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    Clinical Trial Results:
    A double-blind, randomised, placebo-controlled study to assess the effect of SNF472 on progression of cardiovascular calcification on top of standard of care in end-stage-renal-disease (ESRD) patients on haemodialysis (HD)

    Summary
    EudraCT number
    2016-002834-59
    Trial protocol
    GB   ES  
    Global end of trial date
    14 Aug 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    26 Sep 2020
    First version publication date
    26 Sep 2020
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    SNFCT2015-05
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02966028
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Sanifit Therapeutics S.A.
    Sponsor organisation address
    PARC BIT. Europa Building. 2nd Floor, Palma , Spain, 07121
    Public contact
    Sanifit Information, Sanifit Therapeutics S.A, info@sanifit.com
    Scientific contact
    Regulatory Affairs, Sanifit Therapeutics S.A., lydie.yang@sanifit.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
    14 Aug 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    14 Aug 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Aug 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to assess the effect of 2 dose levels of SNF472 (300 mg and 600 mg) compared to placebo on the progression of absolute change in coronary artery calcium volume score over a 12 month (52 weeks) period in ESRD patients on HD.
    Protection of trial subjects
    Written informed consent was obtained from each subject prior to evaluations being performed for eligibility. Subjects were given adequate time to review the information in the informed consent and were allowed to ask, and have answered, questions concerning all portions of the conduct of the study. Through the informed consent process each subject was made aware of the purpose of the study, the procedures, the benefits and risks of the study, the discomforts and the precautions taken. Any side effects or other health issues occurring during the study were followed up by the study doctor. Subjects were able to stop taking part in the study at any time without giving any reason.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Nov 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 14
    Country: Number of subjects enrolled
    Spain: 94
    Country: Number of subjects enrolled
    United States: 166
    Worldwide total number of subjects
    274
    EEA total number of subjects
    108
    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)
    160
    From 65 to 84 years
    114
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects were required to meet all of the inclusion criteria and none of the exclusion criteria to be enrolled in the study. Subjects with existing coronary artery calcification based on Agatston scores at screening were enrolled because they were more likely to show progressive calcification during the study.

    Pre-assignment
    Screening details
    Screening was conducted in 2 steps: • Step 1: After written informed consent was obtained, a CT scan of the coronary arteries was obtained and bone mineral density was measured by DXA. • Step 2: If eligibility criterion in Step 1 was confirmed, then baseline data were collected at this visit.

    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer
    Blinding implementation details
    Investigators, all clinical staff, study subjects, and study administrators remained blinded throughout the clinical trial, unless safety concerns or a regulatory requirement made unblinding necessary.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    SNF472 300 mg
    Arm description
    Subjects were assigned to receive 300 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 1 vial of SNF472 (300 mg/vial) and 1 vial of physiologic saline.
    Arm type
    Experimental

    Investigational medicinal product name
    SNF472
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    SNF472 was provided as 10 mL of sterile liquid in transparent glass vials, containing either 300 mg of SNF472 for a concentration of 30 mg/mL. The full volume of the vial was injected into a bag of saline (0.9% sodium chloride) and administered as a constant rate intravenous (IV) infusion connected to an infusion pump, which was connected directly to the dialysis machine via an IV giving set and an accessory heparin line. The preferred physiologic saline bag size for dilution of the study drug was 100 mL. The infusion was initiated approximately 30 minutes after the start of the hemodialysis procedure and was to be completed in 2.5 hours.

    Investigational medicinal product name
    Physiologic saline
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Physiologic saline was provided as 10 mL of sterile liquid in transparent glass vials. The full volume of the physiologic saline was injected into a bag of saline (0.9% sodium chloride) and administered as a constant rate intravenous (IV) infusion connected to an infusion pump, which was connected directly to the dialysis machine via an IV giving set and an accessory heparin line. The preferred physiologic saline bag size for dilution of the study drug was 100 mL. The infusion was initiated approximately 30 minutes after the start of the hemodialysis procedure and was to be completed in 2.5 hours.

    Arm title
    SNF472 600 mg
    Arm description
    Subjects were assigned to receive 600 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vials of SNF472 (300 mg/vial).
    Arm type
    Experimental

    Investigational medicinal product name
    SNF472
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    SNF472 was provided as 10 mL of sterile liquid in transparent glass vials, containing either 300 mg of SNF472 for a concentration of 30 mg/mL. The full volume of the vial was injected into a bag of saline (0.9% sodium chloride) and administered as a constant rate intravenous (IV) infusion connected to an infusion pump, which was connected directly to the dialysis machine via an IV giving set and an accessory heparin line. The preferred physiologic saline bag size for dilution of the study drug was 100 mL. The infusion was initiated approximately 30 minutes after the start of the hemodialysis procedure and was to be completed in 2.5 hours.

    Arm title
    Placebo
    Arm description
    Subjects were assigned to receive physiologic saline (0.9% sodium chloride) administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vial of physiologic saline.
    Arm type
    Placebo

    Investigational medicinal product name
    Physiologic saline
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Physiologic saline was provided as 10 mL of sterile liquid in transparent glass vials. The full volume of the physiologic saline was injected into a bag of saline (0.9% sodium chloride) and administered as a constant rate intravenous (IV) infusion connected to an infusion pump, which was connected directly to the dialysis machine via an IV giving set and an accessory heparin line. The preferred physiologic saline bag size for dilution of the study drug was 100 mL. The infusion was initiated approximately 30 minutes after the start of the hemodialysis procedure and was to be completed in 2.5 hours.

    Number of subjects in period 1
    SNF472 300 mg SNF472 600 mg Placebo
    Started
    92
    91
    91
    Received dose
    92
    91
    90
    Completed
    68
    57
    60
    Not completed
    24
    34
    31
         Adverse event, serious fatal
    1
    6
    3
         Physician decision
    1
    -
    -
         Consent withdrawn by subject
    7
    5
    5
         Transferred to other clinic
    2
    -
    -
         Transfer to other clinic
    -
    2
    1
         Adverse event, non-fatal
    6
    7
    7
         Subject determination
    -
    -
    1
         Physician decision Death
    -
    -
    2
         Site/visit compliance
    1
    -
    -
         Kidney transplant
    6
    12
    8
         Site/visit non-compliance
    -
    2
    4

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    SNF472 300 mg
    Reporting group description
    Subjects were assigned to receive 300 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 1 vial of SNF472 (300 mg/vial) and 1 vial of physiologic saline.

    Reporting group title
    SNF472 600 mg
    Reporting group description
    Subjects were assigned to receive 600 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vials of SNF472 (300 mg/vial).

    Reporting group title
    Placebo
    Reporting group description
    Subjects were assigned to receive physiologic saline (0.9% sodium chloride) administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vial of physiologic saline.

    Reporting group values
    SNF472 300 mg SNF472 600 mg Placebo Total
    Number of subjects
    92 91 91 274
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        Adults (18-64 years)
    54 51 40 145
        From 65-84 years
    38 40 51 129
        85 years and over
    0 0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.0 ( 9.48 ) 63.6 ( 8.94 ) 64.1 ( 8.18 ) -
    Gender categorical
    Units: Subjects
        Female
    38 36 33 107
        Male
    54 55 58 167
    Race
    Race was self reported by the subjects. Subjects could select more than one option.
    Units: Subjects
        Asian
    2 4 4 10
        American Indian or Alaska Native
    2 0 0 2
        Black or African American
    26 15 19 60
        Native Hawaiian or Other Pacific Islander
    0 1 0 1
        White
    59 67 63 189
        Not Reported
    3 4 5 12
    Subject analysis sets

    Subject analysis set title
    SNF472 300 mg - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    SNF472 600 mg - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    Placebo - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    SNF472 Combined - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    SNF472 300 mg - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    SNF472 600 mg - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    Placebo - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis sets values
    SNF472 300 mg - Safety Population SNF472 600 mg - Safety Population Placebo - Safety Population SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects
    92
    91
    90
    142
    77
    65
    77
    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)
    54
    51
    40
        From 65-84 years
    38
    40
    50
        85 years and over
    0
    0
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.0 ( 9.48 )
    63.6 ( 8.94 )
    64.1 ( 8.18 )
    63.8 ( 9.07 )
    63.0 ( 9.63 )
    64.5 ( 9.39 )
    64.1 ( 8.25 )
    Gender categorical
    Units: Subjects
        Female
    38
    36
    33
        Male
    54
    55
    57
    Race
    Race was self reported by the subjects. Subjects could select more than one option.
    Units: Subjects
        Asian
    1
        American Indian or Alaska Native
    2
        Black or African American
    26
        Native Hawaiian or Other Pacific Islander
    0
        White
    59
        Not Reported
    3

    End points

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    End points reporting groups
    Reporting group title
    SNF472 300 mg
    Reporting group description
    Subjects were assigned to receive 300 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 1 vial of SNF472 (300 mg/vial) and 1 vial of physiologic saline.

    Reporting group title
    SNF472 600 mg
    Reporting group description
    Subjects were assigned to receive 600 mg SNF472 administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vials of SNF472 (300 mg/vial).

    Reporting group title
    Placebo
    Reporting group description
    Subjects were assigned to receive physiologic saline (0.9% sodium chloride) administered 3 times per week in conjunction with the subject’s hemodialysis sessions. All subjects received 2 identical vials of 10 mL each: 2 vial of physiologic saline.

    Subject analysis set title
    SNF472 300 mg - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    SNF472 600 mg - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    Placebo - Safety Population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Safety Population included subjects who received at least 1 dose of study drug

    Subject analysis set title
    SNF472 Combined - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    SNF472 300 mg - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    SNF472 600 mg - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Subject analysis set title
    Placebo - mITT LOCF
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    The mITT Population included subjects who received at least 1 dose of study drug and had an evaluable baseline and post randomization CT scan with a non missing CAC volume score (Week 52/ET)

    Primary: Change in log coronary artery calcification (CAC) volume score from Baseline to Week 52 for the combined dose groups vs placebo

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    End point title
    Change in log coronary artery calcification (CAC) volume score from Baseline to Week 52 for the combined dose groups vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Primary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    142
    77
    Units: volume score
        geometric mean (confidence interval 95%)
    1.11 (1.067 to 1.153)
    1.20 (1.138 to 1.262)
    Statistical analysis title
    Primary efficacy analysis
    Statistical analysis description
    The primary endpoint was the change in log CAC volume scores between baseline and Week 52 for the combined dose groups vs placebo. The primary comparison was that of the combined dose groups vs the placebo group. The primary efficacy analysis in the mITT Population imputed missing Week 52 CAC volume score using the last observation carried forward (LOCF) from the early termination visit.
    Comparison groups
    SNF472 Combined - mITT LOCF v Placebo - mITT LOCF
    Number of subjects included in analysis
    219
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0163 [1]
    Method
    ANCOVA
    Parameter type
    ratio
    Point estimate
    0.93
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.869
         upper limit
    0.986
    Notes
    [1] - P-value for treatment effect ratio between the combined dose groups and placebo

    Secondary: Change in log coronary artery calcification (CAC) volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo

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    End point title
    Change in log coronary artery calcification (CAC) volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    77
    65
    77
    Units: volume score
        geometric mean (confidence interval 95%)
    1.12 (1.060 to 1.175)
    1.10 (1.042 to 1.165)
    1.20 (1.138 to 1.262)
    No statistical analyses for this end point

    Secondary: Change in log coronary artery calcification (CAC) Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and for the combined dose groups vs the placebo group

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    End point title
    Change in log coronary artery calcification (CAC) Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and for the combined dose groups vs the placebo group
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    142
    77
    65
    77
    Units: Agatson score
        geometric mean (confidence interval 95%)
    1.11 (1.060 to 1.170)
    1.10 (1.027 to 1.170)
    1.13 (1.055 to 1.215)
    1.20 (1.122 to 1.278)
    No statistical analyses for this end point

    Secondary: Number of subjects with <15% progression in coronary artery calcification (CAC) Agatston score at Week 52 for each dose group and the combined dose groups vs placebo

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    End point title
    Number of subjects with <15% progression in coronary artery calcification (CAC) Agatston score at Week 52 for each dose group and the combined dose groups vs placebo
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    142
    77
    65
    77
    Units: subjects
    87
    46
    41
    37
    No statistical analyses for this end point

    Secondary: Number of subjects with ≥15% progression in coronary artery calcification (CAC) volume score at Week 52 for each dose group and the combined dose groups vs placebo

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    End point title
    Number of subjects with ≥15% progression in coronary artery calcification (CAC) volume score at Week 52 for each dose group and the combined dose groups vs placebo
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    142
    77
    65
    77
    Units: subjects
    53
    31
    22
    38
    No statistical analyses for this end point

    Secondary: Change in log thoracic aorta calcification volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo

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    End point title
    Change in log thoracic aorta calcification volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    134
    74
    60
    75
    Units: volume score
        geometric mean (confidence interval 95%)
    1.23 (1.161 to 1.302)
    1.25 (1.156 to 1.346)
    1.21 (1.113 to 1.318)
    1.28 (1.187 to 1.381)
    No statistical analyses for this end point

    Secondary: Change in log thoracic aorta calcification Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo

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    End point title
    Change in log thoracic aorta calcification Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    134
    74
    60
    75
    Units: Agatston score
        geometric mean (confidence interval 95%)
    1.29 (1.201 to 1.384)
    1.30 (1.186 to 1.432)
    1.28 (1.149 to 1.416)
    1.32 (1.205 to 1.452)
    No statistical analyses for this end point

    Secondary: Change in log aortic valve calcification volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo

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    End point title
    Change in log aortic valve calcification volume score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    138
    75
    63
    69
    Units: volume score
        geometric mean (confidence interval 95%)
    1.14 (1.048 to 1.235)
    1.28 (1.143 to 1.426)
    1.01 (0.899 to 1.144)
    1.98 (1.768 to 2.226)
    No statistical analyses for this end point

    Secondary: Change in log aortic valve calcification Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo

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    End point title
    Change in log aortic valve calcification Agatston score between baseline and Week 52 for each dose group (300 mg and 600 mg) vs placebo and the combined dose groups vs placebo
    End point description
    Change is geometric least squares mean (95% confidence intervals)
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 Combined - mITT LOCF SNF472 300 mg - mITT LOCF SNF472 600 mg - mITT LOCF Placebo - mITT LOCF
    Number of subjects analysed
    138
    75
    63
    69
    Units: Agatston score
        geometric mean (confidence interval 95%)
    1.14 (1.022 to 1.277)
    1.33 (1.141 to 1.541)
    0.98 (0.836 to 1.160)
    2.86 (2.449 to 3.349)
    No statistical analyses for this end point

    Secondary: Incidence of the composite safety endpoint (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) for each dose group and placebo

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    End point title
    Incidence of the composite safety endpoint (death from cardiovascular causes, myocardial infarction, stroke, or heart failure) for each dose group and placebo
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 300 mg - Safety Population SNF472 600 mg - Safety Population Placebo - Safety Population
    Number of subjects analysed
    92
    91
    90
    Units: subjects
    7
    6
    10
    No statistical analyses for this end point

    Secondary: Mortality rate (all-cause and cardiovascular) for each dose group and placebo

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    End point title
    Mortality rate (all-cause and cardiovascular) for each dose group and placebo
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline to Week 52
    End point values
    SNF472 300 mg - Safety Population SNF472 600 mg - Safety Population Placebo - Safety Population
    Number of subjects analysed
    92
    91
    90
    Units: subjects
    1
    6
    5
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Baseline to Week 52
    Adverse event reporting additional description
    Treatment-emergent adverse events (TEAEs), defined as adverse events with an onset date on or after the date of first dose of study drug through the subject's early termination visit or until scheduled completion (Week 52 visit)
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.1
    Reporting groups
    Reporting group title
    SNF472 300 mg - Safety Population
    Reporting group description
    -

    Reporting group title
    SNF472 600 mg - Safety Population
    Reporting group description
    -

    Reporting group title
    Placebo - Safety Population
    Reporting group description
    -

    Serious adverse events
    SNF472 300 mg - Safety Population SNF472 600 mg - Safety Population Placebo - Safety Population
    Total subjects affected by serious adverse events
         subjects affected / exposed
    38 / 92 (41.30%)
    55 / 91 (60.44%)
    49 / 90 (54.44%)
         number of deaths (all causes)
    1
    6
    5
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Colon cancer
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Large intestine benign neoplasm
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Hypotension
         subjects affected / exposed
    3 / 92 (3.26%)
    2 / 91 (2.20%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Hypertension
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertensive crisis
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral vascular disorder
         subjects affected / exposed
    0 / 92 (0.00%)
    2 / 91 (2.20%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aortic stenosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Deep vein thrombosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Foreign body embolism
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriosclerosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Surgical and medical procedures
    Renal transplant
         subjects affected / exposed
    6 / 92 (6.52%)
    14 / 91 (15.38%)
    11 / 90 (12.22%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 14
    0 / 11
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Lymphadenectomy
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toe amputation
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    3 / 90 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    0 / 92 (0.00%)
    3 / 91 (3.30%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Asthenia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Systemic inflammatory response syndrome
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute pulmonary oedema
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Asthma
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Mental status changes
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Blood lactic acid increased
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac stress test abnormal
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza A virus test positive
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    International normalised ratio increased
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial necrosis marker increased
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Stress echocardiogram abnormal
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Troponin increased
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Arteriovenous fistula site complication
         subjects affected / exposed
    1 / 92 (1.09%)
    3 / 91 (3.30%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous fistula thrombosis
         subjects affected / exposed
    2 / 92 (2.17%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hip fracture
         subjects affected / exposed
    0 / 92 (0.00%)
    2 / 91 (2.20%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular graft complication
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ankle fracture
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arterial injury
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous fistula site haematoma
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous fistula site haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous graft aneurysm
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous graft thrombosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Fractured sacrum
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Limb injury
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Post procedural complication
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Post procedural haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Procedural hypotension
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Tendon rupture
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Toxicity to various agents
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Atrial fibrillation
         subjects affected / exposed
    3 / 92 (3.26%)
    3 / 91 (3.30%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    4 / 90 (4.44%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 92 (1.09%)
    3 / 91 (3.30%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Atrial flutter
         subjects affected / exposed
    0 / 92 (0.00%)
    3 / 91 (3.30%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriosclerosis coronary artery
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Angina unstable
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Aortic valve stenosis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Atrioventricular block complete
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Cardiogenic shock
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coronary artery stenosis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypertensive heart disease
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Left ventricular failure
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Mitral valve incompetence
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sinus node dysfunction
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Metabolic encephalopathy
         subjects affected / exposed
    2 / 92 (2.17%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Loss of consciousness
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cognitive disorder
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Dizziness postural
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Myasthenia gravis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Uraemic encephalopathy
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Agranulocytosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Anaemia of chronic disease
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Coagulopathy
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhagic anaemia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Nephrogenic anaemia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Retinal detachment
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vitreous haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    4 / 91 (4.40%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 5
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Colitis ischaemic
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal hernia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Abdominal mass
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diabetic gastroparesis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal necrosis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal ulcer haemorrhage
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Haemorrhoidal haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Impaired gastric emptying
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Lower gastrointestinal haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Rectal haemorrhage
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Ulcerative gastritis
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Acute hepatic failure
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Cholelithiasis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Drug-induced liver injury
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatic ischaemia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hepatitis acute
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Renal mass
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthralgia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal pain
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Pneumonia
         subjects affected / exposed
    4 / 92 (4.35%)
    3 / 91 (3.30%)
    7 / 90 (7.78%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 3
    0 / 7
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    2 / 92 (2.17%)
    2 / 91 (2.20%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    Cellulitis
         subjects affected / exposed
    2 / 92 (2.17%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    2 / 92 (2.17%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous graft site infection
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 92 (0.00%)
    2 / 91 (2.20%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gangrene
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    0 / 92 (0.00%)
    2 / 91 (2.20%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arteriovenous graft site abscess
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Arthritis infective
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile infection
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diabetic foot infection
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Emphysematous cystitis
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Enterocolitis viral
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis bacterial
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Herpes zoster
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Localised infection
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Osteomyelitis bacterial
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Pseudomonas infection
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vascular access site infection
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Wound infection
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Fluid overload
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    3 / 90 (3.33%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    2 / 92 (2.17%)
    1 / 91 (1.10%)
    2 / 90 (2.22%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Calciphylaxis
         subjects affected / exposed
    0 / 92 (0.00%)
    0 / 91 (0.00%)
    1 / 90 (1.11%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 91 (0.00%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Malnutrition
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 91 (1.10%)
    0 / 90 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    SNF472 300 mg - Safety Population SNF472 600 mg - Safety Population Placebo - Safety Population
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    41 / 92 (44.57%)
    29 / 91 (31.87%)
    29 / 90 (32.22%)
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    7 / 92 (7.61%)
    11 / 91 (12.09%)
    10 / 90 (11.11%)
         occurrences all number
    7
    11
    10
    Abdominal pain upper
         subjects affected / exposed
    11 / 92 (11.96%)
    2 / 91 (2.20%)
    2 / 90 (2.22%)
         occurrences all number
    11
    2
    2
    Vomiting
         subjects affected / exposed
    1 / 92 (1.09%)
    8 / 91 (8.79%)
    4 / 90 (4.44%)
         occurrences all number
    1
    8
    4
    Nausea
         subjects affected / exposed
    2 / 92 (2.17%)
    5 / 91 (5.49%)
    4 / 90 (4.44%)
         occurrences all number
    2
    5
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    10 / 92 (10.87%)
    9 / 91 (9.89%)
    8 / 90 (8.89%)
         occurrences all number
    10
    9
    8
    Dyspnoea
         subjects affected / exposed
    5 / 92 (5.43%)
    7 / 91 (7.69%)
    7 / 90 (7.78%)
         occurrences all number
    5
    7
    7
    Musculoskeletal and connective tissue disorders
    Pain in extremity
         subjects affected / exposed
    7 / 92 (7.61%)
    7 / 91 (7.69%)
    7 / 90 (7.78%)
         occurrences all number
    7
    7
    7
    Musculoskeletal pain
         subjects affected / exposed
    3 / 92 (3.26%)
    6 / 91 (6.59%)
    5 / 90 (5.56%)
         occurrences all number
    3
    6
    5
    Back pain
         subjects affected / exposed
    6 / 92 (6.52%)
    2 / 91 (2.20%)
    4 / 90 (4.44%)
         occurrences all number
    6
    2
    4
    Arthralgia
         subjects affected / exposed
    5 / 92 (5.43%)
    2 / 91 (2.20%)
    4 / 90 (4.44%)
         occurrences all number
    5
    2
    4
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    2 / 92 (2.17%)
    4 / 91 (4.40%)
    6 / 90 (6.67%)
         occurrences all number
    2
    4
    6
    Nasopharyngitis
         subjects affected / exposed
    3 / 92 (3.26%)
    1 / 91 (1.10%)
    6 / 90 (6.67%)
         occurrences all number
    3
    1
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    31 Jul 2017
    Protocol Amendment 1, dated 31 JUL 2017 (Global) The primary purpose of Amendment 1 was to add the sub-study, an opt-in Investigator addition of echocardiographic assessments at 3 time points (sub-study entry, Week 28 and Week 52/Early Termination), to measure reduction in progression of cardiovascular calcification on arterial stiffness for exploratory analyses on subjects participating in the main study and willing to provide additional informed consent. Additionally, this protocol was amended for administrative updates and to clarify procedural details.
    29 Mar 2018
    Protocol Amendment 2, dated 29 MAR 2018 (Global) The main goals of Protocol Amendment 2 were to increase the upper limit of the coronary artery calcification (CAC) Agatston score allowed for enrollment from 2000 to 3500, to clarify the planned sample size re-estimation, to clarify the endpoint descriptions, and to provide additional details on planned statistical analyses, including those in the sub-study.
    27 Jun 2018
    Protocol Amendment 3, dated 27 JUN 2018 (Global) Protocol Amendment 3 provided a revised sample size calculation that led to a reduction in planned enrollment from approximately 450 to approximately 270 subjects.
    22 Oct 2018
    Protocol Amendment 4, dated 22 OCT 2018 (Global) Protocol Amendment 4 added a non binding interim futility analysis to be conducted when approximately N=120 subjects (63% of N=190) had provided Week 52 data on the primary endpoint. Pharmacokinetic and pharmacodynamic analyses were also added at the time of the interim analysis. Phosphorus (phosphate) was added to the list of analytes in the safety laboratory assessments. The amendment also clarified that study drug must be added to the dialysis circuit before the dialyzer.
    01 Mar 2019
    Protocol Amendment 5, dated 01 MAR 2019 (Global) Protocol Amendment 5 described additional analyses of the dataset used for the futility analyses that would be conducted in the event of an equivocal result of the futility analysis indicating borderline conditional power of the study. These analyses could include primary and secondary endpoints, demographic and background characteristics, key subgroups, and pharmacokinetic/pharmacodynamic correlations with efficacy.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/31707860
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