Status: Ongoing
First registered on:
30/06/2020
Last updated on:
09/09/2020
1. Study identification
EU PAS Register NumberEUPAS36089
Official titleImpact of use of newer glucose lowering drugs on outcomes in patients with COVID-19
Study title acronym
Study typeObservational study
Brief description of the studyThe coronavirus disease 2019 (COVID-19) pandemic poses great health care challenges worldwide. In Denmark, authority regulated social distancing has been the key to limit rapid spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) keeping the diseased population below the tolerable threshold. However, the COVID-19 epidemic is expected to return in one or more waves which emphasizes the need for identifying modifiable risk factors in vulnerable patients.
Newer glucose lowering drugs (GLD) have potential for affecting the disease course by suppressing the inflammatory state or by upregulation of the angiotensin-converting enzyme 2 (ACE2).
The study is a national cohort study on patients tested positive for SARS-CoV-2 in Denmark. This study will examine the association between ongoing use of newer glucose-lowering drugs (Glucagon Like Peptid-1 (GLP-1) receptor agonists, Dipeptidyl Peptidase-4 (DPP4) inihibitors and Sodium-Glucose Transport Protein-2 (SGLT2) inhibitors) and other glucose lowering drugs and risk of severe outcomes in COVID-19 patients. Severe outcomes include hospital admission, intensive care unit (ICU) admission, mechanical ventilation and death within 30 days from positive SARS-CoV-2 test.
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 groupOdense University Pharrnacoepidemiological Database
Organisation/affiliationUniversity of Southern Denmark
Details of (Primary) lead investigator
Title Dr
Last name Bastrup Israelsen
First name Simone
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?3
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Center for Research and Disruption in Infectious Diseases, Department of Infectious Diseases, Amager Hvidovre Hospital, Hvidovre, Denmark
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 signed22/04/2020
Start date of data collection27/02/2020
Start date of data analysis01/07/2020
Date of interim report, if expected
Date of final study report01/10/2020
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
Charities
Government body
Research councils
EU funding scheme
OtherErik and Susanna Olesen's Public Charity Fund100
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Bastrup Israelsen
First name Simone
Address line 1Kettegaard Alle 30
Address line 2
Address line 3
CityHvidovre
PostcodeDK-2650
CountryDenmark
Phone number (incl. country code)45-40335495
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Benfield
First name Thomas
Address line 1Kettegaard Alle 30
Address line 2
Address line 3
CityHvidovre
PostcodeDK-2650
CountryDenmark
Phone number (incl. country code)45-38622302
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)A10BJ (Glucagon-like peptide-1 (GLP-1) analogues)
Substance class (ATC Code)A10BK (Sodium-glucose co-transporter 2 (SGLT2) inhibitors)
Substance class (ATC Code)A10BH (Dipeptidyl peptidase 4 (DPP-4) inhibitors)
7. Medical conditions to be studied
Medical condition(s)Yes
COVID-19
Suspected COVID-19
8. Population under study
Age
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 subjects10000
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
The Danish Microbiology Database, Denmark
Sources of data
Disease/case registry
Administrative database, e.g. claims database
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?
The main objective of the study is to examine the association between ongoing use of newer glucose-lowering drugs (DPP4i, SGLT2i, and GLP-1 receptor agonists) and other glucose lowering drugs and risk of severe outcomes in COVID-19 patients.
Are there primary outcomes?Yes
The primary outcome is death within 30 days after positive SARS-CoV-2 test.
Are there secondary outcomes?Yes
The secondary outcomes include hospital admission, intensive care unit (ICU) admission and mechanical ventilation within 30 days after positive SARS-CoV-2 test.
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 with confirmed COVID-19 are followed from and including date of positive SARS-CoV-2 test until intensive care unit (ICU) admission, mechanical ventilation, date of death, or for up to 30 days.
15. Data analysis plan
Please provide a brief summary of the analysis method
We will estimate risk ratios for hospital admission, ICU admission, mechanical ventilation and death in patients tested positive for SARS-CoV-2 for the exposed group (current use of GLP-1 receptor agonists) vs. the active comparator group (current use of SGLT2 inhibitors) by log binomial regression.
We will apply propensity score matching and inverse probability of treatment weighting to adjust for pre-existing differences in significant risk factors between the exposed and active comparator group. Patients will be matched 1:1, unless other matching sets are possible. Covariates include diabetes duration, use of other glucose lowering drugs, diabetic complications, cardiovascular disease, total burden of comorbidities, markers of tobacco smoking, alcoholism, medical obesty and socioeconomic markers.
In secondary analyses, we will study patients with current use of DPP-4 inhibitors compared to the active comparator group (i.e. patients with current use of SGLT2 inhibitors).
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
