An Efficacy Study of Teriflunomide in Participants With R... | NCT00751881 | Trialant
NCT00751881
Sponsor
Sanofi
Status
Completed
Last Update Posted
Jul 7, 2016Estimated
Enrollment
1,169Actual
Phase
Phase 3
Conditions
Multiple Sclerosis
Interventions
Placebo
Teriflunomide
Countries
United States
Australia
Austria
Belarus
Belgium
Canada
Chile
China
Czechia
Estonia
France
Germany
Greece
Mexico
Netherlands
Philippines
Poland
Romania
Slovakia
Spain
Sweden
Thailand
Tunisia
Turkey (Türkiye)
Ukraine
United Kingdom
Protocol Section
Identification Module
NCT ID
NCT00751881
Obsolete or Duplicate NCT IDs
Not provided
Organization Study
EFC10531
Secondary IDs
ID
Type
Description
Link
2007-004452-36
EudraCT Number
Brief Title
An Efficacy Study of Teriflunomide in Participants With Relapsing Multiple Sclerosis
Official Title
A Multi-center Double-blind Parallel-group Placebo-controlled Study of the Efficacy and Safety of Teriflunomide in Patients With Relapsing Multiple Sclerosis
Acronym
TOWER
Organization
SanofiINDUSTRY
Status Module
Record Verification Date
May 2016
Overall Recruitment Status or Expanded Access Status
Completed
Last Known Status
Not provided
Delayed Posting
Not provided
Why Stopped
Not provided
Expanded Access Info
No
Start Date
Aug 2008
Primary Completion Date
Apr 2012Actual
Completion Date
Aug 2015Actual
First Submitted Date
May 7, 2008
First Submission Date that Met QC Criteria
Sep 11, 2008
First Posted Date
Sep 12, 2008Estimated
Results Waived
Not provided
Results First Submitted Date
Apr 16, 2013
Results First Submitted that Met QC Criteria
Jun 24, 2013
Results First Posted Date
Jun 26, 2013Estimated
Certification/Extension (aka Delayed Results) First Submitted Date
Not provided
Certification/Extension First Submitted that Passed QC Review
Not provided
Certification/Extension First Posted Date
Not provided
Last Update Submitted Date
May 27, 2016
Last Update Posted Date
Jul 7, 2016Estimated
Sponsor/Collaborators Module
Responsible Party, by Official Title
Sponsor
Lead Sponsor
SanofiINDUSTRY
Collaborators
Not provided
Oversight Module
Has Data Monitoring Committee (DMC)
Yes
Is FDA Regulated Drug
Not provided
Is FDA Regulated Device
Not provided
Is Unapproved Device
Not provided
Pediatric Postmarket Surveillance of a Device Product
Not provided
Product Exported from US
Not provided
FDAAA801 Violation
Not provided
Description Module
Brief Summary
The primary objective of the study was to assess the effect of two doses of teriflunomide, in comparison to placebo, on the frequency of multiple sclerosis (MS) relapses in participants with relapsing MS.
Key secondary objective was to assess the effect of the two doses of teriflunomide, in comparison to placebo, on disability progression.
Other secondary objectives were:
To assess the effect of the two doses of teriflunomide in comparison to placebo on:
Fatigue;
Health-related quality of life, a measure of the impact of the participant's health on his or her overall well being.
To evaluate the safety and tolerability of teriflunomide.
Detailed Description
The study consists of:
A core treatment period: Teriflunomide 7 mg or Teriflunomide 14 mg or placebo was administered in double-blind fashion until a fixed common end date which was approximately 48 weeks after randomization of the last participant.
An extension treatment period: the highest dose of teriflunomide was administered in open-label fashion to participants who successfully complete the core treatment period and wish to continue.
The overall treatment period was followed by a 4-week elimination follow-up period.
Conditions Module
Conditions
Multiple Sclerosis
Keywords
relapsing multiple sclerosis
Design Module
Study Type
Interventional
Number of References to an Expanded Access Study
Not provided
Expanded Access Types
Not provided
Patient Registry
Not provided
Target Follow-Up Duration
Not provided
Phases
Phase 3
Interventional Study Design
Allocation
Biospecimen
No data available
No data is available for this block.
Enrollment
1,169Actual
Arms/Interventions Module
Arm Groups
Label
Type
Description
Intervention Names
Teriflunomide 7 mg / 14 mg
Experimental
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
Drug: Teriflunomide
Teriflunomide 14 mg / 14 mg
Experimental
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
Drug: Teriflunomide
Placebo / Teriflunomide 14 mg
Placebo Comparator
Core treatment period: Placebo (for teriflunomide) once daily. Extension treatment period: Teriflunomide 14 mg once daily.
ARR is obtained from the total number of confirmed relapses that occurred during the treatment period divided by the sum of treatment durations.
Each episode of relapse - appearance, or worsening of a clinical symptom that was stable for at least 30 days, that persisted for a minimum of 24 hours in the absence of fever - was to be confirmed by an increase in Expanded Disability Status Scale (EDSS) score or Functional System scores.
To account for the different treatment durations among participants, a Poisson regression model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrollment and baseline EDSS stratum as covariates).
Core treatment period between 48 - 152 weeks depending on time of enrollment
Secondary Outcomes
Measure
Description
Time Frame
Core Treatment Period: Time to Disability Progression
Probability of disability progression at 24, 48, 108 and 132 weeks was estimated using Kaplan-Meier method on the time to disability progression defined as the time from randomization to first 12-week sustained disability progression [i.e. increase from baseline of at least 1 point in EDSS score (at least 0.5 point for participants with baseline EDSS score >5.5) that persisted for at least 12 weeks].
Participants free of disability progression (no disability progression observed on treatment) were censored at the date of the last on-treatment EDSS evaluation.
Kaplan-Meier method consists in computing probabilities of non occurrence of event at any observed time of event and multiplying successive probabilities for time ≤t by any earlier computed probabilities to estimate the probability of being event-free for the amount of time t. Probability of event at time t is 1 minus the probability of being event-free for the amount of time t.
Other Outcomes
Measure
Description
Time Frame
Core Treatment Period: Liver Function: Number of Participants With Potentially Clinically Significant Abnormalities (PCSA)
PCSA values are abnormal values considered medically important by the Sponsor according to predefined criteria based on literature review.
Hepatic parameters thresholds were defined as follows:
Alanine Aminotransferase (ALT) >3, 5, 10 or 20 upper limit of normal(ULN);
Aspartate aminotransferase (AST) >3, 5, 10 or 20 ULN;
Alkaline Phosphatase >1.5 ULN;
Total Bilirubin (TB) >1.5 or 2 ULN;
ALT >3 ULN and TB >2 ULN.
Eligibility Module
Eligibility Criteria
Inclusion Criteria:
Relapsing multiple sclerosis,
Two relapses in prior 2 years or one relapse in prior year.
Exclusion Criteria:
Clinically relevant cardiovascular, hepatic, neurological, endocrine or other major systemic disease,
Significantly impaired bone marrow function or, significant anemia, leukopenia or thrombocytopenia,
Pregnant or nursing woman,
Alcohol or drug abuse,
Prior or concomitant use of cladribine, mitoxantrone, or other immunosuppressant agents such as azathioprine, cyclophosphamide, cyclosporin, methotrexate or mycophenolate,
Human immunodeficiency virus (HIV) positive,
Any known condition or circumstance that would prevent, in the investigator's opinion, compliance or completion of the study.
The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.
Randomization was stratified by investigational site and Expanded Disability Status Scale (EDSS) score ≤3.5 or >3.5). Assignment to groups was done using an Interactive Voice Response System(IVRS) in 1:1:1 ratio. 1169 participants were randomized at 190 sites. 780 participants completed core treatment period and 751 were treated in extension study.
Recruitment Details
A total of 1493 participants were screened at 193 sites in 26 countries. The common end date for core treatment period was on 17 April 2012 (maximum treatment duration of 173 weeks). The extension study was completed on 18 June 2015 (maximum treatment duration was 174 weeks in addition to core treatment period).
Type of Units Analyzed
Not provided
Arm/Group Information
ID
Title
Description
FG000
Placebo / Teriflunomide 14 mg
Core treatment period: Placebo (for teriflunomide) once daily. Extension treatment period: Teriflunomide 14 mg once daily.
FG001
Teriflunomide 7 mg / 14 mg
Periods
Title
Milestones
Reasons Not Completed
Core Treatment Period
Type
Comment
Milestone Data
STARTED
Baseline Characteristics Module
Baseline Analysis Population Description
Not provided
Outcome Measures Module
Outcome Measures
Adverse Events Module
Frequency Threshold
5
More Info Module
Limitations and Caveats
Not provided
Annotation Section
No data available
No data is available for this block.
Document Section
No data available
No data is available for this block.
Derived Section
Miscellaneous Info Module
Version Holder
Jul 10, 2026
Removed Countries
South Africa
Submission Tracking
No data available
No data is available for this block.
Condition Browse Module
MeSH Terms
Intervention Browse Module
MeSH Terms
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Not provided
Primary Purpose
Treatment
Observational Model
Not provided
Time Perspective
Not provided
Masking Info
Masking
Triple
Masking Description
Not provided
Who Masked
ParticipantInvestigatorOutcomes Assessor
Teriflunomide
Drug
Film-coated tablet
Oral administration
Placebo / Teriflunomide 14 mg
Teriflunomide 14 mg / 14 mg
Teriflunomide 7 mg / 14 mg
HMR1726
Core treatment period between 48 - 152 weeks depending on time of enrollment
Core Treatment Period: Time Without Relapse
Probability of no relapse at 24, 48, 108 and 132 weeks was estimated using Kaplan-Meier method on the time to relapse defined as the time from randomization to first EDSS confirmed relapse.
Participants free of confirmed relapse (no EDSS confirmed relapse observed on treatment) were censored at the date of the last study drug intake.
Core treatment period between 48 - 152 weeks depending on time of enrollment
Core Treatment Period: Change From Baseline to Week 48 in EDSS Total Score
EDSS is an ordinal scale in half-point increments that qualifies disability in participants with MS. It consists of 8 ordinal rating scales assessing 7 functional systems (visual, brainstem, pyramidal, cerebellar, sensory, bowel/bladder and cerebral) as well as ambulation.
EDSS total score ranges from 0 (normal neurological examination) to 10 (death due to MS).
Baseline adjusted least-squares means at Week 48 were estimated using a Mixed-effect model with repeated measures (MMRM) on EDSS score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Core Treatment Period: Change From Baseline to Week 48 in Fatigue Impact Scale (FIS) Total Score
FIS is a participants-reported scale that qualifies the impact of fatigue on daily life in participants with MS. It consists of 40 statements that measure fatigue in 3 areas; physical, cognitive, and social.
FIS total score ranges from 0 (no problem) to 160 (extreme problem).
Baseline adjusted least-squares means at week 48 were estimated using a Mixed-effect model with repeated measures (MMRM) on FIS total score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Baseline (before randomization), Week 12, Week 24 and Week 48
Core Treatment Period: Change From Baseline to Last Visit in Fatigue Impact Scale (FIS) Total Score
Baseline adjusted least-squares means at last visit were estimated using an analysis of covariance (ANCOVA) model on collected data for FIS total score (treatment group, region of enrollment, baseline EDSS stratum, visit number for the last visit and baseline value as factors).
Baseline (before randomization) and up to Week 152
Core Treatment Period: Change From Baseline to Week 48 in Short Form Generic Health Survey - 36 Items (SF-36) Summary Scores
SF-36 scale is a generic, self-administered, health-related quality-of-life (QOL) instrument. It is constructed such that the 36 questions represent 8 of the most important health concepts: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health.
Two summary scores are obtained:
the physical health component summary score,
the mental health component summary score.
Both scores range from 0 to 100 and a high score indicates a more favorable health state.
Baseline adjusted least-squares means at week 48 were estimated using a Mixed-effect model with repeated measures [MMRM] on each summary score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Baseline (before randomization), Week 12, Week 24 and Week 48
Core Treatment Period: Change From Baseline to Last Visit in Short Form Generic Health Survey - 36 Items (SF-36) Summary Scores
Baseline adjusted least-squares means at last visit were estimated using an analysis of covariance (ANCOVA) model on collected data for each summary score (treatment group, region of enrollment, baseline EDSS stratum, visit number for the last visit and baseline value as factors).
Baseline (before randomization) and up to Week 152
Core Treatment Period: Overview of Adverse Events
Adverse Events (AE) are any unfavorable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.
From first study drug intake up to 112 days after last intake in the core treatment period or up to first intake in the extension treatment period, whichever occurred first
Extension Treatment Period: Overview of Treatment Emergent Adverse Events (TEAE)
AEs were any unfavourable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.
From first intake of study drug in extension treatment period up to 28 days after the last intake in the extension treatment period
Extension Treatment Period: Time to Disability Progression
Probability of disability progression since the randomization of the core period was estimated using Kaplan-Meier method on the time to disability progression defined as the time from randomization to first 12 week sustained disability progression [i.e. increase from baseline of at least 1 point in EDSS score (at least 0.5 point for participants with baseline EDSS score >5.5) that persisted for at least 12 weeks].
Participants free of disability progression (no disability progression observed on treatment) were censored at the date of the last on-treatment EDSS evaluation.
Kaplan-Meier method consists in computing probabilities of non occurrence of event at any observed time of event and multiplying successive probabilities for time ≤t by any earlier computed probabilities to estimate the probability of being event free for the amount of time t. Probability of event at time t was 1 minus the probability of being event-free for the amount of time t.
Core treatment period (maximum: 173 weeks) and Extension treatment period (maximum: 174 weeks)
ARR was obtained from the total number of confirmed relapses that occurred during the treatment period divided by the sum of treatment durations. A relapse is defined as the appearance of a new clinical sign/symptom or clinical worsening of a previous sign/symptom (one that had been stable for at least 30 days) that persists for a minimum of 24 hours in the absence of fever. Relapse was confirmed by an increase in EDSS score or Functional System scores. To account for the different treatment durations among participants, a Poisson regression model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrolment and baseline EDSS stratum as covariates).
Extension treatment period (Maximum: 174 weeks)
From first study drug intake up to 112 days after last intake in the core treatment period or up to first intake in the extension treatment period, whichever occurred first
Comi G, Freedman MS, Meca-Lallana JE, Vermersch P, Kim BJ, Parajeles A, Edwards KR, Gold R, Korideck H, Chavin J, Poole EM, Coyle PK. Prior treatment status: impact on the efficacy and safety of teriflunomide in multiple sclerosis. BMC Neurol. 2020 Oct 6;20(1):364. doi: 10.1186/s12883-020-01937-4.
Miller AE, Olsson TP, Wolinsky JS, Comi G, Kappos L, Hu X, Xu X, Lublin AL, Truffinet P, Chavin J, Delhay JL, Benamor M, Purvis A, Freedman MS; TOWER investigators. Long-term safety and efficacy of teriflunomide in patients with relapsing multiple sclerosis: Results from the TOWER extension study. Mult Scler Relat Disord. 2020 Nov;46:102438. doi: 10.1016/j.msard.2020.102438. Epub 2020 Aug 1.
Qiu W, Huang DH, Hou SF, Zhang MN, Jin T, Dong HQ, Peng H, Zhang CD, Zhao G, Huang YN, Zhou D, Wu WP, Wang BJ, Li JM, Zhang XH, Cheng Y, Li HF, Li L, Lu CZ, Zhang X, Bu BT, Dong WL, Fan DS, Hu XQ, Xu XH; TOWER Trial Chinese Group. Efficacy and Safety of Teriflunomide in Chinese Patients with Relapsing Forms of Multiple Sclerosis: A Subgroup Analysis of the Phase 3 TOWER Study. Chin Med J (Engl). 2018 Dec 5;131(23):2776-2784. doi: 10.4103/0366-6999.246067.
Freedman MS, Morawski J, Thangavelu K. Clinical efficacy of teriflunomide over a fixed 2-year duration in the TOWER study. Mult Scler J Exp Transl Clin. 2018 May 16;4(2):2055217318775236. doi: 10.1177/2055217318775236. eCollection 2018 Apr-Jun.
Freedman MS, Wolinsky JS, Comi G, Kappos L, Olsson TP, Miller AE, Thangavelu K, Benamor M, Truffinet P, O'Connor PW; TEMSO and TOWER Study Groups. The efficacy of teriflunomide in patients who received prior disease-modifying treatments: Subgroup analyses of the teriflunomide phase 3 TEMSO and TOWER studies. Mult Scler. 2018 Apr;24(4):535-539. doi: 10.1177/1352458517695468. Epub 2017 Mar 17.
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
FG002
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
FG000389 subjectsRandomized
FG001408 subjectsRandomized
FG002372 subjectsRandomized
Treated
FG000388 subjects1 participant received teriflunomide 7 mg and 2 participants teriflunomide 14 mg (at least 1 dose)
FG001407 subjects1 participant received placebo (at least 1 dose)
FG002370 subjects1 participant received teriflunomide 7 mg and 1 participant placebo (at least 1 dose)
COMPLETED
FG000263 subjects
FG001273 subjects
FG002244 subjects
NOT COMPLETED
FG000126 subjects
FG001135 subjects
FG002128 subjects
Type
Comment
Reasons
Not treated
FG0001 subjects
FG0011 subjects
FG0022 subjects
Adverse Event
FG00026 subjects
FG00154 subjects
FG00258 subjects
Lack of Efficacy
FG00037 subjects
FG00130 subjects
FG00220 subjects
Poor compliance to protocol
FG00015 subjects
FG0013 subjects
FG0024 subjects
Lost to Follow-up
FG0006 subjects
FG0014 subjects
FG0023 subjects
Other: protocol deviation
FG0003 subjects
FG0013 subjects
FG0027 subjects
Other: wish to parent
FG0005 subjects
FG0017 subjects
FG0024 subjects
Other: personal/family constraints
FG0006 subjects
FG0017 subjects
FG00210 subjects
Other: MS treatment change
FG0006 subjects
FG0014 subjects
FG0024 subjects
Other: tolerability complaints
FG0002 subjects
FG0010 subjects
FG0020 subjects
Other:participant's decision/unspecified
FG00019 subjects
FG00122 subjects
FG00216 subjects
Extension Study Period
Type
Comment
Milestone Data
STARTED
FG000253 subjects10 participants completed core treatment period but did not enter in extension treatment period.
FG001265 subjects8 participants completed core treatment period but did not enter in extension treatment period.
FG002233 subjects11 participants completed core treatment period but did not enter in extension treatment period.
COMPLETED
FG000188 subjects
FG001194 subjects
FG002167 subjects
NOT COMPLETED
FG00065 subjects
FG00171 subjects
FG00266 subjects
Type
Comment
Reasons
Adverse Event
FG00018 subjects
FG00120 subjects
FG00221 subjects
Lack of Efficacy
FG000
Type of Units Analyzed
Not provided
Arm/Group Information
ID
Title
Description
BG000
Placebo / Teriflunomide 14 mg
Core treatment period: Placebo once daily. Extension treatment period: Teriflunomide 14 mg once daily.
BG001
Teriflunomide 7 mg / 14 mg
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
BG002
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
BG003
Total
Total of all reporting groups
Denominators
Units
Counts
Participants
BG000389
BG001408
BG002372
BG0031169
Baseline Measures
Title
Description
Population Description
Parameter Type
Dispersion Type
Unit of Measure
Calculate Percentage
Denominator Units Selected
Denominators
Classes
Age, Continuous
Mean
Standard Deviation
years
Title
Denominators
Categories
Title
Measurements
BG00038.1± 9.1
BG00137.4± 9.4
BG00238.2± 9.4
BG003
Sex: Female, Male
Count of Participants
Participants
Title
Denominators
Categories
Title
Measurements
Female
BG000273
BG001300
BG002
Region of Enrollment
Due to the small sample size in some countries, the countries were pooled as follows:
Western Europe and Africa: Austria, Belgium, France, Germany, Netherlands, Spain, Sweden and United Kingdom, Tunisia and Turkey
Asia and Australia: China, Philippines, Thailand and Australia
America: Canada, Chile, Mexico and the USA
Number
participants
Title
Denominators
Categories
Eastern Europe
Title
Measurements
BG000117
BG001
Time since first diagnosis of Multiple Sclerosis (MS)
The information was not available for one participant in the teriflunomide 14 mg group
Mean
Standard Deviation
years
Title
Denominators
Categories
Title
Measurements
BG0004.92± 5.66
BG0015.30± 5.45
Number of MS relapses
The information was not available for:
'Within the past year': 1 participant in the placebo group and 1 participant in the teriflunomide 14 mg group
'Within the past 2 years': 2 participants in the teriflunomide 14 mg group
Median
Full Range
relapses
Title
Denominators
Categories
Within the past year
Title
Measurements
BG0001(0 to 7)
BG001
Time since most recent MS relapse onset
The information was not available for one participant in the teriflunomide 14 mg group.
Mean
Standard Deviation
months
Title
Denominators
Categories
Title
Measurements
BG0005.29± 3.41
BG0015.18± 3.41
MS subtype
Number
participants
Title
Denominators
Categories
Relapsing Remitting
Title
Measurements
BG000379
BG001393
BG002
Baseline EDSS score
EDSS is an ordinal scale in half-point increments that qualifies disability in participants with MS. It consists of 8 ordinal rating scales assessing 7 functional systems (visual, brainstem, pyramidal, cerebellar, sensory, bowel/bladder and cerebral) as well as ambulation.
EDSS total score ranges from 0 (normal neurological examination) to 10 (death due to MS).
ARR is obtained from the total number of confirmed relapses that occurred during the treatment period divided by the sum of treatment durations.
Each episode of relapse - appearance, or worsening of a clinical symptom that was stable for at least 30 days, that persisted for a minimum of 24 hours in the absence of fever - was to be confirmed by an increase in Expanded Disability Status Scale (EDSS) score or Functional System scores.
To account for the different treatment durations among participants, a Poisson regression model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrollment and baseline EDSS stratum as covariates).
Intent-to-treat population: all randomized and treated participants. Participants were considered in the treatment group to which they were randomized regardless of the drug they actually received.
Posted
Number
95% Confidence Interval
relapses per year
Core treatment period between 48 - 152 weeks depending on time of enrollment
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Counts
Participants
OG000388
OG001407
OG002370
Title
Denominators
Categories
Title
Measurements
OG0000.501(0.432 to 0.581)
OG0010.389(0.332 to 0.457)
OG0020.319(0.267 to 0.381)
Group IDs
Group Description
Statistical Method
Statistical Comment
P-Value
P-Value Comment
Parameter Type
Parameter Value
Dispersion Type
Dispersion Value
Confidence Interval Sides
Confidence Interval %
CI Lower Limit
CI Upper Limit
CI Lower Limit Comment
CI Upper Limit Comment
Estimate Comment
Tested Non-Inferiority
Non-Inferiority Type
Non-Inferiority Comment
Other Analysis Description
OG000
OG002
Null hypothesis:
H1: No difference between teriflunomide 14 mg and placebo
H2: No difference between teriflunomide 7 mg and placebo
The study was sized to have 94% power to detect a 25% relative risk reduction in ARR with teriflunomide compared to placebo at a 2-sided 0.05 significance level.
Regression, Poisson
0.0001
Step down approach used to adjust for multiplicity:
H1 tested first
H2 tested only if the comparison H1 was statistically significant
A priori threshold for statistical significance for both comparisons ≤0.05
Relative risk reduction (%)
36.3
2-Sided
95
Relative risk reduction with teriflunomide 14 mg compared to placebo
No
Secondary
Core Treatment Period: Time to Disability Progression
Probability of disability progression at 24, 48, 108 and 132 weeks was estimated using Kaplan-Meier method on the time to disability progression defined as the time from randomization to first 12-week sustained disability progression [i.e. increase from baseline of at least 1 point in EDSS score (at least 0.5 point for participants with baseline EDSS score >5.5) that persisted for at least 12 weeks].
Participants free of disability progression (no disability progression observed on treatment) were censored at the date of the last on-treatment EDSS evaluation.
Kaplan-Meier method consists in computing probabilities of non occurrence of event at any observed time of event and multiplying successive probabilities for time ≤t by any earlier computed probabilities to estimate the probability of being event-free for the amount of time t. Probability of event at time t is 1 minus the probability of being event-free for the amount of time t.
Intent-to-treat population
Posted
Number
95% Confidence Interval
percent probability
Core treatment period between 48 - 152 weeks depending on time of enrollment
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Secondary
Core Treatment Period: Time Without Relapse
Probability of no relapse at 24, 48, 108 and 132 weeks was estimated using Kaplan-Meier method on the time to relapse defined as the time from randomization to first EDSS confirmed relapse.
Participants free of confirmed relapse (no EDSS confirmed relapse observed on treatment) were censored at the date of the last study drug intake.
Intent-to-treat population
Posted
Number
95% Confidence Interval
percent probability
Core treatment period between 48 - 152 weeks depending on time of enrollment
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Counts
Participants
Secondary
Core Treatment Period: Change From Baseline to Week 48 in EDSS Total Score
EDSS is an ordinal scale in half-point increments that qualifies disability in participants with MS. It consists of 8 ordinal rating scales assessing 7 functional systems (visual, brainstem, pyramidal, cerebellar, sensory, bowel/bladder and cerebral) as well as ambulation.
EDSS total score ranges from 0 (normal neurological examination) to 10 (death due to MS).
Baseline adjusted least-squares means at Week 48 were estimated using a Mixed-effect model with repeated measures (MMRM) on EDSS score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Core Treatment Period: Change From Baseline to Week 48 in Fatigue Impact Scale (FIS) Total Score
FIS is a participants-reported scale that qualifies the impact of fatigue on daily life in participants with MS. It consists of 40 statements that measure fatigue in 3 areas; physical, cognitive, and social.
FIS total score ranges from 0 (no problem) to 160 (extreme problem).
Baseline adjusted least-squares means at week 48 were estimated using a Mixed-effect model with repeated measures (MMRM) on FIS total score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Intent-to-treat population
Posted
Least Squares Mean
Standard Error
units on a scale
Baseline (before randomization), Week 12, Week 24 and Week 48
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Secondary
Core Treatment Period: Change From Baseline to Last Visit in Fatigue Impact Scale (FIS) Total Score
Baseline adjusted least-squares means at last visit were estimated using an analysis of covariance (ANCOVA) model on collected data for FIS total score (treatment group, region of enrollment, baseline EDSS stratum, visit number for the last visit and baseline value as factors).
Intent-to-treat population
Posted
Least Squares Mean
Standard Error
units on a scale
Baseline (before randomization) and up to Week 152
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Counts
Participants
Secondary
Core Treatment Period: Change From Baseline to Week 48 in Short Form Generic Health Survey - 36 Items (SF-36) Summary Scores
SF-36 scale is a generic, self-administered, health-related quality-of-life (QOL) instrument. It is constructed such that the 36 questions represent 8 of the most important health concepts: physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, and mental health.
Two summary scores are obtained:
the physical health component summary score,
the mental health component summary score.
Both scores range from 0 to 100 and a high score indicates a more favorable health state.
Baseline adjusted least-squares means at week 48 were estimated using a Mixed-effect model with repeated measures [MMRM] on each summary score data (treatment group, region of enrollment, baseline EDSS stratum, visit, treatment-by-visit interaction, baseline value, and baseline-by-visit interaction as factors). All the timepoints from randomization up to Week 48 were included in the model.
Intent-to-treat population
Posted
Least Squares Mean
Standard Error
units on a scale
Baseline (before randomization), Week 12, Week 24 and Week 48
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Secondary
Core Treatment Period: Change From Baseline to Last Visit in Short Form Generic Health Survey - 36 Items (SF-36) Summary Scores
Baseline adjusted least-squares means at last visit were estimated using an analysis of covariance (ANCOVA) model on collected data for each summary score (treatment group, region of enrollment, baseline EDSS stratum, visit number for the last visit and baseline value as factors).
Intent-to-treat population
Posted
Least Squares Mean
Standard Error
units on a scale
Baseline (before randomization) and up to Week 152
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Counts
Participants
Secondary
Core Treatment Period: Overview of Adverse Events
Adverse Events (AE) are any unfavorable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.
All randomized and treated participants. Participants were considered according to the drug actually received.
The 3 participants in the placebo group who received teriflunomide were analyzed according to the teriflunomide dose.
The participant in the teriflunomide 14 mg group who received 7 mg was analyzed in the teriflunomide 7 mg group.
Posted
Number
participants
From first study drug intake up to 112 days after last intake in the core treatment period or up to first intake in the extension treatment period, whichever occurred first
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Secondary
Extension Treatment Period: Overview of Treatment Emergent Adverse Events (TEAE)
AEs were any unfavourable and unintended sign, symptom, syndrome, or illness observed by the investigator or reported by the participant during the study.
Safety population: all randomized participants who received at least 1 dose of investigational product.
Two participants in placebo of core study received teriflunomide and were analyzed according to teriflunomide dose.
One participant in teriflunomide 14 mg in core study group who received 7 mg was analyzed in teriflunomide 7 mg group.
Posted
Number
participants
From first intake of study drug in extension treatment period up to 28 days after the last intake in the extension treatment period
ID
Title
Description
OG000
Placebo / Teriflunomide 14 mg
Core treatment period: Placebo once daily. Extension treatment period: Teriflunomide 14 mg once daily.
OG001
Teriflunomide 7 mg / 14 mg
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
OG002
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
Secondary
Extension Treatment Period: Time to Disability Progression
Probability of disability progression since the randomization of the core period was estimated using Kaplan-Meier method on the time to disability progression defined as the time from randomization to first 12 week sustained disability progression [i.e. increase from baseline of at least 1 point in EDSS score (at least 0.5 point for participants with baseline EDSS score >5.5) that persisted for at least 12 weeks].
Participants free of disability progression (no disability progression observed on treatment) were censored at the date of the last on-treatment EDSS evaluation.
Kaplan-Meier method consists in computing probabilities of non occurrence of event at any observed time of event and multiplying successive probabilities for time ≤t by any earlier computed probabilities to estimate the probability of being event free for the amount of time t. Probability of event at time t was 1 minus the probability of being event-free for the amount of time t.
ITT population for extension treatment period consists of all participants with a signed informed consent form for the extension and with a date of treatment allocated or recorded in the IVRS/IWRS database, regardless of whether the treatment was actually taken.
Posted
Number
95% Confidence Interval
percent probability
Core treatment period (maximum: 173 weeks) and Extension treatment period (maximum: 174 weeks)
ID
Title
Description
OG000
Placebo / Teriflunomide 14 mg
Core treatment period: Placebo once daily. Extension treatment period: Teriflunomide 14 mg once daily.
ARR was obtained from the total number of confirmed relapses that occurred during the treatment period divided by the sum of treatment durations. A relapse is defined as the appearance of a new clinical sign/symptom or clinical worsening of a previous sign/symptom (one that had been stable for at least 30 days) that persists for a minimum of 24 hours in the absence of fever. Relapse was confirmed by an increase in EDSS score or Functional System scores. To account for the different treatment durations among participants, a Poisson regression model with robust error variance was used (total number of confirmed relapses as response variable; log-transformed treatment duration as "offset" variable; treatment group, region of enrolment and baseline EDSS stratum as covariates).
ITT population for extension treatment period consists of all participants with a signed informed consent form for the extension and with a date of treatment allocated or recorded in the IVRS/IWRS database, regardless of whether the treatment was actually taken.
Posted
Number
95% Confidence Interval
relapses per year
Extension treatment period (Maximum: 174 weeks)
ID
Title
Description
OG000
Placebo / Teriflunomide 14 mg
Core treatment period: Placebo once daily. Extension treatment period: Teriflunomide 14 mg once daily.
OG001
Teriflunomide 7 mg / 14 mg
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
Other Pre-specified
Core Treatment Period: Liver Function: Number of Participants With Potentially Clinically Significant Abnormalities (PCSA)
PCSA values are abnormal values considered medically important by the Sponsor according to predefined criteria based on literature review.
Hepatic parameters thresholds were defined as follows:
Alanine Aminotransferase (ALT) >3, 5, 10 or 20 upper limit of normal(ULN);
Aspartate aminotransferase (AST) >3, 5, 10 or 20 ULN;
Alkaline Phosphatase >1.5 ULN;
Total Bilirubin (TB) >1.5 or 2 ULN;
ALT >3 ULN and TB >2 ULN.
All randomized and treated participants. Participants were considered according to the drug actually received.
The 3 participants in the placebo group who received teriflunomide were analyzed according to the teriflunomide dose.
The participant in the teriflunomide 14 mg group who received 7 mg was analyzed in the teriflunomide 7 mg group.
Posted
Number
participants
From first study drug intake up to 112 days after last intake in the core treatment period or up to first intake in the extension treatment period, whichever occurred first
ID
Title
Description
OG000
Placebo
Placebo once daily
OG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
OG002
Teriflunomide 14 mg
Time Frame
AEs were collected from signature of the Informed Consent Form up to the last visit (174 weeks) in the study.
Description
The analysis was performed on the safety population as previously defined and included all AE that developed or worsened and death that occurred during first intake of study drug in extension treatment period up to 28 days after the last intake in the extension study treatment period.
All-Cause Mortality Comment
Not provided
Arm/Groups
ID
Title
Description
Deaths (Affected)
Deaths (At Risk)
Serious Events (Affected)
Serious Events (At Risk)
Other Events (Affected)
Other Events (At Risk)
EG000
Placebo
Placebo once daily
47
385
247
385
EG001
Teriflunomide 7 mg
Teriflunomide 7 mg once daily
52
409
270
409
EG002
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
44
371
254
371
EG003
Placebo / 14 mg
Core treatment period: Placebo once daily. Extension treatment period: Teriflunomide 14 mg once daily
16
251
152
251
EG004
Teriflunomide 7 mg / 14 mg
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
33
267
153
267
EG005
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
29
233
138
233
Serious Adverse Events
Term
Organ System
Source Vocabulary
Assessment Type
Notes
Statistical Information
Bronchitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG0030 affected251 at risk
EG0040 affected267 at risk
EG0051 affected233 at risk
Dengue fever
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Furuncle
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Gastroenteritis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Abscess jaw
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Abscess soft tissue
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Appendiceal abscess
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Appendicitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Bacterial sepsis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Cellulitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Cytomegalovirus infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Diarrhoea infectious
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Endocarditis enterococcal
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Escherichia bacteraemia
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Hepatitis C
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Infected bites
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Influenza
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Lower respiratory tract infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Lung abscess
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Neuroborreliosis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Osteomyelitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Paronychia
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pelvic abscess
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Perichondritis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Peritonitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Pilonidal cyst
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Pneumonia
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Pneumonia bacterial
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Post procedural infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pulmonary tuberculosis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pyelonephritis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Pyelonephritis acute
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Respiratory tract infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Salpingo-oophoritis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Sepsis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Septic shock
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Staphylococcal bacteraemia
Infections and infestations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Staphylococcal infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Tonsillitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Tuberculosis gastrointestinal
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Urinary tract infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0002 affected385 at risk
EG0012 affected409 at risk
EG0022 affected371 at risk
EG003
Wound infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Breast cancer
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Papillary thyroid cancer
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Acoustic neuroma
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Invasive ductal breast carcinoma
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Invasive lobular breast carcinoma
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Lipoma
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Uterine leiomyoma
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0022 affected371 at risk
EG003
Microcytic anaemia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Anaemia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Autoimmune thrombocytopenia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Disseminated intravascular coagulation
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Lymphadenitis
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Neutropenia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0012 affected409 at risk
EG0023 affected371 at risk
EG003
Thrombocytopenia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Anaphylactic reaction
Immune system disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Adrenal insufficiency
Endocrine disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Goitre
Endocrine disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Dehydration
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Diabetes mellitus
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Hyperamylasaemia
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Hyperlipasaemia
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Obesity
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Type 1 diabetes mellitus
Metabolism and nutrition disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Completed suicide
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Suicide attempt
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0023 affected371 at risk
EG003
Anxiety
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Depression
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Major depression
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Mental disorder
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Schizophrenia
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Suicidal behaviour
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Suicidal ideation
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Cervicobrachial syndrome
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Multiple sclerosis relapse
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0002 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Partial seizures
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Sciatica
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Status epilepticus
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Carpal tunnel syndrome
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Coma
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Headache
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0003 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Hydrocephalus
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Hypoaesthesia
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Hypoglycaemic coma
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Intracranial aneurysm
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Intraventricular haemorrhage
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Neuropathy peripheral
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Polyneuropathy
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Seizure
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Somnolence
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Subarachnoid haemorrhage
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Syncope
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Vertebrobasilar insufficiency
Nervous system disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Tinnitus
Ear and labyrinth disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Vertigo
Ear and labyrinth disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Atrioventricular block complete
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Ventricular tachycardia
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Atrial fibrillation
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Coronary artery disease
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Coronary artery occlusion
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Myocardial infarction
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Pericardial effusion
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Sinus bradycardia
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Supraventricular tachycardia
Cardiac disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Blood pressure fluctuation
Vascular disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Hypertension
Vascular disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Shock haemorrhagic
Vascular disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Lung disorder
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Asthma
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0002 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Atelectasis
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Haemoptysis
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Lung consolidation
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pleural effusion
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pulmonary embolism
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Pulmonary hypertension
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Gastropleural fistula
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Haemorrhoids
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Intestinal obstruction
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Abdominal distension
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Abdominal pain
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Abdominal pain lower
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Abdominal pain upper
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Colitis ulcerative
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Diarrhoea
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Dysphagia
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Enterocolitis
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Gastric ulcer
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Gastric ulcer haemorrhage
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Gastritis
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Haematemesis
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Haematochezia
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Inguinal hernia
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pancreatitis
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pancreatitis acute
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Small intestinal obstruction
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Stress ulcer
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Vomiting
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Cholelithiasis
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Cholecystitis
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0003 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Cholecystitis acute
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Cholecystitis chronic
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Gallbladder perforation
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Hepatic dysplasia
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Hepatitis toxic
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Jaundice cholestatic
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Liver injury
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Non-alcoholic steatohepatitis
Hepatobiliary disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Angioedema
Skin and subcutaneous tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Foot deformity
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Fracture nonunion
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Intervertebral disc protrusion
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Knee deformity
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Back pain
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Muscle spasms
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Osteoarthritis
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Acute kidney injury
Renal and urinary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Glomerulonephritis chronic
Renal and urinary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Renal artery stenosis
Renal and urinary disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Renal cyst
Renal and urinary disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Ectopic pregnancy
Pregnancy, puerperium and perinatal conditions
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pregnancy
Pregnancy, puerperium and perinatal conditions
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Menorrhagia
Reproductive system and breast disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Benign prostatic hyperplasia
Reproductive system and breast disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Cervical dysplasia
Reproductive system and breast disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Menopausal symptoms
Reproductive system and breast disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Ovarian cyst
Reproductive system and breast disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Developmental hip dysplasia
Congenital, familial and genetic disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Choledochal cyst
Congenital, familial and genetic disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Congenital flat feet
Congenital, familial and genetic disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Asthenia
General disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
General physical health deterioration
General disorders
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pain
General disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Pyrexia
General disorders
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0012 affected409 at risk
EG0020 affected371 at risk
EG003
Alanine aminotransferase increased
Investigations
meddra-18.0
Systematic Assessment
EG0006 affected385 at risk
EG0016 affected409 at risk
EG0023 affected371 at risk
EG003
Amylase increased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Blood creatine phosphokinase increased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Activated partial thromboplastin time prolonged
Investigations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Aspartate aminotransferase increased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Gamma-glutamyltransferase increased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Hepatic enzyme increased
Investigations
meddra-18.0
Systematic Assessment
EG0002 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Liver function test abnormal
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0021 affected371 at risk
EG003
Neutrophil count decreased
Investigations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Platelet count decreased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Transaminases increased
Investigations
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Weight decreased
Investigations
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Intentional overdose
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Abdominal injury
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Ankle fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0021 affected371 at risk
EG003
Carbon monoxide poisoning
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Contusion
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Face injury
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Fall
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0002 affected385 at risk
EG0012 affected409 at risk
EG0020 affected371 at risk
EG003
Femoral neck fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Femur fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Foot fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Multiple fractures
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Post procedural bile leak
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Post procedural haemorrhage
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Postoperative fever
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Radius fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Road traffic accident
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0012 affected409 at risk
EG0020 affected371 at risk
EG003
Spinal compression fracture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0001 affected385 at risk
EG0010 affected409 at risk
EG0020 affected371 at risk
EG003
Splenic rupture
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Traumatic lung injury
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG0000 affected385 at risk
EG0011 affected409 at risk
EG0020 affected371 at risk
EG003
Other Adverse Events
Term
Organ System
Source Vocabulary
Assessment Type
Notes
Statistical Information
Nasopharyngitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG00065 affected385 at risk
EG00151 affected409 at risk
EG00244 affected371 at risk
EG00322 affected251 at risk
EG00421 affected267 at risk
EG00522 affected233 at risk
Influenza
Infections and infestations
meddra-18.0
Systematic Assessment
EG00019 affected385 at risk
EG00122 affected409 at risk
EG00222 affected371 at risk
EG003
Urinary tract infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG00036 affected385 at risk
EG00138 affected409 at risk
EG00226 affected371 at risk
EG003
Sinusitis
Infections and infestations
meddra-18.0
Systematic Assessment
EG00016 affected385 at risk
EG00125 affected409 at risk
EG00224 affected371 at risk
EG003
Upper respiratory tract infection
Infections and infestations
meddra-18.0
Systematic Assessment
EG00042 affected385 at risk
EG00135 affected409 at risk
EG00233 affected371 at risk
EG003
Neutropenia
Blood and lymphatic system disorders
meddra-18.0
Systematic Assessment
EG00010 affected385 at risk
EG00119 affected409 at risk
EG00218 affected371 at risk
EG003
Depression
Psychiatric disorders
meddra-18.0
Systematic Assessment
EG00025 affected385 at risk
EG00128 affected409 at risk
EG00218 affected371 at risk
EG003
Headache
Nervous system disorders
meddra-18.0
Systematic Assessment
EG00041 affected385 at risk
EG00161 affected409 at risk
EG00247 affected371 at risk
EG003
Hypoaesthesia
Nervous system disorders
meddra-18.0
Systematic Assessment
EG00016 affected385 at risk
EG00122 affected409 at risk
EG00223 affected371 at risk
EG003
Dizziness
Nervous system disorders
meddra-18.0
Systematic Assessment
EG00023 affected385 at risk
EG00117 affected409 at risk
EG00225 affected371 at risk
EG003
Paraesthesia
Nervous system disorders
meddra-18.0
Systematic Assessment
EG00023 affected385 at risk
EG00127 affected409 at risk
EG00222 affected371 at risk
EG003
Hypertension
Vascular disorders
meddra-18.0
Systematic Assessment
EG0008 affected385 at risk
EG00117 affected409 at risk
EG00216 affected371 at risk
EG003
Cough
Respiratory, thoracic and mediastinal disorders
meddra-18.0
Systematic Assessment
EG00012 affected385 at risk
EG00121 affected409 at risk
EG00212 affected371 at risk
EG003
Diarrhoea
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG00039 affected385 at risk
EG00145 affected409 at risk
EG00235 affected371 at risk
EG003
Nausea
Gastrointestinal disorders
meddra-18.0
Systematic Assessment
EG00027 affected385 at risk
EG00138 affected409 at risk
EG00236 affected371 at risk
EG003
Alopecia
Skin and subcutaneous tissue disorders
meddra-18.0
Systematic Assessment
EG00016 affected385 at risk
EG00142 affected409 at risk
EG00250 affected371 at risk
EG003
Back pain
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG00030 affected385 at risk
EG00128 affected409 at risk
EG00232 affected371 at risk
EG003
Arthralgia
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG00015 affected385 at risk
EG00130 affected409 at risk
EG00220 affected371 at risk
EG003
Pain in extremity
Musculoskeletal and connective tissue disorders
meddra-18.0
Systematic Assessment
EG00021 affected385 at risk
EG00119 affected409 at risk
EG00225 affected371 at risk
EG003
Fatigue
General disorders
meddra-18.0
Systematic Assessment
EG00040 affected385 at risk
EG00133 affected409 at risk
EG00237 affected371 at risk
EG003
Alanine aminotransferase increased
Investigations
meddra-18.0
Systematic Assessment
EG00027 affected385 at risk
EG00143 affected409 at risk
EG00248 affected371 at risk
EG003
Fall
Injury, poisoning and procedural complications
meddra-18.0
Systematic Assessment
EG00014 affected385 at risk
EG00122 affected409 at risk
EG00223 affected371 at risk
EG003
Certain Agreements
Are all PI(s) employees of the sponsor?
No
Restriction Type
OTHER
Results Disclosure Restriction on PI(s)?
Yes
Other Details
If no publication has occurred within 12 months after trial completion, the Investigator can present or publish results. The investigator provides the sponsor with a copy of the presentation or publication for review and comment at least 30 days in advance of its submission.
The sponsor can delay the submission for a period not exceeding 90 days to allow for filing a patent application or such other measures as sponsor deems appropriate to establish and preserve its proprietary rights.
Point of Contact
Title
Organization
Phone
Extension
Email
Trial Transparency Team
Sanofi
Contact-US@sanofi.com
ID
Term
D009103
Multiple Sclerosis
Ancestor Terms
ID
Term
D020278
Demyelinating Autoimmune Diseases, CNS
D020274
Autoimmune Diseases of the Nervous System
D009422
Nervous System Diseases
D003711
Demyelinating Diseases
D001327
Autoimmune Diseases
D007154
Immune System Diseases
Browse Leaves
Not provided
Browse Branches
Not provided
ID
Term
C527525
teriflunomide
Ancestor Terms
Not provided
Browse Leaves
Not provided
Browse Branches
Not provided
14 subjects
FG00110 subjects
FG00220 subjects
Lost to Follow-up
FG0004 subjects
FG0019 subjects
FG0026 subjects
Poor Compliance to Protocol
FG0003 subjects
FG0012 subjects
FG0021 subjects
Other than specified above
FG00026 subjects
FG00130 subjects
FG00218 subjects
37.9
± 9.3
258
BG003831
Male
BG000116
BG001108
BG002114
BG003338
124
BG002116
BG003357
Western Europe and Africa
Title
Measurements
BG000121
BG001127
BG002120
BG003368
Asia and Australia
Title
Measurements
BG00067
BG00165
BG00255
BG003187
America
Title
Measurements
BG00084
BG00192
BG00281
BG003257
BG0025.27± 5.90
BG0035.16± 5.66
1
(0 to 5)
BG0021(0 to 5)
BG0031(0 to 7)
Within the past 2 years
Title
Measurements
BG0002(1 to 8)
BG0012(1 to 8)
BG0022(1 to 9)
BG0032(1 to 9)
BG0025.33± 3.32
BG0035.26± 3.38
366
BG0031138
Secondary Progressive
Title
Measurements
BG0004
BG0013
BG0022
BG0039
Progressive Relapsing
Title
Measurements
BG0006
BG00112
BG0022
BG00320
Information not available
Title
Measurements
BG0000
BG0010
BG0022
BG0032
301
BG002276
BG003871
>3.5
Title
Measurements
BG00095
BG001107
BG00296
BG003298
Superiority or Other
OG000
OG001
Regression, Poisson
0.0183
Step down approach used to adjust for multiplicity:
H1 tested first
H2 tested only if the comparison H1 was statistically significant
A priori threshold for statistical significance for both comparisons ≤0.05
Relative Risk Reduction (%)
22.3
2-Sided
95
Relative risk reduction with teriflunomide 7 mg compared to placebo
No
Superiority or Other
Teriflunomide 14 mg once daily
Units
Counts
Participants
OG000388
OG001407
OG002370
Title
Denominators
Categories
Probability of disability progression at 24 weeks
Title
Measurements
OG0008.0(5.2 to 10.7)
OG0015.3(3.0 to 7.6)
OG0022.7(0.9 to 4.4)
Probability of disability progression at 48 weeks
Title
Measurements
OG00014.2(10.6 to 17.9)
OG00112.1(8.7 to 15.5)
OG0027.8(4.9 to 10.8)
Probability of disability progression at 108 weeks
Title
Measurements
OG00019.7(15.2 to 24.1)
OG00121.1(16.1 to 26.1)
OG00215.8(11.2 to 20.4)
Probability of disability progression at 132 weeks
Title
Measurements
OG00021.0(15.9 to 26.0)
OG00122.2(16.8 to 27.6)
OG00215.8(11.2 to 20.4)
Group IDs
Group Description
Statistical Method
Statistical Comment
P-Value
P-Value Comment
Parameter Type
Parameter Value
Dispersion Type
Dispersion Value
Confidence Interval Sides
Confidence Interval %
CI Lower Limit
CI Upper Limit
CI Lower Limit Comment
CI Upper Limit Comment
Estimate Comment
Tested Non-Inferiority
Non-Inferiority Type
Non-Inferiority Comment
Other Analysis Description
OG000
OG002
Null hypothesis:
S1: No difference between teriflunomide 14 mg and placebo
S2: No difference between teriflunomide 7 mg and placebo
The study was also sized to have 75% power to detect a 37% hazard ratio reduction in time to disability progression with teriflunomide compared to placebo.
Log Rank
Two-sided Log-rank test stratified by region of enrollment and baseline EDSS stratum
0.0442
Step down approach:
S1 tested only if both comparisons on the primary outcome measure were statistically significant
S2 tested only if the comparison S1 was statistically significant
A priori threshold for statistical significance ≤0.05
Hazard ratio reduction (%)
31.5
2-Sided
95
Relative reduction in the hazard rate with teriflunomide 14 mg compared to placebo (estimated from a Cox proportional hazard model with treatment arm, region of enrollment and baseline EDSS stratum as covariates)
No
Superiority or Other
OG000
OG001
Log Rank
Two-sided Log-rank test stratified by region of enrollment and baseline EDSS stratum
0.7620
Step down approach:
S1 tested only if both comparisons on the primary outcome measure were statistically significant
S2 tested only if the comparison S1 was statistically significant
A priori threshold for statistical significance ≤0.05
Hazard ratio reduction (%)
4.5
2-Sided
95
Relative reduction in the hazard rate with teriflunomide 7 mg compared to placebo (estimated from a Cox proportional hazard model with treatment arm, region of enrollment and baseline EDSS stratum as covariates)
No
Superiority or Other
OG000388
OG001407
OG002370
Title
Denominators
Categories
Probability of no relapse at 24 weeks
Title
Measurements
OG00076.4(72.1 to 80.7)
OG00181.5(77.6 to 85.4)
OG00285.5(81.8 to 89.2)
Probability of no relapse at 48 weeks
Title
Measurements
OG00060.6(55.5 to 65.6)
OG00171.9(67.3 to 76.5)
OG00276.3(71.7 to 81.0)
Probability of no relapse at 108 weeks
Title
Measurements
OG00046.8(41.0 to 52.6)
OG00158.2(52.6 to 63.8)
OG00257.1(50.5 to 63.7)
Probability of no relapse at 132 weeks
Title
Measurements
OG00037.7(30.2 to 45.2)
OG00155.4(48.8 to 62.0)
OG00251.5(43.6 to 59.5)
Units
Counts
Participants
OG000388
OG001407
OG002370
Title
Denominators
Categories
Title
Measurements
OG0000.089± 0.050
OG0010.042± 0.049
OG002-0.050± 0.052
Units
Counts
Participants
OG000388
OG001407
OG002370
Title
Denominators
Categories
Title
Measurements
OG0004.669± 1.576
OG0012.512± 1.533
OG0021.915± 1.628
OG000388
OG001407
OG002370
Title
Denominators
Categories
Title
Measurements
OG0006.311± 1.671
OG0014.464± 1.657
OG0022.043± 1.682
Teriflunomide 14 mg
Teriflunomide 14 mg once daily
Units
Counts
Participants
OG000388
OG001407
OG002370
Title
Denominators
Categories
Physical health component
Title
Measurements
OG000-1.082± 0.405
OG001-0.397± 0.396
OG002-0.105± 0.418
Mental health component
Title
Measurements
OG000-2.913± 0.586
OG001-2.031± 0.571
OG002-1.434± 0.606
OG000388
OG001407
OG002370
Title
Denominators
Categories
Physical Health component
Title
Measurements
OG000-1.629± 0.435
OG001-0.909± 0.441
OG002-0.638± 0.436
Mental Health component
Title
Measurements
OG000-2.792± 0.592
OG001-1.704± 0.597
OG002-1.087± 0.593
Counts
Participants
OG000385
OG001409
OG002371
Title
Denominators
Categories
Any AE
Title
Measurements
OG000320
OG001344
OG002320
- Any serious AE
Title
Measurements
OG00047
OG00152
OG00244
- Any AE leading to death
Title
Measurements
OG0001
OG0011
OG0022
- Any AE leading to treatment discontinuation
Title
Measurements
OG00024
OG00153
OG00258
Units
Counts
Participants
OG000251
OG001267
OG002233
Title
Denominators
Categories
Any TEAE
Title
Measurements
OG000203
OG001200
OG002188
Any serious TEAE
Title
Measurements
OG00016
OG00133
OG00229
Any TEAE leading to death
Title
Measurements
OG0001
OG0013
OG0021
Any TEAE leading to treatment discontinuation
Title
Measurements
OG00017
OG00117
OG00220
Teriflunomide 7 mg / 14 mg
Core treatment period: Teriflunomide 7 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
OG002
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.
Units
Counts
Participants
OG000253
OG001265
OG002233
Title
Denominators
Categories
1 year
Title
Measurements
OG0000.130(0.089 to 0.172)
OG0010.117(0.078 to 0.156)
OG0020.077(0.043 to 0.112)
2 year
Title
Measurements
OG0000.190(0.142 to 0.238)
OG0010.175(0.129 to 0.221)
OG0020.147(0.101 to 0.192)
3 year
Title
Measurements
OG0000.245(0.191 to 0.299)
OG0010.233(0.181 to 0.285)
OG0020.190(0.139 to 0.241)
4 year
Title
Measurements
OG0000.307(0.246 to 0.368)
OG0010.270(0.214 to 0.326)
OG0020.248(0.189 to 0.307)
5 year
Title
Measurements
OG0000.328(0.262 to 0.395)
OG0010.317(0.250 to 0.384)
OG0020.265(0.203 to 0.327)
OG002
Teriflunomide 14 mg / 14 mg
Core treatment period: Teriflunomide 14 mg once daily. Extension treatment period: Teriflunomide 14 mg once daily.