Status: Finalised
First registered on:
25/03/2014
Last updated on:
10/10/2018
1. Study identification
EU PAS Register NumberEUPAS6147
Official titleReal-world effectiveness of extra-fine Ciclesonide (Alvesco®) versus standard particle inhaled corticosteroid (ICS)
Study title acronym
Study typeObservational study
Brief description of the studyAim of the study:
A retrospective, database analysis comparing effectiveness (in terms of exacerbations prevention and asthma control) of Ciclesonide, an extra-fine (EF) particle ICS, with other commonly prescribed standard particle (SP) ICS therapies in patients prescribed asthma therapy from the Netherlands.
Data source:
the PHARMO Database Network, comprising pharmacy and hospital discharge records for approximately 20% of the Dutch population.
Study population:
The study population will include patients aged 12-60 years with a history of ≥2 prescriptions for asthma therapy and initiating ICS treatment as EF-ICS ciclesonide or SP-ICS. Data will be collected over one year before (baseline) and one year after (outcome) treatment initiation. Study period is September 2005 – December 2012. Potential COPD patients (>60 years old and those using long-acting muscarinic antagonists) will be excluded.
Primary outcomes:
Severe exacerbation rate in the year after initiation of ICS therapy, defined as asthma-related hospital admissions OR use of acute oral steroids (based on the American Thoracic Society/European Respiratory Society task force definition).
Modified definition of Risk Domain Asthma Control in the year after initiation of ICS therapy, defined as absence of asthma-related hospital admissions AND absence of prescriptions for acute courses of oral steroids.
Modified definition of Overall Asthma Control in the year after initiation of ICS therapy defined as no asthma-related hospital admissions AND no prescriptions for acute courses of oral steroids AND average daily dose of ≤200mcg salbutamol / ≤500mcg terbutaline.
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
Department/Research groupObservational and Pragmatic Research Institute Pte Ltd
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
Multiple centres
In total how many centres are involved in this Study?2
Countries in which this study is being conducted
National study
Netherlands
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed31/03/201418/06/2014
Start date of data collection01/04/201401/04/2014
Start date of data analysis22/05/201422/05/2014
Date of interim report, if expected
Date of final study report22/12/201422/12/2014
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesTakeda Pharmaceuticals100
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 116 Raffles Quay
Address line 2#33-03
Address line 3Hong Leong Building
CitySingapore
Postcode
CountrySingapore
Phone number (incl. country code)44-1223967829
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Price
First name David
Address line 116 Raffles Quay
Address line 2#33-03
Address line 3Hong Leong Building
CitySingapore
Postcode
CountrySingapore
Phone number (incl. country code)44-1223967829
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)R01AD (Corticosteroids)
Product NameAlvesco
CountryNetherlands
Substance INN(s)CICLESONIDE
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)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects4064
Additional information
After applying all the inclusion/exclusion criteria 1,382 and 2,682 patients were selected in the ciclesonide and SP-ICS treatment groups, respectively. After matching, 1,244 patients were selected in each of the ciclesonide/SP-ICS treatment groups.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Pharmacy dispensing records
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 compare effectiveness (in terms of asthma control) of extra-fine ICS Ciclesonide (Alvesco) vs standard particle ICS
Are there primary outcomes?Yes
(i) Asthma Exacerbation Rate:
• Asthma related hospital admissions OR
• Use of acute oral steroid .
(ii) Risk domain asthma control:
• Hospital attendance/admission; AND
• Prescriptions for acute courses of oral steroids.
(iii) Overall asthma control:
• Risk domain asthma control AND
• Average daily dose of ≤200mcg salbutamol / ≤500mcg terbutaline
Are there secondary outcomes?Yes
(i) Change in therapy :
- Addition of new therapy, including LTRA, THEO or LABA OR,
- Patients who increased their ICS therapy by ≥50%.
(ii) Average daily short-acting β2-agonists (SABA) usage during outcome year, calculated as average number of puffs per day over the year multiplied by strength.
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
Statistically significant results will be defined as p<0.05 and trends as 0.05≤p<0.10
Summary statistics will be produced for all baseline and outcome variables, as a complete
dataset and by therapy. Treatment groups will be compared using t-test / Mann Whitney
U-test (depending on distribution) for variables measured on the interval/ratio scale and
using a chi square test for categorical variables.
Outcomes analyses: patients will be matched on demographics and key measures of
disease severity to ensure comparison of similar patients, using random selection process through SAS
statistical software to avoid selection bias.
Effectiveness outcomes will be compared between treatment groups using a conditional regression model. The model will use empirical standard errors (for more conservative confidence interval estimations) and adjustments will be made for potential baseline confounders. The adjusted rate ratio with 95% confidence interval will be reported.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
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
