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    Clinical Trial Results:
    AFFIRM: A Multinational Phase 3, Randomized, Double-Blind, Placebo-Controlled Efficacy and Safety Study of Oral MDV3100 in Patients with Progressive Castration-Resistant Prostate Cancer Previously Treated with Docetaxel-Based Chemotherapy

    Summary
    EudraCT number
    2009-013174-41
    Trial protocol
    BE   GB   FR   ES   DE   AT   IT  
    Global end of trial date
    02 Nov 2017

    Results information
    Results version number
    v2(current)
    This version publication date
    03 Nov 2018
    First version publication date
    06 Jan 2017
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    CRPC2 (C3431010)
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00974311
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Pfizer Inc.
    Sponsor organisation address
    235 E 42nd Street, New York, United States, 10017
    Public contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., 001 18007181021, ClinicalTrials.gov_Inquiries@pfizer.com
    Scientific contact
    Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., 001 18007181021, ClinicalTrials.gov_Inquiries@pfizer.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
    20 Feb 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Nov 2017
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the benefit of MDV3100 as compared to placebo as assessed by overall survival.
    Protection of trial subjects
    The study was conducted in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Council for Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Sep 2009
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety
    Long term follow-up duration
    5 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Argentina: 10
    Country: Number of subjects enrolled
    Australia: 93
    Country: Number of subjects enrolled
    Austria: 25
    Country: Number of subjects enrolled
    Belgium: 45
    Country: Number of subjects enrolled
    Canada: 107
    Country: Number of subjects enrolled
    Chile: 11
    Country: Number of subjects enrolled
    France: 273
    Country: Number of subjects enrolled
    Germany: 86
    Country: Number of subjects enrolled
    Italy: 30
    Country: Number of subjects enrolled
    Netherlands: 46
    Country: Number of subjects enrolled
    Poland: 11
    Country: Number of subjects enrolled
    South Africa: 6
    Country: Number of subjects enrolled
    Spain: 36
    Country: Number of subjects enrolled
    United Kingdom: 132
    Country: Number of subjects enrolled
    United States: 288
    Worldwide total number of subjects
    1199
    EEA total number of subjects
    684
    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)
    362
    From 65 to 84 years
    819
    85 years and over
    18

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 1199 subjects were enrolled and randomized for double-blind (DB) phase. Out of which, 159 subjects entered the optional open-label extension (OLE) phase.

    Pre-assignment
    Screening details
    Subjects were randomized 2:1 to receive either Enzalutamide or Placebo in DB phase. All subjects who continued in OLE phase, received Enzalutamide.

    Period 1
    Period 1 title
    DB Phase (up to 24 months)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Enzalutamide
    Arm description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).
    Arm type
    Experimental

    Investigational medicinal product name
    Enzalutamide
    Investigational medicinal product code
    MDV3100
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Enzalutamide was administered as oral capsules, once daily, up to a maximum of 36 months.

    Arm title
    Placebo
    Arm description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received Enzalutamide 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months in DB Phase and 7.7 months in OLE Phase).
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matched to Enzalutamide was administered as oral capsules, once daily, up to a maximum of 36 months.

    Number of subjects in period 1
    Enzalutamide Placebo
    Started
    800
    399
    Completed
    109
    50
    Not completed
    691
    349
         Consent withdrawn by subject
    16
    7
         Death
    561
    298
         Unspecified
    1
    -
         Study Terminated by Sponsor
    108
    42
         Lost to follow-up
    5
    2
    Period 2
    Period 2 title
    OLE Phase (up to 77 months)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Enzalutamide
    Arm description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).
    Arm type
    Experimental

    Investigational medicinal product name
    Enzalutamide
    Investigational medicinal product code
    MDV3100
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Enzalutamide was administered as oral capsules, once daily, up to a maximum of 88 months.

    Arm title
    Placebo
    Arm description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received Enzalutamide 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months in DB Phase and 7.7 months in OLE Phase).
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matched to Enzalutamide was administered as oral capsules, once daily, up to a maximum of 88 months.

    Number of subjects in period 2
    Enzalutamide Placebo
    Started
    109
    50
    Completed
    0
    0
    Not completed
    109
    50
         Consent withdrawn by subject
    2
    1
         Death
    14
    21
         Unspecified
    15
    2
         Study Terminated by Sponsor
    78
    26

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Enzalutamide
    Reporting group description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).

    Reporting group title
    Placebo
    Reporting group description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received Enzalutamide 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months in DB Phase and 7.7 months in OLE Phase).

    Reporting group values
    Enzalutamide Placebo Total
    Number of subjects
    800 399 1199
    Age Categorical
    Units: Subjects
        <=18 years
    0 0 0
        Between 18 and 65 years
    232 130 362
        >=65 years
    568 269 837
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    68.8 ( 7.96 ) 68.6 ( 8.39 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    0 0 0
        Male
    800 399 1199
    Region of Enrollment
    Units: Subjects
        United States
    181 107 288
        Spain
    23 13 36
        Austria
    15 10 25
        Chile
    6 5 11
        United Kingdom
    82 50 132
        Italy
    20 10 30
        France
    193 80 273
        Canada
    82 25 107
        Argentina
    7 3 10
        Belgium
    27 18 45
        Poland
    7 4 11
        Australia
    60 33 93
        South Africa
    3 3 6
        Germany
    62 24 86
        Netherlands
    32 14 46
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    32 23 55
        Not Hispanic or Latino
    768 376 1144
        Unknown or Not Reported
    0 0 0
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    1 1 2
        Asian
    5 8 13
        Native Hawaiian or Other Pacific Islander
    1 0 1
        Black or African American
    27 20 47
        White
    745 366 1111
        More than one race
    0 0 0
        Unknown or Not Reported
    21 4 25

    End points

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    End points reporting groups
    Reporting group title
    Enzalutamide
    Reporting group description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).

    Reporting group title
    Placebo
    Reporting group description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received Enzalutamide 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months in DB Phase and 7.7 months in OLE Phase).
    Reporting group title
    Enzalutamide
    Reporting group description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).

    Reporting group title
    Placebo
    Reporting group description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received Enzalutamide 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months in DB Phase and 7.7 months in OLE Phase).

    Subject analysis set title
    Enzalutamide: DB + OLE Phase
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).

    Subject analysis set title
    Placebo: DB Phase
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months).

    Subject analysis set title
    Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Subjects who received placebo in DB phase, completed DB Phase and entered in optional OLE Phase, received Enzalutamide capsules 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 7.7 months).

    Primary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Survival was defined as time from randomization to death due to any cause. The duration of overall survival was right-censored for subjects who were lost to follow-up since randomization or not known to have died at the data analysis cut-off date (this included subjects who were known to have died after the data analysis cut-off date). Intent to treat (ITT) population included all subjects who were randomized into the study. The upper limit of the 95% confidence interval was not calculable because an insufficient number of subjects reached the event at the final time point for assessment, and has been denoted by ‘99999’.
    End point type
    Primary
    End point timeframe
    During study period (up to 101 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    800
    399
    Units: months
        median (confidence interval 95%)
    18.4 (17.3 to 99999)
    13.6 (11.3 to 15.8)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    1199
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [1]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.63
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.53
         upper limit
    0.75
    Notes
    [1] - Stratified by baseline Eastern Cooperative Oncology Group (ECOG) performance status and mean Brief Pain Inventory – Short Form score (Question #3). Hazard Ratio and 95% confidence interval are from Cox regression model.

    Secondary: Radiographic Progression-Free Survival

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    End point title
    Radiographic Progression-Free Survival
    End point description
    Radiographic progression-free survival was defined as time from randomization to the earliest objective evidence of radiographic progression or death due to any cause. Subjects were assessed for objective disease progression at regularly scheduled visits. The consensus guidelines of the Prostate Cancer Clinical Trials Working Group 2 were taken into consideration for the determination of disease progression. Radiographic disease progression was defined by Response Evaluation Criteria in Solid Tumours (RECIST) version (vs.) 1.1 for soft tissue disease, or the appearance of two or more new bone lesions on bone scan. Progression at the first scheduled reassessment at Week 13 required a confirmatory scan 6 or more weeks later. Subjects who did not reach the endpoint were right censored at their last assessment. ITT population included all subjects who were randomized into the study.
    End point type
    Secondary
    End point timeframe
    During DB phase (up to 24 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    800
    399
    Units: months
        median (confidence interval 95%)
    8.3 (8.2 to 9.4)
    2.9 (2.8 to 3.4)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    1199
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [2]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.35
         upper limit
    0.47
    Notes
    [2] - Stratified by baseline ECOG performance status and mean Brief Pain Inventory – Short Form score (Question #3). Hazard Ratio and 95% confidence interval are from Cox regression model.

    Secondary: Time to First Skeletal-Related Event

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    End point title
    Time to First Skeletal-Related Event
    End point description
    The time to first skeletal-related event was defined as time from randomization to the occurrence of the first skeletal-related event. Subjects were assessed for skeletal-related events at regularly scheduled visits. A skeletal-related event was defined as radiation therapy or surgery to bone, pathologic bone fracture, spinal cord compression, or change of antineoplastic therapy to treat bone pain. Subjects who did not reach the endpoint were right censored at their last assessment. ITT population included all subjects who were randomized into the study. The upper limit of the 95% confidence interval was not calculable because an insufficient number of subjects reached the event at the final time point for assessment, and has been denoted by ‘99999’.
    End point type
    Secondary
    End point timeframe
    During DB Phase (up to 24 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    800
    399
    Units: months
        median (confidence interval 95%)
    16.7 (14.6 to 19.1)
    13.3 (9.9 to 99999)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    1199
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0001 [3]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.69
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.566
         upper limit
    0.835
    Notes
    [3] - Stratified by baseline ECOG performance status and mean Brief Pain Inventory – Short Form score (Question #3). Hazard Ratio and 95% confidence interval are from Cox regression model.

    Secondary: Percentage of Subjects who Were Responders for Functional Assessment of Cancer Therapy-Prostate (FACT-P)

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    End point title
    Percentage of Subjects who Were Responders for Functional Assessment of Cancer Therapy-Prostate (FACT-P)
    End point description
    The FACT-P was a 39-item subject questionnaire which assessed physical well-being (7 items), social/family well-being (7 items), emotional well-being (6 items), functional well-being (7 items), and additional prostate cancer specific concerns (12 items). All items were scored from 0 (not at all) to 4 (very much). The sum of scores on all 5 domains constitutes the global FACT-P. The global/total FACT-P score ranged from 0 (worst) to 156 (best), higher scores indicate better health status. Responders were those subjects who had a 10-point improvement in their total FACT-P score, as compared with baseline, on two consecutive measurements obtained at least 3 weeks apart. Here, number of subjects analyzed signifies evaluable ITT that included all subjects who were part of the ITT population and had a global FACT-P score at baseline and at least 1 post-baseline assessment.
    End point type
    Secondary
    End point timeframe
    Baseline up to 24 months
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    651
    257
    Units: percentage of subjects
        number (confidence interval 95%)
    43.2 (39.3 to 47.1)
    18.3 (13.8 to 23.6)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    908
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [4]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in Percentage of Subjects
    Point estimate
    24.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    18.8
         upper limit
    30.9
    Notes
    [4] - Stratified by baseline ECOG performance status and mean Brief Pain Inventory – Short Form score (Question #3). Confidence Interval based on standard normal approximation.

    Secondary: Time to Prostate-Specific Antigen (PSA) Progression

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    End point title
    Time to Prostate-Specific Antigen (PSA) Progression
    End point description
    Time to PSA progression was defined as time from randomization to PSA progression. Subjects who did not reach the endpoint were right censored at their last assessment. For subjects with PSA declines at Week 13, the PSA progression date was defined as the date that a greater than and equal to (>=)25 percent (%) increase and an absolute increase of >=2 nanogram per milliliter (ng/mL) above the nadir was documented, which was confirmed by a second consecutive value obtained 3 or more weeks later (required only if PSA progression did not occur at last PSA assessment). For subjects with no PSA declines at Week 13, PSA progression date was defined as the date that a >=25% increase and an absolute increase of >=2 ng/mL above the baseline was documented, which was confirmed by a second consecutive value 3 or more weeks later (required only if PSA progression did not occur at last PSA assessment). ITT population included all subjects who were randomized into the study.
    End point type
    Secondary
    End point timeframe
    Baseline and at every study visit from Week 13 while on study drug (up to 24 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    800
    399
    Units: months
        median (confidence interval 95%)
    8.3 (5.8 to 8.3)
    3.0 (2.9 to 3.7)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    1199
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001 [5]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.248
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.204
         upper limit
    0.303
    Notes
    [5] - Stratified by baseline ECOG performance status and mean Brief Pain Inventory – Short Form score (Question #3). Hazard Ratio and 95% confidence interval are from Cox regression model.

    Secondary: Percentage of Subjects With Pain Palliation

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    End point title
    Percentage of Subjects With Pain Palliation
    End point description
    Proportion of subjects with pain palliation was assessed for subjects with a stable and sufficient pain burden at study entry. Pain burden was measured by question #3 of Brief Pain Inventory (short form). This scale measures pain on a 0 to 10 scale with 0 indicating no pain and 10 indicating pain as bad as you can imagine. Pain palliation at Week 13 was determined for proportion of men with baseline bone metastasis (es) who had baseline pain attributable to metastasis (es). Palliation was defined as >=30% reduction in average pain score at Week 13 compared to baseline without a >=30% increase in analgesic use. Here, number of subject analyzed signifies evaluable ITT that included subjects with metastatic bone disease at baseline; provided answers to Question #3 of Brief Pain Inventory - short form for a minimum of 4 out of 7 days in baseline run-in period; stable baseline pain; stable analgesic use; and had an average pain score during baseline run-in period of >=4.
    End point type
    Secondary
    End point timeframe
    Baseline up to 24 months
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    49
    15
    Units: percentage of subjects
        number (confidence interval 95%)
    44.9 (30.7 to 59.8)
    6.7 (0.2 to 31.9)
    Statistical analysis title
    Enzalutamide vs. Placebo
    Comparison groups
    Enzalutamide v Placebo
    Number of subjects included in analysis
    64
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0079 [6]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in Rate of Pain Palliation
    Point estimate
    38.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    19.4
         upper limit
    57
    Notes
    [6] - Stratified by baseline Eastern Cooperative Oncology Group performance status (0–1 vs. 2). Confidence Interval based on standard normal approximation.

    Secondary: Percentage of Subjects With Prostate Specific Antigen (PSA) Response

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    End point title
    Percentage of Subjects With Prostate Specific Antigen (PSA) Response
    End point description
    Subjects were evaluable for PSA response rate if they had a PSA level measured at baseline and at least 1 post-baseline assessment. Both PSA responses of > 50% and > 90% were determined. PSA responses required confirmation with a subsequent assessment that was conducted at least 3 weeks later. Here, number of subject analyzed signifies evaluable ITT that included subjects who were part of the ITT Population and had a PSA level measured at baseline and at least 1 post-baseline assessment.
    End point type
    Secondary
    End point timeframe
    During DB phase (up to 24 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    731
    330
    Units: percentage of subjects
        Decline >=50% from baseline
    54
    2
        Decline >=90% from baseline
    25
    1
    No statistical analyses for this end point

    Secondary: Percentage of Subjects With Soft-Tissue Objective Response

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    End point title
    Percentage of Subjects With Soft-Tissue Objective Response
    End point description
    Best overall soft tissue response as assessed using RECIST vs.1.1 during study was summarized using investigators’ response assessments and also derived response assessments by treatment group. Only subjects with measurable soft tissue disease at screening were included in this analysis. Subjects with measurable disease at screening are subjects who had at least 1 target lesion identified per RECIST vs.1.1 at screening. Percentage of subjects summarizes number of subjects with complete or partial objective response (%). Soft Tissue assessment based on Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (vs.1.1). Eur J Cancer 2009; 45:228-247. Here, number of subject analyzed signifies evaluable ITT with measurable disease that included subjects who were part of ITT population and had measurable soft tissue disease at screening, defined by at least 1 target lesion according to RECIST vs.1.1.
    End point type
    Secondary
    End point timeframe
    During DB phase (up to 24 months)
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    446
    208
    Units: percentage of subjects
    29
    4
    No statistical analyses for this end point

    Secondary: European Quality of Life Five-Domain (EQ-5D) Scale

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    End point title
    European Quality of Life Five-Domain (EQ-5D) Scale
    End point description
    EQ-5D: subject rated questionnaire to assess health-related quality of life in terms of a single utility or index score. Five parameters (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) were assessed on 3-point categorical scale (1= no problems, 2= some/moderate problems and 3= severe problem). Score were transformed and resulted in a total EQ-5D score range of 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating better health and quality of life. Here, number of subject analyzed signifies evaluable ITT that included subjects who were part of the ITT population and who were evaluable for EQ-5D.
    End point type
    Secondary
    End point timeframe
    Week 13
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    126
    55
    Units: units on a scale
        arithmetic mean (standard deviation)
    67.2 ( 19.29 )
    60.0 ( 19.26 )
    No statistical analyses for this end point

    Secondary: Percentage of Subjects with Circulating Tumor Cell (CTC) Conversion

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    End point title
    Percentage of Subjects with Circulating Tumor Cell (CTC) Conversion
    End point description
    CTC conversion was assessed for subjects with baseline CTC counts of >=5 cells per 7.5 milliliter (mL) of blood. A CTC conversion was defined as a decline in the CTC count to less than (<) 5 cells per 7.5 mL of blood. In this endpoint percentage of subjects with CTC conversion was reported. Here, number of subject analyzed signifies CTC evaluable population that included subjects with a baseline and at least 1 post baseline CTC assessment.
    End point type
    Secondary
    End point timeframe
    Baseline up to 24 months
    End point values
    Enzalutamide Placebo
    Number of subjects analysed
    127
    62
    Units: percentage of subjects
        number (confidence interval 95%)
    48 (39.09 to 57.07)
    9.7 (3.63 to 19.88)
    No statistical analyses for this end point

    Other pre-specified: Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)

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    End point title
    Number of Subjects With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Events (SAEs)
    End point description
    AE:any untoward medical occurrence in subject who received study drug without regard to possibility of causal relationship. SAE:AE resulting in any of following outcome/deemed significant and jeopardized subjects/required treatment to prevent other AE outcomes for any other reason:death;initial/prolonged inpatient hospitalization;life-threatening experience(immediate risk of dying);persistent/significant disability/incapacity;congenital anomaly.TEAEs:events occurred between first dose of study drug and up to safety follow-up visit/initiation of another anti-neoplastic therapy, whichever occurred first(up to 101 months).AEs included both serious and non-serious AEs.Clinically significant physical examination abnormalities were reported as AEs.Safety population:all randomized subjects who received at least 1 dose of study drug.Unscheduled visit:performed at any time during study whenever necessary to assess for/follow-up on AEs, at subject’s request/if deemed necessary by investigator.
    End point type
    Other pre-specified
    End point timeframe
    Baseline, up to the safety follow-up visit or unscheduled visit or the initiation of another anti-neoplastic therapy whichever occurred first (up to 101 months)
    End point values
    Enzalutamide: DB + OLE Phase Placebo: DB Phase Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Number of subjects analysed
    800
    399
    50
    Units: subjects
        AEs
    789
    390
    48
        SAEs
    319
    155
    25
    No statistical analyses for this end point

    Other pre-specified: Number of Subjects with Clinically Significant Changes in Vital Signs

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    End point title
    Number of Subjects with Clinically Significant Changes in Vital Signs
    End point description
    Criteria for abnormalities in vital signs included: sitting/supine systolic blood pressure (SBP) values: absolute result greater than (>) 180 millimeter of mercury (mmHg) and >40 mmHg increase from baseline (BL) and < 90 mmHg and >30 mmHg decrease from BL; diastolic blood pressure (DBP) values: absolute result >105 mmHg and >30 mmHg increase from BL and absolute result < 50 mmHg and >20 mmHg decrease from BL; any abnormalities in SBP or DBP; heart rate values: absolute result > 120 beats per minute (bpm) and >30 bpm increase from BL and absolute result < 50 bpm and >20 bpm decrease from BL or any abnormalities in heart rate. Safety population was defined as all randomized subjects who received at least 1 dose of study drug. Unscheduled visit was performed at any time during the study whenever necessary to assess for/follow-up on AEs, at the subject’s request/if deemed necessary by the investigator.
    End point type
    Other pre-specified
    End point timeframe
    Baseline, up to the safety follow-up visit or unscheduled visit or the initiation of another anti-neoplastic therapy whichever occurred first (up to 101 months)
    End point values
    Enzalutamide: DB + OLE Phase Placebo: DB Phase Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Number of subjects analysed
    800
    399
    50
    Units: subjects
        SBP: >180 mmHg and >40 mmHg Increase from BL
    28
    7
    1
        SBP: < 90 mmHg and >30 mmHg Decrease from BL
    13
    5
    0
        DBP: >105 mmHg and >30 mmHg Increase from BL
    5
    2
    0
        DBP: < 50 mmHg and >20 mmHg Decrease from BL
    13
    3
    1
        Any abnormalities in SBP or DBP
    52
    16
    2
        Heart Rate: > 120 bpm and >30 bpm Increase from BL
    7
    5
    0
        Heart Rate: < 50 bpm and >20 bpm Decrease from BL
    18
    1
    0
        Any abnormalities in Heart Rate
    25
    6
    0
    No statistical analyses for this end point

    Other pre-specified: Number of Subjects With Any Newly Clinically Significant Abnormal Finding in Electrocardiogram (ECG)

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    End point title
    Number of Subjects With Any Newly Clinically Significant Abnormal Finding in Electrocardiogram (ECG) [7]
    End point description
    Any new post baseline abnormality was defined as any abnormal ECG finding that appeared after baseline assessment which was not seen at the screening or baseline ECG assessment. Where, criteria of abnormality was QTcF interval > 470 millisecond (msec). Subjects were counted once only for a specific abnormality. This endpoint was planned to be analysed in double blind phase only. Safety population was defined as all randomized subjects who received at least 1 dose of study drug. Unscheduled visit was performed at any time during the study whenever necessary to assess for or follow-up on AEs, at the subject’s request or if deemed necessary by the investigator.
    End point type
    Other pre-specified
    End point timeframe
    Baseline, up to the end of DB phase or unscheduled visit (up to 24 months)
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Only arms which are applicable to the endpoint are reported.
    End point values
    Enzalutamide Placebo: DB Phase
    Number of subjects analysed
    800
    399
    Units: subjects
    28
    13
    No statistical analyses for this end point

    Other pre-specified: Number of Subjects With Grade 3/4 Post-Baseline Laboratory Toxicity (Hematology and Chemistry)

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    End point title
    Number of Subjects With Grade 3/4 Post-Baseline Laboratory Toxicity (Hematology and Chemistry)
    End point description
    Laboratory parameters included hematological and chemistry parameters. Chemistry parameters included alanine aminotransferase, albumin, alkaline phosphatase, aspartate aminotransferase, bilirubin, calcium, creatine kinase, creatinine, glucose, magnesium, phosphate, potassium and sodium. Hematology parameters included haemoglobin, leukocytes, lymphocytes, neutrophils and platelet. Test abnormalities were graded by NCI CTCAE version 4.03 as Grade 3= severe and Grade 4= life-threatening or disabling. Only categories with at least 1 subject with abnormality are reported in this endpoint. Safety population was defined as all randomized subjects who received at least 1 dose of study drug. Unscheduled visit was performed at any time during the study whenever necessary to assess for or follow-up on AEs, at the subject’s request or if deemed necessary by the investigator.
    End point type
    Other pre-specified
    End point timeframe
    Baseline, up to the safety follow-up visit or unscheduled visit or the initiation of another anti-neoplastic therapy whichever occurred first (up to 101 months)
    End point values
    Enzalutamide: DB + OLE Phase Placebo: DB Phase Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Number of subjects analysed
    800
    399
    50
    Units: subjects
        Alanine Aminotransferase:High
    2
    2
    1
        Albumin: Low
    7
    3
    0
        Alkaline Phosphatase: High
    102
    74
    3
        Aspartate Aminotransferase: High
    3
    4
    1
        Bilirubin: High
    2
    0
    0
        Calcium: Low
    14
    15
    1
        Calcium: High
    1
    0
    0
        Creatine Kinase: High
    4
    2
    0
        Creatinine: High
    0
    2
    0
        Glucose: High
    17
    10
    1
        Magnesium: Low
    0
    1
    0
        Magnesium: High
    1
    1
    0
        Phosphate: Low
    28
    10
    2
        Potassium: Low
    7
    4
    1
        Potassium: High
    2
    3
    0
        Sodium: Low
    19
    13
    0
        Sodium: High
    0
    1
    0
        Hemoglobin: Low
    38
    20
    4
        Hemoglobin: High
    1
    0
    0
        Leukocytes: Low
    8
    1
    1
        Lymphocytes: Low
    80
    48
    5
        Neutrophils: Low
    10
    0
    1
        Platelet; Low
    4
    4
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline, up to the safety follow-up visit or unscheduled visit or the initiation of another anti-neoplastic therapy whichever occurred first (up to 101 months)
    Adverse event reporting additional description
    An event may be categorized as serious in 1 subject and non serious in another, or 1 subject may experience both serious and non serious event. All TEAEs and SAEs were collected and reported. The same event may appear as both AE and SAE. Analysis was done on safety population. Total number of deaths (all causes) included only grade 5 AEs.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    Enzalutamide: DB + OLE Phase
    Reporting group description
    In DB Phase, subjects received Enzalutamide capsules 160 mg orally per day. Subjects who completed DB Phase, entered in optional OLE Phase and received same treatment until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 8.3 months).

    Reporting group title
    Placebo: DB Phase
    Reporting group description
    In DB Phase, subjects received placebo capsules (for Enzalutamide) orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 3.0 months).

    Reporting group title
    Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Reporting group description
    Subjects who received placebo in DB phase, completed DB Phase and entered in optional OLE Phase, received Enzalutamide capsules 160 mg orally per day until unacceptable toxicity, confirmed disease progression and the subject was scheduled to initiate a new systemic anti-neoplastic therapy, death or withdrawal (median treatment duration was 7.7 months).

    Serious adverse events
    Enzalutamide: DB + OLE Phase Placebo: DB Phase Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Total subjects affected by serious adverse events
         subjects affected / exposed
    319 / 800 (39.88%)
    155 / 399 (38.85%)
    25 / 50 (50.00%)
         number of deaths (all causes)
    578
    321
    21
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Metastatic pain
         subjects affected / exposed
    18 / 800 (2.25%)
    3 / 399 (0.75%)
    3 / 50 (6.00%)
         occurrences causally related to treatment / all
    0 / 22
    1 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cancer pain
         subjects affected / exposed
    10 / 800 (1.25%)
    5 / 399 (1.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 12
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    5 / 800 (0.63%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Metastases to Bone
         subjects affected / exposed
    1 / 800 (0.13%)
    5 / 399 (1.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malignant pleural effusion
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 800 (0.00%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute leukaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Acute monocytic leukaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Bone marrow tumour cell infiltration
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to liver
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to meninges
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Neoplasm progression
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small cell lung cancer
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal tract adenoma
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchial carcinoma
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to lung
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute lymphocytic leukaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Colon cancer
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intracranial tumour haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of head and neck
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    3 / 800 (0.38%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    3 / 800 (0.38%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphoedema
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    Bladder catheter removal
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Limb operation
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pain management
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cataract operation
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colon polypectomy
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal dilation procedure
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleurodesis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ureteral stent insertion
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    General physical health deterioration
         subjects affected / exposed
    22 / 800 (2.75%)
    8 / 399 (2.01%)
    3 / 50 (6.00%)
         occurrences causally related to treatment / all
    0 / 22
    0 / 9
    0 / 3
         deaths causally related to treatment / all
    0 / 7
    0 / 5
    0 / 1
    Asthenia
         subjects affected / exposed
    4 / 800 (0.50%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 5
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    5 / 800 (0.63%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    3 / 800 (0.38%)
    2 / 399 (0.50%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    2 / 800 (0.25%)
    5 / 399 (1.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 800 (0.13%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    2 / 800 (0.25%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Euthanasia
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    General symptom
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device dislocation
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device occlusion
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    2 / 50 (4.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
    Local swelling
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    5 / 800 (0.63%)
    4 / 399 (1.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 6
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 800 (0.25%)
    3 / 399 (0.75%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    4 / 800 (0.50%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    2 / 800 (0.25%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute pulmonary oedema
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory arrest
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hydropneumothorax
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleuritic pain
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 800 (0.25%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Depressed mood
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hallucination
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disorientation
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Liver function test abnormal
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coagulation time prolonged
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Subdural haematoma
         subjects affected / exposed
    3 / 800 (0.38%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    3 / 800 (0.38%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lumbar vertebral fracture
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Patella fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Post procedural haematuria
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Post-traumatic pain
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Radiation oesophagitis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Soft tissue injury
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hand fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Facial bones fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis radiation
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Heat stroke
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pubis fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Adenomatous polyposis coli
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Cardiac failure
         subjects affected / exposed
    3 / 800 (0.38%)
    2 / 399 (0.50%)
    2 / 50 (4.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    3 / 800 (0.38%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mitral valve incompetance
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ventricular fibrillation
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arrhythmia supraventricular
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block complete
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 800 (0.00%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Acute coronary syndrome
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aortic valve incompetence
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Nervous system disorders
    Spinal cord compression
         subjects affected / exposed
    54 / 800 (6.75%)
    15 / 399 (3.76%)
    3 / 50 (6.00%)
         occurrences causally related to treatment / all
    0 / 56
    0 / 16
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cauda equina syndrome
         subjects affected / exposed
    6 / 800 (0.75%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nerve root compression
         subjects affected / exposed
    1 / 800 (0.13%)
    4 / 399 (1.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    5 / 800 (0.63%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    4 / 800 (0.50%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Hepatic encephalopathy
         subjects affected / exposed
    1 / 800 (0.13%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    Dizziness
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient ischemic attack
         subjects affected / exposed
    3 / 800 (0.38%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Convulsion
         subjects affected / exposed
    4 / 800 (0.50%)
    0 / 399 (0.00%)
    2 / 50 (4.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Epiduritis
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nerve compression
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Partial seizures
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lethargy
         subjects affected / exposed
    3 / 800 (0.38%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Akathisia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Central nervous system lesion
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cranial nerve palsies multiple
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Embolic stroke
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhage intracranial
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhagic stroke
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Lacunar infarction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lumbar radiculopathy
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Motor dysfunction
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pachymeningitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Status epilepticus
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglossal nerve paresis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Normal pressure hydrocephalus
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tremor
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Trigeminal neuralgia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Visual field defect
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ataxia
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Carpal tunnel syndrome
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Complex partial seizures
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cranial nerve disorder
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myoclonus
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraplegia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sciatica
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Senile dementia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thalamic infarction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    VIIth nerve paralysis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neuropathy peripheral
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    22 / 800 (2.75%)
    12 / 399 (3.01%)
    2 / 50 (4.00%)
         occurrences causally related to treatment / all
    1 / 29
    2 / 15
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anaemia of malignant disease
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Disseminated intravascular coagulation
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Leukocytosis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vertigo
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Retinal detachment
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Papilloedema
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Visual acuity reduced
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Visual impairment
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eyelid bleeding
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Vomiting
         subjects affected / exposed
    3 / 800 (0.38%)
    8 / 399 (2.01%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    2 / 3
    4 / 9
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    5 / 800 (0.63%)
    3 / 399 (0.75%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    2 / 5
    2 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    5 / 800 (0.63%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    3 / 800 (0.38%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    2 / 800 (0.25%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    4 / 800 (0.50%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    3 / 800 (0.38%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Faecaloma
         subjects affected / exposed
    0 / 800 (0.00%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal obstruction
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematochezia
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Retroperitoneal haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Intestinal mass
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peptic ulcer
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulum intestinal haemorrhagic
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Duodenal ulcer haemorrhage
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Proctocolitis
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct obstruction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholangitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Hyperhidrosis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular purpura
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    18 / 800 (2.25%)
    5 / 399 (1.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 27
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    7 / 800 (0.88%)
    8 / 399 (2.01%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 10
    0 / 9
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    8 / 800 (1.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Post renal failure
         subjects affected / exposed
    3 / 800 (0.38%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    3 / 800 (0.38%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal failure acute
         subjects affected / exposed
    3 / 800 (0.38%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    1 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder perforation
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cystitis haemorrhagic
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal colic
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder obstruction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysuria
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Obstructive uropathy
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ureteric obstruction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral obstruction
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral stenosis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    11 / 800 (1.38%)
    7 / 399 (1.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 13
    0 / 8
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    12 / 800 (1.50%)
    3 / 399 (0.75%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 12
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    15 / 800 (1.88%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 16
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    4 / 800 (0.50%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthralgia
         subjects affected / exposed
    3 / 800 (0.38%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myalgia
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteonecrosis of jaw
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal chest pain
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chondrocalcinosis pyrophosphate
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Flank pain
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscle haemorrhage
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    4 / 800 (0.50%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal column stenosis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal pain
         subjects affected / exposed
    2 / 800 (0.25%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bursitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    15 / 800 (1.88%)
    5 / 399 (1.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    1 / 15
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    9 / 800 (1.13%)
    5 / 399 (1.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 10
    0 / 5
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    4 / 800 (0.50%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    4 / 800 (0.50%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 800 (0.13%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    3 / 800 (0.38%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 3
    0 / 1
    0 / 1
    Staphylococcal sepsis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal abscess
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chest wall abscess
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Extradural abscess
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Kidney infection
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Klebsiella bacteraemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Parotitis
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal abscess
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic Shock
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Tooth Infection
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Viral pericarditis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abscess jaw
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anal abscess
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atypical mycobacterial pneumonia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Febrile infection
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gas gangrene
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Pleural infection
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia pneumococcal
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    4 / 800 (0.50%)
    3 / 399 (0.75%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 800 (0.25%)
    3 / 399 (0.75%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    2 / 399 (0.50%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    2 / 800 (0.25%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperuricaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypophosphataemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypovolaemia
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cachexia
         subjects affected / exposed
    0 / 800 (0.00%)
    1 / 399 (0.25%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    1 / 800 (0.13%)
    1 / 399 (0.25%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diabetes mellitus
         subjects affected / exposed
    1 / 800 (0.13%)
    0 / 399 (0.00%)
    0 / 50 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Malnutrition
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoalbuminaemia
         subjects affected / exposed
    0 / 800 (0.00%)
    0 / 399 (0.00%)
    1 / 50 (2.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Enzalutamide: DB + OLE Phase Placebo: DB Phase Placebo (DB) /Enzalutamide 160 mg (OLE) Phase
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    784 / 800 (98.00%)
    385 / 399 (96.49%)
    47 / 50 (94.00%)
    Vascular disorders
    Hot flush
         subjects affected / exposed
    165 / 800 (20.63%)
    41 / 399 (10.28%)
    1 / 50 (2.00%)
         occurrences all number
    186
    46
    1
    Hypertension
         subjects affected / exposed
    60 / 800 (7.50%)
    11 / 399 (2.76%)
    2 / 50 (4.00%)
         occurrences all number
    88
    12
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    280 / 800 (35.00%)
    115 / 399 (28.82%)
    14 / 50 (28.00%)
         occurrences all number
    424
    158
    20
    Asthenia
         subjects affected / exposed
    148 / 800 (18.50%)
    67 / 399 (16.79%)
    9 / 50 (18.00%)
         occurrences all number
    228
    93
    11
    Oedema peripheral
         subjects affected / exposed
    121 / 800 (15.13%)
    46 / 399 (11.53%)
    4 / 50 (8.00%)
         occurrences all number
    145
    57
    6
    Pyrexia
         subjects affected / exposed
    59 / 800 (7.38%)
    23 / 399 (5.76%)
    4 / 50 (8.00%)
         occurrences all number
    70
    31
    4
    Pain
         subjects affected / exposed
    27 / 800 (3.38%)
    12 / 399 (3.01%)
    3 / 50 (6.00%)
         occurrences all number
    33
    16
    4
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    88 / 800 (11.00%)
    39 / 399 (9.77%)
    6 / 50 (12.00%)
         occurrences all number
    108
    45
    6
    Cough
         subjects affected / exposed
    60 / 800 (7.50%)
    25 / 399 (6.27%)
    2 / 50 (4.00%)
         occurrences all number
    64
    27
    2
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    71 / 800 (8.88%)
    24 / 399 (6.02%)
    2 / 50 (4.00%)
         occurrences all number
    78
    25
    2
    Anxiety
         subjects affected / exposed
    55 / 800 (6.88%)
    16 / 399 (4.01%)
    6 / 50 (12.00%)
         occurrences all number
    64
    16
    6
    Depression
         subjects affected / exposed
    51 / 800 (6.38%)
    19 / 399 (4.76%)
    4 / 50 (8.00%)
         occurrences all number
    54
    21
    4
    Confusional state
         subjects affected / exposed
    23 / 800 (2.88%)
    9 / 399 (2.26%)
    3 / 50 (6.00%)
         occurrences all number
    27
    9
    4
    Investigations
    Weight decreased
         subjects affected / exposed
    108 / 800 (13.50%)
    42 / 399 (10.53%)
    7 / 50 (14.00%)
         occurrences all number
    138
    49
    8
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    44 / 800 (5.50%)
    5 / 399 (1.25%)
    5 / 50 (10.00%)
         occurrences all number
    52
    5
    5
    Nervous system disorders
    Headache
         subjects affected / exposed
    101 / 800 (12.63%)
    21 / 399 (5.26%)
    1 / 50 (2.00%)
         occurrences all number
    130
    25
    1
    Dizziness
         subjects affected / exposed
    59 / 800 (7.38%)
    22 / 399 (5.51%)
    4 / 50 (8.00%)
         occurrences all number
    70
    22
    5
    Paraesthesia
         subjects affected / exposed
    53 / 800 (6.63%)
    18 / 399 (4.51%)
    1 / 50 (2.00%)
         occurrences all number
    62
    19
    1
    Hypoaesthesia
         subjects affected / exposed
    33 / 800 (4.13%)
    7 / 399 (1.75%)
    4 / 50 (8.00%)
         occurrences all number
    42
    7
    6
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    123 / 800 (15.38%)
    70 / 399 (17.54%)
    11 / 50 (22.00%)
         occurrences all number
    211
    117
    41
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    276 / 800 (34.50%)
    166 / 399 (41.60%)
    16 / 50 (32.00%)
         occurrences all number
    391
    218
    19
    Constipation
         subjects affected / exposed
    209 / 800 (26.13%)
    109 / 399 (27.32%)
    7 / 50 (14.00%)
         occurrences all number
    249
    249
    8
    Diarrhoea
         subjects affected / exposed
    180 / 800 (22.50%)
    70 / 399 (17.54%)
    9 / 50 (18.00%)
         occurrences all number
    251
    82
    11
    Vomiting
         subjects affected / exposed
    141 / 800 (17.63%)
    84 / 399 (21.05%)
    8 / 50 (16.00%)
         occurrences all number
    214
    112
    8
    Abdominal pain
         subjects affected / exposed
    47 / 800 (5.88%)
    21 / 399 (5.26%)
    2 / 50 (4.00%)
         occurrences all number
    51
    23
    2
    Abdominal pain upper
         subjects affected / exposed
    41 / 800 (5.13%)
    13 / 399 (3.26%)
    0 / 50 (0.00%)
         occurrences all number
    50
    16
    0
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    51 / 800 (6.38%)
    14 / 399 (3.51%)
    3 / 50 (6.00%)
         occurrences all number
    75
    19
    3
    Pollakiuria
         subjects affected / exposed
    44 / 800 (5.50%)
    10 / 399 (2.51%)
    3 / 50 (6.00%)
         occurrences all number
    48
    11
    3
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    225 / 800 (28.13%)
    91 / 399 (22.81%)
    9 / 50 (18.00%)
         occurrences all number
    324
    136
    11
    Arthralgia
         subjects affected / exposed
    182 / 800 (22.75%)
    71 / 399 (17.79%)
    2 / 50 (4.00%)
         occurrences all number
    276
    112
    2
    Pain in extremity
         subjects affected / exposed
    137 / 800 (17.13%)
    62 / 399 (15.54%)
    5 / 50 (10.00%)
         occurrences all number
    198
    97
    6
    Bone pain
         subjects affected / exposed
    101 / 800 (12.63%)
    61 / 399 (15.29%)
    2 / 50 (4.00%)
         occurrences all number
    132
    75
    2
    Musculoskeletal pain
         subjects affected / exposed
    121 / 800 (15.13%)
    40 / 399 (10.03%)
    3 / 50 (6.00%)
         occurrences all number
    154
    154
    3
    Musculoskeletal chest pain
         subjects affected / exposed
    77 / 800 (9.63%)
    34 / 399 (8.52%)
    2 / 50 (4.00%)
         occurrences all number
    101
    44
    2
    Muscular weakness
         subjects affected / exposed
    74 / 800 (9.25%)
    27 / 399 (6.77%)
    1 / 50 (2.00%)
         occurrences all number
    95
    34
    1
    Myalgia
         subjects affected / exposed
    56 / 800 (7.00%)
    26 / 399 (6.52%)
    2 / 50 (4.00%)
         occurrences all number
    61
    34
    6
    Neck pain
         subjects affected / exposed
    34 / 800 (4.25%)
    17 / 399 (4.26%)
    3 / 50 (6.00%)
         occurrences all number
    35
    19
    3
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    68 / 800 (8.50%)
    24 / 399 (6.02%)
    3 / 50 (6.00%)
         occurrences all number
    90
    27
    3
    Nasopharyngitis
         subjects affected / exposed
    47 / 800 (5.88%)
    12 / 399 (3.01%)
    2 / 50 (4.00%)
         occurrences all number
    58
    18
    2
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    246 / 800 (30.75%)
    121 / 399 (30.33%)
    9 / 50 (18.00%)
         occurrences all number
    317
    146
    10
    Hypokalaemia
         subjects affected / exposed
    31 / 800 (3.88%)
    14 / 399 (3.51%)
    3 / 50 (6.00%)
         occurrences all number
    37
    16
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    30 Jul 2009
    The dose for evaluation in this study was decreased from 240 mg/day to 160 mg/day to improve the risk/benefit profile of trial.
    19 Apr 2011
    The target number of deaths needed for the final analysis of overall survival reduced from 786 events to 650 events with an interim analysis at approximately 520 events.
    05 Jan 2012
    Access was provided to MDV3100 to patients who were either actively taking MDV3100 at the time of unblinding or were originally randomized to the placebo arm.

    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.
    The primary objectives (overall survival) of the study had been met and all subjecst who had remained on study treatment have discontinued and therefore the study has been considered as completed.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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