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    Clinical Trial Results:
    Phase III Randomized, Open Label Study of Single Agent Ofatumumab vs. Single Agent Rituximab in Indolent B-Cell Non Hodgkin Lymphoma Relapsed After Rituximab Containing Therapy

    Summary
    EudraCT number
    2010-018780-42
    Trial protocol
    SK   CZ   BG   BE   FR   HU  
    Global end of trial date
    19 Dec 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Dec 2017
    First version publication date
    22 Dec 2017
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    COMB157D2303
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01200589
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    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
    19 Dec 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Dec 2016
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To compare PFS following therapy with single agent ofatumumab vs. single agent rituximab in subjects with iNHL that had relapsed after prior rituximab containing therapy.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    11 Oct 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Belgium: 26
    Country: Number of subjects enrolled
    Brazil: 21
    Country: Number of subjects enrolled
    Bulgaria: 12
    Country: Number of subjects enrolled
    Canada: 21
    Country: Number of subjects enrolled
    China: 36
    Country: Number of subjects enrolled
    Czech Republic: 24
    Country: Number of subjects enrolled
    France: 33
    Country: Number of subjects enrolled
    Hungary: 19
    Country: Number of subjects enrolled
    Japan: 116
    Country: Number of subjects enrolled
    Korea, Republic of: 15
    Country: Number of subjects enrolled
    Peru: 8
    Country: Number of subjects enrolled
    Slovakia: 3
    Country: Number of subjects enrolled
    South Africa: 12
    Country: Number of subjects enrolled
    Ukraine: 8
    Country: Number of subjects enrolled
    United States: 84
    Worldwide total number of subjects
    438
    EEA total number of subjects
    117
    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)
    277
    From 65 to 84 years
    156
    85 years and over
    5

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Participants were randomized in a 1:1 ratio to Ofatumumab or Rituximab.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ofatumumab
    Arm description
    Four weekly doses of single agent ofatumumab 1000 mg by intravenous (i.v.) infusion, followed by ofatumumab 1000 mg i.v. every two months for four additional doses.
    Arm type
    Experimental

    Investigational medicinal product name
    Ofatumumab
    Investigational medicinal product code
    OMB157
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Four weekly doses of single agent ofatumumab 1000 mg by intravenous (i.v.) infusion), followed by ofatumumab 1000 mg i.v. every two months for four additional doses.

    Arm title
    Rituximab
    Arm description
    Four weekly doses of single agent rituximab 375 mg/m2 i.v., followed by rituximab 375 mg/m2 i.v. every two months for four additional doses.
    Arm type
    Active comparator

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Four weekly doses of single agent rituximab 375 mg/m2 i.v., followed by rituximab 375 mg/m2 i.v. every two months for four additional doses.

    Number of subjects in period 1
    Ofatumumab Rituximab
    Started
    219
    219
    Intent-to-treat (ITT) analysis set
    219
    219
    Safety set
    217
    218
    Completed
    29
    30
    Not completed
    190
    189
         Study terminated
    170
    172
         Consent withdrawn by subject
    13
    11
         Physician decision
    2
    2
         Lost to follow-up
    5
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ofatumumab
    Reporting group description
    Four weekly doses of single agent ofatumumab 1000 mg by intravenous (i.v.) infusion, followed by ofatumumab 1000 mg i.v. every two months for four additional doses.

    Reporting group title
    Rituximab
    Reporting group description
    Four weekly doses of single agent rituximab 375 mg/m2 i.v., followed by rituximab 375 mg/m2 i.v. every two months for four additional doses.

    Reporting group values
    Ofatumumab Rituximab Total
    Number of subjects
    219 219 438
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    142 135 277
        From 65-84 years
    73 83 156
        85 years and over
    4 1 5
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    60.8 ( 11.27 ) 60.7 ( 11.84 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    115 109 224
        Male
    104 110 214

    End points

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    End points reporting groups
    Reporting group title
    Ofatumumab
    Reporting group description
    Four weekly doses of single agent ofatumumab 1000 mg by intravenous (i.v.) infusion, followed by ofatumumab 1000 mg i.v. every two months for four additional doses.

    Reporting group title
    Rituximab
    Reporting group description
    Four weekly doses of single agent rituximab 375 mg/m2 i.v., followed by rituximab 375 mg/m2 i.v. every two months for four additional doses.

    Primary: Progression-free survival (PFS) - Number of participants with PFS events

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    End point title
    Progression-free survival (PFS) - Number of participants with PFS events
    End point description
    PFS was defined as the interval of time between the date of randomization and the earlier of the date of disease progression or death due to any cause. Disease response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML). Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation. Bone marrow examination to confirm a suspected complete response (CR) was performed within 8 weeks following the onset of a CT scan confirmed CR. The number of patients with PFS events was assessed.
    End point type
    Primary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    219
    219
    Units: Participants
    114
    117
    Statistical analysis title
    Progression Free Survival
    Comparison groups
    Ofatumumab v Rituximab
    Number of subjects included in analysis
    438
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.89
         upper limit
    1.49

    Secondary: Number of participants with complete response (CR)

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    End point title
    Number of participants with complete response (CR)
    End point description
    Disease response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML). Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation. Bone marrow examination to confirm a suspected complete response (CR) was performed within 8 weeks following the onset of a CT scan confirmed CR.
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    219
    219
    Units: Participants
    36
    44
    No statistical analyses for this end point

    Secondary: Number of participants with overall response (OR)

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    End point title
    Number of participants with overall response (OR)
    End point description
    The overall response rate (ORR) was defined as the number of participants achieving a CR or partial response (PR). from start of randomization until disease progression, or the start of a new anti-cancer therapy. Disease response was assessed according to modified 2007 Revised Response Criteria for Malignant Lymphoma (RRCML). Computed tomography (CT) scans of the neck, thorax, abdomen and pelvis were performed as part of the efficacy evaluation. Bone marrow examination to confirm a suspected complete response (CR) was performed within 8 weeks following the onset of a CT scan confirmed CR.
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    219
    219
    Units: Participants
    110
    144
    No statistical analyses for this end point

    Secondary: Overall survival (OS) - Number of deaths

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    End point title
    Overall survival (OS) - Number of deaths
    End point description
    OS was defined as the interval of time between the date of randomization and the date of death due to any cause. The number of deaths were assessed.
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    219
    219
    Units: Participants
    28
    30
    No statistical analyses for this end point

    Secondary: Number of participants with infection related adverse events

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    End point title
    Number of participants with infection related adverse events
    End point description
    The number of participants with infection related adverse events was assessed.
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    217
    218
    Units: Participants
    69
    81
    No statistical analyses for this end point

    Secondary: Number of participants with infusion related adverse events due to study drug

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    End point title
    Number of participants with infusion related adverse events due to study drug
    End point description
    The number of participants with infusion related adverse events due to study drug was assessed.
    End point type
    Secondary
    End point timeframe
    36 weeks + 60 days
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    217
    218
    Units: Participants
    178
    112
    No statistical analyses for this end point

    Secondary: Number of participants with myelosuppression adverse events

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    End point title
    Number of participants with myelosuppression adverse events
    End point description
    The number of participants with myelosuppression adverse events was assessed.
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    217
    218
    Units: Participants
    24
    41
    No statistical analyses for this end point

    Secondary: Duration of response

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    End point title
    Duration of response
    End point description
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    0 [1]
    0 [2]
    Units: weeks
        number (not applicable)
    Notes
    [1] - The analysis of this end point was not performed due to the early termination of the study.
    [2] - The analysis of this end point was not performed due to the early termination of the study.
    No statistical analyses for this end point

    Secondary: Time to next treatment

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    End point title
    Time to next treatment
    End point description
    End point type
    Secondary
    End point timeframe
    200 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    0 [3]
    0 [4]
    Units: weeks
        number (not applicable)
    Notes
    [3] - The analysis of this end point was not performed due to the early termination of the study.
    [4] - The analysis of this end point was not performed due to the early termination of the study.
    No statistical analyses for this end point

    Secondary: Pharmacokinetics

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    End point title
    Pharmacokinetics
    End point description
    End point type
    Secondary
    End point timeframe
    70 weeks
    End point values
    Ofatumumab Rituximab
    Number of subjects analysed
    0 [5]
    0 [6]
    Units: mL
        number (not applicable)
    Notes
    [5] - The analysis of this end point was not performed due to the early termination of the study.
    [6] - The analysis of this end point was not performed due to the early termination of the study.
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit.
    Adverse event reporting additional description
    Consistent with EudraCT disclosure specifications, Novartis has reported under the Serious adverse events field “number of deaths resulting from adverse events” all those deaths, resulting from serious adverse events that are deemed to be causally related to treatment by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Ofatumumab
    Reporting group description
    Ofatumumab

    Reporting group title
    Rituximab
    Reporting group description
    Rituximab

    Serious adverse events
    Ofatumumab Rituximab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    38 / 217 (17.51%)
    37 / 218 (16.97%)
         number of deaths (all causes)
    1
    0
         number of deaths resulting from adverse events
    1
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma of appendix
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Adenocarcinoma of colon
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Carcinoid tumour pulmonary
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Colorectal cancer
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic neoplasm
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatocellular carcinoma
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malignant pleural effusion
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mycosis fungoides
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal carcinoma
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Prostate cancer
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    2 / 217 (0.92%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Poor peripheral circulation
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Performance status decreased
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 217 (0.00%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopneumopathy
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cough
         subjects affected / exposed
    0 / 217 (0.00%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 217 (0.00%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung disorder
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 217 (0.46%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 217 (0.00%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    5 / 217 (2.30%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    4 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pubis fracture
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    1 / 217 (0.46%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Normal pressure hydrocephalus
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphopenia
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 217 (0.92%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Otosclerosis
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Cataract
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Crohn's disease
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    0 / 217 (0.00%)
    2 / 218 (0.92%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mesenteric vein thrombosis
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Retroperitoneal haematoma
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Hepatotoxicity
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Toxic epidermal necrolysis
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 217 (0.46%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal colic
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 217 (0.46%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bursitis
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymph gland infection
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic sepsis
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 217 (0.92%)
    5 / 218 (2.29%)
         occurrences causally related to treatment / all
    1 / 2
    4 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory syncytial virus infection
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 217 (0.46%)
    3 / 218 (1.38%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 217 (0.46%)
    0 / 218 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin infection
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    0 / 217 (0.00%)
    1 / 218 (0.46%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ofatumumab Rituximab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    177 / 217 (81.57%)
    150 / 218 (68.81%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    3 / 217 (1.38%)
    11 / 218 (5.05%)
         occurrences all number
    3
    11
    Neutrophil count decreased
         subjects affected / exposed
    10 / 217 (4.61%)
    16 / 218 (7.34%)
         occurrences all number
    17
    18
    White blood cell count decreased
         subjects affected / exposed
    12 / 217 (5.53%)
    23 / 218 (10.55%)
         occurrences all number
    19
    29
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    40 / 217 (18.43%)
    19 / 218 (8.72%)
         occurrences all number
    54
    27
    Nervous system disorders
    Headache
         subjects affected / exposed
    11 / 217 (5.07%)
    20 / 218 (9.17%)
         occurrences all number
    13
    35
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    6 / 217 (2.76%)
    16 / 218 (7.34%)
         occurrences all number
    7
    17
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    9 / 217 (4.15%)
    14 / 218 (6.42%)
         occurrences all number
    11
    14
    Chills
         subjects affected / exposed
    8 / 217 (3.69%)
    13 / 218 (5.96%)
         occurrences all number
    10
    13
    Fatigue
         subjects affected / exposed
    21 / 217 (9.68%)
    28 / 218 (12.84%)
         occurrences all number
    23
    30
    Pyrexia
         subjects affected / exposed
    9 / 217 (4.15%)
    21 / 218 (9.63%)
         occurrences all number
    10
    25
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    12 / 217 (5.53%)
    7 / 218 (3.21%)
         occurrences all number
    14
    8
    Constipation
         subjects affected / exposed
    17 / 217 (7.83%)
    11 / 218 (5.05%)
         occurrences all number
    20
    11
    Diarrhoea
         subjects affected / exposed
    20 / 217 (9.22%)
    15 / 218 (6.88%)
         occurrences all number
    25
    17
    Nausea
         subjects affected / exposed
    19 / 217 (8.76%)
    16 / 218 (7.34%)
         occurrences all number
    21
    19
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    9 / 217 (4.15%)
    18 / 218 (8.26%)
         occurrences all number
    10
    23
    Dyspnoea
         subjects affected / exposed
    13 / 217 (5.99%)
    13 / 218 (5.96%)
         occurrences all number
    14
    13
    Oropharyngeal discomfort
         subjects affected / exposed
    6 / 217 (2.76%)
    11 / 218 (5.05%)
         occurrences all number
    17
    13
    Oropharyngeal pain
         subjects affected / exposed
    12 / 217 (5.53%)
    11 / 218 (5.05%)
         occurrences all number
    14
    14
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    20 / 217 (9.22%)
    14 / 218 (6.42%)
         occurrences all number
    21
    17
    Rash
         subjects affected / exposed
    42 / 217 (19.35%)
    11 / 218 (5.05%)
         occurrences all number
    51
    13
    Rash maculo-papular
         subjects affected / exposed
    16 / 217 (7.37%)
    2 / 218 (0.92%)
         occurrences all number
    20
    2
    Urticaria
         subjects affected / exposed
    41 / 217 (18.89%)
    3 / 218 (1.38%)
         occurrences all number
    42
    3
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    14 / 217 (6.45%)
    7 / 218 (3.21%)
         occurrences all number
    16
    7
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    8 / 217 (3.69%)
    11 / 218 (5.05%)
         occurrences all number
    8
    15
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    14 / 217 (6.45%)
    22 / 218 (10.09%)
         occurrences all number
    25
    28
    Upper respiratory tract infection
         subjects affected / exposed
    13 / 217 (5.99%)
    11 / 218 (5.05%)
         occurrences all number
    15
    15

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    28 Apr 2010
    • Revision of response criteria. • Sample size increased. • Several exclusion criteria amended to allow greater medical judgment in determining eligibility. • Premedication and infusion schedule information moved from SPM to protocol.
    24 Nov 2010
    • Addition of study logo and acronym. • Additional details added for the randomization method. • Inclusion and exclusion criteria modified to further define the subject population. • Acetaminophen pre-infusion medication requirement clarified. • Further define the OS analysis plan. • Addition of a Japanese specific HBV DNA monitoring schedule. Removal of a sample size re-estimation.
    09 Apr 2013
    • Further define the requirements for baseline bone marrow and lymphoma samples. • Inclusion and exclusion criteria modified to further define and clarify the subject population. • Clarification on study medication dosing and dose delays, including rapid infusion schedule use. • Clarifications to the ofatumumab pre-medication requirements. • Clarification concerning the management of ofatumumab related infusion reactions. • Response assessment updated to align more specifically with the Cheson 2007 criteria. • Clarifications to the pharmacokinetic sub-study sample collection requirements.
    02 Dec 2013
    • Exclusion criteria and guidelines for events of special interest were modified to clearly define the care and management of subjects with Hepatitis B. • Clarification visit scheduling requirements for HAHA/PK collection. • Revisions to the Time and Events Table to ensure consistency throughout the protocol. • Addition of Universal Trial Number (UTN): U1111-1148-8535 • Specified local laboratory information that must be entered into eCRF
    05 Aug 2014
    • Protocol title was replaced with FL with iNHL. • In addition to FL grades 1-3A, other types of iNHL were included in eligibility criteria. • In addition to stratification by FLIPI-1 score (0-2 vs. 3-5, for FL subjects only) and last prior rituximab therapy (monotherapy vs. combination therapy), subjects were to be stratified by disease type (FL vs. Non-FL). • Since this study used an IDMC and not an Independent Safety Review Committee (iSRC), only the IDMC is referenced.
    16 Jul 2016
    • Delete or replace references to GlaxoSmithKline or its staff with that of Novartis and its authorized agents to align with the change of sponsorship. • Make administrative changes to align with Novartis processes and procedures. • The previous protocol Id was OMB113676, which is now owned by Novartis. The Novartis code is OMB157D2303. Both codes are being used for this study.

    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 study was terminated due to futility of the primary end point.
    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
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