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    Clinical Trial Results:
    Multinational, Phase 3, Randomized, Double-blind, Placebo-controlled Efficacy and Safety Study of Enzalutamide Plus Androgen Deprivation Therapy (ADT) Versus Placebo Plus ADT in Patients With Metastatic Hormone Sensitive Prostate Cancer (mHSPC)

    Summary
    EudraCT number
    2015-003869-28
    Trial protocol
    NL   BE   ES   DK   FI   SE   DE   SK   GB   FR   IT  
    Global end of trial date

    Results information
    Results version number
    v2(current)
    This version publication date
    18 Apr 2022
    First version publication date
    23 Apr 2020
    Other versions
    v1
    Version creation reason

    Trial information

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    Trial identification
    Sponsor protocol code
    9785-CL-0335
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02677896
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Astellas Pharma Global Development, Inc. (APGD)
    Sponsor organisation address
    1 Astellas Way, Northbrook, IL, United States, 60062
    Public contact
    Clinical Trial Disclosure, Astellas Pharma Global Development, Inc. (APGD), astellas.resultsdisclosure@astellas.com
    Scientific contact
    Clinical Trial Disclosure, Astellas Pharma Global Development, Inc. (APGD), astellas.resultsdisclosure@astellas.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Interim
    Date of interim/final analysis
    28 May 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to determine the benefit of enzalutamide plus ADT as compared to placebo plus ADT as assessed by radiographic progression-free survival (rPFS) based on independent central review (ICR).
    Protection of trial subjects
    This clinical study was written, conducted and reported in accordance with the protocol, International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Good Clinical Practice (GCP) Guidelines, and applicable local regulations, including the European Directive 2001/20/EC, on the protection of human rights, and with the ethical principles that have their origin in the Declaration of Helsinki. Astellas ensures that the use and disclosure of protected health information (PHI) obtained during a research study complies with the federal, national and/or regional legislation related to the privacy and protection of personal information.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    09 Mar 2016
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Efficacy, Safety
    Long term follow-up duration
    31 Months
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Japan: 92
    Country: Number of subjects enrolled
    Taiwan: 30
    Country: Number of subjects enrolled
    Korea, Republic of: 25
    Country: Number of subjects enrolled
    Australia: 47
    Country: Number of subjects enrolled
    New Zealand: 23
    Country: Number of subjects enrolled
    Russian Federation: 139
    Country: Number of subjects enrolled
    Slovakia: 81
    Country: Number of subjects enrolled
    Italy: 68
    Country: Number of subjects enrolled
    Denmark: 62
    Country: Number of subjects enrolled
    Romania: 57
    Country: Number of subjects enrolled
    Spain: 55
    Country: Number of subjects enrolled
    Netherlands: 54
    Country: Number of subjects enrolled
    Poland: 47
    Country: Number of subjects enrolled
    France: 44
    Country: Number of subjects enrolled
    Finland: 39
    Country: Number of subjects enrolled
    Belgium: 15
    Country: Number of subjects enrolled
    Sweden: 12
    Country: Number of subjects enrolled
    Germany: 10
    Country: Number of subjects enrolled
    United Kingdom: 2
    Country: Number of subjects enrolled
    United States: 122
    Country: Number of subjects enrolled
    Canada: 41
    Country: Number of subjects enrolled
    Argentina: 10
    Country: Number of subjects enrolled
    Chile: 52
    Country: Number of subjects enrolled
    Israel: 23
    Worldwide total number of subjects
    1150
    EEA total number of subjects
    544
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    300
    From 65 to 84 years
    824
    85 years and over
    26

    Subject disposition

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    Recruitment
    Recruitment details
    Participants with metastatic hormone sensitive prostate cancer (mHSPC) were enrolled in 204 study sites worldwide.

    Pre-assignment
    Screening details
    The randomization was stratified by volume of disease (low vs high) and prior docetaxel therapy for prostate cancer (no prior docetaxel, 1 to 5 cycles, 6 cycles).

    Period 1
    Period 1 title
    Double Blind Period (up to 35 months)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Arm description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.
    Arm type
    Experimental

    Investigational medicinal product name
    Enzalutamide
    Investigational medicinal product code
    MDV3100
    Other name
    Xtandi
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received 4 capsules (40 mg each) of enzalutamide orally once a day, for a total daily dose of 160 mg. Treatment was given with or without food and as close as possible to the same time each day.

    Arm title
    Placebo + Androgen Deprivation Therapy (ADT)
    Arm description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received 4 capsules of matching placebo orally once a day. Treatment was given with or without food and as close as possible to the same time each day.

    Number of subjects in period 1
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy (ADT)
    Started
    574
    576
    Completed
    0
    0
    Not completed
    574
    576
         Death
    113
    189
         Progressive Disease
    3
    4
         Miscellaneous
    9
    14
         Followed-up for OS
    31
    108
         Lost to follow-up
    12
    12
         Continued in OLE
    365
    180
         Withdrawal by subject
    41
    69
    Period 2
    Period 2 title
    Open-Label Extension (up to 25 months)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    No

    Arm title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Arm description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.
    Arm type
    Experimental

    Investigational medicinal product name
    Enzalutamide
    Investigational medicinal product code
    MDV3100
    Other name
    Xtandi
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received 4 capsules (40 mg each) of enzalutamide orally once a day, for a total daily dose of 160 mg. Treatment was given with or without food and as close as possible to the same time each day.

    Arm title
    Placebo + Androgen Deprivation Therapy (ADT)
    Arm description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.
    Arm type
    Experimental

    Investigational medicinal product name
    Enzalutamide
    Investigational medicinal product code
    MDV3100
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Participants received 4 capsules (40 mg each) of enzalutamide orally once a day, for a total daily dose of 160 mg. Treatment was given with or without food and as close as possible to the same time each day.

    Number of subjects in period 2
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy (ADT)
    Started
    365
    180
    Completed
    0
    0
    Not completed
    365
    180
         Followed up for OS
    49
    18
         Death
    40
    14
         Progressive Disease
    3
    1
         Miscellaneous
    -
    1
         Lost to follow-up
    2
    1
         OLE treatment ongoing
    261
    136
         Withdrawal by subject
    10
    9

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Reporting group title
    Placebo + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Reporting group values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy (ADT) Total
    Number of subjects
    574 576
    Age categorical
    Units: Subjects
    Age continuous
    All randomized participants.
    Units: years
        arithmetic mean (standard deviation)
    69.5 ± 8 69.5 ± 8.4 -
    Gender categorical
    All randomized participants.
    Units: Subjects
        Female
    0 0 0
        Male
    574 576 1150
    Race (NIH/OMB)
    All randomized participants.
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    75 80 155
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    8 8 16
        White
    466 460 926
        More than one race
    0 0 0
        Unknown or Not Reported
    25 28 53
    Ethnicity (NIH/OMB)
    All randomized participants.
    Units: Subjects
        Hispanic or Latino
    46 37 83
        Not Hispanic or Latino
    504 514 1018
        Unknown or Not Reported
    24 25 49
    Volume of Disease
    High volume of disease was defined as metastases involving the viscera or, in the absence of visceral lesions, 4 or more bone lesions, at least 1 of which was in a bony structure beyond the vertebral column and pelvic bone. Low volume was anything that wasn’t considered high volume by definition provided. Intent-to-Treat (ITT) population is defined as all participants who were randomized in this study.
    Units: Subjects
        Low
    220 203 423
        High
    354 373 727
    Prior Docetaxel Therapy Use
    ITT
    Units: Subjects
        None
    471 474 945
        1 to 5 cycles
    14 11 25
        6 cycles
    89 91 180

    End points

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    End points reporting groups
    Reporting group title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Reporting group title
    Placebo + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.
    Reporting group title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or luteinizing hormone-releasing hormone (LHRH) agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Reporting group title
    Placebo + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Subject analysis set title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the Participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Subject analysis set title
    Placebo + Androgen Deprivation Therapy
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the Participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Primary: Radiographic Progression-Free Survival (rPFS) Based on Independent Central Review (ICR) of Bone Scan According to Prostate Cancer Clinical Trials Working Group 2 (PCWG2) Criteria

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    End point title
    Radiographic Progression-Free Survival (rPFS) Based on Independent Central Review (ICR) of Bone Scan According to Prostate Cancer Clinical Trials Working Group 2 (PCWG2) Criteria
    End point description
    rPFS was calculated as the time from the date of randomization to the first objective evidence of radiographic progression disease (rPD) at any time or death up to 24 weeks after study drug discontinuation without documented radiographic progression, whichever occurred first. rPD was defined as progressive disease by RECIST version 1.1 for soft tissue disease or by appearance of 2 or more new lesions on bone scan compared to baseline or week 13 according to PCWG2 criteria, as assessed by ICR or death. In participants with no rPFS event, rPFS was censored on the date of last evaluable radiographic assessment prior to the data analysis cutoff date. In participants with no baseline radiographic assessment, participants with no postbaseline radiographic assessments and participants with all postbaseline radiographic assessments documented as “not evaluable (NE),” rPFS was censored on the date of randomization. ITT population. "99999" denotes data not reached due to low number of events.
    End point type
    Primary
    End point timeframe
    From randomization until the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    19.4 (16.59 to 99999)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    rPFS Treatment Comparison
    Comparison groups
    Placebo + Androgen Deprivation Therapy v Enzalutamide + Androgen Deprivation Therapy (ADT)
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [1]
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.39
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.3
         upper limit
    0.5
    Notes
    [1] - Stratified by volume of disease (low vs high) and prior docetaxel use (yes vs no) during screening period.

    Primary: rPFS Based on ICR of Bone Scan According to Protocol Assessment Criteria

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    End point title
    rPFS Based on ICR of Bone Scan According to Protocol Assessment Criteria
    End point description
    rPFS was calculated as the time from the date of randomization to the first objective evidence of rPD at any time or death up to 24 weeks after study drug discontinuation without documented radiographic progression, whichever occurred first. rPD was defined as progressive disease by RECIST version 1.1 for soft tissue disease or by appearance of 2 or more new lesions on bone scan compared to baseline for week 13 or the best response on treatment for week 25 or later assessments, as assessed by ICR or death. In participants with no rPFS event, rPFS was censored on the date of last evaluable radiographic assessment prior to the data analysis cutoff date. In participants with no baseline radiographic assessment, participants with no postbaseline radiographic assessments & participants with all postbaseline radiographic assessments documented as “not evaluable(NE),” rPFS was censored on the date of randomization.ITT population."99999" denotes data not reached due to low number of events.
    End point type
    Primary
    End point timeframe
    From randomization until the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months.
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    19.0 (16.59 to 22.24)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    rPFS Treatment Comparision
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Logrank
    Parameter type
    Cox proportional hazards model
    Point estimate
    0.39
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.3
         upper limit
    0.5

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS)
    End point description
    OS was defined as the time from randomization to death due to any cause. In participants still alive at the date of the analysis cutoff point, OS was censored on the last date the participant was known to be alive. OS was analyzed using Kaplan-Meier estimates. ITT population 99999 denotes data was not reached due to low number of events.
    End point type
    Secondary
    End point timeframe
    From date of randomization to OS final analysis (28 May 2021); Maximum treatment duration was 58.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
        median (confidence interval 95%)
    99999 (99999 to 99999)
    99999 (49.74 to 99999)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority [2]
    P-value
    < 0.0001 [3]
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.53
         upper limit
    0.81
    Notes
    [2] - Significance level is 0.04. Hazard ratio and 95 % CI are estimated by cox proportional hazards model.
    [3] - P-value from stratified log-rank test.

    Secondary: Time to Prostate Specific Antigen (PSA) Progression

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    End point title
    Time to Prostate Specific Antigen (PSA) Progression
    End point description
    Time to PSA progression was calculated as the time from the date of randomization to the first observation of PSA progression. A PSA progression was defined as a ≥ 25% increase and an absolute increase of ≥ 2 ng/mL above the nadir, which was confirmed by a second consecutive value at least 3 weeks later. In participants with no PSA progression, time to PSA progression was censored on the date of the last PSA sample taken (or last value prior to 2 or more consecutive missed PSA assessments). ITT population. "99999" denotes data not reached due to low number of events.
    End point type
    Secondary
    End point timeframe
    From randomization until the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    99999 (16.59 to 99999)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to PSA Progression Treatment Comparison
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [4]
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.19
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.13
         upper limit
    0.26
    Notes
    [4] - Stratified by volume of disease (low vs high) and prior docetaxel use (yes vs no) during screening period.

    Secondary: Time to Start of New Antineoplastic Therapy

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    End point title
    Time to Start of New Antineoplastic Therapy
    End point description
    In participants with a new antineoplastic therapy initiated for prostate cancer after randomization, time to start of a new antineoplastic therapy was defined as the time interval from randomization to the date of the first dose administration of the first antineoplastic therapy. In participants with no new antineoplastic therapy initiated for prostate cancer after randomization, time to start of new antineoplastic therapy was censored on the last visit date or the date of randomization, whichever occurred last. ITT population. 99999 denotes data not reached due to low number of events. Time to start of new antineoplastic therapy was analyzed using Kaplan-Meier estimates.
    End point type
    Secondary
    End point timeframe
    From date of randomization to data cut-off date (28 May 2021); Maximum treatment duration was 58.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    40.5 (26.25 to 99999)
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority [5]
    Method
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.38
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.31
         upper limit
    0.48
    Notes
    [5] - Hazard ratio and 95 % CI are estimated by cox proportional hazards model.

    Secondary: PSA Undetectable Rate

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    End point title
    PSA Undetectable Rate
    End point description
    The PSA undetectable rate was defined as the percentage of participants with undetectable (< 0.2 ng/mL) PSA values at any time during study treatment, of those participants with detectable (≥ 0.2 ng/mL) PSA values at baseline. ITT with detectable PSA at baseline.
    End point type
    Secondary
    End point timeframe
    Up to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    511
    506
    Units: percentage of participants
    number (confidence interval 95%)
        percentage of participants
    68.1 (63.9 to 72.1)
    17.6 (14.4 to 21.2)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    PSA Undetectable Rate Treatment Comparison
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1017
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [6]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in rate
    Point estimate
    50.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    45.3
         upper limit
    55.7
    Notes
    [6] - Stratified by volume of disease (low vs high) and prior docetaxel use (yes vs no) during screening period.

    Secondary: Objective Response Rate (ORR)

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    End point title
    Objective Response Rate (ORR)
    End point description
    The ORR was calculated as the percentage of participants who achieved a completed response (CR) or a partial response (PR) (unconfirmed responses) in their soft tissue disease using the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 assessed by ICR. ITT participants with measurable disease at baseline.
    End point type
    Secondary
    End point timeframe
    Up to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    177
    182
    Units: percentage of participants
    number (confidence interval 95%)
        percentage of participants
    83.1 (76.7 to 88.3)
    63.7 (56.3 to 70.7)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    ORR Treatment Comparison
    Comparison groups
    Placebo + Androgen Deprivation Therapy v Enzalutamide + Androgen Deprivation Therapy (ADT)
    Number of subjects included in analysis
    359
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [7]
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Difference in rate
    Point estimate
    19.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    10.4
         upper limit
    28.2
    Notes
    [7] - Stratified by volume of disease (low vs high) and prior docetaxel use (yes vs no) during screening period.

    Secondary: Time to Deterioration in Urinary Symptoms

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    End point title
    Time to Deterioration in Urinary Symptoms
    End point description
    In participants with deterioration, time to deterioration was calculated as the time interval between randomization and the first deterioration in urinary symptoms at any postbaseline visit. Deterioration in urinary symptoms was defined as an increase in the Quality of Life Prostate-specific Questionnaire(QLQ-PR25) modified urinary symptoms. Subscale score by ≥50% of the standard deviation observed in the QLQ-PR25 modified urinary symptoms subscale score at baseline. Modified urinary symptoms subscale score consisted of 3-items(Q31–Q33) from the QLQ-PR25,each scored from 1(not at all) to 4(very much). Total modified urinary symptoms subscale score ranges from 0-100,higher scores represents a higher level of symptomatology/problems. In participants without deterioration in urinary symptoms, the time to deterioration in urinary symptoms was censored on the date the last urinary symptoms QLQ-PR25 score was calculable. ITT. "99999" denotes data not reached due to low number of events.
    End point type
    Secondary
    End point timeframe
    From randomization to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (19.35 to 99999)
    16.8 (14.06 to 99999)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to Deterioration of Urinary Symptoms Treatment Comparison
    Comparison groups
    Placebo + Androgen Deprivation Therapy v Enzalutamide + Androgen Deprivation Therapy (ADT)
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.2162 [8]
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.88
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.72
         upper limit
    1.08
    Notes
    [8] - Stratified by volume of disease (low vs high) and prior docetaxel use (yes vs no) during screening period.

    Secondary: Time to First Symptomatic Skeletal Event (SSE)

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    End point title
    Time to First Symptomatic Skeletal Event (SSE)
    End point description
    Time to first SSE was calculated as the time from randomization to the occurrence of the first SSE prior to the data analysis cut-off date. An SSE was defined as radiation to bone, surgery to bone, clinically apparent pathological bone fracture, or spinal cord compression. In participants with no SSE by the time of the data cut-off point, time to SSE was censored on the last visit date or the date of randomization, whichever occurred last. ITT population. "99999" denotes data not reached due to low number of events.
    End point type
    Secondary
    End point timeframe
    From randomization to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to SSE Treatment Comparison
    Comparison groups
    Placebo + Androgen Deprivation Therapy v Enzalutamide + Androgen Deprivation Therapy (ADT)
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0026
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.52
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.33
         upper limit
    0.8

    Secondary: Time to Castration Resistance

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    End point title
    Time to Castration Resistance
    End point description
    Time to castration resistance was calculated as the time from randomization to the first castration-resistant event. A castration resistance event was defined as any of the following in the presence of castrate levels of testosterone (< 50 ng/dL): radiographic disease progression, PSA progression or SSE, whichever occurred first. In participants with no documented castration resistance event, the time to castration resistance was censored on the latest date from: the date of last radiologic assessment, the last PSA sample taken prior to the start of any new prostate cancer therapy and prior to 2 or more consecutive missed PSA assessments (if applicable), and the last visit date performed. ITT population. "99999" denotes data not reached due to low number of events.
    End point type
    Secondary
    End point timeframe
    From randomization to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    99999 (99999 to 99999)
    13.9 (11.40 to 17.18)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to Castration Resistance Treatment Comparison
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.28
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.22
         upper limit
    0.36

    Secondary: Time to Deterioration of Quality of Life (QoL) in Functional Assessment of Cancer Therapy-Prostate (FACT-P)

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    End point title
    Time to Deterioration of Quality of Life (QoL) in Functional Assessment of Cancer Therapy-Prostate (FACT-P)
    End point description
    Time to deterioration of QoL was calculated as the time interval from the date of randomization to the first date a decline from baseline of 10 points or more in the FACT-P total score was recorded. The FACT-P consists of 27 core items that assess participant function in 4 domains and 12 prostate cancer-related items grouped into 5 subscales as follows: physical wellbeing, social/family wellbeing, emotional wellbeing, functional wellbeing and prostate cancer subscale. Each item is rated on a 0 to 4 Likert-type scale. The FACT-P total score is the sum of all 5 subscale scores of the FACT-P questionnaire and ranges from 0 to 156), where high score represent better quality of life. In participants without FACT-P progression, the time to deterioration of QoL was censored on the date of the last FACT-P total score was calculable. ITT population.
    End point type
    Secondary
    End point timeframe
    From randomization to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    11.3 (11.04 to 13.83)
    11.1 (8.48 to 13.83)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to Deterioration of QoL in FACT-P Treatment Comparison
    Comparison groups
    Placebo + Androgen Deprivation Therapy v Enzalutamide + Androgen Deprivation Therapy (ADT)
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.6548
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.96
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.81
         upper limit
    1.14

    Secondary: Time to Pain Progression Based on Brief Pain Inventory-Short Form (BPI-SF)

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    End point title
    Time to Pain Progression Based on Brief Pain Inventory-Short Form (BPI-SF)
    End point description
    Time to pain progression was defined as time from randomization to the first pain progression event. Pain progression was defined as an increase of ≥ 30% from baseline in the average BPI-SF pain severity score. BPI-SF contains 9 questions with rating scales from 0 (no pain/no interference) to 10 (worst pain/interferes completely). Total score was calculated as the average of each question. Higher scores represent a higher level of pain or interference. In participants with no pain progression event, time to pain progression was censored on the last visit date where BPI-SF was collected. ITT population.
    End point type
    Secondary
    End point timeframe
    From randomization to the data cut-off date of 14 October 2018; maximum duration of treatment was 26.6 months
    End point values
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy
    Number of subjects analysed
    574
    576
    Units: months
    median (confidence interval 95%)
        months
    8.3 (8.25 to 10.91)
    8.3 (5.65 to 8.38)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Time to Pain Progression Based on BPI-SF Treatment Comparison
    Comparison groups
    Enzalutamide + Androgen Deprivation Therapy (ADT) v Placebo + Androgen Deprivation Therapy
    Number of subjects included in analysis
    1150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.2715
    Method
    Logrank
    Parameter type
    Cox hazard ratio
    Point estimate
    0.92
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.78
         upper limit
    1.07

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose of study drug up to 30 days after last dose of study or prior to initiation of new therapy for prostate cancer, whichever occurred first. Maximum duration of treatment to the data cut-off date of 28 May 2021 was 58.6 months
    Adverse event reporting additional description
    Safety Analysis Set (SAF) consisted of all randomized participants who received at least one dose of study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    v23
    Reporting groups
    Reporting group title
    Enzalutamide + Androgen Deprivation Therapy (ADT)
    Reporting group description
    Participants received 160 mg of enzalutamide orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. Eligible participants who received enzalutamide during double blind treatment period and provided informed consent to take part in open-label period continued to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock.

    Reporting group title
    Placebo + Androgen Deprivation Therapy
    Reporting group description
    Participants received enzalutamide matching placebo orally once daily during double blind treatment period until radiographic progression was documented or until the participants started an investigational agent or new therapy for treatment of prostate cancer or until any other discontinuation criterion was met. This arm represents only double blind period.

    Reporting group title
    Placebo cross-over Enzalutamide
    Reporting group description
    Eligible participants who received enzalutamide matching placebo during double blind treatment period and provided informed consent to take part in open-label period switched to receive 160 mg enzalutamide orally once daily in open-label period until disease progression, unacceptable toxicity or any other discontinuation criteria were met. ADT (either bilateral orchiectomy or LHRH agonist/antagonist) was maintained during study treatment as per standard of care and provided by the site’s pharmacy stock. This arm represents only the open-label extension period.

    Serious adverse events
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy Placebo cross-over Enzalutamide
    Total subjects affected by serious adverse events
         subjects affected / exposed
    197 / 572 (34.44%)
    128 / 574 (22.30%)
    36 / 180 (20.00%)
         number of deaths (all causes)
    154
    189
    14
         number of deaths resulting from adverse events
    30
    12
    3
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Adenocarcinoma gastric
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    4 / 572 (0.70%)
    5 / 574 (0.87%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Benign pancreatic neoplasm
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder cancer
         subjects affected / exposed
    3 / 572 (0.52%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone cancer
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchial carcinoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cancer pain
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colon cancer
         subjects affected / exposed
    2 / 572 (0.35%)
    3 / 574 (0.52%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diffuse large B-cell lymphoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastric cancer
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Laryngeal squamous cell carcinoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung adenocarcinoma stage 0
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung adenocarcinoma stage I
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lung neoplasm malignant
         subjects affected / exposed
    3 / 572 (0.52%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Malignant melanoma in situ
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malignant neoplasm progression
         subjects affected / exposed
    11 / 572 (1.92%)
    3 / 574 (0.52%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    0 / 12
    0 / 4
    0 / 4
         deaths causally related to treatment / all
    0 / 7
    0 / 2
    0 / 2
    Metastases to liver
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Monoclonal gammopathy
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neuroendocrine carcinoma
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Non-small cell lung cancer
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraproteinaemia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Plasmacytoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of head and neck
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transitional cell carcinoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Adenocarcinoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    B-cell lymphoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bowen's disease
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colorectal adenocarcinoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malignant melanoma
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Meningioma
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to adrenals
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metastases to central nervous system
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Oesophageal squamous cell carcinoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Penile cancer
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of lung
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Aortic aneurysm
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aortic dissection
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aortic dissection rupture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Granulomatosis with polyangiitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Phlebitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thrombosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vena cava thrombosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Essential hypertension
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypovolaemic shock
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphoedema
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral embolism
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Venous thrombosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    Bone lesion excision
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Euthanasia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    Fatigue
         subjects affected / exposed
    3 / 572 (0.52%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    3 / 4
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    3 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
    Malaise
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Sudden death
         subjects affected / exposed
    0 / 572 (0.00%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    Chills
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drowning
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Implant site dehiscence
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Benign prostatic hyperplasia
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pelvic pain
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 572 (0.00%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    5 / 572 (0.87%)
    3 / 574 (0.52%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    1 / 6
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 4
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diaphragmatic paralysis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eosinophilic pneumonia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Epistaxis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    3 / 572 (0.52%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Completed suicide
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    2 / 572 (0.35%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Product issues
    Device occlusion
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Antineutrophil cytoplasmic antibody increased
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aspartate aminotransferase increased
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    3 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood creatinine increased
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood testosterone increased
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Intraocular pressure increased
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Liver function test abnormal
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transaminases increased
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Accidental overdose
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone fissure
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cervical vertebral fracture
         subjects affected / exposed
    0 / 572 (0.00%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clavicle fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Comminuted fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coronary artery restenosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    8 / 572 (1.40%)
    4 / 574 (0.70%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    4 / 8
    1 / 4
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    2 / 572 (0.35%)
    3 / 574 (0.52%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fracture displacement
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Limb injury
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lumbar vertebral fracture
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Multiple fractures
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral artery restenosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Radius fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Road traffic accident
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Stenosis of vesicourethral anastomosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thoracic vertebral fracture
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ulna fracture
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary retention postoperative
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract stoma complication
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Brain contusion
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Concussion
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Craniocerebral injury
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    4 / 572 (0.70%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Humerus fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infusion related reaction
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Jaw fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Overdose
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Patella fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Scapula fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Skull fractured base
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal compression fracture
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thermal burn
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Wound haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wrong dose
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute coronary syndrome
         subjects affected / exposed
    2 / 572 (0.35%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    8 / 572 (1.40%)
    7 / 574 (1.22%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    2 / 10
    0 / 10
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block complete
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block second degree
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    3 / 572 (0.52%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure chronic
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardio-respiratory arrest
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    Cardiopulmonary failure
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    0 / 3
    2 / 2
    2 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Ventricular fibrillation
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    3 / 572 (0.52%)
    1 / 574 (0.17%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Aortic valve incompetence
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bradycardia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Coronary artery stenosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial ischaemia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sinus node dysfunction
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Trifascicular block
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Subarachnoid haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Carotid arteriosclerosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebellar infarction
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Cervicobrachial syndrome
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dementia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Guillain-Barre syndrome
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lethargy
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Monoparesis
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Paraparesis
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal cord compression
         subjects affected / exposed
    3 / 572 (0.52%)
    7 / 574 (1.22%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    2 / 3
    0 / 7
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    5 / 572 (0.87%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    3 / 5
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toxic encephalopathy
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient global amnesia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    4 / 572 (0.70%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Altered state of consciousness
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aphasia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Brain stem haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Dementia Alzheimer's type
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Facial paralysis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hemianopia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemic seizure
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lumbar radiculopathy
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Memory impairment
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Thalamus haemorrhage
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    5 / 572 (0.87%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood loss anaemia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Immune thrombocytopenia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    6 / 6
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Iron deficiency anaemia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lymphadenopathy
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    3 / 572 (0.52%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Deafness
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Deafness neurosensory
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Eye haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Retinal detachment
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ulcerative keratitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cataract
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulum intestinal haemorrhagic
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Duodenal ulcer perforation
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Duodenitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dyspepsia
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Epiploic appendagitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastritis erosive
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Impaired gastric emptying
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Incarcerated inguinal hernia
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestinal obstruction
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestine perforation
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumoperitoneum
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Proctalgia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Retroperitoneal fibrosis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subileus
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Duodenal ulcer haemorrhage
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestine polyp
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Retroperitoneal haematoma
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatic function abnormal
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    3 / 180 (1.67%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    4 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    6 / 572 (1.05%)
    3 / 574 (0.52%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    3 / 9
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder perforation
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Calculus bladder
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dysuria
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    8 / 572 (1.40%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 12
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hydronephrosis
         subjects affected / exposed
    4 / 572 (0.70%)
    3 / 574 (0.52%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 4
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal colic
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal impairment
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ureterolithiasis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral obstruction
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urethral stenosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    7 / 572 (1.22%)
    4 / 574 (0.70%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 4
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bladder mass
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary bladder haemorrhage
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary incontinence
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Goitre
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperparathyroidism
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 3
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bone pain
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscular weakness
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Neck pain
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteoarthritis
         subjects affected / exposed
    3 / 572 (0.52%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal osteoarthritis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthralgia
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthritis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Compartment syndrome
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Flank pain
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Groin pain
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Muscle spasms
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteonecrosis of jaw
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteoporotic fracture
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Anorectal infection
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Appendicitis
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchopulmonary aspergillosis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis infective
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Escherichia pyelonephritis
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Escherichia urinary tract infection
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Genital abscess
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Groin abscess
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infected lymphocele
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Otitis media chronic
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    5 / 572 (0.87%)
    5 / 574 (0.87%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 8
    0 / 6
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    4 / 572 (0.70%)
    3 / 574 (0.52%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 572 (0.17%)
    2 / 574 (0.35%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection bacterial
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    2 / 572 (0.35%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    2 / 180 (1.11%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    COVID-19 pneumonia
         subjects affected / exposed
    3 / 572 (0.52%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    Gangrene
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    2 / 572 (0.35%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteomyelitis
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Spinal cord infection
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Subcutaneous abscess
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Systemic candida
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection staphylococcal
         subjects affected / exposed
    0 / 572 (0.00%)
    0 / 574 (0.00%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Cachexia
         subjects affected / exposed
    1 / 572 (0.17%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    1 / 180 (0.56%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 572 (0.00%)
    1 / 574 (0.17%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Adult failure to thrive
         subjects affected / exposed
    1 / 572 (0.17%)
    0 / 574 (0.00%)
    0 / 180 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Enzalutamide + Androgen Deprivation Therapy (ADT) Placebo + Androgen Deprivation Therapy Placebo cross-over Enzalutamide
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    443 / 572 (77.45%)
    396 / 574 (68.99%)
    110 / 180 (61.11%)
    Investigations
    Weight increased
         subjects affected / exposed
    46 / 572 (8.04%)
    45 / 574 (7.84%)
    2 / 180 (1.11%)
         occurrences all number
    83
    51
    2
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    52 / 572 (9.09%)
    16 / 574 (2.79%)
    12 / 180 (6.67%)
         occurrences all number
    78
    16
    18
    Vascular disorders
    Hot flush
         subjects affected / exposed
    171 / 572 (29.90%)
    131 / 574 (22.82%)
    15 / 180 (8.33%)
         occurrences all number
    196
    137
    16
    Hypertension
         subjects affected / exposed
    75 / 572 (13.11%)
    35 / 574 (6.10%)
    13 / 180 (7.22%)
         occurrences all number
    87
    37
    15
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    44 / 572 (7.69%)
    22 / 574 (3.83%)
    7 / 180 (3.89%)
         occurrences all number
    47
    24
    7
    Headache
         subjects affected / exposed
    46 / 572 (8.04%)
    22 / 574 (3.83%)
    5 / 180 (2.78%)
         occurrences all number
    52
    27
    6
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    49 / 572 (8.57%)
    28 / 574 (4.88%)
    4 / 180 (2.22%)
         occurrences all number
    70
    35
    5
    Fatigue
         subjects affected / exposed
    141 / 572 (24.65%)
    92 / 574 (16.03%)
    39 / 180 (21.67%)
         occurrences all number
    180
    103
    45
    Oedema peripheral
         subjects affected / exposed
    46 / 572 (8.04%)
    40 / 574 (6.97%)
    7 / 180 (3.89%)
         occurrences all number
    60
    48
    7
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    38 / 572 (6.64%)
    28 / 574 (4.88%)
    4 / 180 (2.22%)
         occurrences all number
    55
    39
    5
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    52 / 572 (9.09%)
    34 / 574 (5.92%)
    8 / 180 (4.44%)
         occurrences all number
    60
    34
    8
    Diarrhoea
         subjects affected / exposed
    48 / 572 (8.39%)
    34 / 574 (5.92%)
    6 / 180 (3.33%)
         occurrences all number
    60
    35
    7
    Nausea
         subjects affected / exposed
    51 / 572 (8.92%)
    34 / 574 (5.92%)
    12 / 180 (6.67%)
         occurrences all number
    62
    35
    16
    Reproductive system and breast disorders
    Gynaecomastia
         subjects affected / exposed
    33 / 572 (5.77%)
    8 / 574 (1.39%)
    3 / 180 (1.67%)
         occurrences all number
    37
    8
    3
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    29 / 572 (5.07%)
    20 / 574 (3.48%)
    4 / 180 (2.22%)
         occurrences all number
    31
    21
    4
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    104 / 572 (18.18%)
    65 / 574 (11.32%)
    11 / 180 (6.11%)
         occurrences all number
    136
    78
    14
    Back pain
         subjects affected / exposed
    74 / 572 (12.94%)
    67 / 574 (11.67%)
    19 / 180 (10.56%)
         occurrences all number
    98
    70
    22
    Musculoskeletal pain
         subjects affected / exposed
    50 / 572 (8.74%)
    26 / 574 (4.53%)
    7 / 180 (3.89%)
         occurrences all number
    59
    30
    10
    Bone pain
         subjects affected / exposed
    34 / 572 (5.94%)
    31 / 574 (5.40%)
    2 / 180 (1.11%)
         occurrences all number
    42
    34
    2
    Pain in extremity
         subjects affected / exposed
    37 / 572 (6.47%)
    27 / 574 (4.70%)
    7 / 180 (3.89%)
         occurrences all number
    45
    28
    7
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    48 / 572 (8.39%)
    33 / 574 (5.75%)
    13 / 180 (7.22%)
         occurrences all number
    57
    39
    17
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    39 / 572 (6.82%)
    18 / 574 (3.14%)
    12 / 180 (6.67%)
         occurrences all number
    41
    20
    13

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    02 Jun 2016
    The changes included: ● Added 2 exclusion criteria to o exclude patients who had not received bisphosphonates or denosumab at a stable dose (unless diagnosed with osteoporosis) and o exclude patients who had shown a hypersensitivity reaction to any of the study capsule components. ● Revised test drug information to remove information related to tablet formulations and add information related to the capsule formulation of study drug and placebo (chemical name, physical description and storage requirements).
    14 Dec 2017
    The changes included: ● Revised the number of events required for the primary endpoint to reflect that primary analysis was to occur when 262 rPD events were confirmed by independent central imaging review. All secondary endpoints were to be evaluated at the time of primary analysis (and are considered final, except for OS [Section 5.5.5]). ● Specified a step-wise approach for the statistical testing of the key secondary endpoints. To maintain the family-wise 2-sided type I error rate at 0.05, a parallel testing strategy between OS (with allocated type I error rate 0.04) and the other 4 endpoints (with allocated type I error rate 0.01) was developed. If the interim results of the OS analysis were statistically significant, no further analysis of OS would be completed. ● Specified that unblinding of study treatment assignment could have been performed if a patient discontinued due to disease progression and in the investigator’s opinion this information was necessary to determine the next course of therapy.
    10 Dec 2018
    The changes included: ● Added an open-label extension period. Following unblinding at the end of the doubleblind period and demonstration of a statistically significant advantage of enzalutamide over placebo when added to ADT, as assessed by the primary endpoint, all eligible patients could be treated on study with open-label enzalutamide at the discretion of the patient and investigator. ● Specific QoL assessments related to deterioration of urinary symptoms and QoL were added to the secondary endpoints.
    31 Mar 2021
    The Changes included: ● Survival follow-up is considered complete and patients will be discontinued from long term follow-up when a final number of OS events has been reached. Sites will no longer be required to collect assessments at that time. ● Following the final OS analysis, patients continuing to receive clinical benefit from enzalutamide treatment may continue open-label treatment in another Astellas-sponsored study, provided they have not met any discontinuation criteria.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/31329516
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