Status: Ongoing
First registered on:
25/11/2015
Last updated on:
18/03/2020
1. Study identification
EU PAS Register NumberEUPAS11684
Official titleComparison of the Risk of Acute Kidney Injury Between Patients With Type 2 Diabetes Exposed to Dapagliflozin and Those Exposed to Other Antidiabetic Treatments
Study title acronym
Study typeObservational study
Brief description of the studyThe overall goal of this research study is to estimate the risk of hospitalization for acute kidney injury in patients who are prescribed dapagliflozin compared to patients prescribed other specific oral antidiabetic drugs. Dapagliflozin and other antidiabetic drugs are used to treat type 2 diabetes mellitus. Because of the mechanism of action for dapagliflozin and results from small safety monitoring studies, there is interest in further evaluating the safety of dapagliflozin in large populations.
The study will be implemented in three administrative health care data sources in two countries: in the United Kingdom, the Clinical Practice Research Datalink (CPRD); and in the United States, the Centers for Medicare and Medicaid Services (CMS) Medicare databases and the HealthCore Integrated Research Database (HIRDSM). Individuals in the databases will be included in the study if they meet the following age criteria; 18 years and older (CPRD and HIRD), or 65 years or older (Medicare); and if they did not have type 1 diabetes, are new users of one of the study drugs and meet the criteria of at least 180 days of electronic data before their first prescription of the study drug. The study period starts July 1, 2013 in CPRD and January 9, 2014 in the United States data sources, and will end at the latest available data at each database at the time of analysis.
Was this study requested by a regulator?Yes: EMA
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 applicableD1690R00004
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 Johannes
First name Catherine
Is this study being carried out with the collaboration of a research network?
Yes
HealthCore
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?2
HealthCore, United States
Countries in which this study is being conducted
International study
United Kingdom
United States
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed12/02/201512/02/2015
Start date of data collection29/01/201602/02/2016
Start date of data analysis
Date of interim report, if expected30/12/201622/11/2016
Date of final study report30/11/2020
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAztraZeneca100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Johannes
First name Catherine
Address line 1307 Waverley Oaks Rd
Address line 2Suite 101
Address line 3
CityWaltham
Postcode
CountryUnited States
Phone number (incl. country code)17814341784
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name AstraZeneca
First name Clinical Study Information Center
Address line 11800 Concord Pike
Address line 2PO Box 15437
Address line 3
CityWilmington
Postcode19850
CountryUnited States
Phone number (incl. country code)0018772409479
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)A10BX09 (dapagliflozin)
Substance class (ATC Code)A10BD15 (metformin and dapagliflozin)
Single-Constituent (Substance INN)DAPAGLIFLOZIN
Product NameFarxiga
CountryUnited States
Substance INN(s)DAPAGLIFLOZIN
Product NameXigduo XR
CountryUnited States
Substance INN(s)DAPAGLIFLOZIN
METFORMIN
Product NameForxiga
CountryUnited Kingdom
Substance INN(s)DAPAGLIFLOZIN
Product NameXigduo
CountryUnited Kingdom
Substance INN(s)DAPAGLIFLOZIN
METFORMIN
7. Medical conditions to be studied
Medical condition(s)Yes
Acute kidney injury
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 subjects65703
Additional information
For the final study report, we estimate there will be 91,927 dapagliflozin exposed person-years and 367,708 unexposed person-years across all data sources
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
HealthCore Integrated Research Database, United States
Medicare, United States
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?
Risk assessment
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
To compare, by insulin use at the index date, the incidence of hospitalization for acute kidney injury (AKI) among patients with type 2 diabetes mellitus who are new users of dapagliflozin with those who are new users of antidiabetic drugs (ADs) in classes other than sodium-glucose cotransporter 2 (SGLT2) inhibitors, insulin monotherapy, metformin monotherapy, or sulfonylurea monotherapy.
Are there primary outcomes?Yes
acute kidney injury
Are there secondary outcomes?No
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
Patients will be followed from their index date (date of first study drug prescription or dispensing) until they experience one of the following: an event under study, end of time at risk for index medication, death, addition of a non-dapagliflozin SGLT2 inhibitor, termination of health plan, transfer out of the GP practice or end of the study period
15. Data analysis plan
Please provide a brief summary of the analysis method
Descriptive statistics will be calculated to compare baseline characteristics at cohort entry between dapagliflozin users versus comparator antidiabetic users. Propensity scores will be estimated by using logistic regression, with measured potential predictors of acute kidney injury as independent variables in the regression model and actual exposure group (dapagliflozin or comparator) as the outcome. Incidence rates of acute kidney injury will be estimated during exposure time at risk for dapagliflozin initiators and comparators. Unadjusted incidence rate ratios (IRRs) of the outcome of interest with 95% confidence intervals in dapagliflozin users versus other AD users will be calculated, and adjusted using propensity score–stratified analysis. Analyses will be conducted in each data source separately, and a pooled estimate will be calculated if deemed appropriate.
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
