Status: Finalised
First registered on:
02/06/2015
Last updated on:
11/03/2019
1. Study identification
EU PAS Register NumberEUPAS9871
Official titleEvaluation of the Effectiveness of Risk Minimization Measures: Trimetazidine Drug Utilization Study in European Countries using databases – analysis for France, Hungary, Romania and Spain
Study title acronym
Study typeObservational study
Brief description of the studyTMZ-containing medicinal products were indicated in EU for various cardiology, ophthalmology and otolaryngology indications.
Otolaryngology and ophthalmology indications included:
i. Ancillary symptomatic treatment of vertigo and tinnitus and
ii. Ancillary treatment of visual acuity decrease and visual field disturbances due to vascular reasons
On 22 April 2011, France had requested the Committee for Medicinal Products for Human Use (CHMP) to give its opinion under Article 31 of Directive 2001/83/EC on whether the marketing authorization for TMZ-containing medicinal products will be maintained, varied, suspended or withdrawn.
The review conducted by the CHMP concluded that the evidence of the efficacy and safety in the ophthalmology and otolaryngology indications, initially suggested by the studies on the basis of multiple assessments was considered weak due to the methodology applied to the investigation and was no longer recommended since September 2012 (3).
Potential prescribers were informed of this change in the indication of TMZ through “Direct Healthcare Professional Communications” (DHPCs) and other appropriate notifications.
The drug utilization study presented here is designed to evaluate the effectiveness of these risk minimization measures (RMM) on the use of TMZ in targeted countries based on information from prescription databases. In a parallel protocol, a survey will be conducted to provide information on the knowledge, attitude and behaviour of the physicians in the targeted countries about the content of the DHPC and the updated SMPC are evaluated.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 1 (imposed as condition of marketing authorisation)
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 belongsIMS Health
Department/Research groupReal World Evidence Solutions
Organisation/affiliationIMS Health
Details of (Primary) lead investigator
Title Dr
Last name Massoud
First name Toussi
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
International study
France
Hungary
Romania
Spain
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed08/01/201508/01/2015
Start date of data collection01/06/201501/06/2015
Start date of data analysis
Date of interim report, if expected
Date of final study report30/09/201516/09/2015
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesConsoritum headed by Lupin Pharma100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Massoud
First name Toussi
Address line 15-7 place des Pyramides
Address line 2
Address line 3
CityParis La Défense
Postcode92088
CountryFrance
Phone number (incl. country code)33-1413-51335
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Massoud
First name Toussi
Address line 15-7 place des Pyramides
Address line 2
Address line 3
CityParis La Défense
Postcode92088
CountryFrance
Phone number (incl. country code)33-1413-51335
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Single-Constituent (Substance INN)TRIMETAZIDINE
Single-Constituent (Substance INN)TRIMETAZIDINE DIHYDROCHLORIDE
7. Medical conditions to be studied
Medical condition(s)Yes
Angina pectoris
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)
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 subjects1500
Additional information
Since there is no evidence supporting the expected proportion of TMZ prescription for ophthalmological or ENT diagnoses after the restriction of TMZ indications, it has been considered 50% (this assumption yields the largest sample size). Given this assumption, and for a confidence interval of 95% (t=1.96) and an error margin (e) of 5%, the required sample size would need 384 cases per country.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
IMS health prescribing insights, France
IMS health prescribing insights, Spain
National diagnostic index, Romania
National prescribing audit, Hungary
Sources of data
Prescription event monitoring
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?
The primary objective is to Assess, per country, the proportion of prescriptions of TMZ for ophthalmological or ENT diagnoses (within the scope of its past indications) among the total prescriptions of TMZ after the restriction of its indications.
Are there primary outcomes?No
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cross-sectional 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
The statistical analysis will be conducted using SAS® software Version 9.3 for Windows™ (SAS Institute, North Carolina, USA).
The analysis will include descriptive statistics. Interrupted time series (ITS) analysis will be conducted if the conditions are met.
The number of missing data will be indicated. Missing data will not be replaced by imputation methods.
The statistical unit will be the prescription (for extractions from PI) or the dispensed prescription (for extractions from NDI and NPA database).
Prescribers’ profile will be described per country: age, gender, speciality and region.
Summaries will be reported at country level and by period (reference period and assessment period) categorized according to the speciality.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
Not submitted
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
