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    Clinical Trial Results:
    A Two-Cohort, Open-Label, Multicenter, Study of Trastuzumab Emtansine (T-DM1) in HER2-Positive Locally Advanced or Metastatic Breast Cancer Patients Who Have Received Prior Anti-HER2 and Chemotherapy-Based Treatment

    Summary
    EudraCT number
    2012-001628-37
    Trial protocol
    DE   BE   ES   SE   GB   DK   HU   PT   NO   AT   FI   IT   GR   IE   SI   BG   NL   EE   IS   SK  
    Global end of trial date
    31 Jul 2020

    Results information
    Results version number
    v2(current)
    This version publication date
    30 Jul 2021
    First version publication date
    14 Oct 2017
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    MO28231
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01702571
    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
    F. Hoffmann-La Roche AG, F. Hoffmann-La Roche AG, 41 616878333, global.trial_information@roche.com
    Scientific contact
    F. Hoffmann-La Roche AG, 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
    31 Jul 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    31 Jul 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To gain better understanding of the safety profile of trastuzumab emtansine in this study the safety and tolerability of trastuzumab emtansine was investigated in human epidermal growth factor receptor 2 (HER2)-positive locally advanced breast cancer (LABC) and metastatic breast cancer (mBC) patients who had received prior anti-HER2 and chemotherapy-based treatment.
    Protection of trial subjects
    All study subjects were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Nov 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    France: 515
    Country: Number of subjects enrolled
    Spain: 182
    Country: Number of subjects enrolled
    United Kingdom: 164
    Country: Number of subjects enrolled
    Italy: 153
    Country: Number of subjects enrolled
    Germany: 120
    Country: Number of subjects enrolled
    Turkey: 71
    Country: Number of subjects enrolled
    Poland: 55
    Country: Number of subjects enrolled
    Netherlands: 54
    Country: Number of subjects enrolled
    Brazil: 50
    Country: Number of subjects enrolled
    Canada: 50
    Country: Number of subjects enrolled
    Mexico: 48
    Country: Number of subjects enrolled
    Australia: 46
    Country: Number of subjects enrolled
    Ireland: 45
    Country: Number of subjects enrolled
    Portugal: 39
    Country: Number of subjects enrolled
    Belgium: 36
    Country: Number of subjects enrolled
    Denmark: 34
    Country: Number of subjects enrolled
    Greece: 31
    Country: Number of subjects enrolled
    Hungary: 30
    Country: Number of subjects enrolled
    Norway: 24
    Country: Number of subjects enrolled
    Taiwan: 22
    Country: Number of subjects enrolled
    Austria: 21
    Country: Number of subjects enrolled
    Bulgaria: 20
    Country: Number of subjects enrolled
    Finland: 20
    Country: Number of subjects enrolled
    Panama: 17
    Country: Number of subjects enrolled
    Slovenia: 17
    Country: Number of subjects enrolled
    Sweden: 16
    Country: Number of subjects enrolled
    Slovakia: 15
    Country: Number of subjects enrolled
    Argentina: 14
    Country: Number of subjects enrolled
    Peru: 12
    Country: Number of subjects enrolled
    Croatia: 8
    Country: Number of subjects enrolled
    Ecuador: 7
    Country: Number of subjects enrolled
    Estonia: 7
    Country: Number of subjects enrolled
    Guatemala: 7
    Country: Number of subjects enrolled
    Hong Kong: 5
    Country: Number of subjects enrolled
    Iceland: 4
    Country: Number of subjects enrolled
    Luxembourg: 4
    Country: Number of subjects enrolled
    United Arab Emirates: 4
    Country: Number of subjects enrolled
    Dominican Republic: 1
    Country: Number of subjects enrolled
    China: 155
    Country: Number of subjects enrolled
    Indonesia: 12
    Country: Number of subjects enrolled
    Korea, Republic of: 25
    Country: Number of subjects enrolled
    Thailand: 15
    Country: Number of subjects enrolled
    Venezuela, Bolivarian Republic of: 10
    Worldwide total number of subjects
    2185
    EEA total number of subjects
    1450
    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)
    1802
    From 65 to 84 years
    379
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    For one participant, the site incorrectly answered the question 'Did the participant complete follow-up as per protocol?' It was answered No, however the participant was in survival follow-up and the site should have answered Yes. This participant is wrongly counted in the 'discontinued from study' number.

    Pre-assignment
    Screening details
    Subjects with HER2-positive disease with invasive breast cancer and prior treatment (both chemotherapy, alone or with another agent, and an anti-HER2 agent, alone or with another agent) with disease progression during or after the most recent treatment for LABC/mBC or within 6 months of completing adjuvant therapy were included in the study.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Trastuzumab Emtansine (All Participants)
    Arm description
    This cohort (Cohort 1) enrolled all subjects with human epidermal growth factor receptor 2 (HER2) positive, unresectable, locally advanced breast cancer (LABC) or metastatic breast cancer (mBC) who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Subjects received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.
    Arm type
    Experimental

    Investigational medicinal product name
    Trastuzumab emtansine
    Investigational medicinal product code
    Other name
    RO5304020, T-DM1, Kadcyla,
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received trastuzumab emtansine 3.6 milligrams per kilogram (mg/kg) intravenously (IV) on Day 1 of a 3-week cycle every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Arm title
    Trastuzumab Emtansine (Asian Participants)
    Arm description
    This cohort (Cohort 2) enrolled Asian race participants with HER2-positive, unresectable, LABC or mBC who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Participants received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.
    Arm type
    Experimental

    Investigational medicinal product name
    Trastuzumab emtansine
    Investigational medicinal product code
    Other name
    RO5304020, T-DM1, Kadcyla,
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Subjects received trastuzumab emtansine 3.6 milligrams per kilogram (mg/kg) intravenously (IV) on Day 1 of a 3-week cycle every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Number of subjects in period 1
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Started
    2003
    182
    Completed
    494
    65
    Not completed
    1509
    117
         On Study Treatment At Lplv/Cohort 1
    93
    -
         On Study Treatment At Lplv/Cohort 2
    -
    1
         Not Classifiable
    1
    -
         Death
    1067
    76
         Lost to Follow-up
    144
    10
         Adverse Event/Unacceptable Toxicity
    4
    -
         Progressive Disease
    3
    -
         Termination By Sponsor
    4
    -
         Withdrawal by Subject
    177
    29
         Investigator Decision
    5
    -
         Protocol Violation
    2
    -
         Safety FU Done < 3 Months Prior To CCOD
    9
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Trastuzumab Emtansine (All Participants)
    Reporting group description
    This cohort (Cohort 1) enrolled all subjects with human epidermal growth factor receptor 2 (HER2) positive, unresectable, locally advanced breast cancer (LABC) or metastatic breast cancer (mBC) who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Subjects received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Reporting group title
    Trastuzumab Emtansine (Asian Participants)
    Reporting group description
    This cohort (Cohort 2) enrolled Asian race participants with HER2-positive, unresectable, LABC or mBC who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Participants received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Reporting group values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants) Total
    Number of subjects
    2003 182 2185
    Age categorical
    Units: Subjects
        Preterm newborn infants(gestational age <37 weeks)
    0 0 0
        Newborns(0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    1630 172 1802
        From 65-84 years
    369 10 379
        85 years and over
    4 0 4
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    54.5 ( 11.35 ) 49.1 ( 10.1 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    1989 182 2171
        Male
    14 0 14
    Race
    Units: Subjects
        Caucasian
    1397 0 1397
        Black
    21 0 21
        Asian
    72 182 254
        Native American
    41 0 41
        N/A as per local regulation
    466 0 466
        Unknown
    3 0 3
        Other
    2 0 2
        Missing
    1 0 1
    Ethnicity
    Units: Subjects
        Hispanic/Latino
    300 0 300
        Chinese
    29 147 176
        N/A as per local regulation
    997 16 1013
        Other
    417 19 436
        Mixed
    9 0 9
        Indian (Indian subcontinent)
    4 0 4
        Unknown
    247 0 247

    End points

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    End points reporting groups
    Reporting group title
    Trastuzumab Emtansine (All Participants)
    Reporting group description
    This cohort (Cohort 1) enrolled all subjects with human epidermal growth factor receptor 2 (HER2) positive, unresectable, locally advanced breast cancer (LABC) or metastatic breast cancer (mBC) who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Subjects received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Reporting group title
    Trastuzumab Emtansine (Asian Participants)
    Reporting group description
    This cohort (Cohort 2) enrolled Asian race participants with HER2-positive, unresectable, LABC or mBC who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Participants received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Primary: Percentage of Participants with Adverse Events of Primary Interest (AEPIs)

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    End point title
    Percentage of Participants with Adverse Events of Primary Interest (AEPIs) [1]
    End point description
    The AEPIs in this study were defined as the following: adverse events (AEs) Grade >/= 3, specifically, hepatic events, allergic reactions, thrombocytopenia and hemorrhage events, all Grade >/= 3 AEs related to trastuzumab emtansine and pneumonitis events of all grades. The safety population included all participants who had received at least 1 dose of study medication.
    End point type
    Primary
    End point timeframe
    Baseline up to approximately 7 years
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistical analysis is not applicable to this study.
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2002
    181
    Units: Percentage of Participants
        number (confidence interval 95%)
    23.1 (21.2 to 25.0)
    51.4 (43.9 to 58.9)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Specific AEPIs

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    End point title
    Percentage of Participants with Specific AEPIs
    End point description
    The AEPIs in this study were defined as the following: adverse events (AEs) Grade >/= 3, specifically, hepatic events, allergic reactions, thrombocytopenia and hemorrhage events, all Grade >/= 3 AEs related to trastuzumab emtansine and pneumonitis events of all grades. The safety population included all participants who had received at least 1 dose of study medication.
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 7 years
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2002
    181
    Units: Percentage of Participants
    number (not applicable)
        AEs Grade >/= 3 for hepatic events
    6.9
    12.2
        AEs Grade >/= 3 for allergic reactions
    2.3
    1.1
        AEs Grade >/= 3 for thrombocytopenia
    3.7
    36.5
        AEs Grade >/= 3 for hemorrhage events
    2.3
    1.7
        AEs Grade >/= 3 related to trastuzumab emtansine
    18.4
    48.6
        Pneumonitis of all grades
    1.0
    2.2
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Adverse Events of Special Interest (AESIs)

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    End point title
    Percentage of Participants with Adverse Events of Special Interest (AESIs)
    End point description
    AESIs included: 1) Potential drug-induced liver injury, which included any potential case of drug-induced liver injury as, assessed by laboratory criteria for Hy’s law (AST and/or ALT elevations that were >3 × ULN, Concurrent elevation of total bilirubin >2 × ULN (or clinical jaundice if total bilirubin measures were not available), except in participants with documented Gilbert’s syndrome. Those with Gilbert’s syndrome, elevation of direct bilirubin >2 × ULN was used instead. 2) Suspected transmission of an infectious agent by study drug was defined as any organism, virus, or infectious particle (e.g., prion protein transmitting transmissible spongiform encephalopathy), pathogenic or non-pathogenic. A transmission of an infectious agent suspected from clinical symptoms or laboratory findings indicating an infection in a participant exposed to a medicinal product. The safety population included all participants who had received at least 1 dose of study medication.
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 7 years
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2002
    181
    Units: Percentage of Participants
    number (not applicable)
        Potential drug-induced liver injury
    1.2
    1.1
        Suspected transmission of an infectious agent
    0.2
    0.0
    No statistical analyses for this end point

    Secondary: Progression-Free Survival According to Response Evaluation for Solid Tumors (RECIST) Version (v) 1.1 As Per Investigator Assessment

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    End point title
    Progression-Free Survival According to Response Evaluation for Solid Tumors (RECIST) Version (v) 1.1 As Per Investigator Assessment
    End point description
    Progression free survival is defined as the time (in months) between the date of first dose and the date of disease progression or death from any cause. Progressive disease (PD) is defined as at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters on study (including baseline). In addition to the relative increase of 20%, the sum of diameters must also demonstrate an absolute increase of >/= 5 millimeters (mm). Intent to Treat (ITT) population included all participants enrolled in the study.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death due to any cause, whichever occurs first (assessed every 12 weeks during treatment period thereafter 28-42 days after the last dose or every 3-6 months up to approximately 7 years)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2003
    182
    Units: months
        median (confidence interval 95%)
    6.8 (5.8 to 7.6)
    5.7 (5.5 to 7.0)
    No statistical analyses for this end point

    Secondary: Overall Survival

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    End point title
    Overall Survival
    End point description
    Overall survival is defined as time to death, which is the time from the date of dosing until the date of death, regardless of the cause of death. ITT Population included all participants enrolled in the study. The value of 9999999 means that the CI has no upper limit.
    End point type
    Secondary
    End point timeframe
    Baseline until death (up to approximately 7 years)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2003
    182
    Units: months
        median (confidence interval 95%)
    27.2 (25.5 to 28.7)
    29.5 (21.1 to 9999999)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Best Overall Response (Complete Response [CR] or Partial Response [PR]) According to RECIST v 1.1 As Per Investigator Assessment

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    End point title
    Percentage of Participants with Best Overall Response (Complete Response [CR] or Partial Response [PR]) According to RECIST v 1.1 As Per Investigator Assessment
    End point description
    Best Overall Response reported here is the Best confirmed Overall Response. To be assigned a status of PR or CR, i.e., to be a responder, changes in tumor measurements had to be confirmed by repeat assessments that had to be performed no less than 4 weeks after the criteria for response were first met, i.e., subjects needed to have two consecutive assessments of PR or CR. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. ITT population included all participants enrolled in the study. Only participants with measurable disease were included in the analysis.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death due to any cause, whichever occurs first (assessed every 12 weeks during treatment period thereafter 28-42 days after the last dose or every 3-6 months up to approximately 7 years)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    1613
    169
    Units: Percentage of Participants
        number (confidence interval 95%)
    29.3 (27.1 to 31.6)
    29.6 (22.8 to 37.1)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Clinical Benefit (CR or PR or Stable Disease [SD]) According to RECIST v 1.1

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    End point title
    Percentage of Participants with Clinical Benefit (CR or PR or Stable Disease [SD]) According to RECIST v 1.1
    End point description
    Clinical Benefit was defined as CR plus PR plus SD. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. SD: neither sufficient shrinkage to qualify for CR or PR nor sufficient increase to qualify for PD. ITT population included all participants enrolled in the study. Only participants with measurable disease were included in the analysis.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death due to any cause, whichever occurs first (assessed every 12 weeks during treatment period thereafter 28-42 days after the last dose or every 3-6 months up to approximately 47 months)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    1613
    169
    Units: Percentage of Participants
        number (confidence interval 95%)
    47.1 (44.7 to 49.6)
    39.6 (32.2 to 47.4)
    No statistical analyses for this end point

    Secondary: Duration of Response (DOR) According to RECIST v 1.1

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    End point title
    Duration of Response (DOR) According to RECIST v 1.1
    End point description
    DOR is defined as the period from the date of initial confirmed PR or CR (whichever occurs first) until the date of PD or death from any cause. CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. PD: at least a 20% increase in the sum of diameters of target lesions, taking as reference the smallest sum of diameters on study (including baseline). In addition to the relative increase of 20%, the sum of diameters must also demonstrate an absolute increase of >/= 5 millimeters (mm). ITT population included all participants enrolled in the study. Only participants with measurable disease were included in the analysis.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death due to any cause, whichever occurs first (assessed every 12 weeks during treatment period thereafter 28-42 days after the last dose or every 3-6 months up to approximately 47 months)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    1613
    169
    Units: months
        median (confidence interval 95%)
    13.8 (12.2 to 15.0)
    14.2 (11.1 to 24.4)
    No statistical analyses for this end point

    Secondary: Time to Response According to RECIST v 1.1

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    End point title
    Time to Response According to RECIST v 1.1
    End point description
    Time to Response is defined as the time from first dose to first documentation of confirmed PR or CR (whichever occurs first). CR: disappearance of all target lesions. PR: At least a 30% decrease in the sum of diameters of all target lesions, taking as reference the baseline sum of diameters, in the absence of CR. ITT population included all participants enrolled in the study. Only responders were included in the analysis. The value of 9999999 means that the CI has no upper limit.
    End point type
    Secondary
    End point timeframe
    Baseline up to disease progression or death due to any cause, whichever occurs first (assessed every 12 weeks during treatment period thereafter 28-42 days after the last dose or every 3-6 months up to approximately 47 months)
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    473
    50
    Units: months
        median (confidence interval 95%)
    22.3 (11.8 to 38.2)
    8.3 (5.7 to 9999999)
    No statistical analyses for this end point

    Secondary: Number of Hospital Visits

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    End point title
    Number of Hospital Visits
    End point description
    The number of hospital visits were recorded to evaluate the resoruce expenditures while participants were on study treatment.
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 7 years
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2002
    181
    Units: Number of Hospital Visits
        arithmetic mean (standard deviation)
    2.7 ( 2.78 )
    2.1 ( 1.70 )
    No statistical analyses for this end point

    Secondary: Type of Hospital Visits

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    End point title
    Type of Hospital Visits
    End point description
    The type of hospital visits (intensive care unit (ICU) versus other) were recorded to evaluate the resoruce expenditures while participants were on study treatment. The number of participants with at least one ICU visit are based on the number of participants with at least one hospital visit, in each group.
    End point type
    Secondary
    End point timeframe
    Baseline up to approximately 7 years
    End point values
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Number of subjects analysed
    2002
    181
    Units: Participants
    number (not applicable)
        Other Hospital Visit
    558
    33
        ICU Visit
    39
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline up to approximately 7 years
    Adverse event reporting additional description
    The analysis of AEs focused on treatment-emergent AEs (TEAEs) which were AEs that occurred on the day of or after first administration of study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.1
    Reporting groups
    Reporting group title
    Trastuzumab Emtansine (All Participants)
    Reporting group description
    This cohort (Cohort 1) enrolled all participants with HER2 positive, unresectable, LABC or mBC who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Participants received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Reporting group title
    Trastuzumab Emtansine (Asian Participants)
    Reporting group description
    This cohort (Cohort 2) enrolled Asian race participants with HER2-positive, unresectable, LABC or mBC who had received prior anti-HER2 and chemotherapy treatment and had progressed on or after the most recent treatment for LABC or mBC, or within 6 months of completing adjuvant therapy. Participants received trastuzumab emtansine every 3 weeks until unacceptable toxicity, withdrawal of consent, or disease progression.

    Serious adverse events
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    427 / 2002 (21.33%)
    36 / 181 (19.89%)
         number of deaths (all causes)
    1072
    77
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    BASAL CELL CARCINOMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BENIGN NEOPLASM
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BREAST CANCER METASTATIC
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CANCER PAIN
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MALIGNANT MELANOMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MENINGIOMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    METASTASES TO BONE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    METASTATIC UTERINE CANCER
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    NAEVUS HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SARCOMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SKIN NEOPLASM BLEEDING
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    CIRCULATORY COLLAPSE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    EMBOLISM
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    HAEMATOMA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPOTENSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ORTHOSTATIC HYPOTENSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VENA CAVA THROMBOSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VENOUS THROMBOSIS LIMB
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    BREAST CONSERVING SURGERY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SCAR EXCISION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    ASTHENIA
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CATHETER SITE ERYTHEMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CHILLS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEATH
         subjects affected / exposed
    5 / 2002 (0.25%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 5
    0 / 0
    FATIGUE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GENERAL PHYSICAL HEALTH DETERIORATION
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    3 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPERTHERMIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    IMPLANT SITE DEHISCENCE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INFLAMMATION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MALAISE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MULTIPLE ORGAN DYSFUNCTION SYNDROME
         subjects affected / exposed
    3 / 2002 (0.15%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    PYREXIA
         subjects affected / exposed
    13 / 2002 (0.65%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    30 / 42
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SUDDEN DEATH
         subjects affected / exposed
    0 / 2002 (0.00%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Immune system disorders
    ALLERGIC OEDEMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPERSENSITIVITY
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    CYSTOCELE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    METRORRHAGIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    UTERINE HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    UTERINE POLYP
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VAGINAL HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    ACUTE PULMONARY OEDEMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ASPIRATION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ASTHMATIC CRISIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CHOKING
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    DYSPNOEA
         subjects affected / exposed
    7 / 2002 (0.35%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 24
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    EPISTAXIS
         subjects affected / exposed
    7 / 2002 (0.35%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    3 / 8
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HAEMOPTYSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INTERSTITIAL LUNG DISEASE
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    3 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    PLEURAL EFFUSION
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PLEURITIC PAIN
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PNEUMONITIS
         subjects affected / exposed
    6 / 2002 (0.30%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    PNEUMOTHORAX
         subjects affected / exposed
    5 / 2002 (0.25%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PULMONARY ALVEOLAR HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PULMONARY EMBOLISM
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    PULMONARY FIBROSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    PULMONARY OEDEMA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RESPIRATORY DISTRESS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    RESPIRATORY FAILURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    RESPIRATORY TRACT HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SLEEP APNOEA SYNDROME
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    AGITATION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COMPLETED SUICIDE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    CONFUSIONAL STATE
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEPRESSION
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HALLUCINATION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    DEVICE BREAKAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEVICE EXTRUSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEVICE LOOSENING
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    ALANINE AMINOTRANSFERASE INCREASED
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    AMYLASE INCREASED
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ASPARTATE AMINOTRANSFERASE INCREASED
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BLOOD BILIRUBIN INCREASED
         subjects affected / exposed
    2 / 2002 (0.10%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ECG SIGNS OF MYOCARDIAL ISCHAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GAMMA-GLUTAMYLTRANSFERASE INCREASED
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HEPATIC ENZYME INCREASED
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LIVER FUNCTION TEST ABNORMAL
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LIVER FUNCTION TEST INCREASED
         subjects affected / exposed
    0 / 2002 (0.00%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NEUTROPHIL COUNT DECREASED
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PLATELET COUNT DECREASED
         subjects affected / exposed
    2 / 2002 (0.10%)
    8 / 181 (4.42%)
         occurrences causally related to treatment / all
    2 / 2
    12 / 12
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TRANSAMINASES INCREASED
         subjects affected / exposed
    0 / 2002 (0.00%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    ANASTOMOTIC ULCER
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ANKLE FRACTURE
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FALL
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FEMORAL NECK FRACTURE
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FEMUR FRACTURE
         subjects affected / exposed
    8 / 2002 (0.40%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FOREARM FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HAND FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HEAD INJURY
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HIP FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HUMERUS FRACTURE
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INFUSION RELATED REACTION
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INTENTIONAL OVERDOSE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LUMBAR VERTEBRAL FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PELVIC FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    POST PROCEDURAL HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RADIATION NECROSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    RIB FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ROAD TRAFFIC ACCIDENT
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    SKELETAL INJURY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SPLENIC INJURY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    THERMAL BURN
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    UPPER LIMB FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    WRIST FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    ACUTE CORONARY SYNDROME
         subjects affected / exposed
    3 / 2002 (0.15%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    1 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ANGINA PECTORIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CARDIAC ARREST
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    CARDIAC FAILURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CARDIAC TAMPONADE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    CARDIO-RESPIRATORY ARREST
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    PALPITATIONS
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PERICARDIAL EFFUSION
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SUPRAVENTRICULAR TACHYCARDIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    APHASIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ATAXIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BRAIN OEDEMA
         subjects affected / exposed
    6 / 2002 (0.30%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 7
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    CENTRAL NERVOUS SYSTEM NECROSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CEREBRAL HAEMORRHAGE
         subjects affected / exposed
    4 / 2002 (0.20%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    4 / 8
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CEREBRAL ISCHAEMIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CEREBROVASCULAR ACCIDENT
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DIZZINESS
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    EPILEPSY
         subjects affected / exposed
    8 / 2002 (0.40%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 15
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HAEMORRHAGE INTRACRANIAL
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    HAEMORRHAGIC STROKE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HEADACHE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HEMIPARESIS
         subjects affected / exposed
    5 / 2002 (0.25%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    IIIRD NERVE PARESIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LEUKOENCEPHALOPATHY
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MIGRAINE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MOTOR DYSFUNCTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NERVOUS SYSTEM DISORDER
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PARTIAL SEIZURES
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PRESYNCOPE
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SCIATICA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SEIZURE
         subjects affected / exposed
    7 / 2002 (0.35%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 11
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TRANSIENT ISCHAEMIC ATTACK
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VOCAL CORD PARALYSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    ANAEMIA
         subjects affected / exposed
    13 / 2002 (0.65%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    8 / 14
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BONE MARROW FAILURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DISSEMINATED INTRAVASCULAR COAGULATION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FEBRILE NEUTROPENIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    THROMBOCYTOPENIA
         subjects affected / exposed
    11 / 2002 (0.55%)
    10 / 181 (5.52%)
         occurrences causally related to treatment / all
    11 / 11
    11 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    VERTIGO
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    BLINDNESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CATARACT
         subjects affected / exposed
    0 / 2002 (0.00%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RETINAL VEIN THROMBOSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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 DISTENSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ABDOMINAL PAIN
         subjects affected / exposed
    4 / 2002 (0.20%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    2 / 12
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ABDOMINAL PAIN UPPER
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ANAL FISSURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ASCITES
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    3 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COLITIS
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CONSTIPATION
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DIARRHOEA
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DUODENAL ULCER
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DUODENAL ULCER HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DYSPHAGIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRIC ANTRAL VASCULAR ECTASIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRIC HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRIC ULCER
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRITIS
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRITIS EROSIVE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRODUODENAL ULCER
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTROINTESTINAL HAEMORRHAGE
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GINGIVAL BLEEDING
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GLOSSITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LOWER GASTROINTESTINAL HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MELAENA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 8
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NAUSEA
         subjects affected / exposed
    5 / 2002 (0.25%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    5 / 6
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    OESOPHAGEAL FISTULA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    OESOPHAGEAL VARICES HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PANCREATITIS ACUTE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PERIODONTAL DISEASE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PROCTALGIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RECTAL HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SMALL INTESTINAL HAEMORRHAGE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SMALL INTESTINAL OBSTRUCTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    STOMATITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SUBILEUS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TOOTH LOSS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    3 / 2002 (0.15%)
    2 / 181 (1.10%)
         occurrences causally related to treatment / all
    2 / 6
    4 / 6
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    VOMITING
         subjects affected / exposed
    17 / 2002 (0.85%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    10 / 19
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    CHOLECYSTITIS
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CHOLESTASIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DRUG-INDUCED LIVER INJURY
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    3 / 3
    3 / 3
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    HEPATIC FAILURE
         subjects affected / exposed
    5 / 2002 (0.25%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 6
    0 / 0
    HEPATIC FUNCTION ABNORMAL
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    HEPATIC PAIN
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HEPATOTOXICITY
         subjects affected / exposed
    7 / 2002 (0.35%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    10 / 14
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    JAUNDICE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NODULAR REGENERATIVE HYPERPLASIA
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NON-CIRRHOTIC PORTAL HYPERTENSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PORTAL HYPERTENSION
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    SPIDER NAEVUS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    ACUTE KIDNEY INJURY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    HAEMATURIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    4 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    NEPHROLITHIASIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RENAL COLIC
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RENAL FAILURE
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    RENAL INJURY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    URINARY TRACT OBSTRUCTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endocrine disorders
    ADRENAL INSUFFICIENCY
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPERTHYROIDISM
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    ARTHRALGIA
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BACK PAIN
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BONE LESION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BONE PAIN
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HAEMATOMA MUSCLE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INTERVERTEBRAL DISC PROTRUSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    KYPHOSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MOBILITY DECREASED
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MUSCULAR WEAKNESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MUSCULOSKELETAL CHEST PAIN
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    OSTEONECROSIS OF JAW
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PAIN IN EXTREMITY
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PATHOLOGICAL FRACTURE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SPINAL PAIN
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SYSTEMIC LUPUS ERYTHEMATOSUS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    ABSCESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ACINETOBACTER INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ARTHRITIS INFECTIVE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BACTERAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BACTERIAL INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BACTERIAL SEPSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BRAIN ABSCESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    BREAST CELLULITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (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
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CATHETER SITE INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    8 / 2002 (0.40%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CLOSTRIDIUM DIFFICILE COLITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CYSTITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DENGUE HAEMORRHAGIC FEVER
         subjects affected / exposed
    0 / 2002 (0.00%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEVICE RELATED INFECTION
         subjects affected / exposed
    6 / 2002 (0.30%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ENCEPHALITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ENDOCARDITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ERYSIPELAS
         subjects affected / exposed
    4 / 2002 (0.20%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTROENTERITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTROENTERITIS NOROVIRUS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTROINTESTINAL VIRAL INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HERPES ZOSTER
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (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
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INFECTIOUS PLEURAL EFFUSION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    INFECTIVE EXACERBATION OF BRONCHIECTASIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INTERVERTEBRAL DISCITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    KLEBSIELLA BACTERAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LISTERIOSIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    LIVER ABSCESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
         subjects affected / exposed
    9 / 2002 (0.45%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 10
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MASTITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    MENINGITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    OTITIS MEDIA
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PERITONITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    PHARYNGITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PNEUMOCOCCAL INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PNEUMONIA
         subjects affected / exposed
    22 / 2002 (1.10%)
    8 / 181 (4.42%)
         occurrences causally related to treatment / all
    2 / 23
    3 / 8
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    PNEUMONIA STREPTOCOCCAL
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PNEUMONIA VIRAL
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PYELONEPHRITIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PYELONEPHRITIS ACUTE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PYELONEPHRITIS CHRONIC
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    RESPIRATORY TRACT INFECTION VIRAL
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    9 / 2002 (0.45%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 9
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    SEPTIC SHOCK
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SKIN INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SOFT TISSUE INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    STAPHYLOCOCCAL BACTERAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    STAPHYLOCOCCAL INFECTION
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    STAPHYLOCOCCAL SEPSIS
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    STREPTOCOCCAL INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TRACHEOBRONCHITIS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    URINARY TRACT INFECTION
         subjects affected / exposed
    11 / 2002 (0.55%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    1 / 12
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VASCULAR DEVICE INFECTION
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VIRAL INFECTION
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    VULVAL ABSCESS
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (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
    DECREASED APPETITE
         subjects affected / exposed
    2 / 2002 (0.10%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DEHYDRATION
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    FAILURE TO THRIVE
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    HYPERCALCAEMIA
         subjects affected / exposed
    3 / 2002 (0.15%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPERURICAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPOGLYCAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPOKALAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    1 / 181 (0.55%)
         occurrences causally related to treatment / all
    0 / 1
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HYPONATRAEMIA
         subjects affected / exposed
    1 / 2002 (0.05%)
    0 / 181 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    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
    Trastuzumab Emtansine (All Participants) Trastuzumab Emtansine (Asian Participants)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    1734 / 2002 (86.61%)
    170 / 181 (93.92%)
    Investigations
    ALANINE AMINOTRANSFERASE INCREASED
         subjects affected / exposed
    86 / 2002 (4.30%)
    58 / 181 (32.04%)
         occurrences all number
    100
    133
    ASPARTATE AMINOTRANSFERASE INCREASED
         subjects affected / exposed
    136 / 2002 (6.79%)
    77 / 181 (42.54%)
         occurrences all number
    156
    143
    BLOOD ALKALINE PHOSPHATASE INCREASED
         subjects affected / exposed
    52 / 2002 (2.60%)
    14 / 181 (7.73%)
         occurrences all number
    52
    16
    BLOOD BILIRUBIN INCREASED
         subjects affected / exposed
    89 / 2002 (4.45%)
    30 / 181 (16.57%)
         occurrences all number
    171
    85
    GAMMA-GLUTAMYLTRANSFERASE INCREASED
         subjects affected / exposed
    84 / 2002 (4.20%)
    21 / 181 (11.60%)
         occurrences all number
    94
    31
    NEUTROPHIL COUNT DECREASED
         subjects affected / exposed
    36 / 2002 (1.80%)
    20 / 181 (11.05%)
         occurrences all number
    58
    84
    PLATELET COUNT DECREASED
         subjects affected / exposed
    91 / 2002 (4.55%)
    55 / 181 (30.39%)
         occurrences all number
    124
    191
    TRANSAMINASES INCREASED
         subjects affected / exposed
    27 / 2002 (1.35%)
    18 / 181 (9.94%)
         occurrences all number
    28
    39
    WEIGHT DECREASED
         subjects affected / exposed
    106 / 2002 (5.29%)
    8 / 181 (4.42%)
         occurrences all number
    109
    8
    WHITE BLOOD CELL COUNT DECREASED
         subjects affected / exposed
    11 / 2002 (0.55%)
    20 / 181 (11.05%)
         occurrences all number
    13
    85
    Vascular disorders
    HYPERTENSION
         subjects affected / exposed
    96 / 2002 (4.80%)
    12 / 181 (6.63%)
         occurrences all number
    113
    17
    Nervous system disorders
    DIZZINESS
         subjects affected / exposed
    117 / 2002 (5.84%)
    11 / 181 (6.08%)
         occurrences all number
    137
    17
    HEADACHE
         subjects affected / exposed
    454 / 2002 (22.68%)
    19 / 181 (10.50%)
         occurrences all number
    650
    32
    PARAESTHESIA
         subjects affected / exposed
    128 / 2002 (6.39%)
    4 / 181 (2.21%)
         occurrences all number
    139
    5
    PERIPHERAL SENSORY NEUROPATHY
         subjects affected / exposed
    113 / 2002 (5.64%)
    0 / 181 (0.00%)
         occurrences all number
    132
    0
    Blood and lymphatic system disorders
    ANAEMIA
         subjects affected / exposed
    173 / 2002 (8.64%)
    27 / 181 (14.92%)
         occurrences all number
    231
    49
    LEUKOPENIA
         subjects affected / exposed
    19 / 2002 (0.95%)
    15 / 181 (8.29%)
         occurrences all number
    23
    69
    NEUTROPENIA
         subjects affected / exposed
    79 / 2002 (3.95%)
    17 / 181 (9.39%)
         occurrences all number
    151
    72
    THROMBOCYTOPENIA
         subjects affected / exposed
    165 / 2002 (8.24%)
    47 / 181 (25.97%)
         occurrences all number
    257
    157
    General disorders and administration site conditions
    ASTHENIA
         subjects affected / exposed
    491 / 2002 (24.53%)
    18 / 181 (9.94%)
         occurrences all number
    828
    44
    FATIGUE
         subjects affected / exposed
    556 / 2002 (27.77%)
    12 / 181 (6.63%)
         occurrences all number
    846
    17
    INFLUENZA LIKE ILLNESS
         subjects affected / exposed
    107 / 2002 (5.34%)
    3 / 181 (1.66%)
         occurrences all number
    161
    3
    OEDEMA PERIPHERAL
         subjects affected / exposed
    102 / 2002 (5.09%)
    6 / 181 (3.31%)
         occurrences all number
    115
    10
    PAIN
         subjects affected / exposed
    85 / 2002 (4.25%)
    10 / 181 (5.52%)
         occurrences all number
    92
    11
    PYREXIA
         subjects affected / exposed
    339 / 2002 (16.93%)
    47 / 181 (25.97%)
         occurrences all number
    1599
    243
    Gastrointestinal disorders
    ABDOMINAL PAIN
         subjects affected / exposed
    139 / 2002 (6.94%)
    6 / 181 (3.31%)
         occurrences all number
    182
    8
    ABDOMINAL PAIN UPPER
         subjects affected / exposed
    135 / 2002 (6.74%)
    5 / 181 (2.76%)
         occurrences all number
    163
    5
    CONSTIPATION
         subjects affected / exposed
    394 / 2002 (19.68%)
    10 / 181 (5.52%)
         occurrences all number
    568
    38
    DIARRHOEA
         subjects affected / exposed
    252 / 2002 (12.59%)
    9 / 181 (4.97%)
         occurrences all number
    376
    9
    DRY MOUTH
         subjects affected / exposed
    283 / 2002 (14.14%)
    7 / 181 (3.87%)
         occurrences all number
    303
    13
    GINGIVAL BLEEDING
         subjects affected / exposed
    83 / 2002 (4.15%)
    14 / 181 (7.73%)
         occurrences all number
    96
    19
    NAUSEA
         subjects affected / exposed
    651 / 2002 (32.52%)
    28 / 181 (15.47%)
         occurrences all number
    1204
    45
    STOMATITIS
         subjects affected / exposed
    160 / 2002 (7.99%)
    4 / 181 (2.21%)
         occurrences all number
    213
    6
    VOMITING
         subjects affected / exposed
    294 / 2002 (14.69%)
    17 / 181 (9.39%)
         occurrences all number
    408
    24
    Respiratory, thoracic and mediastinal disorders
    COUGH
         subjects affected / exposed
    220 / 2002 (10.99%)
    23 / 181 (12.71%)
         occurrences all number
    256
    28
    DYSPNOEA
         subjects affected / exposed
    211 / 2002 (10.54%)
    2 / 181 (1.10%)
         occurrences all number
    705
    6
    EPISTAXIS
         subjects affected / exposed
    402 / 2002 (20.08%)
    30 / 181 (16.57%)
         occurrences all number
    669
    43
    Psychiatric disorders
    INSOMNIA
         subjects affected / exposed
    118 / 2002 (5.89%)
    11 / 181 (6.08%)
         occurrences all number
    134
    13
    Musculoskeletal and connective tissue disorders
    ARTHRALGIA
         subjects affected / exposed
    265 / 2002 (13.24%)
    6 / 181 (3.31%)
         occurrences all number
    349
    7
    BACK PAIN
         subjects affected / exposed
    199 / 2002 (9.94%)
    5 / 181 (2.76%)
         occurrences all number
    226
    5
    MUSCLE SPASMS
         subjects affected / exposed
    124 / 2002 (6.19%)
    1 / 181 (0.55%)
         occurrences all number
    154
    1
    MUSCULOSKELETAL PAIN
         subjects affected / exposed
    135 / 2002 (6.74%)
    3 / 181 (1.66%)
         occurrences all number
    150
    3
    MYALGIA
         subjects affected / exposed
    205 / 2002 (10.24%)
    8 / 181 (4.42%)
         occurrences all number
    279
    11
    PAIN IN EXTREMITY
         subjects affected / exposed
    148 / 2002 (7.39%)
    3 / 181 (1.66%)
         occurrences all number
    169
    3
    Infections and infestations
    NASOPHARYNGITIS
         subjects affected / exposed
    136 / 2002 (6.79%)
    8 / 181 (4.42%)
         occurrences all number
    195
    13
    UPPER RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    80 / 2002 (4.00%)
    14 / 181 (7.73%)
         occurrences all number
    107
    18
    URINARY TRACT INFECTION
         subjects affected / exposed
    157 / 2002 (7.84%)
    4 / 181 (2.21%)
         occurrences all number
    230
    4
    Metabolism and nutrition disorders
    DECREASED APPETITE
         subjects affected / exposed
    320 / 2002 (15.98%)
    16 / 181 (8.84%)
         occurrences all number
    398
    23
    HYPOALBUMINAEMIA
         subjects affected / exposed
    13 / 2002 (0.65%)
    11 / 181 (6.08%)
         occurrences all number
    13
    14
    HYPOKALAEMIA
         subjects affected / exposed
    73 / 2002 (3.65%)
    19 / 181 (10.50%)
         occurrences all number
    91
    37

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    21 Aug 2012
    This amendment included treatment discontinuation in participants who were diagnosed with pneumonitis; clarification that prospective HER2 analysis was not needed and that results from earlier immunohistochemistry/in-situ hybridization (IHC/ISH) assessments were acceptable; the Eastern Cooperative Oncology Group (ECOG) performance status table in Appendix 4 was amended to include Grade 0 and scale wording for grade 4 status.
    11 Feb 2013
    The reasons for this amendment include adjusting the target population definition to provide further clarification to investigators; inclusion criteria number 17 was updated to provide further clarification to investigator of the trastuzumab emtansine components and prevent possible participant hypersensitivity reaction; inclusion of the OS results of the Phase III Study TDM4370g (EMILIA); a subgroup analysis of >75 versus <= 75 years of age was added to be in line with other studies and Health Authority guidance; Safety data review by the independent Data Monitoring Committee (iDMC) after enrollment of approximately 50 participants was an interim safety analysis.
    20 May 2013
    In this amendment, the sample size was increased from 1000 to 2000 participants to further understand the trastuzumab emtansine safety profile.
    29 Jan 2014
    This amendment presented the inclusion of an additional cohort (Cohort 2) to further explore the higher incidence of thrombocytopenia in the Asian population. This cohort only recruited participants of Asian race.
    18 Jul 2019
    This protocol amendment included a clarification about post-trial access to the extension study; clarifications regarding traditional Chinese medicines was added; language was updated to reflect the revised pregnancy and post-study AE reporting.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    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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