Status: Finalised
First registered on:
08/07/2014
Last updated on:
31/01/2017
1. Study identification
EU PAS Register NumberEUPAS7034
Official titleOff-label use of neuroleptics and antidepressants and risks of psychostimulant use in ADHD patients during childhood and adolescents
Study title acronymOLUNAR
Study typeObservational study
Brief description of the studyBased on data from statutory health insurance (SHI) providers, the study focuses on the off-label use of antipsychotic and antidepressant drugs in children and adolescents and evaluates the related risks and side effects (first part). Furthermore, the risks of stimulant use in children and adolescents with attention deficit and hyperactivity disorder (ADHD) are investigated (second part).
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 applicable
2. Research centres and Investigator details
Coordinating study entity
Centre to which the investigator belongsBIPS GmbH
Department/Research groupClinical Epidemiology
Organisation/affiliationLeibniz Inst. for Prevention Research and Epidem.
Details of (Primary) lead investigator
Title Dr
Last name Riedel
First name Oliver
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
Germany
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed29/10/201229/10/2012
Start date of data collection16/07/201316/07/2013
Start date of data analysis18/12/201318/12/2013
Date of interim report, if expected12/06/201412/06/2014
Date of final study report31/12/201531/10/2015
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
Charities
Government bodyFederal Institute for Drugs and Medical Devices100
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Mr
Last name Scholle
First name Oliver
Address line 1Achterstraße 30
Address line 2
Address line 3
CityBremen
Postcode
CountryGermany
Phone number (incl. country code)004942121856878
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Mr
Last name Scholle
First name Oliver
Address line 1Achterstraße 30
Address line 2
Address line 3
CityBremen
Postcode
CountryGermany
Phone number (incl. country code)004942121856878
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)N05A (ANTIPSYCHOTICS)
Substance class (ATC Code)N06A (ANTIDEPRESSANTS)
Substance class (ATC Code)N06BA04 (methylphenidate)
7. Medical conditions to be studied
Medical condition(s)Yes
Completed suicide
Cardiovascular disorder
Cerebrovascular disorder
Neuroleptic malignant syndrome
Extrapyramidal disorder
Ischaemic stroke
Myocardial infarction
Angina pectoris
Cardiomyopathy
Death
8. Population under study
Age
Preterm newborns
Term newborns (0-27 days)
Infants and toddlers (28 days - 23 months)
Children (2 - 11 years)
Adolescents (12 - 17 years)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects2000000
Additional information
Study population: 2,020,316 children in 2004 and 2,159,774 children in 2009; in 2010 and 2011, the study population comprised 857,270 and 755,078 children
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Administrative database, e.g. claims database
11. Scope of the study
What is the scope of the study?
Risk assessment
Drug utilisation study
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
The objectives are to examine the extent of off-label use of antidepressant(ATDs) and antipsychotic(AP) drugs in children and adolescents and to estimate the risk of specific adverse events associated with off-label use of these drugs. Also, we evaluate the cardio- and cerebrovascular risks of methylphenidate use compared to nonuse for the treatment of children and adolescents with ADHD in Germany
Are there primary outcomes?Yes
Risks and side effects, including Drug-induced obesity, Hyperglycemia, Diabetes mellitus, Hyperprolactinemia, Malignant neuroleptic syndrome, Drug-induced parkinsonism, Drug-induced dystonia / tardive Dyskinesia, Drug-induced tremor, Poisoning by psychotropic drugs, Myocardial infarction, Stroke, Bradycardia / Tachycardia, Cardiomyopathy, Heart failure, Suicide risk, All-cause mortality
Are there secondary outcomes?Yes
in the second part of the study (methylphenidate in children with ADHD): cardiac arrhythmia, angina pectoris, cardiomyopathy and all-cause mortality
13. Study design
What is the design of the study?
Cross-sectional study
Cohort study
Drug utilisation 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
In both study parts, prevalence and incidence rates of the considered medications will be determined.
First part: for the antipsychotic cohort, the primary analysis will be a Cox regression analysis estimating the adjusted hazard ratio (HR) for metabolic and endocrine adverse effects in off-label users vs. on-label users. For the antidepressant cohort, the primary analysis will be a Cox regression analysis estimating the adjusted HR for cardio- and cerebrovascular side effects in off-label users vs. on-label users.
Second part: a time-dependent Cox proportional hazard model will be used to estimate the adjusted hazard ratio for major cardio-cerebrovascular events in current MPH use vs. nonuse.
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
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
