Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43876   clinical trials with a EudraCT protocol, of which   7294   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Download PDF

    Clinical Trial Results:
    A Randomized, Multicenter, Open-label, Phase 3 Study of the Bruton's Tyrosine Kinase (BTK) Inhibitor Ibrutinib (PCI-32765) versus Ofatumumab in Patients with Relapsed or Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

    Summary
    EudraCT number
    2012-000694-23
    Trial protocol
    GB   IE   PL   ES   IT   AT   BE  
    Global end of trial date

    Results information
    Results version number
    v1
    This version publication date
    14 Oct 2016
    First version publication date
    14 Oct 2016
    Other versions
    v2

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    PCYC-1112-CA
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01578707
    WHO universal trial number (UTN)
    -
    Other trial identifiers
    provider NLM_DES study id: S0003GEU
    Sponsors
    Sponsor organisation name
    Pharmacyclics LLC
    Sponsor organisation address
    999 E Arques Ave, Sunnyvale, United States, 94085
    Public contact
    Devon Chung, Pharmacyclics LLC, 001 855-427-8846, pharmacyclics@medcomsol.com
    Scientific contact
    Dr. George Cole, Pharmacyclics LLC, 001 408-990-7340, gecole@pcyc.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
    Interim
    Date of interim/final analysis
    06 Nov 2013
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Nov 2013
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    The purpose of the study was to evaluate whether treatment with ibrutinib as a monotherapy results in a clinically significant improvement in progression free survival (PFS) as compared to treatment with ofatumumab in patients with relapsed or refractory Chronic Lymphocytic Leukemia (CLL) or Small Lymphocytic Lymphoma (SLL)
    Protection of trial subjects
    The study was conducted in accordance with the Declaration of Helsinki and ICH GCP.
    Background therapy
    -
    Evidence for comparator
    NCCN and ESMO Guidelines Support the use of ofatumumab in the target patient population.
    Actual start date of recruitment
    22 Jun 2012
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy, Regulatory reason
    Long term follow-up duration
    5 Years
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 29
    Country: Number of subjects enrolled
    United States: 192
    Country: Number of subjects enrolled
    Spain: 17
    Country: Number of subjects enrolled
    France: 27
    Country: Number of subjects enrolled
    United Kingdom: 73
    Country: Number of subjects enrolled
    Italy: 20
    Country: Number of subjects enrolled
    Poland: 8
    Country: Number of subjects enrolled
    Ireland: 9
    Country: Number of subjects enrolled
    Austria: 16
    Worldwide total number of subjects
    391
    EEA total number of subjects
    170
    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)
    152
    From 65 to 84 years
    235
    85 years and over
    4

    Subject disposition

    Close Top of page
    Recruitment
    Recruitment details
    A total of 391 subjects were enrolled in the study from sites located in the US, Europe, and Australia. The first subject consented 22 June 2012, the data base lock for the present analysis was 06 November 2013.

    Pre-assignment
    Screening details
    Patients with previously treated CLL were screened for potential participation by the investigators based on the eligibility criteria. Patients who met the criteria were asked whether they were willing to participate in the study. A total of 391 subjects were randomized.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Ofatumumab (Arm A)
    Arm description
    An anti-CD20 monoclonal antibody. The ofatumumab (IV) dosage and schedule was 12 doses administered over 24 weeks or until disease Progression or unacceptable toxicity. Week 1: 300 mg Initial dose Week 2 through 8: 2,000 mg (once weekly) Week 12, 16, 20, and 24: 2,000 mg (every 4 weeks)
    Arm type
    Active comparator

    Investigational medicinal product name
    ofatumumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    The ofatumumab (IV) dosage and schedule is 12 doses administered over 24 weeks or until disease progression, unacceptable toxicity. Week 1: 300 mg initial dose Week 2 through 8: 2,000 mg (once weekly) Week 12, 16, 20 and 24: 2,000 mg (every 4 weeks)

    Arm title
    ibrutinib (Arm B)
    Arm description
    Ibrutinib 420 mg daily
    Arm type
    Experimental

    Investigational medicinal product name
    ibrutinib
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    ibrutinib 420 mg (3 x 140-mg capsules) was administered orally once daily until disease progression or unacceptable toxicity

    Number of subjects in period 1
    Ofatumumab (Arm A) ibrutinib (Arm B)
    Started
    196
    195
    Completed
    188
    193
    Not completed
    8
    2
         Consent withdrawn by subject
    8
    2

    Baseline characteristics

    Close Top of page
    Baseline characteristics reporting groups
    Reporting group title
    Ofatumumab (Arm A)
    Reporting group description
    An anti-CD20 monoclonal antibody. The ofatumumab (IV) dosage and schedule was 12 doses administered over 24 weeks or until disease Progression or unacceptable toxicity. Week 1: 300 mg Initial dose Week 2 through 8: 2,000 mg (once weekly) Week 12, 16, 20, and 24: 2,000 mg (every 4 weeks)

    Reporting group title
    ibrutinib (Arm B)
    Reporting group description
    Ibrutinib 420 mg daily

    Reporting group values
    Ofatumumab (Arm A) ibrutinib (Arm B) Total
    Number of subjects
    196 195 391
    Age Categorical
    Units: Subjects
        <=18 years
    0 0 0
        Between 18 and 65 years
    75 77 152
        >=65 years
    121 118 239
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    66.8 ( 8.88 ) 66.1 ( 10.15 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    59 66 125
        Male
    137 129 266

    End points

    Close Top of page
    End points reporting groups
    Reporting group title
    Ofatumumab (Arm A)
    Reporting group description
    An anti-CD20 monoclonal antibody. The ofatumumab (IV) dosage and schedule was 12 doses administered over 24 weeks or until disease Progression or unacceptable toxicity. Week 1: 300 mg Initial dose Week 2 through 8: 2,000 mg (once weekly) Week 12, 16, 20, and 24: 2,000 mg (every 4 weeks)

    Reporting group title
    ibrutinib (Arm B)
    Reporting group description
    Ibrutinib 420 mg daily

    Primary: PFS (Progression Free Survival)

    Close Top of page
    End point title
    PFS (Progression Free Survival)
    End point description
    The primary objective of this study was to evaluate the efficacy of ibrutinib compared to ofatumumab based on progression-free survival (PFS) assessed by the Independent Review Committee (IRC) per International Workshop on Chronic Lymphocytic Leukemia Criteria (IWCLL; Hallek et al, 2008) in subjects with relapsed or refractory CLL/SLL.
    End point type
    Primary
    End point timeframe
    Analysis was conducted after observing 146 PFS Events. Median follow-up time in the study was 9.4 month. As the median PFS was not reached in the ibrutinib arm (8.1 months in the ofatumumab arm), PFS rates at 12 months are presented.
    End point values
    Ofatumumab (Arm A) ibrutinib (Arm B)
    Number of subjects analysed
    196
    195
    Units: percentage
        number (not applicable)
    5.9
    65.7
    Statistical analysis title
    PFS (Progression free survival
    Comparison groups
    Ofatumumab (Arm A) v ibrutinib (Arm B)
    Number of subjects included in analysis
    391
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Kaplan-Meier estimates
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.215
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.146
         upper limit
    0.317

    Secondary: OS (Overall Survival)

    Close Top of page
    End point title
    OS (Overall Survival)
    End point description
    End point type
    Secondary
    End point timeframe
    Analysis was conducted after observing 146 PFS Events. Median follow-up time in the study was 9.4 month. As the median OS was not reached in either arm, OS rates at 12 months are presented.
    End point values
    Ofatumumab (Arm A) ibrutinib (Arm B)
    Number of subjects analysed
    196
    195
    Units: percentage
        number (not applicable)
    81.3
    90.2
    Statistical analysis title
    OS (Overall Survival)
    Comparison groups
    ibrutinib (Arm B) v Ofatumumab (Arm A)
    Number of subjects included in analysis
    391
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.049
    Method
    Kaplan-Meier Estimates
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.434
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.238
         upper limit
    0.789

    Secondary: ORR (Overall Response Rate)

    Close Top of page
    End point title
    ORR (Overall Response Rate)
    End point description
    ORR was defined as the Proportion of subjects who achieved complete Response (CR), complete Response with incomplete marrow recovery (CRi), nodule partial Response (nPR), partial response (PR), or partial response with lymmphocytosis (PRL) per IRC assessment.
    End point type
    Secondary
    End point timeframe
    Analysis was conducted after observing 146 PFS events. Median follow-up time in the study was 9.4 months.
    End point values
    Ofatumumab (Arm A) ibrutinib (Arm B)
    Number of subjects analysed
    196
    195
    Units: percentage
        number (not applicable)
    4.1
    42.6
    Statistical analysis title
    ORR (Overall response rate)
    Comparison groups
    Ofatumumab (Arm A) v ibrutinib (Arm B)
    Number of subjects included in analysis
    391
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Fisher exact
    Confidence interval

    Adverse events

    Close Top of page
    Adverse events information
    Timeframe for reporting adverse events
    From June 2012 through Nov 2013
    Adverse event reporting additional description
    Note: Safety has not been updated from the primary analysis, as only efficacy updates were requested on the present study and as the times of exposures were comparable in both arms at that time point.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    ibrutinib (Arm B)
    Reporting group description
    A Bruton Tyrosine Kinase Inhibitor ibrutinib: ibrutinib 420 mg (3 x 140-mg capsules) will be administered orally once daily until disease progression or unacceptable toxicity

    Reporting group title
    Ofatumumab (Arm A)
    Reporting group description
    An anti-CD20 monoclonal antibody ofatumumab: The ofatumumab (IV) dosage and schedule is 12 doses administered over 24 weeks or until disease progression, unacceptable toxicity. Week 1: 300 mg initial dose Week 2 through 8: 2,000 mg (once weekly) Week 12, 16, 20 and 24: 2,000 mg (every 4 weeks)

    Serious adverse events
    ibrutinib (Arm B) Ofatumumab (Arm A)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    81 / 195 (41.54%)
    58 / 191 (30.37%)
         number of deaths (all causes)
    12
    16
         number of deaths resulting from adverse events
    1
    2
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Leukaemia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Chronic lymphocytic leukaemia
         subjects affected / exposed
    3 / 195 (1.54%)
    3 / 191 (1.57%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 2
    0 / 2
    Gastrointestinal carcinoma
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Lung adenocarcinoma metastatic
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Sarcoma
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metastatic squamous cell carcinoma
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Richter's syndrome
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Tumour flare
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aneurysm
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Cyst
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza like illness
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injection site discharge
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
    alternative assessment type: Non-systematic
         subjects affected / exposed
    6 / 195 (3.08%)
    4 / 191 (2.09%)
         occurrences causally related to treatment / all
    5 / 10
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Immune system disorders
    Anaphylactic shock
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Social circumstances
    Pregnancy of partner
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (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
    Dyspnoea
         subjects affected / exposed
    2 / 195 (1.03%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopneumopathy
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary mass
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract inflammation
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Major depression
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mania
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Immunoglobulins decreased
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Muscle strain
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    0 / 195 (0.00%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple fractures
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    6 / 195 (3.08%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    1 / 9
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial tachycardia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrioventricular block
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Cardiac failure
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cardiac failure congestive
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus tachycardia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
    alternative assessment type: Non-systematic
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    3 / 195 (1.54%)
    4 / 191 (2.09%)
         occurrences causally related to treatment / all
    3 / 4
    4 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Autoimmune haemolytic anaemia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anaemia
         subjects affected / exposed
    2 / 195 (1.03%)
    4 / 191 (2.09%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenia
         subjects affected / exposed
    2 / 195 (1.03%)
    3 / 191 (1.57%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Methaemoglobinaemia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymphadenopathy
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemolytic anaemia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Hearing impaired
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Colitis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    3 / 195 (1.54%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain
    alternative assessment type: Non-systematic
         subjects affected / exposed
    2 / 195 (1.03%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malabsorption
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal spasm
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Poor dental condition
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Angioedema
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal failure acute
         subjects affected / exposed
    1 / 195 (0.51%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Renal impairment
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myalgia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Abscess limb
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal infection
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspergillus infection
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (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 / 195 (0.51%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteroides bacteraemia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
    alternative assessment type: Non-systematic
         subjects affected / exposed
    0 / 195 (0.00%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Breast cellulitis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopulmonary aspergillosis
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchopneumonia
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Bronchitis bacterial
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Campylobacter gastroenteritis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    3 / 195 (1.54%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterococcal infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis infectious
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia urinary tract infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis viral
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Folliculitis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile infection
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes simplex
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemophilus sepsis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemophilus bacteraemia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes virus infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Impetigo
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infectious pleural effusion
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Lung infection
         subjects affected / exposed
    5 / 195 (2.56%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    3 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    4 / 195 (2.05%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    2 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intervertebral discitis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lymph gland infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumococcal sepsis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Parainfluenzae virus infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nocardiosis
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Neutropenic sepsis
         subjects affected / exposed
    2 / 195 (1.03%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    1 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 1
    1 / 1
    Pneumocystis jirovecii infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumocystis jirovecii pneumonia
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    17 / 195 (8.72%)
    12 / 191 (6.28%)
         occurrences causally related to treatment / all
    8 / 20
    6 / 13
         deaths causally related to treatment / all
    1 / 3
    0 / 2
    Pneumonia bacterial
         subjects affected / exposed
    1 / 195 (0.51%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia mycoplasmal
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia pseudomonas aeruginosa
         subjects affected / exposed
    0 / 195 (0.00%)
    3 / 191 (1.57%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 195 (0.00%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis syndrome
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Rhinovirus infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 195 (1.03%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Tonsillitis fungal
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (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
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 195 (0.51%)
    4 / 191 (2.09%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Stenotrophomonas infection
         subjects affected / exposed
    0 / 195 (0.00%)
    2 / 191 (1.05%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal skin infection
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral upper respiratory tract infection
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral pharyngitis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (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
    4 / 195 (2.05%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urethritis
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    1 / 195 (0.51%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tumour lysis syndrome
         subjects affected / exposed
    0 / 195 (0.00%)
    1 / 191 (0.52%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    2 / 195 (1.03%)
    0 / 191 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    ibrutinib (Arm B) Ofatumumab (Arm A)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    194 / 195 (99.49%)
    187 / 191 (97.91%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    10 / 195 (5.13%)
    0 / 191 (0.00%)
         occurrences all number
    12
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    13 / 195 (6.67%)
    0 / 191 (0.00%)
         occurrences all number
    17
    0
    Fatigue
         subjects affected / exposed
    54 / 195 (27.69%)
    57 / 191 (29.84%)
         occurrences all number
    77
    78
    Pyrexia
         subjects affected / exposed
    42 / 195 (21.54%)
    26 / 191 (13.61%)
         occurrences all number
    58
    37
    Oedema peripheral
         subjects affected / exposed
    22 / 195 (11.28%)
    15 / 191 (7.85%)
         occurrences all number
    27
    17
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    22 / 195 (11.28%)
    20 / 191 (10.47%)
         occurrences all number
    25
    22
    Cough
         subjects affected / exposed
    38 / 195 (19.49%)
    44 / 191 (23.04%)
         occurrences all number
    52
    53
    Epistaxis
         subjects affected / exposed
    17 / 195 (8.72%)
    0 / 191 (0.00%)
         occurrences all number
    17
    0
    Oropharyngeal pain
         subjects affected / exposed
    13 / 195 (6.67%)
    0 / 191 (0.00%)
         occurrences all number
    14
    0
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    0 / 195 (0.00%)
    17 / 191 (8.90%)
         occurrences all number
    0
    17
    Investigations
    Weight decreased
         subjects affected / exposed
    11 / 195 (5.64%)
    12 / 191 (6.28%)
         occurrences all number
    12
    12
    Injury, poisoning and procedural complications
    Infusion related reaction
         subjects affected / exposed
    0 / 195 (0.00%)
    51 / 191 (26.70%)
         occurrences all number
    0
    74
    Contusion
         subjects affected / exposed
    21 / 195 (10.77%)
    0 / 191 (0.00%)
         occurrences all number
    29
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    27 / 195 (13.85%)
    11 / 191 (5.76%)
         occurrences all number
    35
    11
    Dizziness
         subjects affected / exposed
    22 / 195 (11.28%)
    10 / 191 (5.24%)
         occurrences all number
    25
    11
    Paraesthesia
         subjects affected / exposed
    0 / 195 (0.00%)
    10 / 191 (5.24%)
         occurrences all number
    0
    12
    Peripheral sensory neuropathy
         subjects affected / exposed
    0 / 195 (0.00%)
    24 / 191 (12.57%)
         occurrences all number
    0
    29
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    43 / 195 (22.05%)
    31 / 191 (16.23%)
         occurrences all number
    88
    59
    Increased tendency to bruise
         subjects affected / exposed
    17 / 195 (8.72%)
    0 / 191 (0.00%)
         occurrences all number
    21
    0
    Neutropenia
         subjects affected / exposed
    42 / 195 (21.54%)
    26 / 191 (13.61%)
         occurrences all number
    95
    59
    Thrombocytopenia
         subjects affected / exposed
    33 / 195 (16.92%)
    22 / 191 (11.52%)
         occurrences all number
    55
    30
    Eye disorders
    Lacrimation increased
         subjects affected / exposed
    10 / 195 (5.13%)
    0 / 191 (0.00%)
         occurrences all number
    11
    0
    Dry eye
         subjects affected / exposed
    14 / 195 (7.18%)
    10 / 191 (5.24%)
         occurrences all number
    15
    10
    Vision blurred
         subjects affected / exposed
    19 / 195 (9.74%)
    0 / 191 (0.00%)
         occurrences all number
    20
    0
    Gastrointestinal disorders
    Dry mouth
         subjects affected / exposed
    16 / 195 (8.21%)
    0 / 191 (0.00%)
         occurrences all number
    20
    0
    Dyspepsia
         subjects affected / exposed
    15 / 195 (7.69%)
    0 / 191 (0.00%)
         occurrences all number
    20
    0
    Constipation
         subjects affected / exposed
    30 / 195 (15.38%)
    18 / 191 (9.42%)
         occurrences all number
    33
    19
    Diarrhoea
         subjects affected / exposed
    92 / 195 (47.18%)
    34 / 191 (17.80%)
         occurrences all number
    142
    41
    Abdominal pain
         subjects affected / exposed
    15 / 195 (7.69%)
    18 / 191 (9.42%)
         occurrences all number
    17
    20
    Vomiting
         subjects affected / exposed
    28 / 195 (14.36%)
    11 / 191 (5.76%)
         occurrences all number
    36
    14
    Nausea
         subjects affected / exposed
    51 / 195 (26.15%)
    35 / 191 (18.32%)
         occurrences all number
    72
    50
    Stomatitis
         subjects affected / exposed
    20 / 195 (10.26%)
    0 / 191 (0.00%)
         occurrences all number
    23
    0
    Skin and subcutaneous tissue disorders
    Rash maculo-papular
         subjects affected / exposed
    13 / 195 (6.67%)
    0 / 191 (0.00%)
         occurrences all number
    19
    0
    Pruritus
         subjects affected / exposed
    0 / 195 (0.00%)
    18 / 191 (9.42%)
         occurrences all number
    0
    20
    Rash
         subjects affected / exposed
    15 / 195 (7.69%)
    0 / 191 (0.00%)
         occurrences all number
    24
    0
    Rash erythematous
         subjects affected / exposed
    13 / 195 (6.67%)
    10 / 191 (5.24%)
         occurrences all number
    14
    14
    Petechiae
         subjects affected / exposed
    27 / 195 (13.85%)
    0 / 191 (0.00%)
         occurrences all number
    33
    0
    Urticaria
         subjects affected / exposed
    0 / 195 (0.00%)
    12 / 191 (6.28%)
         occurrences all number
    0
    15
    Night sweats
         subjects affected / exposed
    10 / 195 (5.13%)
    24 / 191 (12.57%)
         occurrences all number
    11
    27
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    21 / 195 (10.77%)
    12 / 191 (6.28%)
         occurrences all number
    22
    15
    Arthralgia
         subjects affected / exposed
    34 / 195 (17.44%)
    13 / 191 (6.81%)
         occurrences all number
    58
    16
    Pain in extremity
         subjects affected / exposed
    20 / 195 (10.26%)
    0 / 191 (0.00%)
         occurrences all number
    24
    0
    Myalgia
         subjects affected / exposed
    18 / 195 (9.23%)
    0 / 191 (0.00%)
         occurrences all number
    23
    0
    Muscle spasms
         subjects affected / exposed
    25 / 195 (12.82%)
    16 / 191 (8.38%)
         occurrences all number
    33
    18
    Infections and infestations
    Sinusitis
         subjects affected / exposed
    21 / 195 (10.77%)
    12 / 191 (6.28%)
         occurrences all number
    26
    14
    Upper respiratory tract infection
         subjects affected / exposed
    30 / 195 (15.38%)
    16 / 191 (8.38%)
         occurrences all number
    36
    18
    Urinary tract infection
         subjects affected / exposed
    17 / 195 (8.72%)
    10 / 191 (5.24%)
         occurrences all number
    18
    11
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    11 / 195 (5.64%)
    0 / 191 (0.00%)
         occurrences all number
    17
    0
    Hyperuricaemia
         subjects affected / exposed
    10 / 195 (5.13%)
    0 / 191 (0.00%)
         occurrences all number
    12
    0
    Decreased appetite
         subjects affected / exposed
    13 / 195 (6.67%)
    14 / 191 (7.33%)
         occurrences all number
    16
    14
    Hypokalaemia
         subjects affected / exposed
    12 / 195 (6.15%)
    0 / 191 (0.00%)
         occurrences all number
    17
    0

    More information

    Close Top of page

    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    28 Sep 2012
    Updated the following information: • Secondary and exploratory objectives/endpoints including corresponding changes to statistical analysis section • Updated response criteria inclusive of the June 2012 clarification to IWCLL 2008 criteria for assessing response with BCR-inhibiting agents, including guidance to assess the clinical improvement in other disease parameters upon observation of lymphocytosis • Guidelines for concomitant use of CYP inhibiting/inducing drugs, QT prolonging medications, and antiplatelet agents and anticoagulants • Revised Inclusion criteria #5 to include subjects age ≥ 70 years who have received ≥ 2 prior lines of systemic therapy • Clarified that 2 separate randomization schemes were to be generated (one for each geographic region [US versus non-US])
    13 Dec 2012
    • Provided instructions on administration of ibrutinib in case of planned or unplanned surgery • Allowed allogeneic stem cell transplant within 6 months prior to randomization with no active graft vs. host disease. • Clarified that pre-treatment FISH should be performed on marrow sample for subjects without lymphocytosis (eg, SLL) • Included provisionary language for supplying ibrutinib to control arm subjects • Allowed screening computed tomography (CT) scan from up to 6 weeks prior to randomization
    08 Aug 2013
    • Allowed subjects treated with ofatumumab and with documented IRC-confirmed progression to receive therapy with ibrutinib at investigator’s discretion • Updated guideline for concomitant use local site or hormonal therapy for non-B cell malignancies and growth factors • Added collection for other malignancies that develop at anytime during study follow-up
    24 Sep 2013
    • Changed the overall two-sided significance level for PFS from 0.01 to 0.05 following review with global regulatory authorities.

    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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/24881631
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Thu May 09 22:49:33 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA