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    Clinical Trial Results:
    A COMPARATIVE, RANDOMIZED, PARALLEL-GROUP, MULTI-CENTER, PHASE IIIB STUDY TO INVESTIGATE THE EFFICACY OF SUBCUTANEOUS (SC) RITUXIMAB VERSUS INTRAVENOUS (IV) RITUXIMAB BOTH IN COMBINATION WITH CHOP (R-CHOP) IN PREVIOUSLY UNTREATED PATIENTS WITH CD20-POSITIVE DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL)

    Summary
    EudraCT number
    2012-000669-19
    Trial protocol
    ES   FI   NL   GR   GB   IT   IE   FR   BE   BG   PT  
    Global end of trial date
    16 Sep 2016

    Results information
    Results version number
    v2(current)
    This version publication date
    27 Sep 2017
    First version publication date
    09 Apr 2016
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    MO28107
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01649856
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    F. Hoffmann-La Roche AG
    Sponsor organisation address
    Grenzacherstrasse 124, Basel, Switzerland, CH-4070
    Public contact
    Roche Trial Information Hotline, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.com
    Scientific contact
    Roche Trial Information Hotline, F. Hoffmann-La Roche AG, +41 616878333, global.trial_information@roche.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
    28 Apr 2017
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    21 Oct 2014
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Sep 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    This multicenter, randomized, open-label parallel-group study evaluated the efficacy and safety of subcutaneous (SC) versus intravenous (IV) rituximab, both in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), in participants with previously untreated cluster of differentiation (CD) 20-positive diffuse large B-cell lymphoma (DLBCL). Participants were randomized 2:1 to receive either SC or IV rituximab on Day 1 of each cycle for 8 cycles, in combination with 6 to 8 cycles of CHOP chemotherapy. Cycle length (14 or 21 days) was decided by the individual study center.
    Protection of trial subjects
    The study was conducted in full conformance with the International Conference on Harmonisation (ICH)-E6 Guideline for Good Clinical Practice (GCP) and the principles of the Declaration of Helsinki, or the laws and regulations of the country in which the research was conducted, whichever afforded greater protection to the participant. The study has complied with requirements of the ICH-E2A Guideline for Clinical Safety Data Management, and for study sites in the European Union (EU)/European Economic Area (EEA), the study has also complied with the EU Clinical Trial Directive (2001/20/EC).
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    22 Aug 2012
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    2 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Argentina: 3
    Country: Number of subjects enrolled
    Belgium: 17
    Country: Number of subjects enrolled
    Brazil: 7
    Country: Number of subjects enrolled
    Bulgaria: 10
    Country: Number of subjects enrolled
    Canada: 30
    Country: Number of subjects enrolled
    Colombia: 13
    Country: Number of subjects enrolled
    Finland: 21
    Country: Number of subjects enrolled
    France: 30
    Country: Number of subjects enrolled
    Greece: 30
    Country: Number of subjects enrolled
    Ireland: 11
    Country: Number of subjects enrolled
    Israel: 30
    Country: Number of subjects enrolled
    Italy: 74
    Country: Number of subjects enrolled
    Netherlands: 43
    Country: Number of subjects enrolled
    Peru: 6
    Country: Number of subjects enrolled
    Poland: 13
    Country: Number of subjects enrolled
    Portugal: 12
    Country: Number of subjects enrolled
    Russian Federation: 37
    Country: Number of subjects enrolled
    Serbia: 7
    Country: Number of subjects enrolled
    South Africa: 3
    Country: Number of subjects enrolled
    Spain: 40
    Country: Number of subjects enrolled
    Thailand: 21
    Country: Number of subjects enrolled
    Turkey: 74
    Country: Number of subjects enrolled
    Ukraine: 20
    Country: Number of subjects enrolled
    United Kingdom: 18
    Country: Number of subjects enrolled
    Venezuela, Bolivarian Republic of: 2
    Worldwide total number of subjects
    572
    EEA total number of subjects
    319
    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)
    306
    From 65 to 84 years
    266
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 662 individuals were screened for entry into the study, and 86 failed the screening procedure. Overall, 576 participants were randomized; 572 received treatment and were included in the analyses.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Rituximab SC
    Arm description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For Cycle 1, rituximab was administered at a dose of 375 milligrams per meter-squared (mg/m^2) via IV infusion; subsequent doses were given as 1400 milligrams (mg) via SC injection. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved complete response (CR) or complete response unconfirmed (CRu) after 4 cycles, but all participants received a full 8 cycles of rituximab.
    Arm type
    Experimental

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection, Concentrate and solvent for solution for infusion
    Routes of administration
    Subcutaneous use, Intravenous use
    Dosage and administration details
    Rituximab was administered as 1400 mg via SC injection or as 375 mg/m^2 via IV infusion, depending upon treatment assignment, on Day 1 of each cycle. During the first cycle, all participants received the IV formulation regardless of treatment assignment.

    Arm title
    Rituximab IV
    Arm description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For all cycles, rituximab was administered at a dose of 375 mg/m^2 via IV infusion. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved CR or CRu after 4 cycles, but all participants received a full 8 cycles of rituximab.
    Arm type
    Active comparator

    Investigational medicinal product name
    Rituximab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate and solvent for solution for infusion, Solution for injection
    Routes of administration
    Intravenous use, Subcutaneous use
    Dosage and administration details
    Rituximab was administered as 1400 mg via SC injection or as 375 mg/m^2 via IV infusion, depending upon treatment assignment, on Day 1 of each cycle. During the first cycle, all participants received the IV formulation regardless of treatment assignment.

    Number of subjects in period 1
    Rituximab SC Rituximab IV
    Started
    369
    203
    Completed
    230
    125
    Not completed
    139
    78
         Consent withdrawn by subject
    14
    14
         Treatment failure
    1
    1
         Death
    69
    34
         Lack of compliance
    6
    1
         Reason not specified
    20
    5
         Stable or progressed disease
    5
    3
         Lost to follow-up
    20
    16
         Protocol deviation
    4
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Rituximab SC
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For Cycle 1, rituximab was administered at a dose of 375 milligrams per meter-squared (mg/m^2) via IV infusion; subsequent doses were given as 1400 milligrams (mg) via SC injection. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved complete response (CR) or complete response unconfirmed (CRu) after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Reporting group title
    Rituximab IV
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For all cycles, rituximab was administered at a dose of 375 mg/m^2 via IV infusion. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved CR or CRu after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Reporting group values
    Rituximab SC Rituximab IV Total
    Number of subjects
    369 203 572
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    60.4 ( 13.78 ) 61 ( 12.63 ) -
    Gender categorical
    Units: Subjects
        Female
    165 100 265
        Male
    204 103 307

    End points

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    End points reporting groups
    Reporting group title
    Rituximab SC
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For Cycle 1, rituximab was administered at a dose of 375 milligrams per meter-squared (mg/m^2) via IV infusion; subsequent doses were given as 1400 milligrams (mg) via SC injection. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved complete response (CR) or complete response unconfirmed (CRu) after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Reporting group title
    Rituximab IV
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For all cycles, rituximab was administered at a dose of 375 mg/m^2 via IV infusion. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved CR or CRu after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Primary: Percentage of Participants with Complete Response (CR) or Complete Response Unconfirmed (CRu)

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    End point title
    Percentage of Participants with Complete Response (CR) or Complete Response Unconfirmed (CRu)
    End point description
    Tumor response was assessed per criteria published by Cheson et al (1999). According to consensus recommendations, CR was defined as complete disappearance of all clinical and radiographic evidence of disease and disease-related symptoms, regression of lymph nodes to normal size, absence of splenomegaly, and absence of bone marrow involvement. CRu was defined as disappearance of clinical and radiographic evidence of disease and absence of splenomegaly, with regression of lymph nodes by greater than (>) 75 percent (%) but still >1.5 centimeters (cm) in size, and indeterminate bone marrow assessment. The percentage of participants with either response at the end of induction (EOI) was determined with corresponding 95% Pearson-Clopper confidence interval (CI). Intent-to-Treat (ITT) Population: All participants who completed Baseline and at least one on-treatment efficacy assessment.
    End point type
    Primary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: percentage of participants
        number (confidence interval 95%)
    50.6 (45.2 to 56)
    42.4 (35 to 50)
    Statistical analysis title
    Difference in response rates
    Comparison groups
    Rituximab SC v Rituximab IV
    Number of subjects included in analysis
    519
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.076
    Method
    Chi-squared
    Parameter type
    Difference in response rates
    Point estimate
    8.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.1
         upper limit
    17.5

    Secondary: Cancer Treatment Satisfaction Questionnaire (CTSQ) Domain Scores

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    End point title
    Cancer Treatment Satisfaction Questionnaire (CTSQ) Domain Scores
    End point description
    The CTSQ is a validated 16-item questionnaire that measures three domains related to satisfaction with cancer therapy. These include expectations of therapy, feelings about side effects, and satisfaction with therapy. Each domain is scored on a scale of 0 to 100, with higher scores indicative of more positive feelings toward therapy. The score for each domain was averaged among all participants. ITT Population (CTSQ Subpopulation): All participants who completed the CTSQ at Cycles 3 and 7.
    End point type
    Secondary
    End point timeframe
    At Cycle 7 (each cycle was 14 or 21 days)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    280 [1]
    141 [2]
    Units: units on a scale
    arithmetic mean (standard deviation)
        Expectations of Therapy (n=280,141)
    79.35 ( 17.422 )
    82.94 ( 16.536 )
        Feelings about Side Effects (n=276,141)
    60.69 ( 21.594 )
    57.62 ( 23.339 )
        Satisfaction with Therapy (n=278,141)
    85.92 ( 11.428 )
    83.6 ( 13.451 )
    Notes
    [1] - number (n) = number of participants in the analysis for the specified domain.
    [2] - n = number of participants in the analysis for the specified domain.
    No statistical analyses for this end point

    Secondary: Rituximab Administration Satisfaction Questionnaire (RASQ) Domain Scores

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    End point title
    Rituximab Administration Satisfaction Questionnaire (RASQ) Domain Scores
    End point description
    The RASQ is a 20-item questionnaire that measures five domains related to the impact of treatment administration. These include physical impact, psychological impact, impact on activities of daily living (ADLs), convenience, and satisfaction. Each domain is scored on a scale of 0 to 100, with higher scores indicative of more positive feelings toward therapy. The score for each domain was averaged among all participants. ITT Population (RASQ Subpopulation): All participants who completed the RASQ at Cycles 3 and 7.
    End point type
    Secondary
    End point timeframe
    At Cycle 7 (each cycle was 14 or 21 days)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    284 [3]
    144 [4]
    Units: units on a scale
    arithmetic mean (standard deviation)
        Physical Impact (n=278,140)
    86.24 ( 14.012 )
    81.49 ( 16.848 )
        Psychological Impact (n=277,141)
    85.65 ( 13.92 )
    78.65 ( 18.233 )
        Impact on ADLs (n=266,140)
    83.77 ( 16.117 )
    57.38 ( 19.23 )
        Convenience (n=279,143)
    82.32 ( 13.428 )
    60.14 ( 17.473 )
        Satisfaction (n=282,141)
    89.58 ( 12.051 )
    77.39 ( 18.232 )
    Notes
    [3] - n = number of participants in the analysis for the specified domain.
    [4] - n = number of participants in the analysis for the specified domain.
    No statistical analyses for this end point

    Secondary: Median Duration of Rituximab Administration for Each Treatment Cycle

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    End point title
    Median Duration of Rituximab Administration for Each Treatment Cycle
    End point description
    Duration of rituximab administration was defined as the time from start to end of the SC injection or IV infusion. The median duration was reported. Safety Population: All participants who received at least one dose of study drug according to treatment received.
    End point type
    Secondary
    End point timeframe
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    369 [5]
    203 [6]
    Units: hours
    median (full range (min-max))
        Cycle 1 (n=346,190)
    4 (0.1 to 11)
    4 (1.2 to 10)
        Cycle 2 (n=361,178)
    0.1 (0.1 to 23.1)
    3 (0.5 to 10)
        Cycle 3 (n=349,177)
    0.1 (0.1 to 5.5)
    2.8 (1 to 21.4)
        Cycle 4 (n=346,173)
    0.1 (0 to 2.5)
    2.7 (0.5 to 8)
        Cycle 5 (n=332,165)
    0.1 (0 to 2.5)
    2.6 (0.1 to 8.1)
        Cycle 6 (n=319,162)
    0.1 (0 to 2.5)
    2.7 (0.1 to 20)
        Cycle 7 (n=304,156)
    0.1 (0 to 23.6)
    2.7 (0.5 to 6.7)
        Cycle 8 (n=305,152)
    0.1 (0 to 2.5)
    2.55 (0.1 to 17.9)
        Overall (n=368,201)
    4.7 (0.1 to 28.7)
    19 (1.2 to 57.4)
    Notes
    [5] - n = number of participants in the analysis for the specified timepoint.
    [6] - n = number of participants in the analysis for the specified timepoint.
    No statistical analyses for this end point

    Secondary: Percentage of Participants by Time Spent in the Infusion Chair/Bed for Each Treatment Cycle

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    End point title
    Percentage of Participants by Time Spent in the Infusion Chair/Bed for Each Treatment Cycle
    End point description
    Chair time was defined as the amount of time the participant occupied an infusion chair/bed for a single treatment cycle of rituximab + CHOP chemotherapy. Where the chair time was not documented for a given cycle, it was reported as "Missing". Safety Population.
    End point type
    Secondary
    End point timeframe
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    369
    203
    Units: percentage of participants
    number (not applicable)
        Less than 30 minutes (Cycle 1)
    0
    0
        30 minutes to 1 hour (Cycle 1)
    0
    0.5
        1 to 2 hours (Cycle 1)
    1.4
    0
        2 to 4 hours (Cycle 1)
    20.6
    17.2
        4 to 12 hours (Cycle 1)
    69.4
    72.4
        More than 12 hours (Cycle 1)
    7.3
    7.9
        Missing (Cycle 1)
    1.4
    2
        Less than 30 minutes (Cycle 2)
    7.3
    0
        30 minutes to 1 hour (Cycle 2)
    2.4
    0
        1 to 2 hours (Cycle 2)
    17.1
    1.1
        2 to 4 hours (Cycle 2)
    56.1
    36.2
        4 to 12 hours (Cycle 2)
    12.2
    60.1
        More than 12 hours (Cycle 2)
    0.3
    1.1
        Missing (Cycle 2)
    4.6
    1.6
        Less than 30 minutes (Cycle 3)
    5.6
    0
        30 minutes to 1 hour (Cycle 3)
    2
    0
        1 to 2 hours (Cycle 3)
    22.1
    0.5
        2 to 4 hours (Cycle 3)
    55.9
    38.9
        4 to 12 hours (Cycle 3)
    12.6
    58.4
        More than 12 hours (Cycle 3)
    0.3
    0.5
        Missing (Cycle 3)
    1.7
    1.6
        Less than 30 minutes (Cycle 4)
    5.1
    0
        30 minutes to 1 hour (Cycle 4)
    2.8
    0
        1 to 2 hours (Cycle 4)
    21.8
    1.1
        2 to 4 hours (Cycle 4)
    55
    36.7
        4 to 12 hours (Cycle 4)
    13.9
    60.6
        More than 12 hours (Cycle 4)
    0.3
    0.6
        Missing (Cycle 4)
    1.1
    1.1
        Less than 30 minutes (Cycle 5)
    5
    0.6
        30 minutes to 1 hour (Cycle 5)
    2.4
    0
        1 to 2 hours (Cycle 5)
    25.2
    1.1
        2 to 4 hours (Cycle 5)
    53.4
    40.2
        4 to 12 hours (Cycle 5)
    12.8
    56.3
        More than 12 hours (Cycle 5)
    0
    0.6
        Missing (Cycle 5)
    1.2
    1.1
        Less than 30 minutes (Cycle 6)
    3.4
    0.6
        30 minutes to 1 hour (Cycle 6)
    3.1
    0
        1 to 2 hours (Cycle 6)
    23
    1.8
        2 to 4 hours (Cycle 6)
    56.7
    42.5
        4 to 12 hours (Cycle 6)
    12.3
    53.3
        More than 12 hours (Cycle 6)
    0
    0
        Missing (Cycle 6)
    1.5
    1.8
        Less than 30 minutes (Cycle 7)
    18.7
    0
        30 minutes to 1 hour (Cycle 7)
    7
    0
        1 to 2 hours (Cycle 7)
    26.9
    4.9
        2 to 4 hours (Cycle 7)
    40.2
    48.8
        4 to 12 hours (Cycle 7)
    6
    44.4
        More than 12 hours (Cycle 7)
    0
    0
        Missing (Cycle 7)
    1.3
    1.9
        Less than 30 minutes (Cycle 8)
    20.3
    0.6
        30 minutes to 1 hour (Cycle 8)
    6.4
    0
        1 to 2 hours (Cycle 8)
    29.3
    4.4
        2 to 4 hours (Cycle 8)
    36.7
    50.9
        4 to 12 hours (Cycle 8)
    5.8
    43.4
        More than 12 hours (Cycle 8)
    0
    0
        Missing (Cycle 8)
    1.6
    0.6
    No statistical analyses for this end point

    Secondary: Percentage of Participants by Time Spent in the Hospital for Each Treatment Cycle

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    End point title
    Percentage of Participants by Time Spent in the Hospital for Each Treatment Cycle
    End point description
    Hospital time was defined as the amount of time the participant was in the hospital for the course of one cycle of rituximab + CHOP chemotherapy. Where the hospital time was not documented for a given cycle, it was reported as "Missing". Safety Population.
    End point type
    Secondary
    End point timeframe
    Cycles 1, 2, 3, 4, 5, 6, 7, and 8 (each cycle was 14 or 21 days)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    369
    203
    Units: percentage of participants
    number (not applicable)
        Less than 2 hours (Cycle 1)
    0.3
    0
        2 to 4 hours (Cycle 1)
    3
    1.5
        4 to 6 hours (Cycle 1)
    19.8
    20.7
        6 to 12 hours (Cycle 1)
    39
    43.8
        12 to 24 hours (Cycle 1)
    8.9
    6.9
        More than 24 hours (Cycle 1)
    26.8
    24.1
        Missing (Cycle 1)
    2.2
    3
        Less than 2 hours (Cycle 2)
    3.8
    0
        2 to 4 hours (Cycle 2)
    33.1
    10.1
        4 to 6 Hours (Cycle 2)
    27.9
    33.5
        6 to 12 Hours (Cycle 2)
    16.3
    38.8
        12 to 24 Hours (Cycle 2)
    3.8
    1.1
        More than 24 Hours (Cycle 2)
    10.3
    11.7
        Missing (Cycle 2)
    4.9
    4.8
        Less Than 2 Hours (Cycle 3)
    3.6
    0.5
        2 to 4 Hours (Cycle 3)
    37.2
    11.9
        4 to 6 Hours (Cycle 3)
    30.2
    30.8
        6 to 12 Hours (Cycle 3)
    14.5
    41.6
        12 to 24 Hours (Cycle 3)
    2.8
    2.2
        More than 24 Hours (Cycle 3)
    9.8
    10.3
        Missing (Cycle 3)
    2
    2.7
        Less Than 2 Hours (Cycle 4)
    4.5
    0
        2 to 4 Hours (Cycle 4)
    36.3
    10
        4 to 6 Hours (Cycle 4)
    27.5
    31.1
        6 to 12 Hours (Cycle 4)
    17.6
    42.2
        12 to 24 Hours (Cycle 4)
    2
    2.8
        More than 24 Hours (Cycle 4)
    10.2
    10.6
        Missing (Cycle 4)
    2
    3.3
        Less Than 2 Hours (Cycle 5)
    5
    0.6
        2 to 4 Hours (Cycle 5)
    39.5
    11.5
        4 to 6 Hours (Cycle 5)
    26.4
    34.5
        6 to 12 Hours (Cycle 5)
    16
    37.4
        12 to 24 Hours (Cycle 5)
    2.1
    1.7
        More than 24 Hours (Cycle 5)
    8.9
    10.9
        Missing (Cycle 5)
    2.1
    3.4
        Less Than 2 Hours (Cycle 6)
    4.3
    0.6
        2 to 4 Hours (Cycle 6)
    39.6
    12.6
        4 to 6 Hours (Cycle 6)
    26.4
    34.1
        6 to 12 Hours (Cycle 6)
    16.3
    38.3
        12 to 24 Hours (Cycle 6)
    2.5
    2.4
        More than 24 Hours (Cycle 6)
    8.6
    9
        Missing (Cycle 6)
    2.5
    3
        Less Than 2 Hours (Cycle 7)
    17.7
    0
        2 to 4 Hours (Cycle 7)
    40.8
    23.5
        4 to 6 Hours (Cycle 7)
    19.9
    36.4
        6 to 12 Hours (Cycle 7)
    10.4
    30.9
        12 to 24 Hours (Cycle 7)
    2.8
    2.5
        More than 24 Hours (Cycle 7)
    5.7
    3.7
        Missing (Cycle 7)
    2.5
    3.1
        Less Than 2 Hours (Cycle 8)
    18
    0
        2 to 4 Hours (Cycle 8)
    40.5
    25.8
        4 to 6 Hours (Cycle 8)
    21.9
    34
        6 to 12 Hours (Cycle 8)
    8.7
    30.8
        12 to 24 Hours (Cycle 8)
    2.6
    1.3
        More than 24 Hours (Cycle 8)
    5.8
    5
        Missing (Cycle 8)
    2.6
    3.1
    No statistical analyses for this end point

    Secondary: Number of Participants with an Event-Free Survival (EFS) Event

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    End point title
    Number of Participants with an Event-Free Survival (EFS) Event
    End point description
    EFS events included disease progression, relapse, initiation of other anti-lymphoma therapy, or death. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as greater than or equal to (≥) 50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. ITT Population.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: participants
    116
    53
    No statistical analyses for this end point

    Secondary: Duration of EFS

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    End point title
    Duration of EFS
    End point description
    EFS was defined as the time from randomization to first occurrence of disease progression, relapse, initiation of other anti-lymphoma therapy, or death, whichever occurred first. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as a ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. ITT Population. 99999 = Median EFS was not reached.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: months
        median (full range (min-max))
    99999 (-99999 to 99999)
    99999 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: Number of Participants with Relapse or Death at the Time of Primary Analysis

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    End point title
    Number of Participants with Relapse or Death at the Time of Primary Analysis
    End point description
    Tumor response was assessed according to criteria published by Cheson et al (1999). Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. The number of participants who had experienced relapse or death prior to the clinical cut-off date (October 2014) was determined. ITT Population (Responder Subpopulation): All participants who achieved CR or CRu after 4 cycles.
    End point type
    Secondary
    End point timeframe
    Up to approximately 2 years (assessed at Baseline, Day 1 of each cycle [maximum 8 cycles; each cycle was 14 to 21 days], every 3 months thereafter, and/or 4 weeks after early termination)
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    178
    90
    Units: participants
    12
    5
    No statistical analyses for this end point

    Secondary: Duration of Disease-Free Survival (DFS)

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    End point title
    Duration of Disease-Free Survival (DFS)
    End point description
    DFS was defined as the time from date of initial CR/CRu to the date of relapse or death from any cause. Tumor response was assessed according to criteria published by Cheson et al (1999). Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. ITT Population (Responder Subpopulation). 99999 = Median DFS was not reached.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    240
    118
    Units: months
        median (full range (min-max))
    99999 (-99999 to 99999)
    99999 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: Number of Participants with Progression, Relapse, or Death

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    End point title
    Number of Participants with Progression, Relapse, or Death
    End point description
    Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. ITT Population.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: participants
    95
    38
    No statistical analyses for this end point

    Secondary: Duration of Progression-Free Survival (PFS)

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    End point title
    Duration of Progression-Free Survival (PFS)
    End point description
    PFS was defined as the time from randomization to first occurrence of disease progression, relapse, or death from any cause. Tumor response was assessed according to criteria published by Cheson et al (1999). Progression was defined as ≥50% increase in the sum of products of greatest diameters of any previously identified abnormal lymph node or the appearance of any new lesion. Relapse was defined as a new lesion or increase by ≥50% in size of previously involved sites, or ≥50% increase in greatest diameter of any previously identified node >1 cm, following an earlier assessment of CR or CRu. ITT Population. 99999 = Median PFS was not reached.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: months
        median (full range (min-max))
    99999 (-99999 to 99999)
    99999 (-99999 to 99999)
    No statistical analyses for this end point

    Secondary: Number of Deaths

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    End point title
    Number of Deaths
    End point description
    ITT Population.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: participants
    56
    22
    No statistical analyses for this end point

    Secondary: Duration of Overall Survival (OS)

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    End point title
    Duration of Overall Survival (OS)
    End point description
    OS was defined as the time from randomization to death from any cause. ITT Population. 99999 = Median OS was not reached.
    End point type
    Secondary
    End point timeframe
    Up to approximately 4.25 years
    End point values
    Rituximab SC Rituximab IV
    Number of subjects analysed
    342
    177
    Units: months
        median (full range (min-max))
    99999 (-99999 to 99999)
    99999 (-99999 to 99999)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to approximately 4.25 years
    Adverse event reporting additional description
    Safety Population.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.1
    Reporting groups
    Reporting group title
    Rituximab SC
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For Cycle 1, rituximab was administered at a dose of 375 mg/m^2 via IV infusion; subsequent doses were given as 1400 mg via SC injection. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved CR or CRu after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Reporting group title
    Rituximab IV
    Reporting group description
    Participants with previously untreated, CD20-positive DLBCL received up to 8 cycles of rituximab in combination with CHOP. Treatment was given on Day 1 of each cycle, and the cycle length (14 or 21 days) was decided by the study center. For all cycles, rituximab was administered at a dose of 375 mg/m^2 via IV infusion. Tumor response was assessed after 4 cycles according to criteria published by Cheson et al (1999), which are presented in Endpoint 1. The duration of CHOP therapy could be reduced from 8 to 6 cycles for those who achieved CR or CRu after 4 cycles, but all participants received a full 8 cycles of rituximab.

    Serious adverse events
    Rituximab SC Rituximab IV
    Total subjects affected by serious adverse events
         subjects affected / exposed
    155 / 369 (42.01%)
    77 / 203 (37.93%)
         number of deaths (all causes)
    69
    34
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Papillary thyroid cancer
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal cell carcinoma
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Invasive ductal breast carcinoma
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Metastatic renal cell carcinoma
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myelodysplastic syndrome
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-small cell lung cancer
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Prostate cancer
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Prostate cancer metastatic
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism venous
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Flushing
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subclavian vein thrombosis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Thrombosis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arterial disorder
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Surgical and medical procedures
    Knee arthroplasty
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    7 / 369 (1.90%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    1 / 8
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chills
         subjects affected / exposed
    2 / 369 (0.54%)
    2 / 203 (0.99%)
         occurrences causally related to treatment / all
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Fatigue
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza like illness
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injection site hypertrophy
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Localised oedema
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Ill-defined disorder
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Immune system disorders
    Cytokine release syndrome
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 369 (0.27%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    1 / 369 (0.27%)
    2 / 203 (0.99%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Dyspnoea
         subjects affected / exposed
    0 / 369 (0.00%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    2 / 369 (0.54%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    Epistaxis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Organising pneumonia
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleurisy
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary fibrosis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Adjustment disorder
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anxiety
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    3 / 369 (0.81%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    2 / 3
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic enzyme increased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Troponin T increased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Weight decreased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Multiple fractures
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transfusion reaction
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fracture
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Procedural pneumothorax
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    2 / 369 (0.54%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 369 (0.27%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 2
    Atrial flutter
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 369 (0.00%)
    2 / 203 (0.99%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Tachycardia
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac failure acute
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Congestive cardiomyopathy
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tachycardia induced cardiomyopathy
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute coronary syndrome
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Nervous system disorders
    Syncope
         subjects affected / exposed
    2 / 369 (0.54%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    2 / 369 (0.54%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Dysarthria
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    49 / 369 (13.28%)
    24 / 203 (11.82%)
         occurrences causally related to treatment / all
    22 / 64
    12 / 27
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Neutropenia
         subjects affected / exposed
    22 / 369 (5.96%)
    10 / 203 (4.93%)
         occurrences causally related to treatment / all
    13 / 26
    8 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anaemia
         subjects affected / exposed
    2 / 369 (0.54%)
    2 / 203 (0.99%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Leukopenia
         subjects affected / exposed
    1 / 369 (0.27%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    1 / 1
    6 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile bone marrow aplasia
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    3 / 369 (0.81%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Vomiting
         subjects affected / exposed
    3 / 369 (0.81%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal distension
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal fissure
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal haemorrhage
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric perforation
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhoidal haemorrhage
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic colitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstruction gastric
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal perforation
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct obstruction
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic failure
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Skin and subcutaneous tissue disorders
    Eczema
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Proteinuria
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone pain
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myalgia
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Osteonecrosis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tendonitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spondylolisthesis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    27 / 369 (7.32%)
    7 / 203 (3.45%)
         occurrences causally related to treatment / all
    5 / 28
    3 / 7
         deaths causally related to treatment / all
    2 / 6
    1 / 1
    Septic shock
         subjects affected / exposed
    3 / 369 (0.81%)
    3 / 203 (1.48%)
         occurrences causally related to treatment / all
    4 / 5
    0 / 3
         deaths causally related to treatment / all
    2 / 2
    0 / 3
    Lung infection
         subjects affected / exposed
    4 / 369 (1.08%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    2 / 5
    0 / 1
         deaths causally related to treatment / all
    1 / 2
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sepsis
         subjects affected / exposed
    5 / 369 (1.36%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Cellulitis
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal abscess
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchiolitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    H1N1 influenza
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes oesophagitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes simplex hepatitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Klebsiella sepsis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic infection
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral candidiasis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oral herpes
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pneumocystis jirovecii infection
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinusitis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tuberculosis
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral upper respiratory tract infection
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection viral
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intervertebral discitis
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Localised infection
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis norovirus
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia cytomegaloviral
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    1 / 369 (0.27%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 369 (0.54%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    1 / 369 (0.27%)
    0 / 203 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypernatraemia
         subjects affected / exposed
    0 / 369 (0.00%)
    1 / 203 (0.49%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Rituximab SC Rituximab IV
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    319 / 369 (86.45%)
    172 / 203 (84.73%)
    Investigations
    Neutrophil count decreased
         subjects affected / exposed
    81 / 369 (21.95%)
    43 / 203 (21.18%)
         occurrences all number
    104
    63
    Weight decreased
         subjects affected / exposed
    28 / 369 (7.59%)
    8 / 203 (3.94%)
         occurrences all number
    29
    8
    White blood cell count decreased
         subjects affected / exposed
    51 / 369 (13.82%)
    23 / 203 (11.33%)
         occurrences all number
    85
    43
    Lymphocyte count decreased
         subjects affected / exposed
    53 / 369 (14.36%)
    20 / 203 (9.85%)
         occurrences all number
    73
    32
    Platelet count decreased
         subjects affected / exposed
    19 / 369 (5.15%)
    11 / 203 (5.42%)
         occurrences all number
    28
    17
    Nervous system disorders
    Neuropathy peripheral
         subjects affected / exposed
    44 / 369 (11.92%)
    24 / 203 (11.82%)
         occurrences all number
    50
    27
    Paraesthesia
         subjects affected / exposed
    32 / 369 (8.67%)
    13 / 203 (6.40%)
         occurrences all number
    33
    15
    Headache
         subjects affected / exposed
    21 / 369 (5.69%)
    15 / 203 (7.39%)
         occurrences all number
    28
    21
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    104 / 369 (28.18%)
    54 / 203 (26.60%)
         occurrences all number
    186
    92
    Anaemia
         subjects affected / exposed
    88 / 369 (23.85%)
    40 / 203 (19.70%)
         occurrences all number
    110
    49
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    71 / 369 (19.24%)
    29 / 203 (14.29%)
         occurrences all number
    76
    38
    Pyrexia
         subjects affected / exposed
    40 / 369 (10.84%)
    23 / 203 (11.33%)
         occurrences all number
    50
    31
    Asthenia
         subjects affected / exposed
    42 / 369 (11.38%)
    24 / 203 (11.82%)
         occurrences all number
    59
    29
    Mucosal inflammation
         subjects affected / exposed
    29 / 369 (7.86%)
    16 / 203 (7.88%)
         occurrences all number
    37
    19
    Oedema peripheral
         subjects affected / exposed
    27 / 369 (7.32%)
    9 / 203 (4.43%)
         occurrences all number
    30
    9
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    79 / 369 (21.41%)
    47 / 203 (23.15%)
         occurrences all number
    112
    65
    Constipation
         subjects affected / exposed
    56 / 369 (15.18%)
    34 / 203 (16.75%)
         occurrences all number
    65
    39
    Diarrhoea
         subjects affected / exposed
    52 / 369 (14.09%)
    20 / 203 (9.85%)
         occurrences all number
    70
    25
    Vomiting
         subjects affected / exposed
    40 / 369 (10.84%)
    17 / 203 (8.37%)
         occurrences all number
    52
    23
    Stomatitis
         subjects affected / exposed
    23 / 369 (6.23%)
    11 / 203 (5.42%)
         occurrences all number
    28
    14
    Abdominal pain
         subjects affected / exposed
    24 / 369 (6.50%)
    12 / 203 (5.91%)
         occurrences all number
    28
    12
    Dyspepsia
         subjects affected / exposed
    19 / 369 (5.15%)
    14 / 203 (6.90%)
         occurrences all number
    22
    16
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    42 / 369 (11.38%)
    19 / 203 (9.36%)
         occurrences all number
    52
    22
    Dyspnoea
         subjects affected / exposed
    22 / 369 (5.96%)
    6 / 203 (2.96%)
         occurrences all number
    24
    7
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    87 / 369 (23.58%)
    48 / 203 (23.65%)
         occurrences all number
    88
    48
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    23 / 369 (6.23%)
    13 / 203 (6.40%)
         occurrences all number
    23
    18
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    18 / 369 (4.88%)
    11 / 203 (5.42%)
         occurrences all number
    22
    12
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    28 / 369 (7.59%)
    18 / 203 (8.87%)
         occurrences all number
    30
    23
    Hypokalaemia
         subjects affected / exposed
    19 / 369 (5.15%)
    5 / 203 (2.46%)
         occurrences all number
    25
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    01 May 2012
    The protocol was amended to clarify reporting requirements for certain events, and also to specify the procedure for submitting protocol amendments to the Institutional Review Board (IRB)/Ethics Committee (EC) and to regulatory authorities in accordance with local requirements.
    20 Mar 2013
    The protocol was amended to clarify and correct several sections including the defined patient population (with the added exclusion of pregnant women), study treatment schedules, timing of study assessments, and description of the statistical analysis plan.

    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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