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    Clinical Trial Results:
    A Randomized, Double-Blind, Phase 3 Study to Evaluate the Activity of Momelotinib (MMB) versus Danazol (DAN) in Symptomatic, Anemic Subjects with Primary Myelofibrosis (PMF), Post-Polycythemia Vera (PV) Myelofibrosis, or Post Essential Thrombocythemia (ET) Myelofibrosis who were Previously Treated with JAK Inhibitor Therapy

    Summary
    EudraCT number
    2019-000583-18
    Trial protocol
    GB   DE   SE   DK   FR   CZ   ES   PL   HU   AT   IT   RO  
    Global end of trial date
    29 Dec 2022

    Results information
    Results version number
    v2(current)
    This version publication date
    15 Nov 2023
    First version publication date
    11 Aug 2023
    Other versions
    v1
    Version creation reason

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    SRA-MMB-301
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT04173494
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Sierra Oncology LLC – a GSK company
    Sponsor organisation address
    980 Great West Road, Brentford, Middlesex, United Kingdom, TW8 9GS
    Public contact
    GSK Response Center, Sierra Oncology, a GlaxoSmithKline company, 1 877-379-3718, GSKClinicalSupportHD@gsk.com
    Scientific contact
    GSK Response Center, Sierra Oncology LLC – a GSK company, 1 877-379-3718, GSKClinicalSupportHD@gsk.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 Apr 2023
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Dec 2022
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To determine the efficacy of MMB versus DAN assessed by improvement in Myelofibrosis Symptom Assessment Form version (v) 4.0 (MFSAF) total symptom score (TSS) in participants with PMF, post-PV myelofibrosis (MF), or post-ET MF who were previously treated with approved Janus kinase (JAK) inhibitor therapy
    Protection of trial subjects
    Not applicable
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    07 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
    Australia: 5
    Country: Number of subjects enrolled
    Austria: 2
    Country: Number of subjects enrolled
    Belgium: 6
    Country: Number of subjects enrolled
    Bulgaria: 5
    Country: Number of subjects enrolled
    Canada: 5
    Country: Number of subjects enrolled
    Czechia: 1
    Country: Number of subjects enrolled
    Denmark: 2
    Country: Number of subjects enrolled
    France: 13
    Country: Number of subjects enrolled
    Germany: 14
    Country: Number of subjects enrolled
    Hungary: 13
    Country: Number of subjects enrolled
    Israel: 18
    Country: Number of subjects enrolled
    Italy: 32
    Country: Number of subjects enrolled
    New Zealand: 2
    Country: Number of subjects enrolled
    Poland: 14
    Country: Number of subjects enrolled
    Romania: 8
    Country: Number of subjects enrolled
    Singapore: 4
    Country: Number of subjects enrolled
    Korea, Republic of: 11
    Country: Number of subjects enrolled
    Spain: 9
    Country: Number of subjects enrolled
    Taiwan: 2
    Country: Number of subjects enrolled
    United Kingdom: 5
    Country: Number of subjects enrolled
    United States: 24
    Worldwide total number of subjects
    195
    EEA total number of subjects
    119
    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)
    40
    From 65 to 84 years
    151
    85 years and over
    4

    Subject disposition

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    Recruitment
    Recruitment details
    This study evaluated the activity of Momelotinib (MMB) versus Danazol (DAN) in Symptomatic, Anemic participants. This study consists of Randomized Double-blind (DB) Treatment Period (TP) and Open-label extended Treatment Period (OLP).

    Pre-assignment
    Screening details
    A total of 195 participants were enrolled in the study.

    Period 1
    Period 1 title
    Randomized DB TP (Up to Week 24)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    MMB 200 mg Once Daily (QD) + Placebo
    Arm description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo matching DAN
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matching DAN was was administered orally BID

    Investigational medicinal product name
    MMB 200 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    MMB was administered with a dose of 200 mg orally QD.

    Arm title
    DAN 300 mg BID + Placebo
    Arm description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 enrolled in an open-label extended treatment period. Participants switched to receive 200 mg of MMB orally QD during open-label extended treatment period. All participants elected to receive MMB as open-label treatment during the open-label extended treatment period.
    Arm type
    Active comparator

    Investigational medicinal product name
    Placebo matching MMB
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matching MMB was was administered orally QD

    Investigational medicinal product name
    DAN 300 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    DAN was administered with a dose of 300 mg orally BID.

    Number of subjects in period 1
    MMB 200 mg Once Daily (QD) + Placebo DAN 300 mg BID + Placebo
    Started
    130
    65
    Completed
    94
    38
    Not completed
    36
    27
         Adverse event, serious fatal
    9
    7
         Consent withdrawn by subject
    6
    5
         Physician decision
    -
    1
         Leukemic Transformation
    2
    2
         Adverse event, non-fatal
    7
    4
         Death
    4
    3
         Lost to follow-up
    1
    -
         Disease Progression
    1
    2
         Lack of efficacy
    6
    3
    Period 2
    Period 2 title
    Open-Label extended TP(Weeks 24 to 151)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    MMB 200 mg Once Daily (QD) + Placebo
    Arm description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo matching DAN
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matching DAN was was administered orally BID

    Investigational medicinal product name
    MMB 200 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    MMB was administered with a dose of 200 mg orally QD.

    Arm title
    DAN 300 mg BID + Placebo
    Arm description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 enrolled in an open-label extended treatment period. Participants switched to receive 200 mg of MMB orally QD during open-label extended treatment period. All participants elected to receive MMB as open-label treatment during the open-label extended treatment period.
    Arm type
    Active comparator

    Investigational medicinal product name
    DAN 300 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    DAN was administered with a dose of 300 mg orally BID.

    Investigational medicinal product name
    MMB 200 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    MMB was administered with a dose of 200 mg orally QD.

    Investigational medicinal product name
    Placebo matching MMB
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Film-coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matching MMB was was administered orally QD

    Number of subjects in period 2 [1]
    MMB 200 mg Once Daily (QD) + Placebo DAN 300 mg BID + Placebo
    Started
    93
    36
    Completed
    0
    0
    Not completed
    93
    41
         Adverse event, serious fatal
    8
    -
         Physician decision
    4
    3
         Consent withdrawn by subject
    4
    3
         Leukemic Transformation
    -
    1
         Adverse event, non-fatal
    3
    1
         Death
    6
    3
         Continuing in MMB extension study
    61
    27
         Disease Progression
    1
    1
         Lack of efficacy
    6
    2
    Joined
    0
    5
         Protocol defined criteria
    -
    5
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: 93 participants from Randomized Treatment Phase entered in Open-label Phase

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    MMB 200 mg Once Daily (QD) + Placebo
    Reporting group description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Reporting group title
    DAN 300 mg BID + Placebo
    Reporting group description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 enrolled in an open-label extended treatment period. Participants switched to receive 200 mg of MMB orally QD during open-label extended treatment period. All participants elected to receive MMB as open-label treatment during the open-label extended treatment period.

    Reporting group values
    MMB 200 mg Once Daily (QD) + Placebo DAN 300 mg BID + Placebo Total
    Number of subjects
    130 65 195
    Age categorical
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Participants
        All participants
    130 65 195
    Age Continuous
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: years
        arithmetic mean (standard deviation)
    69.85 ± 8.24 71.46 ± 6.99 -
    Sex: Female, Male
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Participants
        Female
    51 21 72
        Male
    79 44 123
    Ethnicity (NIH/OMB)
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Subjects
        Hispanic or Latino
    5 6 11
        Not Hispanic or Latino
    115 54 169
        Unknown or Not Reported
    10 5 15
    Race (NIH/OMB)
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Subjects
        American Indian or Alaska Native
    0 0 0
        Asian
    12 6 18
        Native Hawaiian or Other Pacific Islander
    0 0 0
        Black or African American
    2 2 4
        White
    107 50 157
        More than one race
    0 0 0
        Unknown or Not Reported
    9 7 16
    Subject analysis sets

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo- Randomized DB TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 mg of MMB orally QD and a DAN-placebo orally BID during the randomized 24-week double-blind treatment period.

    Subject analysis set title
    DAN 300 mg BID + Placebo- Randomized DB TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period.

    Subject analysis set title
    MMB 200 mg QD- Open-Label Extended TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period.

    Subject analysis set title
    DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants who received DAN 300 mg BID during randomized period switched to receive 200 mg of MMB orally QD during open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis sets values
    MMB 200 mg QD + Placebo MMB 200 mg QD + Placebo MMB 200 mg QD + Placebo MMB 200 mg QD + Placebo MMB 200 mg QD + Placebo MMB 200 mg QD + Placebo- Randomized DB TP DAN 300 mg BID + Placebo- Randomized DB TP MMB 200 mg QD- Open-Label Extended TP DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP MMB 200 mg QD + Placebo
    Number of subjects
    130
    92
    32
    40
    63
    130
    65
    93
    41
    89
    Age categorical
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Participants
        All participants
    Age Continuous
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: years
        arithmetic mean (standard deviation)
    ±
    ±
    ±
    ±
    ±
    ±
    ±
    ±
    ±
    ±
    Sex: Female, Male
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Participants
        Female
        Male
    Ethnicity (NIH/OMB)
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Subjects
        Hispanic or Latino
        Not Hispanic or Latino
        Unknown or Not Reported
    Race (NIH/OMB)
    Baseline characteristics were measured in the Intention-To-Treat (ITT) Analysis Set, which included all randomized participants.
    Units: Subjects
        American Indian or Alaska Native
    0
        Asian
    12
        Native Hawaiian or Other Pacific Islander
    0
        Black or African American
    2
        White
    107
        More than one race
    0
        Unknown or Not Reported
    9

    End points

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    End points reporting groups
    Reporting group title
    MMB 200 mg Once Daily (QD) + Placebo
    Reporting group description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Reporting group title
    DAN 300 mg BID + Placebo
    Reporting group description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 enrolled in an open-label extended treatment period. Participants switched to receive 200 mg of MMB orally QD during open-label extended treatment period. All participants elected to receive MMB as open-label treatment during the open-label extended treatment period.
    Reporting group title
    MMB 200 mg Once Daily (QD) + Placebo
    Reporting group description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Reporting group title
    DAN 300 mg BID + Placebo
    Reporting group description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 enrolled in an open-label extended treatment period. Participants switched to receive 200 mg of MMB orally QD during open-label extended treatment period. All participants elected to receive MMB as open-label treatment during the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo- Randomized DB TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 mg of MMB orally QD and a DAN-placebo orally BID during the randomized 24-week double-blind treatment period.

    Subject analysis set title
    DAN 300 mg BID + Placebo- Randomized DB TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period.

    Subject analysis set title
    MMB 200 mg QD- Open-Label Extended TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period.

    Subject analysis set title
    DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants who received DAN 300 mg BID during randomized period switched to receive 200 mg of MMB orally QD during open-label extended treatment period.

    Subject analysis set title
    MMB 200 mg QD + Placebo
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants were randomized to receive 200 milligrams (mg) of MMB orally QD and a DAN-placebo orally twice daily (BID) during the randomized 24-week double-blind treatment period. Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period. Participants who discontinued treatment prior to Week 24 due to splenic progression or other reasons, but completed assessments, were unblinded. Participants who discontinued MMB during the randomized treatment period were not eligible to receive MMB in the open-label extended treatment period. Participants who were randomized to MMB during the randomized treatment period with confirmed splenic progression could not proceed to the open-label extended treatment period.

    Primary: Total Symptom Score (TSS) Response Rate at Week 24

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    End point title
    Total Symptom Score (TSS) Response Rate at Week 24 [1]
    End point description
    Myelofibrosis Symptom Assessment Form (MFSAF) TSS version (v) 4.0 response rate was defined as percentage of participants with a >= 50 percent (%) reduction from Baseline in mean MFSAF TSS over consecutive 28-day period immediately before end of Week 24. TSS response rate was measured using MFSAF v4.0. MFSAF v4.0 comprises 7 domains representing 7 most relevant symptoms of myelofibrosis (MF) identified through existing participant and clinician-based evidence: fatigue,night sweats,pruritus,abdominal discomfort,pain under left ribs,early satietyand bone pain. Participants scored each symptom domain using an 11-point numeric rating scale ranging from 0(absent) to 10(worst imaginable). The MFSAF TSS was calculated as sum of scores of 7 domains for a possible range of scores of 0 to 70, with a higher TSS corresponding to more severe symptoms. A reduction from Baseline corresponded to a lessening of MF symptoms. Baseline was the last assessment done before or on the day of first dose date
    End point type
    Primary
    End point timeframe
    Baseline and Week 24
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [2]
    130 [3]
    Units: Percentage of participants
        number (confidence interval 95%)
    9.23 (3.46 to 19.02)
    24.62 (17.49 to 32.94)
    Notes
    [2] - Intent-To-Treat (ITT) Analysis Set, which included all randomized participants
    [3] - Intent-To-Treat (ITT) Analysis Set, which included all randomized participants
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0095
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified Cochran-Mantel-Haenszel
    Point estimate
    15.67
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    5.54
         upper limit
    25.81

    Primary: Percentage of Participants with Transfusion Independence (TI) at Week 24

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    End point title
    Percentage of Participants with Transfusion Independence (TI) at Week 24 [4]
    End point description
    TI status was defined as not receiving red blood cell (RBC) or whole blood transfusion for >=12 weeks, with no hemoglobin (Hgb) level < 8 grams per deciliter (g/dL) during the same interval. Percentage of participants with TI have been presented.
    End point type
    Primary
    End point timeframe
    Week 24
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [5]
    130 [6]
    Units: Percentage of Participants
        number (confidence interval 95%)
    20.00 (11.10 to 31.77)
    30.0 (22.28 to 38.66)
    Notes
    [5] - ITT Analysis Set
    [6] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    If the lower bound of the confidence interval (CI) is greater than 0, MMB was to be declared non-inferior to DAN.
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    non-inferiority [7]
    P-value
    = 0.0116
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Non-inferiority difference
    Point estimate
    13.58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.86
         upper limit
    25.3
    Notes
    [7] - Non-inferiority difference, defined as p(MMB) - (0.8) *p(DAN) where p(MMB) is percentage of participants with TI status in MMB arm and p(DAN) is percentage of participants with TI status in DAN arm.

    Secondary: Splenic Response Rate (SRR) of >=25% at Week 24

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    End point title
    Splenic Response Rate (SRR) of >=25% at Week 24 [8]
    End point description
    Splenic response rate (SRR) is defined as the percentage of participants who have reduction in spleen volume of >=25% from Baseline at the end of Week 24. Baseline was the last assessment done before or on the day of first dose date.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [8] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [9]
    130 [10]
    Units: Percentage of Participants
        number (confidence interval 95%)
    6.15 (1.70 to 15.01)
    39.23 (30.79 to 48.18)
    Notes
    [9] - ITT Analysis Set
    [10] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.0001
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified Cochran-Mantel-Haenszel
    Point estimate
    33.05
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    22.59
         upper limit
    43.51

    Secondary: Splenic Response Rate (SRR) of >= 35% at Week 24

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    End point title
    Splenic Response Rate (SRR) of >= 35% at Week 24 [11]
    End point description
    Splenic response rate (SRR) is defined as the percentage of participants who have reduction in spleen volume of >=35 % from Baseline at the end of Week 24. Baseline was the last assessment done before or on the day of first dose date.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [11] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [12]
    130 [13]
    Units: Percentage of Participants
        number (confidence interval 95%)
    3.08 (0.37 to 10.68)
    22.31 (15.48 to 30.44)
    Notes
    [12] - ITT Analysis Set
    [13] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0011
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified Cochran-Mantel-Haenszel
    Point estimate
    18.18
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    9.77
         upper limit
    26.59

    Secondary: Change from Baseline in MFSAF TSS at Week 24

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    End point title
    Change from Baseline in MFSAF TSS at Week 24 [14]
    End point description
    TSS was measured using the MFSAF v4.0. The MFSAF v4.0 comprises 7 domains representing the 7 most relevant symptoms of MF identified through existing participant and clinician-based evidence: fatigue, night sweats, pruritus, abdominal discomfort, pain under the left ribs, early satiety, and bone pain. Participants scored each symptom domain using an 11-point numeric rating scale ranging from 0 (absent) to 10 (worst imaginable). The MFSAF TSS was calculated as the sum of scores of the 7 domains for a possible range of scores of 0 to 70, with a higher TSS corresponding to more severe symptoms. A reduction from Baseline corresponded to a lessening of MF symptoms. Baseline was the last assessment done before or on the day of first dose date. Change from Baseline was defined as the post-Baseline value minus Baseline value. Only those participants with data available at specified time points were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [14] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    37 [15]
    92 [16]
    Units: Scores on a scale
        least squares mean (standard error)
    -3.13 ± 1.62
    -9.36 ± 1.08
    Notes
    [15] - ITT Analysis Set
    [16] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    129
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0014
    Method
    mixed model for repeated measures (MMRM)
    Parameter type
    Least Squares Mean Difference
    Point estimate
    -6.22
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -10
         upper limit
    -2.43

    Secondary: Percentage of participants with <=4 RBC units transfused over 24-weeks

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    End point title
    Percentage of participants with <=4 RBC units transfused over 24-weeks [17]
    End point description
    Percentage of participants with <=4 RBC units transfused over 24-weeks were reported.
    End point type
    Secondary
    End point timeframe
    Up to 24 weeks
    Notes
    [17] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [18]
    130 [19]
    Units: Percentage of participants
        number (confidence interval 95%)
    44.62 (32.27 to 57.47)
    55.38 (46.42 to 64.10)
    Notes
    [18] - ITT Analysis Set
    [19] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.1133
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified Cochran-Mantel-Haenszel
    Point estimate
    10.62
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.4
         upper limit
    23.64

    Secondary: Percentage of participants with zero RBC units transfused over 24-Weeks

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    End point title
    Percentage of participants with zero RBC units transfused over 24-Weeks [20]
    End point description
    Percentage of participants with zero RBC units transfused over 24-weeks were reported.
    End point type
    Secondary
    End point timeframe
    Up to 24 weeks
    Notes
    [20] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [21]
    130 [22]
    Units: Percentage of participants
        number (confidence interval 95%)
    16.92 (8.76 to 28.27)
    35.38 (27.20 to 44.25)
    Notes
    [21] - ITT Analysis Set
    [22] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0012
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified Cochran-Mantel-Haenszel
    Point estimate
    17.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    7.99
         upper limit
    26.4

    Secondary: Mean cumulative number of whole blood units transfused over 24 weeks

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    End point title
    Mean cumulative number of whole blood units transfused over 24 weeks [23]
    End point description
    Cumulative transfusion risk was calculated as the estimated mean cumulative number of whole blood units transfused during the study.
    End point type
    Secondary
    End point timeframe
    Up to Week 24
    Notes
    [23] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [24]
    130 [25]
    Units: Whole blood units
        arithmetic mean (standard deviation)
    10.86 ± 13.203
    6.55 ± 8.413
    Notes
    [24] - ITT Analysis Set
    [25] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0006
    Method
    Anderson & Gill proportional means model
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.556
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.397
         upper limit
    0.778

    Secondary: Duration of TI response

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    End point title
    Duration of TI response [26]
    End point description
    Duration of TI is defined as the number of days from (a) the first day of a 12-week period that satisfies the 12-week TI status definition, to (b) the first RBC transfusion or Hgb level < 8 g/dL (except in the case of clinically overt bleeding). Only those participants with data available at specified time point were analyzed. 99999 indicates <25% of participants experienced the event within the treatment arm. Hence, median and inter-quartile range could not be derived.
    End point type
    Secondary
    End point timeframe
    Up to a maximum of 151 weeks
    Notes
    [26] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    13 [27]
    39 [28]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    99999 (99999 to 99999)
    99999 (99999 to 99999)
    Notes
    [27] - ITT Analysis Set
    [28] - ITT Analysis Set
    No statistical analyses for this end point

    Secondary: Duration of MFSAF TSS Response

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    End point title
    Duration of MFSAF TSS Response [29]
    End point description
    Duration of MFSAF TSS response is defined as the number of days from the start of the initial 28-day period in which a participant had a >= 50% reduction from Baseline TSS to the first day of the 7-day assessment that determines the mean TSS for the 28-day period during which the participants TSS equals or exceeds their Baseline value. Only those participants with data available at specified time point were analyzed. 99999 indicates <25% of participants experienced the event within the treatment arm. Hence, median and inter-quartile range could not be derived.
    End point type
    Secondary
    End point timeframe
    Up to a maximum of 151 weeks
    Notes
    [29] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    6 [30]
    32 [31]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    99999 (-99999 to 99999)
    286.00 (286.00 to 286.00)
    Notes
    [30] - ITT Analysis Set
    [31] - ITT Analysis Set
    No statistical analyses for this end point

    Secondary: Percentage of participants with Transfusion Dependence (TD) status at Week 24

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    End point title
    Percentage of participants with Transfusion Dependence (TD) status at Week 24 [32]
    End point description
    TD status at Week 24 is defined as requirement of >=4 RBC units in an 8-week period immediately prior to the end of Week 24.
    End point type
    Secondary
    End point timeframe
    Week 24
    Notes
    [32] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [33]
    130 [34]
    Units: Percentage of participants
        number (confidence interval 95%)
    24.62 (14.77 to 36.87)
    15.38 (9.66 to 22.76)
    Notes
    [33] - ITT Analysis Set
    [34] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.1602
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified CMH
    Point estimate
    -8.26
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -20.18
         upper limit
    3.66

    Secondary: Percentage of participants with a hemoglobin response

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    End point title
    Percentage of participants with a hemoglobin response [35]
    End point description
    Hemoglobin responses are defined as increases of >= 1, >= 1.5, or >= 2 g/dL from Baseline in Hgb, as measured over a (rolling) period of at least 12 consecutive weeks falling entirely before the end of Week 24. Baseline was the last assessment done before or on the day of first dose date. Data has been reported for percentage of participants who had >= 1, >= 1.5, or >= 2 g/dL increase from Baseline in hemoglobin.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [35] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [36]
    130 [37]
    Units: Percentage of participants
    number (confidence interval 95%)
        >=1g/dL Increase
    33.85 (22.57 to 46.65)
    53.08 (44.13 to 61.88)
        >=1.5g/dL Increase
    23.08 (13.53 to 35.19)
    40.00 (31.51 to 48.95)
        >=2g/dL Increase
    20.00 (11.10 to 31.77)
    29.23 (21.59 to 37.85)
    Notes
    [36] - ITT Analysis Set
    [37] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    >=1g/dL Increase in Hemoglobin response
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0124
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified CMH
    Point estimate
    19
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    4.68
         upper limit
    33.32
    Statistical analysis title
    Statistical Analysis 3
    Statistical analysis description
    >=2g/dL Increase in Hemoglobin response
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.2844
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified CMH
    Point estimate
    6.97
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -5.41
         upper limit
    19.35
    Statistical analysis title
    Statistical Analysis 2
    Statistical analysis description
    >=1.5g/dL Increase in Hemoglobin response
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0282
    Method
    Cochran-Mantel-Haenszel
    Parameter type
    Stratified CMH
    Point estimate
    15.68
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    2.47
         upper limit
    28.9

    Secondary: Duration of TI in Baseline TD Participants

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    End point title
    Duration of TI in Baseline TD Participants [38]
    End point description
    Duration of TI is defined as the number of days from (a) the first day of a 12-week period that satisfies the 12-week TI status definition, to (b) the first RBC transfusion or Hgb level < 8 g/dL (except in the case of clinically overt bleeding). Only those participants with data available at specified time points were analyzed. 99999 indicates <50% of participants experienced the event within the treatment arm. Hence, median and third-quartile could not be derived.
    End point type
    Secondary
    End point timeframe
    Up to a maximum of 151 weeks
    Notes
    [38] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    34 [39]
    63 [40]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    99999 (196.0 to 99999)
    99999 (224.0 to 99999)
    Notes
    [39] - ITT Analysis Set
    [40] - ITT Analysis Set
    No statistical analyses for this end point

    Secondary: Number of Baseline TD Participants With TI Status at Week 24

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    End point title
    Number of Baseline TD Participants With TI Status at Week 24 [41]
    End point description
    Participants were defined as having TD if they met both of the following requirements in the 8 weeks immediately before the end of Week 24: >= 4 red blood cell or whole blood units were transfused (except in the case of clinically overt bleeding), each in response to a hemoglobin assessment of <= 9.5 g/dL; and there were >= 2 hemoglobin assessments with >= 28 days between the earliest and latest hemoglobin assessments. TI status was defined as not requiring red blood cell transfusion (except in the case of clinically overt bleeding) for >= 12 weeks immediately prior to the end of Week 24, with hemoglobin levels >= 8 g/dL. Only those participants with data available at specified time points were analyzed.
    End point type
    Secondary
    End point timeframe
    Week 24
    Notes
    [41] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    34 [42]
    63 [43]
    Units: Participants
    3
    9
    Notes
    [42] - ITT Analysis Set
    [43] - ITT Analysis Set
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS) [44]
    End point description
    Overall survival is defined as the interval from the first study drug dosing date (or randomization date for participants who did not receive treatment) to death from any cause. Values are presented based on the Kaplan-Meier analysis. All participants (overall population) were included in analysis. 99999 indicates <50% of participants experienced the event within the treatment arm. Hence, median and third-quartile could not be derived and 88888 indicates <75% of participants experienced the event within the treatment arm. Hence, third-quartile could not be derived.
    End point type
    Secondary
    End point timeframe
    Up to a maximum of 151 weeks
    Notes
    [44] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [45]
    130 [46]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    99999 (309.00 to 99999)
    624.0 (333.0 to 88888)
    Notes
    [45] - ITT Analysis Set
    [46] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.6879
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.89
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.504
         upper limit
    1.572

    Secondary: Number of participants with serious adverse events (SAEs) and non-serious adverse events (non-SAEs)- up to Week 24

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    End point title
    Number of participants with serious adverse events (SAEs) and non-serious adverse events (non-SAEs)- up to Week 24
    End point description
    An Adverse event (AE) is any untoward medical occurrence in a trial participant administered an investigational product(s), a comparator product, or an approved drug regardless of the causal relationship with treatment. An SAE is an AE that Results in death, life threatening, requires inpatient hospitalization or prolongation of an existing hospitalization, results in persistent or significant disability or incapacity, results in a congenital anomaly/birth defect or any important medical events as per medical or scientific judgment. Adverse events which were not Serious were considered as Non-Serious adverse events. Safety analysis set included all participants in the ITT Analysis set who received at least one dose of study drug.
    End point type
    Secondary
    End point timeframe
    Up to Week 24
    End point values
    MMB 200 mg QD + Placebo- Randomized DB TP DAN 300 mg BID + Placebo- Randomized DB TP
    Number of subjects analysed
    130 [47]
    65 [48]
    Units: Participants
        Any non-SAEs
    108
    55
        Any SAEs
    45
    26
    Notes
    [47] - Safety analysis set
    [48] - Safety analysis set
    No statistical analyses for this end point

    Secondary: Number of participants with serious adverse events (SAEs) and non-serious adverse events (non-SAEs)- From Week 24 to a maximum of 151 weeks

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    End point title
    Number of participants with serious adverse events (SAEs) and non-serious adverse events (non-SAEs)- From Week 24 to a maximum of 151 weeks
    End point description
    An AE is any untoward medical occurrence in a trial participant administered an investigational product(s), a comparator product, or an approved drug regardless of the causal relationship with treatment. An SAE is an AE that Results in death, life threatening, requires inpatient hospitalization or prolongation of an existing hospitalization, results in persistent or significant disability or incapacity, results in a congenital anomaly/birth defect or any important medical events as per medical or scientific judgment. Adverse events which were not Serious were considered as Non-Serious adverse events.
    End point type
    Secondary
    End point timeframe
    From Week 24 to a maximum of 151 weeks
    End point values
    MMB 200 mg QD- Open-Label Extended TP DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP
    Number of subjects analysed
    93 [49]
    41 [50]
    Units: Participants
        Any non-SAEs
    57
    28
        Any SAEs
    30
    12
    Notes
    [49] - Safety analysis set
    [50] - Safety analysis set
    No statistical analyses for this end point

    Secondary: Change From Baseline in Disease-related Fatigue as Assessed by MFSAF TSS v4.0 at Week 24

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    End point title
    Change From Baseline in Disease-related Fatigue as Assessed by MFSAF TSS v4.0 at Week 24 [51]
    End point description
    The MFSAF v4.0 comprises 7 domains representing the 7 most relevant symptoms of MF identified through existing participant- and clinician-based evidence: fatigue, night sweats, pruritus, abdominal discomfort, pain under the left ribs, early satiety, and bone pain. Participants scored each symptom domain using an 11-point numeric rating scale ranging from 0 (absent) to 10 (worst imaginable). Data has been reported for Disease-related Fatigue domain measured using an 11-point numeric rating scale ranging from 0 (absent) to 10 (worst imaginable), higher score indicates worst outcome. An increase in score from Baseline indicated a worsening of fatigue and a decrease in score from Baseline indicated an improvement in fatigue. Baseline was the last assessment done before or on the day of first dose date. Change from Baseline was defined as the post-Baseline value minus Baseline value.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [51] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    37 [52]
    92 [53]
    Units: Scores on a scale
        least squares mean (standard error)
    -0.82 ± 0.31
    -1.53 ± 0.20
    Notes
    [52] - ITT Analysis Set
    [53] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    129
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0513
    Method
    MMRM
    Parameter type
    Least Squares Mean Difference
    Point estimate
    -0.71
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.42
         upper limit
    0

    Secondary: Leukemia-free Survival (LFS)

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    End point title
    Leukemia-free Survival (LFS) [54]
    End point description
    LFS is defined as the interval from first study drug dosing date (or randomization date for participants who did not receive treatment) to any evidence of leukemic transformation and/or death (from any cause). Values are presented based on the Kaplan-Meier analysis. All participants (overall population) were included in analysis. 99999 indicates <50% of participants experienced the event within the treatment arm. Hence, median and third-quartile could not be derived and 88888 indicates <75% of participants experienced the event within the treatment arm. Hence, third-quartile could not be derived.
    End point type
    Secondary
    End point timeframe
    Up to a maximum of 151 weeks
    Notes
    [54] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    65 [55]
    130 [56]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    99999 (284.0 to 99999)
    624.0 (325.0 to 88888)
    Notes
    [55] - ITT Analysis Set
    [56] - ITT Analysis Set
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    195
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.432
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    0.804
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.466
         upper limit
    1.386

    Secondary: Change From Baseline in Cancer-related Fatigue as Assessed by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at Week 24

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    End point title
    Change From Baseline in Cancer-related Fatigue as Assessed by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) at Week 24 [57]
    End point description
    The EORTC QLQ-C30 is comprised of 5 functional scales (physical, role, emotional, social, cognitive), eight single item symptom scales (fatigue, pain, nausea/vomiting, appetite loss, constipation, diarrhea, insomnia, dyspnea), as well as sub-scales assessing global health/quality of life and financial impact. Most items use a 4-point Likert scale from "not at all" to "very much" and a one-week recall period with the exception of the final two items which use a 7 point scale response from "very poor" to "excellent". Scores were averaged and transformed to a 0-100 scale, with higher scores representing better functioning/quality of life. An increase in scores from Baseline indicated an improved functioning/quality of life, and a decrease in scores from Baseline indicated a worsened functioning/quality of life. Baseline was the last assessment done before or on the day of first dose date. Change from Baseline was defined as the post-Baseline value minus Baseline value.
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [57] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    35 [58]
    89 [59]
    Units: Scores on a scale
        least squares mean (standard error)
    -3.52 ± 3.65
    -14.34 ± 2.35
    Notes
    [58] - ITT Analysis Set. Only those participants with data available at specified time points were analyzed
    [59] - ITT Analysis Set. Only those participants with data available at specified time points were analyzed
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    124
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.0113
    Method
    MMRM
    Parameter type
    Least Squares Mean Difference
    Point estimate
    -10.82
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -19.15
         upper limit
    -2.48

    Secondary: Change From Baseline in Physical Function Score as Assessed by Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10b at Week 24

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    End point title
    Change From Baseline in Physical Function Score as Assessed by Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Short Form 10b at Week 24 [60]
    End point description
    PROMIS Physical Function Short Form 10b consists of 14 questions; each with a 5-point response. PROMIS short form assesses self-reported capability of a participant rather than actual performance of physical activities. This includes functioning of one's upper extremities (dexterity), lower extremities (walking or mobility), and central regions (neck, back) as well as instrumental activities of daily living, such as running errands. Participants scored each response on a scale from 1 (unable to do) to 5 (without any difficulty, or not at all). Total possible range of scores was 14 to 70, with higher scores corresponding to a greater physical function ability. An increase in score from Baseline indicated an improvement in physical function ability and a decrease in score from Baseline indicated a reduction in physical function ability. Baseline was last assessment done before or on the day of first dose date. Change from Baseline was defined as post-Baseline value minus Baseline value
    End point type
    Secondary
    End point timeframe
    Baseline and Week 24
    Notes
    [60] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This endpoint is only reporting on a subset of the arms that are contained in the Baseline period.
    End point values
    DAN 300 mg BID + Placebo MMB 200 mg QD + Placebo
    Number of subjects analysed
    32 [61]
    89 [62]
    Units: Scores on a scale
        least squares mean (standard error)
    -0.11 ± 1.21
    1.19 ± 0.77
    Notes
    [61] - ITT Analysis Set. Only those participants with data available at specified time points were analyzed
    [62] - ITT Analysis Set. Only those participants with data available at specified time points were analyzed
    Statistical analysis title
    Statistical Analysis 1
    Comparison groups
    DAN 300 mg BID + Placebo v MMB 200 mg QD + Placebo
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    = 0.357
    Method
    MMRM
    Parameter type
    Least Squares Mean Difference
    Point estimate
    1.31
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.49
         upper limit
    4.11

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All-cause mortality, Serious adverse events (SAEs) and non-SAEs were collected up to Week 24 for Randomized Double-Blind Treatment Period and From Week 24 to a maximum of 151 weeks for the Open-Label Extended Treatment Period
    Adverse event reporting additional description
    Serious adverse events (SAEs) and non-SAEs were measured in the Safety analysis set, which included all participants in the ITT analysis set who received at least one dose of study drug. All-cause mortality was measured in the ITT analysis set, which included all randomized participants. Data are presented per treatment received.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.0
    Reporting groups
    Reporting group title
    MMB 200 mg QD + Placebo- Randomized DB TP
    Reporting group description
    Participants were randomized to receive 200 mg of MMB orally QD and a DAN-placebo orally BID during the randomized 24-week double-blind treatment period.

    Reporting group title
    DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP
    Reporting group description
    Participants who completed the randomized treatment period, discontinued treatment early due to splenic progression, or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants who received DAN 300 mg BID during randomized period switched to receive 200 mg of MMB orally QD during open-label extended treatment period.

    Reporting group title
    MMB 200 mg QD- Open-Label Extended TP
    Reporting group description
    Participants who completed the randomized treatment period or discontinued treatment early for other reasons but completed scheduled assessments through Week 24 were enrolled in an open-label extended treatment period. Participants continued to receive 200 mg of MMB orally QD during the open-label extended treatment period.

    Reporting group title
    DAN 300 mg BID + Placebo- Randomized DB TP
    Reporting group description
    Participants were randomized to receive 300 mg of DAN orally BID and MMB-placebo orally QD during the randomized 24-week double-blind treatment period.

    Serious adverse events
    MMB 200 mg QD + Placebo- Randomized DB TP DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP MMB 200 mg QD- Open-Label Extended TP DAN 300 mg BID + Placebo- Randomized DB TP
    Total subjects affected by serious adverse events
         subjects affected / exposed
    45 / 130 (34.62%)
    12 / 41 (29.27%)
    30 / 93 (32.26%)
    26 / 65 (40.00%)
         number of deaths (all causes)
    25
    8
    23
    16
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Acute myeloid leukaemia
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    Leukaemia cutis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metastatic malignant melanoma
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tongue neoplasm malignant stage unspecified
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transformation to acute myeloid leukaemia
         subjects affected / exposed
    3 / 130 (2.31%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    2 / 65 (3.08%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 1
    Adenocarcinoma
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    Basal cell carcinoma
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    2 / 93 (2.15%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Aortic stenosis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Shock haemorrhagic
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Circulatory collapse
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Haematoma
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Chest pain
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pyrexia
         subjects affected / exposed
    3 / 130 (2.31%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Death
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Disease progression
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    General physical health deterioration
         subjects affected / exposed
    2 / 130 (1.54%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    2 / 65 (3.08%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
    Oedema peripheral
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sudden death
         subjects affected / exposed
    1 / 130 (0.77%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
    Multiple organ dysfunction syndrome
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Complication associated with device
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Prostatitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia aspiration
         subjects affected / exposed
    1 / 130 (0.77%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dyspnoea
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary oedema
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary arterial hypertension
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Restrictive pulmonary disease
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Delirium
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Depression
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Personality change
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Investigations
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General physical condition abnormal
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Liver function test increased
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cervical vertebral fracture
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Femur fracture
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Subdural haematoma
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    Periprosthetic fracture
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lower limb fracture
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    1 / 130 (0.77%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery disease
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiogenic shock
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
    Atrial fibrillation
         subjects affected / exposed
    2 / 130 (1.54%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Coronary artery stenosis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Myocardial ischaemia
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tachycardia
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure congestive
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure chronic
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac arrest
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    Atrial thrombosis
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Nervous system disorders
    Syncope
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Subarachnoid haemorrhage
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    5 / 130 (3.85%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    3 / 65 (4.62%)
         occurrences causally related to treatment / all
    1 / 5
    0 / 2
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 3
    Splenic infarction
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    2 / 65 (3.08%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Blood loss anaemia
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Splenic haematoma
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Thrombocytopenia
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    2 / 4
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Febrile neutropenia
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    2 / 93 (2.15%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Splenic vein thrombosis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Upper gastrointestinal haemorrhage
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Small intestinal obstruction
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Oesophageal varices haemorrhage
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Melaena
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemoperitoneum
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haematochezia
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastric ulcer perforation
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Enteritis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemorrhagic erosive gastritis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis acute
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholangitis acute
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatotoxicity
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal and urinary disorders
    Chronic kidney disease
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Acute kidney injury
         subjects affected / exposed
    4 / 130 (3.08%)
    2 / 41 (4.88%)
    2 / 93 (2.15%)
    3 / 65 (4.62%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 2
    0 / 2
    1 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Renal failure
         subjects affected / exposed
    2 / 130 (1.54%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Tenosynovitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Sarcopenia
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    COVID-19
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
    0 / 0
    Enterococcal sepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Escherichia sepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cystitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Clostridium difficile colitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    2 / 130 (1.54%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    COVID-19 pneumonia
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    4 / 93 (4.30%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 3
    0 / 0
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Biliary sepsis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Staphylococcal sepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Streptococcal bacteraemia
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    3 / 130 (2.31%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    6 / 65 (9.23%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 1
    0 / 1
    2 / 6
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Septic shock
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    Listeria sepsis
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Joint abscess
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tooth abscess
         subjects affected / exposed
    1 / 130 (0.77%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    2 / 130 (1.54%)
    1 / 41 (2.44%)
    2 / 93 (2.15%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Endocarditis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Abscess limb
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Escherichia infection
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Gastroenteritis rotavirus
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Infective exacerbation of chronic obstructive airways disease
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Periorbital cellulitis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Enterobacter sepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    Splenic abscess
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Pulmonary sepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia staphylococcal
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Pneumonia influenzal
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urosepsis
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
    Metabolism and nutrition disorders
    Fluid overload
         subjects affected / exposed
    2 / 130 (1.54%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperkalaemia
         subjects affected / exposed
    1 / 130 (0.77%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypoglycaemia
         subjects affected / exposed
    0 / 130 (0.00%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    1 / 65 (1.54%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Decreased appetite
         subjects affected / exposed
    0 / 130 (0.00%)
    1 / 41 (2.44%)
    0 / 93 (0.00%)
    0 / 65 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    MMB 200 mg QD + Placebo- Randomized DB TP DAN 300 mg BID to MMB 200 mg QD- Open-Label Extended TP MMB 200 mg QD- Open-Label Extended TP DAN 300 mg BID + Placebo- Randomized DB TP
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    108 / 130 (83.08%)
    28 / 41 (68.29%)
    57 / 93 (61.29%)
    55 / 65 (84.62%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    6 / 130 (4.62%)
    5 / 41 (12.20%)
    3 / 93 (3.23%)
    6 / 65 (9.23%)
         occurrences all number
    6
    5
    3
    6
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    17 / 130 (13.08%)
    0 / 41 (0.00%)
    12 / 93 (12.90%)
    6 / 65 (9.23%)
         occurrences all number
    20
    0
    15
    8
    Pyrexia
         subjects affected / exposed
    11 / 130 (8.46%)
    3 / 41 (7.32%)
    12 / 93 (12.90%)
    5 / 65 (7.69%)
         occurrences all number
    13
    4
    13
    6
    Oedema peripheral
         subjects affected / exposed
    9 / 130 (6.92%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    9 / 65 (13.85%)
         occurrences all number
    9
    1
    3
    10
    Fatigue
         subjects affected / exposed
    8 / 130 (6.15%)
    3 / 41 (7.32%)
    6 / 93 (6.45%)
    6 / 65 (9.23%)
         occurrences all number
    10
    3
    11
    10
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    9 / 130 (6.92%)
    2 / 41 (4.88%)
    8 / 93 (8.60%)
    2 / 65 (3.08%)
         occurrences all number
    10
    2
    9
    2
    Epistaxis
         subjects affected / exposed
    7 / 130 (5.38%)
    3 / 41 (7.32%)
    1 / 93 (1.08%)
    4 / 65 (6.15%)
         occurrences all number
    7
    3
    2
    6
    Dyspnoea
         subjects affected / exposed
    9 / 130 (6.92%)
    0 / 41 (0.00%)
    7 / 93 (7.53%)
    10 / 65 (15.38%)
         occurrences all number
    10
    0
    8
    12
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    9 / 130 (6.92%)
    1 / 41 (2.44%)
    2 / 93 (2.15%)
    5 / 65 (7.69%)
         occurrences all number
    13
    1
    4
    11
    Weight decreased
         subjects affected / exposed
    14 / 130 (10.77%)
    7 / 41 (17.07%)
    9 / 93 (9.68%)
    3 / 65 (4.62%)
         occurrences all number
    16
    7
    9
    4
    Platelet count decreased
         subjects affected / exposed
    9 / 130 (6.92%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    3 / 65 (4.62%)
         occurrences all number
    24
    2
    7
    4
    Blood creatinine increased
         subjects affected / exposed
    10 / 130 (7.69%)
    4 / 41 (9.76%)
    7 / 93 (7.53%)
    10 / 65 (15.38%)
         occurrences all number
    18
    4
    13
    16
    Blood alkaline phosphatase increased
         subjects affected / exposed
    10 / 130 (7.69%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    0 / 65 (0.00%)
         occurrences all number
    18
    1
    3
    0
    Aspartate aminotransferase increased
         subjects affected / exposed
    7 / 130 (5.38%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    4 / 65 (6.15%)
         occurrences all number
    9
    1
    3
    5
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    7 / 130 (5.38%)
    0 / 41 (0.00%)
    4 / 93 (4.30%)
    3 / 65 (4.62%)
         occurrences all number
    9
    0
    6
    3
    Nervous system disorders
    Paraesthesia
         subjects affected / exposed
    8 / 130 (6.15%)
    0 / 41 (0.00%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences all number
    10
    0
    1
    1
    Dizziness
         subjects affected / exposed
    8 / 130 (6.15%)
    4 / 41 (9.76%)
    1 / 93 (1.08%)
    1 / 65 (1.54%)
         occurrences all number
    9
    4
    1
    1
    Blood and lymphatic system disorders
    Neutropenia
         subjects affected / exposed
    7 / 130 (5.38%)
    2 / 41 (4.88%)
    5 / 93 (5.38%)
    2 / 65 (3.08%)
         occurrences all number
    11
    2
    9
    5
    Thrombocytopenia
         subjects affected / exposed
    28 / 130 (21.54%)
    7 / 41 (17.07%)
    13 / 93 (13.98%)
    7 / 65 (10.77%)
         occurrences all number
    50
    10
    22
    11
    Anaemia
         subjects affected / exposed
    12 / 130 (9.23%)
    3 / 41 (7.32%)
    9 / 93 (9.68%)
    6 / 65 (9.23%)
         occurrences all number
    34
    6
    18
    11
    Gastrointestinal disorders
    Abdominal pain upper
         subjects affected / exposed
    3 / 130 (2.31%)
    1 / 41 (2.44%)
    2 / 93 (2.15%)
    5 / 65 (7.69%)
         occurrences all number
    3
    1
    3
    6
    Constipation
         subjects affected / exposed
    11 / 130 (8.46%)
    2 / 41 (4.88%)
    4 / 93 (4.30%)
    5 / 65 (7.69%)
         occurrences all number
    13
    2
    4
    5
    Abdominal pain
         subjects affected / exposed
    10 / 130 (7.69%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    6 / 65 (9.23%)
         occurrences all number
    12
    2
    3
    6
    Diarrhoea
         subjects affected / exposed
    29 / 130 (22.31%)
    5 / 41 (12.20%)
    16 / 93 (17.20%)
    6 / 65 (9.23%)
         occurrences all number
    40
    7
    21
    7
    Vomiting
         subjects affected / exposed
    9 / 130 (6.92%)
    1 / 41 (2.44%)
    3 / 93 (3.23%)
    0 / 65 (0.00%)
         occurrences all number
    10
    1
    3
    0
    Nausea
         subjects affected / exposed
    21 / 130 (16.15%)
    0 / 41 (0.00%)
    8 / 93 (8.60%)
    6 / 65 (9.23%)
         occurrences all number
    28
    0
    10
    6
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    13 / 130 (10.00%)
    1 / 41 (2.44%)
    6 / 93 (6.45%)
    7 / 65 (10.77%)
         occurrences all number
    14
    1
    7
    7
    Rash
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    0 / 93 (0.00%)
    4 / 65 (6.15%)
         occurrences all number
    3
    0
    0
    4
    Night sweats
         subjects affected / exposed
    4 / 130 (3.08%)
    0 / 41 (0.00%)
    2 / 93 (2.15%)
    4 / 65 (6.15%)
         occurrences all number
    4
    0
    2
    5
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    2 / 130 (1.54%)
    1 / 41 (2.44%)
    1 / 93 (1.08%)
    5 / 65 (7.69%)
         occurrences all number
    2
    1
    1
    5
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    4 / 130 (3.08%)
    3 / 41 (7.32%)
    1 / 93 (1.08%)
    2 / 65 (3.08%)
         occurrences all number
    5
    4
    1
    3
    Infections and infestations
    COVID-19
         subjects affected / exposed
    9 / 130 (6.92%)
    0 / 41 (0.00%)
    8 / 93 (8.60%)
    0 / 65 (0.00%)
         occurrences all number
    9
    0
    8
    0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    9 / 130 (6.92%)
    1 / 41 (2.44%)
    4 / 93 (4.30%)
    6 / 65 (9.23%)
         occurrences all number
    13
    1
    5
    8
    Hyperkalaemia
         subjects affected / exposed
    6 / 130 (4.62%)
    2 / 41 (4.88%)
    2 / 93 (2.15%)
    6 / 65 (9.23%)
         occurrences all number
    7
    2
    3
    12
    Hyponatraemia
         subjects affected / exposed
    3 / 130 (2.31%)
    0 / 41 (0.00%)
    3 / 93 (3.23%)
    4 / 65 (6.15%)
         occurrences all number
    5
    0
    3
    4
    Hyperuricaemia
         subjects affected / exposed
    9 / 130 (6.92%)
    3 / 41 (7.32%)
    3 / 93 (3.23%)
    4 / 65 (6.15%)
         occurrences all number
    9
    3
    3
    6

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    16 Aug 2019
    Protocol Amendment 1: • Clarified criteria for dose reduction due to thrombocytopenia, neutropenia, and nonhematologic or other toxicities; and subsequent dose re-escalation. • Modified thresholds for platelet count recovery required to resume treatment based on Baseline value. • Updated procedures for managing transition from randomized treatment to open-label treatment so treatment assignment would only be unblinded when required to determine eligibility for open-label treatment with MMB or DAN.
    18 Dec 2020
    Protocol Amendment 2: • Removed interim analysis for sample size reassessment from the study design. • Modified the planned statistical analysis: Moved the MMRM analysis of the MFSAF TSS secondary endpoint to the fourth position in the overall statistical testing hierarchy. – Revised description of the hierarchal statistical testing of secondary endpoints. Updated descriptions of the secondary endpoints. Updated statistics section. • Changed timing of first dose after randomization, JAK inhibitor nontreatment period, exclusion of active anti-MF medication, and Baseline spleen volume assessment to allow flexibility for scheduling randomization and day 1. • Inclusion criteria were modified: Criterion 3: clarified that an MFSAF TSS of >= 10 units was required during screening prior to Baseline day 1. Criteria 4a and 4c: clarified the definition of anemic. – Criterion 5b: added that participants receiving a low dose of a JAK inhibitor could have a reduced taper period, or no taper, with sponsor approval. Criterion 9: clarified that platelet count must be met without requirement for platelet transfusion. • Exclusion criteria were modified: Criterion 1b: clarified that approved JAK inhibitors were prohibited and reduced the study period and window for use. – Criterion 1c: reduced the study period and window for use of anti-MF therapy. Criterion 1e: clarified that investigational JAK inhibitors were prohibited within 4 weeks prior to randomization. Criterion 7: added thalassemia as a cause of clinically significant anemia. • Updated criteria for adjusting or stopping doses to provide guidance that investigator clinical discretion should be used and that in the event of grade 3 or 4 toxicity, relevant laboratory tests should be closely monitored per investigator clinical discretion.
    18 Dec 2020
    Protocol Amendment 2 (continued): • Clarified the anticipated risks of DAN to emphasize that the provided safety information references the approved indications for DAN and should be interpreted by the investigator for guidance when assessing participants in this study. • Updated criteria for crossing over to open-label MMB to add sponsor approval for short-term use of restricted anti-MF medication to treat severe splenic progression, revise criteria for splenic progression, and add sponsor approval for spleen volume measurements read locally. • Updated restricted treatment use for consistency with exclusion criterion 1 and to clearly define the beginning and end of the study period. • Added that alternative methods, including paper forms, could be used to record Patient Reported Outcome responses in exceptional circumstances, with sponsor approval. • Updated adverse event and serious adverse event reporting criteria and procedures. • Clarified requirements for hepatitis testing. • Added that local laboratory assessments could be used to determine eligibility, with sponsor approval, if central laboratory assessments were not available prior to day 1. • Clarified the window (+/- 7 days) for MFSAF assessments and PRO responses during the open-label extended treatment period. • Added that participants requiring antihypertensive medication should be closely monitored on the day of the first study drug dose and that medication could be administered if clinically necessary. • Added that investigators were to advise participants on the conservation of gametes prior to receiving study drug due to the possibility of infertility. • Updated DAN packaging configuration and procedures for receipt of study drug. • Added that a male condom must be used in combination with a diaphragm (with spermicide). • Added a protocol addendum for guidance on modified study procedures that could be followed during the Coronavirus 2019 (COVID-19) pandemic.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

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