Status: Finalised
First registered on:
26/01/2015
Last updated on:
10/04/2019
1. Study identification
EU PAS Register NumberEUPAS8441
Official titlePost-Authorization Safety Program—Validation of the Danish Data Resources for the Study of Cardiovascular and Neoplasm Events in Users of Treatments for Overactive Bladder
Study title acronym
Study typeObservational study
Brief description of the studyMirabegron is a first in class therapeutic agent, with a mechanism of action distinct from that of antimuscarinic agents indicated for the treatment of overactive bladder (OAB).
This is a retrospective cohort study of new users of individual antimuscarinic drugs: oxybutynin, tolterodine, darifenacin, solifenacin, trospium, and fesoterodine. The objectives are: to describe drug-use patterns, to describe the availability of potential confounders, and to calculate background rates of cardiovascular (CV) and cancer outcomes among antimuscarinic drug users in the Danish National Databases, in collaboration with the University of Southern Denmark (SDU). Results will help to refine the study size and statistical power assessment for the post-marketing safety studies of Mirabegron, to be conducted, among other datasources, in the Danish Databases.
The study period is January 2004 through December 2012.
The study will calculate incidence rates of the following endpoints:
- CV: including acute myocardial infarction, stroke, all-cause mortality, a MACE composite endpoint, and CV mortality.
- Neoplasm endpoint: The study will focus on a composite of the 10 most commonly occurring malignancies. For cancer analyses only the first incident targeted cancer is considered.
Was this study requested by a regulator?Yes: EMA, 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 applicable
2. Research centres and Investigator details
Coordinating study entity
Centre to which the investigator belongsRTI-HS
Department/Research groupPharmacoepidemiology & Risk Management
Organisation/affiliationRTI Health Solutions
Details of (Primary) lead investigator
Title Dr
Last name Arana
First name Alejandro
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
Denmark
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed15/09/201410/10/2014
Start date of data collection31/10/201431/10/2014
Start date of data analysis31/01/201531/01/2015
Date of interim report, if expected
Date of final study report29/03/201526/03/2015
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAstellas Pharma Global Development, Inc.100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Arana
First name Alejandro
Address line 1Trav. Gracia, 56, Atico 1
Address line 2
Address line 3
CityBarcelona
Postcode08006
CountrySpain
Phone number (incl. country code)34933622805
Alternative phone number
Fax number (incl. country code)34934142610
Public Enquiries
Title Dr
Last name Arana
First name Alejandro
Address line 1Trav. Gracia, 56, Atico 1
Address line 2
Address line 3
CityBarcelona
Postcode08006
CountrySpain
Phone number (incl. country code)34933622805
Alternative phone number
Fax number (incl. country code)34934142610
6. Study drug(s) information
Substance class (ATC Code)G04BD04 (oxybutynin)
Substance class (ATC Code)G04BD07 (tolterodine)
Substance class (ATC Code)G04BD08 (solifenacin)
Substance class (ATC Code)G04BD09 (trospium)
Substance class (ATC Code)G04BD10 (darifenacin)
Substance class (ATC Code)G04BD11 (fesoterodine)
7. Medical conditions to be studied
Medical condition(s)Yes
Urinary incontinence
8. Population under study
Age
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 subjects90000
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
The Danish National Health Registers, Denmark
Sources of data
Disease/case registry
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?
Risk assessment
Drug utilisation study
Validation of the database Danish National Health Registries for the study of CV and neoplasm events in users of treatments for overactive bladder
Primary scope : Validation of the database Danish National Health Registries for the study of CV and neoplasm events in users of treatments for overactive bladder
12. Main objective(s)
What is the main objective of the study?
Characterize users of OAB drugs.
Describe patterns of usage of OAB drugs.
Describe the availability of potential confounders in the database, to help in the design of the PASS studies of mirabegron.
Estimate IRs of study endpoints in new users of OAB drugs.
Estimate the IRRs of CV outcomes in users of OAB drugs compared with tolterodine.
Are there primary outcomes?Yes
CV endpoints: AMI, stroke, CV mortality, all-cause mortality, major adverse cardiac events (MACE).
Composite cancer endpoints: lung & bronchus, colon & rectum, melanoma of skin, urinary bladder, non-Hodgkin lymphoma, kidney & renal pelvis, pancreas, prostate (males), breast (females), corpus uteri (females).
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
Drug utilisation study
Database validation study
14. Follow-up of patients
Will patients be followed up?Yes
Please describe duration of follow up
For each subject, follow-up will start on the date of the first prescription for a drug of interest and will finish at the earliest of the following events: end of the study period, death, disenrollment from the database, or occurrence of a study endpoint.
15. Data analysis plan
Please provide a brief summary of the analysis method
Summary statistics of the covariates will be generated. Characteristics of the users at cohort entry and the patterns of use of the study medications will be described.
Users of OAB medications will be characterized with respect to selected covariates.
Patterns of use of OAB drugs including dose, duration of treatment, drug switching, and use of drugs as add-on therapy will be described.
The frequency of the different characteristics of the covariates and the degree of missing information will be described.
3 types of incidence endpoints will be estimated:
-IRs of 4 different CV events+all-cause mortality in new users of antimuscarinic drugs for the treatment of OAB.
-IRR of 4 different CV outcomes+all-cause mortality in new users of each of the OAB drugs compared with tolterodine.
-IRs of 2 sex-specific, multiple-cancer composite endpoints (1 for men/1 for women) during the first year after start of treatment and during subsequent years, among new users of antimuscarinic drugs
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
Hallas J, Margulis AV, Pottegard A, Kristiansen NS, Atsma WJ, Appenteng K, de Vogel S, Kaye JA, Perez-Gutthann S, Arana A. Incidence of Common Cancers in Users of Antimuscarinic Medications for Overactive Bladder: A Danish Nationwide Cohort Study. (epub). Basic and Clinical Pharmacology and Toxicology 2018 Jan 17.https://www.ncbi.nlm.nih.gov/pubmed/29345103
Margulis AV, Hallas J, Pottegard A, Kristiansen NS, Atsma WJ, Franks B, D'Silva M, Varas-Lorenzo C, Perez Gutthann S, Arana A. Comparison of Cardiovascular Events Among Treatments for Overactive Bladder: A Danish Nationwide Cohort Study. Eur J Clin Pharmacol 2017 Feb;74(2):193-9.https://www.ncbi.nlm.nih.gov/pubmed/29134254.
Margulis AV, Linder M, Arana A, Pottegard A, Anveden-Berglind I, Bui CB, Kristiansen NS, Bahmanyar S, McQuay LJ, Atsma WJ, Appenteng K, D´Silva M, Perez-Gutthann S, Hallas J. Patterns of Use of Antimuscarinic Drugs to Treat Overactive Bladder in Denmark, Sweden, and the United Kingdom. (epub). PLoS One 2018 Sep 27;13(9):e0204456.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204456
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
