1. Study identification
EU PAS Register NumberEUPAS9977
Official titleAn Observational Post-authorization Safety Specialist Cohort Event Monitoring Study (SCEM) to Monitor the Safety and Utilization of rivaroxaban (XARELTO®) initiated in secondary care for the prevention of atherothrombotic events in patients who have had acute coronary syndrome in England and Wales
Study title acronymROSE ACS
Study typeObservational study
Brief description of the studyRivaroxaban is a medicine which reduces the formation of blood clots. Acute coronary syndrome (ACS) comprises a range of disorders, including heart attack and unstable angina, caused by a sudden reduction in blood flow to part of the heart muscle. This study aims to collect information on the use of rivaroxaban and its safety when used by patients for the prevention of artherothrombotic (plaque rupture leading to a blood clot) events following ACS, during the first three months after starting. This study was requested by the European regulatory body (EMA) which is responsible for the use and safety of medicines. It will last for approximately 3 years and is a national study covering the whole of England and Wales. The study aims to recruit 1193 patients who have been prescribed rivaroxaban and antiplatelet therapy and 1193 patients who have been prescribed alternative dual antiplatelet therapy for the secondary prevention of artherothrombotic events following ACS. Each patient will only be monitored for the first 13 weeks after hospital admission for ACS. Patients who choose to take part will complete a consent form. The patient’s care team will be asked to complete a baseline questionnaire about the patient at the time the medicine is given and a further questionnaire up to 16 weeks later, specifically asking about the patient’s experiences whilst on the medication. If anything unusual is reported during the observation period, the care team may be asked to fill out a followup questionnaire. With the patient’s consent, the study team will also inform the patient’s GP of their participation in the study and will ask the GP to complete an abridged questionnaire from the patient’s medical records. The study team will analyse and aggregate the data, carefully protecting patient confidentiality, to classify adverse events of interest, in particular bleeding events.
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 belongsDSRU
Department/Research group
Organisation/affiliationDrug Safety Research Unit
Details of (Primary) lead investigator
Title Professor
Last name Shakir
First name Saad
Is this study being carried out with the collaboration of a research network?
Yes
NIHR Clinical Research Network Cardiology specialty
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
National study
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed02/06/201402/06/2015
Start date of data collection01/09/201501/09/2015
Start date of data analysis
Date of interim report, if expected30/09/201727/10/2017
Date of final study report31/10/201930/10/2019
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesBayer Pharma AG100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Shakir
First name Saad
Address line 1DSRU
Address line 2Bursledon Hall
Address line 3Blundell Lane
CitySouthampton
PostcodeSO31 1AA
CountryUnited Kingdom
Phone number (incl. country code)44-2380-408600
Alternative phone number
Fax number (incl. country code)44-2380-408609
Public Enquiries
Title Professor
Last name Shakir
First name Saad
Address line 1DSRU
Address line 2Bursledon Hall
Address line 3Blundell Lane
CitySouthampton
PostcodeSO31 1AA
CountryUnited Kingdom
Phone number (incl. country code)44-2380-408600
Alternative phone number
Fax number (incl. country code)44-2380-408609
6. Study drug(s) information
Single-Constituent (Substance INN)RIVAROXABAN
7. Medical conditions to be studied
Medical condition(s)No
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 subjects2386
Additional information
• 1193 patients who have been prescribed rivaroxaban plus antiplatelet therapy following ACS,
AND
• 1193 patients who have been prescribed dual antiplatelet therapy (without rivaroxaban) following ACS
10. Source of data
Is this study being carried out with an established data source?No
Sources of data
Study questionnaires will be completed using data from patient medical records.
11. Scope of the study
What is the scope of the study?
Drug utilisation study
Safety
Primary scope : Safety
12. Main objective(s)
What is the main objective of the study?
1. To quantify the cumulative incidence (risk and rate) of haemorrhage (major bleeding within intracranial, gastrointestinal and urogenital organ sites) occurring in the 12 week observation period
Are there primary outcomes?Yes
Intracranial, gastrointestinal or urogenital major bleeding.
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
The basic observation period is 12 weeks following the initiation of treatment with rivaroxaban. After this, a supplementary follow-up questionnaire which is bespoke to the outcome of interest may gather additional relevant information where recorded within medical charts.
15. Data analysis plan
Please provide a brief summary of the analysis method
- quantify the cumulative incidence (risk and rate) of major bleeding
- descriptive exploratory analysis of patient population prescribed rivaroxaban
-quantify the risk of other major (in any other site not specified in the primary objective) or minor bleeding outcomes (in any site) reported in the 12 week observation period overall