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    Clinical Trial Results:
    A 52-week, multicenter, randomized, double-blind study of secukinumab (300 mg) to demonstrate efficacy as assessed by Psoriasis Area and Severity Index and Investigator’s Global Assessment after 12 weeks of treatment, compared to ustekinumab, and to assess long-term safety, tolerability, and efficacy in patients with moderate to severe plaque psoriasis (CLARITY).

    Summary
    EudraCT number
    2015-002898-37
    Trial protocol
    HU   SK   IS   PL   CZ  
    Global end of trial date
    09 Jul 2018

    Results information
    Results version number
    v2(current)
    This version publication date
    30 Jul 2023
    First version publication date
    06 Jul 2019
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    AGE TABLE CORRECTED TO INCLUDE ONE 17 YEAR OLD PARTICIPANT

    Trial information

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    Trial identification
    Sponsor protocol code
    CAIN457A2326
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02826603
    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, 41 613 241 1111, novartis.email@novartis.com
    Scientific contact
    Study Director, Novartis Pharmaceuticals, 41 613 241 1111, novartis.email@novartis.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
    11 Dec 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    09 Jul 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The co-primary objectives were to demonstrate the superiority of secukinumab compared to ustekinumab in patients with moderate to severe plaque psoriasis with respect to both PASI 90 and IGA mod 2011 0 or 1 response 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
    22 Jun 2016
    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
    Canada: 27
    Country: Number of subjects enrolled
    Czech Republic: 12
    Country: Number of subjects enrolled
    Guatemala: 65
    Country: Number of subjects enrolled
    Hungary: 21
    Country: Number of subjects enrolled
    Iceland: 33
    Country: Number of subjects enrolled
    Korea, Republic of: 38
    Country: Number of subjects enrolled
    Malaysia: 30
    Country: Number of subjects enrolled
    Poland: 139
    Country: Number of subjects enrolled
    Slovakia: 10
    Country: Number of subjects enrolled
    United States: 707
    Country: Number of subjects enrolled
    Vietnam: 20
    Worldwide total number of subjects
    1102
    EEA total number of subjects
    215
    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)
    1
    Adults (18-64 years)
    981
    From 65 to 84 years
    120
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Overall, 1353 patients were screened of which 1102 patients completed the Screening phase; 251 patients were screen failures

    Pre-assignment
    Screening details
    The randomized set was defined as all patients who were randomized at the baseline visit. Unless otherwise specified, mis-randomized patients were excluded from the randomized set. Mis-randomized patients were those who were screen failures, but had been randomized by the Investigator before eligibility was assessed, but had not been treated

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Assessor
    Blinding implementation details
    Designated Novartis personnel were unblinded following database lock for the interim analysis after all patients completed Week 16 visit. Field monitors/clinical research associates remained blinded until after final database lock. All blinded site personnel, including the assessor remained blinded to individual treatment allocation until after final database lock

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Secukinumab 300mg (2 x 150 mg)
    Arm description
    Secukinumab 300mg s.c. injection (2 150mg pre-fiilled syringes)
    Arm type
    Experimental

    Investigational medicinal product name
    Secukinumab
    Investigational medicinal product code
    Other name
    AIN457
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Secukinumab 300mg s.c. injection (2 150mg pre-fiilled syringes)

    Investigational medicinal product name
    Ustekinumab
    Investigational medicinal product code
    Other name
    UST
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Ustekinumab s.c. 45 mg or 90 mg (depending on body weight) using 45mg pre-filled syringes (1 or 2 syringes)

    Arm title
    Ustekinumab 45mg or 90mg
    Arm description
    Ustekinumab s.c. 45 mg or 90 mg (depending on body weight) using 45mg pre-filled syringes (1 or 2 syringes)
    Arm type
    Active comparator

    Investigational medicinal product name
    ustekinumab
    Investigational medicinal product code
    Other name
    UST
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    45 mg or 90 mg pre-filled syringe(s)

    Number of subjects in period 1
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Started
    550
    552
    Completed
    489
    488
    Not completed
    61
    64
         Adverse event, serious fatal
    2
    -
         Consent withdrawn by subject
    20
    19
         Physician decision
    1
    7
         Adverse event, non-fatal
    17
    9
         Pregnancy
    1
    2
         Lost to follow-up
    13
    12
         Noncompliance with treatment
    -
    2
         New therapy for study indication
    -
    1
         Lack of efficacy
    4
    9
         Protocol deviation
    3
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Secukinumab 300mg (2 x 150 mg)
    Reporting group description
    Secukinumab 300mg s.c. injection (2 150mg pre-fiilled syringes)

    Reporting group title
    Ustekinumab 45mg or 90mg
    Reporting group description
    Ustekinumab s.c. 45 mg or 90 mg (depending on body weight) using 45mg pre-filled syringes (1 or 2 syringes)

    Reporting group values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg Total
    Number of subjects
    550 552 1102
    Age, Customized
    Units: Subjects
        <65 years
    488 494 982
        >=65 years
    60 48 108
        >=75 years
    2 10 12
    Age Continuous
    average age of participants
    Units: years
        arithmetic mean (standard deviation)
    45.4 ± 14.09 45.3 ± 14.16 -
    Sex: Female, Male
    Units: Subjects
        Female
    194 176 370
        Male
    356 376 732
    Race/Ethnicity, Customized
    Units: Subjects
        Caucasian
    416 410 826
        Black
    21 24 45
        Asian
    60 57 117
        Native American
    34 41 75
        Pacific Islander
    1 5 6
        Unknown
    4 2 6
        Other
    14 13 27

    End points

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    End points reporting groups
    Reporting group title
    Secukinumab 300mg (2 x 150 mg)
    Reporting group description
    Secukinumab 300mg s.c. injection (2 150mg pre-fiilled syringes)

    Reporting group title
    Ustekinumab 45mg or 90mg
    Reporting group description
    Ustekinumab s.c. 45 mg or 90 mg (depending on body weight) using 45mg pre-filled syringes (1 or 2 syringes)

    Primary: Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 12

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 12
    End point description
    Number of participants who achieved ≥ 90% reduction in PASI compared to baseline. Logistic regression analysis of PASI 90 response at Week 12 PASI is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, upper limbs, trunk, lower limbs; each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area* area score weight of body region (head: 0.1, upper limbs: 0.2, trunk: 0.3, lower limbs: 0.4).
    End point type
    Primary
    End point timeframe
    Week 12
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    366
    265
    Statistical analysis title
    Statistical Analysis of Primary Outcome
    Comparison groups
    Ustekinumab 45mg or 90mg v Secukinumab 300mg (2 x 150 mg)
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.21
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.72
         upper limit
    2.84

    Primary: Participants with IGA mod 2011 0 or 1 at Week 12

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    End point title
    Participants with IGA mod 2011 0 or 1 at Week 12
    End point description
    Investigator's Global Assessment uses a scale (IGA mod 2011) that rates disease from a score of 0 (clear skin) to 4 (severe disease)
    End point type
    Primary
    End point timeframe
    Week 12
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    397
    306
    Statistical analysis title
    Statististical Analysis of Outcome Measure
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.63
         upper limit
    2.72

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 12

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 12
    End point description
    Number of participants who achieved ≥ 75% reduction in PASI at Week 12 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    484
    409
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.62
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.89
         upper limit
    3.62

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 4

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 4
    End point description
    Number of participants who achieved ≥ 75% reduction in PASI at Week 4 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 4
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    221
    90
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    3.53
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    2.65
         upper limit
    4.71

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 100 response at Week 16

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 100 response at Week 16
    End point description
    Number of participants who achieved 100% reduction in PASI at Week 16 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    250
    147
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.33
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.8
         upper limit
    3.01

    Secondary: Participants with IGA mod 2011 0 or 1 at 16 weeks

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    End point title
    Participants with IGA mod 2011 0 or 1 at 16 weeks
    End point description
    Investigator's Global Assessment uses a scale (IGA mod 2011) that rates disease from a score of 0 (clear skin) to 4 (severe disease)
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    432
    326
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.57
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.96
         upper limit
    3.37

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 100 response at Week 12

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 100 response at Week 12
    End point description
    Number of participants who achieved 100% reduction in PASI at Week 12 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 12
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    210
    111
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.89
         upper limit
    3.31

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 16

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 75 response at Week 16
    End point description
    Number of participants who achieved ≥ 75% reduction in PASI at Week 16 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    506
    441
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.86
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.96
         upper limit
    4.17

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 16

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 16
    End point description
    Number of participants who achieved ≥ 90% reduction in PASI at Week 16 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 16
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    423
    299
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    2.85
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    2.19
         upper limit
    3.71

    Secondary: Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 52

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    End point title
    Participants who achieved Psoriasis Area and Severity Index (PASI) 90 response at Week 52
    End point description
    Number of participants who achieved ≥ 90% reduction in PASI at Week 52 compared to baseline.
    End point type
    Secondary
    End point timeframe
    Week 52
    End point values
    Secukinumab 300mg (2 x 150 mg) Ustekinumab 45mg or 90mg
    Number of subjects analysed
    550
    552
    Units: participants
    402
    330
    Statistical analysis title
    Statististical Analysis of Secondary Outcome
    Comparison groups
    Secukinumab 300mg (2 x 150 mg) v Ustekinumab 45mg or 90mg
    Number of subjects included in analysis
    1102
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.84
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.41
         upper limit
    2.41

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs and SAEs were collected for maximum duration of treatment and follow up for a participant per protocol for 52 weeks. All cause mortality (deaths) was collected from First Patient First Visit (FPFV) to Last Patient Last Visit (LPLV) until 52 weeks
    Adverse event reporting additional description
    All-cause mortality (deaths) was collected for as long as participants could be contacted from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV) up to a maximum of 52 weeks
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    AIN457 300 mg
    Reporting group description
    AIN457 300 mg

    Reporting group title
    UST 45/90 mg
    Reporting group description
    UST 45/90 mg

    Reporting group title
    All Patients
    Reporting group description
    All Patients

    Serious adverse events
    AIN457 300 mg UST 45/90 mg All Patients
    Total subjects affected by serious adverse events
         subjects affected / exposed
    29 / 550 (5.27%)
    21 / 552 (3.80%)
    50 / 1102 (4.54%)
         number of deaths (all causes)
    2
    0
    2
         number of deaths resulting from adverse events
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Invasive ductal breast carcinoma
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Laryngeal squamous cell carcinoma
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of the oral cavity
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    T-cell lymphoma
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    2 / 550 (0.36%)
    1 / 552 (0.18%)
    3 / 1102 (0.27%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Sudden cardiac death
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug hypersensitivity
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    3 / 550 (0.55%)
    0 / 552 (0.00%)
    3 / 1102 (0.27%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Asthma
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary thrombosis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Product issues
    Device inappropriate shock delivery
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Haemoglobin decreased
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Comminuted fracture
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gun shot wound
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Incisional hernia
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Postoperative ileus
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toxicity to various agents
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    Wrist fracture
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    3 / 550 (0.55%)
    0 / 552 (0.00%)
    3 / 1102 (0.27%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ventricular tachycardia
         subjects affected / exposed
    2 / 550 (0.36%)
    0 / 552 (0.00%)
    2 / 1102 (0.18%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebrovascular accident
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Lymphadenopathy
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Anal fissure
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis erosive
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis ulcerative
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Drug eruption
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toxic skin eruption
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal infarct
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bursitis
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 550 (0.18%)
    2 / 552 (0.36%)
    3 / 1102 (0.27%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dengue fever
         subjects affected / exposed
    2 / 550 (0.36%)
    0 / 552 (0.00%)
    2 / 1102 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peritonitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pharyngitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia streptococcal
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skin candida
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    1 / 550 (0.18%)
    0 / 552 (0.00%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    0 / 550 (0.00%)
    1 / 552 (0.18%)
    1 / 1102 (0.09%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    AIN457 300 mg UST 45/90 mg All Patients
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    216 / 550 (39.27%)
    229 / 552 (41.49%)
    445 / 1102 (40.38%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    17 / 550 (3.09%)
    22 / 552 (3.99%)
    39 / 1102 (3.54%)
         occurrences all number
    20
    24
    44
    Nervous system disorders
    Headache
         subjects affected / exposed
    26 / 550 (4.73%)
    25 / 552 (4.53%)
    51 / 1102 (4.63%)
         occurrences all number
    31
    30
    61
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    26 / 550 (4.73%)
    24 / 552 (4.35%)
    50 / 1102 (4.54%)
         occurrences all number
    40
    26
    66
    Nausea
         subjects affected / exposed
    6 / 550 (1.09%)
    13 / 552 (2.36%)
    19 / 1102 (1.72%)
         occurrences all number
    6
    15
    21
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    17 / 550 (3.09%)
    16 / 552 (2.90%)
    33 / 1102 (2.99%)
         occurrences all number
    19
    19
    38
    Oropharyngeal pain
         subjects affected / exposed
    14 / 550 (2.55%)
    17 / 552 (3.08%)
    31 / 1102 (2.81%)
         occurrences all number
    15
    17
    32
    Skin and subcutaneous tissue disorders
    Dermatitis contact
         subjects affected / exposed
    12 / 550 (2.18%)
    8 / 552 (1.45%)
    20 / 1102 (1.81%)
         occurrences all number
    13
    8
    21
    Pruritus
         subjects affected / exposed
    12 / 550 (2.18%)
    18 / 552 (3.26%)
    30 / 1102 (2.72%)
         occurrences all number
    12
    20
    32
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    9 / 550 (1.64%)
    14 / 552 (2.54%)
    23 / 1102 (2.09%)
         occurrences all number
    11
    15
    26
    Back pain
         subjects affected / exposed
    14 / 550 (2.55%)
    20 / 552 (3.62%)
    34 / 1102 (3.09%)
         occurrences all number
    14
    22
    36
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    8 / 550 (1.45%)
    18 / 552 (3.26%)
    26 / 1102 (2.36%)
         occurrences all number
    8
    19
    27
    Conjunctivitis
         subjects affected / exposed
    12 / 550 (2.18%)
    6 / 552 (1.09%)
    18 / 1102 (1.63%)
         occurrences all number
    14
    6
    20
    Nasopharyngitis
         subjects affected / exposed
    55 / 550 (10.00%)
    54 / 552 (9.78%)
    109 / 1102 (9.89%)
         occurrences all number
    72
    69
    141
    Sinusitis
         subjects affected / exposed
    25 / 550 (4.55%)
    18 / 552 (3.26%)
    43 / 1102 (3.90%)
         occurrences all number
    26
    22
    48
    Upper respiratory tract infection
         subjects affected / exposed
    49 / 550 (8.91%)
    61 / 552 (11.05%)
    110 / 1102 (9.98%)
         occurrences all number
    56
    69
    125
    Urinary tract infection
         subjects affected / exposed
    13 / 550 (2.36%)
    9 / 552 (1.63%)
    22 / 1102 (2.00%)
         occurrences all number
    14
    9
    23

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    22 Apr 2016
    Per the new protocol, all drug administrations will be performed at the site in order to minimize potential influence of subjects’ non-compliance at home administrations in this head to head study. Also, the Non-responder imputation method is updated. This change is in line with recommendations to impute subjects with all post-baseline missing values as non-responders according to the Intent-to-treat (ITT) principle.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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