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    Clinical Trial Results:
    BI 655066 [risankizumab] versus placebo in a multicenter randomized double-blind study in participants with moderate to severe chronic plaque psoriasis evaluating the efficacy and safety with randomized withdrawal and re-treatment.

    Summary
    EudraCT number
    2014-005102-38
    Trial protocol
    DE   BE   CZ  
    Global end of trial date
    26 Jul 2018

    Results information
    Results version number
    v2(current)
    This version publication date
    11 Nov 2019
    First version publication date
    01 Aug 2019
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    1311.4
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02672852
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Boehringer Ingelheim
    Sponsor organisation address
    Binger Strasse 173, Ingelheim am Rhein, Germany, Ingelheim am Rhein
    Public contact
    QRPE Processes and Systems Coordination, Clinical Trial Information Disclosure, Boehringer Ingelheim, +1 8002430127, clintriage.rdg@boehringer-ingelheim.com
    Scientific contact
    QRPE Processes and Systems Coordination, Clinical Trial Information Disclosure, Boehringer Ingelheim, +1 8002430127, clintriage.rdg@boehringer-ingelheim.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 Jul 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 Aug 2017
    Global end of trial reached?
    Yes
    Global end of trial date
    26 Jul 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objectives of this study were to assess the efficacy and safety of risankizumab compared with placebo in participants with moderate to severe chronic plaque psoriasis, the maintenance of response following drug withdrawal after Week 28 through Week 104, and the response after re-treatment in participants who experienced relapse after drug withdrawal and were re-treated with risankizumab. In addition, this study was designed to assess the pharmacokinetics (PK) of risankizumab, emergence of anti-drug antibodies, and the effect of anti-drug antibodies on efficacy and safety.
    Protection of trial subjects
    Only participants that met all the study inclusion and none of the exclusion criteria were to be entered in the study. All participants were free to withdraw from the clinical trial at any time for any reason given. Close monitoring of all participants was adhered to throughout the trial conduct. Rescue medication was allowed for all participants as required.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    29 Feb 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 32
    Country: Number of subjects enrolled
    Belgium: 1
    Country: Number of subjects enrolled
    Canada: 117
    Country: Number of subjects enrolled
    Czech Republic: 15
    Country: Number of subjects enrolled
    France: 12
    Country: Number of subjects enrolled
    Germany: 27
    Country: Number of subjects enrolled
    Japan: 15
    Country: Number of subjects enrolled
    Korea, Republic of: 56
    Country: Number of subjects enrolled
    United States: 288
    Worldwide total number of subjects
    563
    EEA total number of subjects
    55
    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)
    493
    From 65 to 84 years
    70
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Part A1: double-blind (DB) risankizumab or placebo (Weeks 0,4). Part A2 (Week 16) DB placebo to DB risankizumab; risankizumab continued risankizumab. Part B (Week 28) risankizumab responders rerandomized to DB risankizumab/placebo; risankizumab nonresponders continued risankizumab. Week 32: rerandomized relapsed switch risankizumab.

    Period 1
    Period 1 title
    Part A1
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    This was double-blind part of the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo (Part A1)
    Arm description
    Participants randomized at Baseline to receive double-blind (DB) placebo by subcutaneous injection at Weeks 0 and 4 (Part A1).
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants randomized at Baseline to receive double-blind (DB) placebo by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Arm title
    Risankizumab (Part A1)
    Arm description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab 150 mg by subcutaneous injection at Weeks 0 and 4 (Part A1).
    Arm type
    Experimental

    Investigational medicinal product name
    Rrisankizumab
    Investigational medicinal product code
    Other name
    BI 655066
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants randomized at Baseline to receive double-blind (DB) risankizumab 150 mg by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Number of subjects in period 1 [1]
    Placebo (Part A1) Risankizumab (Part A1)
    Started
    100
    407
    Completed
    97
    403
    Not completed
    3
    4
         Consent withdrawn by subject
    1
    1
         Adverse event, non-fatal
    -
    1
         Disease worsening
    1
    -
         Lost to follow-up
    1
    2
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Baseline characteristics are based on patients who were randomised after successfully completing the screening period and received at least one dose of the trial medication.
    Period 2
    Period 2 title
    Part A2
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    This was double-blind part of the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo/Risankizumab Part A2/Part B
    Arm description
    Participants randomized at Baseline to receive double-blind (DB) placebo then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2) and at Week 28 and every 12 weeks up to 88 weeks (Part B).
    Arm type
    Placebo

    Investigational medicinal product name
    Risankizumab
    Investigational medicinal product code
    Other name
    BI 655066
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants randomized at Baseline to receive double-blind (DB) placebo then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2) and at Week 28 and every 12 weeks up to 88 weeks (Part B).

    Arm title
    Risankizumab/Risankizumab Part A2
    Arm description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2).
    Arm type
    Experimental

    Investigational medicinal product name
    Risankizumab
    Investigational medicinal product code
    Other name
    BI 655066
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants randomized at Baseline to receive double-blind (DB) risankizumab then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2).

    Number of subjects in period 2 [2]
    Placebo/Risankizumab Part A2/Part B Risankizumab/Risankizumab Part A2
    Started
    93
    403
    Completed
    83
    399
    Not completed
    10
    4
         Consent withdrawn by subject
    1
    -
         Adverse event, non-fatal
    3
    -
         Not entered in Part B
    -
    4
         Not specified
    3
    -
         Disease worsening
    1
    -
         Lost to follow-up
    2
    -
    Notes
    [2] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Baseline characteristics are based on patients who were randomised after successfully completing the screening period and received at least one dose of the trial medication.
    Period 3
    Period 3 title
    Part B
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    This was double-blind part of the study.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Risankizumab/Placebo (Part B; Rerandomized Responders)
    Arm description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive placebo by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive placebo by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Arm title
    Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Arm description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).
    Arm type
    Experimental

    Investigational medicinal product name
    Risankizumab
    Investigational medicinal product code
    Other name
    BI 655066
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Arm title
    Risankizumab/Risankizumab Part B (Nonresponders)
    Arm description
    Participants who received risankizumab in Part A and were nonresponders (sPGA ≥2) at Week 28 received risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).
    Arm type
    Experimental

    Investigational medicinal product name
    Risankizumab
    Investigational medicinal product code
    Other name
    BI 655066
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Participants who received risankizumab in Part A and were nonresponders (sPGA ≥2) at Week 28 received risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Number of subjects in period 3 [3]
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders) Risankizumab/Risankizumab Part B (Nonresponders)
    Started
    225
    111
    63
    Completed
    209
    100
    51
    Not completed
    16
    11
    12
         Consent withdrawn by subject
    5
    -
    7
         Not specified
    4
    1
    2
         Other adverse event
    3
    5
    1
         Worsening pre-existing condition
    -
    1
    -
         Disease worsening
    1
    -
    1
         Lost to follow-up
    3
    4
    1
    Notes
    [3] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Baseline characteristics are based on patients who were randomised after successfully completing the screening period and received at least one dose of the trial medication.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) placebo by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Reporting group title
    Risankizumab (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab 150 mg by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Reporting group values
    Placebo (Part A1) Risankizumab (Part A1) Total
    Number of subjects
    100 407 507
    Age categorical
    Units: Subjects
    Age Continuous
    Intent to Treat (ITT) Population in Part A1 (ITT_A1): All participants who were randomized at Baseline
    Units: years
        arithmetic mean (standard deviation)
    47.9 ± 13.78 49.6 ± 13.17 -
    Sex: Female, Male
    ITT_A1
    Units: Subjects
        Female
    27 124 151
        Male
    73 283 356
    Ethnicity (NIH/OMB)
    ITT_A1
    Units: Subjects
        Hispanic or Latino
    11 45 56
        Not Hispanic or Latino
    89 362 451
        Unknown or Not Reported
    0 0 0
    Race (NIH/OMB)
    ITT_A1
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    15 64 79
        Native Hawaiian or Other Pacific Islander
    1 3 4
        Black or African American
    2 18 20
        White
    82 320 402
        More than one race
    0 2 2
        Unknown or Not Reported
    0 0 0

    End points

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    End points reporting groups
    Reporting group title
    Placebo (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) placebo by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Reporting group title
    Risankizumab (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab 150 mg by subcutaneous injection at Weeks 0 and 4 (Part A1).
    Reporting group title
    Placebo/Risankizumab Part A2/Part B
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) placebo then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2) and at Week 28 and every 12 weeks up to 88 weeks (Part B).

    Reporting group title
    Risankizumab/Risankizumab Part A2
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab then received DB risankizumab 150 mg by subcutaneous injection at Weeks 16 (Part A2).
    Reporting group title
    Risankizumab/Placebo (Part B; Rerandomized Responders)
    Reporting group description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive placebo by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Reporting group title
    Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Reporting group description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Reporting group title
    Risankizumab/Risankizumab Part B (Nonresponders)
    Reporting group description
    Participants who received risankizumab in Part A and were nonresponders (sPGA ≥2) at Week 28 received risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Primary: Percentage of Participants Achieving 90% Improvement Psoriasis Area and Severity Index (PASI) score (PASI90) from baseline to week 16

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    End point title
    Percentage of Participants Achieving 90% Improvement Psoriasis Area and Severity Index (PASI) score (PASI90) from baseline to week 16
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI90 is defined as at least a 90% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. Non-responder imputation (NRI) was used for missing data. Intent to treat (ITT) Population in Part A1(ITT_A1): all participants who were randomized at Baseline.
    End point type
    Primary
    End point timeframe
    Baseline, Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [1]
    407 [2]
    Units: Percentage of participants
        number (not applicable)
    2.0
    73.2
    Notes
    [1] - ITT_A1
    [2] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the Cochran-Mantel-Haenszel (CMH) test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab (Part A1) v Placebo (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    70.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    65.7
         upper limit
    76

    Primary: Percentage of Participants Achieving static Physician Global Assessment (sPGA) score of clear or almost clear at week 16

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    End point title
    Percentage of Participants Achieving static Physician Global Assessment (sPGA) score of clear or almost clear at week 16
    End point description
    The sPGA is an assessment by the investigator of the overall disease severity at the time of evaluation. Erythema (E), induration (I), and desquamation (D) are scored on a 5-point scale ranging from 0 (none) to 4 (severe). The sPGA ranges from 0 to 4, and is calculated as Clear (0) = 0 for all three; Almost clear (1) = mean >0, <1.5; Mild (2) = mean ≥1.5, <2.5; Moderate (3) = mean ≥2.5, <3.5; and Severe (4) = mean ≥3.5. NRI was used for missing data.
    End point type
    Primary
    End point timeframe
    Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [3]
    407 [4]
    Units: Percentage of participants
        number (not applicable)
    7.0
    83.5
    Notes
    [3] - ITT_A1
    [4] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Placebo (Part A1) v Risankizumab (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    76.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    70.4
         upper limit
    82.5

    Primary: Percentage of Participants Achieving sPGA score of clear or almost clear at week 52

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    End point title
    Percentage of Participants Achieving sPGA score of clear or almost clear at week 52
    End point description
    The sPGA is an assessment by the investigator of the overall disease severity at the time of evaluation. Erythema (E), induration (I), and desquamation (D) are scored on a 5-point scale ranging from 0 (none) to 4 (severe). The sPGA ranges from 0 to 4, and is calculated as Clear (0) = 0 for all three; Almost clear (1) = mean >0, <1.5; Mild (2) = mean ≥1.5, <2.5; Moderate (3) = mean ≥2.5, <3.5; and Severe (4) = mean ≥3.5. NRI was used for missing data. ITT Population in Part B for re-randomized participants (ITT_B_R): All participants who were randomized to Arm 1 at Baseline and re randomized at Week 28.
    End point type
    Primary
    End point timeframe
    Week 52
    End point values
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects analysed
    225 [5]
    111 [6]
    Units: Percentage of participants
        number (not applicable)
    61.3
    87.4
    Notes
    [5] - ITT_B_R
    [6] - ITT_B_R
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab/Placebo (Part B; Rerandomized Responders) v Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects included in analysis
    336
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    25.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    17.3
         upper limit
    34.6

    Secondary: Percentage of Participants Achieving 75% Improvement in PASI score (PASI75) at week 16

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    End point title
    Percentage of Participants Achieving 75% Improvement in PASI score (PASI75) at week 16
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI75 is defined as at least a 75% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [7]
    407 [8]
    Units: Percentage of participants
        number (not applicable)
    8.0
    88.7
    Notes
    [7] - ITT_A1
    [8] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Placebo (Part A1) v Risankizumab (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    80.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    74.5
         upper limit
    86.6

    Secondary: Percentage of Participants Achieving 100% improvement in PASI score (PASI100) at week 16

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    End point title
    Percentage of Participants Achieving 100% improvement in PASI score (PASI100) at week 16
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI100 is defined as a 100% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [9]
    407 [10]
    Units: Percentage of participants
        number (not applicable)
    1.0
    47.2
    Notes
    [9] - ITT_A1
    [10] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Placebo (Part A1) v Risankizumab (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    45.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    40.3
         upper limit
    50.8

    Secondary: Percentage of Participants Achieving an sPGA score of clear at Week 16

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    End point title
    Percentage of Participants Achieving an sPGA score of clear at Week 16
    End point description
    The sPGA is an assessment by the investigator of the overall disease severity at the time of evaluation. Erythema (E), induration (I), and desquamation (D) are scored on a 5-point scale ranging from 0 (none) to 4 (severe). The sPGA ranges from 0 to 4, and is calculated as Clear (0) = 0 for all three; Almost clear (1) = mean >0, <1.5; Mild (2) = mean ≥1.5, <2.5; Moderate (3) = mean ≥2.5, <3.5; and Severe (4) = mean ≥3.5. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [11]
    407 [12]
    Units: Percentage of participants
        number (not applicable)
    1.0
    46.4
    Notes
    [11] - ITT_A1
    [12] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Placebo (Part A1) v Risankizumab (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    44.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    39.5
         upper limit
    50

    Secondary: Percentage of Participants Achieving a Dermatology Life Quality Index (DLQI) score of 0 or 1 at Week 16

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    End point title
    Percentage of Participants Achieving a Dermatology Life Quality Index (DLQI) score of 0 or 1 at Week 16
    End point description
    The DLQI is a 10-question questionnaire that asks the participant to evaluate the degree that psoriasis has affected their quality of life in the last week and includes 6 domains (symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment). Responses to each domain are not relevant (0), not at all (0), a little (1), a lot (2), and very much (3). The DLQI is calculated by summing the scores of the questions and ranges from 1 to 30, where 0-1 = no effect on patient’s life, 2-5 = small effect, 6-10 = moderate effect, 11-20 = very large effect, and 21-30 = extremely large effect on patient’s life. The higher the score, the more the quality of life is impaired. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Placebo (Part A1) Risankizumab (Part A1)
    Number of subjects analysed
    100 [13]
    407 [14]
    Units: Percentage of participants
        number (not applicable)
    3.0
    65.4
    Notes
    [13] - ITT_A1
    [14] - ITT_A1
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Placebo (Part A1) v Risankizumab (Part A1)
    Number of subjects included in analysis
    507
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    62.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    56.4
         upper limit
    67.9

    Secondary: Percentage of Participants Achieving an sPGA score of clear or almost clear at Week 104

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    End point title
    Percentage of Participants Achieving an sPGA score of clear or almost clear at Week 104
    End point description
    The sPGA is an assessment by the investigator of the overall disease severity at the time of evaluation. Erythema (E), induration (I), and desquamation (D) are scored on a 5-point scale ranging from 0 (none) to 4 (severe). The sPGA ranges from 0 to 4, and is calculated as Clear (0) = 0 for all three; Almost clear (1) = mean >0, <1.5; Mild (2) = mean ≥1.5, <2.5; Moderate (3) = mean ≥2.5, <3.5; and Severe (4) = mean ≥3.5. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 104
    End point values
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects analysed
    225 [15]
    111 [16]
    Units: Percentage of participants
        number (not applicable)
    7.1
    81.1
    Notes
    [15] - ITT_B_R
    [16] - ITT_B_R
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab/Placebo (Part B; Rerandomized Responders) v Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects included in analysis
    336
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    73.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    66
         upper limit
    81.9

    Secondary: Percentage of Participants Achieving 75% improvement in PASI Score (PASI75) at Week 52

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    End point title
    Percentage of Participants Achieving 75% improvement in PASI Score (PASI75) at Week 52
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI75 is defined as at least a 75% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 52
    End point values
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects analysed
    225 [17]
    111 [18]
    Units: Percentage of participants
        number (not applicable)
    71.6
    92.8
    Notes
    [17] - ITT_B_R
    [18] - ITT_B_R
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab/Placebo (Part B; Rerandomized Responders) v Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects included in analysis
    336
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    21.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    13.7
         upper limit
    28.7

    Secondary: Percentage of Participants Achieving 90% Improvement in PASI Score (PASI90) at Week 52

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    End point title
    Percentage of Participants Achieving 90% Improvement in PASI Score (PASI90) at Week 52
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI90 is defined as at least a 90% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 52
    End point values
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects analysed
    225 [19]
    111 [20]
    Units: Percentage of participants
        number (not applicable)
    52.4
    85.6
    Notes
    [19] - ITT_B_R
    [20] - ITT_B_R
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab/Placebo (Part B; Rerandomized Responders) v Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects included in analysis
    336
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    33.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    24
         upper limit
    42.2

    Secondary: Percentage of Participants Achieving 100% Improvement in PASI Score (PASI100) at Week 52

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    End point title
    Percentage of Participants Achieving 100% Improvement in PASI Score (PASI100) at Week 52
    End point description
    PASI is a composite score based on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The severity of each sign was assessed using a 5-point scale, where 0=no symptoms, 1=slight, 2=moderate, 3=marked, 4=very marked. The PASI score ranges from 0 to 72, where 0 indicates no psoriasis and 72 indicates very severe psoriasis. PASI100 is defined as a 100% reduction in PASI score compared with the Baseline PASI score. The percent reduction in score is calculated as (PASI score at Baseline - score at follow-up visit) / PASI score at Baseline * 100. NRI was used for missing data.
    End point type
    Secondary
    End point timeframe
    Week 52
    End point values
    Risankizumab/Placebo (Part B; Rerandomized Responders) Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects analysed
    225 [21]
    111 [22]
    Units: Percentage of participants
        number (not applicable)
    30.2
    64.0
    Notes
    [21] - ITT_B_R
    [22] - ITT_B_R
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Across strata, P value was calculated from the CMH test adjusted for strata. Within each stratum, P value was calculated based on the chi-square test (or Fisher's exact test if ≥25% of the cells had expected cell count <5).
    Comparison groups
    Risankizumab/Placebo (Part B; Rerandomized Responders) v Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Number of subjects included in analysis
    336
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Adjusted percentage difference
    Point estimate
    33.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    23.2
         upper limit
    44.2

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events (TEAEs) and serious adverse events (TESAEs) were collected from first dose of study drug until 15 weeks after the last dose of study drug (up to 103 weeks).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    Placebo (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) placebo by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Reporting group title
    Risankizumab (Part A1)
    Reporting group description
    Participants randomized at Baseline to receive double-blind (DB) risankizumab 150 mg by subcutaneous injection at Weeks 0 and 4 (Part A1).

    Reporting group title
    Risankizumab/Risankizumab (Part B; Rerandomized Responders)
    Reporting group description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive risankizumab 150 mg by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Reporting group title
    Risankizumab/Placebo (Part B; Rerandomized Responders)
    Reporting group description
    Participants who received risankizumab in Part A and were responders (sPGA 0 or 1) at Week 28, and rerandomized to receive placebo by subcutaneous injection at Week 28 and every 12 weeks up to Week 88 (Part B).

    Reporting group title
    Any Risankizumab
    Reporting group description
    Participants who received at least one dose of risankizumab during the study.

    Serious adverse events
    Placebo (Part A1) Risankizumab (Part A1) Risankizumab/Risankizumab (Part B; Rerandomized Responders) Risankizumab/Placebo (Part B; Rerandomized Responders) Any Risankizumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    8 / 100 (8.00%)
    8 / 407 (1.97%)
    13 / 111 (11.71%)
    17 / 225 (7.56%)
    55 / 500 (11.00%)
         number of deaths (all causes)
    0
    0
    2
    0
    4
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    B-cell lymphoma
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    3 / 500 (0.60%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Breast cancer
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Breast cancer stage I
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric cancer
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatic cancer metastatic
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Intestinal adenocarcinoma
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Invasive ductal breast carcinoma
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Malignant melanoma in situ
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metastases to lymph nodes
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophageal carcinoma
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Prostate cancer
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    2 / 225 (0.89%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Surgical and medical procedures
    Alcohol detoxification
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Death
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    Reproductive system and breast disorders
    Benign prostatic hyperplasia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cervical dysplasia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Menometrorrhagia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Menorrhagia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chylothorax
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Alcoholism
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Anxiety
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Delirium tremens
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Insomnia
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Somatic symptom disorder
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Suicidal ideation
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Burns second degree
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hand fracture
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Incisional hernia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ligament sprain
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Muscle strain
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Open globe injury
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Benign familial pemphigus
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Huntington's disease
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Aortic valve disease mixed
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intracardiac thrombus
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ventricular arrhythmia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Basal ganglia infarction
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Carotid artery occlusion
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dementia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Encephalitis autoimmune
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    Hemiplegia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tension headache
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Blood and lymphatic system disorders
    Disseminated intravascular coagulation
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Amaurosis fugax
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diabetic retinopathy
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Retinal detachment
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    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
    Alcoholic pancreatitis
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Haemorrhoids
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 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
    Intestinal obstruction
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct stone
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatic cirrhosis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Liver injury
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    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
    Skin and subcutaneous tissue disorders
    Skin ulcer
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arthropathy
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bursitis
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gouty tophus
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Jaw cyst
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psoriatic arthropathy
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rotator cuff syndrome
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal abscess
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abscess neck
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 100 (1.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Meningitis bacterial
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nasopharyngitis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    1 / 111 (0.90%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    1 / 225 (0.44%)
    0 / 500 (0.00%)
         occurrences causally related to treatment / all
    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
    Sepsis
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    2 / 500 (0.40%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 100 (0.00%)
    0 / 407 (0.00%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 100 (0.00%)
    1 / 407 (0.25%)
    0 / 111 (0.00%)
    0 / 225 (0.00%)
    1 / 500 (0.20%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo (Part A1) Risankizumab (Part A1) Risankizumab/Risankizumab (Part B; Rerandomized Responders) Risankizumab/Placebo (Part B; Rerandomized Responders) Any Risankizumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    17 / 100 (17.00%)
    52 / 407 (12.78%)
    52 / 111 (46.85%)
    92 / 225 (40.89%)
    242 / 500 (48.40%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 100 (0.00%)
    14 / 407 (3.44%)
    8 / 111 (7.21%)
    7 / 225 (3.11%)
    34 / 500 (6.80%)
         occurrences all number
    0
    15
    15
    9
    47
    Skin and subcutaneous tissue disorders
    Psoriasis
         subjects affected / exposed
    5 / 100 (5.00%)
    2 / 407 (0.49%)
    0 / 111 (0.00%)
    8 / 225 (3.56%)
    4 / 500 (0.80%)
         occurrences all number
    6
    2
    0
    8
    4
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 100 (2.00%)
    7 / 407 (1.72%)
    10 / 111 (9.01%)
    13 / 225 (5.78%)
    35 / 500 (7.00%)
         occurrences all number
    2
    7
    10
    16
    37
    Back pain
         subjects affected / exposed
    0 / 100 (0.00%)
    2 / 407 (0.49%)
    4 / 111 (3.60%)
    12 / 225 (5.33%)
    28 / 500 (5.60%)
         occurrences all number
    0
    2
    7
    13
    31
    Infections and infestations
    Influenza
         subjects affected / exposed
    1 / 100 (1.00%)
    3 / 407 (0.74%)
    7 / 111 (6.31%)
    8 / 225 (3.56%)
    22 / 500 (4.40%)
         occurrences all number
    1
    3
    8
    10
    24
    Nasopharyngitis
         subjects affected / exposed
    6 / 100 (6.00%)
    21 / 407 (5.16%)
    23 / 111 (20.72%)
    45 / 225 (20.00%)
    116 / 500 (23.20%)
         occurrences all number
    6
    21
    36
    53
    170
    Upper respiratory tract infection
         subjects affected / exposed
    5 / 100 (5.00%)
    6 / 407 (1.47%)
    16 / 111 (14.41%)
    23 / 225 (10.22%)
    77 / 500 (15.40%)
         occurrences all number
    5
    6
    19
    29
    97

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    11 Mar 2016
    Added Infection Testing (Tuberculosis (TB)) to Screening. Several footnotes added. Vital Status information updated. Justification provide for Section 2.3. Section 3.1.2 and 3.1.3 clarified. Section 3.3.4.1, 5.1.3, 7.5 and 4.1.4 updated. Added tofacitinib (Xeljanz®), apremilast (Otezla®) and removed efalizumab (Raptiva®)in Table 4.2.2.1:1. Added a paragraph for TB testing in Section 6.2. Maximum of 2 visits a patient may need for screening was deleted. Updated Section 6.2.3, Follow-up Period and Trial Completion. Separated out re-randomized hypothesis from hypotheses tested on all randomized patients. Definition of analysis sets clarified. Wording “IPV’s would be provided in trial statistical analysis plan (TSAP) and added verbiage about IPVs and PPS sensitivity analyses” and data monitoring committee (DMC) information deleted. Added “The hypothesis tests as described in Section 7.2 will be repeated on the PPS or RRSPPS populations, as appropriate". Order of Psoriatic arthritis (PsA) assessments changed at Visit 2. Investigator Brochure document ID was changed. References added. Added risankizumab after BI 655066.
    28 Jul 2016
    Footnotes were revised. Abbreviation added and corrected. Figure 3.1:1 was replaced with new trial design. Summary and Overall trial design and plan were updated. Section 3.3.4.2 updated. Section 4.1.2 re-written according to new study design to be consistent with section 3.1. 650666 changed to 655066 in section 4.1.3. Section 4.1.4 Drug assignment and administration of doses for each patient updated. Section 4.1.5.1 Blinding and 7.6 Randomisation re-written according to new study design to be consistent with section 3.1, clarifying the criteria for receiving open label. Deleted reference to Section 3.3.3, and corrected to 3.3.2. Text added in section 5.1.3 Further endpoints. Section 5.3.2 Vital Signs updated to specify timing of vitals relative to injection times and also timing of monitoring hypersensitivity with respect to injection times. Added absolute count to differential, activated to aPTT, calculated to LDL, creatinineand Albumin/creatinine ratio to urinalysis. Deleted “MB” from Troponin reflex and creatinine” from urinalysis stix in Table 5.3.3:1 laboratory tests. Added paragraph to note that efficacy questionnaires are direct data capture on an electronic device. Wording revised due to implementation of continuing blinded treatment. Further instructions given for staying in the trial or terminating from the trial when a patient ends treatment early updated. Added “and who have not discontinued drug prematurely” to definition of trial completion. Section 7.1, Section 7.3 Planned Analyses, 7.3.3 Further endpoint analyses, 7.3.3 Further endpoint analyses and 7.5 Handling of Missing Data updated. In Table 7.7.1 changed PBO to “placebo”. Wording from “scored” to “scores” corrected. Response categories for Dermatology life quality index (DLQI) updated. Blind break for week 28 responders was updated.
    11 Oct 2016
    The compound name was revised to add “ABBV-066” to BI 655066 (risankizumab). Changed sponsor from Boehringer Ingelheim (BI) to AbbVie in the USA and BI for non-USA participating countries. Updated text to “AbbVie/Boehringer Ingelheim reserves the right to discontinue the trial overall or at a particular trial site at any time for the following reasons”. Changed DNA banking sample storage from Boehringer Ingelheim to “AbbVie or a third party delegate (e.g. Boehringer Ingelheim Pharma GmbH & Co. KG; Birkendorfer Str. 65, 88397 Biberach, Germany)”. Changed text to specify that AbbVie summary tables and listings will be produced and analyses based on AbbVie standards.

    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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