a. 1). Safety results are expressed as the number of patients with an adverse reaction per 100 patient-years of exposure (except for injection site reactions). The most frequently reported events were injection site reactions, diarrhoea and nausea.
The addition of Fuzeon to background antiretroviral therapy generally did not increase the frequency or severity of most adverse reactions. b. Tabulated list of adverse reactions Table 2 presents events seen at a higher rate among patients receiving Fuzeon + OB regimen than among patients on the OB alone regimen with an exposure adjusted increase of at least 2 patients with event per 100 patient-years.
A statistically significant increase was seen for pneumonia and lymphadenopathy. Most adverse reactions were of mild or moderate intensity. Adverse reactions are listed according to MedDRA system organ class and frequency category. Frequency categories are defined using the following convention: very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); not known (cannot be estimated from the available data).
6 Table 2: Adverse reactions attributed to treatment with Fuzeon in studies TORO 1 and TORO 2 combined System organ class Frequency Adverse reaction Infections and infestations Common Sinusitis, skin papilloma, influenza, pneumonia, ear infection Blood and lymphatic system disorders Common Lymphadenopathy Metabolism and nutrition disorders Common Appetite decreased, anorexia, hypertriglyceridaemia, blood triglycerides increased, diabetes mellitus Psychiatric disorders Common Anxiety, nightmare, irritability Nervous system disorders Very common Common Peripheral neuropathy Hypoaesthesia, disturbance in attention, tremor Eye disorders Common Conjunctivitis Ear and labyrinth disorders Common Vertigo Respiratory, thoracic and mediastinal disorders Common Nasal congestion Gastrointestinal disorders Common Pancreatitis, gastro-oesophageal reflux disease Skin and subcutaneous tissue disorders Common Dry skin, eczema seborrhoeic, erythema, acne Musculoskeletal, connective tissue and bone disorders Common Myalgia Renal and Urinary Disorders Common Nephrolithiasis, haematuria General disorders and administration site conditions Very common Common Weight decreased Influenza like illness, asthenia c.
Description of selected adverse reactions Injection site reactions Injection site reactions (ISRs) were the most frequently reported adverse reaction and occurred in 98% of the patients (Table 3). The vast majority of ISRs occurred within the first week of Fuzeon 7 administration and were associated with mild to moderate pain or discomfort at the injection site without limitation of usual activities.
The severity of the pain and discomfort did not increase with treatment duration. The signs and symptoms generally lasted equal to or less than 7 days. 5% of patients. 7%g aAny severity grade. bGrade 3= severe pain requiring analgesics (or narcotic analgesics for ≤ 72 hours) and/or limiting usual activities; Grade 4= severe pain requiring hospitalisation or prolongation of hospitalisation, resulting in death, or persistent or significant disability/incapacity, or life-threatening, or medically significant.
cGrade 3= ≥ 50 mm but < 85 mm average diameter; Grade 4= ≥ 85 mm average diameter. dGrade 3= ≥ 25 mm but < 50 mm average diameter; Grade 4= ≥ 50 mm average diameter. eGrade 3= ≥ 3 cm; Grade 4= If draining. fGrade 3= refractory to topical treatment or requiring oral or parenteral treatment; Grade 4= not defined.
gGrade 3= > 3 cm but ≤ 5 cm; Grade 4= > 5 cm. 4). Other adverse reactions In HIV-infected patients with severe immune deficiency at the time of initiation of combination antiretroviral therapy (CART), an inflammatory reaction to asymptomatic or residual opportunistic infections may arise.
4). Cases of osteonecrosis have been reported, particularly in patients with generally acknowledged risk factors, advanced HIV disease or long-term exposure to CART. 4). As a peptide, enfuvirtide can cause cutaneous amyloidosis at the injection site.
Laboratory abnormalities The majority of patients had no change in the toxicity grade of any laboratory parameter during the study except for those listed in Table 4. 6 patients with event per 100 patient-years). 8 patients with event per 100 patient- years).
8 Table 4: Exposure adjusted Grade 3 & 4 laboratory abnormalities among patients […]