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    Clinical Trial Results:
    A Prospective Study Evaluating the Safety and Effectiveness of EVARREST® Fibrin Sealant Patch in Controlling Mild or Moderate Hepatic Parenchyma or Soft Tissue Bleeding During Open Abdominal, Retroperitoneal, Pelvic and Thoracic (non-cardiac) Surgery in Pediatric Patients

    Summary
    EudraCT number
    2019-004657-89
    Trial protocol
    GB  
    Global end of trial date
    13 Feb 2025

    Results information
    Results version number
    v1(current)
    This version publication date
    14 Feb 2026
    First version publication date
    14 Feb 2026
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    BIOS-16-001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03255174
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    ETHICON Inc.
    Sponsor organisation address
    1000 US Highway 202 S, Raritan, United States, NJ 08869
    Public contact
    Clinical Registry Group, ETHICON Inc., ClinicalTrialsEU@its.jnj.com
    Scientific contact
    Clinical Registry Group, ETHICON Inc., ClinicalTrialsEU@its.jnj.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
    13 Feb 2025
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Feb 2025
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to evaluate the safety and hemostatic effectiveness of EVARREST Fibrin Sealant Patch (EVARREST) in controlling mild or moderate soft tissue & parenchymal bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery in pediatric participants.
    Protection of trial subjects
    The study was conducted in accordance with the Code of Federal Regulations, the UK statutory instruments, the International Council for Harmonization (ICH) Guideline for Good Clinical Practice (GCP), and the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    19 Mar 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United States: 16
    Country: Number of subjects enrolled
    United Kingdom: 19
    Worldwide total number of subjects
    35
    EEA total number of subjects
    0
    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)
    12
    Children (2-11 years)
    18
    Adolescents (12-17 years)
    5
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 35 participants were treated in the study. All participants completed the study. This was a single-arm study.

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

    Arms
    Arm title
    EVARREST Fibrin Sealant Patch
    Arm description
    Participants with mild or moderate soft tissue or parenchymal bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery were treated with EVARREST Fibrin Sealant Patch (EVARREST). EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component used as an adjunct to hemostasis during surgery.
    Arm type
    Experimental

    Investigational medicinal product name
    EVARREST Fibrin Sealant Patch
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Sealant
    Routes of administration
    Topical use
    Dosage and administration details
    Participants with mild or moderate soft tissue or parenchymal bleeding were treated with EVARREST during surgical procedure.

    Number of subjects in period 1
    EVARREST Fibrin Sealant Patch
    Started
    35
    Full analysis set
    31 [1]
    Completed
    35
    Notes
    [1] - The number of subjects at this milestone seems inconsistent with the number of subjects in the arm. It is expected that the number of subjects will be greater than, or equal to the number that completed, minus those who left.
    Justification: Reported participants in the milestone are of full analysis set.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    EVARREST Fibrin Sealant Patch
    Reporting group description
    Participants with mild or moderate soft tissue or parenchymal bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery were treated with EVARREST Fibrin Sealant Patch (EVARREST). EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component used as an adjunct to hemostasis during surgery.

    Reporting group values
    EVARREST Fibrin Sealant Patch Total
    Number of subjects
    35 35
    Age categorical
    Units: Subjects
        In Utero
    0 0
        Preterm newborn infants (gestional age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days - 23 months)
    12 12
        Children (2 - 11 years)
    18 18
        12 - 17 years
    5 5
        Adults (18 - 64 years)
    0 0
        From 65 - 84 years
    0 0
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    4.59 ( 4.341 ) -
    Gender categorical
    Units: Subjects
        Male
    20 20
        Female
    15 15

    End points

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    End points reporting groups
    Reporting group title
    EVARREST Fibrin Sealant Patch
    Reporting group description
    Participants with mild or moderate soft tissue or parenchymal bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery were treated with EVARREST Fibrin Sealant Patch (EVARREST). EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component used as an adjunct to hemostasis during surgery.

    Primary: Absolute Time to Hemostasis

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    End point title
    Absolute Time to Hemostasis [1]
    End point description
    Hemostasis was defined as no detectable bleeding at the Target Bleeding Site (TBS). Absolute time to hemostasis was defined as the absolute time elapsed from TBS identification to the last moment in time at which detectable bleeding at the TBS was observed. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression.
    End point type
    Primary
    End point timeframe
    During surgical procedure on Day 0 (from TBS identification to the last moment in time at which detectable bleeding at TBS observed)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: only descriptive data was planned to be reported for this endpoint.
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    31
    Units: Minutes
        median (confidence interval 95%)
    4.00 (4.00 to 4.00)
    No statistical analyses for this end point

    Secondary: Percentage of Participants who Achieved Hemostatic Success at 4 Minutes

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    End point title
    Percentage of Participants who Achieved Hemostatic Success at 4 Minutes
    End point description
    Percentage of participants who achieved hemostatic success at 4 minutes was reported. A participant was considered hemostatic success at 4 minutes if the TBS was hemostatic at 4 minutes, and there was no re-bleeding that required treatment (other than observation only) at the TBS from 4 minutes following the first TBS identification through final fascial closure. Hemostasis was assessed at 4 minutes from TBS identification by carefully releasing manual compression and removing the surgical sponge (if used). TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression.
    End point type
    Secondary
    End point timeframe
    4 minutes after TBS identification (during surgical procedure on Day 0)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    31
    Units: Percentage of participants
        number (confidence interval 95%)
    77.4 (58.90 to 90.41)
    No statistical analyses for this end point

    Secondary: Percentage of Participants who Achieved Hemostatic Success at 10 Minutes

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    End point title
    Percentage of Participants who Achieved Hemostatic Success at 10 Minutes
    End point description
    Percentage of participants who achieved hemostatic success at 10 minutes was reported. A participant was considered hemostatic success at 10 minutes if the TBS was hemostatic at 10 minutes, and there was no re-bleeding that required treatment (other than observation only) at the TBS from 10 minutes following the first TBS identification through final fascial closure. Hemostasis was assessed at 10 minutes from TBS identification and at initiation of final fascial closure. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression.
    End point type
    Secondary
    End point timeframe
    10 minutes after TBS identification (during surgical procedure on Day 0)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    31
    Units: Percentage of participants
        number (confidence interval 95%)
    93.5 (78.58 to 99.21)
    No statistical analyses for this end point

    Secondary: Percentage of Participants with No Re-bleeding at the TBS

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    End point title
    Percentage of Participants with No Re-bleeding at the TBS
    End point description
    Percentage of participants with no re-bleeding at the TBS was reported. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression.
    End point type
    Secondary
    End point timeframe
    During surgical procedure on Day 0 (from TBS identification to final fascial closure)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    31
    Units: Percentage of participants
        number (not applicable)
    96.8
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Adverse Events That Were Potentially Related to Bleeding at the TBS

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    End point title
    Percentage of Participants with Adverse Events That Were Potentially Related to Bleeding at the TBS
    End point description
    Percentage of participants with adverse events that were potentially related to bleeding at the TBS was reported. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression. An adverse event means any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE can be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a drug, without judgment about causality.
    End point type
    Secondary
    End point timeframe
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    35
    Units: Percentage of participants
        number (not applicable)
    5.7
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Adverse Events That Were Potentially Related to Thrombotic Events

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    End point title
    Percentage of Participants with Adverse Events That Were Potentially Related to Thrombotic Events
    End point description
    Percentage of participants with adverse events that were potentially related to thrombotic events at the TBS was reported. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression. An adverse event means any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE can be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a drug, without judgment about causality.
    End point type
    Secondary
    End point timeframe
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    35
    Units: Percentage of participants
        number (not applicable)
    0
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Re-treatment at the TBS

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    End point title
    Percentage of Participants With Re-treatment at the TBS
    End point description
    Percentage of participants with re-treatment at the TBS was reported. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression.
    End point type
    Secondary
    End point timeframe
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    35
    Units: Percentage of participants
        number (not applicable)
    25.7
    No statistical analyses for this end point

    Secondary: Percentage of Participants With Adverse Events

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    End point title
    Percentage of Participants With Adverse Events
    End point description
    Percentage of participants with adverse events (including serious and non-serious) were reported. TBS was defined as the first accessible mild or moderate bleeding site identified in the hepatic parenchyma or soft tissue, where conventional methods of controlling bleeding were ineffective or impractical and was amenable to manual compression. An adverse event means any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related. An AE can be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a drug, without judgment about causality.
    End point type
    Secondary
    End point timeframe
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    35
    Units: Percentage of participants
        number (not applicable)
    68.6
    No statistical analyses for this end point

    Secondary: Change From Baseline in Laboratory Parameter: Hemoglobin

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    End point title
    Change From Baseline in Laboratory Parameter: Hemoglobin
    End point description
    Change from baseline in laboratory parameter (hemoglobin) was reported. Baseline was defined as the value that was the closest to the procedure time (the latest value). Safety analysis set included all participants who received treatment. Here, 'N' (overall number of participants analyzed) signifies the number of participants evaluable for this outcome measure.
    End point type
    Secondary
    End point timeframe
    From baseline up to hospital discharge (up to 44-day post-surgery on Day 0)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    32
    Units: Grams per liter (g/L)
        arithmetic mean (standard deviation)
    -5.59 ( 16.353 )
    No statistical analyses for this end point

    Secondary: Change From Baseline in Laboratory Parameter: Hematocrit

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    End point title
    Change From Baseline in Laboratory Parameter: Hematocrit
    End point description
    Change from baseline in laboratory parameter (hematocrit) was reported. Baseline was defined as the value that was the closest to the procedure time (the latest value). Safety analysis set included all participants who received treatment. Here, 'N' (overall number of participants analyzed) signifies the number of participants evaluable for this outcome measure.
    End point type
    Secondary
    End point timeframe
    From baseline up to hospital discharge (up to 44-day post-surgery on Day 0)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    25
    Units: Liters per liter (L/L)
        arithmetic mean (standard deviation)
    -0.02 ( 0.048 )
    No statistical analyses for this end point

    Secondary: Change From Baseline in Laboratory Parameter: Platelets

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    End point title
    Change From Baseline in Laboratory Parameter: Platelets
    End point description
    Change from baseline in laboratory parameter (platelets) was reported. Baseline was defined as the value that was the closest to the procedure time (the latest value). Safety analysis set included all participants who received treatment. Here, 'N' (overall number of participants analyzed) signifies the number of participants evaluable for this outcome measure.
    End point type
    Secondary
    End point timeframe
    From baseline up to hospital discharge (up to 44-day post-surgery on Day 0)
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    31
    Units: 10^9 cells per liter
        arithmetic mean (standard deviation)
    -18.87 ( 130.724 )
    No statistical analyses for this end point

    Secondary: Estimated Intraoperative Blood Loss

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    End point title
    Estimated Intraoperative Blood Loss
    End point description
    Estimated intraoperative blood loss was reported. Safety analysis set included all participants who received treatment. Here, 'N' (overall number of participants analyzed) signifies the number of participants evaluable for this outcome measure.
    End point type
    Secondary
    End point timeframe
    During surgical procedure on Day 0
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    33
    Units: Milliliters (mL)
        arithmetic mean (standard deviation)
    81.9 ( 112.00 )
    No statistical analyses for this end point

    Secondary: Number of Participants With Blood Products Transfusion

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    End point title
    Number of Participants With Blood Products Transfusion
    End point description
    Number of participants with blood products transfused was reported. Safety analysis set included all participants who received treatment.
    End point type
    Secondary
    End point timeframe
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    End point values
    EVARREST Fibrin Sealant Patch
    Number of subjects analysed
    35
    Units: Participants
    11
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From the day of surgical procedure (Day 0) up to 44-days post-surgery
    Adverse event reporting additional description
    Safety analysis set included all participants who received treatment.
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    EVARREST Fibrin Sealant Patch
    Reporting group description
    Participants with mild or moderate soft tissue or parenchymal bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery were treated with EVARREST Fibrin Sealant Patch (EVARREST). EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component used as an adjunct to hemostasis during surgery.

    Serious adverse events
    EVARREST Fibrin Sealant Patch
    Total subjects affected by serious adverse events
         subjects affected / exposed
    9 / 35 (25.71%)
         number of deaths (all causes)
    0
         number of deaths resulting from adverse events
    0
    Injury, poisoning and procedural complications
    Procedural vomiting
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Procedural pain
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Post procedural bile leak
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Surgical and medical procedures
    Central venous catheterisation
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Syncope
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Pyrexia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Respiratory syncytial virus infection
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Lower respiratory tract infection
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Catheter site infection
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 0%
    Non-serious adverse events
    EVARREST Fibrin Sealant Patch
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    21 / 35 (60.00%)
    Vascular disorders
    Hypotension
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    4 / 35 (11.43%)
         occurrences all number
    4
    Hypertension
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    11 / 35 (31.43%)
         occurrences all number
    15
    General disorders and administration site conditions
    Pyrexia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    8 / 35 (22.86%)
         occurrences all number
    9
    Peripheral swelling
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    2
    Impaired healing
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Feeling jittery
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Respiratory acidosis
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Bradypnoea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    4
    Cough
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    3
    Dyspnoea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    3
    Hypoxia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Rhinorrhoea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Oropharyngeal pain
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Tachypnoea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    4
    Psychiatric disorders
    Nervousness
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Agitation
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    3
    Product issues
    Device leakage
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Investigations
    Alanine aminotransferase increased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Aspartate aminotransferase increased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Blood lactic acid increased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Body temperature decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Blood magnesium abnormal
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Blood potassium decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    4 / 35 (11.43%)
         occurrences all number
    4
    Blood potassium abnormal
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Blood magnesium decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Coagulation time prolonged
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Body temperature increased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Culture urine positive
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Haemoglobin decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    2
    Hepatic enzyme increased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Liver function test abnormal
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Oxygen saturation decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    4 / 35 (11.43%)
         occurrences all number
    5
    Platelet count decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Prothrombin time abnormal
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Respiratory rate decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    2
    Staphylococcus test positive
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Weight decreased
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Injury, poisoning and procedural complications
    Wound haemorrhage
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Procedural pain
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    11 / 35 (31.43%)
         occurrences all number
    11
    Procedural haemorrhage
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    3
    Procedural complication
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Incision site pain
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Cardiac disorders
    Bradycardia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    4
    Tachycardia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    10 / 35 (28.57%)
         occurrences all number
    13
    Nervous system disorders
    Tremor
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Somnolence
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    3
    Dyskinesia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Dizziness
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Eye disorders
    Eye swelling
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Gastrointestinal disorders
    Nausea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    2
    Diarrhoea
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    3 / 35 (8.57%)
         occurrences all number
    3
    Constipation
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    10 / 35 (28.57%)
         occurrences all number
    10
    Abdominal pain
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    5 / 35 (14.29%)
         occurrences all number
    5
    Abdominal distension
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    4
    Vomiting
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    8 / 35 (22.86%)
         occurrences all number
    11
    Toothache
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Hepatobiliary disorders
    Retrograde portal vein flow
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Skin and subcutaneous tissue disorders
    Erythema
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Rash
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    2 / 35 (5.71%)
         occurrences all number
    4
    Renal and urinary disorders
    Bladder dilatation
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Polyuria
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Pain in extremity
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Muscle twitching
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Infections and infestations
    Clostridium difficile infection
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Enterobacter infection
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Influenza
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Metabolism and nutrition disorders
    Hypokalaemia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Hypomagnesaemia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1
    Hypophagia
    alternative dictionary used: MedDRA 19.0
         subjects affected / exposed
    1 / 35 (2.86%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    26 Oct 2017
    The overall rationale for the amendment-1 was to remove post-surgery lab tests.
    05 Feb 2018
    The overall rationale for the amendment-2 was to update the re-instate post-surgery lab tests per food and drug administration (FDA) request.
    12 Dec 2019
    The overall rationale for the amendment-3 was to addition of OUS (United Kingdom sites) – Not implemented in UK.
    12 May 2020
    The overall rationale for the amendment-4 was to update that 30-day follow-up (FU) visit could be by telephone (need for physical exam removed). The per protocol (PP) set should only exclude intent-to-treat (ITT) participants with major protocol deviations affecting the primary effectiveness endpoint, instead of all participants with major protocol deviations.
    23 Jul 2021
    The overall rationale for the amendment-5 was to exclude participants who received a coronavirus disease (COVID) vaccine within 4 weeks of surgery, or scheduled to have in follow-up period.
    02 Nov 2023
    The overall rationale for the amendment-6 was to remove age stratification (to allow participants less than [<] 1 year to be included at any stage of enrolment, not just final 4 participants).

    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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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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