline: N=72 Month 48: N=0
    No statistical analyses for this end point

    Other pre-specified: Change of QRS duration from ECG

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    End point title
    Change of QRS duration from ECG
    End point description
    QRS duration was evaluated as part of ECG. ECGs were recorded after the subject had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set. "99999" denotes that value was not calculated due to very low number of subjects.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Month 48
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [25]
    82 [26]
    Units: msec
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    104.30 ( 17.85 )
    104.11 ( 18.24 )
        Change from baseline to Month 48
    3.00 ( 4.24 )
    99999 ( 99999 )
    Notes
    [25] - Baseline: N=148 Month 48: N=2
    [26] - Baseline: N=74 Month 48: N=0
    No statistical analyses for this end point

    Other pre-specified: Change of QT duration in ECG

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    End point title
    Change of QT duration in ECG
    End point description
    QT duration was evaluated as part of ECG. ECGs were recorded after the subject had been at rest for 15 minutes in a supine position. Analyses up to Month 48. After this timepoint, data was available for considerably fewer participants in the analysis set. "99999" denotes that value was not calculated due to very low number of subjects.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Month 48
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [27]
    82 [28]
    Units: msec
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    405.82 ( 31.29 )
    408.45 ( 30.98 )
        Change from baseline to Month 48
    42.00 ( 39.60 )
    99999 ( 99999 )
    Notes
    [27] - Baseline: N=114 Month 48: N=2
    [28] - Baseline: N=53 Month 48: N=0
    No statistical analyses for this end point

    Other pre-specified: Change in Six-minute walking distance (6MWD) test

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    End point title
    Change in Six-minute walking distance (6MWD) test
    End point description
    6MWD is exercise testing and is one of efficacy evaluation
    End point type
    Other pre-specified
    End point timeframe
    From baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [29]
    82 [30]
    Units: meters
    median (full range (min-max))
        Baseline (Week 0)
    361.0 (150 to 557)
    372.0 (170 to 474)
        Change from baseline to End of study visit
    31.0 (-447 to 230)
    12.5 (-448 to 215)
    Notes
    [29] - Baseline: N=155 End of study visit: N=155
    [30] - Baseline: N=82 End of study visit: N=82
    No statistical analyses for this end point

    Other pre-specified: Change in Pulmonary vascular resistance (PVR)

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    End point title
    Change in Pulmonary vascular resistance (PVR)
    End point description
    Pulmonary vascular resistance (PVR) was measured only if right-heart catheterization was performed as part of a regular diagnostic work-up. Analyses up to Month 48 due to limited data. "99999" denotes that value was not calculated due to very low number of subjects.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Month 45 and Month 48
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [31]
    82 [32]
    Units: dyn*s*cm-5
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    796.64 ( 435.24 )
    761.83 ( 388.87 )
        Change from baseline to Month 45
    99999 ( 99999 )
    -1243.48 ( 99999 )
        Change from baseline to Month 48
    -148.29 ( 74.39 )
    99999 ( 99999 )
    Notes
    [31] - Baseline: N=146 Month 45: N=0 Month 48: N=2
    [32] - Baseline: N=80 Month 45: N=1 Month 48: N=0
    No statistical analyses for this end point

    Other pre-specified: Change in N-terminal prohormone of brain natriuretic peptide (NT-proBNP)

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    End point title
    Change in N-terminal prohormone of brain natriuretic peptide (NT-proBNP)
    End point description
    NT-proBNP levels in the blood are used for diagnosis of acute congestive heart failure (CHF) and may be useful to establish prognosis in heart failure
    End point type
    Other pre-specified
    End point timeframe
    From baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [33]
    82 [34]
    Units: picograms/millilitre (pg/mL)
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    1553.19 ( 2435.94 )
    1404.23 ( 1745.48 )
        Change from baseline to End of study visit
    -125.99 ( 2503.78 )
    -187.96 ( 1438.96 )
    Notes
    [33] - Baseline: N=135 End of study visit: N=135
    [34] - Baseline: N=69 End of study visit: N=69
    No statistical analyses for this end point

    Other pre-specified: Change in World Health Organization (WHO) functional class

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    End point title
    Change in World Health Organization (WHO) functional class
    End point description
    The subject’s functional class was determined according to the WHO classification: I: Patients with PH but without resulting limitation of physical activity. Ordinary physical activity does not cause undue dyspnea or fatigue, chest pain, or near syncope. II: Patients with PH resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity causes undue dyspnea or fatigue, chest pain, or near syncope. III: Patients with PH resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes undue dyspnea or fatigue, chest pain, or near syncope. IV: Patients with PH with inability to carry out any physical activity without symptoms. These subjects manifest signs of right-heart failure. Dyspnea and/or fatigue may even be present at rest. Discomfort is increased by any physical activity.
    End point type
    Other pre-specified
    End point timeframe
    From baseline to End of study (EOS) visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [35]
    82 [36]
    Units: Subjects
        Baseline-class I
    3
    0
        Baseline-class II
    48
    25
        Baseline-class III
    100
    54
        Baseline-class IV
    4
    2
        Baseline-Missing
    0
    1
        Change from baseline to EOS visit- -2
    7
    4
        Change from baseline to EOS visit- -1
    44
    24
        Change from baseline to EOS visit- 0
    72
    38
        Change from baseline to EOS visit- +1
    11
    2
        Change from baseline to EOS visit- +2
    13
    7
        Change from baseline to EOS visit- +3
    7
    6
        Change from baseline to EOS visit- +4
    1
    0
    Notes
    [35] - Baseline: N=155 End of study visit: N=155
    [36] - Baseline: N=82 End of study visit: N=81
    No statistical analyses for this end point

    Other pre-specified: Number of subjects with clinical worsening

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    End point title
    Number of subjects with clinical worsening
    End point description
    Time to clinical worsening was a parameter that combined death and events reflective of persistent clinical worsening of the subject’s underlying diagnosis of pulmonary hypertension (PH).
    End point type
    Other pre-specified
    End point timeframe
    From the baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Subjects
        Pulmonary endarterectomy
    4
    3
        Hospitalization due to PH
    7
    3
        Start of new PH treatment
    21
    9
        Decrease in 6MWD due to PH
    4
    2
        Persistent worsening of functional class due to PH
    7
    2
        Death
    22
    13
        Any clinical worsening
    45
    23
    No statistical analyses for this end point

    Other pre-specified: Incidence of clinical worsening events

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    End point title
    Incidence of clinical worsening events
    End point description
    Time to clinical worsening was a parameter that combined death and events reflective of persistent clinical worsening of the subject’s underlying diagnosis of pulmonary hypertension (PH).
    End point type
    Other pre-specified
    End point timeframe
    From the baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155
    82
    Units: Percentage per 100 person-years
    number (not applicable)
        Pulmonary endarterectomy
    0.73
    1.04
        Hospitalization due to PH
    1.65
    1.04
        Start of new PH treatment
    4.40
    3.81
        Decrease in 6MWD due to PH
    0.73
    0.69
        Persistent worsening of functional class due to PH
    1.28
    0.69
        Death
    4.04
    4.50
        Any clinical worsening event
    12.85
    11.77
    No statistical analyses for this end point

    Other pre-specified: Change from baseline in Borg CR 10 Scale

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    End point title
    Change from baseline in Borg CR 10 Scale
    End point description
    The Borg CR10 Scale was measured in conjunction with the 6MWD test. The test was explained to the subject before starting the 6MWD test. Subjects were asked to rank their exertion at the end of the 6MWD test. Low values indicate low levels of exertion; high values indicate more intense exertion reported by the participant. The score ranges from 0 ("Nothing at all") to 10 (“Extremely strong – Maximal”).
    End point type
    Other pre-specified
    End point timeframe
    From baseline to Week 12
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [37]
    82 [38]
    Units: Scores on a scale
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    4.36 ( 2.30 )
    4.45 ( 2.26 )
        Change from baseline to Week 12
    -1.04 ( 2.35 )
    -0.70 ( 1.93 )
    Notes
    [37] - Baseline: N=155 Week 12: N=143
    [38] - Baseline: N=82 Week 12: N=75
    No statistical analyses for this end point

    Other pre-specified: Change in score of EQ-5D questionnaire

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    End point title
    Change in score of EQ-5D questionnaire
    End point description
    The EQ-5D is a standardized instrument for use as a measure of health outcome. The EQ-5D is a self report questionnaire. The utility score is calculated based on five questions concerning problems with mobility, self-care, usual activities, pain/discomfort and anxiety/depression. An increase in the utility score represents an improvement in quality of life. The score ranges from -0.594 (worst answer in all five questions) to 1 (best answer in all five questions).
    End point type
    Other pre-specified
    End point timeframe
    From baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [39]
    82 [40]
    Units: Scores on a scale
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    0.6406 ( 0.2509 )
    0.6569 ( 0.2518 )
        Change from baseline to End of study Visit
    -0.1008 ( 0.4965 )
    -0.1230 ( 0.5213 )
    Notes
    [39] - Baseline: N=154 End of study visit: N=154
    [40] - Baseline: N=81 End of study visit: N=81
    No statistical analyses for this end point

    Other pre-specified: Change in score of Living with Pulmonary Hypertension (LPH) questionnaire

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    End point title
    Change in score of Living with Pulmonary Hypertension (LPH) questionnaire
    End point description
    The LPH questionnaire is designed to measure the effects of PH and PH-specific treatments on an individual’s quality of life. The LPH is a self-report questionnaire and was completed by the subject. The LPH total score can range from 0 (best) to 105 (worst).
    End point type
    Other pre-specified
    End point timeframe
    From baseline to End of study visit
    End point values
    Riociguat-Former Riociguat 1.0-2.5 mg Riociguat-Former Placebo
    Number of subjects analysed
    155 [41]
    82 [42]
    Units: Scores on a scale
    arithmetic mean (standard deviation)
        Baseline (Week 0)
    42.19 ( 22.05 )
    46.01 ( 22.93 )
        Change from baseline to End of study Visit
    -2.64 ( 29.26 )
    -0.56 ( 30.83 )
    Notes
    [41] - Baseline: N=152 End of study visit: N=152
    [42] - Baseline: N=80 End of study visit: N=80
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From administration of first dose of study medication up to 2 days after end of treatment with study medication.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    Former Riociguat 1.0-2.5 mg
    Reporting group description
    Subjects from the riociguat 1.0-2.5 mg group of CHEST-1 entered the extension study(CHEST-2) with the same dose as they received on the last day of CHEST-1 (Visit7).

    Reporting group title
    Former Placebo
    Reporting group description
    Subjects from the placebo group of CHEST-1 entered the extension study (CHEST-2),the starting dose in CHEST-2 was 1.0 mg riociguat tid.

    Serious adverse events
    Former Riociguat 1.0-2.5 mg Former Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    96 / 155 (61.94%)
    56 / 82 (68.29%)
         number of deaths (all causes)
    22
    13
         number of deaths resulting from adverse events
    22
    13
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Breast cancer
         subjects affected / exposed
    3 / 155 (1.94%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fibroadenoma of breast
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant melanoma
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant melanoma in situ
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Plasma cell myeloma
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Transitional cell carcinoma
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Uterine leiomyoma
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung neoplasm
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Rectal neoplasm
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thyroid cancer
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Vascular disorders
    Circulatory collapse
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    3 / 155 (1.94%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Temporal arteritis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vena cava thrombosis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Surgical and medical procedures
    Angioplasty
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystectomy
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colostomy
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritoneal dialysis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Removal of internal fixation
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Splenectomy
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transurethral prostatectomy
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vitrectomy
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vena cava filter insertion
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hysterosalpingo-oophorectomy
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Knee operation
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hospitalisation
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cervical conisation
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac ablation
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary artery therapeutic procedure
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cataract operation
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary endarterectomy
         subjects affected / exposed
    2 / 155 (1.29%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Pregnancy
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 155 (0.65%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Fatigue
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Generalised oedema
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 155 (0.65%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pelvic mass
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Reproductive system and breast disorders
    Bartholin's cyst
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vaginal haemorrhage
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adenomyosis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthma
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Bronchospasm
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    2 / 155 (1.29%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    4 / 155 (2.58%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiogenic pulmonary oedema
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    2 / 155 (1.29%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    1 / 1
    0 / 1
    Pulmonary hypertension
         subjects affected / exposed
    16 / 155 (10.32%)
    13 / 82 (15.85%)
         occurrences causally related to treatment / all
    1 / 29
    0 / 15
         deaths causally related to treatment / all
    0 / 2
    0 / 3
    Pulmonary oedema
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sleep apnoea syndrome
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary arterial hypertension
         subjects affected / exposed
    4 / 155 (2.58%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Psychiatric disorders
    Bipolar I disorder
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric decompensation
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular cognitive impairment
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Device dislocation
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Angiogram pulmonary
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Catheterisation cardiac
         subjects affected / exposed
    8 / 155 (5.16%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 9
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colonoscopy
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    International normalised ratio increased
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigation
         subjects affected / exposed
    2 / 155 (1.29%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Clavicle fracture
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Concussion
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foot fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Humerus fracture
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Incisional hernia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple injuries
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Radius fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Traumatic haematoma
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Procedural pain
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    5 / 155 (3.23%)
    5 / 82 (6.10%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    5 / 155 (3.23%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    1 / 7
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial tachycardia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    5 / 155 (3.23%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 5
    0 / 1
    Cardiac failure
         subjects affected / exposed
    8 / 155 (5.16%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 9
    0 / 3
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    Cardiac failure acute
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cor pulmonale chronic
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Prinzmetal angina
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Right ventricular failure
         subjects affected / exposed
    13 / 155 (8.39%)
    8 / 82 (9.76%)
         occurrences causally related to treatment / all
    0 / 24
    0 / 13
         deaths causally related to treatment / all
    0 / 5
    0 / 1
    Supraventricular extrasystoles
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute coronary syndrome
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute right ventricular failure
         subjects affected / exposed
    3 / 155 (1.94%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Nervous system disorders
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dementia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    14 / 155 (9.03%)
    11 / 82 (13.41%)
         occurrences causally related to treatment / all
    3 / 16
    5 / 17
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vertebrobasilar stroke
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    4 / 155 (2.58%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    3 / 6
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bicytopenia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Glaucoma
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Retinal detachment
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vitreous haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulum
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulum intestinal
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Food poisoning
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastritis erosive
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    6 / 155 (3.87%)
    3 / 82 (3.66%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Gingival bleeding
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hiatus hernia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Incarcerated inguinal hernia
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Melaena
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mechanical ileus
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestine polyp
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Varices oesophageal
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Retroperitoneal haematoma
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Intestinal haemorrhage
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct stone
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Purpura
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Azotaemia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 155 (1.29%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary incontinence
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic kidney disease
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    3 / 155 (1.94%)
    5 / 82 (6.10%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Endocrine disorders
    Myxoedema
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rheumatoid arthritis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    2 / 155 (1.29%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    2 / 155 (1.29%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphangitis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pelvic inflammatory disease
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    17 / 155 (10.97%)
    7 / 82 (8.54%)
         occurrences causally related to treatment / all
    0 / 20
    0 / 8
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Pyelonephritis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    3 / 155 (1.94%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinusitis
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 155 (0.00%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 155 (1.29%)
    2 / 82 (2.44%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Subdiaphragmatic abscess
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    3 / 155 (1.94%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone abscess
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gout
         subjects affected / exposed
    1 / 155 (0.65%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 155 (0.00%)
    1 / 82 (1.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoproteinaemia
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Steroid diabetes
         subjects affected / exposed
    1 / 155 (0.65%)
    0 / 82 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Former Riociguat 1.0-2.5 mg Former Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    148 / 155 (95.48%)
    79 / 82 (96.34%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    12 / 155 (7.74%)
    10 / 82 (12.20%)
         occurrences all number
    13
    13
    General disorders and administration site conditions
    Chest discomfort
         subjects affected / exposed
    7 / 155 (4.52%)
    7 / 82 (8.54%)
         occurrences all number
    12
    9
    Chest pain
         subjects affected / exposed
    15 / 155 (9.68%)
    8 / 82 (9.76%)
         occurrences all number
    20
    10
    Fatigue
         subjects affected / exposed
    10 / 155 (6.45%)
    8 / 82 (9.76%)
         occurrences all number
    10
    8
    Oedema
         subjects affected / exposed
    6 / 155 (3.87%)
    8 / 82 (9.76%)
         occurrences all number
    8
    13
    Oedema peripheral
         subjects affected / exposed
    38 / 155 (24.52%)
    27 / 82 (32.93%)
         occurrences all number
    58
    40
    Pyrexia
         subjects affected / exposed
    9 / 155 (5.81%)
    4 / 82 (4.88%)
         occurrences all number
    11
    7
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    27 / 155 (17.42%)
    17 / 82 (20.73%)
         occurrences all number
    34
    23
    Dyspnoea
         subjects affected / exposed
    25 / 155 (16.13%)
    15 / 82 (18.29%)
         occurrences all number
    29
    23
    Epistaxis
         subjects affected / exposed
    17 / 155 (10.97%)
    11 / 82 (13.41%)
         occurrences all number
    20
    15
    Haemoptysis
         subjects affected / exposed
    8 / 155 (5.16%)
    6 / 82 (7.32%)
         occurrences all number
    10
    9
    Hypoxia
         subjects affected / exposed
    8 / 155 (5.16%)
    9 / 82 (10.98%)
         occurrences all number
    8
    10
    Productive cough
         subjects affected / exposed
    8 / 155 (5.16%)
    3 / 82 (3.66%)
         occurrences all number
    9
    4
    Pulmonary hypertension
         subjects affected / exposed
    8 / 155 (5.16%)
    7 / 82 (8.54%)
         occurrences all number
    16
    8
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    8 / 155 (5.16%)
    9 / 82 (10.98%)
         occurrences all number
    8
    10
    Investigations
    Activated partial thromboplastin time prolonged
         subjects affected / exposed
    10 / 155 (6.45%)
    2 / 82 (2.44%)
         occurrences all number
    15
    2
    Blood potassium decreased
         subjects affected / exposed
    1 / 155 (0.65%)
    5 / 82 (6.10%)
         occurrences all number
    1
    9
    International normalised ratio increased
         subjects affected / exposed
    13 / 155 (8.39%)
    6 / 82 (7.32%)
         occurrences all number
    19
    6
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    4 / 155 (2.58%)
    5 / 82 (6.10%)
         occurrences all number
    4
    5
    Ligament sprain
         subjects affected / exposed
    9 / 155 (5.81%)
    3 / 82 (3.66%)
         occurrences all number
    10
    3
    Contusion
         subjects affected / exposed
    12 / 155 (7.74%)
    7 / 82 (8.54%)
         occurrences all number
    16
    8
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    12 / 155 (7.74%)
    6 / 82 (7.32%)
         occurrences all number
    13
    11
    Palpitations
         subjects affected / exposed
    13 / 155 (8.39%)
    9 / 82 (10.98%)
         occurrences all number
    15
    11
    Supraventricular extrasystoles
         subjects affected / exposed
    2 / 155 (1.29%)
    5 / 82 (6.10%)
         occurrences all number
    3
    8
    Ventricular extrasystoles
         subjects affected / exposed
    4 / 155 (2.58%)
    5 / 82 (6.10%)
         occurrences all number
    4
    8
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    34 / 155 (21.94%)
    20 / 82 (24.39%)
         occurrences all number
    47
    28
    Headache
         subjects affected / exposed
    14 / 155 (9.03%)
    12 / 82 (14.63%)
         occurrences all number
    19
    21
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    15 / 155 (9.68%)
    9 / 82 (10.98%)
         occurrences all number
    24
    9
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    8 / 155 (5.16%)
    8 / 82 (9.76%)
         occurrences all number
    11
    8
    Abdominal pain upper
         subjects affected / exposed
    13 / 155 (8.39%)
    7 / 82 (8.54%)
         occurrences all number
    16
    9
    Constipation
         subjects affected / exposed
    14 / 155 (9.03%)
    9 / 82 (10.98%)
         occurrences all number
    17
    11
    Diarrhoea
         subjects affected / exposed
    30 / 155 (19.35%)
    17 / 82 (20.73%)
         occurrences all number
    37
    27
    Dyspepsia
         subjects affected / exposed
    17 / 155 (10.97%)
    11 / 82 (13.41%)
         occurrences all number
    22
    12
    Gastritis
         subjects affected / exposed
    4 / 155 (2.58%)
    6 / 82 (7.32%)
         occurrences all number
    5
    6
    Gastrooesophageal reflux disease
         subjects affected / exposed
    9 / 155 (5.81%)
    4 / 82 (4.88%)
         occurrences all number
    10
    5
    Nausea
         subjects affected / exposed
    19 / 155 (12.26%)
    16 / 82 (19.51%)
         occurrences all number
    23
    27
    Toothache
         subjects affected / exposed
    10 / 155 (6.45%)
    4 / 82 (4.88%)
         occurrences all number
    10
    4
    Vomiting
         subjects affected / exposed
    15 / 155 (9.68%)
    8 / 82 (9.76%)
         occurrences all number
    19
    8
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    9 / 155 (5.81%)
    3 / 82 (3.66%)
         occurrences all number
    10
    3
    Rash
         subjects affected / exposed
    2 / 155 (1.29%)
    6 / 82 (7.32%)
         occurrences all number
    2
    6
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    28 / 155 (18.06%)
    10 / 82 (12.20%)
         occurrences all number
    33
    19
    Back pain
         subjects affected / exposed
    27 / 155 (17.42%)
    11 / 82 (13.41%)
         occurrences all number
    40
    14
    Muscle spasms
         subjects affected / exposed
    8 / 155 (5.16%)
    4 / 82 (4.88%)
         occurrences all number
    12
    6
    Musculoskeletal pain
         subjects affected / exposed
    8 / 155 (5.16%)
    5 / 82 (6.10%)
         occurrences all number
    8
    6
    Pain in extremity
         subjects affected / exposed
    16 / 155 (10.32%)
    8 / 82 (9.76%)
         occurrences all number
    16
    11
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    24 / 155 (15.48%)
    11 / 82 (13.41%)
         occurrences all number
    39
    15
    Influenza
         subjects affected / exposed
    7 / 155 (4.52%)
    5 / 82 (6.10%)
         occurrences all number
    7
    8
    Nasopharyngitis
         subjects affected / exposed
    55 / 155 (35.48%)
    24 / 82 (29.27%)
         occurrences all number
    108
    47
    Pneumonia
         subjects affected / exposed
    11 / 155 (7.10%)
    4 / 82 (4.88%)
         occurrences all number
    12
    4
    Upper respiratory tract infection
         subjects affected / exposed
    26 / 155 (16.77%)
    13 / 82 (15.85%)
         occurrences all number
    32
    25
    Urinary tract infection
         subjects affected / exposed
    15 / 155 (9.68%)
    9 / 82 (10.98%)
         occurrences all number
    24
    15
    Respiratory tract infection
         subjects affected / exposed
    12 / 155 (7.74%)
    8 / 82 (9.76%)
         occurrences all number
    27
    17
    Metabolism and nutrition disorders
    Hyperuricaemia
         subjects affected / exposed
    5 / 155 (3.23%)
    7 / 82 (8.54%)
         occurrences all number
    5
    8
    Hypokalaemia
         subjects affected / exposed
    16 / 155 (10.32%)
    9 / 82 (10.98%)
         occurrences all number
    20
    14
    Decreased appetite
         subjects affected / exposed
    6 / 155 (3.87%)
    6 / 82 (7.32%)
         occurrences all number
    6
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    09 Jun 2009
    Amendment 3:This amendment was implemented in response to recommendations from a series of investigator meetings conducted on a global level. The major changes concerned: - Clarifications and additions of exclusion criteria, including mandatory withdrawal from the trial if a subject misses study medication for longer than 3days at a stretch (9 missing doses) during the titration phase - Specification of 6MWD test - Change of Modified Borg Dyspnoea score to Borg CR10 Scale - Collection of healthcare resource information - Addition of definition of physical training program - Specification of timelines for study medication dosing - Addition of methodology for blood pressure measurement - Addition of dizziness and syncope as undesirable effects - Extension of visit window from Vn on to 14days - Addition of role of SC and DMC
    21 Mar 2010
    Amendment 4:This amendment was implemented in response to recommendations from the SC and a series of investigator meetings conducted on a global level. The major changes concerned: - Abolition of mandatory overnight stays at Visit1 - Clarification of contraception methods in exclusion criteria - Clarification of pregnancy testing - Change in assessment periods - Clarification of use of the Modified Borg Dyspnoea Score in subjects who were enrolled before approval of CHEST-1 amendment3 in their country - Collection of smoking status information - Smoking added as interaction. Clearance of riociguat was found to be increased in smokers compared to non-smokers in study12166 in subjects with PH. - Addition of vomiting and gastritis as undesirable effects - Visit window for safety follow-up visit extended from 30 (+2) days to 30 (+5) days.
    14 Feb 2011
    Amendment 5:This amendment modified the protocol to correct some typographical errors and to add laboratory measurements for calcium and phosphate for subjects included under amendment6 of CHEST-1.
    12 Dec 2012
    Amendment 8:This amendment was initiated as an update based on the results of CHEST-1 and the overall riociguat development program. Changes to the protocol focused on operational aspects and were to facilitate some of the study-related activities. Among others, central laboratory and ECG collection was stopped and instead performed locally upon decision of the investigator. Visit procedures at individual visits were reduced, but all other aspects of safety monitoring remained unchanged. Other changes concerned: - Clarification of SAE definition: any hospitalization required to conduct a routine RHC was excluded from the definition - Change in 6MWD test: two conditions related to supplemental oxygen were removed. - DMC: a statement was added that DMC would stop when all patients are on open label dose of riociguat.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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