Trial Outcomes & Findings for Study of the Efficacy and Safety of DU-176b in Preventing Blood Clots in Patients Undergoing Total Hip Replacement (NCT NCT00107900)

NCT ID: NCT00107900

Last Updated: 2019-02-26

Results Overview

The primary efficacy endpoint was the proportion of subjects who experienced at least one of the thromboembolic events listed below during the period from the start of study treatment to the venography at the end of study treatment (approximately 2 weeks post surgery). Confirmed deep vein thrombosis ( both proximal and distal ) as assessed by unilateral or bilateral ascending contrast venograms 7 to 10 days following surgery Symptomatic and objectively proven Pulmonary Embolism (PE) prior to venography Symptomatic and objectively proven Deep Vein Thrombosis (DVT) prior to venography

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

606 participants

Primary outcome timeframe

2 weeks

Results posted on

2019-02-26

Participant Flow

Participant milestones

Participant milestones
Measure
15mg BID
15mg edoxaban administered twice daily (BID)
30mg QD
30mg edoxaban administered once daily (QD)
30mg BID
30mg edoxaban administered twice daily (BID)
60mg QD
60mg edoxaban administered once daily (QD)
60mg BID
60mg edoxaban administered twice daily (BID)
120mg QD
120mg edoxaban administered once daily (QD)
Overall Study
STARTED
85
75
129
99
115
103
Overall Study
COMPLETED
75
72
104
87
94
94
Overall Study
NOT COMPLETED
10
3
25
12
21
9

Reasons for withdrawal

Reasons for withdrawal
Measure
15mg BID
15mg edoxaban administered twice daily (BID)
30mg QD
30mg edoxaban administered once daily (QD)
30mg BID
30mg edoxaban administered twice daily (BID)
60mg QD
60mg edoxaban administered once daily (QD)
60mg BID
60mg edoxaban administered twice daily (BID)
120mg QD
120mg edoxaban administered once daily (QD)
Overall Study
Adverse Event
3
2
10
3
5
3
Overall Study
Death
0
0
0
0
1
0
Overall Study
Lost to Follow-up
4
1
3
2
5
5
Overall Study
Protocol Violation
1
0
5
5
7
0
Overall Study
Withdrawal by Subject
1
0
5
0
1
1
Overall Study
Administrative Reasons
1
0
2
2
2
0

Baseline Characteristics

Study of the Efficacy and Safety of DU-176b in Preventing Blood Clots in Patients Undergoing Total Hip Replacement

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
15mg BID
n=85 Participants
15mg edoxaban administered twice daily (BID)
30mg QD
n=75 Participants
30mg edoxaban administered once daily (QD)
30mg BID
n=129 Participants
30mg edoxaban administered twice daily (BID)
60mg QD
n=99 Participants
60mg edoxaban administered once daily (QD)
60mg BID
n=115 Participants
60mg edoxaban administered twice daily (BID)
120mg QD
n=103 Participants
120mg edoxaban administered once daily (QD)
Total
n=606 Participants
Total of all reporting groups
Age, Continuous
57.6 years
STANDARD_DEVIATION 10.71 • n=5 Participants
59.0 years
STANDARD_DEVIATION 11.06 • n=7 Participants
60.1 years
STANDARD_DEVIATION 13.09 • n=5 Participants
58.6 years
STANDARD_DEVIATION 11.90 • n=4 Participants
58.8 years
STANDARD_DEVIATION 12.80 • n=21 Participants
56.5 years
STANDARD_DEVIATION 12.83 • n=8 Participants
58.5 years
STANDARD_DEVIATION 12.25 • n=8 Participants
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
0 Participants
n=8 Participants
Age, Categorical
Between 18 and 65 years
60 Participants
n=5 Participants
48 Participants
n=7 Participants
73 Participants
n=5 Participants
65 Participants
n=4 Participants
78 Participants
n=21 Participants
72 Participants
n=8 Participants
396 Participants
n=8 Participants
Age, Categorical
>=65 years
25 Participants
n=5 Participants
27 Participants
n=7 Participants
56 Participants
n=5 Participants
34 Participants
n=4 Participants
37 Participants
n=21 Participants
31 Participants
n=8 Participants
210 Participants
n=8 Participants
Sex: Female, Male
Female
44 Participants
n=5 Participants
48 Participants
n=7 Participants
71 Participants
n=5 Participants
62 Participants
n=4 Participants
69 Participants
n=21 Participants
56 Participants
n=8 Participants
350 Participants
n=8 Participants
Sex: Female, Male
Male
41 Participants
n=5 Participants
27 Participants
n=7 Participants
58 Participants
n=5 Participants
37 Participants
n=4 Participants
46 Participants
n=21 Participants
47 Participants
n=8 Participants
256 Participants
n=8 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
1 Participants
n=8 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
1 Participants
n=8 Participants
1 Participants
n=8 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
0 Participants
n=8 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
0 Participants
n=7 Participants
12 Participants
n=5 Participants
0 Participants
n=4 Participants
3 Participants
n=21 Participants
3 Participants
n=8 Participants
19 Participants
n=8 Participants
Race (NIH/OMB)
White
84 Participants
n=5 Participants
75 Participants
n=7 Participants
115 Participants
n=5 Participants
97 Participants
n=4 Participants
108 Participants
n=21 Participants
99 Participants
n=8 Participants
578 Participants
n=8 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
0 Participants
n=8 Participants
0 Participants
n=8 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
1 Participants
n=4 Participants
4 Participants
n=21 Participants
0 Participants
n=8 Participants
7 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
6 Participants
n=5 Participants
2 Participants
n=4 Participants
4 Participants
n=21 Participants
0 Participants
n=8 Participants
12 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
20 Participants
n=5 Participants
11 Participants
n=7 Participants
83 Participants
n=5 Participants
22 Participants
n=4 Participants
31 Participants
n=21 Participants
27 Participants
n=8 Participants
194 Participants
n=8 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
65 Participants
n=5 Participants
64 Participants
n=7 Participants
40 Participants
n=5 Participants
75 Participants
n=4 Participants
80 Participants
n=21 Participants
76 Participants
n=8 Participants
400 Participants
n=8 Participants
Region of Enrollment
United States
20 participants
n=5 Participants
11 participants
n=7 Participants
89 participants
n=5 Participants
24 participants
n=4 Participants
35 participants
n=21 Participants
27 participants
n=8 Participants
206 participants
n=8 Participants
Region of Enrollment
Europe
65 participants
n=5 Participants
64 participants
n=7 Participants
40 participants
n=5 Participants
75 participants
n=4 Participants
80 participants
n=21 Participants
76 participants
n=8 Participants
400 participants
n=8 Participants

PRIMARY outcome

Timeframe: 2 weeks

Population: modified ITT population

The primary efficacy endpoint was the proportion of subjects who experienced at least one of the thromboembolic events listed below during the period from the start of study treatment to the venography at the end of study treatment (approximately 2 weeks post surgery). Confirmed deep vein thrombosis ( both proximal and distal ) as assessed by unilateral or bilateral ascending contrast venograms 7 to 10 days following surgery Symptomatic and objectively proven Pulmonary Embolism (PE) prior to venography Symptomatic and objectively proven Deep Vein Thrombosis (DVT) prior to venography

Outcome measures

Outcome measures
Measure
15mg BID
n=68 Participants
15mg edoxaban administered twice daily (BID)
30mg QD
n=65 Participants
30mg edoxaban administered once daily (QD)
30mg BID
n=97 Participants
30mg edoxaban administered twice daily (BID)
60mg QD
n=73 Participants
60mg edoxaban administered once daily (QD)
60mg BID
n=84 Participants
60mg edoxaban administered twice daily (BID)
120mg QD
n=80 Participants
120mg edoxaban administered once daily (QD)
Prevention of Venous Thromboembolism (VTE)
13 percentage of patients with event
Interval 11.7 to 28.7
13 percentage of patients with event
Interval 12.3 to 29.9
10 percentage of patients with event
Interval 5.7 to 16.9
13 percentage of patients with event
Interval 10.9 to 26.8
16 percentage of patients with event
Interval 12.3 to 27.5
17 percentage of patients with event
Interval 14.0 to 30.2

SECONDARY outcome

Timeframe: end of treatment

Population: ITT population

Intent to Treat (ITT) population

Outcome measures

Outcome measures
Measure
15mg BID
n=72 Participants
15mg edoxaban administered twice daily (BID)
30mg QD
n=72 Participants
30mg edoxaban administered once daily (QD)
30mg BID
n=86 Participants
30mg edoxaban administered twice daily (BID)
60mg QD
n=84 Participants
60mg edoxaban administered once daily (QD)
60mg BID
n=95 Participants
60mg edoxaban administered twice daily (BID)
120mg QD
n=91 Participants
120mg edoxaban administered once daily (QD)
Change From Baseline for Prothrombin Time (PT) Results
-.2 seconds
Standard Deviation 2.3
-.1 seconds
Standard Deviation 2.7
.7 seconds
Standard Deviation 1.3
.8 seconds
Standard Deviation 2.0
1.1 seconds
Standard Deviation 1.9
1.8 seconds
Standard Deviation 4.3

SECONDARY outcome

Timeframe: end of treatment

Population: ITT population

Intent to Treat (ITT) population

Outcome measures

Outcome measures
Measure
15mg BID
n=72 Participants
15mg edoxaban administered twice daily (BID)
30mg QD
n=72 Participants
30mg edoxaban administered once daily (QD)
30mg BID
n=86 Participants
30mg edoxaban administered twice daily (BID)
60mg QD
n=84 Participants
60mg edoxaban administered once daily (QD)
60mg BID
n=95 Participants
60mg edoxaban administered twice daily (BID)
120mg QD
n=91 Participants
120mg edoxaban administered once daily (QD)
Change From Baseline for International Normalized Ratio (INR) Results
0 INR ratio
Standard Deviation .2
0 INR ratio
Standard Deviation .3
.1 INR ratio
Standard Deviation .1
.1 INR ratio
Standard Deviation .2
.1 INR ratio
Standard Deviation .2
.2 INR ratio
Standard Deviation .4

SECONDARY outcome

Timeframe: end of treatment

Population: ITT population

Intent to Treat (ITT) population

Outcome measures

Outcome measures
Measure
15mg BID
n=72 Participants
15mg edoxaban administered twice daily (BID)
30mg QD
n=72 Participants
30mg edoxaban administered once daily (QD)
30mg BID
n=87 Participants
30mg edoxaban administered twice daily (BID)
60mg QD
n=84 Participants
60mg edoxaban administered once daily (QD)
60mg BID
n=94 Participants
60mg edoxaban administered twice daily (BID)
120mg QD
n=91 Participants
120mg edoxaban administered once daily (QD)
Change From Baseline for Activated Partial Thromboplastin Time (aPTT) Results
-5.1 seconds
Standard Deviation 22.0
-1.6 seconds
Standard Deviation 25.3
2.5 seconds
Standard Deviation 9.8
4.1 seconds
Standard Deviation 17.0
5.8 seconds
Standard Deviation 16.1
11.3 seconds
Standard Deviation 23.1

Adverse Events

15mg BID

Serious events: 4 serious events
Other events: 24 other events
Deaths: 0 deaths

30mg QD

Serious events: 3 serious events
Other events: 19 other events
Deaths: 0 deaths

30mg BID

Serious events: 9 serious events
Other events: 65 other events
Deaths: 0 deaths

60mg QD

Serious events: 10 serious events
Other events: 56 other events
Deaths: 0 deaths

60mg BID

Serious events: 10 serious events
Other events: 66 other events
Deaths: 0 deaths

120mg QD

Serious events: 4 serious events
Other events: 34 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
15mg BID
n=85 participants at risk
15mg edoxaban administered twice daily (BID)
30mg QD
n=75 participants at risk
30mg edoxaban administered once daily (QD)
30mg BID
n=129 participants at risk
30mg edoxaban administered twice daily (BID)
60mg QD
n=99 participants at risk
60mg edoxaban administered once daily (QD)
60mg BID
n=115 participants at risk
60mg edoxaban administered twice daily (BID)
120mg QD
n=103 participants at risk
120mg edoxaban administered once daily (QD)
Gastrointestinal disorders
obstructive inguinal hernia
1.2%
1/85 • Number of events 1
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.00%
0/103
Injury, poisoning and procedural complications
dislocation of joint prosthesis
1.2%
1/85 • Number of events 1
0.00%
0/75
0.78%
1/129 • Number of events 1
1.0%
1/99 • Number of events 1
0.87%
1/115 • Number of events 1
0.00%
0/103
Vascular disorders
haematoma
1.2%
1/85 • Number of events 1
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Infections and infestations
wound infection
1.2%
1/85 • Number of events 1
0.00%
0/75
0.00%
0/129
1.0%
1/99 • Number of events 1
0.00%
0/115
0.97%
1/103 • Number of events 1
Cardiac disorders
atrial fibrillation
1.2%
1/85 • Number of events 1
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.00%
0/103
Infections and infestations
postoperative wound infection
0.00%
0/85
1.3%
1/75 • Number of events 1
0.00%
0/129
2.0%
2/99 • Number of events 2
0.87%
1/115 • Number of events 1
0.97%
1/103 • Number of events 1
Investigations
haemoglobin decreased
0.00%
0/85
1.3%
1/75 • Number of events 1
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.00%
0/103
Respiratory, thoracic and mediastinal disorders
pulmonary embolism
0.00%
0/85
1.3%
1/75 • Number of events 1
0.78%
1/129 • Number of events 1
2.0%
2/99 • Number of events 2
0.87%
1/115 • Number of events 1
0.00%
0/103
Injury, poisoning and procedural complications
hip fracture
0.00%
0/85
1.3%
1/75 • Number of events 1
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.00%
0/103
Gastrointestinal disorders
gastrointestinal haemorrhage
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Blood and lymphatic system disorders
thrombocytopenia
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Investigations
blood alkaline phosphatase abnormal
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Investigations
alanine aminotransferase abnormal
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Investigations
blood bilirubin abnormal
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Investigations
aspartate amniotransferase abnormal
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Gastrointestinal disorders
rectal haemorrhage
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Investigations
hepatic enzyme increase
0.00%
0/85
0.00%
0/75
0.78%
1/129 • Number of events 1
0.00%
0/99
0.00%
0/115
0.00%
0/103
Nervous system disorders
sciatic nerve palsy
0.00%
0/85
0.00%
0/75
0.00%
0/129
1.0%
1/99 • Number of events 1
0.00%
0/115
0.00%
0/103
Injury, poisoning and procedural complications
snake bite
0.00%
0/85
0.00%
0/75
0.00%
0/129
1.0%
1/99 • Number of events 1
0.00%
0/115
0.00%
0/103
Injury, poisoning and procedural complications
contrast media reaction
0.00%
0/85
0.00%
0/75
0.00%
0/129
1.0%
1/99 • Number of events 1
0.00%
0/115
0.00%
0/103
Vascular disorders
wound haemorrhage
0.00%
0/85
0.00%
0/75
0.00%
0/129
1.0%
1/99 • Number of events 1
0.87%
1/115 • Number of events 1
0.97%
1/103 • Number of events 1
Injury, poisoning and procedural complications
postprocedural fistula
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Nervous system disorders
acute psychosis
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Injury, poisoning and procedural complications
anemia postoperative
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.97%
1/103 • Number of events 1
Blood and lymphatic system disorders
lymphadentis
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Infections and infestations
infection
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
1.7%
2/115 • Number of events 2
0.00%
0/103
Injury, poisoning and procedural complications
hip arthroplasty
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Investigations
alanine aminotransferase increase
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Investigations
blood alkaline phosphatase increase
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Blood and lymphatic system disorders
anemia
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Respiratory, thoracic and mediastinal disorders
chronic obstructive pulmonary disease
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.87%
1/115 • Number of events 1
0.00%
0/103
Gastrointestinal disorders
pancreatitis
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.97%
1/103 • Number of events 1
Nervous system disorders
tremor
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.97%
1/103 • Number of events 1
Nervous system disorders
anxiety
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.97%
1/103 • Number of events 1
Musculoskeletal and connective tissue disorders
back pain
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.97%
1/103 • Number of events 1
Vascular disorders
pallor
0.00%
0/85
0.00%
0/75
0.00%
0/129
0.00%
0/99
0.00%
0/115
0.97%
1/103 • Number of events 1

Other adverse events

Other adverse events
Measure
15mg BID
n=85 participants at risk
15mg edoxaban administered twice daily (BID)
30mg QD
n=75 participants at risk
30mg edoxaban administered once daily (QD)
30mg BID
n=129 participants at risk
30mg edoxaban administered twice daily (BID)
60mg QD
n=99 participants at risk
60mg edoxaban administered once daily (QD)
60mg BID
n=115 participants at risk
60mg edoxaban administered twice daily (BID)
120mg QD
n=103 participants at risk
120mg edoxaban administered once daily (QD)
Cardiac disorders
tachycardia
1.2%
1/85
1.3%
1/75
0.78%
1/129
7.1%
7/99
2.6%
3/115
2.9%
3/103
Gastrointestinal disorders
constipation
3.5%
3/85
5.3%
4/75
18.6%
24/129
7.1%
7/99
10.4%
12/115
7.8%
8/103
Gastrointestinal disorders
nausea
3.5%
3/85
2.7%
2/75
7.0%
9/129
6.1%
6/99
7.0%
8/115
3.9%
4/103
General disorders
hyperthermia
9.4%
8/85
6.7%
5/75
3.9%
5/129
27.3%
27/99
20.0%
23/115
8.7%
9/103
General disorders
oedema peripheral
7.1%
6/85
4.0%
3/75
9.3%
12/129
4.0%
4/99
9.6%
11/115
4.9%
5/103
General disorders
pyrexia
3.5%
3/85
5.3%
4/75
17.8%
23/129
10.1%
10/99
9.6%
11/115
8.7%
9/103
Injury, poisoning and procedural complications
procedural pain
1.2%
1/85
2.7%
2/75
2.3%
3/129
3.0%
3/99
5.2%
6/115
0.00%
0/103
Investigations
activated partial thromboplastin time prolonged
0.00%
0/85
1.3%
1/75
0.00%
0/129
13.1%
13/99
4.3%
5/115
5.8%
6/103
Investigations
prothrombin time prolonged
0.00%
0/85
0.00%
0/75
0.00%
0/129
15.2%
15/99
2.6%
3/115
3.9%
4/103
Nervous system disorders
dizziness
1.2%
1/85
0.00%
0/75
5.4%
7/129
4.0%
4/99
2.6%
3/115
0.97%
1/103
Nervous system disorders
headache
0.00%
0/85
1.3%
1/75
7.0%
9/129
1.0%
1/99
3.5%
4/115
1.9%
2/103
Psychiatric disorders
insomnia
0.00%
0/85
0.00%
0/75
7.0%
9/129
5.1%
5/99
4.3%
5/115
0.00%
0/103
Blood and lymphatic system disorders
anaemia
2.4%
2/85
4.0%
3/75
6.2%
8/129
2.0%
2/99
8.7%
10/115
7.8%
8/103
Injury, poisoning and procedural complications
anaemia post-operative
3.5%
3/85
1.3%
1/75
3.9%
5/129
5.1%
5/99
4.3%
5/115
0.97%
1/103

Additional Information

Victor Fernandez

Daiichi Sankyo, Inc.

Phone: 732-590-5000

Results disclosure agreements

  • Principal investigator is a sponsor employee A study site may not publish results of a study until after a coordinated multicenter publication has been submitted for publication or until one year after the study has ended, whichever occurs first. The study site will have the opportunity to publish results of the study, provided Daiichi Sankyo has had the opportunity to review and comment on the study site's proposed publication prior to being submitted for publication with the advice of patent council and need for subject protection.
  • Publication restrictions are in place

Restriction type: OTHER