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Adalimumab is one of the pharmacological treatments for rheumatoid arthritis (RA) of more recent marketing authorization, and as a result of this, there are only efficacy and safety data from clinical trials with controlled conditions.The study will evaluate the safety and effectiveness of adalimumab in the common clinical practice of RA treatment in Spain, with several types of patients showing concomitant treatments or diseases and compliance. Among the tumor necrosis factor antagonists safety studies, adalimumab safety has been the less investigated in the common clinical practice because of, as a result of its recent marketing, it was not included in the BIOBADASER (Data Base for Biological Products in Spain, Rheumatology Spanish Society), Biologic Products Database of the Spanish Society of Rheumatology ) in which was determined an association between infliximab therapy and the risk of developing active tuberculosis. To ensure the maintaining of the strict common physician practice (no prescription induction), and following the recommendations of the SER (Sociedad Española de Reumatología, Spanish Society of Rheumatology) consensus documents, it will be selected only those patients that were already in treatment with adalimumab (HUMIRA),(except patients involved in clinical studies with Adalimumab), and had shown good response, or those that fulfilled treatment indication in accordance with the SER recommendations and following the Summary of Products Characteristics of adalimumab (HUMIRA).
Main objective
Secondary objectives
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| RA patients in treatment with adalimumab (Humira) | RA patients in treatment with adalimumab (Humira) at 40mg alternate weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| adalimumab (HUMIRA®) | Biological | The primary objective of the study is to evaluate the safety and tolerability of adalimumab (HUMIRA®) treatment, administered both in monotherapy and combined therapy, in rheumatoid arthritis (RA) patients under usual practice conditions. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety and Tolerability of Adalimumab Treatment. Adverse Events: Medical Occurrence in a Patient or Clinical Investigation Subject Administered a Pharmaceutical Product and Which Does Not Necessarily Have a Causal Relationship With the Treatment | The safety and tolerability of adalimumab was assessed at each study visit. The overall number of participants experiencing serious adverse events (SAEs), non-serious adverse events (AEs) and AEs that led to discontinuation are presented. The number of participants presenting with any serious or non-serious event at each particular study visit is also reported. Note that for the incidence data participants were counted multiple times if they experienced an adverse event at more than 1 visit. For additional information see Reported Adverse Events. | Baseline, 1, 4, 6, and 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Disease Activity Score (DAS 28) Index Mean Change From Baseline. The Disease Activity Score (DAS) is a Combined Index That Has Been Developed to Measure the Disease Activity in Patients With Rheumatoid Arthritis (RA). | The DAS 28 index measures disease activity in rheumatoid arthritis and is derived from the number swollen/tender joints, laboratory tests of inflammation, and participant assessment of global health (by marking a 10 cm line from "very good" to "very bad"). Ranges were used to classify participants, with a higher score indicating worse control of disease: Remission (<= 2.6), Low Disease Activity (>2.6 to <=3.2), Moderate Disease Activity (>3.2 to <= 5.1) and High Disease Activity (>5.1). The mean change in DAS 28 score from baseline to final is presented. |
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Inclusion Criteria:
Exclusion Criteria:
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Rheumatologist consultant
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| Name | Affiliation | Role |
|---|---|---|
| Ana M Ruiz-Zorrilla, MD | Abbott | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Site Reference ID/Investigator# 29714 | A Coruña | 15006 | Spain | |||
| Site Reference ID/Investigator# 29061 |
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| ID | Title | Description |
|---|---|---|
| FG000 | Adalimumab Treatment | Participants with rheumatoid arthritis receiving treatment with adalimumab at 40 mg alternate weeks |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
| Baseline and 12 months |
| Disease Activity Score (DAS 28) Index Percentage Change From Baseline. The Disease Activity Score (DAS) is a Combined Index That Has Been Developed to Measure the Disease Activity in Patients With Rheumatoid Arthritis (RA). | The DAS 28 index measures disease activity in rheumatoid arthritis and is derived from the number swollen/tender joints, laboratory tests of inflammation, and participant assessment of global health (by marking a 10 cm line from "very good" to "very bad"). Ranges were used to classify participants, with a higher score indicating worse control of disease: Remission (<= 2.6), Low Disease Activity (>2.6 to <=3.2), Moderate Disease Activity (>3.2 to <= 5.1) and High Disease Activity (>5.1). The percentage reduction of baseline values is presented. | Baseline and 12 months |
| Clinical Evaluation of Rheumatoid Arthritis (RA). Clinical Evaluation in the Inclusion Visit and in Each One of the Study Visits. | The treating physician was to clinically assess each participant at each study visit and report the number of painful and swollen joints. The mean number of painful or swollen joints for participants evaluated at each time point are presented by subgroup. The number of participants evaluated in each subgroup at each time point are also reported. | Baseline, 1, 4, 6, and 12 months |
| Life Quality Assessment Health Assessment Questionnaire (HAQ Questionnaire) Mean Change From Baseline. | Quality of life was assessed using the Health Assessment Questionnaire (HAQ). The HAQ is a self-reported scale used in studies of rheumatoid arthritis to assess areas such as dressing/grooming arising, eating, walking, reach, grip, maintaining hygiene, and daily activities. The global HAQ questionnaire was scored as follows: <1 = no/mild disability, 1 to 2 = moderate disability, and >2 = severe disability. An increased score indicates a worsening of the disability. The mean change in global HAQ score from baseline to 12 months is reported (baseline value - final value). | Baseline and 12 months |
| Life Quality Assessment Health Assessment Questionnaire (HAQ Questionnaire) Percentage Change From Baseline. | Quality of life was assessed using the Health Assessment Questionnaire (HAQ). The HAQ is a self-reported scale used in studies of rheumatoid arthritis to assess areas such as dressing/grooming arising, eating, walking, reach, grip, maintaining hygiene, and daily activities. The global HAQ questionnaire was scored as follows: <1 = no/mild disability, 1 to 2 = moderate disability, and >2 = severe disability. An increased score indicates a worsening of the disability. The percentage change from baseline to 12 months (12-month score minus baseline score divided by baseline score) is presented. | Baseline and 12 Months |
| Radiological Evaluation of Rheumatoid Arthritis (RA). | Treating physicians were asked to obtain a structural damage assessment by performing x-rays of the hands and feet approximately 1 year after the previous structural damage assessment that was done prior to the participant entering the study. The number of participants with radiological erosions evaluated at baseline and the 12-month visit are summarized by subgroup. | Baseline and 12 months |
| Algeciras |
| 11207 |
| Spain |
| Site Reference ID/Investigator# 29710 | Almería | 04009 | Spain |
| Site Reference ID/Investigator# 29719 | Barcelona | 08003 | Spain |
| Site Reference ID/Investigator# 29054 | Barcelona | 08025 | Spain |
| Site Reference ID/Investigator# 29698 | Barcelona | 08025 | Spain |
| Site Reference ID/Investigator# 29063 | Barcelona | 08035 | Spain |
| Site Reference ID/Investigator# 29718 | Barcelona | 08035 | Spain |
| Site Reference ID/Investigator# 29720 | Barcelona | 08036 | Spain |
| Site Reference ID/Investigator# 29706 | Cadiz | 11009 | Spain |
| Site Reference ID/Investigator# 29052 | Calella | 08370 | Spain |
| Site Reference ID/Investigator# 29065 | Cartagena | 30203 | Spain |
| Site Reference ID/Investigator# 29713 | Córdoba | 14004 | Spain |
| Site Reference ID/Investigator# 29703 | El Palmar | 31120 | Spain |
| Site Reference ID/Investigator# 28607 | Ferrol | 15405 | Spain |
| Site Reference ID/Investigator# 5338 | Girona | 17002 | Spain |
| Site Reference ID/Investigator# 29701 | Granada | 18014 | Spain |
| Site Reference ID/Investigator# 29705 | Huelva | 21080 | Spain |
| Site Reference ID/Investigator# 29050 | Ibiza Town | 07800 | Spain |
| Site Reference ID/Investigator# 29708 | Jaén | 23007 | Spain |
| Site Reference ID/Investigator# 29709 | Jerez de la Frontera | 11407 | Spain |
| Site Reference ID/Investigator# 29711 | L'Hospitalet de Llobregat | 08907 | Spain |
| Site Reference ID/Investigator# 29716 | Lugo | 27004 | Spain |
| Site Reference ID/Investigator# 29038 | Manacor | 07500 | Spain |
| Site Reference ID/Investigator# 29712 | Mataro, Barcelona | 08304 | Spain |
| Site Reference ID/Investigator# 29700 | Málaga | 29009 | Spain |
| Site Reference ID/Investigator# 29051 | Ourense | 32005 | Spain |
| Site Reference ID/Investigator# 29699 | Palma de Mallorca | 07014 | Spain |
| Site Reference ID/Investigator# 29717 | Pamplona | 31000 | Spain |
| Site Reference ID/Investigator# 29704 | Reus | 43201 | Spain |
| Site Reference ID/Investigator# 29715 | Santiago de Compostela | 15706 | Spain |
| Site Reference ID/Investigator# 30823 | Seville | 41009 | Spain |
| Site Reference ID/Investigator# 29068 | Seville | 41013 | Spain |
| Site Reference ID/Investigator# 29064 | Tarragona | 43003 | Spain |
| Site Reference ID/Investigator# 29058 | Valls | 43800 | Spain |
| Site Reference ID/Investigator# 29055 | Vic | 08500 | Spain |
| Site Reference ID/Investigator# 29697 | Vigo | 36204 | Spain |
| Site Reference ID/Investigator# 29059 | Vigo | 36211 | Spain |
| Site Reference ID/Investigator# 29702 | Vigo/Pontevedra | 36200 | Spain |
| Site Reference ID/Investigator# 29053 | Viladecans | 08840 | Spain |
| Safety Population |
|
| Intent-to-treat (ITT) Population |
|
| COMPLETED |
|
| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Adalimumab (Humira) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Based on the ITT population minus 5 who did not report their age (586). | Mean | Standard Deviation | years |
| |||||||||||||||||||||
| Sex/Gender, Customized | Based on the ITT population (591). | Number | participants |
| ||||||||||||||||||||||
| Region of Enrollment | Based on the ITT population (591). | Number | participants |
| ||||||||||||||||||||||
| Time from Diagnosis of Rheumatoid Arthritis | The number of years since the participant first received a diagnosis of rheumatoid arthritis. Based on the ITT population minus 91 who did not report the time since first diagnosis (500). | Mean | Standard Deviation | Years |
| |||||||||||||||||||||
| Positivity of the Rheumatoid Factor | The number of participants testing positive or negative for rheumatoid factor. Based on the ITT population (591). | Number | participants |
| ||||||||||||||||||||||
| Previous Rheumatoid Arthritis Treatment | Whether or not participants had taken medication for rheumatoid arthritis within the last 5 years. Based on the ITT population (591). | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Safety and Tolerability of Adalimumab Treatment. Adverse Events: Medical Occurrence in a Patient or Clinical Investigation Subject Administered a Pharmaceutical Product and Which Does Not Necessarily Have a Causal Relationship With the Treatment | The safety and tolerability of adalimumab was assessed at each study visit. The overall number of participants experiencing serious adverse events (SAEs), non-serious adverse events (AEs) and AEs that led to discontinuation are presented. The number of participants presenting with any serious or non-serious event at each particular study visit is also reported. Note that for the incidence data participants were counted multiple times if they experienced an adverse event at more than 1 visit. For additional information see Reported Adverse Events. | This analysis was performed in the safety population of all participants who took at least 1 dose of adalimumab (675 participants). | Posted | Number | Participants | Baseline, 1, 4, 6, and 12 months |
|
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Disease Activity Score (DAS 28) Index Mean Change From Baseline. The Disease Activity Score (DAS) is a Combined Index That Has Been Developed to Measure the Disease Activity in Patients With Rheumatoid Arthritis (RA). | The DAS 28 index measures disease activity in rheumatoid arthritis and is derived from the number swollen/tender joints, laboratory tests of inflammation, and participant assessment of global health (by marking a 10 cm line from "very good" to "very bad"). Ranges were used to classify participants, with a higher score indicating worse control of disease: Remission (<= 2.6), Low Disease Activity (>2.6 to <=3.2), Moderate Disease Activity (>3.2 to <= 5.1) and High Disease Activity (>5.1). The mean change in DAS 28 score from baseline to final is presented. | Mean change from baseline to 12 months included the ITT population of 310 de novo and 281 participants treated greater than 4 months. | Posted | Mean | Standard Deviation | Units on a scale | Baseline and 12 months |
| |||||||||||||||||||||||||||||||||||||
| Secondary | Disease Activity Score (DAS 28) Index Percentage Change From Baseline. The Disease Activity Score (DAS) is a Combined Index That Has Been Developed to Measure the Disease Activity in Patients With Rheumatoid Arthritis (RA). | The DAS 28 index measures disease activity in rheumatoid arthritis and is derived from the number swollen/tender joints, laboratory tests of inflammation, and participant assessment of global health (by marking a 10 cm line from "very good" to "very bad"). Ranges were used to classify participants, with a higher score indicating worse control of disease: Remission (<= 2.6), Low Disease Activity (>2.6 to <=3.2), Moderate Disease Activity (>3.2 to <= 5.1) and High Disease Activity (>5.1). The percentage reduction of baseline values is presented. | Mean reduction from baseline to 12 months was calculated for the ITT population of 310 de novo and 279 participants treated greater than 4 months. | Posted | Mean | Standard Deviation | Percentage reduction | Baseline and 12 months |
| |||||||||||||||||||||||||||||||||||||
| Secondary | Clinical Evaluation of Rheumatoid Arthritis (RA). Clinical Evaluation in the Inclusion Visit and in Each One of the Study Visits. | The treating physician was to clinically assess each participant at each study visit and report the number of painful and swollen joints. The mean number of painful or swollen joints for participants evaluated at each time point are presented by subgroup. The number of participants evaluated in each subgroup at each time point are also reported. | This analysis was conducted in the ITT population of 591 participants who had assessments at each time point. The number of de novo participants and participants treated greater than 4 months who were analyzed at each time point are given in parentheses. | Posted | Mean | Standard Deviation | Joints | Baseline, 1, 4, 6, and 12 months |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Life Quality Assessment Health Assessment Questionnaire (HAQ Questionnaire) Mean Change From Baseline. | Quality of life was assessed using the Health Assessment Questionnaire (HAQ). The HAQ is a self-reported scale used in studies of rheumatoid arthritis to assess areas such as dressing/grooming arising, eating, walking, reach, grip, maintaining hygiene, and daily activities. The global HAQ questionnaire was scored as follows: <1 = no/mild disability, 1 to 2 = moderate disability, and >2 = severe disability. An increased score indicates a worsening of the disability. The mean change in global HAQ score from baseline to 12 months is reported (baseline value - final value). | The analysis was conducted for participants who had both baseline and 12-month global HAQ assessments. | Posted | Mean | Standard Deviation | Units on a scale | Baseline and 12 months |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Life Quality Assessment Health Assessment Questionnaire (HAQ Questionnaire) Percentage Change From Baseline. | Quality of life was assessed using the Health Assessment Questionnaire (HAQ). The HAQ is a self-reported scale used in studies of rheumatoid arthritis to assess areas such as dressing/grooming arising, eating, walking, reach, grip, maintaining hygiene, and daily activities. The global HAQ questionnaire was scored as follows: <1 = no/mild disability, 1 to 2 = moderate disability, and >2 = severe disability. An increased score indicates a worsening of the disability. The percentage change from baseline to 12 months (12-month score minus baseline score divided by baseline score) is presented. | The analysis was conducted for participants who had both baseline and 12-month global HAQ assessments. | Posted | Mean | Standard Deviation | Percentage change | Baseline and 12 Months |
| |||||||||||||||||||||||||||||||||||||
| Secondary | Radiological Evaluation of Rheumatoid Arthritis (RA). | Treating physicians were asked to obtain a structural damage assessment by performing x-rays of the hands and feet approximately 1 year after the previous structural damage assessment that was done prior to the participant entering the study. The number of participants with radiological erosions evaluated at baseline and the 12-month visit are summarized by subgroup. | This analysis was conducted in the intent-to-treat population (591 participants total). | Posted | Number | Participant | Baseline and 12 months |
|
|
All adverse events that occurred during the course of the study were reported in detail on case report forms. Adverse events occurring during the study were reported up to 30 days or 5 half-lives after the last dose of adalimumab.
The safety population included all participants who received at least one dose of adalimumab (675 total). While 184 participants experienced a non-serious adverse event, 18 experienced non-serious adverse events that had an incidence greater than 1% and are presented in the Other Adverse Event table.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Adalimumab Treatment | Participants with rheumatoid arthritis receiving treatment with adalimumab at 40 mg alternate weeks | 28 | 675 | 18 | 675 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute coronary syndrome | Cardiac disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Acute myocardial infarction | Cardiac disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Cardiac failure | Cardiac disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Pericarditis | Cardiac disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Pancreatitis acute | Gastrointestinal disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Pain | General disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Hypertransaminasaemia | Hepatobiliary disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Abscess | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Arthritis bacterial | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Bacteraemia/listeriosis | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Diarrhoea/pyrexia/salmonellosis | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Herpes zoster | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Lower respiratory tract infection | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Respiratory tract infection | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Fracture | Injury, poisoning and procedural complications | MedDRA 13.1 | Systematic Assessment |
| |
| Radius fracture/sternal fracture | Injury, poisoning and procedural complications | MedDRA 13.1 | Systematic Assessment |
| |
| Lupus-like syndrome | Musculoskeletal and connective tissue disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Sjogren's syndrome | Musculoskeletal and connective tissue disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Colon cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 13.1 | Systematic Assessment |
| |
| Malignant melanoma | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 13.1 | Systematic Assessment |
| |
| Ovarian cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA 13.1 | Systematic Assessment |
| |
| Cerebrovascular accident | Nervous system disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Anxiety | Psychiatric disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Bronchospasm | Respiratory, thoracic and mediastinal disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders | MedDRA 13.1 | Systematic Assessment |
| |
| Cutaneous lupus erythematosus | Skin and subcutaneous tissue disorders | MedDRA 13.1 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Respiratory tract infection | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA 13.1 | Systematic Assessment |
|
Abbott requests that any investigator or institution that plans on presenting/publishing results disclosure, provide written notification of their request 60 days prior to their presentation/publication. Abbott requests that no presentation/publication will be instituted until 12 months after a study is completed, or after the first presentation/publication whichever occurs first. A delay may be proposed of a presentation/publication if Abbott needs to secure patent or proprietary protection.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Global Medical Services | Abbott | 1-800-633-9110 |
| ID | Term |
|---|---|
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D000068879 | Adalimumab |
| ID | Term |
|---|---|
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
Not provided
Not provided
| Gender not reported |
|
| Rheumatoid Factor Results Unknown or Missing |
|
| Title | Measurements |
|---|---|
|
| Incidence: At least 1 AE at Baseline |
|
| -- Incidence: At least 1 AE at 1 month |
|
| -- Incidence: At least 1 AE at 4 months |
|
| -- Incidence: At least 1 AE at 6 months |
|
| -- Incidence: At least 1 AE at 12 months |
|
| Incidence: At least 1 SAE at Baseline |
|
| -- Incidence: At least 1 SAE at 1 month |
|
| -- Incidence: At least 1 SAE at 4 months |
|
| -- Incidence: At least 1 SAE at 6 months |
|
| -- Incidence: At least 1 SAE at 12 months |
|
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