1. Study identification
EU PAS Register NumberEUPAS19129
Official titleUtilisation of antiepileptic medicines in girls and women of childbearing potential - a study in three European countries
Study title acronym
Study typeObservational study
Brief description of the studyThe use of certain antiepileptic drugs (AEDs) is known to increase the risk of both physical and neurodevelopmental abnormalities in the foetus and child. The European Medicines Agency recently carried out a review of the evidence relating to the use of the AED sodium valproate during pregnancy. Following this review, the guidelines for prescribing sodium valproate to women of childbearing age were changed in January 2015.
This study will use electronic healthcare data from databases in the United Kingdom, France and Italy (Tuscany and Emilia Romagna). The study will calculate the prevalence of AED prescribing in all females of childbearing age and in females during pregnancy, stratified by calendar year, age at prescription and indication for prescribing. It will also look at the incidence of prescribing of each of the different AEDs among new users stratified by calendar year, age at prescription and indication for prescribing and evaluate the extent to which women switch AED products, particularly in relation to pregnancy.
Was this study requested by a regulator?Yes: EMA
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 groupPharmacy & Pharmacology
Organisation/affiliationUniversity of Bath
Details of (Primary) lead investigator
Title Dr
Last name Rachel
First name Charlton
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?5
Centre for Environmental and Preventive Medicine, Queen Mary University of London, United Kingdom
Drug Policy Service, Emilia Romagna Region Health Authority, Italy
Countries in which this study is being conducted
International study
France
Italy
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed16/12/201616/12/2016
Start date of data collection09/05/201724/05/2017
Start date of data analysis09/09/201709/09/2017
Date of interim report, if expected04/05/2018
Date of final study report09/05/201807/06/2018
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 body
Research councils
EU funding scheme
OtherEuropean Medicines Agency100
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Rachel
First name Charlton
Address line 1Dept. of Pharmacy & Pharmacology
Address line 2University of Bath
Address line 3Claverton Down
CityBath
PostcodeBA2 7AY
CountryUnited Kingdom
Phone number (incl. country code)44-1225-383672
Alternative phone number
Fax number (incl. country code)44-1225-386114
Public Enquiries
Title Dr
Last name Rachel
First name Charlton
Address line 1Dept. of Pharmacy & Pharmacology
Address line 2University of Bath
Address line 3Claverton Down
CityBath
PostcodeBA2 7AY
CountryUnited Kingdom
Phone number (incl. country code)44-1225-383672
Alternative phone number
Fax number (incl. country code)44-1225-386114
6. Study drug(s) information
Substance class (ATC Code)N03A (ANTIEPILEPTICS)
7. Medical conditions to be studied
Medical condition(s)No
8. Population under study
Age
Adolescents (12 - 17 years)
Adults (18 - 44 years)
Adults (45 - 64 years)
Sex
Female
Other population
Pregnant women
9. Number of subjects
Estimated total number of subjects5439534
Additional information
Information on 1,089,526 pregnancies
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
Echantillon Généraliste des Bénéficiaires (EGD) database, France
Databases of Agenzia regionale di sanità della Toscana, Italy
Emilia Romagna Prescription database and CeDAP database, Italy
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?
Drug utilisation study
Primary scope : Drug utilisation study
12. Main objective(s)
What is the main objective of the study?
To characterise the prescription patterns of antiepileptic drugs (AEDs) in girls and women of childbearing potential between January 2007 and December 2016, using electronic healthcare data from the United Kingdom (UK), France and Italy.
Are there primary outcomes?No
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
Drug utilisation study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
Patients will be followed up in the electronic data source until the earliest of, the date they left the database, the date of their 51st birthday or the end of the study period (31-Dec-2016).
15. Data analysis plan
Please provide a brief summary of the analysis method
The prevalence of AED prescribing (overall and for specific AEDs) will be calculated per 1,000 female population with 95% confidence intervals (CI95). This will be calculated stratified by calendar year, age at prescription and indication for prescribing.
The incidence of AED prescribing (new users) (overall and for specific AEDs) will be calculated per 10,000 person-years with CI95 stratified by calendar year, age at prescription and indication for prescribing
The prevalence of AED prescribing will be calculated during the 6 months before pregnancy (broken into 3-month time periods) and during each of the pregnancy trimesters. The prevalence of prescribing will be calculated stratified by pregnancy outcome, calendar year at pregnancy start and indication for prescribing
The percentage of women prescribed AEDs who initiate a switch in treatment will be calculated (overall and for each specific AED) stratified by calendar year, age at first switch and indication for prescribing.