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    Clinical Trial Results:
    A randomized, multicenter 28 week study to compare the efficacy and safety of combining Cosentyx (Secukinumab) (4-weekly, 300 mg s.c.) with a lifestyle intervention to Cosentyx therapy alone in adult patients with moderate to severe plaque-type psoriasis and concomitant metabolic syndrome, followed by a 28 week extension period

    Summary
    EudraCT number
    2016-001671-79
    Trial protocol
    DE  
    Global end of trial date
    03 Jun 2022

    Results information
    Results version number
    v1(current)
    This version publication date
    02 Jun 2023
    First version publication date
    02 Jun 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CAIN457ADE08
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03440736
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    Novartis Campus, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, Novartis.email@Novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, Novartis.email@Novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    03 Jun 2022
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Jun 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the Core Study was to demonstrate that the combination of Secukinumab (300 mg, 4-weekly s.c.) with lifestyle intervention results in higher psoriasis treatment efficacy than Secukinumab alone in psoriasis patients with concomitant metabolic syndrome.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Feb 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 781
    Worldwide total number of subjects
    781
    EEA total number of subjects
    781
    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)
    673
    From 65 to 84 years
    107
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted at 81 centers in Germany.

    Pre-assignment
    Screening details
    Patients were screened for eligibility for a period of 1 to 4 weeks prior to inclusion in the study.

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Secukinumab 300 mg subcutaneous (s.c.)
    Arm description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24).
    Arm type
    Active comparator

    Investigational medicinal product name
    Secukinumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24)

    Arm title
    Secukinumab 300 mg s.c. and lifestyle intervention
    Arm description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24). In addition they participated in a lifestyle intervention program.
    Arm type
    Experimental

    Investigational medicinal product name
    Secukinumab
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection in pre-filled syringe
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24)

    Number of subjects in period 1 [1]
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Started
    371
    409
    Full Analysis Set (FAS)
    371
    409
    Safety Set (SAF)
    371
    409
    Completed
    342
    374
    Not completed
    29
    35
         Physician decision
    2
    2
         Consent withdrawn by subject
    9
    10
         Adverse event, non-fatal
    8
    7
         Non-compliance with study treatment
    1
    1
         Lost to follow-up
    2
    8
         Subject discontinued the study due to emergency
    1
    -
         Lack of efficacy
    2
    3
         Protocol deviation
    4
    4
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: One participant in the Secukinumab 300 mg s.c. and lifestyle intervention arm was never treated and was therefore excluded from all analysis (including patient disposition and baseline characteristics)

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Secukinumab 300 mg subcutaneous (s.c.)
    Reporting group description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24).

    Reporting group title
    Secukinumab 300 mg s.c. and lifestyle intervention
    Reporting group description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24). In addition they participated in a lifestyle intervention program.

    Reporting group values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention Total
    Number of subjects
    371 409 780
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    313 359 672
        From 65-84 years
    57 50 107
        85 years and over
    1 0 1
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    50.4 ( 13.29 ) 50.1 ( 12.48 ) -
    Sex: Female, Male
    Units: Participants
        Female
    105 115 220
        Male
    266 294 560
    Race/Ethnicity, Customized
    Units: Subjects
        Asian
    7 1 8
        Caucasian
    359 397 756
        Black or African American
    2 2 4
        Other
    3 8 11
        Unknown
    0 1 1

    End points

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    End points reporting groups
    Reporting group title
    Secukinumab 300 mg subcutaneous (s.c.)
    Reporting group description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24).

    Reporting group title
    Secukinumab 300 mg s.c. and lifestyle intervention
    Reporting group description
    Patients received therapy with Secukinumab 300 mg s.c., which consisted of two injections with 150 mg prefilled syringes at weeks 0, 1, 2, 3, 4, 8, 12, 16, 20 and 24 (last injection was performed at week 24). In addition they participated in a lifestyle intervention program.

    Primary: Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 90 at week 28

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    End point title
    Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 90 at week 28
    End point description
    The Psoriasis Area and Severity Index (PASI) is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, trunk, upper limbs, lower limbs); each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area * area score weight of section (head: 0.1, arms: 0.2 body: 0.3 legs: 0.4). PASI 90 represents patients achieving >= 90% improvement (reduction) in PASI score compared to Baseline. Patients with missing PASI at Week 28 were counted as non-responders.
    End point type
    Primary
    End point timeframe
    Baseline, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Participants
    219
    261
    Statistical analysis title
    PASI 90 at week 28
    Statistical analysis description
    Comparison of mean change between treatments in PASI 90 at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.3857
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.17
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.82
         upper limit
    1.67

    Secondary: Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 75 over time

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    End point title
    Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 75 over time
    End point description
    The Psoriasis Area and Severity Index (PASI) is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, trunk, upper limbs, lower limbs); each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area * area score weight of section (head: 0.1, arms: 0.2 body: 0.3 legs: 0.4). PASI 75 represents patients achieving >= 75% improvement (reduction) in PASI score compared to Baseline.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Participants
        Week 1
    2
    1
        Week 2
    11
    3
        Week 3
    50
    56
        Week 4
    108
    135
        Week 8
    239
    265
        Week 12
    241
    276
        Week 16
    287
    332
        Week 20
    290
    333
        Week 24
    285
    333
        Week 28
    286
    335
    Statistical analysis title
    PASI 75 at Week 28
    Statistical analysis description
    Comparison of mean change between treatments in PASI 75 at Week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.03
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.06
         upper limit
    3.06

    Secondary: Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 90 over time

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    End point title
    Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 90 over time
    End point description
    The Psoriasis Area and Severity Index (PASI) is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, trunk, upper limbs, lower limbs); each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area * area score weight of section (head: 0.1, arms: 0.2 body: 0.3 legs: 0.4). PASI 90 represents patients achieving ≥ 90% improvement (reduction) in PASI score compared to Baseline.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Participants
        Week 1
    0
    0
        Week 2
    2
    0
        Week 3
    7
    4
        Week 4
    25
    30
        Week 8
    130
    141
        Week 12
    159
    182
        Week 16
    215
    241
        Week 20
    217
    242
        Week 24
    224
    251
        Week 28
    219
    261
    No statistical analyses for this end point

    Secondary: Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 100 over time

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    End point title
    Percentage of patients achieving Psoriasis Area and Severity Index (PASI) Score of 100 over time
    End point description
    The Psoriasis Area and Severity Index (PASI) is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, trunk, upper limbs, lower limbs); each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area * area score weight of section (head: 0.1, arms: 0.2 body: 0.3 legs: 0.4). PASI 100 response/remission represents patients achieving complete clearing of psoriasis (PASI = 0) compared to Baseline.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Participants
        Week 1
    0
    0
        Week 2
    1
    0
        Week 3
    1
    0
        Week 4
    5
    4
        Week 8
    35
    39
        Week 12
    48
    71
        Week 16
    82
    115
        Week 20
    100
    108
        Week 24
    101
    115
        Week 28
    105
    118
    Statistical analysis title
    PASI 100 at Week 28
    Statistical analysis description
    Comparison of mean change between treatments in PASI 100 at Week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.4351
    Method
    Regression, Logistic
    Parameter type
    Odds ratio (OR)
    Point estimate
    0.87
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.61
         upper limit
    1.24

    Secondary: Mean absolute Psoriasis Area and Severity Index (PASI) Score over time

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    End point title
    Mean absolute Psoriasis Area and Severity Index (PASI) Score over time
    End point description
    The Psoriasis Area and Severity Index (PASI) is a combined assessment of lesion severity and affected area into a single score: 0 (no disease) to 72 (maximal disease). Body is divided into 4 areas for scoring (head, trunk, upper limbs, lower limbs); each area is scored by itself and scores are combined for final PASI. For each area, percent of skin involved is estimated: 0 (0%) to 6 (90-100%), and severity is estimated by clinical signs, erythema, induration and desquamation; scale 0 (none) to 4 (maximum). Final PASI = sum of severity parameters for each area * area score weight of section (head: 0.1, arms: 0.2 body: 0.3 legs: 0.4). A negative change in absolute PASI score means that the severity of psoriasis has decreased, indicating an improvement in the patient's condition.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard error)
        Baseline (n= 371, 409)
    19.8 ( 0.39 )
    19.7 ( 0.38 )
        Week 1 (n= 365, 402)
    -2.8 ( 0.22 )
    -2.9 ( 0.21 )
        Week 2 (n= 361, 394)
    -6.6 ( 0.23 )
    -6.9 ( 0.22 )
        Week 3 (n= 362, 392)
    -9.9 ( 0.25 )
    -10.1 ( 0.23 )
        Week 4 (n= 364, 393)
    -12.0 ( 0.26 )
    -12.4 ( 0.25 )
        Week 8 (n= 360, 394)
    -15.5 ( 0.26 )
    -15.5 ( 0.25 )
        Week 12 (n= 309, 335)
    -16.6 ( 0.26 )
    -16.9 ( 0.25 )
        Week 16 (n= 354, 388)
    -17.2 ( 0.27 )
    -17.3 ( 0.26 )
        Week 20 (n= 346, 380)
    -17.4 ( 0.27 )
    -17.5 ( 0.26 )
        Week 24 (n= 337, 376)
    -17.4 ( 0.28 )
    -17.6 ( 0.26 )
        Week 28 (n= 334, 366)
    -17.3 ( 0.29 )
    -17.6 ( 0.27 )
    Statistical analysis title
    Absolute PASI Score at week 28
    Statistical analysis description
    Mean change from Baseline in absolute PASI Score at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.5443
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1
         upper limit
    0.5
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.38

    Secondary: Mean change from Baseline in high-sensitivity C-reactive Protein (hsCRP)

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    End point title
    Mean change from Baseline in high-sensitivity C-reactive Protein (hsCRP)
    End point description
    High-sensitivity C-reactive Protein (hsCRP) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 2, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    370
    409
    Units: milligram/litre (mg/L)
    arithmetic mean (standard deviation)
        Baseline (n=370, 409)
    0.648 ( 0.7565 )
    0.575 ( 0.6239 )
        Change from BL @ Week 2 (n=354, 386)
    -0.087 ( 0.7242 )
    -0.124 ( 0.5178 )
        Change from BL @ Week 4 (n=362, 392)
    -0.098 ( 0.6860 )
    -0.117 ( 0.5218 )
        Change from BL @ Week 8 (n=357, 392)
    -0.117 ( 0.6797 )
    -0.092 ( 0.5733 )
        Change from BL @ Week 12 (n=310, 334)
    -0.069 ( 0.7539 )
    -0.078 ( 0.7599 )
        Change from BL @ Week 16 (n=352, 387)
    -0.100 ( 0.6654 )
    -0.116 ( 0.4679 )
        Change from BL @ Week 20 (n=345, 378)
    -0.074 ( 0.7019 )
    -0.113 ( 0.5109 )
        Change from BL @ Week 24 (n=333, 373)
    -0.087 ( 0.7964 )
    -0.097 ( 0.5783 )
        Change from BL @ Week 28 (n=332, 362)
    -0.101 ( 0.7694 )
    -0.141 ( 0.4254 )
    Statistical analysis title
    hsCRP at week 28
    Statistical analysis description
    Comparison of mean change between treatments in hsCRP at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    779
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0057
    Method
    Mixed models analysis
    Parameter type
    Comparison of mean change between treatm
    Point estimate
    -0.114
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.194
         upper limit
    -0.033

    Secondary: Mean change from Baseline in Hemoglobin A1c (HbA1c)

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    End point title
    Mean change from Baseline in Hemoglobin A1c (HbA1c)
    End point description
    Hemoglobin A1c (HbA1c) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    365
    402
    Units: Percentage (%)
    arithmetic mean (standard deviation)
        Baseline (n= 365, 402)
    5.69 ( 0.706 )
    5.69 ( 0.694 )
        Change from BL @ Week 8 (n=346, 378)
    0.01 ( 0.293 )
    -0.07 ( 0.314 )
        Change from BL @ Week 16 (n=346, 380)
    0.03 ( 0.389 )
    -0.06 ( 0.342 )
        Change from BL @ Week 24 (n=180, 180))
    0.03 ( 0.388 )
    -0.04 ( 0.332 )
        Change from BL @ Week 28 (n=317, 348)
    0.03 ( 0.417 )
    -0.05 ( 0.353 )
    Statistical analysis title
    HbA1c at week 28
    Statistical analysis description
    HbA1c - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    767
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0012
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -0.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.14
         upper limit
    -0.04
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.027

    Secondary: Mean change from Baseline in Fructosamine

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    End point title
    Mean change from Baseline in Fructosamine
    End point description
    Fructosamine was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    365
    402
    Units: micromole/liter (µmol/L)
    arithmetic mean (standard deviation)
        Baseline (n=365, 402)
    270.1 ( 61.62 )
    266.7 ( 61.91 )
        Change from BL @ Week 4 (n=127, 135)
    -1.0 ( 43.96 )
    -9.6 ( 43.23 )
        Change from BL @ Week 8 (n=349, 378)
    -2.4 ( 41.24 )
    -4.2 ( 48.95 )
        Change from BL @ Week 12 (n=137, 135)
    6.6 ( 45.84 )
    -6.4 ( 39.15 )
        Change from BL @ Week 16 (n=346, 381)
    0.8 ( 45.17 )
    -0.4 ( 48.15 )
        Change from BL @ Week 20 (n=157, 154)
    -0.6 ( 46.43 )
    -6.4 ( 56.76 )
        Change from BL @ Week 24 (n=177, 179)
    0.6 ( 44.51 )
    3.9 ( 51.88 )
        Change from BL @ Week 28 (n=317, 347)
    2.3 ( 47.29 )
    1.7 ( 48.00 )
    Statistical analysis title
    Fructosamine at week 28
    Statistical analysis description
    Fructosamine - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    767
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.9835
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -0.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.4
         upper limit
    6.3
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.23

    Secondary: Mean change from Baseline in Fasting Plasma Glucose (FPG)

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    End point title
    Mean change from Baseline in Fasting Plasma Glucose (FPG)
    End point description
    Fasting Plasma Glucose (FPG) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    366
    402
    Units: milligram per deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (n=366, 402)
    102.8 ( 23.35 )
    103.1 ( 25.61 )
        Change from BL @ Week 8 (n=347, 375)
    0.8 ( 17.14 )
    -1.7 ( 16.71 )
        Change from BL @ Week 16 (n=343, 377)
    1.9 ( 20.51 )
    -2.1 ( 16.26 )
        Change from BL @ Week 28 (n=320, 347)
    2.9 ( 22.29 )
    -0.5 ( 18.60 )
    Statistical analysis title
    FPG at week 28
    Statistical analysis description
    FPG - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    768
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0086
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -3.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.2
         upper limit
    -0.9
    Variability estimate
    Standard error of the mean
    Dispersion value
    1.35

    Secondary: Mean change from Baseline in Low-Density Lipoprotein (LDL)

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    End point title
    Mean change from Baseline in Low-Density Lipoprotein (LDL)
    End point description
    Low-Density Lipoprotein (LDL) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    370
    409
    Units: milligram per deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (n=370, 409)
    136.6 ( 39.98 )
    143.3 ( 39.39 )
        Change from BL @ Week 8 (n=355, 394)
    1.6 ( 21.53 )
    -2.2 ( 22.00 )
        Change from BL @ Week 16 (n=350, 386)
    -1.4 ( 22.67 )
    -0.9 ( 24.14 )
        Change from BL @ Week 28 (n=332, 359)
    1.9 ( 25.57 )
    -1.2 ( 25.10 )
    Statistical analysis title
    LDL at week 28
    Statistical analysis description
    LDL - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    779
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.1298
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -2.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.5
         upper limit
    0.8
    Variability estimate
    Standard error of the mean
    Dispersion value
    1.86

    Secondary: Mean change from Baseline in Total cholesterol

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    End point title
    Mean change from Baseline in Total cholesterol
    End point description
    Total cholesterol was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    370
    409
    Units: milligram per deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (n=370, 409)
    203.4 ( 42.38 )
    208.2 ( 41.61 )
        Change from BL @ Week 8 (n=355, 394)
    1.9 ( 26.75 )
    -2.5 ( 24.84 )
        Change from BL @ Week 16 (n=350, 386)
    -0.2 ( 25.33 )
    -1.3 ( 25.30 )
        Change from BL @ Week 28 (n=332, 359)
    -0.4 ( 30.13 )
    -3.1 ( 25.45 )
    Statistical analysis title
    Total cholesterol at week 28
    Statistical analysis description
    Total cholesterol - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    779
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.2755
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -2.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.4
         upper limit
    1.8
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.08

    Secondary: Mean change from Baseline in High-Density Lipoprotein (HDL)

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    End point title
    Mean change from Baseline in High-Density Lipoprotein (HDL)
    End point description
    High-Density Lipoprotein (HDL) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    370
    409
    Units: milligram per deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (n=370, 409)
    45.5 ( 11.81 )
    46.1 ( 10.62 )
        Change from BL @ Week 8 (n=355, 394)
    -0.5 ( 5.29 )
    -1.0 ( 6.20 )
        Change from BL @ Week 16 (n=350, 386)
    -0.8 ( 5.92 )
    0.0 ( 6.69 )
        Change from BL @ Week 28 (n=332, 359)
    0.0 ( 6.91 )
    0.5 ( 7.29 )
    Statistical analysis title
    HDL at week 28
    Statistical analysis description
    HDL - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    779
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.2084
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    0.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.4
         upper limit
    1.7
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.53

    Secondary: Mean change from Baseline in Triglycerides

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    End point title
    Mean change from Baseline in Triglycerides
    End point description
    Triglycerides were evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 8, Week 16, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    370
    409
    Units: milligram per deciliter (mg/dL)
    arithmetic mean (standard deviation)
        Baseline (n=370, 409)
    210.4 ( 169.58 )
    195.8 ( 126.83 )
        Change from BL @ Week 8 (n=355, 394)
    2.5 ( 100.55 )
    -2.7 ( 100.29 )
        Change from BL @ Week 16 (n=350, 386)
    11.0 ( 146.64 )
    -1.7 ( 111.36 )
        Change from BL @ Week 28 (n=332, 359)
    -5.9 ( 187.93 )
    -6.3 ( 98.69 )
    Statistical analysis title
    TRIG at week 28
    Statistical analysis description
    TRIG - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    779
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.5187
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -5.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -23.3
         upper limit
    11.7
    Variability estimate
    Standard error of the mean
    Dispersion value
    8.92

    Secondary: Mean change from Baseline in Waist circumference

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    End point title
    Mean change from Baseline in Waist circumference
    End point description
    Waist circumference was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Centimeter (cm)
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    115.3 ( 15.10 )
    114.9 ( 13.99 )
        Change from BL @ Week 1 (n=365, 402)
    -0.5 ( 2.97 )
    -0.3 ( 3.41 )
        Change from BL @ Week 2 (n=361, 393)
    -0.7 ( 3.74 )
    -1.1 ( 4.30 )
        Change from BL @ Week 3 (n=362, 391)
    -0.8 ( 3.66 )
    -1.3 ( 4.71 )
        Change from BL @ Week 4 (n=363, 393)
    -0.9 ( 3.92 )
    -2.0 ( 4.54 )
        Change from BL @ Week 8 (n=359, 394)
    -1.2 ( 4.53 )
    -2.6 ( 5.34 )
        Change from BL @ Week 12 (n=309, 335)
    -1.1 ( 4.43 )
    -2.9 ( 5.68 )
        Change from BL @ Week 16 (n=353, 388)
    -1.4 ( 5.22 )
    -3.5 ( 6.09 )
        Change from BL @ Week 20 (n=346, 381)
    -1.3 ( 5.47 )
    -3.5 ( 6.09 )
        Change from BL @ Week 24 (n=337, 375)
    -1.4 ( 5.34 )
    -3.7 ( 6.72 )
        Change from BL @ Week 28 (n=331, 366)
    -1.5 ( 5.50 )
    -3.9 ( 7.04 )
    Statistical analysis title
    Waist circumference at week 28
    Statistical analysis description
    Waist circumference - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -2.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.6
         upper limit
    -1.8
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.47

    Secondary: Mean change from Baseline in Body weight

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    End point title
    Mean change from Baseline in Body weight
    End point description
    Body weight was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Kilogram (kg)
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    107.16 ( 22.624 )
    107.9 ( 20.765 )
        Change from BL @ Week 1 (n=365, 402)
    0.06 ( 2.120 )
    -0.33 ( 1.401 )
        Change from BL @ Week 2 (n=361, 394)
    -0.04 ( 1.729 )
    -0.75 ( 1.739 )
        Change from BL @ Week 3 (n=362, 392)
    -0.05 ( 2.189 )
    -1.08 ( 2.278 )
        Change from BL @ Week 4 (n=363, 394)
    -0.08 ( 2.326 )
    -1.20 ( 2.177 )
        Change from BL @ Week 8 (n=360, 393)
    -0.15 ( 2.447 )
    -1.84 ( 3.471 )
        Change from BL @ Week 12 (n=310, 335)
    0.02 ( 2.726 )
    -2.38 ( 4.150 )
        Change from BL @ Week 16 (n=355, 388)
    -0.21 ( 3.243 )
    -2.65 ( 4.892 )
        Change from BL @ Week 20 (n=346, 381)
    -0.36 ( 3.581 )
    -2.72 ( 5.480 )
        Change from BL @ Week 24 (n=337, 376)
    -0.30 ( 3.815 )
    -2.86 ( 6.056 )
        Change from BL @ Week 28 (n=334, 366)
    -0.17 ( 3.803 )
    -3.03 ( 6.107 )
    Statistical analysis title
    Body weight at week 28
    Statistical analysis description
    Body weight - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -2.85
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.61
         upper limit
    -2.09
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.385

    Secondary: Mean change from Baseline in Body Mass Index (BMI)

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    End point title
    Mean change from Baseline in Body Mass Index (BMI)
    End point description
    Body Mass Index (BMI) was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Kilogram by square meter (kg/m^2)
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    34.788 ( 6.8112 )
    34.631 ( 6.4232 )
        Change from BL @ Week 1 (n=365, 402)
    0.015 ( 0.6846 )
    -0.110 ( 0.4515 )
        Change from BL @ Week 2 (n=361, 394)
    -0.015 ( 0.5545 )
    -0.240 ( 0.5649 )
        Change from BL @ Week 3 (n=362, 392)
    -0.014 ( 0.7076 )
    -0.346 ( 0.7352 )
        Change from BL @ Week 4 (n=363, 394)
    -0.027 ( 0.7451 )
    -0.386 ( 0.7128 )
        Change from BL @ Week 8 (n=360, 393)
    -0.047 ( 0.7838 )
    -0.582 ( 1.1641 )
        Change from BL @ Week 12 (n=310, 335)
    0.009 ( 0.8768 )
    -0.758 ( 1.3522 )
        Change from BL @ Week 16 (n=355, 388)
    -0.070 ( 1.0432 )
    -0.843 ( 1.5780 )
        Change from BL @ Week 20 (n=346, 381)
    -0.113 ( 1.1627 )
    -0.864 ( 1.7769 )
        Change from BL @ Week 24 (n=337, 376)
    -0.094 ( 1.2417 )
    -0.906 ( 1.9591 )
        Change from BL @ Week 28 (n=334, 366)
    -0.054 ( 1.2309 )
    -0.961 ( 1.9665 )
    Statistical analysis title
    BMI at week 28
    Statistical analysis description
    BMI - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -0.907
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.151
         upper limit
    -0.663
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.1243

    Secondary: Mean change from Baseline in Systolic Blood Pressure

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    End point title
    Mean change from Baseline in Systolic Blood Pressure
    End point description
    Systolic Blood Pressure was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: millimeter of mercury (mmHg)
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    139.44 ( 11.703 )
    139.19 ( 11.711 )
        Change from BL @ Week 1 (n=365, 402)
    -0.66 ( 10.033 )
    -1.44 ( 10.964 )
        Change from BL @ Week 2 (n=361, 394)
    -1.24 ( 11.499 )
    -3.12 ( 11.422 )
        Change from BL @ Week 3 (n=362, 392)
    -1.05 ( 11.086 )
    -3.67 ( 12.740 )
        Change from BL @ Week 4 (n=362, 394)
    -3.02 ( 10.693 )
    -4.33 ( 11.763 )
        Change from BL @ Week 8 (n=360, 394)
    -2.52 ( 12.394 )
    -3.88 ( 12.545 )
        Change from BL @ Week 12 (n=310, 335)
    -1.64 ( 12.054 )
    -3.65 ( 12.982 )
        Change from BL @ Week 16 (n=354, 388)
    -3.03 ( 12.646 )
    -4.33 ( 12.980 )
        Change from BL @ Week 20 (n=346, 381)
    -1.65 ( 12.067 )
    -3.70 ( 13.323 )
        Change from BL @ Week 24 (n=337, 376)
    -2.53 ( 12.681 )
    -4.35 ( 13.455 )
        Change from BL @ Week 28 (n=334, 366)
    -2.56 ( 12.179 )
    -4.28 ( 13.475 )
    Statistical analysis title
    SYSBP at week 28
    Statistical analysis description
    SYSBP - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0204
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.7
         upper limit
    -0.3
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.87

    Secondary: Mean change from Baseline in Diastolic Blood Pressure

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    End point title
    Mean change from Baseline in Diastolic Blood Pressure
    End point description
    Diastolic Blood Pressure was evaluated in both treatment arms throughout the duration of the core study and summarized using descriptive statistics.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 1, Week 2, Week 3, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: millimeter of mercury (mmHg)
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    86.44 ( 7.116 )
    86.50 ( 7.305 )
        Change from BL @ Week 1 (n=365, 402)
    -0.39 ( 6.761 )
    -1.02 ( 7.495 )
        Change from BL @ Week 2 (n=361, 394)
    -0.65 ( 7.460 )
    -1.16 ( 7.630 )
        Change from BL @ Week 3 (n=362, 392)
    -0.62 ( 7.180 )
    -1.66 ( 8.030 )
        Change from BL @ Week 4 (n=362, 394)
    -1.29 ( 7.349 )
    -2.00 ( 7.925 )
        Change from BL @ Week 8 (n=360, 394)
    -0.60 ( 7.510 )
    -1.51 ( 7.517 )
        Change from BL @ Week 12 (n=310, 335)
    -0.37 ( 7.820 )
    -1.56 ( 8.754 )
        Change from BL @ Week 16 (n=354, 388)
    -0.60 ( 7.969 )
    -1.99 ( 8.211 )
        Change from BL @ Week 20 (n=346, 381)
    -0.59 ( 8.040 )
    -2.28 ( 8.275 )
        Change from BL @ Week 24 (n=337, 376)
    -0.73 ( 8.270 )
    -2.04 ( 8.701 )
        Change from BL @ Week 28 (n=334, 366)
    -0.48 ( 8.417 )
    -1.65 ( 8.877 )
    Statistical analysis title
    DIABP at week 28
    Statistical analysis description
    DIABP - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0652
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -1.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.2
         upper limit
    0.1
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.58

    Secondary: Dermatology Life Quality Index (DLQI) Total Score over time

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    End point title
    Dermatology Life Quality Index (DLQI) Total Score over time
    End point description
    The Dermatology life Quality Index (DLQI) is a ten-question questionnaire used to measure the impact of skin disease on the quality of life of an affected person. Each question refers to the impact of the skin disease on the patient’s life (symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, treatment) over the previous week and is scored from 0 to 3, giving a possible score range from 0 (meaning no impact of skin disease on quality of life) to 30 (meaning maximum impact on quality of life).
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    19.55 ( 5.124 )
    19.12 ( 5.449 )
        Week 4 (n=366, 394)
    8.57 ( 5.932 )
    7.92 ( 6.119 )
        Week 8 (n=360, 395)
    5.47 ( 5.725 )
    5.18 ( 5.405 )
        Week 12 (n= 309, 335)
    4.29 ( 5.341 )
    4.16 ( 5.100 )
        Week 16 (n= 354, 388)
    3.90 ( 5.374 )
    3.73 ( 4.927 )
        Week 20 (n= 346, 380)
    3.43 ( 5.101 )
    3.43 ( 5.061 )
        Week 24 (n=337, 378)
    3.42 ( 5.261 )
    3.33 ( 4.824 )
        Week 28 (n=334, 366)
    3.42 ( 5.242 )
    3.30 ( 5.312 )
    No statistical analyses for this end point

    Secondary: Mean change from Baseline in Dermatology Life Quality Index (DLQI) Total Score over time

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    End point title
    Mean change from Baseline in Dermatology Life Quality Index (DLQI) Total Score over time
    End point description
    The Dermatology life Quality Index (DLQI) is a ten-question questionnaire used to measure the impact of skin disease on the quality of life of an affected person. Each question refers to the impact of the skin disease on the patient’s life (symptoms, embarrassment, shopping and home care, clothes, social and leisure, sport, work or study, close relationships, sex, treatment) over the previous week and is scored from 0 to 3, giving a possible score range from 0 (meaning no impact of skin disease on quality of life) to 30 (meaning maximum impact on quality of life).
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    19.5 ( 5.12 )
    19.1 ( 5.45 )
        Change from BL @ Week 4 (n=366, 394)
    -11.0 ( 6.66 )
    -11.3 ( 6.68 )
        Change from BL @ Week 8 (n=360, 395)
    -14.1 ( 6.91 )
    -14.1 ( 6.60 )
        Change from BL @ Week 12 (n=309, 335)
    -15.5 ( 6.68 )
    -15.1 ( 6.51 )
        Change from BL @ Week 16 (n=354, 388)
    -15.7 ( 6.60 )
    -15.4 ( 6.33 )
        Change from BL @ Week 20 (n=346, 380)
    -16.2 ( 6.81 )
    -15.7 ( 6.66 )
        Change from BL @ Week 24 (n=337, 378)
    -16.1 ( 6.75 )
    -15.8 ( 6.46 )
        Change from BL @ Week 28 (n=334, 366)
    -16.1 ( 6.80 )
    -15.9 ( 6.67 )
    Statistical analysis title
    DLQI Total Score at Week 28
    Statistical analysis description
    DLQI Total Score - Comparison of mean change between treatments at Week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.7733
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    -0.12
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.9
         upper limit
    0.7
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.41

    Secondary: Percentage of patients with Dermatology Life Quality Index (DLQI) Response

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    End point title
    Percentage of patients with Dermatology Life Quality Index (DLQI) Response
    End point description
    All patients with DLQI score 0 and 1 were considered as responders and patients with DLQI score >=2 were considered as non-responders. Subjects with missing DLQI score were counted as non-responders.
    End point type
    Secondary
    End point timeframe
    Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Participants
        Non-Responders @ Week 4
    323
    344
        Responders @ Week 4
    43
    50
        Non-Responders @ Week 8
    249
    269
        Responders @ Week 8
    111
    126
        Non-Responders @ Week 12
    179
    192
        Responders @ Week 12
    130
    143
        Non-Responders @ Week 16
    176
    201
        Responders @ Week 16
    178
    187
        Non-Responders @ Week 20
    153
    170
        Responders @ Week 20
    193
    210
        Non-Responders @ Week 24
    148
    175
        Responders @ Week 24
    189
    203
        Non-Responders @ Week 28
    145
    154
        Responders @ Week 28
    189
    212
    No statistical analyses for this end point

    Secondary: World Health Organization Well-Being Index (WHO-5) Total score over time

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    End point title
    World Health Organization Well-Being Index (WHO-5) Total score over time
    End point description
    The 5-item World Health Organization Well-Being Index (WHO-5) is a validated, short questionnaire consisting of 5 simple questions, assessing subjective psychological well-being of the respondents: Felt cheerful and in good spirits, Felt calm and relaxed, Felt active and vigorous, Feeling fresh and rested and Things that interest me in daily life. The recall period is the previous two weeks. Each item has 6 response categories, ranging from 5 (“the whole time”) to 0 (“at no time point”). The raw score ranges from 0 to 25, with 0 representing worst possible and 25 representing best possible quality of life. To obtain a percentage score ranging from 0 to 100, the raw score is multiplied by 4. A percentage score of 0 represents worst possible, whereas a score of 100 represents best possible quality of life.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    10.46 ( 5.208 )
    10.62 ( 5.283 )
        Week 4 (n=365, 394)
    14.45 ( 5.236 )
    15.52 ( 4.921 )
        Week 8 (n=360, 395)
    15.65 ( 4.889 )
    15.99 ( 4.697 )
        Week 12 (n=309, 335)
    15.77 ( 5.083 )
    16.37 ( 4.824 )
        Week 16 (n=353, 388)
    15.91 ( 5.334 )
    16.45 ( 4.902 )
        Week 20 (n=346, 379)
    16.30 ( 5.364 )
    16.44 ( 4.978 )
        Week 24 (n=337, 378)
    16.47 ( 5.173 )
    16.55 ( 4.865 )
        Week 28 (n=334, 366)
    16.20 ( 5.583 )
    16.69 ( 4.910 )
    No statistical analyses for this end point

    Secondary: Mean change from Baseline in World Health Organization Well-Being Index (WHO-5) Total score over time

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    End point title
    Mean change from Baseline in World Health Organization Well-Being Index (WHO-5) Total score over time
    End point description
    The 5-item World Health Organization Well-Being Index (WHO-5) is a validated, short questionnaire consisting of 5 simple questions, assessing subjective psychological well-being of the respondents: Felt cheerful and in good spirits, Felt calm and relaxed, Felt active and vigorous, Feeling fresh and rested and Things that interest me in daily life. The recall period is the previous two weeks. Each item has 6 response categories, ranging from 5 (“the whole time”) to 0 (“at no time point”). The raw score ranges from 0 to 25, with 0 representing worst possible and 25 representing best possible quality of life. To obtain a percentage score ranging from 0 to 100, the raw score is multiplied by 4. A percentage score of 0 represents worst possible, whereas a score of 100 represents best possible quality of life.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard deviation)
        Baseline (n=371, 409)
    10.5 ( 5.21 )
    10.6 ( 5.28 )
        Week 4 (n= 365, 394)
    4.0 ( 5.21 )
    4.9 ( 5.51 )
        Week 8 (n= 360, 395)
    5.1 ( 5.61 )
    5.4 ( 5.76 )
        Week 12 (n= 309, 335)
    5.2 ( 5.73 )
    5.7 ( 5.95 )
        Week 16 (n= 353, 388)
    5.4 ( 5.59 )
    5.8 ( 5.85 )
        Week 20 (n= 346, 379)
    5.8 ( 6.08 )
    5.8 ( 5.79 )
        Week 24 (n= 337, 378)
    5.9 ( 5.65 )
    5.9 ( 6.19 )
        Week 28 (n= 334, 366)
    5.6 ( 6.20 )
    5.9 ( 6.12 )
    Statistical analysis title
    WHO-5 at week 28
    Statistical analysis description
    WHO-5 - Comparison of mean change between treatments at week 28
    Comparison groups
    Secukinumab 300 mg subcutaneous (s.c.) v Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects included in analysis
    780
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.0982
    Method
    Mixed models analysis
    Parameter type
    least squares (LS) mean change
    Point estimate
    0.59
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.1
         upper limit
    1.3
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.36

    Secondary: Participant’s self-assessed pain, itching and scaling over time

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    End point title
    Participant’s self-assessed pain, itching and scaling over time
    End point description
    A self-administered, 11-point numeric rating scale (NRS, 0-10) was used to evaluate the subject’s assessment of their current pain, itching and scaling. Respondents answered the following questions for the assessment of: * Pain: Overall, how severe was your psoriasis-related pain over the past 24 hours * Itching: Overall, how severe was your psoriasis-related itch over the past 24 hours * Scaling: Overall, how severe was your psoriasis-related scaling over the past 24 hours Subjects had to rate their pain, itching, and scaling from 0 to 10 (11-point scale), with the understanding that the 0 represented the absence or null end of the pain, itching, or scale intensity (i.e., no pain, itching or scaling) and the 10 represented the other extreme of pain, itching, or scaling intensity (i.e., pain, itching or scaling as bad as it could be). The number that the patient selected represented his or her intensity score.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Unit on a scale
    arithmetic mean (standard deviation)
        Pain at Baseline (n=371, 409)
    4.9 ( 2.93 )
    4.6 ( 2.87 )
        Pain at week 4 (n= 366, 392)
    1.9 ( 2.29 )
    1.7 ( 2.23 )
        Pain at week 8 (n= 359, 394)
    1.1 ( 1.88 )
    1.3 ( 2.05 )
        Pain at week 12 (n= 309, 335)
    1.2 ( 2.14 )
    1.0 ( 1.84 )
        Pain at week 16 (n= 353, 388)
    1.1 ( 2.04 )
    1.1 ( 1.88 )
        Pain at week 20 (n= 346, 380)
    1.0 ( 1.93 )
    1.0 ( 1.81 )
        Pain at week 24 (n= 337, 378)
    1.0 ( 1.91 )
    1.0 ( 1.85 )
        Pain at week 28 (n= 333, 366)
    1.2 ( 2.10 )
    1.0 ( 2.00 )
        Itching at Baseline (n=371, 409)
    7.4 ( 2.08 )
    7.1 ( 2.39 )
        Itching at week 4 (n=366, 393)
    3.2 ( 2.43 )
    3.0 ( 2.60 )
        Itching at week 8 (n=359, 394)
    2.4 ( 2.36 )
    2.3 ( 2.47 )
        Itching at week 12 (n=309, 335)
    2.2 ( 2.38 )
    2.0 ( 2.29 )
        Itching at week 16 (n=353, 388)
    2.0 ( 2.29 )
    2.0 ( 2.43 )
        Itching at week 20 (n= 346, 380)
    1.9 ( 2.23 )
    1.9 ( 2.19 )
        Itching at week 24 (n= 337, 378)
    1.9 ( 2.35 )
    1.8 ( 2.23 )
        Itching at week 28 (n=334, 366)
    2.0 ( 2.47 )
    1.9 ( 2.38 )
        Scaling at Baseline (n=371, 409)
    7.5 ( 2.01 )
    7.3 ( 2.17 )
        Scaling at week 4 (n=366, 393)
    2.7 ( 2.18 )
    2.4 ( 2.16 )
        Scaling at week 8 (n=359, 394)
    1.7 ( 1.94 )
    1.7 ( 2.03 )
        Scaling at week 12 (n=309, 335)
    1.7 ( 2.00 )
    1.6 ( 1.90 )
        Scaling at week 16 (n=353, 388)
    1.6 ( 2.10 )
    1.5 ( 1.95 )
        Scaling at week 20 (n=346, 380)
    1.6 ( 2.10 )
    1.5 ( 1.98 )
        Scaling at week 24 (n=337, 378)
    1.7 ( 2.22 )
    1.4 ( 1.84 )
        Scaling at week 28 (n=334, 366)
    1.8 ( 2.28 )
    1.5 ( 2.04 )
    No statistical analyses for this end point

    Secondary: Percentage change from Baseline in Participant’s self-assessed pain, itching and scaling

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    End point title
    Percentage change from Baseline in Participant’s self-assessed pain, itching and scaling
    End point description
    A self-administered, 11-point numeric rating scale (NRS, 0-10) was used to evaluate the subject’s assessment of their current pain, itching and scaling. Respondents answered the following questions for the assessment of: * Pain: Overall, how severe was your psoriasis-related pain over the past 24 hours * Itching: Overall, how severe was your psoriasis-related itch over the past 24 hours * Scaling: Overall, how severe was your psoriasis-related scaling over the past 24 hours Subjects had to rate their pain, itching, and scaling from 0 to 10 (11-point scale), with the understanding that the 0 represented the absence or null end of the pain, itching, or scale intensity (i.e., no pain, itching or scaling) and the 10 represented the other extreme of pain, itching, or scaling intensity (i.e., pain, itching or scaling as bad as it could be). The number that the patient selected represented his or her intensity score.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24, Week 28
    End point values
    Secukinumab 300 mg subcutaneous (s.c.) Secukinumab 300 mg s.c. and lifestyle intervention
    Number of subjects analysed
    371
    409
    Units: Percentage change
    arithmetic mean (standard deviation)
        Pain at Baseline (n=371, 409)
    4.9 ( 2.93 )
    4.6 ( 2.87 )
        Pain at week 4 (n= 328, 349)
    -61.4 ( 44.13 )
    -60.2 ( 59.10 )
        Pain at week 8 (n= 321, 352)
    -74.4 ( 44.39 )
    -68.5 ( 53.86 )
        Pain at week 12 (n= 276, 299)
    -72.2 ( 54.73 )
    -76.6 ( 40.64 )
        Pain at week 16 (n= 315, 345)
    -77.3 ( 38.93 )
    -74.0 ( 46.10 )
        Pain at week 20 (n= 308, 339)
    -78.4 ( 41.88 )
    -75.2 ( 43.55 )
        Pain at week 24 (n= 302, 340)
    -78.4 ( 41.88 )
    -75.7 ( 47.05 )
        Pain at week 28 (n= 299, 328)
    -76.3 ( 42.22 )
    -75.3 ( 52.42 )
        Itching at Baseline (n=371, 409)
    7.4 ( 2.08 )
    7.1 ( 2.39 )
        Itching at week 4 (n=365, 386)
    -54.1 ( 33.82 )
    -55.8 ( 41.19 )
        Itching at week 8 (n=358, 387)
    -63.7 ( 39.78 )
    -66.7 ( 34.31 )
        Itching at week 12 (n=308, 329)
    -66.6 ( 40.58 )
    -70.0 ( 33.53 )
        Itching at week 16 (n=352, 381)
    -70.6 ( 34.79 )
    -70.0 ( 35.79 )
        Itching at week 20 (n= 345, 373)
    -71.1 ( 37.64 )
    -73.0 ( 35.36 )
        Itching at week 24 (n= 326, 374)
    -69.6 ( 46.85 )
    -72.6 ( 35.64 )
        Itching at week 28 (n=333, 361)
    -68.5 ( 48.46 )
    -72.1 ( 35.97 )
        Scaling at Baseline (n=371, 409)
    7.5 ( 2.01 )
    7.3 ( 2.17 )
        Scaling at week 4 (n=366, 389)
    -62.2 ( 30.65 )
    -64.9 ( 34.27 )
        Scaling at week 8 (n=359, 390)
    -74.9 ( 38.02 )
    -75.1 ( 30.50 )
        Scaling at week 12 (n=309, 332)
    -76.5 ( 29.91 )
    -76.9 ( 31.93 )
        Scaling at week 16 (n=353, 384)
    -74.3 ( 40.92 )
    -77.2 ( 32.84 )
        Scaling at week 20 (n=346, 376)
    -76.4 ( 31.93 )
    -76.2 ( 36.76 )
        Scaling at week 24 (n=337, 375)
    -75.4 ( 35.21 )
    -78.2 ( 33.38 )
        Scaling at week 28 (n=334, 362)
    -74.3 ( 36.50 )
    -77.7 ( 35.84 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were reported from first dose of secukinumab in the Core Study up to 84 days after the last dose (Week 24).
    Adverse event reporting additional description
    Consistent with EudraCT disclosure specifications, Novartis has reported under the Serious adverse events field “number of deaths resulting from adverse events” all those deaths, resulting from serious adverse events that are deemed to be causally related to treatment by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    Core Period Secukinumab
    Reporting group description
    Core Period Secukinumab

    Reporting group title
    Core Period Secukinumab + Lifestyle Intervention
    Reporting group description
    Core Period Secukinumab + Lifestyle Intervention

    Reporting group title
    Extension Period Lifestyle Intervention
    Reporting group description
    Extension Period Lifestyle Intervention

    Reporting group title
    Extension Period Lifestyle Intervention + Secukinumab
    Reporting group description
    Extension Period Lifestyle Intervention + Secukinumab

    Reporting group title
    Extension Period Secukinumab
    Reporting group description
    Extension Period Secukinumab

    Serious adverse events
    Core Period Secukinumab Core Period Secukinumab + Lifestyle Intervention Extension Period Lifestyle Intervention Extension Period Lifestyle Intervention + Secukinumab Extension Period Secukinumab
    Total subjects affected by serious adverse events
         subjects affected / exposed
    18 / 371 (4.85%)
    20 / 409 (4.89%)
    11 / 189 (5.82%)
    10 / 164 (6.10%)
    32 / 427 (7.49%)
         number of deaths (all causes)
    2
    0
    0
    0
    2
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Malignant melanoma
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bladder cancer
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Colorectal adenocarcinoma
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urethral cancer
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Scrotal cancer
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Parathyroid tumour benign
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metastases to spine
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metastases to bone
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Flushing
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous fistula
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Peripheral arterial occlusive disease
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Varicose vein
         subjects affected / exposed
    1 / 371 (0.27%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    2 / 164 (1.22%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    2 / 371 (0.54%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    2 / 427 (0.47%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
    0 / 0
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chest discomfort
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Cystocele
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Dyspnoea
         subjects affected / exposed
    3 / 371 (0.81%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    4 / 427 (0.94%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
    0 / 0
    0 / 1
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Asthma
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Mania
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Product issues
    Device loosening
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Alanine aminotransferase increased
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Concussion
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Foot fracture
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Head injury
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary contusion
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reactive gastropathy
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Road traffic accident
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin laceration
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tendon rupture
         subjects affected / exposed
    2 / 371 (0.54%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    2 / 427 (0.47%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    1 / 371 (0.27%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    2 / 427 (0.47%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    2 / 427 (0.47%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Coronary artery disease
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pericarditis
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Cerebral infarction
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Endocrine ophthalmopathy
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Macular oedema
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ocular fistula
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ulcerative keratitis
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Enterocolitis haemorrhagic
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertrophy of tongue papillae
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hiatus hernia
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal polyp
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femoral hernia
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Psoriasis
         subjects affected / exposed
    2 / 371 (0.54%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    3 / 427 (0.70%)
         occurrences causally related to treatment / all
    1 / 2
    1 / 1
    0 / 1
    0 / 0
    2 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Erythrodermic psoriasis
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Nephrolithiasis
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    1 / 189 (0.53%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Goitre
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Osteoarthritis
         subjects affected / exposed
    2 / 371 (0.54%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    3 / 427 (0.70%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intervertebral disc protrusion
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bursitis
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bronchiolitis
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    2 / 427 (0.47%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal infection
         subjects affected / exposed
    0 / 371 (0.00%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    1 / 189 (0.53%)
    0 / 164 (0.00%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vestibular neuronitis
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulpitis dental
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Otitis media
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 371 (0.00%)
    1 / 409 (0.24%)
    0 / 189 (0.00%)
    1 / 164 (0.61%)
    0 / 427 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypercalcaemia
         subjects affected / exposed
    1 / 371 (0.27%)
    0 / 409 (0.00%)
    0 / 189 (0.00%)
    0 / 164 (0.00%)
    1 / 427 (0.23%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Core Period Secukinumab Core Period Secukinumab + Lifestyle Intervention Extension Period Lifestyle Intervention Extension Period Lifestyle Intervention + Secukinumab Extension Period Secukinumab
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    178 / 371 (47.98%)
    204 / 409 (49.88%)
    101 / 189 (53.44%)
    103 / 164 (62.80%)
    225 / 427 (52.69%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    10 / 371 (2.70%)
    7 / 409 (1.71%)
    2 / 189 (1.06%)
    9 / 164 (5.49%)
    9 / 427 (2.11%)
         occurrences all number
    14
    9
    2
    14
    10
    Vascular disorders
    Hypertension
         subjects affected / exposed
    19 / 371 (5.12%)
    16 / 409 (3.91%)
    9 / 189 (4.76%)
    9 / 164 (5.49%)
    20 / 427 (4.68%)
         occurrences all number
    19
    18
    9
    10
    21
    Nervous system disorders
    Headache
         subjects affected / exposed
    40 / 371 (10.78%)
    36 / 409 (8.80%)
    18 / 189 (9.52%)
    20 / 164 (12.20%)
    40 / 427 (9.37%)
         occurrences all number
    57
    51
    22
    34
    59
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    14 / 371 (3.77%)
    10 / 409 (2.44%)
    2 / 189 (1.06%)
    9 / 164 (5.49%)
    16 / 427 (3.75%)
         occurrences all number
    14
    14
    2
    13
    16
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    19 / 371 (5.12%)
    22 / 409 (5.38%)
    14 / 189 (7.41%)
    10 / 164 (6.10%)
    23 / 427 (5.39%)
         occurrences all number
    26
    25
    20
    12
    27
    Respiratory, thoracic and mediastinal disorders
    Oropharyngeal pain
         subjects affected / exposed
    6 / 371 (1.62%)
    16 / 409 (3.91%)
    3 / 189 (1.59%)
    9 / 164 (5.49%)
    11 / 427 (2.58%)
         occurrences all number
    6
    18
    4
    9
    13
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    16 / 371 (4.31%)
    17 / 409 (4.16%)
    3 / 189 (1.59%)
    14 / 164 (8.54%)
    22 / 427 (5.15%)
         occurrences all number
    17
    22
    4
    14
    27
    Psoriasis
         subjects affected / exposed
    17 / 371 (4.58%)
    18 / 409 (4.40%)
    19 / 189 (10.05%)
    19 / 164 (11.59%)
    37 / 427 (8.67%)
         occurrences all number
    20
    18
    19
    20
    40
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    11 / 371 (2.96%)
    40 / 409 (9.78%)
    18 / 189 (9.52%)
    19 / 164 (11.59%)
    19 / 427 (4.45%)
         occurrences all number
    14
    50
    25
    23
    26
    Back pain
         subjects affected / exposed
    23 / 371 (6.20%)
    22 / 409 (5.38%)
    19 / 189 (10.05%)
    9 / 164 (5.49%)
    23 / 427 (5.39%)
         occurrences all number
    24
    22
    19
    9
    26
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    83 / 371 (22.37%)
    96 / 409 (23.47%)
    41 / 189 (21.69%)
    49 / 164 (29.88%)
    108 / 427 (25.29%)
         occurrences all number
    107
    121
    51
    67
    145

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 Jan 2018
    Amendment 1: The original protocol was amended in order to align details of the protocol with the patient documents of the lifestyle intervention program (“Lesebuch”) and in order to complement the protocol with a few details that made the study procedure more clear. • Section 5.5.3.2: Additional explanation about the time point (visit 2) when patients in arm B receive the materials which are part of the lifestyle intervention • Section 6.5.4.1: Two laboratory markers are additionally captured at visit 1. • Section 6: Additional explanatory footnote for table 6-1. • Section 6.4.5: Waist circumference measurement method is adapted in order to align it with the patient documents of the lifestyle intervention program (“Lesebuch”).
    05 Sep 2018
    Amendment 2: The protocol was amended in order to incorporate a biomarker sub-study. Moreover, regulations of study treatment discontinuations are being improved, minor inconsistencies are being corrected and clarifications are being added. • Descriptions of the biomarker sub-study were added to the sections 2, 3.1, 3.6, 4.1, 6, 6.6.5, 7.1, 9.5.6, and 9.6. • Section 5.6.2 and table 5-1: After study treatment discontinuation (i.e. discontinuation of secukinumab, lifestyle intervention or both) the patient will now continue to attend regular study visits as per visit schedule and all assessments will be performed as planned. If one study treatment is discontinued (i.e. secukinumab or lifestyle intervention) this should not lead to discontinuation of the other, unless there is a reason for discontinuation of the other. If a study treatment is discontinued, adequate replacement for this treatment may be sought outside of the study despite continued study participation. • Table 6-1: Clarification that physical examination and drug accounting will only be performed at unscheduled visits if necessary, as determined by the treating physician. • Section 6.2.2: Clarification that topical therapies are only collected for the last 24 month prior to signing the informed consent. • Section 6.5.4.3.: Clarification that urine microscopy assessment, if needed, will be performed locally and correction of parameters assessed with the dipstick measurement. • Section 9.5.1: Clarification that PASI assessments will also be performed at weeks 1, 2 and 3 and addition of missing secondary endpoints. • Section 9.5.2.2: Change of wording from serum chemistry to clinical chemistry to align with the rest of the protocol. • The list of abbreviations has been updated.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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