Status: Planned
First registered on:
18/10/2016
Last updated on:
18/10/2016
1. Study identification
EU PAS Register NumberEUPAS15869
Official titleBenefits of high dose ICS in patients with asthma and high blood eosinophil counts
Study title acronym
Study typeObservational study
Brief description of the studyA previous study conducted by the Observational and Pragmatic Research Institute (OPRI) found that patients with asthma and high blood eosinophil counts experience more severe exacerbations and have poorer asthma control.
The results suggest that this subpopulation of patients with asthma does not respond well to guideline-recommended therapy.
There is no evidence available that a step-up to high dose ICS would be effective in preventing asthma attacks in these patients.
Nevertheless, high ICS doses are frequently prescribed in real-life, exposing patients to the risk of adverse effects.
The objective is to study the effectiveness of initiating patients with high blood eosinophil counts on high dose ICS to reduce exacerbation risk and to achieve asthma control.
Patients with asthma and high blood eosinophil counts who step-up to high dose ICS will be extracted from the Clinical Practice Research Datalink or the Optimum Patient Care Research Database (date is index date (ID)).
Patients who step-up from medium to high dose ICS will be matched to and compared with control patients on stable medium dose treatment during follow-up.
The ID of control patients will be chosen at exactly the same number of days after the date of blood eosinophil count recording as the matched step-up patient.
Patients who step up from low to high dose ICS will be matched to and compared with patients who step up from low to medium dose ICS.
Patients will be matched on the following characteristics assessed in the year prior to ID: timing and value of eosinophil count, number of exacerbations, ICS drug and dose, propensity score of high dose ICS assignment.
Survival and negative binomial regression analyses will be used to compare the rates of asthma exacerbations over 1 and 3 years of follow-up.
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
Not applicable
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicableNot applicable
2. Research centres and Investigator details
Coordinating study entity
Department/Research groupOPRI
Organisation/affiliationOPRI Pte Ltd
Details of (Primary) lead investigator
Title Professor
Last name Price
First name David
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
National study
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed30/05/201630/05/2016
Start date of data collection09/09/2016
Start date of data analysis17/10/2016
Date of interim report, if expected03/02/2017
Date of final study report31/03/2017
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAstraZeneca100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Price
First name David
Address line 15a Coles Lane
Address line 2Oakington
Address line 3
CityCambridge
Postcode
CountryUnited Kingdom
Phone number (incl. country code)44-1223967582
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Price
First name David
Address line 15a Coles Lane
Address line 2Oakington
Address line 3
CityCambridge
Postcode
CountryUnited Kingdom
Phone number (incl. country code)44-1223967582
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Not applicable (disease/epidemiology study)
7. Medical conditions to be studied
Medical condition(s)Yes
Asthma
8. Population under study
Age
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 subjects7200
Additional information
Around 1800 patients who step up to high dose ICS will be matched to 5400 controls (1:3)
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Prospective patient-based data collection
11. Scope of the study
What is the scope of the study?
Effectiveness evaluation
Primary scope : Effectiveness evaluation
12. Main objective(s)
What is the main objective of the study?
To study the effectiveness of initiating patients with high blood eosinophil counts on high ICS doses to reduce future exacerbation risk and to achieve asthma cont
Are there primary outcomes?Yes
Number of severe asthma exacerbations
Are there secondary outcomes?Yes
Acute oral corticosteroid courses for respiratory conditions
Hospitalizations for asthma exacerbation
Acute respiratory events
Excessive use of Short-acting ß2-agonists (SABA)
13. Study design
What is the design of the study?
Cohort study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
3 years
15. Data analysis plan
Please provide a brief summary of the analysis method
Conditional Cox regression will be performed with time to the first event during stable ICS treatment as the outcome variable to estimate HRs with 95% CI. Right censoring will be applied when a change in ICS prescriptions is observed during follow up.
Conditional negative binomial regression / logistic regression with the number of events per time periods of one and three years will be performed to estimate RRs / ORs with 95% CI for patients with a continuous follow up time without a change in ICS prescription for these time periods.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
Not submitted
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
None
19. Other relevant documents
Conflict(s) of interest of
investigator(s)Not submitted
Composition of Steering Group and
ObserversNot submitted
Other documentsNot
submitted
Signed Code of
Conduct Checklist
Not submitted
Signed Code of Conduct Declaration
Not submitted
Signed Checklist for Study
Protocols
Not submitted
