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    Clinical Trial Results:
    A Single Blind, Randomized, Controlled Study to Evaluate the Safety and Effectiveness of EVICEL® as an Adjunct to Gastrointestinal Anastomosis Techniques

    Summary
    EudraCT number
    2011-005479-17
    Trial protocol
    GB   BE  
    Global end of trial date
    06 Jan 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Jul 2016
    First version publication date
    16 Jul 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    400-11-002
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01589822
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Ethicon Inc., a Johnson & Johnson Co.
    Sponsor organisation address
    Route 22 West, Somerville, United States,
    Public contact
    Senior Clinical Director, Ethicon Inc., a Johnson & Johnson Co., 1 9082182492, jbatill2@its.jnj.com
    Scientific contact
    Senior Clinical Director, Ethicon Inc., a Johnson & Johnson Co., 1 9082182492, jbatill2@its.jnj.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
    06 Feb 2014
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Jan 2014
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Jan 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the safety and effectiveness of EVICEL® Fibrin Sealant (Human) for use as an adjunct to stapled anastomosis after lower anterior resection (LAR). This will be done by assessing the absence of clinical anastomotic leak (success) within 40 days post operatively. Clinical anastomotic leak is defined as signs and symptoms that are confirmed by one or more of the following methods: • Confirmation on imaging; • Visual confirmation (eg., reoperation/drain output).
    Protection of trial subjects
    The protocol and consent form were provided to the appropriate Ethics Committee for approval.In addition, an independent Data Monitoring Committee was established and had responsibility for evaluating the progress of the trial and assessing patient safety and data quality.
    Background therapy
    Not applicable
    Evidence for comparator
    Standard of care (standard surgical technique for GI anastomosis) used as comparator
    Actual start date of recruitment
    29 Jun 2012
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Scientific research
    Long term follow-up duration
    1 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 31
    Country: Number of subjects enrolled
    Belgium: 37
    Country: Number of subjects enrolled
    Canada: 8
    Country: Number of subjects enrolled
    United States: 45
    Country: Number of subjects enrolled
    Australia: 25
    Country: Number of subjects enrolled
    New Zealand: 21
    Country: Number of subjects enrolled
    Korea, Republic of: 47
    Worldwide total number of subjects
    214
    EEA total number of subjects
    68
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    124
    From 65 to 84 years
    89
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    The first subject was recruited on the 29 June 2012 and last subject was 20 September 2013.

    Pre-assignment
    Screening details
    Prospective subjects were screened within 21 days prior to surgery. Prior to any study related procedures, subjects were fully informed of all aspects of the study and asked to sign a consent form. Inclusion criteria are detailed in Section 4 of the protocol.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Single blind
    Roles blinded
    Subject
    Blinding implementation details
    Actual treatment not discussed with the patient

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Evicel Non randomized
    Arm description
    Evicel Non randomized
    Arm type
    Non randomized run in

    Investigational medicinal product name
    Evicel
    Investigational medicinal product code
    Evicel
    Other name
    Pharmaceutical forms
    Sealant
    Routes of administration
    Topical use
    Dosage and administration details
    At least 10mL of EVICEL (5mL BAC2 plus 5mL Human Thrombin) was to be dripped or sprayed around the circumference of the anastomotic staple line ensuring its full coverage with a layer of EVICEL of approximately 3mm in thickness and 1cm in width on either side of the staple line.

    Arm title
    Evicel Randomized
    Arm description
    Evicel Randomized
    Arm type
    Active comparator

    Investigational medicinal product name
    Evicel
    Investigational medicinal product code
    Evicel
    Other name
    Pharmaceutical forms
    Sealant
    Routes of administration
    Topical use
    Dosage and administration details
    At least 10mL of EVICEL (5mL BAC2 plus 5mL Human Thrombin) was to be dripped or sprayed around the circumference of the anastomotic staple line ensuring its full coverage with a layer of EVICEL of approximately 3mm in thickness and 1cm in width on either side of the staple line.

    Arm title
    Standard of care
    Arm description
    Standard of care
    Arm type
    Standard of care

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 1
    Evicel Non randomized Evicel Randomized Standard of care
    Started
    41
    84
    89
    Completed
    40
    80
    86
    Not completed
    1
    4
    3
         Adverse event, serious fatal
    -
    1
    -
         Consent withdrawn by subject
    -
    -
    2
         Lost to follow-up
    -
    1
    -
         Patient did not complete follow-up
    -
    2
    -
         Pt did not complete 90-day visit
    1
    -
    -
         Pt overseas and unable to be contacted
    -
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Evicel Non randomized
    Reporting group description
    Evicel Non randomized

    Reporting group title
    Evicel Randomized
    Reporting group description
    Evicel Randomized

    Reporting group title
    Standard of care
    Reporting group description
    Standard of care

    Reporting group values
    Evicel Non randomized Evicel Randomized Standard of care Total
    Number of subjects
    41 84 89 214
    Age categorical
    Units: Subjects
        Adults (18-<50 years)
    6 14 10 30
        Adults (50-<65 years)
    18 37 39 94
        Adults (65-<75 years)
    11 23 28 62
        Adults (>=75 years)
    6 10 12 28
    Gender categorical
    Units: Subjects
        Female
    21 41 33 95
        Male
    20 43 56 119

    End points

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    End points reporting groups
    Reporting group title
    Evicel Non randomized
    Reporting group description
    Evicel Non randomized

    Reporting group title
    Evicel Randomized
    Reporting group description
    Evicel Randomized

    Reporting group title
    Standard of care
    Reporting group description
    Standard of care

    Subject analysis set title
    Intent to Treat (ITT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    The ITT set was defined as all randomized subjects (with treatment defined by planned/randomized treatment).

    Subject analysis set title
    Per Protocol (PP)
    Subject analysis set type
    Per protocol
    Subject analysis set description
    The PP set was defined as all subjects in the ITT set who had no major protocol deviations.

    Subject analysis set title
    Safety
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The safety set is defined as all subjects who received treatment.

    Primary: Absence of clinical anastomotic leak within 40 days post operatively

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    End point title
    Absence of clinical anastomotic leak within 40 days post operatively [1]
    End point description
    Absence of clinical anastomotic leak within 40 days post operatively
    End point type
    Primary
    End point timeframe
    Within 40 days post-operatively
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistical data was provided for all the arms. The endpoint efficacy analysis was conducted using the intent-to-treat (ITT) set according to the protocol. The ITT included only all randomized subjects. Safety analysis set included all patients in the trial, which included non-randomized run-in patients.
    End point values
    Evicel Randomized Standard of care
    Number of subjects analysed
    84
    89
    Units: Absence of Leaks
        Absence of clinical anastomotic leak within 40 day
    72
    81
    Statistical analysis title
    Primary analysis
    Statistical analysis description
    The primary efficacy endpoint was the absence of clinical anastomotic leak (success) within 40 days post operatively.
    Comparison groups
    Evicel Randomized v Standard of care
    Number of subjects included in analysis
    173
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.276
    Method
    Test of natural logarithm of odds ratio
    Confidence interval

    Secondary: Incidence of clinical anastomotic leak up to post operative day 90

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    End point title
    Incidence of clinical anastomotic leak up to post operative day 90 [2]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 90 days
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistical data was provided for all the arms. The endpoint efficacy analysis was conducted using the intent-to-treat (ITT) set according to the protocol. The ITT included only all randomized subjects. Safety analysis set included all patients in the trial, which included non-randomized run-in patients.
    End point values
    Evicel Randomized Standard of care
    Number of subjects analysed
    84
    89
    Units: Leaks
    9
    6
    No statistical analyses for this end point

    Secondary: Incidence of stricture up to post operative day 90

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    End point title
    Incidence of stricture up to post operative day 90 [3]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 90 days
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistical data was provided for all the arms. The endpoint efficacy analysis was conducted using the intent-to-treat (ITT) set according to the protocol. The ITT included only all randomized subjects. Safety analysis set included all patients in the trial, which included non-randomized run-in patients.
    End point values
    Evicel Randomized Standard of care
    Number of subjects analysed
    84
    89
    Units: Number of strictures
    2
    3
    No statistical analyses for this end point

    Secondary: Incidence of post operative intervention related to clinical anastomotic leak or stricture up to post operative day 90

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    End point title
    Incidence of post operative intervention related to clinical anastomotic leak or stricture up to post operative day 90 [4]
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 90 days
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Statistical data was provided for all the arms. The endpoint efficacy analysis was conducted using the intent-to-treat (ITT) set according to the protocol. The ITT included only all randomized subjects. Safety analysis set included all patients in the trial, which included non-randomized run-in patients.
    End point values
    Evicel Randomized Standard of care
    Number of subjects analysed
    84
    89
    Units: No. of subjects requiring intervention
    9
    6
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs were collected from the start of randomisation during the procedure, throughout the hospital admission, and until completion of the 90 day follow up visit (with the exception of incidence of stricture which was assessed up to Day 360)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    15.0
    Reporting groups
    Reporting group title
    EVICEL Fibrin Sealant :Randomized
    Reporting group description
    -

    Reporting group title
    Standard of Care
    Reporting group description
    -

    Reporting group title
    EVICEL Fibrin Sealant Non Randomized
    Reporting group description
    -

    Serious adverse events
    EVICEL Fibrin Sealant :Randomized Standard of Care EVICEL Fibrin Sealant Non Randomized
    Total subjects affected by serious adverse events
         subjects affected / exposed
    25 / 84 (29.76%)
    22 / 89 (24.72%)
    10 / 41 (24.39%)
         number of deaths (all causes)
    1
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Breast cancer
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral cancer
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    Abscess drainage
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    2 / 84 (2.38%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Benign prostatic hyperplasia
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pelvic haematoma
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchial secretion retention
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hiccups
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory arrest
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 84 (1.19%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Blood magnesium decreased
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Anastomotic haemorrhage
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anastomotic leak
         subjects affected / exposed
    9 / 84 (10.71%)
    6 / 89 (6.74%)
    3 / 41 (7.32%)
         occurrences causally related to treatment / all
    9 / 9
    0 / 6
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anastomotic stenosis
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal anastomosis complication
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Postoperative ileus
         subjects affected / exposed
    0 / 84 (0.00%)
    3 / 89 (3.37%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound complication
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound dehiscence
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound evisceration
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block complete
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Nervous system disorders
    Critical illness polyneuropathy
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Enterocutaneous fistula
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    3 / 84 (3.57%)
    2 / 89 (2.25%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ileus paralytic
         subjects affected / exposed
    1 / 84 (1.19%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intestinal perforation
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    0 / 84 (0.00%)
    2 / 89 (2.25%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal perforation
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Portal vein thrombosis
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    renal failure acute
         subjects affected / exposed
    1 / 84 (1.19%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ureteric stenosis
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral stenosis
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal infection
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal sepsis
         subjects affected / exposed
    2 / 84 (2.38%)
    2 / 89 (2.25%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abscess
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematoma infection
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    infectious peritonitis
         subjects affected / exposed
    2 / 84 (2.38%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Liver abscess
         subjects affected / exposed
    1 / 84 (1.19%)
    0 / 89 (0.00%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Necrotising fasciitis
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic abscess
         subjects affected / exposed
    2 / 84 (2.38%)
    2 / 89 (2.25%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    2 / 84 (2.38%)
    3 / 89 (3.37%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    0 / 84 (0.00%)
    0 / 89 (0.00%)
    1 / 41 (2.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 84 (0.00%)
    3 / 89 (3.37%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 84 (0.00%)
    1 / 89 (1.12%)
    0 / 41 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    EVICEL Fibrin Sealant :Randomized Standard of Care EVICEL Fibrin Sealant Non Randomized
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    81 / 84 (96.43%)
    83 / 89 (93.26%)
    41 / 41 (100.00%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    4 / 84 (4.76%)
    9 / 89 (10.11%)
    3 / 41 (7.32%)
         occurrences all number
    4
    11
    3
    Hypotension
         subjects affected / exposed
    13 / 84 (15.48%)
    16 / 89 (17.98%)
    5 / 41 (12.20%)
         occurrences all number
    16
    21
    5
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    7 / 84 (8.33%)
    3 / 89 (3.37%)
    4 / 41 (9.76%)
         occurrences all number
    7
    4
    7
    Pain
         subjects affected / exposed
    5 / 84 (5.95%)
    10 / 89 (11.24%)
    5 / 41 (12.20%)
         occurrences all number
    7
    10
    6
    Pyrexia
         subjects affected / exposed
    15 / 84 (17.86%)
    17 / 89 (19.10%)
    9 / 41 (21.95%)
         occurrences all number
    18
    23
    12
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    5 / 84 (5.95%)
    3 / 89 (3.37%)
    1 / 41 (2.44%)
         occurrences all number
    5
    3
    1
    Pleural effusion
         subjects affected / exposed
    1 / 84 (1.19%)
    5 / 89 (5.62%)
    2 / 41 (4.88%)
         occurrences all number
    1
    5
    2
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    5 / 84 (5.95%)
    3 / 89 (3.37%)
    2 / 41 (4.88%)
         occurrences all number
    5
    3
    2
    Insomnia
         subjects affected / exposed
    7 / 84 (8.33%)
    7 / 89 (7.87%)
    6 / 41 (14.63%)
         occurrences all number
    7
    8
    8
    Investigations
    C-reactive protein increased
         subjects affected / exposed
    4 / 84 (4.76%)
    6 / 89 (6.74%)
    0 / 41 (0.00%)
         occurrences all number
    4
    6
    0
    Oxygen saturation decreased
         subjects affected / exposed
    6 / 84 (7.14%)
    1 / 89 (1.12%)
    1 / 41 (2.44%)
         occurrences all number
    6
    1
    2
    Urine output decreased
         subjects affected / exposed
    7 / 84 (8.33%)
    10 / 89 (11.24%)
    2 / 41 (4.88%)
         occurrences all number
    9
    11
    2
    White blood cell count increased
         subjects affected / exposed
    5 / 84 (5.95%)
    2 / 89 (2.25%)
    1 / 41 (2.44%)
         occurrences all number
    6
    3
    1
    Injury, poisoning and procedural complications
    Anastomotic leak
         subjects affected / exposed
    9 / 84 (10.71%)
    6 / 89 (6.74%)
    3 / 41 (7.32%)
         occurrences all number
    9
    6
    3
    Incision site pain
         subjects affected / exposed
    3 / 84 (3.57%)
    3 / 89 (3.37%)
    6 / 41 (14.63%)
         occurrences all number
    4
    3
    7
    Procedural pain
         subjects affected / exposed
    19 / 84 (22.62%)
    17 / 89 (19.10%)
    6 / 41 (14.63%)
         occurrences all number
    20
    19
    6
    Wound complication
         subjects affected / exposed
    5 / 84 (5.95%)
    2 / 89 (2.25%)
    0 / 41 (0.00%)
         occurrences all number
    5
    2
    0
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    6 / 84 (7.14%)
    12 / 89 (13.48%)
    4 / 41 (9.76%)
         occurrences all number
    7
    14
    6
    Ileus
         subjects affected / exposed
    6 / 84 (7.14%)
    5 / 89 (5.62%)
    1 / 41 (2.44%)
         occurrences all number
    6
    5
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    5 / 84 (5.95%)
    9 / 89 (10.11%)
    4 / 41 (9.76%)
         occurrences all number
    5
    12
    5
    Peripheral sensory neuropathy
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    2 / 41 (4.88%)
         occurrences all number
    3
    6
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    4 / 41 (9.76%)
         occurrences all number
    4
    5
    4
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    12 / 84 (14.29%)
    17 / 89 (19.10%)
    5 / 41 (12.20%)
         occurrences all number
    14
    19
    6
    Abdominal pain
         subjects affected / exposed
    17 / 84 (20.24%)
    17 / 89 (19.10%)
    8 / 41 (19.51%)
         occurrences all number
    20
    23
    8
    Constipation
         subjects affected / exposed
    14 / 84 (16.67%)
    17 / 89 (19.10%)
    11 / 41 (26.83%)
         occurrences all number
    15
    19
    12
    Diarrhoea
         subjects affected / exposed
    11 / 84 (13.10%)
    15 / 89 (16.85%)
    8 / 41 (19.51%)
         occurrences all number
    11
    18
    12
    Nausea
         subjects affected / exposed
    42 / 84 (50.00%)
    47 / 89 (52.81%)
    22 / 41 (53.66%)
         occurrences all number
    63
    65
    43
    Proctalgia
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    1 / 41 (2.44%)
         occurrences all number
    5
    5
    1
    Rectal haemorrhage
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    4 / 41 (9.76%)
         occurrences all number
    3
    6
    4
    Vomiting
         subjects affected / exposed
    20 / 84 (23.81%)
    22 / 89 (24.72%)
    11 / 41 (26.83%)
         occurrences all number
    29
    26
    14
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    9 / 84 (10.71%)
    8 / 89 (8.99%)
    6 / 41 (14.63%)
         occurrences all number
    10
    8
    7
    Renal and urinary disorders
    Dysuria
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    2 / 41 (4.88%)
         occurrences all number
    3
    5
    2
    Urinary retention
         subjects affected / exposed
    3 / 84 (3.57%)
    5 / 89 (5.62%)
    0 / 41 (0.00%)
         occurrences all number
    3
    5
    0
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    5 / 84 (5.95%)
    11 / 89 (12.36%)
    1 / 41 (2.44%)
         occurrences all number
    5
    15
    1
    Wound infection
         subjects affected / exposed
    2 / 84 (2.38%)
    5 / 89 (5.62%)
    4 / 41 (9.76%)
         occurrences all number
    3
    5
    4
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    8 / 84 (9.52%)
    6 / 89 (6.74%)
    2 / 41 (4.88%)
         occurrences all number
    10
    6
    2
    Hypokalaemia
         subjects affected / exposed
    5 / 84 (5.95%)
    9 / 89 (10.11%)
    5 / 41 (12.20%)
         occurrences all number
    5
    11
    5

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Mar 2012
    1) Clarity on measurement of level of anastomosis 2) Exclusion criteria updated 3) Stopping rules included
    09 May 2013
    Several protocol clarifications and expansion of visit windows to allow for standard follow up visits to align with study visits.

    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
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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