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    Clinical Trial Results:
    A phase II, open-label, non-controlled, intra-patient dose-escalation study to characterize the pharmacokinetics after oral administration of eltrombopag in pediatric patients with refractory, relapsed or treatment-naive severe aplastic anemia or recurrent aplastic anemia. Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com for complete trial results.

    Summary
    EudraCT number
    2015-003166-91
    Trial protocol
    GB   PT   NL  
    Global end of trial date

    Results information
    Results version number
    v1(current)
    This version publication date
    11 Apr 2025
    First version publication date
    11 Apr 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CETB115E2201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03025698
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma, AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma, AG, 41 613241111, novartis.email@novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma, AG, 41 613241111, novartis.email@novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    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
    Interim
    Date of interim/final analysis
    22 Apr 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    22 Apr 2022
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    To characterize the PK of eltrombopag at the highest dose after oral administration in pediatric patients with SAA.
    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
    30 Sep 2017
    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
    United Kingdom: 4
    Country: Number of subjects enrolled
    Hong Kong: 3
    Country: Number of subjects enrolled
    Portugal: 1
    Country: Number of subjects enrolled
    Russian Federation: 10
    Country: Number of subjects enrolled
    Thailand: 9
    Country: Number of subjects enrolled
    United States: 24
    Worldwide total number of subjects
    51
    EEA total number of subjects
    1
    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)
    30
    Adolescents (12-17 years)
    21
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Due to low participant numbers in Cohort A regimens 1 and 2, this report will focus on total participants in Cohort A and Cohort B.

    Pre-assignment
    Screening details
    Study was conducted in 19 sites in 6 countries.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Total Cohort A (Regimens 1 & 2)
    Arm description
    Regimen 1: Participants received hATG (ATGAM®), CsA and eltrombopag beginning on Day 1. Regimen 2: Participants received CsA and eltrombopag beginning on Day 1.
    Arm type
    Experimental

    Investigational medicinal product name
    Eltrombopag
    Investigational medicinal product code
    ETB115
    Other name
    Pharmaceutical forms
    Tablet, Powder for oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    Eltrombopag tablets were supplied at dose strengths of 12.5 mg, 25 mg, 50 mg, and 75 mg or as a 25 mg powder for oral solution.

    Arm title
    Cohort B
    Arm description
    Participants who previously had untreated SAA received hATG, CsA and eltrombopag beginning on Day 1.
    Arm type
    Experimental

    Investigational medicinal product name
    Eltrombopag
    Investigational medicinal product code
    ETB115
    Other name
    Pharmaceutical forms
    Tablet, Powder for oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    Eltrombopag tablets were supplied at dose strengths of 12.5 mg, 25 mg, 50 mg, and 75 mg or as a 25 mg powder for oral solution.

    Number of subjects in period 1
    Total Cohort A (Regimens 1 & 2) Cohort B
    Started
    14
    37
    Subjs who entered 26-wk treatment phase
    14
    37
    Completed 26-week (Wk) treatment
    11
    25
    Entered 52-wk post-trtmnt f/u phase
    13
    26
    Did not enter 52-wk post-trtmnt f/u ph
    1 [1]
    11 [2]
    Completed
    9
    19
    Not completed
    5
    18
         Adverse event, serious fatal
    1
    -
         Physician decision
    1
    2
         Patient/Guardian Decision
    2
    4
         Progressive Disease
    -
    1
         Did not enter post-treatment f/u 1 (Wk 78)
    1
    11
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Added for reader clarification
    [2] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Added for reader clarification

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Total Cohort A (Regimens 1 & 2)
    Reporting group description
    Regimen 1: Participants received hATG (ATGAM®), CsA and eltrombopag beginning on Day 1. Regimen 2: Participants received CsA and eltrombopag beginning on Day 1.

    Reporting group title
    Cohort B
    Reporting group description
    Participants who previously had untreated SAA received hATG, CsA and eltrombopag beginning on Day 1.

    Reporting group values
    Total Cohort A (Regimens 1 & 2) Cohort B Total
    Number of subjects
    14 37 51
    Age categorical
    Units: Subjects
        Children (2-11 years)
    8 22 30
        Adolescents (12-17 years)
    6 15 21
    Age Continuous
    Units: Years
        median (full range (min-max))
    11.0 (4.0 to 17.0) 10.0 (2.0 to 17.0) -
    Sex: Female, Male
    Units: Participants
        Female
    6 17 23
        Male
    8 20 28
    Race/Ethnicity, Customized
    Units: Subjects
        Caucasian
    6 24 30
        Black
    3 4 7
        Asian
    4 9 13
        Unknown
    1 0 1

    End points

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    End points reporting groups
    Reporting group title
    Total Cohort A (Regimens 1 & 2)
    Reporting group description
    Regimen 1: Participants received hATG (ATGAM®), CsA and eltrombopag beginning on Day 1. Regimen 2: Participants received CsA and eltrombopag beginning on Day 1.

    Reporting group title
    Cohort B
    Reporting group description
    Participants who previously had untreated SAA received hATG, CsA and eltrombopag beginning on Day 1.

    Subject analysis set title
    Total Cohort A (Regiments 1 & 2): 1 to < 6 years
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Regimen 1: hATG (ATGAM®), CsA and eltrombopag begin on Day 1. Regimen 2: CsA and eltrombopag begin on Day 1.

    Subject analysis set title
    Cohort B (1 to < 6 years)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Previously untreated SAA, hATG (ATGAM®), CsA and eltrombopag begin on Day 1 and all patients will be treated with the same regimen

    Subject analysis set title
    Total Cohort A (Regiments 1 & 2)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Regimen 1: hATG, CsA and eltrombopag begin on Day 1. Regimen 2: CsA and eltrombopag begin on Day 1.

    Subject analysis set title
    Total Participants
    Subject analysis set type
    Per protocol
    Subject analysis set description
    Response to all participants in the study exposed to eltrombopag per age group.

    Subject analysis set title
    Total Cohort A (Regiments 1 & 2): 1 to < 6 years
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Regimen 1: hATG (ATGAM®), CsA and eltrombopag begin on Day 1. Regimen 2: CsA and eltrombopag begin on Day 1.

    Subject analysis set title
    Cohort B (1 to < 6 years)
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Previously untreated SAA, hATG (ATGAM®), CsA and eltrombopag begin on Day 1 and all patients will be treated with the same regimen

    Primary: Eltrombopag PK parameters: AUCtau, AUClast

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    End point title
    Eltrombopag PK parameters: AUCtau, AUClast [1]
    End point description
    AUC tau: Area under the curve calculated to the end of the dosing interval ( tau) (mass*time/volume) AUC last: Area under the curve calculated to the last quantifiable concentration point (Tlast) (mass*time/volume)
    End point type
    Primary
    End point timeframe
    11 weeks after dose initiation or later when patients are taking the highest dose
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistics planned
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B Total Cohort A (Regiments 1 & 2): 1 to < 6 years Cohort B (1 to < 6 years)
    Number of subjects analysed
    7
    15
    1
    8
    Units: hr*ng/mL
    geometric mean (geometric coefficient of variation)
        AUCtau (n = 1, 5, 6, 10)
    306000 ( 63.8 )
    275000 ( 52.6 )
    272000 ( 999 )
    502000 ( 65.6 )
        AUClast
    253000 ( 85.8 )
    259000 ( 75.1 )
    272000 ( 999 )
    477000 ( 52.5 )
    No statistical analyses for this end point

    Primary: Eltrombopag PK parameter: Cmax

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    End point title
    Eltrombopag PK parameter: Cmax [2]
    End point description
    Cmax is the observed maximum plasma concentration following administration (mass/volume)
    End point type
    Primary
    End point timeframe
    11 weeks after dose initiation or later when patients are taking the highest dose
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistics planned
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B Total Cohort A (Regiments 1 & 2): 1 to < 6 years Cohort B (1 to < 6 years)
    Number of subjects analysed
    7
    15
    1
    8
    Units: ng/mL
        geometric mean (geometric coefficient of variation)
    14500 ( 58.2 )
    15600 ( 47.2 )
    16100 ( 999 )
    27100 ( 40.6 )
    No statistical analyses for this end point

    Primary: Eltrombopag PK parameter: Ctrough at the highest dose level

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    End point title
    Eltrombopag PK parameter: Ctrough at the highest dose level [3]
    End point description
    Ctrough is the pre-dose plasma concentration (mass/volume).
    End point type
    Primary
    End point timeframe
    11 weeks after dose initiation or later when patients are taking the highest dose
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistics planned
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B Total Cohort A (Regiments 1 & 2): 1 to < 6 years Cohort B (1 to < 6 years)
    Number of subjects analysed
    7
    15
    1
    8
    Units: ng/mL
        geometric mean (geometric coefficient of variation)
    9920 ( 56.2 )
    9670 ( 64.5 )
    5470 ( 999 )
    13400 ( 113 )
    No statistical analyses for this end point

    Secondary: Percentage of participants with an overall response and percentage of participants with a platelet response

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    End point title
    Percentage of participants with an overall response and percentage of participants with a platelet response [4]
    End point description
    Overall response rate (ORR) is defined as the percentage of participants who have achieved a complete response (CR) or partial response (PR) by the Investigator. CR criteria: Platelet (PLT) and red blood cell (RBC) transfusion independence, Normal age-adjusted Hgb, PLT >100 × 10^9/L and absolute neutrophil count (ANC) >1.5 × 10^9/L. PR: PLT and RBC Transfusion independence and at least 2 of the following criteria: Reticulocytes >30 × 10^9/L, PLT >30 × 10^9/L, ANC >1.5 x 10^9L. PLT transfusion independence is defined as a period for at least 28 days without PLT transfusion. Platelet response rate (PRR): Platelet response is comprised of CR + PR based on the following criteria: CR: PLT >100 × 10^9/L; PR: PLT >30 × 10^9/L
    End point type
    Secondary
    End point timeframe
    Week 12, Week 26, Week 52, Week 78
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: No statistics planned
    End point values
    Cohort B Total Cohort A (Regiments 1 & 2)
    Number of subjects analysed
    37
    14
    Units: Percentage of participants
    number (confidence interval 95%)
        ORR: Week 12
    13.5 (4.5 to 28.8)
    35.7 (12.8 to 64.9)
        ORR: Week 26
    45.9 (29.5 to 63.1)
    71.4 (41.9 to 91.6)
        ORR: Week 52
    43.2 (27.1 to 60.5)
    50.0 (23.0 to 77.0)
        ORR: Week 78
    40.5 (24.8 to 57.9)
    57.1 (28.9 to 82.3)
        PRR: Week 12
    67.6 (50.2 to 82.0)
    71.4 (41.9 to 91.6)
        PRR: Week 26
    70.3 (53.0 to 84.1)
    71.4 (41.9 to 91.6)
        PRR: Week 52
    48.6 (31.9 to 65.6)
    57.1 (28.9 to 82.3)
        PRR: Week 78
    45.9 (29.5 to 63.1)
    57.1 (28.9 to 82.3)
    No statistical analyses for this end point

    Secondary: Hematologic counts (platelets (blood), neutrophils (blood))

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    End point title
    Hematologic counts (platelets (blood), neutrophils (blood))
    End point description
    Individual Platelets (PLT) and neutrophil counts were summarized for all participants.
    End point type
    Secondary
    End point timeframe
    Week 12, Week 26, Week 52, Week 78
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Number of counts x 10^9/L
    median (full range (min-max))
        Week 12: Platelets (blood) (n = 14, 35)
    41.000 (5.00 to 260.00)
    50.000 (3.00 to 338.00)
        Week 26: Platelets (blood) (n = 14, 31)
    77.000 (3.00 to 222.00)
    106.000 (3.00 to 230.00)
        Week 52: Platelets (blood) (n = 11, 19)
    159.000 (7.00 to 240.00)
    163.000 (28.00 to 318.00)
        Week 78: Platelets (blood) (n = 9, 18)
    134.000 (6.00 to 308.00)
    152.500 (28.00 to 278.00)
        Week 12: Neutrophils (blood) (n = 14, 35)
    1.795 (0.72 to 11.72)
    1.100 (0.00 to 8.10)
        Week 26: Neutrophils (blood) (n = 14, 31)
    1.7716 (0.52 to 4.60)
    1.640 (0.40 to 4.47)
        Week 52: Neutrophils (blood) n = 11, 19)
    1.987 (0.17 to 4.29)
    2.600 (0.83 to 5.75)
        Week 78: Neutrophils (blood) (n = 9, 18)
    2.627 (0.56 to 4.91)
    2.292 (0.69 to 5.41)
    No statistical analyses for this end point

    Secondary: Hematologic counts (hemoglobin (blood))

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    End point title
    Hematologic counts (hemoglobin (blood))
    End point description
    Individual hemoglobin (Hgb) counts were summarized for all participants.
    End point type
    Secondary
    End point timeframe
    Week 12, Week 26, Week 52, Week 78
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: g/L
    median (full range (min-max))
        Week 12 (n = 14, 35)
    87.5 (64 to 131)
    88.0 (57 to 130)
        Week 26 (n = 14, 31)
    100.0 (59 to 128)
    95.0 (44 to 125)
        Week 52 (n = 11, 19)
    105.0 (52 to 138)
    110.0 (92 to 133)
        Week 78 (n = 9, 18)
    112.0 (67 to 138)
    117.0 (97 to 148)
    No statistical analyses for this end point

    Secondary: Number and frequency of Red Blood Cell (RBC) transfusion

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    End point title
    Number and frequency of Red Blood Cell (RBC) transfusion
    End point description
    Number of transfusions during the treatment period refers to total number of RBC transfusions participants have received while on treatment. Frequency of transfusions during the treatment period refers to number of RBC transfusions during the treatment period divided by number of months of treatment duration.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 3 years
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    11
    33
    Units: RBC transfusions
    median (full range (min-max))
        Number of RBC transfusions
    4.0 (1 to 34)
    7.0 (1 to 26)
        Frequency of RBC transfusions
    1.2 (0 to 4)
    0.9 (0 to 5)
    No statistical analyses for this end point

    Secondary: Number and frequency of Platelet (PLT) transfusion

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    End point title
    Number and frequency of Platelet (PLT) transfusion
    End point description
    Number of transfusions during the treatment period refers to total number of PLT transfusions participants have received while on treatment. Frequency of transfusions during the treatment period refers to number of PLT transfusions during the treatment period divided by number of months of treatment duration.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 3 years
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    9
    34
    Units: Platelet transfusions
    median (full range (min-max))
        Number of platelet transfusions
    14.0 (3 to 53)
    13.0 (2 to 65)
        Frequency of platelet transfusions
    2.4 (0 to 14)
    2.0 (0 to 13)
    No statistical analyses for this end point

    Secondary: Total duration of Red Blood Cell (RBC) transfusion independence during the treatment period

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    End point title
    Total duration of Red Blood Cell (RBC) transfusion independence during the treatment period
    End point description
    RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. Duration of RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. First transfusion duration was calculated as the date of the day before the first transfusion after baseline minus the date of first exposure eltrombopag + 1.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 1074 days
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    9
    25
    Units: days
    median (full range (min-max))
        Duration of RBC transfusion independence
    430.0 (185 to 860)
    267.0 (58 to 1074)
    No statistical analyses for this end point

    Secondary: Total duration of Platelet (PLT) transfusion independence during the treatment period

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    End point title
    Total duration of Platelet (PLT) transfusion independence during the treatment period
    End point description
    Duration of RBC transfusion independence defined as the period of time between a participant’s last RBC and platelets transfusion and withdrawal from the trial or trial completion.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 1100 days
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    12
    28
    Units: days
    median (full range (min-max))
        Duration of PLT transfusion independence
    268.0 (36 to 860)
    268.0 (34 to 1100)
    No statistical analyses for this end point

    Secondary: Maximum duration of platelet (PLT) transfusion independence

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    End point title
    Maximum duration of platelet (PLT) transfusion independence
    End point description
    Maximum duration of PLT transfusion independence that is defined as a period of time of at least 28 days without platelet transfusion. First transfusion duration was calculated as the date of first transfusion after baseline minus the date of first exposure eltrombopag + 1.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 3 years
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    12
    28
    Units: days
        median (full range (min-max))
    268.0 (36 to 860)
    249.5 (34 to 1067)
    No statistical analyses for this end point

    Secondary: Maximum duration of Red Blood Cell (RBC) transfusion independence

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    End point title
    Maximum duration of Red Blood Cell (RBC) transfusion independence
    End point description
    RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. Maximum duration of RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. First transfusion duration was calculated as the date of first transfusion after baseline minus the date of first exposure eltrombopag + 1.
    End point type
    Secondary
    End point timeframe
    From date of first dose to approx. 3 years
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    9
    25
    Units: days
    median (full range (min-max))
        RBC
    321.0 (185 to 860)
    259.0 (58 to 1074)
    No statistical analyses for this end point

    Secondary: Overall Bone marrow cellularity

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    End point title
    Overall Bone marrow cellularity
    End point description
    Percentage of cells in bone marrow biopsy - a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
    End point type
    Secondary
    End point timeframe
    Screening, Week 26, Week 52, Week 78 and then annually up to 3 years
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Percentage cellularity cells
    median (full range (min-max))
        Overall cellularity (OC): Screening (n = 14, 26)
    15.0 (5.0 to 50.0)
    4.0 (2.0 to 40.0)
        OC: Week 26 (n = 11, 30)
    30.0 (10.0 to 50.0)
    22.5 (2.0 to 55.0)
        OC: Week 52 (n = 8, 16)
    45.0 (5.0 to 65.0)
    35.0 (3.0 to 55.0)
        OC: Week 78 (n = 7, 15)
    35.0 (5.0 to 50.0)
    35.0 (3.0 to 70.0)
        Hematologic cellularity (HC): Screening (n=14, 26)
    7.5 (1.0 to 45.0)
    1.5 (1.0 to 25.0)
        HC: Week 26 (n = 11, 30)
    25.0 (5.0 to 45.0)
    17.5 (1.0 to 50.0)
        HC: Week 52 (n = 8, 16)
    40.0 (3.0 to 50.0)
    27.5 (2.0 to 50.0)
        HC: Week 78 (n = 7, 15)
    25.0 (3.0 to 40.0)
    30.0 (2.0 to 50.0)
    No statistical analyses for this end point

    Secondary: Bone marrow morphology

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    End point title
    Bone marrow morphology
    End point description
    Percentage of morphology (erythropoiesis, granulopoiesis, megakaryopoiesis, CD34+ (blast cells) cells in bone marrow aspirate - a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
    End point type
    Secondary
    End point timeframe
    Screening, Week, 26, Week 52, Week 78
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Percentage morphology cells
    median (full range (min-max))
        Erythroid cells: Screening (n = 14, 26)
    13.5 (0.0 to 39.0)
    5.0 (0.0 to 38.0)
        Erythroid cells: Week 26 (n = 12, 30 )
    10.0 (1.0 to 25.0)
    18.0 (0.0 to 55.0)
        Erythroid cells: Week 52 (n = 9, 16)
    13.0 (2.0 to 37.0)
    14.5 (1.0 to 28.0)
        Erythroid cells: Week 78 (n = 7, 14)
    15.0 (5.0 to 20.0)
    20.5 (4.0 to 26.0)
        Neutrophil: Screening (n = 14, 26)
    33.0 (1.0 to 48.0)
    8.0 (0.0 to 45.0)
        Neutrophil cells: Week 26 (n = 12, 30)
    51.5 (29.0 to 66.0)
    50.0 (17.0 to 78.0)
        Neutrophil: Week 52 (n = 9, 16)
    57.0 (32.0 to 67.0)
    52.5 (20.0 to 76.0)
        Neutrophil: Week 78 (n = 7, 14)
    43.0 (4.0 to 54.0)
    52.0 (34.0 to 67.0)
        Blast cells: Screening (n = 14, 26)
    0.0 (0.0 to 5.0)
    0.0 (0.0 to 3.0)
        Blast cells: Week 26 (n = 12, 30)
    0.0 (0.0 to 2.0)
    0.0 (0.0 to 1.0)
        Blast cells: Week 52 (n = 9, 16)
    0.0 (0.0 to 2.0)
    0.0 (0.0 to 1.0)
        Blast cells: Week 78 (n = 7, 14)
    0.0 (0.0 to 1.0)
    1.0 (0.0 to 2.0)
    No statistical analyses for this end point

    Secondary: Bone marrow cytogenetics

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    End point title
    Bone marrow cytogenetics
    End point description
    Number of bone marrow cytogenetics (chromosomal structure) by kryotyping and Fluorescence in situ hybridization (FISH). This is a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
    End point type
    Secondary
    End point timeframe
    at Week 26
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Participants
        Normal
    11
    28
        Absent
    0
    0
        Not Available
    3
    9
    No statistical analyses for this end point

    Secondary: Acceptability and palatability for both tablets and powder formulation for oral solution (PfOS)

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    End point title
    Acceptability and palatability for both tablets and powder formulation for oral solution (PfOS)
    End point description
    Standardized (total) summary score, ranged from 0-100 was derived from all items from the questionnaire based on a scoring matrix. The questionnaire was completed by parents and caregivers of patients under 12 years of age (ObsRO) and a questionnaire completed by patients 12 years and older (PRO).
    End point type
    Secondary
    End point timeframe
    From Day 1 to up to Week 78
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: scores on a scale (of acceptability)
    median (full range (min-max))
        Acceptability (including palatability) - Tablet
    75.0 (58.0 to 96.0)
    71.0 (46.0 to 96.0)
        Acceptability (including palatability) - PfOS
    999 (999 to 999)
    71.0 (46.0 to 96.0)
    No statistical analyses for this end point

    Secondary: Clonal evolution to Paroxysmal Nocturnal Hemoglobinuria (PNH)

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    End point title
    Clonal evolution to Paroxysmal Nocturnal Hemoglobinuria (PNH)
    End point description
    Percentage of participants with clonal evolution to PNH.
    End point type
    Secondary
    End point timeframe
    Baseline, Week (W) 26 Day (D) 1, W52D1, W78D1
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Percentage of participants
    number (not applicable)
        Baseline: Positive clonal evolution:
    21.4
    29.7
        Baseline: Negative clonal evolution:
    78.6
    64.9
        W26D1: Positive clonal evolution:
    21.4
    8.1
        W26D1: Negative clonal evolution:
    64.3
    64.9
        W52D1: Positive clonal evolution:
    7.1
    2.7
        W52D1: Negative clonal evolution:
    28.6
    29.7
        W78D1: Positive clonal evolution:
    7.1
    0
        W78D1: Negative clonal evolution:
    35.7
    21.6
    No statistical analyses for this end point

    Secondary: Exposure (AUCtau) - response relationship of eltrombopag and overall response rate by age groups - Total participants

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    End point title
    Exposure (AUCtau) - response relationship of eltrombopag and overall response rate by age groups - Total participants
    End point description
    Pharmacokinetic parameter (AUCtau) of eltrombopag at the highest dose in relationship to overall response rate. AUC tau: Area under the curve calculated to the end of the dosing interval ( tau) (mass*time/volume)
    End point type
    Secondary
    End point timeframe
    From Day 1 to up to Week 78
    End point values
    Total Participants
    Number of subjects analysed
    10
    Units: hr*ng/mL
    geometric mean (geometric coefficient of variation)
        Complete response (CR): 1 to < 6 yrs (n = 1)
    2260000 ( 999 )
        Partial Response (PR): 1 to < 6 yrs (n = 1)
    671000 ( 999 )
        No response (NR): 1 to < 6 yrs (n = 5)
    1160000 ( 30.9 )
        Complete response (CR): 6 to < 18 yrs (n = 10)
    571000 ( 65.6 )
        Partial Response (PR): 6 to < 18 yrs (n = 4)
    1020000 ( 64.5 )
        No Response (NR): 6 to < 18 yrs (n =1)
    390000 ( 999 )
    No statistical analyses for this end point

    Secondary: Exposure (Cmax, Ctrough) - response relationship of eltrombopag and overall response rate by age groups - Total participants

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    End point title
    Exposure (Cmax, Ctrough) - response relationship of eltrombopag and overall response rate by age groups - Total participants
    End point description
    Pharmacokinetic parameters (Cmax and Ctrough) of eltrombopag at the highest dose in relationship to overall response rate. Cmax is the observed maximum plasma concentration following administration (mass/volume). Ctrough is the pre-dose plasma concentration (mass/volume).
    End point type
    Secondary
    End point timeframe
    From Day 1 to up to Week 78
    End point values
    Total Participants
    Number of subjects analysed
    12
    Units: ng/mL
    geometric mean (geometric coefficient of variation)
        Cmax - CR: 1 to < 6 yrs (n = 1)
    112000 ( 999 )
        Cmax - PR: 1 to < 6 yrs (n = 3)
    60500 ( 26.6 )
        Cmax- NR: 1 to < 6 yrs (n = 5)
    759000 ( 38.6 )
        Cmax - CR: 6 to < 18 yrs (n = 12)
    32300 ( 65.4 )
        Cmax - PR: 6 to < 18 yrs (n = 6)
    41700 ( 96.4 )
        Cmax - NR: 6 to < 18 yrs (n= 4)
    36400 ( 61.7 )
        Ctrough - CR: 1 to < 6 yrs (n = 1)
    84700 ( 999 )
        Ctrough - PR: 1 to < 6 yrs (n = 3)
    23800 ( 194 )
        Ctrough - NR: 1 to < 6 yrs (n = 5)
    32000 ( 48.9 )
        Ctrough - CR: 6 to < 18 yrs (n = 12)
    21600 ( 76.5 )
        Ctrough - PR: 6 to < 18 yrs (n = 6)
    27800 ( 90.1 )
        Ctrough - NR: 6 to < 18 yrs (n = 4)
    19200 ( 60.3 )
    No statistical analyses for this end point

    Secondary: Exposure (AUCtau) - response relationship of eltrombopag and platelet response rate by age groups - Total participants

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    End point title
    Exposure (AUCtau) - response relationship of eltrombopag and platelet response rate by age groups - Total participants
    End point description
    Pharmacokinetic parameter (AUCtau) of eltrombopag at the highest dose in relationship to platelet response rate. AUC tau: Area under the curve calculated to the end of the dosing interval ( tau) (mass*time/volume)
    End point type
    Secondary
    End point timeframe
    From Day 1 to up to Week 78
    End point values
    Total Participants
    Number of subjects analysed
    13
    Units: hr*ng/mL
    geometric mean (geometric coefficient of variation)
        Complete response (CR): 1 to < 6 yrs (n = 2)
    1670000 ( 45.2 )
        Partial Response (PR): 1 to < 6 yrs (n = 4)
    1090000 ( 43.5 )
        No response (NR): 1 to < 6 yrs (n = 1)
    816000 ( 999 )
        Complete response (CR): 6 to < 18 yrs (n = 13)
    642000 ( 70.0 )
        Partial Response (PR): 6 to < 18 yrs (n = 1)
    390000 ( 999 )
        No Response (NR): 6 to < 18 yrs (n =1)
    1280000 ( 999 )
    No statistical analyses for this end point

    Secondary: Exposure (Cmax, Ctrough) - response relationship of eltrombopag and platelet response rate by age groups - Total participants

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    End point title
    Exposure (Cmax, Ctrough) - response relationship of eltrombopag and platelet response rate by age groups - Total participants
    End point description
    Pharmacokinetic parameters (Cmax and Ctrough) of eltrombopag at the highest dose in relationship to platelet response rate. Cmax is the observed maximum plasma concentration following administration (mass/volume). Ctrough is the pre-dose plasma concentration (mass/volume).
    End point type
    Secondary
    End point timeframe
    or up to Week 26 when the PK highest dose has been achieved
    End point values
    Total Participants
    Number of subjects analysed
    38
    Units: ng/mL
    geometric mean (geometric coefficient of variation)
        Cmax - CR: 1 to < 6 yrs (n = 4)
    80900 ( 31.7 )
        Cmax - PR: 1 to < 6 yrs (n = 4)
    74000 ( 42.1 )
        Cmax- NR: 1 to < 6 yrs (n = 1)
    48400 ( 999 )
        Cmax - CR: 6 to < 18 yrs (n = 17)
    33800 ( 74.3 )
        Cmax - PR: 6 to < 18 yrs (n = 3)
    30100 ( 54.8 )
        Cmax - NR: 6 to < 18 yrs (n= 2)
    65700 ( 1.83 )
        Ctrough - CR: 1 to < 6 yrs (n = 4)
    50100 ( 48.8 )
        Ctrough - PR: 1 to < 6 yrs (n = 4)
    24600 ( 132 )
        Ctrough - NR: 1 to < 6 yrs (n = 1)
    16400 ( 999 )
        Ctrough - CR: 6 to < 18 yrs (n = 17)
    22600 ( 79.5 )
        Ctrough - PR: 6 to < 18 yrs (n = 3)
    15500 ( 45.4 )
        Ctrough - NR: 6 to < 18 yrs (n = 2)
    40700 ( 14.3 )
    No statistical analyses for this end point

    Secondary: Alternate overall response rate (aORR)

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    End point title
    Alternate overall response rate (aORR)
    End point description
    Alternate overall responses were derived using hematological parameters (i.e., hemoglobin, platelet, reticulocyte, and ANC). aORR is defined as the percentage of participants who achieved an alternate complete response (aCR) or an alternate partial response (aPR)
    End point type
    Secondary
    End point timeframe
    Week 12, Week 26, Week 52, and Week 78.
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    14
    37
    Units: Percentage of participants
    number (confidence interval 95%)
        Week 12
    92.9 (66.1 to 99.8)
    64.9 (47.5 to 79.8)
        Week 26
    92.9 (66.1 to 99.8)
    75.7 (58.8 to 88.2)
        Week 52
    35.7 (12.8 to 64.9)
    40.5 (24.8 to 57.9)
        Week 78
    57.1 (28.9 to 82.3)
    48.6 (31.9 to 65.6)
    No statistical analyses for this end point

    Secondary: Pharmacokinetics (PK) of eltrombopag at the starting dose (AUCtau)

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    End point title
    Pharmacokinetics (PK) of eltrombopag at the starting dose (AUCtau)
    End point description
    PK parameter, AUCtau. AUC tau: Area under the curve calculated to the end of the dosing interval (tau) (mass*time/volume)
    End point type
    Secondary
    End point timeframe
    Week 3 Day 1
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    8
    12
    Units: hr*ng/mL
        geometric mean (geometric coefficient of variation)
    367000 ( 37.0 )
    441000 ( 55.2 )
    No statistical analyses for this end point

    Secondary: PK of eltrombopag at the starting dose (Cmax)

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    End point title
    PK of eltrombopag at the starting dose (Cmax)
    End point description
    PK parameter, Cmax Cmax is the observed maximum plasma concentration following administration (mass/volume)
    End point type
    Secondary
    End point timeframe
    Week 3 Day 1
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    9
    16
    Units: ng/mL
        geometric mean (geometric coefficient of variation)
    20100 ( 38.5 )
    24000 ( 51.0 )
    No statistical analyses for this end point

    Secondary: PK of eltrombopag at the starting dose (Ctrough)

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    End point title
    PK of eltrombopag at the starting dose (Ctrough)
    End point description
    PK parameter, Ctrough Ctrough is the pre-dose plasma concentration (mass/volume).
    End point type
    Secondary
    End point timeframe
    Week 3 Day 1
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B
    Number of subjects analysed
    9
    16
    Units: ng/mL
        geometric mean (geometric coefficient of variation)
    9430 ( 67.0 )
    13200 ( 52.2 )
    No statistical analyses for this end point

    Post-hoc: All Collected Deaths

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    End point title
    All Collected Deaths
    End point description
    Adverse events and on-treatment deaths were collected from the first dose of study treatment up to 30 days after last dose of study medication, for a maximum duration of XXX days. Post-treatment survival follow-up deaths were collected 31 days after last dose of study medication until the end of the study, up to XXX days.
    End point type
    Post-hoc
    End point timeframe
    Pre-treatment deaths: from randomization up to before treatment, Post-treatment survival follow-up deaths: Up to approx. XXX months after the end of treatment for the data cut-off, approx. XXX weeks
    End point values
    Total Cohort A (Regimens 1 & 2) Cohort B Total Cohort A (Regiments 1 & 2): 1 to < 6 years Cohort B (1 to < 6 years)
    Number of subjects analysed
    14
    37
    10
    37
    Units: Participants
        Total deaths
    1
    1
    0
    0
        Pre-treatment deaths
    1
    1
    0
    0
        On-treatment deaths
    0
    0
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events (AEs) were collected from first dosing (Day 1) until date of the last follow-up for the primary analysis, up to 234 weeks.
    Adverse event reporting additional description
    An Adverse Event (AE) is any untoward medical occurrence in a clinical investigation participant after providing written informed consent for participation in the study. Therefore, an AE may or may not be temporally or causally associated with the use of a medicinal (investigational) product.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    26.1
    Reporting groups
    Reporting group title
    Cohort A (Regimen 2)
    Reporting group description
    Regimen 2: CsA and eltrombopag begin on Day 1.

    Reporting group title
    Cohort A (Regimen 1)
    Reporting group description
    Regimen 1: hATG (ATGAM®), CsA and eltrombopag begin on Day 1.

    Reporting group title
    Cohort B
    Reporting group description
    Previously untreated SAA, hATG (ATGAM®), CsA and eltrombopag begin on Day 1 and all patients will be treated with the same regimen

    Reporting group title
    Total Patients
    Reporting group description
    All participant in Total Cohort A & Cohort B.

    Reporting group title
    Total Cohort A (Regimens 1 & 2)
    Reporting group description
    Regimen 1: hATG (ATGAM®), CsA and eltrombopag begin on Day 1.Regimen 2: CsA and eltrombopag begin on Day 1.

    Serious adverse events
    Cohort A (Regimen 2) Cohort A (Regimen 1) Cohort B Total Patients Total Cohort A (Regimens 1 & 2)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    2 / 4 (50.00%)
    4 / 10 (40.00%)
    23 / 37 (62.16%)
    29 / 51 (56.86%)
    6 / 14 (42.86%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    1 / 4 (25.00%)
    2 / 10 (20.00%)
    8 / 37 (21.62%)
    11 / 51 (21.57%)
    3 / 14 (21.43%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 2
    0 / 9
    0 / 16
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Serum sickness
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Abnormal uterine bleeding
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Hypoxia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oropharyngeal pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory disorder
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tonsillar exudate
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Product issues
    Device malfunction
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Platelet count decreased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Liver function test increased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    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
    Toxicity to various agents
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sunburn
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Post procedural haemorrhage
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    5 / 37 (13.51%)
    7 / 51 (13.73%)
    2 / 14 (14.29%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
    0 / 8
    0 / 14
    0 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Ileus
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gingival pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Stomatitis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Drug-induced liver injury
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Petechiae
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rash
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Azotaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Anal abscess
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Herpes simplex
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchiolitis
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bacillus bacteraemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Klebsiella sepsis
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metapneumovirus infection
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory syncytial virus infection
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Varicella
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         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 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypomagnesaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 3
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Magnesium metabolism disorder
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    1 / 51 (1.96%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         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
    Cohort A (Regimen 2) Cohort A (Regimen 1) Cohort B Total Patients Total Cohort A (Regimens 1 & 2)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    4 / 4 (100.00%)
    10 / 10 (100.00%)
    37 / 37 (100.00%)
    51 / 51 (100.00%)
    14 / 14 (100.00%)
    Vascular disorders
    Thrombophlebitis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Hyperaemia
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Hypertension
         subjects affected / exposed
    1 / 4 (25.00%)
    4 / 10 (40.00%)
    15 / 37 (40.54%)
    20 / 51 (39.22%)
    5 / 14 (35.71%)
         occurrences all number
    2
    8
    19
    29
    10
    Hypotension
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    2
    3
    1
    Poor peripheral circulation
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    General disorders and administration site conditions
    Catheter site pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Chills
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    3 / 37 (8.11%)
    4 / 51 (7.84%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    3
    4
    1
    Pyrexia
         subjects affected / exposed
    1 / 4 (25.00%)
    3 / 10 (30.00%)
    10 / 37 (27.03%)
    14 / 51 (27.45%)
    4 / 14 (28.57%)
         occurrences all number
    3
    4
    15
    22
    7
    Pain
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    2
    3
    1
    Oedema peripheral
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Fatigue
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    5 / 51 (9.80%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    7
    7
    0
    Feeling hot
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    2
    3
    1
    Face oedema
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Immune system disorders
    Anaphylactic shock
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Haemophagocytic lymphohistiocytosis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Serum sickness
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    6 / 37 (16.22%)
    8 / 51 (15.69%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    6
    8
    2
    Reproductive system and breast disorders
    Heavy menstrual bleeding
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    0
    3
    3
    6
    3
    Respiratory, thoracic and mediastinal disorders
    Laryngospasm
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    2
    0
    2
    2
    Acute respiratory distress syndrome
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Cough
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    0
    3
    4
    7
    3
    Epistaxis
         subjects affected / exposed
    1 / 4 (25.00%)
    2 / 10 (20.00%)
    5 / 37 (13.51%)
    8 / 51 (15.69%)
    3 / 14 (21.43%)
         occurrences all number
    1
    3
    10
    14
    4
    Nasal congestion
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    3 / 37 (8.11%)
    4 / 51 (7.84%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    4
    5
    1
    Oropharyngeal pain
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    1
    1
    5
    7
    2
    Rhinorrhoea
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    4
    0
    1
    5
    4
    Tonsillar exudate
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Nasal obstruction
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    0
    2
    2
    Psychiatric disorders
    Psychotic disorder
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Insomnia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    3 / 37 (8.11%)
    3 / 51 (5.88%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    3
    3
    0
    Anxiety
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    5 / 51 (9.80%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    5
    5
    0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 4 (25.00%)
    7 / 10 (70.00%)
    16 / 37 (43.24%)
    24 / 51 (47.06%)
    8 / 14 (57.14%)
         occurrences all number
    1
    14
    32
    47
    15
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 4 (25.00%)
    6 / 10 (60.00%)
    13 / 37 (35.14%)
    20 / 51 (39.22%)
    7 / 14 (50.00%)
         occurrences all number
    1
    11
    24
    36
    12
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    1
    1
    1
    3
    2
    Blood bilirubin increased
         subjects affected / exposed
    0 / 4 (0.00%)
    6 / 10 (60.00%)
    18 / 37 (48.65%)
    24 / 51 (47.06%)
    6 / 14 (42.86%)
         occurrences all number
    0
    16
    39
    55
    16
    Blood creatinine increased
         subjects affected / exposed
    2 / 4 (50.00%)
    5 / 10 (50.00%)
    12 / 37 (32.43%)
    19 / 51 (37.25%)
    7 / 14 (50.00%)
         occurrences all number
    3
    13
    15
    31
    16
    Blood folate decreased
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Blood glucose increased
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Blood phosphorus increased
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Blood pressure increased
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    6 / 51 (11.76%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    5
    6
    1
    Blood urea increased
         subjects affected / exposed
    3 / 4 (75.00%)
    4 / 10 (40.00%)
    5 / 37 (13.51%)
    12 / 51 (23.53%)
    7 / 14 (50.00%)
         occurrences all number
    8
    7
    6
    21
    15
    Immunosuppressant drug level increased
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Klebsiella test positive
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Liver function test increased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    SARS-CoV-2 test negative
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    5
    0
    0
    5
    5
    Serum ferritin increased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Staphylococcus test positive
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Blood magnesium decreased
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Injury, poisoning and procedural complications
    Transfusion reaction
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Refractoriness to platelet transfusion
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Procedural pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Infusion related reaction
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Accidental overdose
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Contusion
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    1
    1
    4
    6
    2
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    3
    4
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    8 / 37 (21.62%)
    10 / 51 (19.61%)
    2 / 14 (14.29%)
         occurrences all number
    0
    6
    10
    16
    6
    Syncope
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Tremor
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    2
    1
    Dizziness
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Blood and lymphatic system disorders
    Aplastic anaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Lymphadenopathy
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Haemolysis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Febrile neutropenia
         subjects affected / exposed
    1 / 4 (25.00%)
    2 / 10 (20.00%)
    8 / 37 (21.62%)
    11 / 51 (21.57%)
    3 / 14 (21.43%)
         occurrences all number
    1
    2
    14
    17
    3
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Eye disorders
    Accommodation disorder
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Choroidal effusion
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Dry eye
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    3
    3
    0
    Conjunctival haemorrhage
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    0
    2
    2
    Eye pain
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    2
    1
    3
    2
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    2 / 4 (50.00%)
    1 / 10 (10.00%)
    13 / 37 (35.14%)
    16 / 51 (31.37%)
    3 / 14 (21.43%)
         occurrences all number
    3
    1
    17
    21
    4
    Abdominal distension
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Constipation
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    6 / 37 (16.22%)
    6 / 51 (11.76%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    6
    6
    0
    Aphthous ulcer
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    3
    0
    1
    4
    3
    Chronic gastritis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Abdominal pain upper
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    6 / 51 (11.76%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    5
    7
    2
    Periodontal disease
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    2
    1
    Oral pain
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    2
    1
    Oral blood blister
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Anal haemorrhage
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Enterocolitis
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    0
    3
    5
    8
    3
    Gastritis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Gastrooesophageal reflux disease
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Diarrhoea
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    9 / 37 (24.32%)
    10 / 51 (19.61%)
    1 / 14 (7.14%)
         occurrences all number
    4
    0
    11
    15
    4
    Small intestinal obstruction
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Mucous stools
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Nausea
         subjects affected / exposed
    1 / 4 (25.00%)
    2 / 10 (20.00%)
    17 / 37 (45.95%)
    20 / 51 (39.22%)
    3 / 14 (21.43%)
         occurrences all number
    2
    2
    27
    31
    4
    Odynophagia
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    3
    0
    0
    3
    3
    Stomatitis
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    6 / 37 (16.22%)
    8 / 51 (15.69%)
    2 / 14 (14.29%)
         occurrences all number
    3
    1
    6
    10
    4
    Gingival hypertrophy
         subjects affected / exposed
    3 / 4 (75.00%)
    0 / 10 (0.00%)
    4 / 37 (10.81%)
    7 / 51 (13.73%)
    3 / 14 (21.43%)
         occurrences all number
    3
    0
    5
    8
    3
    Haematochezia
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    3
    0
    0
    3
    3
    Gingival swelling
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    3 / 37 (8.11%)
    3 / 51 (5.88%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    3
    3
    0
    Tongue ulceration
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    0
    2
    2
    Mouth ulceration
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Vomiting
         subjects affected / exposed
    2 / 4 (50.00%)
    1 / 10 (10.00%)
    18 / 37 (48.65%)
    21 / 51 (41.18%)
    3 / 14 (21.43%)
         occurrences all number
    6
    1
    31
    38
    7
    Gingival pain
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Gingival bleeding
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    6 / 51 (11.76%)
    1 / 14 (7.14%)
         occurrences all number
    3
    0
    7
    10
    3
    Hepatobiliary disorders
    Hyperbilirubinaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    0
    2
    2
    4
    2
    Jaundice
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Ocular icterus
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    3
    0
    3
    3
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    2 / 4 (50.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    2
    0
    1
    3
    2
    Petechiae
         subjects affected / exposed
    2 / 4 (50.00%)
    0 / 10 (0.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    2
    0
    8
    10
    2
    Alopecia
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Ecchymosis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    3
    0
    3
    3
    Hirsutism
         subjects affected / exposed
    2 / 4 (50.00%)
    0 / 10 (0.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    2
    0
    3
    5
    2
    Acne
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    2
    1
    Pruritus
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    4 / 37 (10.81%)
    5 / 51 (9.80%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    4
    5
    1
    Rash
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    10 / 37 (27.03%)
    11 / 51 (21.57%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    11
    12
    1
    Rash maculo-papular
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    2 / 37 (5.41%)
    4 / 51 (7.84%)
    2 / 14 (14.29%)
         occurrences all number
    1
    1
    3
    5
    2
    Rash papular
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Skin hyperpigmentation
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    2 / 37 (5.41%)
    4 / 51 (7.84%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    3
    5
    2
    Urticaria
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    6 / 37 (16.22%)
    7 / 51 (13.73%)
    1 / 14 (7.14%)
         occurrences all number
    0
    3
    6
    9
    3
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    3 / 37 (8.11%)
    5 / 51 (9.80%)
    2 / 14 (14.29%)
         occurrences all number
    1
    1
    6
    8
    2
    Renal tubular acidosis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Azotaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Nephropathy toxic
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Paroxysmal nocturnal haemoglobinuria
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Renal failure
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Renal impairment
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Endocrine disorders
    Adrenal insufficiency
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    1
    3
    2
    Cushingoid
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    1
    2
    1
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    2 / 4 (50.00%)
    2 / 10 (20.00%)
    5 / 37 (13.51%)
    9 / 51 (17.65%)
    4 / 14 (28.57%)
         occurrences all number
    2
    3
    6
    11
    5
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    2
    3
    1
    Arthralgia
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    4 / 37 (10.81%)
    6 / 51 (11.76%)
    2 / 14 (14.29%)
         occurrences all number
    1
    3
    5
    9
    4
    Back pain
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    2 / 37 (5.41%)
    4 / 51 (7.84%)
    2 / 14 (14.29%)
         occurrences all number
    1
    2
    2
    5
    3
    Kyphosis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Tendon pain
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Infections and infestations
    Rhinitis
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    2 / 37 (5.41%)
    4 / 51 (7.84%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    3
    5
    2
    Respiratory tract infection viral
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Pharyngitis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    2 / 37 (5.41%)
    3 / 51 (5.88%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    2
    3
    1
    Bacterial disease carrier
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    COVID-19
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Epididymitis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Escherichia bacteraemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Fungal infection
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Gingivitis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Soft tissue infection
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    1 / 37 (2.70%)
    2 / 51 (3.92%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    1
    2
    1
    Paronychia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Molluscum contagiosum
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    0
    1
    1
    Vascular device infection
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    0
    1
    1
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    7 / 37 (18.92%)
    8 / 51 (15.69%)
    1 / 14 (7.14%)
         occurrences all number
    2
    0
    9
    11
    2
    Tonsillitis
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    4 / 37 (10.81%)
    5 / 51 (9.80%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    7
    8
    1
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    3 / 37 (8.11%)
    4 / 51 (7.84%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    8
    9
    1
    Hypermagnesaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    1 / 51 (1.96%)
    1 / 14 (7.14%)
         occurrences all number
    0
    2
    0
    2
    2
    Dehydration
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Fluid retention
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Hyperkalaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    0
    6
    1
    7
    6
    Decreased appetite
         subjects affected / exposed
    1 / 4 (25.00%)
    0 / 10 (0.00%)
    5 / 37 (13.51%)
    6 / 51 (11.76%)
    1 / 14 (7.14%)
         occurrences all number
    1
    0
    5
    6
    1
    Hypervolaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Hypokalaemia
         subjects affected / exposed
    0 / 4 (0.00%)
    1 / 10 (10.00%)
    4 / 37 (10.81%)
    5 / 51 (9.80%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    5
    6
    1
    Hypomagnesaemia
         subjects affected / exposed
    1 / 4 (25.00%)
    3 / 10 (30.00%)
    15 / 37 (40.54%)
    19 / 51 (37.25%)
    4 / 14 (28.57%)
         occurrences all number
    2
    7
    21
    30
    9
    Hyponatraemia
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    1 / 37 (2.70%)
    3 / 51 (5.88%)
    2 / 14 (14.29%)
         occurrences all number
    3
    1
    1
    5
    4
    Vitamin D deficiency
         subjects affected / exposed
    0 / 4 (0.00%)
    0 / 10 (0.00%)
    2 / 37 (5.41%)
    2 / 51 (3.92%)
    0 / 14 (0.00%)
         occurrences all number
    0
    0
    2
    2
    0
    Metabolic acidosis
         subjects affected / exposed
    1 / 4 (25.00%)
    1 / 10 (10.00%)
    0 / 37 (0.00%)
    2 / 51 (3.92%)
    2 / 14 (14.29%)
         occurrences all number
    2
    1
    0
    3
    3
    Iron overload
         subjects affected / exposed
    0 / 4 (0.00%)
    2 / 10 (20.00%)
    4 / 37 (10.81%)
    6 / 51 (11.76%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    4
    6
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Apr 2017
    Provided further clarification of the study population in Cohort A. Provided dose modification guidelines for G3/4 AEs that are not liver related and are not AEs of special interest. Designated that selected hematology, biochemistry tests and Cyclosporine (CsA) levels could be performed by local lab to facilitate the management of the patients by the site.
    16 Aug 2017
    Modified the ECG monitoring plan to include ECG evaluations at Tmax (time of Cmax) after single dose and at steady-state with eltrombopag treatment. Updated to include additional ECG assessments.
    21 Dec 2017
    Introduced an optional consent form to allow for screening bone marrow aspirate and biopsy specimens to be sent to and analyzed by the central laboratory prior to enrollment.
    05 Oct 2018
    Provided guidance regarding the use of medications belonging to the azole class of antifungal agents. Provided guidance regarding patients already receiving CsA at the time of study entry. Provided guidance regarding appropriate follow up for patients who discontinue eltrombopag prior to completion of the 26-week Treatment Period. Clarified changes of tablets of eltrombopag used in this study, visit frequency during long-term follow up, and ECG monitoring plan.
    20 Aug 2020
    Aligned bone marrow aspirate collection with bone marrow biopsy at Week 12 and Week 78 in order to monitor clonal evolution in the early and late phases of study treatment. Clarified the secondary objectives. Clarified requirements prior to PK sampling. Modified the process of bone marrow karyotyping at screening and added additional probes to improve screening for chromosomal abnormalities. Clarified exclusion and inclusion criteria. Modified guidelines for eltrombopag dose adjustment. Clarified study treatment modifications in case of bone marrow fibrosis and cytogenetic abnormalities. Clarified which abnormalities will not be reported as AEs or SAEs. Modified clonal evolution reporting so that it is consistent across all ETB115 clinical trials. Modified treatment for eltrombopag and CsA to be permitted beyond Week 104.
    16 Apr 2021
    Aligned protocol sections 5.1 ‘Patient population’ and 10.8 ‘Sample size calculation’ to the Pediatric Investigation Plan (PIP) for SAA (EMEA-000170-PIP03-13-M04). Modified objective for exploratory biomarker analysis. Added, as per Novartis guidance, risk mitigation procedures during the public health emergency declared by local or regional authorities.
    20 Apr 2022
    Removed objective #14 exploratory biomarker analysis of assessing proteomics in urine samples as the sample size collected was inadequate to perform a rigorous data analysis and correlate with treatment effect. Clarified that eltrombopag re-initiation was allowed only during the Study Treatment phase until Week 26. Clarified that patients whose SAA progressed during the Follow-up and Long-term Follow-up Period were to be discontinued from the study and that they may receive any SAA therapy at the discretion of the treating physician outside this study. Clarified that any case of MDS or AML must be reported as an adverse event throughout the study, including the Follow-up Period or the Long-term Follow-up Period. Clarified that any cytogenetic abnormality detected was to be recorded in the Cytogenetics CRF, and if clinically significant, was to be reported as an adverse event. Clarified that SAA progression, as determined by the investigator, was to be reported as an adverse event throughout the study, including the Follow-up Period or the Long-term Follow-up Period. Clarified that patients who progressed to MDS/AML or receive HSCT will be discontinued from the study, and they will not to be monitored during the Follow-up and Long-term Follow-up periods.

    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.
    Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com for complete trial results.
    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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