Prism-2: Phase 3 Study to Evaluate the Efficacy & Safety of Self-Administered Injections of BMN165 by Adults With PKU

Sponsor
BioMarin Pharmaceutical (Industry)
Overall Status
Completed
CT.gov ID
NCT01889862
Collaborator
(none)
215
29
4
66.3
7.4
0.1

Study Details

Study Description

Brief Summary

The BMN 165 clinical development program has been designed to demonstrate the safety and efficacy of BMN 165 in reducing blood Phe concentrations in adults with PKU.

Condition or Disease Intervention/Treatment Phase
  • Drug: BMN165 20mg/day
  • Drug: BMN165 40mg/day
  • Drug: Placebo
Phase 3

Detailed Description

165-302 is a Phase 3, 4 Part, Randomized, Double-Blind, Placebo-Controlled, Discontinuation Study to Evaluate the Efficacy and Safety of Self Administered Subcutaneous Injections of BMN 165 by Adults With PKU.

This study is open only to adults who have been exposed to BMN165 in a previous study.

Study BMN 165-302 is a four-Part, Phase 3 study.

  • Part 1: Open-label period

  • Part 2: A Randomized, double-blind, placebo-controlled period of 8 weeks

  • Part 3: Two sub-Parts to Part 3:- Part 3A - BMN 165 administered using vial and syringe during this open label period. Part 3B - BMN 165 administered using prefilled syringe during this open-label period.

  • Part 4: A long-term, open-label extension period.

Study Design

Study Type:
Interventional
Actual Enrollment :
215 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Care Provider, Investigator)
Primary Purpose:
Treatment
Official Title:
A Four-Part, Phase 3, Randomized, Double-Blind, Placebo- Controlled, Four-Arm, Discontinuation Study to Evaluate the Efficacy and Safety of Subcutaneous Injections of BMN 165 Self-Administered by Adults With Phenylketonuria (PKU)
Actual Study Start Date :
Jul 29, 2013
Actual Primary Completion Date :
Jan 13, 2016
Actual Study Completion Date :
Feb 5, 2019

Arms and Interventions

Arm Intervention/Treatment
Active Comparator: BMN165 20mg/day

BMN165 20mg/day self-administered daily

Drug: BMN165 20mg/day
BMN165 20mg/day self-administered daily
Other Names:
  • PEG-PAL
  • Placebo Comparator: 20 mg/day Placebo

    20 mg/day Placebo self-administered daily

    Drug: Placebo
    Non-drug placebo, self-administered daily
    Other Names:
  • Dextran 40
  • Active Comparator: BMN165 40mg/day

    BMN165 40mg/day self-administered daily

    Drug: BMN165 40mg/day
    BMN165 40mg/day self-administered daily
    Other Names:
  • PEG-PAL
  • Placebo Comparator: 40 mg/day Placebo

    40 mg/day Placebo self-administered daily

    Drug: Placebo
    Non-drug placebo, self-administered daily
    Other Names:
  • Dextran 40
  • Outcome Measures

    Primary Outcome Measures

    1. Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2 [At Part 2 baseline and change from baseline at Part 2 week 8]

      Blood phe concentration in subjects previously exposed to BMN165 who were administered BMN165 20 or 40 mg/day compared with those who were administered a matching placebo.

    Secondary Outcome Measures

    1. Change From Baseline in the Cognitive and Mood Symptoms Measured by ADHD Rating Scale (RS)-IV Inattention Subscale at Part 2 [At Part 2 baseline and change from baseline at Part 2 week 8]

      Attention deficit hyperactivity disorder rating scale IV (ADHD RS-IV) is investigator-rated, 9-item, inattention subscale score ranges from 0 to 27, with higher scores indicative of a greater degree of impairment and a baseline score >9 indicative of a presence of symptoms.

    2. Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 4 [At Part 4 week 57, 105, 161, 209 and 249]

      The long term effect of multiple dose levels of BMN165 on blood phe concentration in subjects who are administered BMN165 using pre-filled syringes.

    3. Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS TMD at Part 2 [At Part 2 baseline and change from baseline at Part 2 week 8]

      Phenylketonuria (PKU) Total Mood Disturbance (TMD) Profile of Mood States (POMS) PKU POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    4. Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS Confusion Subscale at Part 2 [At Part 2 baseline and change from baseline at Part 2 week 8]

      PKU POMS confusion mood domain (referred to as the confusion subscale) is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    5. Change From Baseline in the Cognitive and Mood Symptoms Measured by POMS TMD at Part 2 [At Part 2 baseline and change from baseline at Part 2 week 8]

      Full-length POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 70 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No

    INCLUSION CRITERIA

    Individuals eligible to participate in this study must meet all of the following criteria:
    • Have completed a prior BMN 165 study (PAL-003, 165-205, or 165-301) prior to screening

    • Have had a stable BMN 165 dose regimen for at least 14 days prior to screening

    • Are at least 18 y/o and no older than 70 y/o at screening

    • Subjects who are < 18 y/o and are already enrolled into Study 165-301 under Amendment #1 (10JAN2014) may enroll into this study

    • Has identified a person who is > 18 y/o who has the neurocognitive and linguistic capacities to comprehend and complete the Profile of Mood States (POMS)-Observer rated scale

    • Has identified a competent person(s) > 18 y/o who can observe the subject during study drug administration at certain points in the study

    • A home healthcare nurse may perform the study drug observations

    • Are willing and able to provide written, signed informed consent after the nature of the study has been explained and prior to any research-related procedures; for minors, parent or guardian provides written consent and assent may be requested

    • Are willing and able to comply with all study procedures

    • For females of childbearing potential, a negative pregnancy test at screening and willing to have additional pregnancy tests during the study

    • If sexually active, willing to use two acceptable methods of contraception during and for 4 weeks after the study

    • Males post vasectomy for 2 years with no known pregnancies do not need to use any other forms of contraception during the study.

    • Females who have been in menopause for at least 2 years, have had a tubal ligation at least 1 year prior to screening, or have had a total hysterectomy do not need to use any other forms of contraception during the study.

    • Have received documented approval from a study dietitian confirming that the subject is capable of maintaining their diet

    • Have neurocognitive and linguistic capacities to comprehend and answer investigator's prompts for the Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) Investigator rated instrument and to complete the POMS-Subject rated scale

    • If applicable, maintained stable dose of medication for Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety, or other psychiatric disorder ≥8 weeks prior to enrollment and willing to maintain stable dose throughout study unless a change is medically indicated

    • General good health, as evidenced by physical examination, clinical laboratory evaluations, and ECG tests at screening

    Exclusion Criteria

    Individuals who meet any of the following exclusion criteria will not be eligible to participate in the study:

    • Use of any investigational product (except BMN 165) or investigational medical device within 30 days prior to screening or requirement for any investigational agent prior to completion of all scheduled study assessments

    • Use of any medication (except BMN 165) intended to treat PKU, including the use of large neutral amino acids, within 2 days prior to the administration of study drug

    • Have known hypersensitivity to Dextran® or components of Dextran

    • Use or planned use of any injectable drugs containing PEG (except for BMN 165), including medroxyprogesterone injection, within 3 months prior to screening and during study participation

    • Current use of levodopa

    • A positive test for HIV antibody, hepatitis B surface antigen, or hepatitis C antibody

    • A history of organ transplantation or taking chronic immunosuppressive therapy

    • A history of substance abuse in the past 12 months or current alcohol or drug abuse

    • Current participation in the Kuvan registry study (PKUDOS). Patients may discontinue the PKUDOS registry trial to allow enrollment in this study

    • Pregnant or breastfeeding at screening or planning to become pregnant (self or partner) or breastfeed at any time during the study

    • Concurrent disease or condition that would interfere with study participation or safety.

    • Major surgery planned during the study period

    • Any condition that in the view of the investigator, places the subject at high risk of poor treatment compliance or terminating early from the study

    • Alanine aminotransferase (ALT) concentration at least 2x the upper limit of normal

    • Creatinine at least 1.5x the upper limit of normal

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of California, San Diego Clinical and Translational Research Institute La Jolla California United States 92093
    2 UCSF Benioff Children's Hospital Oakland Oakland California United States 94609
    3 Children's Hospital Colorado Aurora Colorado United States 80045
    4 University of Florida Clinical Research Center Gainesville Florida United States 32610
    5 University of South Florida Tampa Florida United States 33606
    6 Emory Universty, Department of Human Genetics, Division of Medical Genetics Atlanta Georgia United States 30322
    7 Ann and Robert H Lurie Children's Hospital of Chicago Chicago Illinois United States 60611
    8 Indiana CTSI Clinical Research Center Indianapolis Indiana United States 46202
    9 University of Kentucky Medical Center Lexington Kentucky United States 40536
    10 University of Louisville, Kosair Charities Pediatric Clinical Research Unit Louisville Kentucky United States 40202
    11 Boston Children's Hospital Boston Massachusetts United States 02115
    12 Wayne State University Clinical Research Center at the Mott Center Detroit Michigan United States 48202
    13 University of Missouri Health Center Columbia Missouri United States 65212
    14 Washington University Center for Applied Research Sciences Saint Louis Missouri United States 63110
    15 University of Nebraska Medical Center Omaha Nebraska United States 68198
    16 Cooper Health Systems Camden New Jersey United States 08103
    17 Atlantic Health System - Morristown Medical Center Morristown New Jersey United States 07960
    18 Albany Medical Center Albany New York United States 12208
    19 Icahn School of Medicine at Mount Sinai Medical Center New York New York United States 10029
    20 University Hospitals Case Medical Center Cleveland Ohio United States 44106
    21 University of Oklahoma Health Sciences Center Oklahoma City Oklahoma United States 73104
    22 Oregon Health and Science University Portland Oregon United States 97239
    23 St. Christopher's Hospital for Children Philadelphia Pennsylvania United States 19134
    24 Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center Pittsburgh Pennsylvania United States 15224
    25 Vanderbilt Children's Hospital Nashville Tennessee United States 37232
    26 University of Texas Houston Medical School Houston Texas United States 77030
    27 University of Utah Hospital Salt Lake City Utah United States 84108
    28 University of Washinton Seattle Washington United States 98195
    29 Medical College of Wisconsin Milwaukee Wisconsin United States 53226

    Sponsors and Collaborators

    • BioMarin Pharmaceutical

    Investigators

    • Study Director: Clinical Trial Specialist, BioMarin Pharmaceutical

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    BioMarin Pharmaceutical
    ClinicalTrials.gov Identifier:
    NCT01889862
    Other Study ID Numbers:
    • 165-302
    First Posted:
    Jul 1, 2013
    Last Update Posted:
    May 21, 2021
    Last Verified:
    Apr 1, 2021
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Keywords provided by BioMarin Pharmaceutical
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details This was a multicenter study, conducted in 29 study centers of United States.
    Pre-assignment Detail A total of 51 out of 215 subjects entered Part 4 directly from 165-301, as they did not receive target dose of 20 or 40 mg/day in 165-301.
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day BMN165
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2. Up to 60mg/day BMN165 subcutaneous injection administered using a prefilled syringe in Part 4.
    Period Title: Part 1 (Up to 13 Weeks)
    STARTED 86 0 78 0 0
    COMPLETED 74 0 78 0 0
    NOT COMPLETED 12 0 0 0 0
    Period Title: Part 1 (Up to 13 Weeks)
    STARTED 34 15 32 14 0
    Per Amendment #2 of the Protocol 29 14 29 14 0
    COMPLETED 34 15 31 14 0
    NOT COMPLETED 0 0 1 0 0
    Period Title: Part 1 (Up to 13 Weeks)
    STARTED 48 0 41 0 0
    Per Amendment #2 of the Protocol 34 0 26 0 0
    COMPLETED 48 0 41 0 0
    NOT COMPLETED 0 0 0 0 0
    Period Title: Part 1 (Up to 13 Weeks)
    STARTED 0 0 0 0 202
    COMPLETED 0 0 0 0 172
    NOT COMPLETED 0 0 0 0 30

    Baseline Characteristics

    Arm/Group Title All Subjects
    Arm/Group Description BMN165 20mg/Day: BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Placebo 20mg/Day: Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/Day: BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Placebo 40mg/Day: Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165: Up to 60mg/day BMN165 subcutaneous injection administered using a prefilled syringe in Part 4.
    Overall Participants 215
    Age (yrs) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [yrs]
    29.22
    (8.74)
    Age, Customized (Count of Participants)
    16 - <18 years
    11
    5.1%
    18 - <66 years
    204
    94.9%
    Sex: Female, Male (Count of Participants)
    Female
    105
    48.8%
    Male
    110
    51.2%
    Race/Ethnicity, Customized (Count of Participants)
    American Indian or Alaska Native
    1
    0.5%
    White
    211
    98.1%
    Black/African American
    2
    0.9%

    Outcome Measures

    1. Primary Outcome
    Title Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 2
    Description Blood phe concentration in subjects previously exposed to BMN165 who were administered BMN165 20 or 40 mg/day compared with those who were administered a matching placebo.
    Time Frame At Part 2 baseline and change from baseline at Part 2 week 8

    Outcome Measure Data

    Analysis Population Description
    Modified Intent-to-Treat (mITT) population consists of all subjects who reached the randomized dose of 20mg/day or 40mg/day and were randomized into Part 2 with a mean blood Phe reduction of ≥20% (using the last two consecutive blood Phe assessments of Part 1) from the baseline of 165-301 (or the Phase 2 study in which they initiated BMN165).
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2.
    Measure Participants 29 14 29 14
    Part 2 Baseline
    596.8
    (582.75)
    563.9
    (504.62)
    410.9
    (439.95)
    508.2
    (363.68)
    Change from Baseline Part 2 Week 8
    -65.9
    (192.02)
    996.4
    (555.00)
    114.1
    (332.40)
    599.0
    (507.40)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection BMN165 20mg/Day, Placebo 20mg/Day
    Comments Change in blood Phe concentration during Part 2 in subjects previously exposed to BMN165 who self administer BMN165 20mg/day compared with those who self administer matching placebo.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments Based on Mixed-Effect Model Repeated Measure (MMRM) model with change from baseline as the response variable, and treatment, visit and treatment by visit interaction and baseline blood phe concentration as factors.
    Method ANCOVA
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Net)
    Estimated Value -973.02
    Confidence Interval (2-Sided) 95%
    -1204.19 to -741.85
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection BMN165 40mg/Day, Placebo 40mg/Day
    Comments Change in blood Phe concentration during Part 2 in subjects previously exposed to BMN165 who self administer BMN165 40mg/day compared with those who self administer matching placebo.
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments Based on Mixed-Effect Model Repeated Measure (MMRM) model with change from baseline as the response variable, and treatment, visit and treatment by visit interaction and baseline blood phe concentration as factors.
    Method ANCOVA
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Net)
    Estimated Value -588.50
    Confidence Interval (2-Sided) 95%
    -830.07 to -346.94
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Secondary Outcome
    Title Change From Baseline in the Cognitive and Mood Symptoms Measured by ADHD Rating Scale (RS)-IV Inattention Subscale at Part 2
    Description Attention deficit hyperactivity disorder rating scale IV (ADHD RS-IV) is investigator-rated, 9-item, inattention subscale score ranges from 0 to 27, with higher scores indicative of a greater degree of impairment and a baseline score >9 indicative of a presence of symptoms.
    Time Frame At Part 2 baseline and change from baseline at Part 2 week 8

    Outcome Measure Data

    Analysis Population Description
    mITT population
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2.
    Measure Participants 29 14 29 14
    Baseline
    5.9
    (4.70)
    5.0
    (4.26)
    6.0
    (6.45)
    2.9
    (3.68)
    Change from Baseline Part 2 Week 8
    1.1
    (3.96)
    1.2
    (3.00)
    0.5
    (5.36)
    -0.4
    (3.44)
    3. Secondary Outcome
    Title Change From Baseline in the Blood Plasma Phenylalanine (Phe) Concentration at Part 4
    Description The long term effect of multiple dose levels of BMN165 on blood phe concentration in subjects who are administered BMN165 using pre-filled syringes.
    Time Frame At Part 4 week 57, 105, 161, 209 and 249

    Outcome Measure Data

    Analysis Population Description
    All Subjects Entered 165-302 Part 4 Data
    Arm/Group Title BMN165 < 20 mg/Day - Part 4 BMN165 20 to < 40 mg/Day - Part 4 BMN165 40 to < 60 mg/Day - Part 4 BMN165 >= 60 mg/Day - Part 4 BMN165 All Dose - Part 4
    Arm/Group Description BMN165 < 20 mg/day subcutaneous injection administered using a prefilled syringe in Part 4. BMN165 < 20 mg/day subcutaneous injection administered using a prefilled syringe in Part 4. BMN165 40 to < 60 mg/day subcutaneous injection administered using a prefilled syringe in Part 4. BMN165 >= 60 mg/day subcutaneous injection administered using a prefilled syringe in Part 4. Up to 60mg/day BMN165 subcutaneous injection administered using a prefilled syringe in Part 4.
    Measure Participants 61 131 184 62 202
    Change from Baseline to Part 4 Week 57
    -1004.9
    (541.19)
    -984.0
    (531.33)
    -810.2
    (595.24)
    -662.3
    (465.61)
    -839.5
    (562.74)
    Change from Baseline to Part 4 Week 105
    -1015.3
    (557.00)
    -1109.2
    (474.25)
    -858.5
    (593.73)
    -641.0
    (568.67)
    -890.8
    (578.38)
    Change from Baseline to Part 4 Week 161
    -1006.5
    (514.76)
    -1111.9
    (519.40)
    -662.8
    (433.80)
    -808.6
    (558.22)
    -882.0
    (528.61)
    Change from Baseline to Part 4 Week 209
    -897.3
    (494.41)
    -1020.4
    (495.79)
    -541.6
    (245.83)
    -961.7
    (339.92)
    -842.3
    (418.37)
    Change from Baseline to Part 4 Week 249
    -1059.5
    (160.51)
    -1314.0
    (NA)
    -1144.3
    (185.67)
    4. Secondary Outcome
    Title Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS TMD at Part 2
    Description Phenylketonuria (PKU) Total Mood Disturbance (TMD) Profile of Mood States (POMS) PKU POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
    Time Frame At Part 2 baseline and change from baseline at Part 2 week 8

    Outcome Measure Data

    Analysis Population Description
    mITT population
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2.
    Measure Participants 29 14 29 14
    Baseline
    7.1
    (14.18)
    8.6
    (10.84)
    8.9
    (12.28)
    5.0
    (8.56)
    Change from Baseline Part 2 Week 8
    4.8
    (12.63)
    4.3
    (11.96)
    -2.0
    (10.25)
    0.0
    (14.08)
    5. Secondary Outcome
    Title Change From Baseline in the Cognitive and Mood Symptoms Measured by PKU POMS Confusion Subscale at Part 2
    Description PKU POMS confusion mood domain (referred to as the confusion subscale) is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
    Time Frame At Part 2 baseline and change from baseline at Part 2 week 8

    Outcome Measure Data

    Analysis Population Description
    mITT population
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2.
    Measure Participants 29 14 29 14
    Baseline
    2.0
    (2.09)
    2.1
    (1.49)
    2.4
    (2.02)
    1.2
    (1.53)
    Change from Baseline Part 2 Week 8
    0.8
    (2.79)
    1.4
    (2.47)
    -0.3
    (1.84)
    0.5
    (2.22)
    6. Secondary Outcome
    Title Change From Baseline in the Cognitive and Mood Symptoms Measured by POMS TMD at Part 2
    Description Full-length POMS TMD is self-rated, each item in the tool is rated using a five-point Likert scale: 0 (not at all), 1 (a little), 2 (moderately), 3 (quite a bit), and 4 (extremely).
    Time Frame At Part 2 baseline and change from baseline at Part 2 week 8

    Outcome Measure Data

    Analysis Population Description
    mITT population
    Arm/Group Title BMN165 20mg/Day Placebo 20mg/Day BMN165 40mg/Day Placebo 40mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe in Part 2. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 1, 2 and 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe in Part 2.
    Measure Participants 29 14 29 14
    Baseline
    16.2
    (35.63)
    18.1
    (28.26)
    24.3
    (35.38)
    13.3
    (21.63)
    Change from Baseline Part 2 Week 8
    13.1
    (30.73)
    7.3
    (26.23)
    -3.2
    (26.63)
    -1.7
    (29.34)

    Adverse Events

    Time Frame Up to 301 weeks
    Adverse Event Reporting Description Safety Analyses consists of the population for safety analyses of all subjects who enrolled into the study and all subjects who enrolled into each study part for analysis by study part.
    Arm/Group Title Part 1 - 20 mg/Day Part 1 - 40 mg/Day Part 2 - 20 mg/Day Active Part 2 - 40 mg/Day Active Part 2 - 20 mg/Day Placebo Part 2 - 40 mg/Day Placebo Part 3 - Stay on Active 20 mg/Day Part 3 - Stay on Active 40 mg/Day Part 3 - Switch From Placebo to Active 20 mg/Day Part 3 - Switch From Placebo to Active 40 mg/Day Part 4 - < 20 mg/Day Part 4 - 20 to < 40 mg/Day Part 4 - 40 to < 60 mg/Day Part 4 - >= 60 mg/Day
    Arm/Group Description BMN165 20mg/day subcutaneous injection administered using vial and syringe. BMN165 40mg/day subcutaneous injection administered using vial and syringe. BMN165 20mg/day subcutaneous injection administered using vial and syringe. BMN165 40mg/day subcutaneous injection administered using vial and syringe. Matching placebo 20mg/day subcutaneous injection administered using vial and syringe. Matching placebo 40mg/day subcutaneous injection administered using vial and syringe. BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. BMN165 20mg/day subcutaneous injection administered using vial and syringe in Part 3A. BMN165 20mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. BMN165 40mg/day subcutaneous injection administered using vial and syringe in Part 3A. BMN165 40mg/day subcutaneous injection administered using a prefilled syringe in Part 3B. BMN165 <20mg/day subcutaneous injection administered using a prefilled syringe. BMN165 20 to <40mg/day subcutaneous injection administered using a prefilled syringe. BMN165 40 to <60mg/day subcutaneous injection administered using a prefilled syringe. BMN165 >=60mg/day subcutaneous injection administered using a prefilled syringe.
    All Cause Mortality
    Part 1 - 20 mg/Day Part 1 - 40 mg/Day Part 2 - 20 mg/Day Active Part 2 - 40 mg/Day Active Part 2 - 20 mg/Day Placebo Part 2 - 40 mg/Day Placebo Part 3 - Stay on Active 20 mg/Day Part 3 - Stay on Active 40 mg/Day Part 3 - Switch From Placebo to Active 20 mg/Day Part 3 - Switch From Placebo to Active 40 mg/Day Part 4 - < 20 mg/Day Part 4 - 20 to < 40 mg/Day Part 4 - 40 to < 60 mg/Day Part 4 - >= 60 mg/Day
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Serious Adverse Events
    Part 1 - 20 mg/Day Part 1 - 40 mg/Day Part 2 - 20 mg/Day Active Part 2 - 40 mg/Day Active Part 2 - 20 mg/Day Placebo Part 2 - 40 mg/Day Placebo Part 3 - Stay on Active 20 mg/Day Part 3 - Stay on Active 40 mg/Day Part 3 - Switch From Placebo to Active 20 mg/Day Part 3 - Switch From Placebo to Active 40 mg/Day Part 4 - < 20 mg/Day Part 4 - 20 to < 40 mg/Day Part 4 - 40 to < 60 mg/Day Part 4 - >= 60 mg/Day
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 6/86 (7%) 2/78 (2.6%) 0/34 (0%) 2/32 (6.3%) 1/15 (6.7%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 7/67 (10.4%) 6/152 (3.9%) 16/186 (8.6%) 5/89 (5.6%)
    Blood and lymphatic system disorders
    Iron Deficiency Anaemia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Lymphoid Tissue Hyperplasia 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Cardiac disorders
    Tachycardia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Gastrointestinal disorders
    Epiploic Appendagitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Haemorrhoidal Haemorrhage 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Haemorrhoids 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Pancreatitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    General disorders
    Chest Pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 2/186 (1.1%) 0/89 (0%)
    Non-cardiac Chest Pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 2/186 (1.1%) 0/89 (0%)
    Immune system disorders
    Anaphylactic Reaction 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 4/186 (2.2%) 0/89 (0%)
    Anaphylactoid Reaction 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Hypersensitivity 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 2/186 (1.1%) 0/89 (0%)
    Infections and infestations
    Appendicitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Cellulitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Diverticulitis 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Pneumonia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Soft Tissue Infection 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Injury, poisoning and procedural complications
    Road Traffic Accident 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Post procedural haematoma 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Tendon injury 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Investigations
    Blood creatine phosphokinase increased 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Blood pressure increased 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Back pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Scoliosis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Appendix Adenoma 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Xanthogranuloma 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Nervous system disorders
    Loss of consciousness 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Migraine 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Presyncope 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Pregnancy, puerperium and perinatal conditions
    Abortion missed 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Gestational hypertension 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Hyperemesis gravidarum 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Psychiatric disorders
    Agitation 0/86 (0%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Depression 0/86 (0%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Anxiety 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Brief Psychotic Disorder with Marked Stressors 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Parasomnia 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Reproductive system and breast disorders
    Endometriosis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Skin and subcutaneous tissue disorders
    Angioedema 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Skin Exfoliation 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Other (Not Including Serious) Adverse Events
    Part 1 - 20 mg/Day Part 1 - 40 mg/Day Part 2 - 20 mg/Day Active Part 2 - 40 mg/Day Active Part 2 - 20 mg/Day Placebo Part 2 - 40 mg/Day Placebo Part 3 - Stay on Active 20 mg/Day Part 3 - Stay on Active 40 mg/Day Part 3 - Switch From Placebo to Active 20 mg/Day Part 3 - Switch From Placebo to Active 40 mg/Day Part 4 - < 20 mg/Day Part 4 - 20 to < 40 mg/Day Part 4 - 40 to < 60 mg/Day Part 4 - >= 60 mg/Day
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 70/86 (81.4%) 59/78 (75.6%) 27/34 (79.4%) 28/32 (87.5%) 14/15 (93.3%) 13/14 (92.9%) 19/23 (82.6%) 15/18 (83.3%) 8/11 (72.7%) 7/8 (87.5%) 62/67 (92.5%) 105/152 (69.1%) 178/186 (95.7%) 59/89 (66.3%)
    Blood and lymphatic system disorders
    Lymphadenopathy 0/86 (0%) 5/78 (6.4%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 2/14 (14.3%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 1/67 (1.5%) 8/152 (5.3%) 18/186 (9.7%) 3/89 (3.4%)
    Ear and labyrinth disorders
    Ear pain 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 3/152 (2%) 4/186 (2.2%) 2/89 (2.2%)
    Tinnitus 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Vertigo 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 1/152 (0.7%) 3/186 (1.6%) 0/89 (0%)
    Eye disorders
    Blepharospasm 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Gastrointestinal disorders
    Vomiting 4/86 (4.7%) 2/78 (2.6%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 1/23 (4.3%) 1/18 (5.6%) 1/11 (9.1%) 1/8 (12.5%) 8/67 (11.9%) 18/152 (11.8%) 34/186 (18.3%) 13/89 (14.6%)
    Nausea 5/86 (5.8%) 5/78 (6.4%) 4/34 (11.8%) 1/32 (3.1%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 3/18 (16.7%) 0/11 (0%) 0/8 (0%) 10/67 (14.9%) 11/152 (7.2%) 28/186 (15.1%) 16/89 (18%)
    Diarrhoea 4/86 (4.7%) 5/78 (6.4%) 2/34 (5.9%) 2/32 (6.3%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 8/67 (11.9%) 15/152 (9.9%) 25/186 (13.4%) 9/89 (10.1%)
    Abdominal pain upper 1/86 (1.2%) 0/78 (0%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 7/67 (10.4%) 5/152 (3.3%) 17/186 (9.1%) 4/89 (4.5%)
    Dyspepsia 3/86 (3.5%) 3/78 (3.8%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 10/152 (6.6%) 10/186 (5.4%) 5/89 (5.6%)
    Abdominal pain 1/86 (1.2%) 2/78 (2.6%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 7/152 (4.6%) 10/186 (5.4%) 6/89 (6.7%)
    Toothache 1/86 (1.2%) 2/78 (2.6%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 6/152 (3.9%) 12/186 (6.5%) 5/89 (5.6%)
    Gastrooesophageal reflux disease 1/86 (1.2%) 2/78 (2.6%) 0/34 (0%) 2/32 (6.3%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 6/152 (3.9%) 8/186 (4.3%) 9/89 (10.1%)
    Constipation 1/86 (1.2%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 3/152 (2%) 10/186 (5.4%) 6/89 (6.7%)
    Abdominal discomfort 2/86 (2.3%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 3/152 (2%) 11/186 (5.9%) 2/89 (2.2%)
    Frequent bowel movements 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Abdominal distension 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 2/186 (1.1%) 5/89 (5.6%)
    General disorders
    Injection site reaction 13/86 (15.1%) 7/78 (9%) 4/34 (11.8%) 1/32 (3.1%) 1/15 (6.7%) 1/14 (7.1%) 3/23 (13%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 6/67 (9%) 14/152 (9.2%) 46/186 (24.7%) 11/89 (12.4%)
    Injection site bruising 9/86 (10.5%) 7/78 (9%) 2/34 (5.9%) 1/32 (3.1%) 2/15 (13.3%) 1/14 (7.1%) 2/23 (8.7%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 14/152 (9.2%) 41/186 (22%) 12/89 (13.5%)
    Injection site pruritus 6/86 (7%) 3/78 (3.8%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 9/152 (5.9%) 24/186 (12.9%) 10/89 (11.2%)
    Fatigue 8/86 (9.3%) 3/78 (3.8%) 4/34 (11.8%) 3/32 (9.4%) 3/15 (20%) 0/14 (0%) 5/23 (21.7%) 4/18 (22.2%) 0/11 (0%) 1/8 (12.5%) 10/67 (14.9%) 8/152 (5.3%) 14/186 (7.5%) 10/89 (11.2%)
    Injection site induration 2/86 (2.3%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 14/152 (9.2%) 24/186 (12.9%) 6/89 (6.7%)
    Injection site pain 3/86 (3.5%) 0/78 (0%) 1/34 (2.9%) 1/32 (3.1%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 10/152 (6.6%) 22/186 (11.8%) 9/89 (10.1%)
    Injection site swelling 5/86 (5.8%) 2/78 (2.6%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 9/152 (5.9%) 19/186 (10.2%) 3/89 (3.4%)
    Injection site erythema 4/86 (4.7%) 5/78 (6.4%) 2/34 (5.9%) 2/32 (6.3%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 3/67 (4.5%) 3/152 (2%) 19/186 (10.2%) 7/89 (7.9%)
    Pyrexia 2/86 (2.3%) 1/78 (1.3%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 4/152 (2.6%) 19/186 (10.2%) 6/89 (6.7%)
    Peripheral swelling 2/86 (2.3%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 4/152 (2.6%) 15/186 (8.1%) 2/89 (2.2%)
    Pain 2/86 (2.3%) 2/78 (2.6%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 2/18 (11.1%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 2/152 (1.3%) 10/186 (5.4%) 5/89 (5.6%)
    Injection site mass 0/86 (0%) 3/78 (3.8%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 2/152 (1.3%) 12/186 (6.5%) 0/89 (0%)
    Non-cardiac chest pain 2/86 (2.3%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 4/152 (2.6%) 10/186 (5.4%) 1/89 (1.1%)
    Injection site haemorrhage 1/86 (1.2%) 1/78 (1.3%) 1/34 (2.9%) 2/32 (6.3%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 5/152 (3.3%) 5/186 (2.7%) 5/89 (5.6%)
    Chest discomfort 1/86 (1.2%) 0/78 (0%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 2/186 (1.1%) 1/89 (1.1%)
    Feeling abnormal 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 2/186 (1.1%) 2/89 (2.2%)
    Inflammation 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 1/152 (0.7%) 0/186 (0%) 0/89 (0%)
    Chest pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 1/67 (1.5%) 1/152 (0.7%) 6/186 (3.2%) 0/89 (0%)
    Malaise 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Immune system disorders
    Seasonal allergy 2/86 (2.3%) 2/78 (2.6%) 0/34 (0%) 2/32 (6.3%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 8/67 (11.9%) 6/152 (3.9%) 19/186 (10.2%) 3/89 (3.4%)
    Hypersensitivity 0/86 (0%) 2/78 (2.6%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 3/152 (2%) 10/186 (5.4%) 2/89 (2.2%)
    Infections and infestations
    Nasopharyngitis 7/86 (8.1%) 11/78 (14.1%) 4/34 (11.8%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 2/23 (8.7%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 15/67 (22.4%) 27/152 (17.8%) 59/186 (31.7%) 19/89 (21.3%)
    Upper respiratory tract infection 8/86 (9.3%) 5/78 (6.4%) 1/34 (2.9%) 0/32 (0%) 3/15 (20%) 2/14 (14.3%) 3/23 (13%) 2/18 (11.1%) 1/11 (9.1%) 0/8 (0%) 14/67 (20.9%) 29/152 (19.1%) 51/186 (27.4%) 10/89 (11.2%)
    Sinusitis 1/86 (1.2%) 2/78 (2.6%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 1/8 (12.5%) 9/67 (13.4%) 13/152 (8.6%) 22/186 (11.8%) 11/89 (12.4%)
    Influenza 1/86 (1.2%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 5/152 (3.3%) 15/186 (8.1%) 8/89 (9%)
    Bronchitis 1/86 (1.2%) 0/78 (0%) 1/34 (2.9%) 1/32 (3.1%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 3/67 (4.5%) 9/152 (5.9%) 13/186 (7%) 3/89 (3.4%)
    Gastroenteritis viral 1/86 (1.2%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 7/152 (4.6%) 11/186 (5.9%) 7/89 (7.9%)
    Urinary tract infection 1/86 (1.2%) 3/78 (3.8%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 5/152 (3.3%) 13/186 (7%) 3/89 (3.4%)
    Pharyngitis streptococcal 0/86 (0%) 2/78 (2.6%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 3/67 (4.5%) 1/152 (0.7%) 10/186 (5.4%) 4/89 (4.5%)
    Ear infection 0/86 (0%) 3/78 (3.8%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 4/152 (2.6%) 6/186 (3.2%) 3/89 (3.4%)
    Viral infection 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 3/152 (2%) 10/186 (5.4%) 1/89 (1.1%)
    Gastroenteritis 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 2/152 (1.3%) 6/186 (3.2%) 2/89 (2.2%)
    Conjunctivitis 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 4/152 (2.6%) 6/186 (3.2%) 1/89 (1.1%)
    Fungal infection 0/86 (0%) 1/78 (1.3%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 3/152 (2%) 2/186 (1.1%) 3/89 (3.4%)
    Fungal skin infection 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Laryngitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 3/186 (1.6%) 0/89 (0%)
    Labyrinthitis 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 2/67 (3%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Vaginal infection 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Injury, poisoning and procedural complications
    Contusion 3/86 (3.5%) 3/78 (3.8%) 1/34 (2.9%) 1/32 (3.1%) 2/15 (13.3%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 2/11 (18.2%) 1/8 (12.5%) 9/67 (13.4%) 9/152 (5.9%) 22/186 (11.8%) 5/89 (5.6%)
    Arthropod bite 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 3/152 (2%) 12/186 (6.5%) 4/89 (4.5%)
    Ligament sprain 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 5/152 (3.3%) 7/186 (3.8%) 5/89 (5.6%)
    Muscle strain 1/86 (1.2%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 2/152 (1.3%) 8/186 (4.3%) 2/89 (2.2%)
    Post-traumatic pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Road traffic accident 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 2/152 (1.3%) 0/186 (0%) 0/89 (0%)
    Skin abrasion 2/86 (2.3%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 1/152 (0.7%) 2/186 (1.1%) 1/89 (1.1%)
    Injury 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Investigations
    Amino acid level decreased 3/86 (3.5%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 9/67 (13.4%) 13/152 (8.6%) 37/186 (19.9%) 13/89 (14.6%)
    Blood creatine phosphokinase increased 0/86 (0%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 2/15 (13.3%) 1/14 (7.1%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 6/186 (3.2%) 1/89 (1.1%)
    Complement factor C3 decreased 1/86 (1.2%) 2/78 (2.6%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 1/152 (0.7%) 5/186 (2.7%) 0/89 (0%)
    Blood bilirubin increased 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Weight decreased 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Weight increased 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 1/186 (0.5%) 0/89 (0%)
    Blood cortisol decreased 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 0/152 (0%) 2/186 (1.1%) 1/89 (1.1%)
    Complement factor decreased 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 1/89 (1.1%)
    Metabolism and nutrition disorders
    Hypoglycaemia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 2/186 (1.1%) 0/89 (0%)
    Musculoskeletal and connective tissue disorders
    Arthralgia 9/86 (10.5%) 13/78 (16.7%) 7/34 (20.6%) 2/32 (6.3%) 1/15 (6.7%) 2/14 (14.3%) 3/23 (13%) 0/18 (0%) 3/11 (27.3%) 2/8 (25%) 16/67 (23.9%) 33/152 (21.7%) 64/186 (34.4%) 22/89 (24.7%)
    Back pain 4/86 (4.7%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 10/67 (14.9%) 14/152 (9.2%) 33/186 (17.7%) 7/89 (7.9%)
    Pain in extremity 5/86 (5.8%) 4/78 (5.1%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 9/67 (13.4%) 14/152 (9.2%) 24/186 (12.9%) 10/89 (11.2%)
    Musculoskeletal pain 3/86 (3.5%) 3/78 (3.8%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 6/152 (3.9%) 16/186 (8.6%) 3/89 (3.4%)
    Myalgia 2/86 (2.3%) 3/78 (3.8%) 0/34 (0%) 2/32 (6.3%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 4/67 (6%) 5/152 (3.3%) 15/186 (8.1%) 2/89 (2.2%)
    Neck pain 0/86 (0%) 2/78 (2.6%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 1/152 (0.7%) 12/186 (6.5%) 5/89 (5.6%)
    Muscle spasms 1/86 (1.2%) 2/78 (2.6%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 3/67 (4.5%) 3/152 (2%) 8/186 (4.3%) 5/89 (5.6%)
    Flank pain 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Nervous system disorders
    Headache 16/86 (18.6%) 12/78 (15.4%) 6/34 (17.6%) 2/32 (6.3%) 3/15 (20%) 4/14 (28.6%) 2/23 (8.7%) 3/18 (16.7%) 1/11 (9.1%) 0/8 (0%) 20/67 (29.9%) 29/152 (19.1%) 59/186 (31.7%) 24/89 (27%)
    Dizziness 2/86 (2.3%) 7/78 (9%) 1/34 (2.9%) 2/32 (6.3%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 10/67 (14.9%) 6/152 (3.9%) 21/186 (11.3%) 11/89 (12.4%)
    Migraine 3/86 (3.5%) 2/78 (2.6%) 0/34 (0%) 2/32 (6.3%) 1/15 (6.7%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 6/67 (9%) 8/152 (5.3%) 18/186 (9.7%) 9/89 (10.1%)
    Disturbance in attention 0/86 (0%) 0/78 (0%) 4/34 (11.8%) 1/32 (3.1%) 2/15 (13.3%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 1/67 (1.5%) 3/152 (2%) 5/186 (2.7%) 3/89 (3.4%)
    Lethargy 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 2/15 (13.3%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 1/11 (9.1%) 1/8 (12.5%) 1/67 (1.5%) 1/152 (0.7%) 8/186 (4.3%) 1/89 (1.1%)
    Memory impairment 0/86 (0%) 2/78 (2.6%) 3/34 (8.8%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 0/152 (0%) 4/186 (2.2%) 1/89 (1.1%)
    Tremor 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 1/14 (7.1%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 4/67 (6%) 0/152 (0%) 4/186 (2.2%) 2/89 (2.2%)
    Dyspraxia 0/86 (0%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Sciatica 0/86 (0%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 1/152 (0.7%) 1/186 (0.5%) 0/89 (0%)
    Hyperreflexia 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 0/152 (0%) 4/186 (2.2%) 0/89 (0%)
    Paraesthesia 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 1/23 (4.3%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 2/152 (1.3%) 5/186 (2.7%) 2/89 (2.2%)
    Somnolence 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Presyncope 1/86 (1.2%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 1/89 (1.1%)
    Psychiatric disorders
    Anxiety 2/86 (2.3%) 2/78 (2.6%) 4/34 (11.8%) 3/32 (9.4%) 0/15 (0%) 2/14 (14.3%) 1/23 (4.3%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 11/67 (16.4%) 10/152 (6.6%) 23/186 (12.4%) 6/89 (6.7%)
    Depression 0/86 (0%) 1/78 (1.3%) 1/34 (2.9%) 2/32 (6.3%) 2/15 (13.3%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 9/67 (13.4%) 11/152 (7.2%) 13/186 (7%) 3/89 (3.4%)
    Insomnia 1/86 (1.2%) 1/78 (1.3%) 1/34 (2.9%) 3/32 (9.4%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 6/67 (9%) 7/152 (4.6%) 17/186 (9.1%) 2/89 (2.2%)
    Irritability 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 2/32 (6.3%) 2/15 (13.3%) 1/14 (7.1%) 1/23 (4.3%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 1/152 (0.7%) 2/186 (1.1%) 1/89 (1.1%)
    Agitation 0/86 (0%) 0/78 (0%) 0/34 (0%) 3/32 (9.4%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)
    Depressive symptom 1/86 (1.2%) 0/78 (0%) 2/34 (5.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 1/186 (0.5%) 2/89 (2.2%)
    Mood altered 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 2/14 (14.3%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 2/89 (2.2%)
    Distractibility 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Emotional disorder 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 1/152 (0.7%) 1/186 (0.5%) 1/89 (1.1%)
    Stress 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 0/67 (0%) 1/152 (0.7%) 1/186 (0.5%) 2/89 (2.2%)
    Renal and urinary disorders
    Ketonuria 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 2/186 (1.1%) 0/89 (0%)
    Proteinuria 0/86 (0%) 1/78 (1.3%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 2/152 (1.3%) 2/186 (1.1%) 3/89 (3.4%)
    Urine odour abnormal 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 1/15 (6.7%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 0/186 (0%) 0/89 (0%)
    Reproductive system and breast disorders
    Dysmenorrhoea 5/86 (5.8%) 1/78 (1.3%) 3/34 (8.8%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 2/23 (8.7%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 2/67 (3%) 4/152 (2.6%) 9/186 (4.8%) 3/89 (3.4%)
    Respiratory, thoracic and mediastinal disorders
    Cough 6/86 (7%) 2/78 (2.6%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 2/14 (14.3%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 6/67 (9%) 20/152 (13.2%) 29/186 (15.6%) 10/89 (11.2%)
    Oropharyngeal pain 4/86 (4.7%) 6/78 (7.7%) 1/34 (2.9%) 1/32 (3.1%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 6/67 (9%) 14/152 (9.2%) 32/186 (17.2%) 8/89 (9%)
    Nasal congestion 4/86 (4.7%) 2/78 (2.6%) 1/34 (2.9%) 0/32 (0%) 3/15 (20%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 9/67 (13.4%) 12/152 (7.9%) 20/186 (10.8%) 8/89 (9%)
    Sinus congestion 3/86 (3.5%) 2/78 (2.6%) 2/34 (5.9%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 7/67 (10.4%) 5/152 (3.3%) 12/186 (6.5%) 4/89 (4.5%)
    Rhinorrhoea 1/86 (1.2%) 2/78 (2.6%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 1/14 (7.1%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 1/67 (1.5%) 2/152 (1.3%) 7/186 (3.8%) 3/89 (3.4%)
    Wheezing 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 2/186 (1.1%) 1/89 (1.1%)
    Skin and subcutaneous tissue disorders
    Rash 2/86 (2.3%) 6/78 (7.7%) 2/34 (5.9%) 3/32 (9.4%) 1/15 (6.7%) 0/14 (0%) 2/23 (8.7%) 2/18 (11.1%) 0/11 (0%) 1/8 (12.5%) 7/67 (10.4%) 8/152 (5.3%) 34/186 (18.3%) 14/89 (15.7%)
    Pruritus 2/86 (2.3%) 7/78 (9%) 1/34 (2.9%) 4/32 (12.5%) 0/15 (0%) 1/14 (7.1%) 1/23 (4.3%) 1/18 (5.6%) 1/11 (9.1%) 0/8 (0%) 6/67 (9%) 13/152 (8.6%) 33/186 (17.7%) 14/89 (15.7%)
    Urticaria 4/86 (4.7%) 0/78 (0%) 2/34 (5.9%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 1/23 (4.3%) 1/18 (5.6%) 0/11 (0%) 1/8 (12.5%) 4/67 (6%) 12/152 (7.9%) 28/186 (15.1%) 12/89 (13.5%)
    Alopecia 2/86 (2.3%) 4/78 (5.1%) 2/34 (5.9%) 0/32 (0%) 2/15 (13.3%) 1/14 (7.1%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 12/152 (7.9%) 12/186 (6.5%) 6/89 (6.7%)
    Erythema 3/86 (3.5%) 2/78 (2.6%) 0/34 (0%) 1/32 (3.1%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 0/8 (0%) 5/67 (7.5%) 6/152 (3.9%) 9/186 (4.8%) 4/89 (4.5%)
    Pruritus generalised 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 2/67 (3%) 2/152 (1.3%) 8/186 (4.3%) 4/89 (4.5%)
    Dry skin 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 1/8 (12.5%) 1/67 (1.5%) 0/152 (0%) 6/186 (3.2%) 0/89 (0%)
    Papule 0/86 (0%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 0/11 (0%) 1/8 (12.5%) 0/67 (0%) 2/152 (1.3%) 4/186 (2.2%) 0/89 (0%)
    Rash maculo-papular 1/86 (1.2%) 0/78 (0%) 0/34 (0%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 0/18 (0%) 1/11 (9.1%) 0/8 (0%) 1/67 (1.5%) 0/152 (0%) 3/186 (1.6%) 0/89 (0%)
    Skin exfoliation 0/86 (0%) 0/78 (0%) 1/34 (2.9%) 0/32 (0%) 0/15 (0%) 0/14 (0%) 0/23 (0%) 1/18 (5.6%) 0/11 (0%) 0/8 (0%) 0/67 (0%) 0/152 (0%) 1/186 (0.5%) 0/89 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo.

    Results Point of Contact

    Name/Title Debra Lounsbury/Sr Principle Scientist, Clinical Sciences
    Organization BioMarin Pharmaceutical Inc
    Phone 415-506-6348
    Email Dlounsbury@bmrn.com
    Responsible Party:
    BioMarin Pharmaceutical
    ClinicalTrials.gov Identifier:
    NCT01889862
    Other Study ID Numbers:
    • 165-302
    First Posted:
    Jul 1, 2013
    Last Update Posted:
    May 21, 2021
    Last Verified:
    Apr 1, 2021