Status: Ongoing
First registered on:
19/03/2015
Last updated on:
20/12/2018
1. Study identification
EU PAS Register NumberEUPAS8976
Official titleTRiptan Use and serious vascular events in Elderly over 65 years
Study title acronymTRUE
Study typeObservational study
Brief description of the studyTriptans have improved the quality of life of acute migraine by providing a higher degree of efficacy and a more favorable side effect profile than ergotamine. Even though triptan are not recommended in older patients (over 65 years), some utilization studies show that older patients account for 5% to 10% of triptan users. To our knowledge, no specific vascular safety study has been performed among older patients exposed to triptan.
The main objective of TRUE study is to compare the incidence of cardiovascular events between a population of older (age > 65 years) triptan users and a control population.
The study design is a French comparative retrospective cohort study (exposed cohort vs. unexposed cohort).
We will use data from the French National Health Insurance information system (SNIIRAM) linked with the French Hospital discharge database (PMSI).
We will include patients aged over 65 years, who are registered in SNIIRAM. For the exposed cohort, we will only include incident users of triptans. Exposed and unexposed cohorts will be matched (1:4 ratio) according to age, gender and area of residence.
The events of interest are i) cardio-vascular events, ii) death from all causes and death related to a cario-vascular event
Data will be analyzed using Cox proportional hazards models, taking into account confounders.
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 belongsUPCET
Department/Research groupPharmacology Department
Organisation/affiliationUPCET
Details of (Primary) lead investigator
Title Dr
Last name MICALLEF
First name Joelle
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
France
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed18/10/2013
Start date of data collection01/06/201501/11/2015
Start date of data analysis10/01/2016
Date of interim report, if expected20/12/2017
Date of final study report01/09/2017
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 bodyAgence Nationale de Sécurité du Médicament et des produits de santé (ANSM)100
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name MICALLEF
First name Joelle
Address line 1Timone University Hospital, 254 Rue saint Pierre, 13385
Address line 2
Address line 3
CityMarseille
Postcode13385
CountryFrance
Phone number (incl. country code)33491387563
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name MICALLEF
First name Joelle
Address line 1Timone University Hospital, 254 Rue saint Pierre, 13385
Address line 2
Address line 3
CityMarseille
Postcode13385
CountryFrance
Phone number (incl. country code)33491387563
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)N02CC (Selective serotonin (5HT1) agonists)
Substance class (ATC Code)N02CA (Ergot alkaloids)
7. Medical conditions to be studied
Medical condition(s)No
8. Population under study
Age
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects150000
Additional information
Cohort "triptans" : 25000
Cohort "unexposed to triptans" : 100000
Cohort "ergot" : 2500
Cohort "unexposed to ergot" : 12500
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
SNIIRAM, France
PMSI, France
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?
To assess the risk of cardiovascular events associated with triptan drug exposure among patients aged 65 years and older
Are there primary outcomes?Yes
The main outcome will be the first cardiovascular event leading to a hospitalization within the exposure period following the first dispensation of a triptan.
Are there secondary outcomes?Yes
The secondary outcomes will be
- Death all cause
- Death related to cardiovascular event
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
The administrative database will allow to follow (retrospectively) each subject included.
Duration of follow-up is 90 days after inclusion. A sensitivity analysis will be performed on this duration of follow-up
15. Data analysis plan
Please provide a brief summary of the analysis method
Hazard ratio for cardiovascular events using a Cox proportional hazard model with covariates.
Patients are followed-up for 90 days after their inclusion in the cohort, and HR estimates are calculated based on this follow-up duration. A sensitivity analysis will be performed for other durations of follow-up (30 days, 90 days, 180 days)
Covariates are CMUC, diabetes mellitus, COPD, dyslipidemia, hypertesion, history of cardiovascular disease
Same approach will be performed for death events (all causes death and cardiovascular related death)
Nested case-control study will allow to study the association between an abuse of triptans and the onset of cardiovascular events. A logistic regression will be performed to compare the risk of cardiovascular events, death all cause and cardiovascular death between patients unexposed to triptans and patients overusing triptans
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
Yes
17. Full protocol
Available when the study ends
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
Triptan use and serious vascular events in elderly over 65 years in France: a nationwide retrospective propensity-matched cohort study. A. Palmaro, D. Braunstein, M. Lanteri-Minet, B. Baricault, Q. Boucherie, V. Pauly, A. Donnet, M. Lapeyre Mestre, J. Micallef.(Abstracts Presented at the Proceedings of the 13th Congress of the European Association for Clinical Pharmacology and Therapeutics, Prague 2017)https://www.clinicaltherapeutics.com/article/S0149-2918(17)30399-5/abstract
Triptan use and serious cardiovascular events in elderly over 65 years in France: a nationwide retrospective propensity‐matched cohort study
J Micallef, D Braunstein, M Lanteri‐Minet, A Palmaro, B Baricault, Q Boucherie, A Donnet, V Pauly, M Lapeyre‐Mestre (Oral communication, Annual congress of the French society of Pharmacology and therapeutics, 2017)https://onlinelibrary.wiley.com/doi/full/10.1111/fcp.12271
19. Other relevant documents
Other documentsNot
submitted
