1. Study identification
EU PAS Register NumberEUPAS2356
Official titleUse of antiepileptics and risk of suicidality. An exploratory study using the UK General Practice Research Database (GPRD) and data from the Danish registries with an evaluation of available data from further European data sources.
Study title acronym
Study typeObservational study
Brief description of the studyThe studies described in this protocol are all performed within the framework of PROTECT (Pharmacoepidemiological Research on Outcomes of Therapeutics by a European ConsorTium) Work Package 2 and Working Group 1. The primary aim of these studies is to develop, test and disseminate methodological standards for the design, conduct and analysis of Pharmacoepidemiological (PE) studies applicable to different safety issues and using different data sources. To achieve this, results from PE studies on 5 key Drug / adverse events (D-AEs) pairs performed in different databases will be evaluated. The use of antiepileptics associated with the risk of suicidality is one of the key D-Ae pair of interest. Therefore, emphasis will be on the methodological aspects of the studies in this protocol and not on the clinical consequences of studying the association under investigation.
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicable
2. Research centres and Investigator details
Coordinating study entity
Centre nameF.Hoffmann-La Roche AG
Centre locationSwitzerland
Details of (Primary) lead investigator
Title Dr
Last name Schuerch
First name Markus
Is this study being carried out with the collaboration of a research network?
Yes
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?6
Agencia Espanola del Medicamento y Productos Sanitarios (AEMPS), Spain
European Medicines Agency (EMA), United Kingdom
Lægemiddelstyrelsen (Danish Medicines Agency (DKMA), Denmark
Ludwig-Maximilians-Universität-München (LMU MUNCHEN), Germany
F.Hoffmann-La Roche AG, Switzerland
Countries in which this study is being conducted
International study
Denmark
Germany
Netherlands
Spain
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed19/08/200919/08/2009
Start date of data collection03/10/201103/10/2011
Start date of data analysis
Date of interim report, if expected
Date of final study report31/12/201301/04/2016
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAmgen, AstraZeneca, Genzyme, GSK, MerckSerono, Novartis, Roche, Pfizer50
Charities
Government body
Research councils
EU funding schemeInnovative Medicines Initiative (IMI)50
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Schuerch
First name Markus
Address line 1F.Hoffmann-La Roche AG
Address line 2PDBE, Bld.663, room 2116
Address line 3
CityBasel
PostcodeCH-4070 Basel
CountrySwitzerland
Phone number (incl. country code)41616882209
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Kurz
First name Xavier
Address line 1European Medicines Agency
Address line 27 Westferry Circus
Address line 3Canary Wharf
CityLondon
PostcodeLondon E14 4HB
CountryUnited Kingdom
Phone number (incl. country code)442074188400
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)N03A (ANTIEPILEPTICS)
7. Medical conditions to be studied
Medical condition(s)Yes
Suicidal behaviour
Suicidal ideation
Completed suicide
Suicide attempt
8. Population under study
Age
Infants and toddlers (28 days - 23 months)
Children (2 - 11 years)
Adolescents (12 - 17 years)
Adults (18 - 44 years)
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects55700000
Additional information
Estimated total number patients all databases approx 55,7millions
Per database (in millions):
DKMA: total=6
Mondriaan: total=1.4 (GP),13.5 (pharmacy),1.2 (claims)
GPRD: total=11.2
BIFAP: total=3.2
Bavaria Claims: total=10.5
THIN: total=8.7
Number of AED users 2009 (approx)
BIFAP: 36170
CPRD: 104604
DKMA: 140458
Mondriaan: 3966
Thin: 84921
TOTAL: 370119
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Data sources not registered with ENCePP
BIFAP, Spain
Bavaria Claims, Germany
Mondriaan, Netherlands
Sources of data
Administrative database, e.g. claims database
Routine primary care electronic patient registry
Pharmacy dispensing records
11. Scope of the study
What is the scope of the study?
Disease epidemiology
Risk assessment
Drug utilisation study
Analysis of discrepancies in results between different databases
Primary scope : Analysis of discrepancies in results between different databases
12. Main objective(s)
What is the main objective of the study?
To assess the association between the use of antiepileptics and the risk of suicidality with different study designs across different primary care databases and to compare the results between databases, across designs to evaluate the impact of design/database/population differences on the outcome of the studied association.
Are there primary outcomes?No
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
14. Follow-up of patients
Will patients be followed up?Not applicable/no follow-up
15. Data analysis plan
Please provide a brief summary of the analysis method
Descriptive studies to compare the six European databases
We will estimate point and period prevalence overall and by AEDs for the study period between 1-Jan-2000 and 31-Dec-2009.
Analytical studies to evaluate a possible association between anti-epileptic drugs and suicidality
We will estimate risks of suicidality for all AEDs and by individual AEDs prescribed in UK and Denmark. We will apply two different study design: cohort study, and case-crossover studies.
For the cohort study we will apply Cox regression analyses with the following potential confounding factors: gender, age, marital status, socio-economic status, BMI , smoking status, alcohol abuse, drug and medication abuse, number of different drugs prescribed in the six months prior to index date, a number of comorbidities associated with a higher risk for suicidality and calendar period. Exposure to AEDs and anti-depressives will be handled as time varying variables.