Status: Finalised
First registered on:
05/07/2016
Last updated on:
28/06/2018
1. Study identification
EU PAS Register NumberEUPAS13956
Official titleIncidence of Pancreatic Malignancy and Thyroid Neoplasm in Type 2 Diabetes Mellitus Patients who Initiate Exenatide Compared to Other Antihyperglycemic Drugs - Phase 2 (Extended Accrual and Follow-Up)
Study title acronym
Study typeObservational study
Brief description of the studyThis is a retrospective cohort study that compares incidence rates of pancreatic cancer and thyroid neoplasm between initiators of exenatide and initiators of other antidiabetic drugs using 2 administrative databases from commercial health plans in the US. The study cohorts will be created to include patients accrued from 01 June 2005 through 30 June 2015 in Optum Research Database and 31 March 2015 in Impact National Benchmark Database. Initiators will be matched 1:1 or 1:2 (exenatide:Others) on propensity scores within 6-month calendar blocks.The matched cohorts, when aggregated, will form the analytic population. The analyses of outcomes will account for the source databases and matching ratios through statistical conditioning. Data from the 2 databases will be combined to increase statistical precision.
Pancreatic cancer and thyroid neoplasm will be identified via patterns of claims using algorithms applied in the previous study. A validation of the algorithms will be conducted within a sample of medical records of patients in the Optum Research Database. Clinical characteristics that are captured poorly in the claims data will be abstracted from the medical records. Estimation of effects will involve time-fixed and time-dependent, cumulative classifications of exposure. A nested case-control analysis will also be performed to account for potential confounders that are captured poorly in the claims data, if sample size allows.
Was this study requested by a regulator?Yes: United States
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 3 (required)
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicableD5550R00003
2. Research centres and Investigator details
Coordinating study entity
Centre to which the investigator belongsOptum
Department/Research group
Organisation/affiliationOptum
Details of (Primary) lead investigator
Title Dr
Last name Liang
First name Caihua
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 States
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed24/10/201424/10/2014
Start date of data collection03/03/201603/03/2016
Start date of data analysis03/03/201603/03/2016
Date of interim report, if expected
Date of final study report01/11/201717/04/2018
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 Dr
Last name Liang
First name Caihua
Address line 11800 Concord Pike
Address line 2PO Box 15437
Address line 3
CityWilmington, De
Postcode19850
CountryUnited States
Phone number (incl. country code)0018772409479
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name AstraZeneca
First name Clinical Study Information Center
Address line 11800 Concord Pike
Address line 2PO Box 15437
Address line 3
CityWilmington, De
Postcode19850
CountryUnited States
Phone number (incl. country code)0018772409479
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)A10BX04 (exenatide)
Single-Constituent (Substance INN)EXENATIDE
Product NameByetta
CountryUnited States
Substance INN(s)EXENATIDE
Product NameBydureon
CountryUnited States
Substance INN(s)EXENATIDE
7. Medical conditions to be studied
Medical condition(s)Yes
Type 2 diabetes mellitus
8. Population under study
Age
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 subjects523741
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
Optum Reseach Database, United States
Impact National Benchmark Database, United States
Sources of data
Administrative database, e.g. claims database
11. Scope of the study
What is the scope of the study?
Risk assessment
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
The primary objectives are to estimate the absolute and relative incidence of pancreatic cancer and thyroid cancer that occurs at least one year after initiation of exenatide twice daily or once weekly or initiation of other antidiabetic drugs—overall and by duration of follow-up and duration of exposure.
Are there primary outcomes?Yes
The primary outcomes are newly diagnosed pancreatic cancer and thyroid cancer occurring at least one year following cohort entry.
Are there secondary outcomes?Yes
The secondary outcomes are newly diagnosed benign thyroid neoplasm, medullary thyroid carcinoma, and non-medullary thyroid carcinoma occurring at least one year following cohort entry.
13. Study design
What is the design of the study?
Case-control study
Retrospective 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
An “intent-to-treat” analysis will be conducted that holds the original exposure assignment constant from the date of accrual through the end of follow-up. At-risk person-time will be accrued from one year post drug initiation until the earliest occurrence of an outcome, health plan disenrollment, or end of study period. Hazard ratios and 95% confidence intervals of newly diagnosed pancreatic cancer or thyroid cancer will be estimated. To estimate the cumulative effect of exenatide exposure on the outcomes Analysis of Cumulative Exposure will also be conducted. A nested case-control study design will be applied to account for potential confounders that are poorly captured in the claims data. The cases will consist of all chart-confirmed cases of pancreatic or thyroid cancers in the propensity-matched exenatide and comparison cohorts from the Optum Research Database. Controls without cancers will be selected from the same source cohorts that gave rise to the cases.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
18. Study Results
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
