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    Clinical Trial Results:
    AN OPEN-LABEL STUDY OF DUPILUMAB IN PATIENTS WITH ATOPIC DERMATITIS WHO PARTICIPATED IN PREVIOUS DUPILUMAB CLINICAL TRIALS

    Summary
    EudraCT number
    2013-001449-15
    Trial protocol
    CZ   HU   DE   PL   SE   LT   EE   DK   FI   ES   IT   NL   AT   BE   SK  
    Global end of trial date
    27 Jun 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    12 Jul 2023
    First version publication date
    12 Jul 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    R668-AD-1225
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Regeneron
    Sponsor organisation address
    777 Old Saw Mill River Road, Tarrytown, United States, 10591
    Public contact
    Clinical Trials Administrator, Regeneron Pharmaceuticals, Inc., 001 8447346643, clinicaltrials@regeneron.com
    Scientific contact
    Clinical Trials Administrator, Regeneron Pharmaceuticals, Inc., 9144093597 18447346643, donell.carey@regeneron.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
    27 Jun 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Jun 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to assess the long-term safety of dupilumab administered in adult patients with atopic dermatitis (AD).
    Protection of trial subjects
    This study was conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki and that are consistent with the International Council for Harmonisation (ICH) guidelines for Good Clinical Practice (GCP) and applicable regulatory requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    10 Oct 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 752
    Country: Number of subjects enrolled
    Australia: 39
    Country: Number of subjects enrolled
    Austria: 7
    Country: Number of subjects enrolled
    Belgium: 11
    Country: Number of subjects enrolled
    Canada: 295
    Country: Number of subjects enrolled
    Czechia: 43
    Country: Number of subjects enrolled
    Denmark: 15
    Country: Number of subjects enrolled
    Estonia: 49
    Country: Number of subjects enrolled
    Finland: 6
    Country: Number of subjects enrolled
    France: 35
    Country: Number of subjects enrolled
    Germany: 431
    Country: Number of subjects enrolled
    Hong Kong: 6
    Country: Number of subjects enrolled
    Hungary: 37
    Country: Number of subjects enrolled
    Ireland: 3
    Country: Number of subjects enrolled
    Italy: 35
    Country: Number of subjects enrolled
    Japan: 246
    Country: Number of subjects enrolled
    Lithuania: 16
    Country: Number of subjects enrolled
    Netherlands: 50
    Country: Number of subjects enrolled
    New Zealand: 6
    Country: Number of subjects enrolled
    Poland: 344
    Country: Number of subjects enrolled
    Romania: 1
    Country: Number of subjects enrolled
    Russian Federation: 15
    Country: Number of subjects enrolled
    Singapore: 10
    Country: Number of subjects enrolled
    Slovakia: 3
    Country: Number of subjects enrolled
    Spain: 48
    Country: Number of subjects enrolled
    United Kingdom: 66
    Country: Number of subjects enrolled
    Korea, Democratic People's Republic of: 96
    Country: Number of subjects enrolled
    Bulgaria: 12
    Worldwide total number of subjects
    2677
    EEA total number of subjects
    1146
    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)
    2568
    From 65 to 84 years
    106
    85 years and over
    3

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    1297 participants completed the study and1380 participants withdrawn. Withdrawal from study included study terminated by the Sponsor (708), and withdrawal by the participant (375), Adverse Event (107), Lost to Follow-Up (73), Lack of Efficacy (50), Protocol Deviation (34), Pregnancy (20), Physician Decision (9), and reasons not specified (4)

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

    Arms
    Arm title
    Dupilumab
    Arm description
    Participants received repeated doses of dupilumab
    Arm type
    Experimental

    Investigational medicinal product name
    Dupilumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    200 mg QW, 300 mg QW, or 300 mg Q2W

    Number of subjects in period 1
    Dupilumab
    Started
    2677
    Completed
    1297
    Not completed
    1380
         Terminated by Sponsor
    708
         Consent withdrawn by subject
    375
         Physician decision
    9
         Protocol Deviation
    34
         Adverse event, non-fatal
    107
         Pregnancy
    20
         Unknown
    4
         Lost to follow-up
    73
         Lack of efficacy
    50

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Dupilumab
    Reporting group description
    Participants received repeated doses of dupilumab

    Reporting group values
    Dupilumab Total
    Number of subjects
    2677 2677
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    2569 2569
        From 65-84 years
    106 106
        85 years and over
    2 2
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    39.2 ( 13.42 ) -
    Sex: Female, Male
    Units: Participants
        Female
    1066 1066
        Male
    1611 1611
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    94 94
        Not Hispanic or Latino
    2532 2532
        Unknown or Not Reported
    51 51
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    541 541
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    147 147
        White
    1936 1936
        More than one race
    33 33
        Unknown or Not Reported
    20 20

    End points

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    End points reporting groups
    Reporting group title
    Dupilumab
    Reporting group description
    Participants received repeated doses of dupilumab

    Primary: OPTIONAL SUB-STUDY: Number of Adverse Events of Special Interest (AESIs) through the last study visit after switching to the new dupilumab drug product

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    End point title
    OPTIONAL SUB-STUDY: Number of Adverse Events of Special Interest (AESIs) through the last study visit after switching to the new dupilumab drug product [1]
    End point description
    Adverse events of special interest in this study include: Anaphylactic reactions, Systemic hypersensitivity reactions, Helminthic infections, Any severe type of conjunctivitis or blepharitis, Keratitis, Clinically symptomatic eosinophilia (or eosinophilia associated with clinical symptoms)
    End point type
    Primary
    End point timeframe
    Up to 24 Weeks
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive data was reported for this endpoint
    End point values
    Dupilumab
    Number of subjects analysed
    50
    Units: Events
    0
    No statistical analyses for this end point

    Primary: Number of Treatment Emergent Adverse Events (TEAEs)

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    End point title
    Number of Treatment Emergent Adverse Events (TEAEs) [2]
    End point description
    End point type
    Primary
    End point timeframe
    Up to 272 weeks
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive data was reported for this endpoint
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Number of Events
    14717
    No statistical analyses for this end point

    Secondary: Percentage of participants with Investigator's Global Assessment (IGA) score = 0-1 at each visit

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    End point title
    Percentage of participants with Investigator's Global Assessment (IGA) score = 0-1 at each visit
    End point description
    IGA is an assessment scale used to determine severity of hand and foot AD and clinical response to treatment on a 5-point scale (0 = clear; 1 = almost clear; 2 = mild; 3 = moderate; 4 = severe) based on erythema and papulation/infiltration.
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Baseline of study
    12.0
        Week 4
    31.1
        Week 16
    46.7
        Week 36
    46.2
        Week 52
    53.8
        Week 100
    58.2
        Week 124
    59.6
        Week 156
    67.2
        Week 172
    71.1
        Week 188
    56.5
        Week 204
    64.4
        Week 220
    81.2
        Week 236
    50.0
        End of Study (Extension)
    67.5
    No statistical analyses for this end point

    Secondary: Rate of AESIs

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    End point title
    Rate of AESIs
    End point description
    Rate (events per patient-year) of AESIs Adverse events of special interest in this study include: Anaphylactic reactions, Systemic hypersensitivity reactions, Helminthic infections, Any severe type of conjunctivitis or blepharitis, Keratitis, Clinically symptomatic eosinophilia (or eosinophilia associated with clinical symptoms)
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Events per Patient-Year
        number (not applicable)
    2.762
    No statistical analyses for this end point

    Secondary: Number of AESIs

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    End point title
    Number of AESIs
    End point description
    Adverse events of special interest in this study include: Anaphylactic reactions, Systemic hypersensitivity reactions, Helminthic infections, Any severe type of conjunctivitis or blepharitis, Keratitis, Clinically symptomatic eosinophilia (or eosinophilia associated with clinical symptoms)
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Events
    161
    No statistical analyses for this end point

    Secondary: Number of Serious Adverse Events (SAEs) of special interest

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    End point title
    Number of Serious Adverse Events (SAEs) of special interest
    End point description
    Adverse events of special interest in this study include: Anaphylactic reactions, Systemic hypersensitivity reactions, Helminthic infections, Any severe type of conjunctivitis or blepharitis, Keratitis, Clinically symptomatic eosinophilia (or eosinophilia associated with clinical symptoms)
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Events
    9
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Eczema Area and Severity Index (EASI)-75 (≥75% reduction in EASI scores from baseline of the parent study) at each visit

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    End point title
    Percentage of Participants with Eczema Area and Severity Index (EASI)-75 (≥75% reduction in EASI scores from baseline of the parent study) at each visit
    End point description
    The EASI score was used to measure the severity and extent of atopic dermatitis (AD) and measures erythema, induration, excoriation and lichenification on 4 anatomic regions of the body: head, trunk, upper and lower extremities. The total EASI score ranges from 0 (minimum) to 72 (maximum) points, with the higher scores reflecting the worse severity of AD.
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Baseline of study
    33.4
        Week 4
    65.3
        Week 16
    82.0
        Week 36
    85.3
        Week 52
    88.8
        Week 100
    91.4
        Week 124
    92.0
        Week 156
    89.5
        Week 172
    94.1
        Week 188
    96.8
        Week 204
    90.9
        Week 220
    93.5
        Week 236
    100
        End of Study (Extension)
    88.9
    No statistical analyses for this end point

    Secondary: Percentage of participants with low disease activity state (eg, IGA ≤2) at each visit

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    End point title
    Percentage of participants with low disease activity state (eg, IGA ≤2) at each visit
    End point description
    Low disease activity state is defined as an IGA score of ≤2 [mild = 2, almost clear = 1, or clear = 0]
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Baseline of study
    34.7
        Week 4
    70.0
        Week 16
    83.0
        Week 36
    84.6
        Week 52
    89.6
        Week 100
    90.9
        Week 124
    93.1
        Week 156
    94.8
        Week 172
    96.3
        Week 188
    96.8
        Week 204
    96.0
        Week 220
    97.1
        Week 236
    90.0
        End of Study (Extension)
    92.6
    No statistical analyses for this end point

    Secondary: Change from baseline in EASI score at each visit

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    End point title
    Change from baseline in EASI score at each visit
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Week 4
    -8.59 ( 10.196 )
        Week 16
    -11.89 ( 12.583 )
        Week 36
    -17.32 ( 13.989 )
        Week 52
    -16.46 ( 13.719 )
        Week 100
    -17.99 ( 14.049 )
        Week 124
    -17.68 ( 13.794 )
        Week 156
    -14.23 ( 14.358 )
        Week 172
    -13.23 ( 13.651 )
        Week 188
    -19.24 ( 11.253 )
        Week 204
    -14.50 ( 15.615 )
        Week 220
    -12.75 ( 14.444 )
        Week 236
    -16.69 ( 9.743 )
        End of Study (Extension)
    -13.14 ( 14.614 )
    No statistical analyses for this end point

    Secondary: Percent change from baseline in EASI score at each visit

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    End point title
    Percent change from baseline in EASI score at each visit
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Week 4
    -42.02 ( 88.963 )
        Week 16
    -54.82 ( 316.630 )
        Week 36
    -60.40 ( 603.886 )
        Week 52
    -75.76 ( 73.014 )
        Week 100
    -82.61 ( 29.534 )
        Week 124
    -84.15 ( 27.737 )
        Week 156
    -83.45 ( 32.410 )
        Week 172
    -74.98 ( 78.138 )
        Week 188
    -88.72 ( 15.122 )
        Week 204
    -70.91 ( 74.941 )
        Week 220
    -30.79 ( 370.994 )
        Week 236
    -87.56 ( 10.851 )
        End of Study (Extension)
    -55.44 ( 213.819 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants with EASI-50 (≥50% reduction in EASI scores from baseline of the parent study) at each visit

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    End point title
    Percentage of Participants with EASI-50 (≥50% reduction in EASI scores from baseline of the parent study) at each visit
    End point description
    EASI-50 was defined as >=50% reduction in EASI scores from baseline of the parent study
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Week 4
    86.0
        Week 16
    95.0
        Week 36
    96.7
        Week 52
    97.4
        Week 100
    98.5
        Week 124
    98.3
        Week 156
    97.4
        Week 172
    98.4
        Week 188
    100
        Week 204
    94.9
        Week 220
    97.8
        Week 236
    100
        End of Study (Extension)
    96.9
    No statistical analyses for this end point

    Secondary: Percentage of Participants with EASI-90 (≥90% reduction in EASI scores from baseline of the parent study) at each visit

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    End point title
    Percentage of Participants with EASI-90 (≥90% reduction in EASI scores from baseline of the parent study) at each visit
    End point description
    EASI-90 was defined as >=90% reduction in EASI scores from baseline of the parent study
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Week 4
    38.6
        Week 16
    57.7
        Week 36
    59.7
        Week 52
    68.4
        Week 100
    73.0
        Week 124
    74.4
        Week 156
    76.3
        Week 172
    81.8
        Week 188
    72.6
        Week 204
    75.8
        Week 220
    84.1
        Week 236
    70.0
        End of Study (Extension)
    76.2
    No statistical analyses for this end point

    Secondary: Change from baseline in Pruritus Numerical Rating Scale (NRS) in Parent Study

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    End point title
    Change from baseline in Pruritus Numerical Rating Scale (NRS) in Parent Study
    End point description
    The Pruritus NRS is an assessment tool for patients to report the intensity of their pruritus (itch), using a scale from 0-10, where 0 is no itch and 10 is the worst itch imaginable. Daily peak pruritus NRS score is the worst one between morning and evening scores of the day. Baseline Pruritus NRS is determined based on average of daily peak NRS scores during the 7 days immediately preceding randomization. A minimum of 4 daily scores out of 7 days is required to calculate baseline average score. Weekly worst score is calculated by taking the worst score within the week
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a Scale
    arithmetic mean (standard deviation)
        Week 1
    -2.86 ( 2.492 )
        Week 4
    -3.81 ( 2.403 )
        Week 16
    -4.44 ( 2.377 )
        Week 36
    -4.67 ( 2.365 )
        Week 52
    -4.76 ( 2.371 )
        Week 100
    -4.69 ( 2.315 )
        Week 124
    -4.56 ( 2.359 )
        Week 156
    -4.37 ( 2.352 )
        Week 172
    -4.64 ( 2.256 )
        Week 188
    -4.73 ( 2.194 )
        Week 204
    -4.83 ( 2.341 )
        Week 220
    -4.90 ( 2.231 )
        Week 236
    -4.81 ( 2.308 )
        Week 252
    -4.89 ( 2.201 )
        Week 272
    -4.69 ( 2.238 )
    No statistical analyses for this end point

    Secondary: Percent change from baseline in Pruritus NRS

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    End point title
    Percent change from baseline in Pruritus NRS
    End point description
    The Pruritus NRS is an assessment tool for patients to report the intensity of their pruritus (itch), using a scale from 0-10, where 0 is no itch and 10 is the worst itch imaginable. Daily peak pruritus NRS score is the worst one between morning and evening scores of the day. Baseline Pruritus NRS is determined based on average of daily peak NRS scores during the 7 days immediately preceding randomization. A minimum of 4 daily scores out of 7 days is required to calculate baseline average score. Weekly worst score is calculated by taking the worst score within the week
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Week 1
    -9.55 ( 40.989 )
        Week 4
    -28.88 ( 41.792 )
        Week 16
    -38.96 ( 47.891 )
        Week 36
    -41.38 ( 52.300 )
        Week 52
    -46.41 ( 41.912 )
        Week 100
    -50.62 ( 42.112 )
        Week 124
    -51.47 ( 39.063 )
        Week 156
    -48.16 ( 55.076 )
        Week 172
    -50.30 ( 42.907 )
        Week 188
    -50.56 ( 43.444 )
        Week 204
    -52.53 ( 43.465 )
        Week 220
    -51.18 ( 39.244 )
        Week 236
    -51.67 ( 37.690 )
        Week 252
    -51.01 ( 47.328 )
        Week 272
    -46.23 ( 46.404 )
    No statistical analyses for this end point

    Secondary: Percentage of Participants with improvement (reduction) of Pruritus NRS ≥3 from baseline

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    End point title
    Percentage of Participants with improvement (reduction) of Pruritus NRS ≥3 from baseline
    End point description
    The Pruritus NRS is an assessment tool for patients to report the intensity of their pruritus (itch), using a scale from 0-10, where 0 is no itch and 10 is the worst itch imaginable. Daily peak pruritus NRS score is the worst one between morning and evening scores of the day. Baseline Pruritus NRS is determined based on average of daily peak NRS scores during the 7 days immediately preceding randomization. A minimum of 4 daily scores out of 7 days is required to calculate baseline average score. Weekly worst score is calculated by taking the worst score within the week
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Week 1
    11.9
        Week 4
    28.3
        Week 16
    39.3
        Week 36
    43.8
        Week 52
    45.9
        Week 100
    51.1
        Week 124
    48.8
        Week 156
    46.5
        Week 172
    54.1
        Week 188
    52.5
        Week 204
    56.9
        Week 220
    51.5
        Week 236
    51.3
        Week 252
    56.2
        Week 272
    50.0
    No statistical analyses for this end point

    Secondary: Percentage of Participants with improvement (reduction) of Pruritus NRS ≥4 from baseline

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    End point title
    Percentage of Participants with improvement (reduction) of Pruritus NRS ≥4 from baseline
    End point description
    The Pruritus NRS is an assessment tool for patients to report the intensity of their pruritus (itch), using a scale from 0-10, where 0 is no itch and 10 is the worst itch imaginable. Daily peak pruritus NRS score is the worst one between morning and evening scores of the day. Baseline Pruritus NRS is determined based on average of daily peak NRS scores during the 7 days immediately preceding randomization. A minimum of 4 daily scores out of 7 days is required to calculate baseline average score. Weekly worst score is calculated by taking the worst score within the week
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
    number (not applicable)
        Week 1
    7.0
        Week 4
    18.6
        Week 16
    29.3
        Week 36
    33.3
        Week 52
    35.4
        Week 100
    41.4
        Week 124
    39.4
        Week 156
    35.6
        Week 172
    42.9
        Week 188
    40.9
        Week 204
    44.1
        Week 220
    40.2
        Week 236
    37.2
        Week 252
    42.7
        Week 272
    36.0
    No statistical analyses for this end point

    Secondary: Percentage of Participants requiring rescue treatment: Phototherapy

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    End point title
    Percentage of Participants requiring rescue treatment: Phototherapy
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
        number (not applicable)
    0.0747
    No statistical analyses for this end point

    Secondary: Percentage of Participants requiring rescue treatment: Systemic treatment

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    End point title
    Percentage of Participants requiring rescue treatment: Systemic treatment
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
        number (not applicable)
    1.6
    No statistical analyses for this end point

    Secondary: Changes from Current Study Baseline to prespecified time points through the end of the study: Dermatology Life Quality Index (DLQI)

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    End point title
    Changes from Current Study Baseline to prespecified time points through the end of the study: Dermatology Life Quality Index (DLQI)
    End point description
    The DLQI is a 10-item, validated questionnaire used in clinical practice and clinical trials to assess the impact of AD disease symptoms and treatment on quality of life (QOL). The format is a simple response to 10 items, which assess QOL over the past week, with an overall scoring system of 0 to 30; a high score is indicative of a poor QOL
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Baseline of Current Study
    8.5 ( 7.11 )
        Week 12
    -4.9 ( 5.93 )
        Week 24
    -6.0 ( 6.41 )
        Week 36
    -6.5 ( 6.51 )
        Week 48
    -5.6 ( 6.20 )
        Week 76
    -7.2 ( 6.41 )
        Week 100
    -7.3 ( 6.66 )
        Week 124
    -7.9 ( 6.40 )
        Week 148
    -8.3 ( 5.14 )
        End of Study
    -3.6 ( 7.37 )
    No statistical analyses for this end point

    Secondary: Percentage of participants requiring rescue treatment: Overall

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    End point title
    Percentage of participants requiring rescue treatment: Overall
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Percentage of Participants
        number (not applicable)
    1.7
    No statistical analyses for this end point

    Secondary: Changes from Current Study Baseline to prespecified time points through the end of the study: Patient Oriented Eczema Measure (POEM)

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    End point title
    Changes from Current Study Baseline to prespecified time points through the end of the study: Patient Oriented Eczema Measure (POEM)
    End point description
    The POEM is a 7-item, validated questionnaire used in clinical practice and clinical trials to assess disease symptoms in children and adults. The format is a response to 7 items (dryness, itching, flaking, cracking, sleep loss, bleeding, and weeping) with a scoring system of 0 to 28; a high score is indicative of a poor QOL.
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Week 12
    -7.7 ( 7.32 )
        Week 24
    -9.3 ( 7.44 )
        Week 36
    -10.0 ( 7.46 )
        Week 48
    -8.8 ( 7.46 )
        Week 76
    -11.6 ( 7.79 )
        Week 100
    -11.4 ( 7.30 )
        Week 124
    -12.7 ( 7.11 )
        Week 148
    -10.5 ( 6.06 )
        End of Study
    -4.5 ( 10.91 )
    No statistical analyses for this end point

    Secondary: Changes from Parent Study Baseline to prespecified time points through the end of the study: EuroQol-5D (EQ-5D)

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    End point title
    Changes from Parent Study Baseline to prespecified time points through the end of the study: EuroQol-5D (EQ-5D)
    End point description
    The EQ-5D as a measure of health-related QOL, defines health in terms of 5 dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 3 ordinal levels of severity: “no problem” (1), “some problems” (2), “severe problems” (3). Overall health state is defined as a 5-digit number.
    End point type
    Secondary
    End point timeframe
    Up to 272 weeks
    End point values
    Dupilumab
    Number of subjects analysed
    2677
    Units: Score on a scale
    arithmetic mean (standard deviation)
        Week 12
    0.2769 ( 0.31571 )
        Week 24
    0.3001 ( 0.32062 )
        Week 36
    0.3056 ( 0.33204 )
        Week 48
    0.2854 ( 0.31017 )
        Week 76
    0.2965 ( 0.30658 )
        Week 100
    0.3217 ( 0.33832 )
        Week 124
    0.3242 ( 0.28937 )
        Week 148
    0.3046 ( 0.26337 )
        End of Study
    0.1864 ( 0.32838 )
    No statistical analyses for this end point

    Secondary: OPTIONAL SUB-STUDY: Incidence of treatment-emergent anti-drug antibody (ADA) response in patients receiving the new dupilumab drug product

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    End point title
    OPTIONAL SUB-STUDY: Incidence of treatment-emergent anti-drug antibody (ADA) response in patients receiving the new dupilumab drug product
    End point description
    For participants receiving dupilumab from a new manufacturing process, ADA baseline was defined as the baseline visit in the sub-study, or at the end of the main study, dependent on available data.
    End point type
    Secondary
    End point timeframe
    Up to 24 Weeks
    End point values
    Dupilumab
    Number of subjects analysed
    999 [3]
    Units: Number of Participants
    9999
    Notes
    [3] - No data was collected
    No statistical analyses for this end point

    Secondary: OPTIONAL SUB-STUDY: Ctrough of functional dupilumab in serum before and after switching to the new dupilumab drug product

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    End point title
    OPTIONAL SUB-STUDY: Ctrough of functional dupilumab in serum before and after switching to the new dupilumab drug product
    End point description
    End point type
    Secondary
    End point timeframe
    Up to 24 Weeks
    End point values
    Dupilumab
    Number of subjects analysed
    50
    Units: mg/L
    arithmetic mean (standard deviation)
        Week 0
    65.9 ( 40.8 )
        Week 12
    65.4 ( 34.7 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose to end of study (plus extension), approximately 272 weeks
    Adverse event reporting additional description
    Participants received repeated doses of dupilumab
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    18.0
    Reporting groups
    Reporting group title
    Total
    Reporting group description
    Participants received repeated doses of dupilumab

    Serious adverse events
    Total
    Total subjects affected by serious adverse events
         subjects affected / exposed
    283 / 2677 (10.57%)
         number of deaths (all causes)
    3
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Uterine leiomyoma
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    8 / 2677 (0.30%)
         occurrences causally related to treatment / all
    0 / 14
         deaths causally related to treatment / all
    0 / 0
    Mycosis fungoides
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Hodgkin's disease
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Intraductal proliferative breast lesion
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Small cell lung cancer
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Adenocarcinoma of colon
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bladder transitional cell carcinoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bowen's disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast cancer female
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast cancer stage I
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon adenoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Colon cancer
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Granular cell tumour
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hodgkin's disease lymphocyte predominance type stage III
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Laryngeal cancer stage II
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Malignant melanoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ovarian germ cell teratoma benign
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatic carcinoma metastatic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Plasma cell myeloma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Plasmacytoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Prostate cancer metastatic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Seminoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Squamous cell carcinoma of the tongue
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    T-cell lymphoma
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine cancer
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Breast cancer
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Vascular disorders
    Peripheral arterial occlusive disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Aortic aneurysm
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Aortic arteriosclerosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arteriosclerosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lymphoedema
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Varicose vein
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Female sterilisation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion spontaneous
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Abortion threatened
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemorrhage in pregnancy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Premature separation of placenta
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cyst
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Device dislocation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Death
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 3
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Food allergy
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Contrast media allergy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sarcoidosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Serum sickness
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Reproductive system and breast disorders
    Endometriosis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Cervical dysplasia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Menometrorrhagia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ovarian cyst
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pelvic pain
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Uterine polyp
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Nasal turbinate hypertrophy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nasal septum deviation
         subjects affected / exposed
    4 / 2677 (0.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Asthma
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Choking
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nasal septum disorder
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax spontaneous
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Status asthmaticus
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rhinitis allergic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychiatric disorders
    Drug abuse
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Depression
         subjects affected / exposed
    4 / 2677 (0.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Panic attack
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Alcohol abuse
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Emotional distress
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    "Schizophrenia, paranoid type"
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Suicide attempt
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Major depression
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    4 / 2677 (0.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Acute hepatic failure
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bile duct stone
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cholestasis of pregnancy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatic cirrhosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatorenal syndrome
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Investigations
    Intraocular pressure increased
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury, poisoning and procedural complications
    Joint dislocation
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Ligament rupture
         subjects affected / exposed
    5 / 2677 (0.19%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Ankle fracture
         subjects affected / exposed
    4 / 2677 (0.15%)
         occurrences causally related to treatment / all
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    Meniscus injury
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Contusion
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Alcohol poisoning
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Comminuted fracture
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Concussion
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Craniocerebral injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Fall
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ligament injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ligament sprain
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Limb traumatic amputation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Muscle injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pubis fracture
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Sternal fracture
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thermal burn
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Transplant dysfunction
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic arthrosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Traumatic intracranial haemorrhage
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Wound dehiscence
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Clavicle fracture
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Congenital, familial and genetic disorders
    Atrial septal defect
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Congenital knee deformity
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dolichocolon
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cardiac disorders
    Myocardial infarction
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Angina pectoris
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Aortic valve incompetence
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Arrhythmia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bundle branch block left
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chordae tendinae rupture
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Prinzmetal angina
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Syncope
         subjects affected / exposed
    5 / 2677 (0.19%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Migraine
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Amnesia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Carotid artery stenosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Carpal tunnel syndrome
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Generalised tonic-clonic seizure
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hypoaesthesia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Intracranial aneurysm
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ischaemic cerebral infarction
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Migraine with aura
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nerve compression
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thalamic infarction
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haemolytic anaemia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ear and labyrinth disorders
    Meniere's disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eye disorders
    Cataract
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Ectropion
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Entropion
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Trichiasis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Atopic keratoconjunctivitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chalazion
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Corneal erosion
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    Corneal neovascularisation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Corneal perforation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Eyelid cyst
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Keratoconus
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Mydriasis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Optic neuropathy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Retinal artery occlusion
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Retinal detachment
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Ulcerative keratitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Inguinal hernia
         subjects affected / exposed
    5 / 2677 (0.19%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Colitis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Large intestine polyp
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Umbilical hernia
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Ascites
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Diverticular perforation
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Hiatus hernia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Incarcerated umbilical hernia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intestinal polyp
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pancreatitis chronic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Haematochezia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin and subcutaneous tissue disorders
    Dermatitis atopic
         subjects affected / exposed
    6 / 2677 (0.22%)
         occurrences causally related to treatment / all
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    Erythema nodosum
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Actinic keratosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Alopecia areata
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Angioedema
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Drug eruption
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Eczema
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Pruritus generalised
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Skin ulcer
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    Calculus ureteric
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Calculus urethral
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Haematuria
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    IgA nephropathy
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Urethral stenosis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Endocrine disorders
    Goitre
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Thyroid mass
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    11 / 2677 (0.41%)
         occurrences causally related to treatment / all
    0 / 12
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Rotator cuff syndrome
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc disorder
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Fibromyalgia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Foot deformity
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Intervertebral disc degeneration
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Rheumatoid arthritis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    6 / 2677 (0.22%)
         occurrences causally related to treatment / all
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    Corona virus infection
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Erysipelas
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    Pilonidal cyst
         subjects affected / exposed
    3 / 2677 (0.11%)
         occurrences causally related to treatment / all
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    Urosepsis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Diverticulitis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Eczema herpeticum
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    Influenza
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Peritonsillar abscess
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Chronic tonsillitis
         subjects affected / exposed
    2 / 2677 (0.07%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Abdominal abscess
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchopneumonia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Chronic sinusitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastroenteritis bacterial
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hand-foot-and-mouth disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Hepatitis A
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes ophthalmic
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Herpes zoster disseminated
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Impetigo
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infected dermal cyst
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Keratitis bacterial
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lung infection
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Parotitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Perirectal abscess
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Superinfection bacterial
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Viral corneal ulcer
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Wound infection staphylococcal
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Hypokalaemia
         subjects affected / exposed
    1 / 2677 (0.04%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Total
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    1613 / 2677 (60.25%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    218 / 2677 (8.14%)
         occurrences all number
    411
    General disorders and administration site conditions
    Injection site reaction
         subjects affected / exposed
    138 / 2677 (5.16%)
         occurrences all number
    506
    Eye disorders
    Conjunctivitis allergic
         subjects affected / exposed
    242 / 2677 (9.04%)
         occurrences all number
    329
    Skin and subcutaneous tissue disorders
    Dermatitis atopic
         subjects affected / exposed
    446 / 2677 (16.66%)
         occurrences all number
    787
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    774 / 2677 (28.91%)
         occurrences all number
    1602
    Upper respiratory tract infection
         subjects affected / exposed
    365 / 2677 (13.63%)
         occurrences all number
    567
    Conjunctivitis
         subjects affected / exposed
    277 / 2677 (10.35%)
         occurrences all number
    417
    Oral herpes
         subjects affected / exposed
    200 / 2677 (7.47%)
         occurrences all number
    463

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Dec 2013
    Removed the requirement to administer 400 mg SC dupilumab as a loading dose for participants treated in a previous AD study unless the last dose administered is less than 4 weeks before their first dose in the OLE study. Permanently discontinued participants from the study who received prohibited medications. Removed the key secondary endpoint of “number of disease-free days per participant year” from the protocol.
    12 Jun 2014
    Changed dose from 200 mg QW to 300 mg QW.
    12 Jan 2015
    Allowed participants who failed screening or who failed to complete the baseline visit within 28 days of screening to be rescreened.
    26 Jul 2015
    Extended the study duration for each participant for to up to 3 years or until the product is commercially available in the geographic region of the participant (whichever comes first), and up to 2 years in the UK.
    28 Jun 2016
    Reduced number of visits and assessments
    05 Jun 2017
    Reduce the duration of the end of study visit from 16 weeks to 12 weeks after the last dose of dupilumab. Allowed participants in DE, PL, FR, and JP who had completed 3 years of treatment to resume treatment until 31 Dec 2017.
    04 Jan 2018
    Extended the treatment period to 5 years in PL and FI, and to September 2018 in FR.
    12 Nov 2019
    Aligned the dosing regimen of dupilumab with the dosing regimen approved by various regulatory agencies, globally, for this patient population (300 mg Q2W). Criteria for the events that required accelerated reporting to the sponsor were updated to align with current standards for the dupilumab clinical development program. The Finland country-specific amendments and PL country-specific amendments were merged into one global protocol.
    11 May 2021
    Included a substudy to assess the safety, PK, and immunogenicity of dupilumab derived from a new manufacturing process in adults with AD.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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