Clinical Trial Page

Clinical Trial Results:
Open, multicentre study on the equivalent efficacy and safety of Botulinum toxin A (500 Units Dysport®) in the treatment of heterogeneous forms of cervical dystonia

Summary
EudraCT number
2004-002086-20
Trial protocol
AT  
Global end of trial date
04 Apr 2008

Results information
Results version number
v1(current)
This version publication date
11 Mar 2016
First version publication date
11 Mar 2016
Other versions

Trial information

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Trial identification
Sponsor protocol code
A-94-52120-098
Additional study identifiers
ISRCTN number
-
US NCT number
-
WHO universal trial number (UTN)
-
Sponsors
Sponsor organisation name
IPSEN PHARMA GmbH
Sponsor organisation address
Willy-Brandt-Straße 3, Ettlingen, Germany, D-76275
Public contact
Medical Director, Neurology, Ipsen, clinical.trials@ipsen.com
Scientific contact
Medical Director, Neurology, Ipsen, clinical.trials@ipsen.com
Paediatric regulatory details
Is trial part of an agreed paediatric investigation plan (PIP)
No
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Results analysis stage
Analysis stage
Final
Date of interim/final analysis
22 Dec 2009
Is this the analysis of the primary completion data?
Yes
Primary completion date
04 Feb 2008
Global end of trial reached?
Yes
Global end of trial date
04 Apr 2008
Was the trial ended prematurely?
No
General information about the trial
Main objective of the trial
The results of a dose finding study have shown that 500 units Dysport® are the optimal starting dose for the treatment of patients with rotational torticollis. Although Dysport is an established first-line neurological treatment for cervical dystonia since its registration in Germany in 1995, there are only little data available on dose, efficacy and safety in the treatment of heterogeneous forms of cervical dystonia. The aim of this multicentre open study is to demonstrate the equivalent efficacy and safety in the treatment of the two most frequent forms of cervical dystonia (predominantly rotational torticollis and predominantly laterocollis) with the standard initial dose of 500 units Dysport.
Protection of trial subjects
This clinical study was designed and implemented and reported in accordance with the International Conference on Harmonization (ICH) Harmonized Tripartite Guidelines for Good Clinical Practice (GCP), with applicable local regulations(including European Directive 2001/20/EC), and with the ethical principles laid down in the Declaration of Helsinki. The clinical trial was performed taking into account the German Medicinal Product Act (AMG). The study was submitted to the Federal Institute for Drugs and Medical Devices (BfArM) and to the responsible regulatory authorities. The patients participating in the study were insured in accordance with the provisions of the German Drug Law (AMG, in particular §40 paragraph 3).
Background therapy
-
Evidence for comparator
-
Actual start date of recruitment
28 Oct 2004
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
Austria: 16
Country: Number of subjects enrolled
Germany: 500
Worldwide total number of subjects
516
EEA total number of subjects
516
Number of subjects enrolled per age group
In utero
0
Preterm newborn - gestational age
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)
409
From 65 to 84 years
106
85 years and over
1

Subject disposition

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Recruitment
Recruitment details
First subject enrolled on 28October2004. To conduct the study 105 German and 5 Austrian centres were selected.

Pre-assignment
Screening details
516 Subjects were enrolled to study. Due to non-availability of safety data, one subject was excluded. The Intention-To-Treat population (ITT) consisted of 515 subjects.

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

Arms
Arm title
Dysport 500 units
Arm description
Predominantly rotatory torticollis & Laterocollis: treatment with a single dose of 500 units Dysport®
Arm type
Experimental

Investigational medicinal product name
Dysport
Investigational medicinal product code
Other name
Clostridium botulinum Toxin Type A
Pharmaceutical forms
Powder for injection
Routes of administration
Intramuscular use
Dosage and administration details
A single injection with 500 units Dysport®, diluted in 2.5 ml 0.9 % NaCl (= 200 units / ml), administered by intramuscular injections according to an injection protocol with optional follow-up injection at week 12.

Number of subjects in period 1 [1]
Dysport 500 units
Started
515
Completed
489
Not completed
26
     Lack of efficacy
2
     Discontinuation of drug therapy by investigator
1
     Unspecified
7
     Consent withdrawn by subject
1
     Insufficient compliance
6
     Lost to follow-up
9
Notes
[1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
Justification: Worldwide numbers reported are per all treated 516 subjects. However, baseline period is per 515 Safety population subjects (includes all patients who received the study medication and for whom any safety data were recorded). Due to non-availability of safety data one subject was excluded from safety population.

Baseline characteristics

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Baseline characteristics reporting groups
Reporting group title
Dysport 500 units
Reporting group description
Predominantly rotatory torticollis & Laterocollis: treatment with a single dose of 500 units Dysport®

Reporting group values
Dysport 500 units Total
Number of subjects
515 515
Age categorical
Units: Subjects
    < 30
24 24
    30 to < 40
60 60
    40 to < 50
147 147
    50 to < 60
126 126
    60 to < 70
112 112
    70 to < 80
43 43
    ≥ 80
3 3
Age continuous
Units: years
    arithmetic mean (standard deviation)
51.9 ± 12.7 -
Gender categorical
Units: Subjects
    Female
353 353
    Male
162 162
Race
Units: Subjects
    Caucasian
511 511
    Asian
1 1
    Oriental
3 3
BMI
The Safety population includes all patients who received the study medication and for whom any safety data were recorded n=510, Body mass index (BMI)
Units: kg/m²
    arithmetic mean (standard deviation)
25.3 ± 4.4 -

End points

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End points reporting groups
Reporting group title
Dysport 500 units
Reporting group description
Predominantly rotatory torticollis & Laterocollis: treatment with a single dose of 500 units Dysport®

Subject analysis set title
Treatment Group: Rotatory torticollis
Subject analysis set type
Sub-group analysis
Subject analysis set description
Rotatory torticollis is a subset group

Subject analysis set title
Treatment Group: Laterocollis
Subject analysis set type
Sub-group analysis
Subject analysis set description
Laterocollis is a subset group

Primary: Change from baseline in the total score of the Tsui rating scale (patient in sitting position)

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End point title
Change from baseline in the total score of the Tsui rating scale (patient in sitting position)
End point description
The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores: • Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0–9 points) • Subscore B: duration of movement (values 1 or 2) • Subscore C: severity and duration of shoulder elevation (range: 0–3 points) • Subscore D: severity and duration of tremor (range: 0–4 points) The total score was to be calculated as follows: total score = subscores (A x B) + C + D The total score ranges between 0 and 25 points. A high (low) total score represents severe (mild) CD. The ITT population includes all patients of the Safety population with a baseline (visit 1, week 0) and a post-baseline (visit 2, week 4 or visit 3, week 12) assessment of the Tsui rating scale.
End point type
Primary
End point timeframe
From Baseline (visit 1) to the first on-treatment visit [visit 2 (week 4)/visit 3 (week 12)]
End point values
Dysport 500 units Treatment Group: Rotatory torticollis Treatment Group: Laterocollis
Number of subjects analysed
503
396
107
Units: Score of the Tsui rating scale
arithmetic mean (standard deviation)
    Baseline (V1)
8.4 ± 3.5
8.4 ± 3.5
8.3 ± 3.3
    First on-treatment measurement (V2/V1)
4.6 ± 3.1
4.6 ± 3.2
4.3 ± 2.6
    First on-treatment measurement - Baseline (V2-V1)
-3.8 ± 3.1
-3.8 ± 3.3
-4 ± 2.6
Statistical analysis title
Rotatory torticollis vs Laterocollis
Statistical analysis description
ANCOVA model includes the baseline total Tsui score (patient in sitting position) as covariate (p < 0.0001) and the main type of CD as between-group factor (due to non-significance the interaction between baseline total Tsui score and the main type of CD was removed from the model)
Comparison groups
Treatment Group: Rotatory torticollis v Treatment Group: Laterocollis
Number of subjects included in analysis
503
Analysis specification
Pre-specified
Analysis type
other [1]
P-value
= 0.2552
Method
ANCOVA
Confidence interval
Notes
[1] - Exploratory analysis

Secondary: Tsui subscores (patient in sitting position)

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End point title
Tsui subscores (patient in sitting position)
End point description
The Tsui rating scale measures severity and duration of head deviation, shoulder elevation and head tremor. This instrument is based on 4 subscores: • Subscore A: amplitude of rotation, deflection (tilt) and ante- / retrocollis (range: 0–9 points) • Subscore B: duration of movement (values 1 or 2) • Subscore C: severity and duration of shoulder elevation (range: 0–3 points) • Subscore D: severity and duration of tremor (range: 0–4 points) The total score was to be calculated as follows: total score = subscores (A x B) + C + D The total score ranges between 0 and 25 points. A high (low) total score represents severe (mild) CD. The ITT population includes all patients of the Safety population with a baseline (visit 1, week 0) and a post-baseline (visit 2, week 4 or visit 3, week 12) assessment of the Tsui rating scale.
End point type
Secondary
End point timeframe
At Baseline (visit 1), first on-treatment visit [visit 2 (week 4) / visit 3 (week 12)], V2 minus V1, V3 minus V1
End point values
Dysport 500 units
Number of subjects analysed
503
Units: score of the Tsui rating scale
arithmetic mean (standard deviation)
    Subscore A: V1 (n=396)
3.5 ± 1.4
    Subscore A: V2 (n=394)
2.2 ± 1.4
    Subscore A: V3 (n=386)
2.7 ± 1.5
    Subscore A:V2 minus V1 (N= 500)
-1.4 ± 1.3
    Subscore A:V3 minus V1 (N= 490)
-0.8 ± 1.3
    Subscore B: V1 (n=396)
1.8 ± 0.4
    Subscore B: V2 (n=394)
1.4 ± 0.6
    Subscore B: V3 (n=386)
1.6 ± 0.5
    Subscore B:V2 minus V1 (N= 500)
-0.3 ± 0.6
    Subscore B:V3 minus V1 (N= 490)
-0.2 ± 0.5
    Subscore c: V1 (n=396)
0.9 ± 0.9
    Subscore C: V2 (n=394)
0.6 ± 0.8
    Subscore C: V3 (n=386)
0.7 ± 0.8
    Subscore C:V2 minus V1 (N= 500)
-0.4 ± 0.8
    Subscore C:V3 minus V1 (N= 490)
-0.2 ± 0.8
    Subscore D: V1 (n= 396)
1.2 ± 1.3
    Subscore D: V2 (n=394)
0.6 ± 0.7
    Subscore D: V3 (n= 386)
0.8 ± 0.9
    Subscore D:V2 minus V1 (N= 500)
-0.6 ± 1
    Subscore D:V3 minus V1 (N= 490)
-0.4 ± 0.9
No statistical analyses for this end point

Secondary: Change from baseline in CDQ total score and subscores

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End point title
Change from baseline in CDQ total score and subscores
End point description
The Craniocervical Dystonia Questionnaire (CDQ-24) is a disease-specific QoL instrument and was to be assessed at visits 1 to 3. It consists of 24 items investigating problems in daily living skills related to CD. This instrument is based on 5 subscales: • Stigma (items 7, 8, 9, 10, 18, 22) • Emotional well-being (items 11, 12, 13, 14, 15) • Pain (items 4, 5, 21) • Activities of daily living (ADL, items 1, 2, 3, 6, 19, 20) • Social / family life (items 16, 17, 23, 24) There are five possible answers to each item representing increasing severity of impairment (scores 0 to 4). In order to obtain scores of the individual subscales, the total score of each subscale (sum of the individual item scores) was transformed linearly to a 0 to 100 scale, where a score of 0 indicates the best The ITT population includes all patients of the Safety population with a baseline (visit 1, week 0) and a post-baseline (visit 2, week 4 or visit 3, week 12) assessment of the Tsui rating scale.
End point type
Secondary
End point timeframe
From Baseline (visit 1) to visit 2 (week 4), visit 3 (week 12).
End point values
Dysport 500 units
Number of subjects analysed
503
Units: Units on a scale
arithmetic mean (standard deviation)
    Total score: V2 minus V1 (N=484)
-11.1 ± 16.1
    Total score: V3 minus V1 (N=474)
-11.8 ± 14.6
    Stigma: V2 minus V1 (N=485)
-16.8 ± 24
    Stigma: V3 minus V1 (N=476)
-16.4 ± 22.5
    Emotional well-being: V2 minus V1 (N=485)
-10.3 ± 19.9
    Emotional well-being: V3 minus V1 (N=476)
-11.1 ± 18.7
    Pain: V2 minus V1 (N=491)
-11.5 ± 27.8
    Pain: V3 minus V1 (N=484)
-13.2 ± 25.5
    Activities of daily living: V2 minus V1 (N=483)
-11.1 ± 19.6
    Activities of daily living: V3 minus V1 (N=474)
-12.5 ± 18.6
    Social / family life: V2 minus V1 (N=481)
-5.6 ± 17.9
    Social / family life: V3 minus V1 (N=469)
-6.7 ± 17.8
No statistical analyses for this end point

Secondary: Change from baseline in the items of the patient dairy based on Day-to-day functions and activities, Pain and duration of pain.

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End point title
Change from baseline in the items of the patient dairy based on Day-to-day functions and activities, Pain and duration of pain.
End point description
The ITT population includes all patients of the Safety population with a baseline (visit 1, week 0) and a post-baseline (visit 2, week 4 or visit 3, week 12) assessment of the Tsui rating scale. The weekly recorded patient diary consists of the three items “Day-to-Day Capacities and Activities”, “Pain” and “Duration of Pain”. Each item was rated by the patient on an 11-point scale ranging from 0 = no problems at all to 10 = most severe problems (the actual wording is adapted to each item in question).
End point type
Secondary
End point timeframe
From Baseline (visit 1) to visit 2 (week 4), visit 3 (week 12).
End point values
Dysport 500 units
Number of subjects analysed
503
Units: Units on a scale
arithmetic mean (standard deviation)
    Day-to-day functions & activities: W4-W0 (N=454)
-1.1 ± 3
    Day-to-day functions & activities: W12-W0 (N=384)
-1.1 ± 2.6
    Pain: W4-W0 (N= 452)
-0.8 ± 2.7
    Pain: W12-W0 (N=383)
-0.9 ± 2.5
    Duration of pain: W4-W0 (N=451)
-1.2 ± 2.9
    Duration of pain: W12-W0 (N=382)
-1.3 ± 2.7
No statistical analyses for this end point

Secondary: Number of subjects without pain and/or with a pain reduction based on Global assessment of pain by investigator and patient

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End point title
Number of subjects without pain and/or with a pain reduction based on Global assessment of pain by investigator and patient
End point description
The ITT population includes all patients of the Safety population with a baseline (visit 1, week 0) and a post-baseline (visit 2, week 4 or visit 3, week 12) assessment of the Tsui rating scale. At visits 2 and 3 investigators and patients had to assess change of global pain according to the following response categories: 1 = no pain (anymore) 2 = less pain 3 = no change 4 = more pain
End point type
Secondary
End point timeframe
'Visits 2 and 3 by Investigator and Visits 2 and 3 by Patient'
End point values
Dysport 500 units
Number of subjects analysed
503
Units: number of patients
    Investigator: No pain V2
131
    Investigator: No pain V3
142
    Investigator: Less pain V2
205
    Investigator: Less pain V3
227
    Investigator: No change V2
94
    Investigator: No change V3
87
    Investigator: More pain V2
70
    Investigator: More pain V3
33
    Patient: No pain V2
128
    Patient: No pain V3
132
    Patient: Less pain V2
202
    Patient: Less pain V3
231
    Patient: No change V2
82
    Patient: No change V3
83
    Patient: More pain V2
88
    Patient: More pain V3
44
No statistical analyses for this end point

Adverse events

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Adverse events information
Timeframe for reporting adverse events
Up to week 12
Adverse event reporting additional description
Treatment with a single dose of 500 units Dysport®
Assessment type
Systematic
Dictionary used for adverse event reporting
Dictionary name
MedDRA
Dictionary version
9.1
Reporting groups
Reporting group title
Dysport 500 units
Reporting group description
'Treatment with a single dose of 500 units Dysport®' as suggested by study team and highlight the change.

Serious adverse events
Dysport 500 units
Total subjects affected by serious adverse events
     subjects affected / exposed
11 / 515 (2.14%)
     number of deaths (all causes)
0
     number of deaths resulting from adverse events
0
Injury, poisoning and procedural complications
Ankle fracture
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Fall
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Femur fracture
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung adenocarcinoma
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Cardiac disorders
Bradycardia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
1 / 1
     deaths causally related to treatment / all
0 / 0
Cardiac failure
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Coronary artery disease
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Myocardial infarction
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Respiratory, thoracic and mediastinal disorders
Pulmonary congestion
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Nervous system disorders
Syncope
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
1 / 1
     deaths causally related to treatment / all
0 / 0
Eye disorders
Blindness
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Psychiatric disorders
Apathy
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Depression
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences causally related to treatment / all
1 / 2
     deaths causally related to treatment / all
0 / 0
Gastrointestinal disorders
Peritonitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Musculoskeletal and connective tissue disorders
Muscular weakness
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences causally related to treatment / all
1 / 2
     deaths causally related to treatment / all
0 / 0
Infections and infestations
Appendicitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences causally related to treatment / all
0 / 1
     deaths causally related to treatment / all
0 / 0
Pneumonia
     subjects affected / exposed
1 / 515 (0.19%)
     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
Dysport 500 units
Total subjects affected by non serious adverse events
     subjects affected / exposed
206 / 515 (40.00%)
Vascular disorders
Circulatory collapse
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Hypertension
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
4
Orthostatic hypotension
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Thrombophlebitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Surgical and medical procedures
Limb operation
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
General disorders and administration site conditions
Asthenia
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Facial pain
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Fatigue
     subjects affected / exposed
6 / 515 (1.17%)
     occurrences all number
6
Gait disturbance
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
General physical health deterioration
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Influenza like illness
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Injection site pain
     subjects affected / exposed
7 / 515 (1.36%)
     occurrences all number
7
Injection site paraesthesia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Local swelling
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Malaise
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Oedema peripheral
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Sensation of foreign body
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Thirst
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Psychiatric disorders
Anxiety
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Anxiety disorder
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Conversion disorder
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Depression
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Initial insomnia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Middle insomnia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Panic attack
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Psychotic disorder
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Restlessness
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Investigations
Blood pressure diastolic increased
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Blood pressure increased
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Blood pressure orthostatic abnormal
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Cardiac disorders
Angina pectoris
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Coronary artery disease
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Tachycardia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Respiratory, thoracic and mediastinal disorders
Asthma
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Cough
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Dyspnoea
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Rhinitis allergic
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Throat irritation
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Nervous system disorders
Burning sensation
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
4
Cervical root pain
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Disturbance in attention
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Dizziness
     subjects affected / exposed
12 / 515 (2.33%)
     occurrences all number
13
Dysarthria
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
4
Head discomfort
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Head titubation
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
2
Headache
     subjects affected / exposed
17 / 515 (3.30%)
     occurrences all number
21
Hypoaesthesia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Mastication disorder
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Migraine
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Neuritis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Paraesthesia
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
4
Paralysis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Paresis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Restless legs syndrome
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Speech disorder
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Tongue paralysis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Tremor
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Eye disorders
Blepharitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Dry eye
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Eyelid ptosis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Glaucoma
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Keratoconjunctivitis sicca
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Vision blurred
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Ear and labyrinth disorders
Sudden hearing loss
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Tinnitus
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Vertigo
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
5
Gastrointestinal disorders
Abdominal discomfort
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Abdominal pain upper
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Constipation
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Dental caries
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Diarrhoea
     subjects affected / exposed
4 / 515 (0.78%)
     occurrences all number
4
Dry mouth
     subjects affected / exposed
6 / 515 (1.17%)
     occurrences all number
6
Dysphagia
     subjects affected / exposed
51 / 515 (9.90%)
     occurrences all number
51
Gastritis
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Gastrointestinal pain
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Nausea
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Toothache
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Vomiting
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Renal and urinary disorders
Dysuria
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Haematuria
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Nephritis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Skin and subcutaneous tissue disorders
Alopecia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Eczema
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
2
Hyperhidrosis
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Pruritus
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Pruritus generalised
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Rash
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
3
Urticaria
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Musculoskeletal and connective tissue disorders
Arthralgia
     subjects affected / exposed
5 / 515 (0.97%)
     occurrences all number
5
Arthritis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Back pain
     subjects affected / exposed
8 / 515 (1.55%)
     occurrences all number
8
Bursitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Joint range of motion decreased
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Joint stiffness
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Muscle spasms
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Muscular weakness
     subjects affected / exposed
70 / 515 (13.59%)
     occurrences all number
70
Musculoskeletal discomfort
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Musculoskeletal disorder
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Musculoskeletal pain
     subjects affected / exposed
12 / 515 (2.33%)
     occurrences all number
9
Musculoskeletal stiffness
     subjects affected / exposed
5 / 515 (0.97%)
     occurrences all number
5
Myalgia
     subjects affected / exposed
8 / 515 (1.55%)
     occurrences all number
9
Neck pain
     subjects affected / exposed
34 / 515 (6.60%)
     occurrences all number
35
Osteoarthritis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
2
Pain in extremity
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
4
Pain in jaw
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Trismus
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Endocrine disorders
Goitre
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Metabolism and nutrition disorders
Hypercholesterolaemia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Hypokalaemia
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Infections and infestations
Acute tonsillitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Bronchitis
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Cystitis
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
3
Device related infection
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Eye infection viral
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Herpes simplex
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Herpes zoster
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Hordeolum
     subjects affected / exposed
2 / 515 (0.39%)
     occurrences all number
2
Laryngitis
     subjects affected / exposed
3 / 515 (0.58%)
     occurrences all number
4
Nasopharyngitis
     subjects affected / exposed
19 / 515 (3.69%)
     occurrences all number
20
Otitis media
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Pneumonia bacterial
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Respiratory tract infection
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Rhinitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
2
Sinusitis
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Upper respiratory tract infection
     subjects affected / exposed
1 / 515 (0.19%)
     occurrences all number
1
Vulvovaginal mycotic infection
     subjects affected / exposed
1 / 515 (0.19%)
     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
30 Mar 2006
Amendments to the study protocol leading to new versions of the study protocol contains :- • Duration of the study : Approx. 3.5 years. • Data Monitoring : A statistical data review will be performed after completion of the first 200 patients. In accordance with the ICH E9 Guideline, Item 4.1, a so-called "Trial Monitoring" or "Data Monitoring" is recommended to evaluate and confirm the quality of the conduct of the study. To prevent jeopardizing the power of the study and/or bias, no efficacy data will be analyzed and no analyses stratified by indication group will be performed. Only initial values, demographic data, distribution of indication groups, protocol violations, withdrawal rate etc, will be descriptively analyzed. Safety data, that is adverse events, will be encoded according to MedDRA, version 9.0, and appropriately analyzed.

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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