Status: Planned
First registered on:
23/06/2020
Last updated on:
23/06/2020
1. Study identification
EU PAS Register NumberEUPAS35964
Official titleBurden and consequences of the use of COPD-related systemic corticosteroids
Study title acronymCOPD OCS study
Study typeObservational study
Brief description of the studyThis will be an observational, retrospective cohort study of patients who are or were diagnosed with COPD. Patterns of use, risk of comorbidities associated with COPD-related systemic corticosteroids (SCS) use and its related cost impact on COPD patients will be evaluated in the CPRD database. Those initiating SCS (SCS arm) will be compared to those not exposed to SCS (non-SCS arm/control arm). This cohort study will be comprised of a minimum 1-year baseline period. The index date for patients in the SCS arm is the date of their first recorded prescription for parenteral or oral COPD-related corticosteroids while the index date for those in the non-SCS arm is the nearest general practice (GP) visit to the matched-case index date. Patients will be followed-up to the end of their individual records which will be defined as either of the following: date of the last data extraction from the GP, date of leaving the GP, date of death, or any study outcome of interest. The study outcomes of interest are incidence of morbidity outcomes: type 2 diabetes mellitus, hypertension, cardio-/cerebrovascular disease (myocardial infarction, dyslipidaemia, congestive heart failure, cerebrovascular accident), osteoporosis, osteoporotic fracture, weight gain, sleep disorders, sleep apnoea, peptic ulcer, cataracts, glaucoma, depression/anxiety, psychosis, pneumonia, antibiotic treated infections, sudden death, and renal impairment. The worsening or recurrence of morbidity outcomes: type 2 diabetes, new osteoporosis related fractures, and pneumonia. HCRU and associated costs to the healthcare system will be described for different resource components as well as SCS-related all-cause and specified comorbid conditions. Exposure of SCS will be measured from index date to incidence of the outcome or to the end of a patient’s observation.
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
Department/Research groupObservational and Pragmatic Research Institute Pte Ltd
Organisation/affiliationOPRI Pte Ltd
Details of (Primary) lead investigator
Title Professor
Last name Price
First name David
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
National study
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed06/11/2019
Start date of data collection28/08/2020
Start date of data analysis28/08/2020
Date of interim report, if expected
Date of final study report30/04/2021
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesAstraZeneca100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Price
First name David
Address line 15a Coles Lane
Address line 2Oakington
Address line 3
CityCambridge
PostcodeCB24 3BA
CountryUnited Kingdom
Phone number (incl. country code)442081233923
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Price
First name David
Address line 15a Coles Lane
Address line 2Oakington
Address line 3
CityCambridge
PostcodeCB24 3BA
CountryUnited Kingdom
Phone number (incl. country code)442081233923
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)H02 (CORTICOSTEROIDS FOR SYSTEMIC USE)
7. Medical conditions to be studied
Medical condition(s)Yes
Chronic obstructive pulmonary disease
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 subjects193320
Additional information
Based on a previous study using data from the CPRD, 193,320 patients with QOF COPD diagnosis or a monitoring code after 1 April 2003 were selected.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Routine primary care electronic patient registry
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 evaluate patterns, risk of comorbidities associated with COPD-related systemic corticosteroids (SCS) use and its related cost impact on COPD patients in the CPRD database
Are there primary outcomes?Yes
Among patients with COPD overall and relevant subgroups, we aim to:
1.Describe patterns of COPD-related SCS use
2.Measure the association between COPD-related SCS exposure and (1)the incidence of outcome morbidities (2)the worsening or recurrence of outcome morbidities
3.Quantify annualised and longitudinal (based on calendar years) healthcare resource utilisation (HCRU) and associated costs
Are there secondary outcomes?Yes
To describe:
1.patterns of all-cause SCS use
2.longitudinal exposures to SCS pre- and post diagnosis with COPD
3.cumulative OCS dose per moderate COPD exacerbation
4.COPD patients who are not on maintenance therapy
5.change in COPD maintenance medication by SCS use
6.correlation of SCS use with a change in blood eosinophil count
7.potential SCS dose threshold at which comorbidity occurs
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-up from index date to the end of their individual records which will be defined as either of the following: date of the last data extraction from the GP, date of leaving the GP, date of death, or any study outcome of interest.
15. Data analysis plan
Please provide a brief summary of the analysis method
For each SCS-related condition, a multivariable Cox proportional hazard model will be considered with time-dependent and -varying exposure measures and confounders accounted for at baseline. Each analysis will be adjusted for the variables identified as residual confounders during the baseline analysis. Time to event will be defined as the time from index date up to the onset of SCS-related conditions. The HCRU outcomes and associated costs to the healthcare system will be described for each of the resource components and SCS-related all-cause and specified comorbid conditions for all complete years of follow-up from the index date until the end of the last completed follow-up year, separately for each risk cohort. Generalised estimating equations with cluster robust standard errors, log link and gamma distribution will be used to estimate the effect of different strata of SCS exposure on annualised HCRU or costs.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
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
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
