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    Clinical Trial Results:
    A single arm, open-label, multicenter study evaluating the long-term, safety and tolerability of 0.5 mg fingolimod (FTY) administered orally once daily in patients with relapsing form of multiple sclerosis

    Summary
    EudraCT number
    2010-020515-37
    Trial protocol
    FI   DE   PT   CZ   ES   SK   HU   GB   SE   FR   EE   IT   AT   GR   NL   IE   BE   DK   NO  
    Global end of trial date
    19 Oct 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    31 Oct 2019
    First version publication date
    31 Oct 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CFTY720D2399
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01201356
    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, Novartis.email@novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, Novartis.email@novartis.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
    19 Oct 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    19 Oct 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate long-term safety and tolerability of fingolimod 0.5 mg/day in patients with Multiple Sclerosis for the duration of the study.
    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
    13 Sep 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
    Argentina: 37
    Country: Number of subjects enrolled
    Australia: 114
    Country: Number of subjects enrolled
    Austria: 42
    Country: Number of subjects enrolled
    Belgium: 89
    Country: Number of subjects enrolled
    Brazil: 65
    Country: Number of subjects enrolled
    Canada: 198
    Country: Number of subjects enrolled
    Czech Republic: 154
    Country: Number of subjects enrolled
    Denmark: 18
    Country: Number of subjects enrolled
    Egypt: 23
    Country: Number of subjects enrolled
    Estonia: 4
    Country: Number of subjects enrolled
    Finland: 43
    Country: Number of subjects enrolled
    France: 85
    Country: Number of subjects enrolled
    Germany: 1229
    Country: Number of subjects enrolled
    United Kingdom: 204
    Country: Number of subjects enrolled
    Greece: 59
    Country: Number of subjects enrolled
    Guatemala: 17
    Country: Number of subjects enrolled
    Hungary: 73
    Country: Number of subjects enrolled
    Ireland: 18
    Country: Number of subjects enrolled
    Israel: 14
    Country: Number of subjects enrolled
    Italy: 323
    Country: Number of subjects enrolled
    Jordan: 2
    Country: Number of subjects enrolled
    Korea, Republic of: 12
    Country: Number of subjects enrolled
    Malaysia: 14
    Country: Number of subjects enrolled
    Netherlands: 92
    Country: Number of subjects enrolled
    Norway: 15
    Country: Number of subjects enrolled
    Panama: 10
    Country: Number of subjects enrolled
    Peru: 23
    Country: Number of subjects enrolled
    Poland: 232
    Country: Number of subjects enrolled
    Portugal: 72
    Country: Number of subjects enrolled
    Romania: 18
    Country: Number of subjects enrolled
    Russian Federation: 135
    Country: Number of subjects enrolled
    Slovakia: 27
    Country: Number of subjects enrolled
    South Africa: 15
    Country: Number of subjects enrolled
    Sweden: 58
    Country: Number of subjects enrolled
    Switzerland: 79
    Country: Number of subjects enrolled
    Turkey: 80
    Country: Number of subjects enrolled
    United States: 221
    Country: Number of subjects enrolled
    Spain: 211
    Worldwide total number of subjects
    4125
    EEA total number of subjects
    3066
    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)
    1
    Adults (18-64 years)
    4121
    From 65 to 84 years
    3
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This was an open-label, multi-center, single treatment arm design allowing patients participating in the fingolimod MS clinical development program to enroll in order to collect additional long-term safety, tolerability, efficacy, and health outcomes data.

    Pre-assignment
    Screening details
    This study had two parts: Part 1, collecting long-term safety, tolerability, efficacy and health outcomes data until all Part 1 end of study (EOS) visits and last follow-up visit; Part 2, collecting limited safety and tolerability data, in a subset of patients who participated in Part 1, and other eligible patients from ongoing fingolimod trials.

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

    Arms
    Arm title
    Fingolimod 0.5 mg/day
    Arm description
    Open-label fingolimod 0.5 mg, taken orally once daily
    Arm type
    Experimental

    Investigational medicinal product name
    Fingolimod
    Investigational medicinal product code
    Other name
    FTY720
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    0.5 mg taken orally once daily

    Number of subjects in period 1
    Fingolimod 0.5 mg/day
    Started
    4125
    Safety Set
    4083
    Fingolimod Full Analysis Set
    4046
    Completed
    3481
    Not completed
    644
         Abnormal laboratory value(s)
    51
         Adverse event, serious fatal
    16
         Consent withdrawn by subject
    144
         Adverse event, non-fatal
    170
         Unsatisfactory therapeutic effect
    112
         Condition no longer requires study drug
    12
         administrative problems
    74
         Lost to follow-up
    50
         Abnormal test procedure result(s)
    3
         Protocol deviation
    12

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Fingolimod 0.5 mg/day
    Reporting group description
    Open-label fingolimod 0.5 mg, taken orally once daily

    Reporting group values
    Fingolimod 0.5 mg/day Total
    Number of subjects
    4125 4125
    Age, Customized
    Units: Subjects
        < 18 years
    1 1
        18 - 30 years
    951 951
        31 - 40 years
    1497 1497
        41 - 55 years
    1605 1605
        > 55 years
    71 71
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    37.8 ( 9.05 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    2933 2933
        Male
    1192 1192
    Race/Ethnicity, Customized
    Units: Subjects
        Caucasian
    3927 3927
        Black
    38 38
        Asian
    35 35
        Native American
    11 11
        Other
    114 114

    End points

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    End points reporting groups
    Reporting group title
    Fingolimod 0.5 mg/day
    Reporting group description
    Open-label fingolimod 0.5 mg, taken orally once daily

    Primary: Parts I and II: Number of Participants with Adverse Events, Serious Adverse Event, and Death

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    End point title
    Parts I and II: Number of Participants with Adverse Events, Serious Adverse Event, and Death [1]
    End point description
    Analysis of absolute and relative frequencies for Adverse Event (AE), Serious Adverse Event (SAE) and Deaths by primary System Organ Class (SOC) to demonstrate that Fingolimod 0.5 mg/day is safe in patients with relapsing forms of Multiple Sclerosis (MS) through the monitoring of relevant clinical and laboratory safety parameters. Only descriptive analysis performed.
    End point type
    Primary
    End point timeframe
    Baseline (Part I) to Month 6 Follow-up (Part II), up to 8 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive analysis performed.
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4083
    Units: Participants
    number (not applicable)
        Adverse Event (AEs)
    2125
        Serious Adverse Events (SAEs)
    515
        Deaths
    16
    No statistical analyses for this end point

    Secondary: Part I: Aggregate annualized Relapse Rates (ARR) from first dose of Fingolimod

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    End point title
    Part I: Aggregate annualized Relapse Rates (ARR) from first dose of Fingolimod
    End point description
    Annualized relapse rate (ARR) is defined as the number of all relapses (including both confirmed and unconfirmed relapses) experienced during a specific period of time adjusted to a one-year period. ARR is calculated as follows: (total number of all relapses) / (total number of days in the study for all patients for that specific period of time) x 365.25. Month 0 is the first dose of fingolimod study drug among all studies in which patient participated. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 0 (Core Baseline) to End of Follow-up Visit (an average of 162 months)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Annual number of relapses per patient
    number (not applicable)
        Month 0 to Month 6
    0.325
        Month 0 to Month 12
    0.273
        Month 0 to Month 24
    0.237
        Month 0 to Month 36
    0.217
        Month 0 to Month 48
    0.208
        Month 0 to Month 60
    0.197
        Month 0 to Month 72
    0.190
        Month 0 to Month 84
    0.182
        Month 0 to Month 96
    0.177
        Month 0 to Month 108
    0.172
        Month 0 to Month 120
    0.170
        Month 0 to Month 132
    0.170
        Month 0 to Month 144
    0.169
        Month 0 to Month 156
    0.169
        Month 0 to end of Study
    0.166
        Month 0 to end of Follow-up
    0.169
    No statistical analyses for this end point

    Secondary: Part I: Number of Participants with relapses (confirmed and unconfirmed) from first dose of Fingolimod

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    End point title
    Part I: Number of Participants with relapses (confirmed and unconfirmed) from first dose of Fingolimod
    End point description
    A relapse is defined as the appearance of a new neurological abnormality or worsening of previously stable or improving pre-existing neurological abnormality, separated by at least 30 days from onset of a preceding clinical demyelinating event. The abnormality must be present for at least 24 hours and occur in the absence of fever (<37.5°C) or infection. In Study Part One, a relapse must be confirmed by an Expanded Disability Status Scale (EDSS) certified Physician within 7 days of the onset of symptoms. A relapse is confirmed when it is accompanied by an increase of at least half a step (0.5) on the EDSS or an increase of 1 point on two different Functional Systems (FS) of the EDSS or 2 points on one of the FS (excluding Bowel/Bladder or Cerebral FS). Month 0 is the first dose of fingolimod study drug among all studies in which patient participated. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 0 (Core Baseline) to End of Follow-up Visit (an average of 162 months)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Participants
    number (not applicable)
        Month 0 to Month 6
    655
        Month 0 to Month 12
    992
        Month 0 to Month 24
    1461
        Month 0 to Month 36
    1794
        Month 0 to Month 48
    2127
        Month 0 to Month 60
    2383
        Month 0 to Month 72
    2616
        Month 0 to Month 84
    2793
        Month 0 to Month 96
    2944
        Month 0 to Month 108
    3036
        Month 0 to Month 120
    3063
        Month 0 to Month 132
    3072
        Month 0 to Month 144
    3075
        Month 0 to Month 156
    3079
        Month 0 to end of Study
    2970
        Month 0 to end of Follow-up
    3079
    No statistical analyses for this end point

    Secondary: Part I: Annualized rates of new or newly enlarging T2 lesions (ARneT2) compared with first dose of Fingolimod

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    End point title
    Part I: Annualized rates of new or newly enlarging T2 lesions (ARneT2) compared with first dose of Fingolimod
    End point description
    Annualized rate of new/newly enlarging T2 lesions (ARneT2) is defined as the number of new or newly enlarging T2 lesions experienced during a specific period of time adjusted to a one-year period. ARneT2 was calculated as follows: (total number of new/newly enlarging T2 lesions) / (total number of days in the study for all patients for that specific period of time) x 365.25.Month 0 is the first dose of fingolimod study drug among all studies in which patient participated. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 0 (Core Baseline) to End of Study (an average of Month 156)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Annual number of T2 lesions per patient
    number (not applicable)
        Month 0 to Month 3
    12.324
        Month 0 to Month 6
    2.073
        Month 0 to Month 12
    1.360
        Month 0 to Month 24
    1.042
        Month 0 to Month 36
    1.011
        Month 0 to Month 48
    1.008
        Month 0 to Month 60
    0.957
        Month 0 to Month 72
    0.963
        Month 0 to Month 84
    0.906
        Month 0 to Month 96
    0.813
        Month 0 to Month 108
    0.713
        Month 0 to Month 120
    0.702
        Month 0 to Month 132
    0.659
        Month 0 to Month 144
    0.681
        Month 0 to Month 156
    0.637
        Month 0 to end of study
    0.751
    No statistical analyses for this end point

    Secondary: Part I: Change from first dose of Fingolimod in Total T2 Lesions volume

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    End point title
    Part I: Change from first dose of Fingolimod in Total T2 Lesions volume
    End point description
    Total volume of T2 lesions was summarized by presenting descriptive statistics for change from first dose of fingolimod baseline values by visit.
    End point type
    Secondary
    End point timeframe
    Month 3 to End of Study (Study Completion Visit)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: mm^3
    arithmetic mean (standard deviation)
        T2 volume change at Month 3
    -749.5 ( 5269.04 )
        T2 volume change at Month 6
    -207.0 ( 1385.64 )
        T2 volume change at Month 12
    -55.0 ( 1700.16 )
        T2 volume change at Month 24
    16.2 ( 2009.87 )
        T2 volume change at Month 36
    235.8 ( 2519.39 )
        T2 volume change at Month 48
    875.1 ( 4145.99 )
        T2 volume change at Month 60
    1546.3 ( 4556.51 )
        T2 volume change at Month 72
    1719.2 ( 5184.27 )
        T2 volume change at Month 84
    1635.8 ( 5075.13 )
        T2 volume change at Month 96
    1303.9 ( 4712.78 )
        T2 volume change at Month 108
    1562.0 ( 4654.67 )
        T2 volume change at Month 120
    1393.1 ( 4908.76 )
        T2 volume change at Month 132
    905.9 ( 3960.94 )
        T2 volume change at Month 144
    702.7 ( 3765.80 )
        T2 volume change at Month 156
    274.0 ( 5784.85 )
        T2 volume change at End of Study
    1588.5 ( 5157.00 )
    No statistical analyses for this end point

    Secondary: Part I: Change from first dose of Fingolimod in Total T1 Hypointense Lesions volume

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    End point title
    Part I: Change from first dose of Fingolimod in Total T1 Hypointense Lesions volume
    End point description
    T1 hypointense lesion (black hole) volume was summarized by presenting descriptive statistics for change from first dose of fingolimod baseline values by visit.
    End point type
    Secondary
    End point timeframe
    Month 3 to End of Study (Study Completion Visit)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: mm^3
    arithmetic mean (standard deviation)
        T1 volume change at Month 3
    -519.8 ( 1339.62 )
        T1 volume change at Month 12
    49.1 ( 718.77 )
        T1 volume change at Month 24
    64.1 ( 786.02 )
        T1 volume change at Month 36
    151.08 ( 1001.28 )
        T1 volume change at Month 48
    524.8 ( 1706.26 )
        T1 volume change at Month 60
    853.6 ( 1957.74 )
        T1 volume change at Month 72
    975.7 ( 2637.67 )
        T1 volume change at Month 84
    930.1 ( 2471.70 )
        T1 volume change at Month 96
    753.4 ( 1845.63 )
        T1 volume change at Month 108
    628.7 ( 1922.45 )
        T1 volume change at Month 120
    817.3 ( 2198.58 )
        T1 volume change at Month 132
    726.7 ( 999 )
        T1 volume change at End of Study
    800.6 ( 2247.27 )
    No statistical analyses for this end point

    Secondary: Part I: Percent brain volume change (PBVC) relative to first dose of Fingolimod

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    End point title
    Part I: Percent brain volume change (PBVC) relative to first dose of Fingolimod
    End point description
    Descriptive statistics on normalized brain volume at core baseline and percent brain volume change from first dose of fingolimod baseline were presented by visit. A negative change from baseline indicates improvement.
    End point type
    Secondary
    End point timeframe
    Month 0 (Core Baseline) to End of Study (an average of Month 156)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: cc
    arithmetic mean (standard deviation)
        Normalized brain volume at Core Baseline
    1519.63 ( 81.193 )
        Percent volume change at Month 3
    -0.19 ( 0.660 )
        Percent volume change at Month 6
    -0.20 ( 0.801 )
        Percent volume change at Month 12
    -0.36 ( 0.901 )
        Percent volume change at Month 24
    -0.74 ( 1.209 )
        Percent volume change at Month 36
    -1.03 ( 1.541 )
        Percent volume change at Month 48
    -1.44 ( 1.851 )
        Percent volume change at Month 60
    -1.65 ( 2.196 )
        Percent volume change at Month 72
    -2.02 ( 2.514 )
        Percent volume change at Month 84
    -2.38 ( 2.638 )
        Percent volume change at Month 96
    -2.41 ( 2.607 )
        Percent volume change at Month 108
    -2.91 ( 2.863 )
        Percent volume change at Month 120
    -3.42 ( 2.911 )
        Percent volume change at Month 132
    -4.61 ( 2.511 )
        Percent volume change at Month 144
    -4.21 ( 2.778 )
        Percent volume change at Month 156
    -4.33 ( 3.146 )
    No statistical analyses for this end point

    Secondary: Part I: Annualized Rate of Brain Atrophy (ARBA) relative to first dose of Fingolimod

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    End point title
    Part I: Annualized Rate of Brain Atrophy (ARBA) relative to first dose of Fingolimod
    End point description
    The annualized rate of brain volume change is an “averaged annual percentage change” in brain volume. ARBA was calculated as: ARBA = [(SIENA/100+1) ^ (365.25/#days)-1]*100 where SIENA=(Vk/V0-1)*100 and Vk is the brain volume at time k, V0 is the brain volume at time 0 and k is the total number of days in the study for all patients for that specific period of time) × 365.25. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 3 to Month 156
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Ratio
    arithmetic mean (standard deviation)
        Month 3
    -0.73 ( 2.834 )
        Month 6
    -0.39 ( 1.590 )
        Month 12
    -0.35 ( 0.891 )
        Month 24
    -0.37 ( 0.615 )
        Month 36
    -0.35 ( 0.522 )
        Month 48
    -0.37 ( 0.480 )
        Month 60
    -0.34 ( 0.451 )
        Month 72
    -0.35 ( 0.433 )
        Month 84
    -0.35 ( 0.395 )
        Month 96
    -0.31 ( 0.340 )
        Month 108
    -0.33 ( 0.326 )
        Month 120
    -0.36 ( 0.308 )
        Month 132
    -0.43 ( 0.240 )
        Month 144
    -0.36 ( 0.244 )
        Month 156
    -0.35 ( 0.256 )
    No statistical analyses for this end point

    Secondary: Part I: Number of Participants with confirmed 6-month disability progression after first dose of Fingolimod

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    End point title
    Part I: Number of Participants with confirmed 6-month disability progression after first dose of Fingolimod
    End point description
    Disability progression was defined based on an increase in the EDSS score by 1.5 point for patients with a first dose of fingolimod (FDF) baseline EDSS score of 0, 1 point for patients with FDF baseline EDSS of >=1 and <=5.5, and by 0.5 points for patients with an FDF baseline EDSS>5.5, confirmed after 6 months and all intermediate EDSS assessments. A 6-month confirmed disability progression was defined as a 6-month sustained increase from the reference (potential onset of progression) value in the EDSS scores. i.e., every EDSS score (scheduled or unscheduled) within a 6-month duration after the first progression should meet the progression criteria as specified above. The confirmation could only happen at a scheduled visit and in the absence of a relapse. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 12 to Month 156
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Participants
    number (not applicable)
        Month 12
    212
        Month 24
    336
        Month 36
    434
        Month 48
    519
        Month 60
    590
        Month 72
    659
        Month 84
    714
        Month 96
    753
        Month 108
    767
        Month 120
    772
        Month 132
    775
        Month 144
    776
        Month 156
    777
    No statistical analyses for this end point

    Secondary: Part I: Number of Participants with categorized change from first dose of Fingolimod in Expanded Disability Status Scale (EDSS) overall score

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    End point title
    Part I: Number of Participants with categorized change from first dose of Fingolimod in Expanded Disability Status Scale (EDSS) overall score
    End point description
    The EDSS is a scale for assessing neurological impairment in MS (Kurtzke 1983) including (1) a series of scores in each of eight functional systems, and (2) the EDSS steps (ranging from 0 (normal) to 10 (death due to MS). The functional systems are Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel and Bladder, Cerebral and Other functions. Based on the assessment of each FS, the participant's overall score is categorized as Improvement, Stable or Deterioration. If baseline EDSS score is <=5, improvement is indicated by an EDSS score change of <= -1, stable is indicated by an EDSS score change of > -1 and <= 0.5, deterioration is indicated by an EDSS score change of > 0.5; if baseline EDSS score is > 5, improvement is indicated by an EDSS score change of <= -0.5, stable is indicated by an EDSS score change of > -0.5 and <= 0, deterioration is indicated by an EDSS score change of > 0. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 3 to Month 6 Follow-up
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: Participants
    number (not applicable)
        Month 3|Improvement
    374
        Month 6|Improvement
    508
        Month 9|Improvement
    482
        Month 12|Improvement
    422
        Month 15|Improvement
    405
        Month 18|Improvement
    345
        Month 21|Improvement
    376
        Month 24|Improvement
    320
        Month 27|Improvement
    313
        Month 30|Improvement
    305
        Month 33|Improvement
    326
        Month 36|Improvement
    309
        Month 39|Improvement
    284
        Month 42|Improvement
    282
        Month 45|Improvement
    244
        Month 48|Improvement
    250
        Month 51|Improvement
    244
        Month 54|Improvement
    256
        Month 57|Improvement
    201
        Month 60|Improvement
    175
        Month 63|Improvement
    182
        Month 66|Improvement
    165
        Month 69|Improvement
    156
        Month 72|Improvement
    143
        Month 75|Improvement
    156
        Month 78|Improvement
    136
        Month 81|Improvement
    150
        Month 84|Improvement
    132
        Month 87|Improvement
    147
        Month 90|Improvement
    120
        Month 93|Improvement
    143
        Month 96|Improvement
    117
        Month 99|Improvement
    110
        Month 102|Improvement
    94
        Month 105|Improvement
    103
        Month 108|Improvement
    87
        Month 111|Improvement
    74
        Month 114|Improvement
    45
        Month 117|Improvement
    31
        Month 120|Improvement
    19
        Month 123|Improvement
    9
        Month 126|Improvement
    14
        Month 129|Improvement
    6
        Month 132|Improvement
    11
        Month 135|Improvement
    5
        Month 138|Improvement
    10
        Month 141|Improvement
    6
        Month 144|Improvement
    7
        Month 147|Improvement
    6
        Month 150|Improvement
    7
        Month 153|Improvement
    8
        Month 156|Improvement
    3
        Month 159|Improvement
    1
        Month 162|Improvement
    0
        End of study|Improvement
    610
        Month 3 follow-up|Improvement
    203
        Month 6 follow-up|Improvement
    29
        Month 3|Stable
    3126
        Month 6|Stable
    2900
        Month 9|Stable
    2425
        Month 12|Stable
    1930
        Month 15|Stable
    1764
        Month 18|Stable
    1361
        Month 21|Stable
    1524
        Month 24|Stable
    1299
        Month 27|Stable
    1271
        Month 30|Stable
    1204
        Month 33|Stable
    1172
        Month 36|Stable
    1065
        Month 39|Stable
    1015
        Month 42|Stable
    948
        Month 45|Stable
    875
        Month 48|Stable
    838
        Month 51|Stable
    784
        Month 54|Stable
    788
        Month 57|Stable
    694
        Month 60|Stable
    577
        Month 63|Stable
    540
        Month 66|Stable
    499
        Month 69|Stable
    503
        Month 72|Stable
    440
        Month 75|Stable
    437
        Month 78|Stable
    398
        Month 81|Stable
    456
        Month 84|Stable
    407
        Month 87|Stable
    450
        Month 90|Stable
    413
        Month 93|Stable
    386
        Month 96|Stable
    375
        Month 99|Stable
    325
        Month 102|Stable
    283
        Month 105|Stable
    261
        Month 108|Stable
    287
        Month 111|Stable
    198
        Month 114|Stable
    181
        Month 117|Stable
    94
        Month 120|Stable
    88
        Month 123|Stable
    36
        Month 126|Stable
    45
        Month 129|Stable
    18
        Month 132|Stable
    36
        Month 135|Stable
    19
        Month 138|Stable
    39
        Month 141|Stable
    18
        Month 144|Stable
    30
        Month 147|Stable
    21
        Month 150|Stable
    22
        Month 153|Stable
    16
        Month 156|Stable
    9
        Month 159|Stable
    2
        Month 162|Stable
    1
        End of study|Stable
    2419
        Month 3 follow-up|Stable
    907
        Month 6 follow-up|Stable
    111
        Month 3|Deterioration
    269
        Month 6|Deterioration
    340
        Month 9|Deterioration
    304
        Month 12|Deterioration
    322
        Month 15|Deterioration
    285
        Month 18|Deterioration
    271
        Month 21|Deterioration
    287
        Month 24|Deterioration
    294
        Month 27|Deterioration
    270
        Month 30|Deterioration
    287
        Month 33|Deterioration
    292
        Month 36|Deterioration
    288
        Month 39|Deterioration
    276
        Month 42|Deterioration
    287
        Month 45|Deterioration
    263
        Month 48|Deterioration
    264
        Month 51|Deterioration
    247
        Month 54|Deterioration
    251
        Month 57|Deterioration
    245
        Month 60|Deterioration
    234
        Month 63|Deterioration
    191
        Month 66|Deterioration
    216
        Month 69|Deterioration
    193
        Month 72|Deterioration
    206
        Month 75|Deterioration
    201
        Month 78|Deterioration
    226
        Month 81|Deterioration
    217
        Month 84|Deterioration
    207
        Month 87|Deterioration
    227
        Month 90|Deterioration
    204
        Month 93|Deterioration
    187
        Month 96|Deterioration
    186
        Month 99|Deterioration
    159
        Month 102|Deterioration
    154
        Month 105|Deterioration
    131
        Month 108|Deterioration
    138
        Month 111|Deterioration
    101
        Month 114|Deterioration
    79
        Month 117|Deterioration
    52
        Month 120|Deterioration
    42
        Month 123|Deterioration
    21
        Month 126|Deterioration
    26
        Month 129|Deterioration
    12
        Month 132|Deterioration
    21
        Month 135|Deterioration
    12
        Month 138|Deterioration
    18
        Month 141|Deterioration
    12
        Month 144|Deterioration
    19
        Month 147|Deterioration
    15
        Month 150|Deterioration
    15
        Month 153|Deterioration
    8
        Month 156|Deterioration
    5
        Month 159|Deterioration
    6
        Month 162|Deterioration
    1
        End of study|Deterioration
    785
        Month 3 follow-up|Deterioration
    381
        Month 6 follow-up|Deterioration
    88
    No statistical analyses for this end point

    Secondary: Part I: Change from first dose of Fingolimod in Expanded Disability Status Scale (EDSS)

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    End point title
    Part I: Change from first dose of Fingolimod in Expanded Disability Status Scale (EDSS)
    End point description
    The EDSS is a scale for assessing neurological impairment in MS (Kurtzke 1983) including (1) a series of scores in each of eight functional systems, and (2) the EDSS steps (ranging from 0 (normal) to 10 (death due to MS). The functional systems are Visual, Brain Stem, Pyramidal, Cerebellar, Sensory, Bowel and Bladder, Cerebral and Other functions. Based on the assessment of each FS, the participant's overall score is determined between 0 to 10. A negative change from baseline indicates improvement. Only descriptive analysis performed.
    End point type
    Secondary
    End point timeframe
    Month 0 (Core Baseline) to End of Follow-up Visit (an average of 162 months)
    End point values
    Fingolimod 0.5 mg/day
    Number of subjects analysed
    4046
    Units: EDSS Overall score
    arithmetic mean (standard deviation)
        Baseline (BL)
    2.39 ( 1.452 )
        Change from BL at Month 3
    -0.06 ( 0.638 )
        Change from BL at Month 6
    -0.07 ( 0.716 )
        Change from BL at Month 9
    -0.09 ( 0.750 )
        Change from BL at Month 12
    -0.07 ( 0.815 )
        Change from BL at Month 15
    -0.08 ( 0.814 )
        Change from BL at Month 18
    -0.05 ( 0.890 )
        Change from BL at Month 21
    -0.08 ( 0.876 )
        Change from BL at Month 24
    -0.01 ( 0.916 )
        Change from BL at Month 27
    -0.03 ( 0.932 )
        Change from BL at Month 30
    -0.00 ( 0.935 )
        Change from BL at Month 33
    -0.02 ( 0.951 )
        Change from BL at Month 36
    0.01 ( 0.997 )
        Change from BL at Month 39
    0.02 ( 0.963 )
        Change from BL at Month 42
    0.04 ( 1.015 )
        Change from BL at Month 45
    0.06 ( 1.006 )
        Change from BL at Month 48
    0.06 ( 1.063 )
        Change from BL at Month 51
    0.06 ( 1.071 )
        Change from BL at Month 54
    0.04 ( 1.120 )
        Change from BL at Month 57
    0.09 ( 1.077 )
        Change from BL at Month 60
    0.17 ( 1.144 )
        Change from BL at Month 63
    0.08 ( 1.123 )
        Change from BL at Month 66
    0.15 ( 1.220 )
        Change from BL at Month 69
    0.14 ( 1.116 )
        Change from BL at Month 72
    0.22 ( 1.205 )
        Change from BL at Month 75
    0.13 ( 1.159 )
        Change from BL at Month 78
    0.28 ( 1.259 )
        Change from BL at Month 81
    0.18 ( 1.158 )
        Change from BL at Month 84
    0.25 ( 1.236 )
        Change from BL at Month 87
    0.24 ( 1.206 )
        Change from BL at Month 90
    0.29 ( 1.282 )
        Change from BL at Month 93
    0.18 ( 1.219 )
        Change from BL at Month 96
    0.31 ( 1.355 )
        Change from BL at Month 99
    0.18 ( 1.220 )
        Change from BL at Month 102
    0.30 ( 1.332 )
        Change from BL at Month 105
    0.21 ( 1.320 )
        Change from BL at Month 108
    0.28 ( 1.270 )
        Change from BL at Month 111
    0.24 ( 1.343 )
        Change from BL at Month 114
    0.30 ( 1.258 )
        Change from BL at Month 117
    0.35 ( 1.389 )
        Change from BL at Month 120
    0.40 ( 1.271 )
        Change from BL at Month 123
    0.60 ( 1.302 )
        Change from BL at Month 126
    0.38 ( 1.441 )
        Change from BL at Month 129
    0.40 ( 1.448 )
        Change from BL at Month 132
    0.40 ( 1.450 )
        Change from BL at Month 135
    0.51 ( 1.519 )
        Change from BL at Month 138
    0.42 ( 1.527 )
        Change from BL at Month 141
    0.54 ( 1.509 )
        Change from BL at Month 144
    0.60 ( 1.553 )
        Change from BL at Month 147
    0.67 ( 1.640 )
        Change from BL at Month 150
    0.44 ( 1.483 )
        Change from BL at Month 153
    0.23 ( 1.534 )
        Change from BL at Month 156
    0.26 ( 1.427 )
        Change from BL at Month 159
    1.17 ( 1.369 )
        Change from BL at Month 162
    0.75 ( 1.061 )
        Change from BL at End of study
    0.14 ( 1.108 )
        Change from BL at Month 3 follow-up
    0.29 ( 1.248 )
        Change from BL at Month 6 follow-up
    0.56 ( 1.487 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected from first dose of study treatment in Study Part I until end of study treatment in Study Part II plus 6 weeks post treatment, up to a maximum duration of 8 years.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.1
    Reporting groups
    Reporting group title
    Any Fingolimod Dose
    Reporting group description
    Any Fingolimod Dose

    Serious adverse events
    Any Fingolimod Dose
    Total subjects affected by serious adverse events
         subjects affected / exposed
    515 / 4083 (12.61%)
         number of deaths (all causes)
    16
         number of deaths resulting from adverse events
    5
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma of colon
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    B-cell lymphoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    30 / 4083 (0.73%)
         occurrences causally related to treatment / all
    22 / 31
         deaths causally related to treatment / all
    0 / 0
    Benign hydatidiform mole
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Benign neoplasm of thyroid gland
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Benign ovarian tumour
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bladder cancer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bone giant cell tumour
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bowen's disease
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Brain neoplasm benign
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast cancer
         subjects affected / exposed
    11 / 4083 (0.27%)
         occurrences causally related to treatment / all
    8 / 11
         deaths causally related to treatment / all
    0 / 0
    Cervix carcinoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon cancer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon cancer metastatic
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Desmoid tumour
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Extranodal marginal zone B-cell lymphoma (MALT type)
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Fibroadenoma of breast
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal neoplasm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intraductal proliferative breast lesion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Invasive lobular breast carcinoma
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Laryngeal squamous cell carcinoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Leiomyoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant melanoma
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Melanocytic naevus
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Meningioma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metastases to lymph nodes
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metastases to spine
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neoplasm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Non-Hodgkin's lymphoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ovarian adenoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ovarian cancer metastatic
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatic carcinoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Papilloma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Phyllodes tumour
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Rectal cancer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal cancer
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Renal cell carcinoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seminoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Small cell lung cancer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Squamous cell carcinoma
         subjects affected / exposed
    9 / 4083 (0.22%)
         occurrences causally related to treatment / all
    7 / 11
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Thyroid adenoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine cancer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine leiomyoma
         subjects affected / exposed
    10 / 4083 (0.24%)
         occurrences causally related to treatment / all
    0 / 11
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Aneurysm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Aortic aneurysm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoperfusion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral artery thrombosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Peripheral venous disease
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Phlebitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vasculitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Venous stenosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Abortion induced
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abortion spontaneous
         subjects affected / exposed
    10 / 4083 (0.24%)
         occurrences causally related to treatment / all
    4 / 11
         deaths causally related to treatment / all
    0 / 0
    Ectopic pregnancy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperemesis gravidarum
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    1 / 2
    Death neonatal
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fat tissue increased
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fatigue
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Gait disturbance
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hernia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypothermia
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Influenza like illness
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Peripheral swelling
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyrexia
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Vascular stent stenosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Immune system disorders
    Haemophagocytic lymphohistiocytosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Immunodeficiency
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Adnexa uteri cyst
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Benign prostatic hyperplasia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast calcifications
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cervical dysplasia
         subjects affected / exposed
    7 / 4083 (0.17%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Dysfunctional uterine bleeding
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endometriosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gynaecomastia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metrorrhagia
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Ovarian cyst
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Postmenopausal haemorrhage
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine cyst
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine haemorrhage
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Uterine polyp
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory distress syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Aspiration
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cough
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemothorax
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nasal polyps
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Acute stress disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Adjustment disorder with depressed mood
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Aggression
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Anxiety
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bipolar I disorder
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Completed suicide
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    1 / 3
    Confusional state
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    9 / 4083 (0.22%)
         occurrences causally related to treatment / all
    1 / 9
         deaths causally related to treatment / all
    0 / 0
    Drug dependence
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eating disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Major depression
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Mania
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Mental disorder
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Panic attack
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Persecutory delusion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Personality change
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Personality change due to a general medical condition
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychogenic seizure
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Somatic symptom disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Stress
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Suicidal ideation
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Suicide attempt
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Product issues
    Device dislocation
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Biliary colic
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    Biliary cyst
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Biliary dyskinesia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholangitis acute
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis chronic
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    10 / 4083 (0.24%)
         occurrences causally related to treatment / all
    2 / 10
         deaths causally related to treatment / all
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hepatitis acute
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Liver disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphocyte count decreased
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Weight decreased
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Alcohol poisoning
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ankle fracture
         subjects affected / exposed
    6 / 4083 (0.15%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Arthropod bite
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Chest injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clavicle fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Concussion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Craniocerebral injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Facial bones fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Femur fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fibula fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Foot fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hip fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Humerus fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Joint injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Kidney contusion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ligament rupture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Meniscus injury
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Multiple injuries
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscle injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Near drowning
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Patella fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pelvic fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pubis fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Radius fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rib fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Road traffic accident
         subjects affected / exposed
    5 / 4083 (0.12%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 1
    Skull fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Splenic rupture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Tibia fracture
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Traumatic haematoma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic spinal cord compression
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ulna fracture
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Ulnar nerve injury
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vaginal laceration
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Wrist fracture
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Congenital, familial and genetic disorders
    Atrial septal defect
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Bicuspid aortic valve
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Congenital cytomegalovirus infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Congenital knee dislocation
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    6 / 4083 (0.15%)
         occurrences causally related to treatment / all
    4 / 6
         deaths causally related to treatment / all
    0 / 0
    Atrioventricular block first degree
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bradycardia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiopulmonary failure
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Cardiovascular insufficiency
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cyanosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    4 / 4
         deaths causally related to treatment / all
    1 / 1
    Pericarditis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ventricular extrasystoles
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ventricular tachycardia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Altered state of consciousness
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    1 / 1
    Brain hypoxia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Carotid artery occlusion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cauda equina syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Central nervous system lesion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebellar infarction
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebral venous thrombosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coma
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Demyelination
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epilepsy
         subjects affected / exposed
    8 / 4083 (0.20%)
         occurrences causally related to treatment / all
    1 / 9
         deaths causally related to treatment / all
    0 / 0
    Facial spasm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fine motor skill dysfunction
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Focal dyscognitive seizures
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Generalised tonic-clonic seizure
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Headache
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Hemianopia homonymous
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hemiparesis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hyperaesthesia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoaesthesia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intracranial aneurysm
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 1
    Lacunar infarction
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Migraine
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Multiple sclerosis
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Multiple sclerosis relapse
         subjects affected / exposed
    34 / 4083 (0.83%)
         occurrences causally related to treatment / all
    1 / 37
         deaths causally related to treatment / all
    0 / 0
    Muscle spasticity
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myelitis transverse
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Neuralgia
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Optic neuritis
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Paraesthesia
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Partial seizures
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Presyncope
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Sciatica
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Secondary progressive multiple sclerosis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Seizure
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Status epilepticus
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    Syncope
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Tension headache
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombotic stroke
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Transient ischaemic attack
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Trigeminal neuralgia
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Uhthoff's phenomenon
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ulnar nerve palsy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Wernicke's encephalopathy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Immune thrombocytopenic purpura
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphadenopathy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphopenia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Photophobia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Retinal detachment
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Retinal haemorrhage
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Retinal vein thrombosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Abdominal adhesions
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal hernia
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Abdominal pain lower
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Anal fissure
         subjects affected / exposed
    4 / 4083 (0.10%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Barrett's oesophagus
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Crohn's disease
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal ulcer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Duodenal ulcer perforation
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Enterocolitis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Flatulence
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Food poisoning
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastric ulcer
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrooesophageal reflux disease
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastritis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Haematochezia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Irritable bowel syndrome
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Large intestine polyp
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Proctitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Rectal polyp
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Dermatitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Dermatitis contact
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Erythema
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Erythema annulare
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rash
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin erosion
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Calculus urinary
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Renal haemorrhage
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary incontinence
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary retention
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Hyperprolactinaemia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thyroid mass
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Amyotrophy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arthralgia
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Back pain
         subjects affected / exposed
    7 / 4083 (0.17%)
         occurrences causally related to treatment / all
    0 / 11
         deaths causally related to treatment / all
    0 / 0
    Bursitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chondromalacia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chondropathy
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Compartment syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Foot deformity
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    8 / 4083 (0.20%)
         occurrences causally related to treatment / all
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    Jaw disorder
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Joint instability
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Joint swelling
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lateral patellar compression syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mobility decreased
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscular weakness
         subjects affected / exposed
    3 / 4083 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    6 / 4083 (0.15%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Osteonecrosis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rhabdomyolysis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rotator cuff syndrome
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal column stenosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Synovial cyst
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Torticollis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Abdominal abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Abdominal sepsis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Appendicitis
         subjects affected / exposed
    10 / 4083 (0.24%)
         occurrences causally related to treatment / all
    1 / 10
         deaths causally related to treatment / all
    0 / 0
    Appendicitis perforated
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Bartholin's abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    6 / 4083 (0.15%)
         occurrences causally related to treatment / all
    4 / 7
         deaths causally related to treatment / all
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dermatitis infected
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epididymitis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Furuncle
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis viral
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Groin abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Helicobacter infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatitis A
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatitis C
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hepatitis E
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes simplex encephalitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster
         subjects affected / exposed
    9 / 4083 (0.22%)
         occurrences causally related to treatment / all
    8 / 9
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster infection neurological
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Histoplasmosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Infected dermal cyst
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Injection site abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral discitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphangitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mastoiditis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Meningitis cryptococcal
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Meningoencephalitis herpetic
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Orchitis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Pelvic inflammatory disease
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Peritonsillar abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pilonidal cyst
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    14 / 4083 (0.34%)
         occurrences causally related to treatment / all
    4 / 14
         deaths causally related to treatment / all
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pulmonary tuberculosis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Renal abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Salpingitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Salpingo-oophoritis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Sinusitis
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Spermatic cord funiculitis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    14 / 4083 (0.34%)
         occurrences causally related to treatment / all
    7 / 16
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection enterococcal
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Viraemia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral diarrhoea
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral infection
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Vulval abscess
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    2 / 4083 (0.05%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Hyperamylasaemia
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Obesity
         subjects affected / exposed
    1 / 4083 (0.02%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Any Fingolimod Dose
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    2125 / 4083 (52.05%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    243 / 4083 (5.95%)
         occurrences all number
    254
    Nervous system disorders
    Headache
         subjects affected / exposed
    348 / 4083 (8.52%)
         occurrences all number
    538
    Blood and lymphatic system disorders
    Lymphopenia
         subjects affected / exposed
    219 / 4083 (5.36%)
         occurrences all number
    266
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    232 / 4083 (5.68%)
         occurrences all number
    259
    Psychiatric disorders
    Depression
         subjects affected / exposed
    205 / 4083 (5.02%)
         occurrences all number
    233
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    208 / 4083 (5.09%)
         occurrences all number
    246
    Back pain
         subjects affected / exposed
    279 / 4083 (6.83%)
         occurrences all number
    346
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    214 / 4083 (5.24%)
         occurrences all number
    285
    Influenza
         subjects affected / exposed
    275 / 4083 (6.74%)
         occurrences all number
    384
    Nasopharyngitis
         subjects affected / exposed
    706 / 4083 (17.29%)
         occurrences all number
    1318
    Upper respiratory tract infection
         subjects affected / exposed
    346 / 4083 (8.47%)
         occurrences all number
    646
    Urinary tract infection
         subjects affected / exposed
    335 / 4083 (8.20%)
         occurrences all number
    604
    Metabolism and nutrition disorders
    Hypercholesterolaemia
         subjects affected / exposed
    212 / 4083 (5.19%)
         occurrences all number
    245

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    14 Jul 2010
    The changes made throughout the protocol are specific to Poland and the UK and update the study endpoint to reflect until fingolimod is registered and through approximately one-year post approval or maximally through 31-Dec-2012.
    02 Mar 2011
    The changes made throughout the protocol are specific to Norway and update the study endpoint to reflect the timepoint approximately 12 months following the completion of the previous fingolimod trial or maximally through 01-Aug-2012.
    18 May 2011
    The changes made throughout the protocol update the study end for the Phase II/III patients to fingolimod registration, commercially availability and reimbursement OR through 30-June-2016, whichever is later.
    06 Oct 2011
    This Amendment aims to further define the extended follow-up for patients who previously completed the phase II or III fingolimod clinical development studies in an interventional trial setting through 30-Jun-2016. It extends the enrollment to patients who have completed CFTY720D2309/E1 as well as the re-enrollment of CFTY720D2399 patients who have previously completed this study based on the original CFTY720D2399 study endpoint of local approval and reimbursement. Furthermore, this amendment will define additional assessments to evaluate the long-term efficacy of fingolimod in phase II and III trial patients. Lastly, this amendment aims to bring the study schedule of assessments as well as the safety monitoring guidelines in alignment with the fingolimod prescribing information of major countries where the medication has been registered.
    06 Feb 2012
    The major changes include the following: • Exclusion criteria related to the cardiovascular conditions are updated. • Appendix 4 Guidance for monitoring of patients taking their first dose of the study drug is updated. • Only for Germany: Patients requiring first dose monitoring will receive continuous 6-hour ECG monitoring after the first dose or upon re-initiation of fingolimod treatment after an interruption of greater than 14 consecutive days.
    24 Jul 2012
    The major changes include the following: • Exclusion criteria related to the cardiovascular conditions are updated. • Exclusion of patients taking medications that lower heart rate has been added. • Germany country-specific recommendations removed; additional procedures and assessments required by local prescribing information should be followed accordingly. • Appendix 4 Guidance for monitoring of patients taking their first dose of the study drug is updated to reflect final guidance.
    18 Aug 2013
    The major changes include the following: • Clarified VZV antibody guidance has been added. • The protocol title has been modified.
    29 Aug 2014
    The major changes include the following: • MRI frequency changed from annually to one at EOS • Clinical laboratory collection changed from a biennial to annual collection, with urine pregnancy tests for females being substituted at the visits during which other clinical laboratory testing has been removed. • Addition of CD4/CD8/CD19 testing as part of the chemistry panel at EOS visit • Reduction in frequency of PRO collection, for those patients who had PRO collection in their prior study
    09 Sep 2015
    The major changes include the following:  Updates to the Background, Physical/neurological exam, Skin assessments, and Guidance on safety monitoring based on investigator brochure (Edition 18) updates.  Updates to Study design, Rationale of study design, Population, Study completion and post-study treatment, and the Schedule of assessments related to Study Completion visit scheduling and/or reintroduction of hematology sampling at the 6-monthly visits.
    14 Mar 2016
    The major changes include the following:  Updates to Study objectives, Study design, Rationale of study design, Rationale of dose/regimen, duration of treatment, Population, Study completion and post-study treatment, Discontinuation of study treatment, Laboratory evaluations, Data analysis, Guidance on Safety Monitoring, and the Schedule of assessments.  Addition of Section 6.6.7, Other Biomarkers, Liver event and Laboratory trigger Definitions and Follow-up Requirements, and the Schedule of assessments for Part II.
    01 Apr 2016
    The purpose of this amendment is to add information inadvertently deleted from Amendment 10 during the publishing process. This study is ongoing with approximately 4,150 enrolled patients. The amendment changes will provide further clarification on the conduct of the protocol.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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