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| ID | Type | Description | Link |
|---|---|---|---|
| 2021-005932-50 | EudraCT Number |
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The purpose of this study is to evaluate the pharmacokinetics (PK), safety and effectiveness of berotralstat to determine the appropriate weight-based dose for pediatric participants 2 to < 12 years of age for prophylactic treatment to prevent attacks of hereditary angioedema (HAE).
This is a single-arm, 3-part, open-label study designed to evaluate the PK, safety, and effectiveness of berotralstat weight-based treatment for the prevention of HAE attacks in pediatric participants 2 to < 12 years of age. Participation in this study is expected to be a minimum of 12 weeks in the standard of care (SOC) period, and in the berotralstat period, it is expected to be 12 weeks in Part 1, 36 weeks in Part 2, and 96 weeks in Part 3 of the study.
Participants were enrolled into 4 cohorts; participant weight at baseline was used to determine assignment to each cohort with the higher weight cohorts (Cohorts 1 and 2) enrolling first and in parallel. Safety assessments and PK modelling from all available PK data were then used to confirm the dose and weight bands for sequentially enrolling Cohorts 3 and 4. The safety and effectiveness of berotralstat in this population was summarized using descriptive statistical methods.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1: ≥ 40 kg body weight (Berotralstat 150 mg) | Experimental | Participants received 150 milligram (mg) berotralstat capsule orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
|
| Cohort 2: 32 to < 40 kg body weight (Berotralstat 108 mg) | Experimental | Participants received 108 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
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| Cohort 3: 24 to < 32 kg body weight (Berotralstat 96 mg) | Experimental | Participants received 96 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
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| Cohort 4: 12 to <24 kg body weight (Berotralstat 78 mg) | Experimental | Participants received 78 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Berotralstat | Drug | Administered orally once daily |
|
| Measure | Description | Time Frame |
|---|---|---|
| Area Under the Plasma Concentration-Time Curve From Time 0 to the Last Measurable Concentration (AUC0-last) of Berotralstat | AUC0-last is the area under the plasma concentration-time curve from time 0 to the time of the last measurable concentration. | Week 2 |
| Area Under the Plasma Concentration-Time Curve From Time 0 to 6 Hours Post-dose (AUC0-6) of Berotralstat | AUC0-6 is the area under the plasma concentration-time curve from time 0 to 6 hours. | Predose and up to 6 hours post dose at Week 2 |
| Concentration at the End of the Dosing Interval (Ctrough) of Berotralstat | Ctrough is the concentration at the end of a dosing interval of berotralstat. | Predose at Week 2 |
| Maximum Observed Plasma Concentration (Cmax) of Berotralstat | Cmax is the maximum observed plasma concentration of berotralstat. | Predose and up to 6 hours post dose at Week 2 |
| Time of Last Measurable Plasma Concentration (Tlast) of Berotralstat | Tlast is the time of the last measurable concentration (Clast) of berotralstat collected over the sampling interval. | Predose and up to 6 hours post dose at Week 2 |
| Time to Maximum Plasma Concentration (Tmax) of Berotralstat | Tmax is the time taken to reach the maximum observed plasma concentration of berotralstat. | Predose and up to 6 hours post dose at Week 2 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) | An adverse event (AE) is any untoward medical occurrence in a clinical study participant. No causal relationship with study drug or with the clinical study itself is implied. An AE could be an unfavorable and unintended sign, symptom (including an abnormal laboratory finding), syndrome, or illness that developed or worsened during the clinical study. A serious adverse event (SAE) is any untoward medical occurrence resulting in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in a congenital anomaly/birth defect, or other medically important event. TEAEs are AEs that occurred on/after first dose of berotralstat through 30 days post discontinuation of study treatment. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jolanta Bernatoniene, MD | Bristol Royal Hospital for Children | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Investigative Site #1 | Vienna | Ontario | Austria | |||
| Investigative Site #1 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40716738 | Derived | Bernatoniene J, Bourgoin-Heck M, Cancian M, Yang W, Hagin D, Pagnier A, Stobiecki M, Kinaciyan T, Phillips-Angles E, Gayet S, Bara NA, Hunter J, Mateescu E, DeSpirito M, Johnston D, Long D, Iocca H, Petroni D, Aygoren-Pursun E. Oral berotralstat for hereditary angioedema prophylaxis in patients aged 2 to <12 years: APeX-P interim results. Ann Allergy Asthma Immunol. 2025 Dec;135(6):681-688.e3. doi: 10.1016/j.anai.2025.07.012. Epub 2025 Jul 25. |
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Participants were enrolled into a 12-week standard of care (SOC) period prior to initiating berotralstat. Participants were assigned to one of 4 cohorts based on body weight. Results contained herein are based on an interim analysis with data cutoff date of 11 September 2024 which was determined by the protocol defined event.
A total of 29 pediatric participants were enrolled in the study at a total of 11 study sites in Austria, Canada, France, Germany, Italy, Israel, Poland, Spain and the United Kingdom (UK).
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| ID | Title | Description |
|---|---|---|
| FG000 | Pre-treatment SOC Period (12 Weeks) | Participants remained on their SOC regimen for the first 12 weeks of the study, prior to start of the study treatment. |
| FG001 | Cohort 1: ≥ 40 kg Body Weight (Berotralstat 150 mg) | Participants received 150 milligram (mg) berotralstat capsule orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| FG002 | Cohort 2: 32 to < 40 kg Body Weight (Berotralstat 108 mg) | Participants received 108 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| FG003 | Cohort 3: 24 to < 32 kg Body Weight (Berotralstat 96 mg) | Participants received 96 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| FG004 | Cohort 4: 12 to <24 kg Body Weight (Berotralstat 78 mg) | Participants received 78 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pre-treatment SOC Period (12 Weeks) |
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| Treatment Period-Part 1 (Weeks 1-12) |
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| Treatment Period-Part 2 (Weeks 13-48) |
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| Treatment Period-Part 3 (Weeks 49-144) |
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Safety population included all participants who received at least 1 dose of berotralstat.
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| ID | Title | Description |
|---|---|---|
| BG000 | Cohort 1: ≥ 40 kg Body Weight (Berotralstat 150 mg) | Participants received 150 mg berotralstat capsule orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| BG001 | Cohort 2: 32 to < 40 kg Body Weight (Berotralstat 108 mg) |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Area Under the Plasma Concentration-Time Curve From Time 0 to the Last Measurable Concentration (AUC0-last) of Berotralstat | AUC0-last is the area under the plasma concentration-time curve from time 0 to the time of the last measurable concentration. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. Per protocol, fewer serial PK samples were drawn in Cohort 4 participants to remain within acceptable ranges of blood draw volumes; hence, Cohort 4 participants were not included in the analysis of this PK parameter. | Posted | Geometric Mean | Geometric Coefficient of Variation | nanogram* hour per milliliter (ng*h/mL) | Week 2 |
|
For SOC period: 12 weeks prior to first dose For AEs: From first dose of study treatment up to approximately 73 weeks
For the SOC period, AE data is presented for all participants who satisfied all entry criteria, were enrolled into the study, and were not considered to be screen failures.
For the treatment period (Cohort 1, Cohort 2, Cohort 3 and Cohort 4), AE data is presented for participants from the Safety Population which included all participants who received at least 1 dose of berotralstat.
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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 | Pre-treatment SOC Period | Participants remained on their SOC regimen for the first 12 weeks of the study, prior to start of the study treatment. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Accident | Injury, poisoning and procedural complications | MedDRA version 25.0 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | BioCryst Pharmaceuticals, Inc. | +1 919-859-1302 | clinicaltrials@biocryst.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 5, 2024 | Dec 19, 2025 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jul 8, 2024 | Dec 19, 2025 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D054179 | Angioedemas, Hereditary |
| ID | Term |
|---|---|
| D000799 | Angioedema |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D000081208 | Hereditary Complement Deficiency Diseases |
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| ID | Term |
|---|---|
| C000706836 | berotralstat |
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This is a sequential, 3-part, open-label study. Participants were assigned a cohort based on weight at baseline.
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| From first dose of study treatment up to approximately 73 weeks |
| Number of Adjusted Hereditary Angioedema (HAE) Attacks | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. | Week 1 through Week 12 and Week 1 through Week 48 |
| Rate of Adjusted HAE Attacks | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The adjusted attack rate was calculated as the number of adjusted attacks observed during a given period and standardized to number of attacks per month, where 1 month is defined as a 28-day (4 week) period. | Week 1 through Week 12 and Week 1 through Week 48 |
| Duration of Adjusted HAE Attack Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The duration of each participant-reported attack was calculated in hours, based on the start, and stop date and time of the adjusted attack (time the attack finished). | Week 1 through Week 12 and Week 1 through Week 48 |
| Incidence of Adjusted HAE Attack Based on Anatomical Location | Adjusted attacks were assessed based on anatomical location. Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Anatomical locations were categorized as abdominal-only, non-abdominal peripheral, mixed, and laryngeal attacks. | Week 1 through Week 12 and Week 1 through Week 48 |
| Number of Adjusted Attacks Requiring On-Demand Treatment | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Number of adjusted attacks treated with targeted HAE medications was assessed. | Week 1 through Week 12 and Week 1 through Week 48 |
| Proportion of Adjusted Attacks Requiring On-Demand Treatment | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Proportion of adjusted attacks treated with targeted HAE medications was assessed. | Week 1 through Week 12 and Week 1 through Week 48 |
| Number of Days With Angioedema Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc)?",were considered unique (attack began > 24 hours from the end of the prior attack),and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The number of days with angioedema symptoms is the number of the days during the reporting period for which at least 1 symptom is reported during an adjusted HAE attack based on the start date and resolution date of an attack. | Week 1 through Week 12 and Week 1 through Week 48 |
| Proportion of Days With Angioedema Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc)?",were considered unique (attack began > 24 hours from the end of the prior attack),and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The proportion of days with angioedema symptoms was based on the number of days with reported symptoms and the number of days the participant was on treatment, where the number of days with angioedema symptoms is the number of the days during the reporting period for which at least 1 symptom is reported during an adjusted HAE attack based on the start date and resolution date of an attack. | Week 1 through Week 12 and Week 1 through Week 48 |
| Assessment of Adjusted HAE Attack Severity | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The severity was assessed by the parent/caregiver as negligible, mild, moderate or severe. | Week 1 through Week 12 and Week 1 through Week 48 |
| Number of Participants Who Discontinued Treatment Due to Perceived Lack of Efficacy | The total number of participants who discontinued the treatment due to perceived lack of efficacy of berotralstat were reported. | Week 1 through Week 12 and Week 1 through Week 48 |
| Number of Hospitalizations and Clinic Visits Due to HAE | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Number of adjusted attacks that required hospitalization or clinic visits are reported. | Week 1 through Week 12 and Week 1 through Week 48 |
| Ottawa |
| Ontario |
| Canada |
| Investigative Site #3 | Grenoble | France |
| Investigative Site #2 | Marseille | France |
| Investigative Site #1 | Paris | France |
| Investigative Site #1 | Berlin | Germany |
| Investigative Site #2 | Frankfurt | Germany |
| Investigative Site #2 | Haifa | Israel |
| Investigative Site #1 | Tel Aviv | Israel |
| Investigative Site #1 | Padova | Italy |
| Investigative Site #1 | Krakow | Poland |
| Investigative Site #1 | Sângeorgiu de Mureş | Romania |
| Investigative Site #1 | Madrid | Spain |
| Investigative Site #2 | Málaga | Spain |
| Investigative Site #1 | Bristol | United Kingdom |
| COMPLETED |
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| NOT COMPLETED |
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| COMPLETED |
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| NOT COMPLETED |
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| COMPLETED |
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| NOT COMPLETED |
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Participants received 108 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| BG002 | Cohort 3: 24 to < 32 kg Body Weight (Berotralstat 96 mg) | Participants received 96 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| BG003 | Cohort 4: 12 to <24 kg Body Weight (Berotralstat 78 mg) | Participants received 78 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| BG004 | Total | Total of all reporting groups |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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Participants received 150 mg berotralstat capsule orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety.
| OG001 | Cohort 2: 32 to < 40 kg Body Weight (Berotralstat 108 mg) | Participants received 108 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| OG002 | Cohort 3: 24 to < 32 kg Body Weight (Berotralstat 96 mg) | Participants received 96 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
| OG003 | Cohort 4: 12 to <24 kg Body Weight (Berotralstat 78 mg) | Participants received 78 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. |
|
|
| Primary | Area Under the Plasma Concentration-Time Curve From Time 0 to 6 Hours Post-dose (AUC0-6) of Berotralstat | AUC0-6 is the area under the plasma concentration-time curve from time 0 to 6 hours. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. Per protocol, fewer serial PK samples were drawn in Cohort 4 participants to remain within acceptable ranges of blood draw volumes; hence, Cohort 4 participants were not included in the analysis of this PK parameter. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng*h/mL | Predose and up to 6 hours post dose at Week 2 |
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|
| Primary | Concentration at the End of the Dosing Interval (Ctrough) of Berotralstat | Ctrough is the concentration at the end of a dosing interval of berotralstat. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. | Posted | Mean | Standard Deviation | Nanograms per milliliter (ng/mL) | Predose at Week 2 |
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| Primary | Maximum Observed Plasma Concentration (Cmax) of Berotralstat | Cmax is the maximum observed plasma concentration of berotralstat. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. Per protocol, fewer serial PK samples were drawn in Cohort 4 participants to remain within acceptable ranges of blood draw volumes; hence, Cohort 4 participants were not included in the analysis of this PK parameter. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng/mL | Predose and up to 6 hours post dose at Week 2 |
|
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| Primary | Time of Last Measurable Plasma Concentration (Tlast) of Berotralstat | Tlast is the time of the last measurable concentration (Clast) of berotralstat collected over the sampling interval. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. Per protocol, fewer serial PK samples were drawn in Cohort 4 participants to remain within acceptable ranges of blood draw volumes; hence, Cohort 4 participants were not included in the analysis of this PK parameter. | Posted | Median | Full Range | hours | Predose and up to 6 hours post dose at Week 2 |
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| Primary | Time to Maximum Plasma Concentration (Tmax) of Berotralstat | Tmax is the time taken to reach the maximum observed plasma concentration of berotralstat. | Pharmacokinetic (PK) population included participants in the safety population with at least 1 evaluable and quantifiable post dose PK sample obtained. Number of participants analyzed refers to the participants who were evaluable for this outcome measure. Per protocol, fewer serial PK samples were drawn in Cohort 4 participants to remain within acceptable ranges of blood draw volumes; hence, Cohort 4 participants were not included in the analysis of this PK parameter. | Posted | Median | Full Range | hours | Predose and up to 6 hours post dose at Week 2 |
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| Secondary | Number of Participants With Treatment Emergent Adverse Events (TEAEs) | An adverse event (AE) is any untoward medical occurrence in a clinical study participant. No causal relationship with study drug or with the clinical study itself is implied. An AE could be an unfavorable and unintended sign, symptom (including an abnormal laboratory finding), syndrome, or illness that developed or worsened during the clinical study. A serious adverse event (SAE) is any untoward medical occurrence resulting in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in a congenital anomaly/birth defect, or other medically important event. TEAEs are AEs that occurred on/after first dose of berotralstat through 30 days post discontinuation of study treatment. | The safety population included all participants who received at least 1 dose of berotralstat. | Posted | Count of Participants | Participants | From first dose of study treatment up to approximately 73 weeks |
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| Secondary | Number of Adjusted Hereditary Angioedema (HAE) Attacks | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Rate of Adjusted HAE Attacks | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The adjusted attack rate was calculated as the number of adjusted attacks observed during a given period and standardized to number of attacks per month, where 1 month is defined as a 28-day (4 week) period. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Duration of Adjusted HAE Attack Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?",were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The duration of each participant-reported attack was calculated in hours, based on the start, and stop date and time of the adjusted attack (time the attack finished). | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Incidence of Adjusted HAE Attack Based on Anatomical Location | Adjusted attacks were assessed based on anatomical location. Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Anatomical locations were categorized as abdominal-only, non-abdominal peripheral, mixed, and laryngeal attacks. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Number of Adjusted Attacks Requiring On-Demand Treatment | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Number of adjusted attacks treated with targeted HAE medications was assessed. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Proportion of Adjusted Attacks Requiring On-Demand Treatment | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Proportion of adjusted attacks treated with targeted HAE medications was assessed. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Number of Days With Angioedema Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc)?",were considered unique (attack began > 24 hours from the end of the prior attack),and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The number of days with angioedema symptoms is the number of the days during the reporting period for which at least 1 symptom is reported during an adjusted HAE attack based on the start date and resolution date of an attack. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Proportion of Days With Angioedema Symptoms | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc)?",were considered unique (attack began > 24 hours from the end of the prior attack),and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The proportion of days with angioedema symptoms was based on the number of days with reported symptoms and the number of days the participant was on treatment, where the number of days with angioedema symptoms is the number of the days during the reporting period for which at least 1 symptom is reported during an adjusted HAE attack based on the start date and resolution date of an attack. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Assessment of Adjusted HAE Attack Severity | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. The severity was assessed by the parent/caregiver as negligible, mild, moderate or severe. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Number of Participants Who Discontinued Treatment Due to Perceived Lack of Efficacy | The total number of participants who discontinued the treatment due to perceived lack of efficacy of berotralstat were reported. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| Secondary | Number of Hospitalizations and Clinic Visits Due to HAE | Adjusted attacks included at least 1 symptom of swelling, had a response of "no" to the diary question: "In retrospect, could there be an alternative explanation for your symptoms other than an HAE attack (that is, allergic reaction, viral cold etc.)?", were considered unique (attack began > 24 hours from the end of the prior attack), and if the entire adjusted attack was untreated, it had a duration of > 24 hours. Any attack that began within 24 hours from the end of a prior attack was combined with the prior attack. Number of adjusted attacks that required hospitalization or clinic visits are reported. | Not Posted | Feb 2028 | Week 1 through Week 12 and Week 1 through Week 48 | Participants |
| 0 |
| 29 |
| 0 |
| 29 |
| 18 |
| 29 |
| EG001 | Cohort 1: ≥ 40 kg Body Weight (Berotralstat 150 mg) | Participants received 150 mg berotralstat capsule orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. | 0 | 7 | 1 | 7 | 6 | 7 |
| EG002 | Cohort 2: 32 to < 40 kg Body Weight (Berotralstat 108 mg) | Participants received 108 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. | 0 | 9 | 0 | 9 | 7 | 9 |
| EG003 | Cohort 3: 24 to < 32 kg Body Weight (Berotralstat 96 mg) | Participants received 96 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. | 0 | 9 | 0 | 9 | 9 | 9 |
| EG004 | Cohort 4: 12 to <24 kg Body Weight (Berotralstat 78 mg) | Participants received 78 mg berotralstat granules orally once daily for up to 144 weeks. Dose modifications were permitted due to weight changes, PK results, or safety. | 0 | 4 | 0 | 4 | 3 | 4 |
| Upper limb fracture | Injury, poisoning and procedural complications | MedDRA version 25.0 | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Gastroenteritis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Viral upper respiratory tract infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Bronchitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Ear infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Gastrointestinal infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Influenza | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Otitis media acute | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Conjunctivitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Erythema infectiosum | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Otitis externa | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Parvovirus infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Pharyngitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Rhinitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Tonsillitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Tracheitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Viral infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Viral rhinitis | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Productive cough | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Tonsillar hypertrophy | Respiratory, thoracic and mediastinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Abdominal pain upper | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Anal incontinence | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Food poisoning | Gastrointestinal disorders | MedDRA version 25.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Back pain | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Groin pain | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Mobility decreased | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Ear pain | Ear and labyrinth disorders | MedDRA version 25.0 | Systematic Assessment |
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| Excessive cerumen production | Ear and labyrinth disorders | MedDRA version 25.0 | Systematic Assessment |
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| Contusion | Injury, poisoning and procedural complications | MedDRA version 25.0 | Systematic Assessment |
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| Eye contusion | Injury, poisoning and procedural complications | MedDRA version 25.0 | Systematic Assessment |
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| Head injury | Injury, poisoning and procedural complications | MedDRA version 25.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA version 25.0 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA version 25.0 | Systematic Assessment |
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| Influenza like illness | General disorders | MedDRA version 25.0 | Systematic Assessment |
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| Affect lability | Psychiatric disorders | MedDRA version 25.0 | Systematic Assessment |
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| Aggression | Psychiatric disorders | MedDRA version 25.0 | Systematic Assessment |
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| Hypersensitivity | Immune system disorders | MedDRA version 25.0 | Systematic Assessment |
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| Seasonal allergy | Immune system disorders | MedDRA version 25.0 | Systematic Assessment |
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| Aspartate aminotransferase increased | Investigations | MedDRA version 25.0 | Systematic Assessment |
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| Crystal urine present | Investigations | MedDRA version 25.0 | Systematic Assessment |
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| Gamma-glutamyltransferase increased | Investigations | MedDRA version 25.0 | Systematic Assessment |
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| Albuminuria | Renal and urinary disorders | MedDRA version 25.0 | Systematic Assessment |
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| Pyelocaliectasis | Renal and urinary disorders | MedDRA version 25.0 | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Rash | Skin and subcutaneous tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Rash maculo-papular | Skin and subcutaneous tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Urticaria | Skin and subcutaneous tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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| Allergic eosinophilia | Blood and lymphatic system disorders | MedDRA version 25.0 | Systematic Assessment |
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| COVID-19 | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Atypical pneumonia | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Furuncle | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Localised infection | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Varicella | Infections and infestations | MedDRA version 25.0 | Systematic Assessment |
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| Neutrophil count decreased | Investigations | MedDRA version 25.0 | Systematic Assessment |
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| White blood cell count decreased | Investigations | MedDRA version 25.0 | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA version 25.0 | Systematic Assessment |
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| Petechiae | Skin and subcutaneous tissue disorders | MedDRA version 25.0 | Systematic Assessment |
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Not provided
Not provided
| D000081207 | Primary Immunodeficiency Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D014581 | Urticaria |
| D017445 | Skin Diseases, Vascular |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
| D007153 | Immunologic Deficiency Syndromes |