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    Clinical Trial Results:
    An open-label, randomised, multicentre, phase III study of irinotecan liposome injection, oxaliplatin, 5-fluorouracil/leucovorin versus nab-paclitaxel plus gemcitabine in subjects who have not previously received chemotherapy for metastatic adenocarcinoma of the pancreas

    Summary
    EudraCT number
    2018-003585-14
    Trial protocol
    DE   ES   GB   HU   AT   FR   PT   GR   IT  
    Global end of trial date

    Results information
    Results version number
    v1(current)
    This version publication date
    06 Apr 2024
    First version publication date
    06 Apr 2024
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    D-US-60010-001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04083235
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Ipsen Bioscience
    Sponsor organisation address
    One Main Street, Cambridge, MA, United States, 02142
    Public contact
    Medical Director, Ipsen Bioscience, clinical.trials@ipsen.com
    Scientific contact
    Medical Director, Ipsen Bioscience, clinical.trials@ipsen.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Interim
    Date of interim/final analysis
    23 Jul 2022
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    23 Jul 2022
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of the regimen of irinotecan liposome injection + oxaliplatin + 5-fluorouracil (5-FU)/leucovorin (LV) [NALIRIFOX] versus nab-paclitaxel + gemcitabine in improving overall survival (OS) in participants who have not previously received chemotherapy for metastatic adenocarcinoma of the pancreas.
    Protection of trial subjects
    The study was conducted under the provisions of the Declaration of Helsinki, in accordance with the International Council for Harmonization Good Clinical Practice and in compliance with independent ethics committees/institutional review boards and informed consent regulations. This study adhered to the United States of America Food and Drug Administration regulations and all applicable local regulations.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    11 Feb 2020
    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
    Portugal: 10
    Country: Number of subjects enrolled
    Spain: 143
    Country: Number of subjects enrolled
    United Kingdom: 13
    Country: Number of subjects enrolled
    Austria: 17
    Country: Number of subjects enrolled
    Belgium: 19
    Country: Number of subjects enrolled
    Czechia: 38
    Country: Number of subjects enrolled
    France: 50
    Country: Number of subjects enrolled
    Germany: 44
    Country: Number of subjects enrolled
    Greece: 4
    Country: Number of subjects enrolled
    Hungary: 18
    Country: Number of subjects enrolled
    Italy: 55
    Country: Number of subjects enrolled
    Korea, Republic of: 22
    Country: Number of subjects enrolled
    United States: 230
    Country: Number of subjects enrolled
    Canada: 12
    Country: Number of subjects enrolled
    Australia: 25
    Country: Number of subjects enrolled
    Brazil: 40
    Country: Number of subjects enrolled
    Israel: 5
    Country: Number of subjects enrolled
    Russian Federation: 25
    Worldwide total number of subjects
    770
    EEA total number of subjects
    398
    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)
    384
    From 65 to 84 years
    385
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    This Phase 3, open-label study was conducted in participants with metastatic adenocarcinoma of the pancreas at 187 investigational sites in 18 countries. First participant was recruited on 11 February 2020 and data cut-off (DCO) date 23 July 2022.

    Pre-assignment
    Screening details
    The study had screening period (up to 28 days), treatment period: 28-day cycles until radiologically determined disease progression per RECIST Version 1.1, unacceptable treatment related toxicity/withdrawal; survival follow-up (until death/study closure). Participants were randomized in 1:1 ratio using an interactive web response system (IWRS).

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

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    NALIRIFOX
    Arm description
    Participants were treated with irinotecan liposome injection 50 milligram per square meter (mg/m^2) followed by oxaliplatin 60 mg/m^2, followed by LV 400 mg/m^2 and then 5-FU 2400 mg/m^2 intravenous (IV) infusion on Days 1 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.
    Arm type
    Experimental

    Investigational medicinal product name
    Irinotecan liposome injection
    Investigational medicinal product code
    IPN60010
    Other name
    Onivyde®
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Irinotecan liposome injection was administered as IV infusion over 90 minutes (±10 minutes).

    Investigational medicinal product name
    Oxaliplatin
    Investigational medicinal product code
    Other name
    Eloxatin®
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Oxaliplatin was administered as IV infusion over 120 minutes (±10 minutes).

    Investigational medicinal product name
    Leucovorin
    Investigational medicinal product code
    Other name
    LV
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    LV was administered as IV infusion over 30 minutes (±5 minutes).

    Investigational medicinal product name
    5-Fluorouracil
    Investigational medicinal product code
    Other name
    5-FU, Adrucil®
    Pharmaceutical forms
    Solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    5-FU was administered as IV infusion over 46-hours (±120 minutes).

    Arm title
    Nab-paclitaxel+Gemcitabine
    Arm description
    Participants were treated with nab-paclitaxel 125 mg/m^2 followed by gemcitabine 1000 mg/m^2 IV on Days 1, 8 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.
    Arm type
    Active comparator

    Investigational medicinal product name
    Nab-paclitaxel
    Investigational medicinal product code
    Other name
    Abraxane®
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Nab-paclitaxel was administered as IV infusion over 35 minutes (±5 minutes).

    Investigational medicinal product name
    Gemcitabine
    Investigational medicinal product code
    Other name
    Gemzar®
    Pharmaceutical forms
    Powder for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Gemcitabine was administered as IV infusion over 30 minutes (±5 minutes).

    Number of subjects in period 1
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Started
    383
    387
    Received Treatment
    370
    379
    Completed
    59
    77
    Not completed
    324
    310
         Consent withdrawn by subject
    13
    17
         Death
    252
    277
         Ongoing at the time of DCO
    44
    7
         Lost to follow-up
    1
    1
         Did not receive treatment
    13
    8
         Does not meet entry criteria
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    NALIRIFOX
    Reporting group description
    Participants were treated with irinotecan liposome injection 50 milligram per square meter (mg/m^2) followed by oxaliplatin 60 mg/m^2, followed by LV 400 mg/m^2 and then 5-FU 2400 mg/m^2 intravenous (IV) infusion on Days 1 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Reporting group title
    Nab-paclitaxel+Gemcitabine
    Reporting group description
    Participants were treated with nab-paclitaxel 125 mg/m^2 followed by gemcitabine 1000 mg/m^2 IV on Days 1, 8 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Reporting group values
    NALIRIFOX Nab-paclitaxel+Gemcitabine Total
    Number of subjects
    383 387 770
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    62.8 ± 9.71 64.0 ± 8.34 -
    Gender categorical
    Units: Subjects
        Female
    179 157 336
        Male
    204 230 434
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    49 30 79
        Not Hispanic or Latino
    305 328 633
        Not Reported
    29 29 58
    Race
    Units: Subjects
        White
    315 324 639
        Not Reported
    26 29 55
        Asian
    20 18 38
        Black or African American
    12 7 19
        Other
    7 6 13
        Multiple
    3 0 3
        American Indian or Alaska Native
    0 2 2
        Native Hawaiian or Other Pacific Islander
    0 1 1

    End points

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    End points reporting groups
    Reporting group title
    NALIRIFOX
    Reporting group description
    Participants were treated with irinotecan liposome injection 50 milligram per square meter (mg/m^2) followed by oxaliplatin 60 mg/m^2, followed by LV 400 mg/m^2 and then 5-FU 2400 mg/m^2 intravenous (IV) infusion on Days 1 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Reporting group title
    Nab-paclitaxel+Gemcitabine
    Reporting group description
    Participants were treated with nab-paclitaxel 125 mg/m^2 followed by gemcitabine 1000 mg/m^2 IV on Days 1, 8 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Primary: OS

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    End point title
    OS
    End point description
    The OS was defined as time from the date of randomization to the date of death due to any cause. Participants who did not have a date of death recorded at the time of the final analysis were censored at the last known time that the participant was alive. The median OS was measured using Kaplan-Meier technique. The Intent-to-Treat (ITT) population consisted of all randomized participants to whom study treatment was assigned by randomization.
    End point type
    Primary
    End point timeframe
    Assessments performed at baseline (within 28 days before start of study treatment), every 8 weeks after first dose, end of treatment (EoT) visit, then every 2 months thereafter up to DCO date of 23 July 2022 (maximum of 893 days)
    End point values
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Number of subjects analysed
    383
    387
    Units: months
        median (confidence interval 95%)
    11.1 (10.0 to 12.1)
    9.2 (8.3 to 10.6)
    Statistical analysis title
    Treatment difference in OS
    Comparison groups
    NALIRIFOX v Nab-paclitaxel+Gemcitabine
    Number of subjects included in analysis
    770
    Analysis specification
    Pre-specified
    Analysis type
    other [1]
    P-value
    = 0.04
    Method
    Stratified log-rank test
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.83
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.7
         upper limit
    0.99
    Notes
    [1] - The HR and 95% confidence interval (CI) was based on a stratified Cox proportional hazards regression model, stratified by baseline Eastern Cooperative Oncology Group (ECOG) performance status, region and liver metastases as per IWRS.

    Secondary: Progression Free Survival (PFS)

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    End point title
    Progression Free Survival (PFS)
    End point description
    PFS was defined as the time from the date of randomization to the first documented disease progression using response evaluation criteria in solid tumors (RECIST Version 1.1) as per Investigator assessment or death due to any cause. The median PFS was measured using Kaplan-Meier technique. The ITT population consisted of all randomized participants to whom study treatment was assigned by randomization. Only participants with PFS event are reported.
    End point type
    Secondary
    End point timeframe
    Assessments performed at baseline (within 28 days before start of study treatment), every 8 weeks after first dose until EoT visit (maximum of 893 days)
    End point values
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Number of subjects analysed
    249
    259
    Units: months
        median (confidence interval 95%)
    7.4 (6.0 to 7.7)
    5.6 (5.3 to 5.8)
    Statistical analysis title
    Treatment difference in PFS
    Comparison groups
    NALIRIFOX v Nab-paclitaxel+Gemcitabine
    Number of subjects included in analysis
    508
    Analysis specification
    Pre-specified
    Analysis type
    other [2]
    P-value
    < 0.0001
    Method
    Stratified log-rank test
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.69
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.58
         upper limit
    0.83
    Notes
    [2] - The HR and 95% CI was based on a stratified Cox proportional hazards regression model, stratified by baseline ECOG performance status, region and liver metastases as per IWRS.

    Secondary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR)
    End point description
    The ORR was defined as the percentage of participants with a best overall response (BOR) characterized as either a complete response or partial response per RECIST Version 1.1. BOR was defined as the best response as recorded from randomization until documented objective disease progression using RECIST Version 1.1. The ORR was calculated using Clopper-Pearson method. The ITT population consisted of all randomized participants to whom study treatment was assigned by randomization.
    End point type
    Secondary
    End point timeframe
    Assessments performed at baseline (within 28 days before start of study treatment), every 8 weeks after first dose until EoT visit (maximum of 893 days)
    End point values
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Number of subjects analysed
    383
    387
    Units: percentage of participants
        number (confidence interval 95%)
    41.8 (36.8 to 46.9)
    36.2 (31.4 to 41.2)
    Statistical analysis title
    Comparison of odds ratio (OR)
    Comparison groups
    NALIRIFOX v Nab-paclitaxel+Gemcitabine
    Number of subjects included in analysis
    770
    Analysis specification
    Pre-specified
    Analysis type
    other [3]
    P-value
    = 0.1131
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.26
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.95
         upper limit
    1.69
    Notes
    [3] - OR, 95% CI and p-value were obtained from the Cochran-Mantel-Haenszel test adjusting by baseline ECOG performance status, region and liver metastases as per IWRS.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events are reported from the time of first study treatment administration (Day 1) up to DCO date of 23 July 2022 (maximum of 893 days)
    Adverse event reporting additional description
    The Safety population was a subset of the ITT population that received at least 1 dose (including a partial dose) of any component of the study medication in the combination.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.0
    Reporting groups
    Reporting group title
    NALIRIFOX
    Reporting group description
    Participants were treated with irinotecan liposome injection 50 mg/m^2 followed by oxaliplatin 60 mg/m^2, followed by LV 400 mg/m^2 and then 5-FU 2400 mg/m^2 IV infusion on Days 1 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Reporting group title
    Nab-paclitaxel+Gemcitabine
    Reporting group description
    Participants were treated with nab-paclitaxel 125 mg/m^2 followed by gemcitabine 1000 mg/m^2 IV on Days 1, 8 and 15 of each 28-day cycle until disease progression, death, unacceptable study treatment-related toxicity or withdrawal of consent.

    Serious adverse events
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Total subjects affected by serious adverse events
         subjects affected / exposed
    201 / 370 (54.32%)
    195 / 379 (51.45%)
         number of deaths (all causes)
    252
    277
         number of deaths resulting from adverse events
    22
    23
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Peritumoural oedema
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Tumour haemorrhage
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Tumour pain
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Deep vein thrombosis
         subjects affected / exposed
    4 / 370 (1.08%)
    8 / 379 (2.11%)
         occurrences causally related to treatment / all
    1 / 4
    2 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Embolism
         subjects affected / exposed
    1 / 370 (0.27%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Embolism arterial
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 2
    Hypertension
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    2 / 370 (0.54%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    2 / 2
    3 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Iliac vein occlusion
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Orthostatic hypotension
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral embolism
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral ischaemia
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Venous thrombosis limb
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    7 / 370 (1.89%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    3 / 7
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Catheter site inflammation
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest pain
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Condition aggravated
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Fatigue
         subjects affected / exposed
    7 / 370 (1.89%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    4 / 7
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    1 / 370 (0.27%)
    6 / 379 (1.58%)
         occurrences causally related to treatment / all
    1 / 1
    3 / 6
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    Generalised oedema
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Inadequate analgesia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Inflammation
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Malaise
         subjects affected / exposed
    3 / 370 (0.81%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mucosal inflammation
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Performance status decreased
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peripheral swelling
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    8 / 370 (2.16%)
    12 / 379 (3.17%)
         occurrences causally related to treatment / all
    1 / 9
    4 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sudden cardiac death
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Reproductive system and breast disorders
    Penile vein thrombosis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Priapism
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Acute respiratory failure
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Aspiration
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Dyspnoea
         subjects affected / exposed
    2 / 370 (0.54%)
    5 / 379 (1.32%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hydrothorax
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Interstitial lung disease
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung infiltration
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pleural effusion
         subjects affected / exposed
    2 / 370 (0.54%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonitis
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Pneumonitis aspiration
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Productive cough
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    10 / 370 (2.70%)
    7 / 379 (1.85%)
         occurrences causally related to treatment / all
    3 / 10
    1 / 7
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Pulmonary hypertension
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Confusional state
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Delirium
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mental status changes
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychotic disorder
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Product issues
    Thrombosis in device
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood bilirubin increased
         subjects affected / exposed
    5 / 370 (1.35%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood glucose abnormal
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General physical condition abnormal
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemoglobin decreased
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutrophil count decreased
         subjects affected / exposed
    2 / 370 (0.54%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Platelet count decreased
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SARS-CoV-2 test positive
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    White blood cell count decreased
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Exposure to SARS-CoV-2
         subjects affected / exposed
    0 / 370 (0.00%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Femoral neck fracture
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Head injury
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Hip fracture
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Wound
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Angina pectoris
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atrial flutter
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Cardiac failure
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure chronic
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac flutter
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sinus node dysfunction
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Aphasia
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral infarction
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral ischaemia
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    4 / 370 (1.08%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 4
    1 / 2
         deaths causally related to treatment / all
    0 / 2
    0 / 0
    Embolic stroke
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Generalised tonic-clonic seizure
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hemiparesis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoaesthesia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ischaemic stroke
         subjects affected / exposed
    4 / 370 (1.08%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    1 / 4
    0 / 2
         deaths causally related to treatment / all
    1 / 2
    0 / 0
    Metabolic encephalopathy
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myoclonus
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pineal gland cyst
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sciatica
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tremor
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    5 / 370 (1.35%)
    8 / 379 (2.11%)
         occurrences causally related to treatment / all
    4 / 6
    7 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Disseminated intravascular coagulation
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Febrile neutropenia
         subjects affected / exposed
    7 / 370 (1.89%)
    6 / 379 (1.58%)
         occurrences causally related to treatment / all
    7 / 9
    6 / 6
         deaths causally related to treatment / all
    1 / 1
    1 / 1
    Neutropenia
         subjects affected / exposed
    2 / 370 (0.54%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    2 / 2
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancytopenia
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    1 / 1
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eye disorders
    Retinal vein occlusion
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal discomfort
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain
         subjects affected / exposed
    9 / 370 (2.43%)
    8 / 379 (2.11%)
         occurrences causally related to treatment / all
    2 / 10
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ascites
         subjects affected / exposed
    6 / 370 (1.62%)
    5 / 379 (1.32%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 6
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Colitis
         subjects affected / exposed
    7 / 370 (1.89%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    6 / 7
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 370 (0.27%)
    6 / 379 (1.58%)
         occurrences causally related to treatment / all
    0 / 1
    2 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    23 / 370 (6.22%)
    9 / 379 (2.37%)
         occurrences causally related to treatment / all
    22 / 28
    6 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea haemorrhagic
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal obstruction
         subjects affected / exposed
    2 / 370 (0.54%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal stenosis
         subjects affected / exposed
    2 / 370 (0.54%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal ulcer
         subjects affected / exposed
    3 / 370 (0.81%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Duodenal ulcer perforation
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dysphagia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterocolitis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Faecaloma
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Food poisoning
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric fistula
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric haemorrhage
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastric ulcer haemorrhage
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorder
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal haemorrhage
         subjects affected / exposed
    3 / 370 (0.81%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 4
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Gastrointestinal toxicity
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    2 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematemesis
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ileus
         subjects affected / exposed
    3 / 370 (0.81%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal obstruction
         subjects affected / exposed
    3 / 370 (0.81%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intestinal pseudo-obstruction
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mesenteric vein thrombosis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nausea
         subjects affected / exposed
    18 / 370 (4.86%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    15 / 24
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neutropenic colitis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Obstruction gastric
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Odynophagia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal ulcer
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Oesophagitis
         subjects affected / exposed
    2 / 370 (0.54%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatitis acute
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal haemorrhage
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Terminal ileitis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 370 (0.27%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    22 / 370 (5.95%)
    6 / 379 (1.58%)
         occurrences causally related to treatment / all
    15 / 26
    4 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Bile duct stenosis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Biliary obstruction
         subjects affected / exposed
    6 / 370 (1.62%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholangitis
         subjects affected / exposed
    4 / 370 (1.08%)
    6 / 379 (1.58%)
         occurrences causally related to treatment / all
    1 / 4
    1 / 6
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Cholecystitis
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis acute
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholestasis
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis toxic
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperbilirubinaemia
         subjects affected / exposed
    2 / 370 (0.54%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice cholestatic
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Decubitus ulcer
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erythema
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pruritus
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Rash
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    3 / 370 (0.81%)
    9 / 379 (2.37%)
         occurrences causally related to treatment / all
    2 / 3
    5 / 10
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haematuria
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Renal impairment
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary retention
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract obstruction
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chest wall haematoma
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myalgia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pain in extremity
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pathological fracture
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Abdominal abscess
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal sepsis
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal abscess
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Asymptomatic COVID-19
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Atypical pneumonia
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacteraemia
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bacterial sepsis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Biliary sepsis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Biliary tract infection
         subjects affected / exposed
    2 / 370 (0.54%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    18 / 370 (4.86%)
    14 / 379 (3.69%)
         occurrences causally related to treatment / all
    0 / 18
    0 / 14
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    COVID-19 pneumonia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Campylobacter colitis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Catheter site infection
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 370 (0.00%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholangitis infective
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related bacteraemia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Device related infection
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diverticulitis
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Enterococcal infection
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Erysipelas
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Escherichia bacteraemia
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Febrile infection
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gallbladder abscess
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    3 / 370 (0.81%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroenteritis norovirus
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatic infection
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatitis E
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Implant site cellulitis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infective spondylitis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Large intestine infection
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Liver abscess
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Peritonitis bacterial
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    7 / 370 (1.89%)
    13 / 379 (3.43%)
         occurrences causally related to treatment / all
    0 / 7
    3 / 13
         deaths causally related to treatment / all
    0 / 2
    0 / 3
    Pneumonia aspiration
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Post procedural cellulitis
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    6 / 370 (1.62%)
    16 / 379 (4.22%)
         occurrences causally related to treatment / all
    4 / 6
    9 / 18
         deaths causally related to treatment / all
    1 / 2
    5 / 8
    Septic shock
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Staphylococcal bacteraemia
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Streptococcal infection
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Suspected COVID-19
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    3 / 370 (0.81%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    2 / 3
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Adult failure to thrive
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    5 / 370 (1.35%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    2 / 5
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    10 / 370 (2.70%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    8 / 11
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetes mellitus inadequate control
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diabetic metabolic decompensation
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Electrolyte imbalance
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Failure to thrive
         subjects affected / exposed
    0 / 370 (0.00%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypercalcaemia
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    0 / 370 (0.00%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    1 / 370 (0.27%)
    4 / 379 (1.06%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypokalaemia
         subjects affected / exposed
    6 / 370 (1.62%)
    3 / 379 (0.79%)
         occurrences causally related to treatment / all
    4 / 7
    3 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyponatraemia
         subjects affected / exposed
    1 / 370 (0.27%)
    2 / 379 (0.53%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypophosphataemia
         subjects affected / exposed
    1 / 370 (0.27%)
    1 / 379 (0.26%)
         occurrences causally related to treatment / all
    1 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Type 2 diabetes mellitus
         subjects affected / exposed
    1 / 370 (0.27%)
    0 / 379 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    NALIRIFOX Nab-paclitaxel+Gemcitabine
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    364 / 370 (98.38%)
    371 / 379 (97.89%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    45 / 370 (12.16%)
    48 / 379 (12.66%)
         occurrences all number
    64
    64
    Aspartate aminotransferase increased
         subjects affected / exposed
    40 / 370 (10.81%)
    40 / 379 (10.55%)
         occurrences all number
    58
    55
    Blood alkaline phosphatase increased
         subjects affected / exposed
    39 / 370 (10.54%)
    31 / 379 (8.18%)
         occurrences all number
    42
    33
    Blood bilirubin increased
         subjects affected / exposed
    21 / 370 (5.68%)
    22 / 379 (5.80%)
         occurrences all number
    23
    23
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    44 / 370 (11.89%)
    34 / 379 (8.97%)
         occurrences all number
    54
    35
    Neutrophil count decreased
         subjects affected / exposed
    73 / 370 (19.73%)
    69 / 379 (18.21%)
         occurrences all number
    208
    112
    Platelet count decreased
         subjects affected / exposed
    39 / 370 (10.54%)
    67 / 379 (17.68%)
         occurrences all number
    71
    109
    Weight decreased
         subjects affected / exposed
    82 / 370 (22.16%)
    33 / 379 (8.71%)
         occurrences all number
    92
    34
    White blood cell count decreased
         subjects affected / exposed
    16 / 370 (4.32%)
    32 / 379 (8.44%)
         occurrences all number
    24
    54
    Vascular disorders
    Hypertension
         subjects affected / exposed
    21 / 370 (5.68%)
    15 / 379 (3.96%)
         occurrences all number
    24
    19
    Hypotension
         subjects affected / exposed
    21 / 370 (5.68%)
    25 / 379 (6.60%)
         occurrences all number
    27
    26
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    24 / 370 (6.49%)
    40 / 379 (10.55%)
         occurrences all number
    25
    44
    Dysgeusia
         subjects affected / exposed
    63 / 370 (17.03%)
    58 / 379 (15.30%)
         occurrences all number
    74
    67
    Headache
         subjects affected / exposed
    23 / 370 (6.22%)
    19 / 379 (5.01%)
         occurrences all number
    37
    24
    Neuropathy peripheral
         subjects affected / exposed
    66 / 370 (17.84%)
    66 / 379 (17.41%)
         occurrences all number
    89
    92
    Neurotoxicity
         subjects affected / exposed
    21 / 370 (5.68%)
    13 / 379 (3.43%)
         occurrences all number
    35
    22
    Paraesthesia
         subjects affected / exposed
    44 / 370 (11.89%)
    33 / 379 (8.71%)
         occurrences all number
    53
    41
    Peripheral sensory neuropathy
         subjects affected / exposed
    56 / 370 (15.14%)
    51 / 379 (13.46%)
         occurrences all number
    79
    60
    Polyneuropathy
         subjects affected / exposed
    16 / 370 (4.32%)
    19 / 379 (5.01%)
         occurrences all number
    19
    20
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    94 / 370 (25.41%)
    151 / 379 (39.84%)
         occurrences all number
    134
    196
    Leukopenia
         subjects affected / exposed
    18 / 370 (4.86%)
    40 / 379 (10.55%)
         occurrences all number
    24
    43
    Neutropenia
         subjects affected / exposed
    108 / 370 (29.19%)
    121 / 379 (31.93%)
         occurrences all number
    264
    278
    Thrombocytopenia
         subjects affected / exposed
    50 / 370 (13.51%)
    93 / 379 (24.54%)
         occurrences all number
    84
    173
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    110 / 370 (29.73%)
    101 / 379 (26.65%)
         occurrences all number
    164
    166
    Chills
         subjects affected / exposed
    6 / 370 (1.62%)
    19 / 379 (5.01%)
         occurrences all number
    6
    20
    Fatigue
         subjects affected / exposed
    120 / 370 (32.43%)
    143 / 379 (37.73%)
         occurrences all number
    173
    183
    Mucosal inflammation
         subjects affected / exposed
    50 / 370 (13.51%)
    16 / 379 (4.22%)
         occurrences all number
    60
    20
    Oedema peripheral
         subjects affected / exposed
    52 / 370 (14.05%)
    107 / 379 (28.23%)
         occurrences all number
    60
    134
    Pyrexia
         subjects affected / exposed
    33 / 370 (8.92%)
    84 / 379 (22.16%)
         occurrences all number
    43
    129
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    22 / 370 (5.95%)
    13 / 379 (3.43%)
         occurrences all number
    26
    15
    Abdominal pain
         subjects affected / exposed
    92 / 370 (24.86%)
    75 / 379 (19.79%)
         occurrences all number
    110
    80
    Abdominal pain upper
         subjects affected / exposed
    27 / 370 (7.30%)
    21 / 379 (5.54%)
         occurrences all number
    34
    29
    Constipation
         subjects affected / exposed
    93 / 370 (25.14%)
    113 / 379 (29.82%)
         occurrences all number
    115
    141
    Diarrhoea
         subjects affected / exposed
    258 / 370 (69.73%)
    135 / 379 (35.62%)
         occurrences all number
    566
    221
    Dry mouth
         subjects affected / exposed
    28 / 370 (7.57%)
    14 / 379 (3.69%)
         occurrences all number
    29
    16
    Dyspepsia
         subjects affected / exposed
    23 / 370 (6.22%)
    18 / 379 (4.75%)
         occurrences all number
    32
    20
    Flatulence
         subjects affected / exposed
    30 / 370 (8.11%)
    18 / 379 (4.75%)
         occurrences all number
    33
    21
    Haemorrhoids
         subjects affected / exposed
    19 / 370 (5.14%)
    12 / 379 (3.17%)
         occurrences all number
    22
    13
    Nausea
         subjects affected / exposed
    215 / 370 (58.11%)
    162 / 379 (42.74%)
         occurrences all number
    406
    216
    Stomatitis
         subjects affected / exposed
    50 / 370 (13.51%)
    45 / 379 (11.87%)
         occurrences all number
    81
    54
    Vomiting
         subjects affected / exposed
    139 / 370 (37.57%)
    96 / 379 (25.33%)
         occurrences all number
    222
    168
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    14 / 370 (3.78%)
    30 / 379 (7.92%)
         occurrences all number
    18
    31
    Dyspnoea
         subjects affected / exposed
    24 / 370 (6.49%)
    45 / 379 (11.87%)
         occurrences all number
    28
    48
    Epistaxis
         subjects affected / exposed
    14 / 370 (3.78%)
    43 / 379 (11.35%)
         occurrences all number
    15
    49
    Pulmonary embolism
         subjects affected / exposed
    20 / 370 (5.41%)
    24 / 379 (6.33%)
         occurrences all number
    20
    24
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    52 / 370 (14.05%)
    119 / 379 (31.40%)
         occurrences all number
    53
    120
    Pruritus
         subjects affected / exposed
    12 / 370 (3.24%)
    22 / 379 (5.80%)
         occurrences all number
    14
    26
    Rash
         subjects affected / exposed
    11 / 370 (2.97%)
    34 / 379 (8.97%)
         occurrences all number
    12
    37
    Rash maculo-papular
         subjects affected / exposed
    3 / 370 (0.81%)
    25 / 379 (6.60%)
         occurrences all number
    3
    30
    Psychiatric disorders
    Anxiety
         subjects affected / exposed
    10 / 370 (2.70%)
    24 / 379 (6.33%)
         occurrences all number
    10
    25
    Insomnia
         subjects affected / exposed
    28 / 370 (7.57%)
    32 / 379 (8.44%)
         occurrences all number
    28
    32
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    13 / 370 (3.51%)
    30 / 379 (7.92%)
         occurrences all number
    16
    41
    Back pain
         subjects affected / exposed
    28 / 370 (7.57%)
    33 / 379 (8.71%)
         occurrences all number
    37
    36
    Muscular weakness
         subjects affected / exposed
    17 / 370 (4.59%)
    21 / 379 (5.54%)
         occurrences all number
    22
    24
    Myalgia
         subjects affected / exposed
    13 / 370 (3.51%)
    31 / 379 (8.18%)
         occurrences all number
    15
    43
    Pain in extremity
         subjects affected / exposed
    7 / 370 (1.89%)
    30 / 379 (7.92%)
         occurrences all number
    8
    35
    Infections and infestations
    Urinary tract infection
         subjects affected / exposed
    27 / 370 (7.30%)
    23 / 379 (6.07%)
         occurrences all number
    29
    29
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    132 / 370 (35.68%)
    68 / 379 (17.94%)
         occurrences all number
    157
    136
    Dehydration
         subjects affected / exposed
    35 / 370 (9.46%)
    29 / 379 (7.65%)
         occurrences all number
    40
    31
    Hypoalbuminaemia
         subjects affected / exposed
    26 / 370 (7.03%)
    30 / 379 (7.92%)
         occurrences all number
    33
    31
    Hypokalaemia
         subjects affected / exposed
    116 / 370 (31.35%)
    49 / 379 (12.93%)
         occurrences all number
    190
    70
    Hypomagnesaemia
         subjects affected / exposed
    34 / 370 (9.19%)
    16 / 379 (4.22%)
         occurrences all number
    44
    22
    Hyponatraemia
         subjects affected / exposed
    18 / 370 (4.86%)
    20 / 379 (5.28%)
         occurrences all number
    21
    21

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    28 Nov 2019
    The study name was updated with the branding logo. Study duration was clarified. Adverse event causality assessment clarified by the investigator. Adverse events of special interest were defined as thromboembolic disease. Collection of electronic serious adverse events (SAE) were clarified. Clarification that disease progression was not classified as an SAE. The use of contraceptive were aligned with all packaging information in all localities of the study. Minor editorial changes to provide additional details.
    03 Jun 2020
    The electrocardiogram assessment timepoint were clarified.
    19 Aug 2021
    Eligibility criterion and protocol procedures were clarified. Details specific to conduct of the study during the COVID-19 pandemic were added. Secondary endpoint analysis was updated to refine the interim analysis of OS.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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

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