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    Clinical Trial Results:
    A prospective, multicenter, 12-week, randomized open label study to evaluate the efficacy and safety of glycopyrronium (50 micrograms o.d.) or indacaterol maleate and glycopyrronium bromide fixed-dose combination (110/50 micrograms o.d.) regarding symptoms and health status in patients with moderate chronic obstructive pulmonary disease (COPD) switching from treatment with any standard COPD regimen

    Summary
    EudraCT number
    2013-003127-11
    Trial protocol
    CZ   LT   SK   BE   EE   LV   IE   SE   AT   PT   IT   GB   DK   GR   HU   PL   ES   DE   SI  
    Global end of trial date
    29 Apr 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Apr 2017
    First version publication date
    22 Apr 2017
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CQVA149A3401
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01985334
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH_4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    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
    29 Apr 2016
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Apr 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    • To show the superiority of glycopyrronium (50 μg o.d.) vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) on trough FEV1 at week 12. • To show the non-inferiority of glycopyrronium (50 μg o.d.) vs. long-acting bronchodilators (LABA or LAMA monotherapy) on trough FEV1 at week 12. • To show the superiority of indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.) vs. LABA and ICS in free or FDC on trough FEV1 at week 12. • To show the superiority of indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.) vs. long-acting bronchodilators (LABA or LAMA monotherapy) on trough FEV1 at week 12.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    03 Jun 2014
    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
    Austria: 84
    Country: Number of subjects enrolled
    Belgium: 209
    Country: Number of subjects enrolled
    Czech Republic: 531
    Country: Number of subjects enrolled
    Denmark: 13
    Country: Number of subjects enrolled
    Estonia: 92
    Country: Number of subjects enrolled
    France: 51
    Country: Number of subjects enrolled
    Germany: 1689
    Country: Number of subjects enrolled
    Hungary: 143
    Country: Number of subjects enrolled
    Ireland: 16
    Country: Number of subjects enrolled
    Italy: 210
    Country: Number of subjects enrolled
    Latvia: 72
    Country: Number of subjects enrolled
    Lithuania: 109
    Country: Number of subjects enrolled
    Norway: 46
    Country: Number of subjects enrolled
    Poland: 103
    Country: Number of subjects enrolled
    Portugal: 35
    Country: Number of subjects enrolled
    Romania: 120
    Country: Number of subjects enrolled
    Russian Federation: 198
    Country: Number of subjects enrolled
    Slovakia: 178
    Country: Number of subjects enrolled
    Slovenia: 53
    Country: Number of subjects enrolled
    Spain: 178
    Country: Number of subjects enrolled
    Sweden: 63
    Country: Number of subjects enrolled
    United Kingdom: 180
    Country: Number of subjects enrolled
    Greece: 16
    Worldwide total number of subjects
    4389
    EEA total number of subjects
    4191
    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)
    2110
    From 65 to 84 years
    2267
    85 years and over
    12

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    This study used a multicenter, parallel-group, randomized 3:1, open-label design. The treatment epoch lasted 12 weeks (i.e. 90 days). The total duration of the study for each patient was 12 weeks (from randomization) plus 30 days of safety follow-up.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    A1 (any SABA and/or SAMA)
    Arm description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or fixed dose combination at enrollment and randomized to remain in their baseline therapy with any SABA and/or SAMA
    Arm type
    Experimental

    Investigational medicinal product name
    any SABA and/or SAMA
    Investigational medicinal product code
    any SABA and/or SAMA
    Other name
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    A2 (glycopyrronium)
    Arm description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or FDC at enrollment and randomized to switch in treatment with glycopyrronium (50 μg o.d.)
    Arm type
    Experimental

    Investigational medicinal product name
    glycopyrronium
    Investigational medicinal product code
    glycopyrronium
    Other name
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    B1 (any LAMA or LABA and mMRC=1)
    Arm description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to remain in their baseline treatment with LABA or LAMA
    Arm type
    Experimental

    Investigational medicinal product name
    LAMA or LABA
    Investigational medicinal product code
    LAMA or LABA
    Other name
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    B2 (glycopyrronium and mMRC=1)
    Arm description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to switch in treatment with glycopyrronium (50 μg o.d.)
    Arm type
    Experimental

    Investigational medicinal product name
    glycopyrronium and mMRC=1
    Investigational medicinal product code
    glycopyrronium and mMRC=1
    Other name
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    C1 (any LABA and ICS)
    Arm description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to remain in their baseline treatment with LABA and ICS in free or FDC
    Arm type
    Experimental

    Investigational medicinal product name
    any LABA and ICS
    Investigational medicinal product code
    any LABA and ICS
    Other name
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    C2 (indacaterol/glycopyrronium)
    Arm description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.)
    Arm type
    Experimental

    Investigational medicinal product name
    indacaterol/glycopyrronium
    Investigational medicinal product code
    Other name
    indacaterol/glycopyrronium
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    D1 (any LAMA or LABA and mMRC>1)
    Arm description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to remain their baseline in treatment with LABA or LAMA
    Arm type
    Experimental

    Investigational medicinal product name
    any LAMA or LABA and mMRC>1
    Investigational medicinal product code
    Other name
    any LAMA or LABA and mMRC>1
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    D2 (indacaterol/glycopyrronium and mMRC>1)
    Arm description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.).
    Arm type
    Experimental

    Investigational medicinal product name
    indacaterol/glycopyrronium and mMRC>1
    Investigational medicinal product code
    Other name
    indacaterol/glycopyrronium and mMRC>1
    Pharmaceutical forms
    Inhalation powder, hard capsule
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Number of subjects in period 1
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Started
    130
    387
    420
    1262
    274
    822
    274
    820
    The intention-to-treat (ITT) population
    122
    369
    420
    1254
    269
    811
    268
    811
    Completed
    107
    303
    367
    1033
    234
    666
    237
    699
    Not completed
    23
    84
    53
    229
    40
    156
    37
    121
         Adverse event, serious fatal
    1
    -
    -
    3
    -
    -
    1
    2
         Moderate / severe COPD exacerbation
    5
    14
    12
    40
    6
    40
    8
    19
         Use of prohibited treatment
    1
    4
    1
    2
    1
    6
    2
    -
         Medication non-compliance
    -
    4
    1
    6
    2
    3
    1
    3
         Worsening of disease
    -
    -
    -
    1
    -
    3
    -
    1
         Administrative problems
    1
    1
    -
    2
    -
    1
    1
    3
         Adverse event, non-fatal
    -
    8
    2
    26
    3
    18
    3
    15
         Other
    2
    9
    7
    17
    4
    8
    4
    7
         Protocol deviation
    6
    31
    25
    84
    17
    47
    15
    42
         Unknown
    4
    2
    3
    10
    1
    6
    2
    2
         Investigator decision
    -
    3
    -
    7
    1
    1
    -
    4
         Lost to follow-up
    -
    2
    -
    3
    1
    4
    -
    3
         Subject withdrawal of consent
    3
    6
    2
    28
    4
    19
    -
    20

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    A1 (any SABA and/or SAMA)
    Reporting group description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or fixed dose combination at enrollment and randomized to remain in their baseline therapy with any SABA and/or SAMA

    Reporting group title
    A2 (glycopyrronium)
    Reporting group description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or FDC at enrollment and randomized to switch in treatment with glycopyrronium (50 μg o.d.)

    Reporting group title
    B1 (any LAMA or LABA and mMRC=1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to remain in their baseline treatment with LABA or LAMA

    Reporting group title
    B2 (glycopyrronium and mMRC=1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to switch in treatment with glycopyrronium (50 μg o.d.)

    Reporting group title
    C1 (any LABA and ICS)
    Reporting group description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to remain in their baseline treatment with LABA and ICS in free or FDC

    Reporting group title
    C2 (indacaterol/glycopyrronium)
    Reporting group description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.)

    Reporting group title
    D1 (any LAMA or LABA and mMRC>1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to remain their baseline in treatment with LABA or LAMA

    Reporting group title
    D2 (indacaterol/glycopyrronium and mMRC>1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.).

    Reporting group values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1) Total
    Number of subjects
    130 387 420 1262 274 822 274 820 4389
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0 0 0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0 0 0 0 0 0
        Newborns (0-27 days)
    0 0 0 0 0 0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0 0 0 0 0 0
        Children (2-11 years)
    0 0 0 0 0 0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0 0 0 0 0 0
        Adults (18-64 years)
    67 214 204 622 131 396 119 357 2110
        From 65-84 years
    63 173 216 635 142 425 154 459 2267
        85 years and over
    0 0 0 5 1 1 1 4 12
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    64.1 ( 7.8 ) 63.1 ( 8.4 ) 64.6 ( 8.2 ) 64.4 ( 8.2 ) 64.4 ( 8.9 ) 64.6 ( 8.7 ) 65.2 ( 7.6 ) 65.4 ( 8.3 ) -
    Gender, Male/Female
    Units: Subjects
        Female
    48 119 131 376 106 286 95 276 1437
        Male
    82 268 289 886 168 536 179 544 2952

    End points

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    End points reporting groups
    Reporting group title
    A1 (any SABA and/or SAMA)
    Reporting group description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or fixed dose combination at enrollment and randomized to remain in their baseline therapy with any SABA and/or SAMA

    Reporting group title
    A2 (glycopyrronium)
    Reporting group description
    Patients treated with any SABA and/or SAMA as monotherapy or in free or FDC at enrollment and randomized to switch in treatment with glycopyrronium (50 μg o.d.)

    Reporting group title
    B1 (any LAMA or LABA and mMRC=1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to remain in their baseline treatment with LABA or LAMA

    Reporting group title
    B2 (glycopyrronium and mMRC=1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score =1 point at Visit 1 and randomized to switch in treatment with glycopyrronium (50 μg o.d.)

    Reporting group title
    C1 (any LABA and ICS)
    Reporting group description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to remain in their baseline treatment with LABA and ICS in free or FDC

    Reporting group title
    C2 (indacaterol/glycopyrronium)
    Reporting group description
    Patients treated with any LABA and ICS in free or FDC at enrollment and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.)

    Reporting group title
    D1 (any LAMA or LABA and mMRC>1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to remain their baseline in treatment with LABA or LAMA

    Reporting group title
    D2 (indacaterol/glycopyrronium and mMRC>1)
    Reporting group description
    Patients treated with any LABA or LAMA monotherapy and mMRC score >1 point at Visit 1 and randomized to switch in treatment with indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d.).

    Subject analysis set title
    A2 + B2
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    A2 (glycopyrronium)+B2 (glycopyrronium and mMRC=1

    Subject analysis set title
    A1 + B1
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    A1(any SABA and/or SAMA+B1 (any LAMA or LABA and mMRC=1

    Subject analysis set title
    A2 +B2
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    A2 (glycopyrronium)+B2 (glycopyrronium and mMRC=1

    Subject analysis set title
    A1 +B1
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    A1(any SABA and/or SAMA+B1 (any LAMA or LABA and mMRC=1)

    Subject analysis set title
    C2 +D2
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    C2 (indacaterol/glycopyrronium)+D2 (indacaterol/glycopyrronium and mMRC>1)

    Subject analysis set title
    C1 + D1
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    C1 (any LABA and ICS)+D1 (any LAMA or LABA and mMRC>1)

    Subject analysis set title
    C2 +D2
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    C2 (indacaterol/glycopyrronium) + D2 (indacaterol/glycopyrronium and mMRC>1)

    Subject analysis set title
    C1 + D1
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    C1 (any LABA and ICS) + D1 (any LAMA or LABA and mMRC>1)

    Primary: Trough FEV1 at week 12 for group: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC)

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    End point title
    Trough FEV1 at week 12 for group: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) [1]
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12 (Visit 4)
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium)
    Number of subjects analysed
    122
    369
    Units: Liters
        least squares mean (confidence interval 95%)
    1.8264 (1.7797 to 1.8732)
    1.8916 (1.8647 to 1.9185)
    Statistical analysis title
    Trough FEV1 at visit 4
    Comparison groups
    A2 (glycopyrronium) v A1 (any SABA and/or SAMA)
    Number of subjects included in analysis
    491
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.018
    Method
    linear mixed model
    Confidence interval

    Primary: Trough FEV1 at week 12 for group: glycopyrronium vs. long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Trough FEV1 at week 12 for group: glycopyrronium vs. long-acting bronchodilators (LABA or LAMA monotherapy) [2]
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12 (Visit 4)
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1)
    Number of subjects analysed
    420
    1254
    Units: Liters
        least squares mean (confidence interval 95%)
    1.8004 (1.7768 to 1.8239)
    1.8215 (1.8078 to 1.8352)
    Statistical analysis title
    Trough FEV1 at week 12
    Comparison groups
    B1 (any LAMA or LABA and mMRC=1) v B2 (glycopyrronium and mMRC=1)
    Number of subjects included in analysis
    1674
    Analysis specification
    Pre-specified
    Analysis type
    [3]
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval
    Notes
    [3] - H0: Glycopyrronium (50 μg o.d.) [randomized group B2] was inferior to LABA or LAMA (random group B1) with respect to mean trough FEV1 after 12 weeks of treatment. H0: μFEV1, NVA237 – μFEV1, LABA and/or LAMA < -40 mL Ha: Glycopyrronium (50 μg o.d.) [randomized group B2] is non-inferior to LABA or LAMA (random group B1) with respect to mean trough FEV1 after 12 weeks of treatment. Ha: μFEV1, NVA237 – μFEV1, LABA and/or LAMA ≥ -40 mL

    Primary: Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. LABA and ICS in free or FDC

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    End point title
    Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. LABA and ICS in free or FDC [4]
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12 (Visit 4)
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium)
    Number of subjects analysed
    269
    811
    Units: Liters
        least squares mean (confidence interval 95%)
    1.6847 (1.6542 to 1.7153)
    1.7558 (1.7378 to 1.7737)
    Statistical analysis title
    Trough FEV1 at week 12
    Comparison groups
    C1 (any LABA and ICS) v C2 (indacaterol/glycopyrronium)
    Number of subjects included in analysis
    1080
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval

    Primary: Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. long-acting bronchodilators (LABA or LAMA monotherapy) [5]
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12 (Visit 4)
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    268
    811
    Units: Liters
        least squares mean (confidence interval 95%)
    1.6728 (1.6461 to 1.6994)
    1.7742 (1.7587 to 1.7896)
    Statistical analysis title
    Trough FEV1 at week 12
    Comparison groups
    D1 (any LAMA or LABA and mMRC>1) v D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects included in analysis
    1079
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval

    Primary: Change from baseline on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC)

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    End point title
    Change from baseline on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) [6]
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12
    Notes
    [6] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium)
    Number of subjects analysed
    122
    369
    Units: Units on a scale
        least squares mean (confidence interval 95%)
    0.5117 (-0.0073 to 1.0306)
    2.3005 (2.0015 to 2.5995)
    Statistical analysis title
    Transition Dyspnea Index (TDI)
    Comparison groups
    A1 (any SABA and/or SAMA) v A2 (glycopyrronium)
    Number of subjects included in analysis
    491
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval

    Primary: Change from baseline on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Change from baseline on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. long-acting bronchodilators (LABA or LAMA monotherapy) [7]
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12
    Notes
    [7] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1)
    Number of subjects analysed
    420
    1254
    Units: Units on a scale
        least squares mean (confidence interval 95%)
    0.6969 (0.4169 to 0.9769)
    1.4351 (1.2718 to 1.5984)
    Statistical analysis title
    Transition Dyspnea Index (TDI)
    Comparison groups
    B1 (any LAMA or LABA and mMRC=1) v B2 (glycopyrronium and mMRC=1)
    Number of subjects included in analysis
    1674
    Analysis specification
    Pre-specified
    Analysis type
    [8]
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval
    Notes
    [8] - A difference of 0.6 points in TDI was adopted as boundary for non-inferiority

    Primary: Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. LABA and ICS in free or FDC

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    End point title
    Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. LABA and ICS in free or FDC [9]
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12
    Notes
    [9] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium)
    Number of subjects analysed
    269
    811
    Units: Units on a scale
        least squares mean (confidence interval 95%)
    0.8508 (0.4676 to 1.234)
    1.9491 (1.7207 to 2.1775)
    Statistical analysis title
    Transition Dyspnea Index (TDI)
    Comparison groups
    C1 (any LABA and ICS) v C2 (indacaterol/glycopyrronium)
    Number of subjects included in analysis
    1080
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval

    Primary: Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. long-acting bronchodilators (LABA or LAMA monotherapy) [10]
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Primary
    End point timeframe
    Day 1 (baseline) and week 12
    Notes
    [10] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: All arms do not apply to this outcome measure
    End point values
    D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    268
    811
    Units: Units on a scale
        least squares mean (confidence interval 95%)
    0.8632 (0.5098 to 1.2166)
    2.1209 (1.913 to 2.3288)
    Statistical analysis title
    Transition Dyspnea Index (TDI)
    Comparison groups
    D1 (any LAMA or LABA and mMRC>1) v D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects included in analysis
    1079
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    linear mixed model
    Confidence interval

    Secondary: Trough FEV1 at week 12 for group: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) or vs. long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Trough FEV1 at week 12 for group: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) or vs. long-acting bronchodilators (LABA or LAMA monotherapy)
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval
    End point type
    Secondary
    End point timeframe
    12 Weeks
    End point values
    A2 + B2 A1 + B1
    Number of subjects analysed
    1623
    542
    Units: Liters
        least squares mean (confidence interval 95%)
    1.8373 (1.825 to 1.8496)
    1.8065 (1.7853 to 1.8276)
    No statistical analyses for this end point

    Secondary: Change from baseline on on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) or long-acting bronchodilators (LABA or LAMA monotherapy)

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    End point title
    Change from baseline on on Transition Dyspnea Index (TDI) for groups: glycopyrronium vs. short-acting bronchodilators (SABA and/or SAMA as monotherapy or in free or FDC) or long-acting bronchodilators (LABA or LAMA monotherapy)
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Secondary
    End point timeframe
    Day 1 (baseline) and week 12
    End point values
    A2 +B2 A1 +B1
    Number of subjects analysed
    1623
    542
    Units: Score on a scale
        least squares mean (confidence interval 95%)
    1.6315 (1.4874 to 1.7756)
    0.6562 (0.4085 to 0.9039)
    No statistical analyses for this end point

    Secondary: Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. LABA or LAMA monotherapy or LABA and ICS in free or FDC on trough FEV1 at week 12.

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    End point title
    Trough FEV1 at week 12 for group: indacaterol maleate and glycopyrronium bromide FDC vs. LABA or LAMA monotherapy or LABA and ICS in free or FDC on trough FEV1 at week 12.
    End point description
    Trough FEV1 at visit 4 is defined as FEV1, computed as the mean of forced expiratory volume in 1 second 15min and 45 min pre dose measurements, at the end of the dosing interval.
    End point type
    Secondary
    End point timeframe
    12 Weeks
    End point values
    C2 +D2 C1 + D1
    Number of subjects analysed
    1622
    537
    Units: Liters
        least squares mean (confidence interval 95%)
    1.765 (1.7532 to 1.7768)
    1.6789 (1.6587 to 1.6992)
    No statistical analyses for this end point

    Secondary: Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. LABA or LAMA monotherapy or LABA and ICS in free or FDC

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    End point title
    Change from baseline on Transition Dyspnea Index (TDI) for groups: indacaterol maleate and glycopyrronium bromide FDC vs. LABA or LAMA monotherapy or LABA and ICS in free or FDC
    End point description
    Transition Dyspnea Index (TDI) captures changes from baseline. The TDI score is based on three domains with each domain scored from -3 (major deterioration) to +3 (major improvement), to give an overall score of -9 to +9, a negative score indicating a deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline.
    End point type
    Secondary
    End point timeframe
    Day 1 (baseline) and week 12
    End point values
    C2 +D2 C1 + D1
    Number of subjects analysed
    1622
    537
    Units: Score on a scale
        least squares mean (confidence interval 95%)
    2.0354 (1.8811 to 2.1896)
    0.8588 (0.5983 to 1.1192)
    No statistical analyses for this end point

    Secondary: Change from baseline on Total score of COPD Assessment Test (CAT) for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC

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    End point title
    Change from baseline on Total score of COPD Assessment Test (CAT) for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC
    End point description
    Total score of COPD Assessment Test (CAT) will be measured at baseline and at week 12. This questionnaire is completed by the patient. The score ranges from 0-40 where higher scores represent worse health status. CAT scores ≥ 10 are associated with significantly impaired health status.
    End point type
    Secondary
    End point timeframe
    Day 1 (baseline) and Week 12
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    122
    369
    420
    1254
    269
    811
    268
    811
    Units: Score
        arithmetic mean (standard deviation)
    0.1 ( 4.6 )
    -1.8 ( 5.3 )
    0.1 ( 4.9 )
    -0.5 ( 4.6 )
    -0.4 ( 4.8 )
    -1.4 ( 5.4 )
    -0.9 ( 5 )
    -1.9 ( 5.3 )
    No statistical analyses for this end point

    Secondary: Change from baseline on Total score of Clinical COPD Questionnaire (CCQ) for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC

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    End point title
    Change from baseline on Total score of Clinical COPD Questionnaire (CCQ) for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC
    End point description
    The Clinical COPD Questionnaire (CCQ) is a self-administered 10-item questionnaire developed to measure clinical control in patients with COPD. Patients will be instructed to recall their experiences during the previous week. They respond to each question using a 7-point scale from 0 = asymptomatic/no imitation to 6 = extremely symptomatic/totally limited. The questionnaire is divided into 3 domains (symptoms [items 1, 2, 5, and 6] functional [items 7, 8, 9, and 10] and mental state [items 3 and 4]). The overall clinical COPD control score and the scores of the domains are calculated by adding all the scores together and dividing this sum by the number of questions. Thus, the overall clinical COPD control score as well as the score on each of the three domains varies between 0 (very good control) to 6 (extremely poor control).
    End point type
    Secondary
    End point timeframe
    Day 1 (baseline) and Week 12
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    122
    369
    420
    1254
    269
    811
    268
    811
    Units: Score
        arithmetic mean (standard deviation)
    0 ( 0.6 )
    -0.3 ( 0.7 )
    0 ( 0.7 )
    -0.1 ( 0.7 )
    -0.1 ( 0.7 )
    -0.2 ( 0.8 )
    -0.1 ( 0.8 )
    -0.3 ( 0.8 )
    No statistical analyses for this end point

    Secondary: Mean number of puffs of rescue medication use for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC

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    End point title
    Mean number of puffs of rescue medication use for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC
    End point description
    Mean number of puffs of rescue medication use will be measured using eDiary data over 12 weeks of treatment.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    122
    369
    420
    1254
    269
    811
    268
    811
    Units: Number of puffs
        arithmetic mean (standard deviation)
    1.8 ( 1.7 )
    1 ( 1.3 )
    0.8 ( 1.2 )
    0.7 ( 1.1 )
    1.6 ( 1.7 )
    1.1 ( 1.4 )
    1.4 ( 1.4 )
    1.1 ( 1.3 )
    No statistical analyses for this end point

    Secondary: Number of reported symptoms of COPD for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC

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    End point title
    Number of reported symptoms of COPD for groups: glycopyrronium and indacaterol maleate and glycopyrronium bromide FDC
    End point description
    Patient-reported symptoms of COPD combined will be measured using eDiary data reported over the 12 week treatment period.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    A1 (any SABA and/or SAMA) A2 (glycopyrronium) B1 (any LAMA or LABA and mMRC=1) B2 (glycopyrronium and mMRC=1) C1 (any LABA and ICS) C2 (indacaterol/glycopyrronium) D1 (any LAMA or LABA and mMRC>1) D2 (indacaterol/glycopyrronium and mMRC>1)
    Number of subjects analysed
    122
    369
    420
    1254
    269
    811
    268
    811
    Units: Score
        arithmetic mean (standard deviation)
    -0.04 ( 0.15 )
    -0.1 ( 0.22 )
    -0.03 ( 0.19 )
    -0.05 ( 0.2 )
    -0.05 ( 0.19 )
    -0.07 ( 0.22 )
    -0.04 ( 0.19 )
    -0.09 ( 0.21 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit
    Adverse event reporting additional description
    Consistent with EudraCT disclosure specifications, Novartis has reported under the Serious adverse events field “number of deaths resulting from adverse events” all those deaths, resulting from serious adverse events that are deemed to be causally related to treatment by the investigator
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.1
    Reporting groups
    Reporting group title
    any SABA and/or SAMA
    Reporting group description
    any SABA and/or SAMA

    Reporting group title
    any LAMA or@ LABA and mMRC eq 1
    Reporting group description
    any LAMA or@ LABA and mMRC eq 1

    Reporting group title
    glycopyrronium
    Reporting group description
    glycopyrronium

    Reporting group title
    glycopyrronium@ and mMRC eq 1
    Reporting group description
    glycopyrronium@ and mMRC eq 1

    Reporting group title
    any LABA and ICS
    Reporting group description
    any LABA and ICS

    Reporting group title
    indacaterol/@glycopyrronium
    Reporting group description
    indacaterol/@glycopyrronium

    Reporting group title
    indacaterol/@glycopyrronium and@ mMRC gt 1
    Reporting group description
    indacaterol/@glycopyrronium and@ mMRC gt 1

    Reporting group title
    any LAMA or@ LABA and mMRC gt 1
    Reporting group description
    any LAMA or@ LABA and mMRC gt 1

    Serious adverse events
    any SABA and/or SAMA any LAMA or@ LABA and mMRC eq 1 glycopyrronium glycopyrronium@ and mMRC eq 1 any LABA and ICS indacaterol/@glycopyrronium indacaterol/@glycopyrronium and@ mMRC gt 1 any LAMA or@ LABA and mMRC gt 1
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 125 (3.20%)
    11 / 417 (2.64%)
    9 / 385 (2.34%)
    30 / 1248 (2.40%)
    6 / 269 (2.23%)
    22 / 816 (2.70%)
    34 / 814 (4.18%)
    10 / 269 (3.72%)
         number of deaths (all causes)
    1
    0
    0
    3
    0
    0
    2
    2
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder neoplasm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Brain neoplasm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Breast cancer
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    2 / 814 (0.25%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchial carcinoma
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    1 / 1
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Colon cancer
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Laryngeal cancer
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metastases to bone
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oropharyngeal cancer
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Prostate cancer
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of the tongue
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Aortic aneurysm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Aortic stenosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    2 / 814 (0.25%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femoral artery aneurysm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    1 / 814 (0.12%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intermittent claudication
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ischaemia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    3 / 814 (0.37%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral artery aneurysm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral artery stenosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    3 / 814 (0.37%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral artery thrombosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Shock
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thrombophlebitis superficial
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    2 / 1248 (0.16%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    2 / 2
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    1 / 385 (0.26%)
    3 / 1248 (0.24%)
    1 / 269 (0.37%)
    3 / 816 (0.37%)
    3 / 814 (0.37%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
    3 / 3
    1 / 1
    3 / 3
    3 / 3
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic shock
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Drug hypersensitivity
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pneumothorax
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory depression
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Alcoholism
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Blood pressure increased
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Heart rate decreased
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Ankle fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bursa injury
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Facial bones fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Hip fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Jaw fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ligament rupture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Splenic rupture
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Traumatic intracranial haemorrhage
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Wound dehiscence
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Congenital central nervous system anomaly
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hydrocele
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    2 / 1248 (0.16%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    2 / 2
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Aortic valve incompetence
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Aortic valve stenosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    1 / 1
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    2 / 385 (0.52%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    2 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ischaemic cardiomyopathy
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Myocardial ischaemia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral ischaemia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular disorder
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Cerebrovascular insufficiency
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Embolic cerebral infarction
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ruptured cerebral aneurysm
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 125 (0.80%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular dementia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular encephalopathy
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune thrombocytopenic purpura
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    2 / 816 (0.25%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    2 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal hernia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abdominal incarcerated hernia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulum oesophageal
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Faecaloma
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct stone
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Biliary tract disorder
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatic cirrhosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Blister
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Fatigue
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hernia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Ulcer
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Back pain
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pseudarthrosis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Synovitis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cystitis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 125 (0.00%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Mediastinal abscess
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophageal candidiasis
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    0 / 269 (0.00%)
    0 / 816 (0.00%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    2 / 1248 (0.16%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    7 / 814 (0.86%)
    1 / 269 (0.37%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    2 / 2
    0 / 0
    1 / 1
    7 / 7
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    0 / 385 (0.00%)
    0 / 1248 (0.00%)
    1 / 269 (0.37%)
    0 / 816 (0.00%)
    0 / 814 (0.00%)
    0 / 269 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 1%
    Non-serious adverse events
    any SABA and/or SAMA any LAMA or@ LABA and mMRC eq 1 glycopyrronium glycopyrronium@ and mMRC eq 1 any LABA and ICS indacaterol/@glycopyrronium indacaterol/@glycopyrronium and@ mMRC gt 1 any LAMA or@ LABA and mMRC gt 1
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    19 / 125 (15.20%)
    63 / 417 (15.11%)
    67 / 385 (17.40%)
    163 / 1248 (13.06%)
    29 / 269 (10.78%)
    119 / 816 (14.58%)
    120 / 814 (14.74%)
    20 / 269 (7.43%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 125 (0.80%)
    7 / 417 (1.68%)
    3 / 385 (0.78%)
    7 / 1248 (0.56%)
    2 / 269 (0.74%)
    5 / 816 (0.61%)
    7 / 814 (0.86%)
    0 / 269 (0.00%)
         occurrences all number
    1
    7
    3
    8
    2
    5
    7
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 125 (0.00%)
    3 / 417 (0.72%)
    7 / 385 (1.82%)
    9 / 1248 (0.72%)
    1 / 269 (0.37%)
    12 / 816 (1.47%)
    8 / 814 (0.98%)
    1 / 269 (0.37%)
         occurrences all number
    0
    3
    8
    13
    1
    16
    8
    1
    Gastrointestinal disorders
    Dyspepsia
         subjects affected / exposed
    2 / 125 (1.60%)
    1 / 417 (0.24%)
    0 / 385 (0.00%)
    3 / 1248 (0.24%)
    0 / 269 (0.00%)
    2 / 816 (0.25%)
    1 / 814 (0.12%)
    0 / 269 (0.00%)
         occurrences all number
    2
    1
    0
    3
    0
    3
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    3 / 125 (2.40%)
    13 / 417 (3.12%)
    5 / 385 (1.30%)
    33 / 1248 (2.64%)
    5 / 269 (1.86%)
    44 / 816 (5.39%)
    27 / 814 (3.32%)
    4 / 269 (1.49%)
         occurrences all number
    3
    13
    6
    35
    7
    47
    29
    4
    Dyspnoea
         subjects affected / exposed
    1 / 125 (0.80%)
    6 / 417 (1.44%)
    5 / 385 (1.30%)
    13 / 1248 (1.04%)
    6 / 269 (2.23%)
    7 / 816 (0.86%)
    7 / 814 (0.86%)
    2 / 269 (0.74%)
         occurrences all number
    1
    6
    5
    14
    7
    7
    7
    2
    Oropharyngeal pain
         subjects affected / exposed
    0 / 125 (0.00%)
    3 / 417 (0.72%)
    4 / 385 (1.04%)
    10 / 1248 (0.80%)
    4 / 269 (1.49%)
    3 / 816 (0.37%)
    4 / 814 (0.49%)
    1 / 269 (0.37%)
         occurrences all number
    0
    3
    4
    10
    4
    3
    4
    1
    Productive cough
         subjects affected / exposed
    0 / 125 (0.00%)
    0 / 417 (0.00%)
    4 / 385 (1.04%)
    1 / 1248 (0.08%)
    0 / 269 (0.00%)
    2 / 816 (0.25%)
    0 / 814 (0.00%)
    2 / 269 (0.74%)
         occurrences all number
    0
    0
    4
    1
    0
    2
    0
    2
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 125 (1.60%)
    3 / 417 (0.72%)
    6 / 385 (1.56%)
    8 / 1248 (0.64%)
    2 / 269 (0.74%)
    10 / 816 (1.23%)
    11 / 814 (1.35%)
    2 / 269 (0.74%)
         occurrences all number
    2
    3
    6
    8
    2
    10
    12
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    0 / 125 (0.00%)
    4 / 417 (0.96%)
    4 / 385 (1.04%)
    4 / 1248 (0.32%)
    1 / 269 (0.37%)
    1 / 816 (0.12%)
    3 / 814 (0.37%)
    1 / 269 (0.37%)
         occurrences all number
    0
    5
    4
    4
    1
    1
    3
    1
    Nasopharyngitis
         subjects affected / exposed
    8 / 125 (6.40%)
    24 / 417 (5.76%)
    38 / 385 (9.87%)
    71 / 1248 (5.69%)
    11 / 269 (4.09%)
    37 / 816 (4.53%)
    54 / 814 (6.63%)
    10 / 269 (3.72%)
         occurrences all number
    8
    26
    40
    81
    12
    39
    59
    12
    Pharyngitis
         subjects affected / exposed
    3 / 125 (2.40%)
    0 / 417 (0.00%)
    1 / 385 (0.26%)
    7 / 1248 (0.56%)
    0 / 269 (0.00%)
    3 / 816 (0.37%)
    5 / 814 (0.61%)
    1 / 269 (0.37%)
         occurrences all number
    3
    0
    1
    8
    0
    3
    6
    1
    Rhinitis
         subjects affected / exposed
    0 / 125 (0.00%)
    7 / 417 (1.68%)
    1 / 385 (0.26%)
    12 / 1248 (0.96%)
    2 / 269 (0.74%)
    5 / 816 (0.61%)
    10 / 814 (1.23%)
    1 / 269 (0.37%)
         occurrences all number
    0
    7
    1
    12
    2
    5
    11
    1
    Tracheitis
         subjects affected / exposed
    2 / 125 (1.60%)
    2 / 417 (0.48%)
    0 / 385 (0.00%)
    2 / 1248 (0.16%)
    0 / 269 (0.00%)
    2 / 816 (0.25%)
    2 / 814 (0.25%)
    0 / 269 (0.00%)
         occurrences all number
    3
    2
    0
    2
    0
    2
    2
    0
    Urinary tract infection
         subjects affected / exposed
    2 / 125 (1.60%)
    1 / 417 (0.24%)
    2 / 385 (0.52%)
    5 / 1248 (0.40%)
    0 / 269 (0.00%)
    1 / 816 (0.12%)
    3 / 814 (0.37%)
    0 / 269 (0.00%)
         occurrences all number
    2
    1
    2
    5
    0
    1
    3
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Feb 2014
    introduced the following changes to be aligned with the requests included in the List of Grounds for Non-acceptance following the results of the assessment during Voluntary Harmonization Procedures VHP419 (VHP2013136): • Addition of Exclusion Criterion 8: “Patients on non-selective beta-blockers. Those patients may enter the study after non-selective beta-blocker withdrawal during a 7-day wash-out period”. Addition of Exclusion Criterion 9: “Patients receiving any other prohibited COPD-related medications.
    05 Mar 2014
    introduced the following change requested by Regulatory Authorities: • A secondary endpoint was added: “To evaluate the effect of glycopyrronium (50 μg o.d.) and indacaterol maleate and glycopyrronium bromide FDC (110/50 μg o.d) vs. baseline therapy on: Trough FEV1 at Visit 4 (after 12 weeks of treatment)”.
    28 Mar 2014
    introduced the following change requested by Regulatory Authorities (Voluntary Harmonization Procedure): • To promote FEV1 as primary endpoint maintaining BDI/TDI as co-primary endpoint since FEV1 is a well-established parameter to measure treatment efficacy and is a well-recognized endpoint in COPD clinical trials
    03 Feb 2015
    introduced the following changes to clarify some issues identified during the trial conduct: • Protocol Requested Treatment (Inclusion Criterion 6) was updated following the intention to clarify that all formulations of inhaled medication commercially available with an indication for use in patients with COPD in the therapeutic categories included in the study protocol were eligible for study inclusion. • Spirometry Guidance was updated to clarify the steps to be taken while performing a spirometry test during the study and how the related results should be interpreted before confirming the patient eligibility for the study.
    27 Jul 2015
    • Due to low recruitment in Groups A and B that would lead to a significant delay of trial completion, a decision was made to close the recruitment of Groups A and B at the time the randomization in Groups C and D would be completed. Recruitment of the Groups C and D continued as originally planned. To guarantee appropriate power, the drop-out rate was updated (from 5% to 10%) according to the approximate number of early terminated patients in the trial at the time when this amendment was written. • Addition of Exclusion Criterion 5: “Patients who have a post-bronchodilator FEV1 decrease more than 10% compared to pre-bronchodilator FEV1 result at Visit 2” to provide further clarity to investigators and support the proper implementation of the reversibility testing criterion.

    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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