1. Study identification
EU PAS Register NumberEUPAS3847
Official titleThe European Drug-induced Agranulocytosis Consortium Study
Study title acronymThe EuDAC Study
Study typeOther: Case-control
Brief description of the studyStudies show that adverse drug reactions (ADRs) are one of the most common reasons for hospitalisation in the adult population. It has also been proposed that ADRs are the fourth to sixth leading cause of death in hospitalised patients. Most ADRs are dose-dependent and pharmacologically predictable (type A reactions), while others have no known pharmacological cause (type B reactions). Agranulocytosis (unless due to chemotherapy) belongs to this second type that commonly is serious and sometimes leads to withdrawal of drugs from the market. The current knowledge about possible genetic causes of drug-induced agranulocytosis is minimal. The aim of EuDAC is to identify genetic factors that predispose to drug-induced agranulocytosis, enabling us to test and predict the individual risk before starting a drug treatment.
Was this study requested by a regulator?No
Is the study required by a Risk Management Plan (RMP)?
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 nameClinical Pharmacology, Department of Medical Sciences, Uppsala University
Centre locationUppsala, Sweden
Details of (Primary) lead investigator
Title Dr
Last name Hallberg
First name Pär
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?11
Clinical Pharmacology Service, University of Málaga, Spain
Medical Products Agency, Sweden
Instituto de Parasitología y Biomedicina López Neyra Avda, Spain
Clinical Pharmacology, Uppsala University, Sweden
Laboratoire de Pharmacologie Médicale et Clinique, Faculté de Médecine de l’Université de Toulouse, France
Charité - University Medicine, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
Countries in which this study is being conducted
International study
France
Germany
Netherlands
Spain
Sweden
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed01/04/200801/04/2008
Start date of data collection01/03/200901/03/2009
Start date of data analysis01/06/2014
Date of interim report, if expected
Date of final study report01/12/2015
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 bodySwedish Medical Products Agency25
Research councilsUppsala County Council Research Fund, Sweden10
EU funding scheme
OtherSwedish research council25
Swedish Society of Medicine25
Serlander’s Fund, Sweden10
Thereus’ Fund, Sweden5
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Hallberg
First name Pär
Address line 1Clinical Pharmacology
Address line 2Entrance 61, 4th floor
Address line 3Uppsala University Hospital
CityUppsala
Postcode751 85
CountrySweden
Phone number (incl. country code)46-186110000
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Hallberg
First name Pär
Address line 1Clinical Pharmacology
Address line 2Entrance 61, 4th floor
Address line 3Uppsala University Hospital
CityUppsala
Postcode751 85
CountrySweden
Phone number (incl. country code)46-186110000
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)A07EC (Aminosalicylic acid and similar agents)
Substance class (ATC Code)H03B (ANTITHYROID PREPARATIONS)
Substance class (ATC Code)J01 (ANTIBACTERIALS FOR SYSTEMIC USE)
Substance class (ATC Code)N03 (ANTIEPILEPTICS)
Substance class (ATC Code)M01A (ANTIINFLAMMATORY AND ANTIRHEUMATIC PRODUCTS, NON-STEROIDS)
Substance class (ATC Code)B01AC (Platelet aggregation inhibitors excl. heparin)
Substance class (ATC Code)D01B (ANTIFUNGALS FOR SYSTEMIC USE)
Substance class (ATC Code)C07 (BETA BLOCKING AGENTS)
Substance class (ATC Code)N06A (ANTIDEPRESSANTS)
7. Medical conditions to be studied
Medical condition(s)Yes
Agranulocytosis
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 subjects300
10. Source of data
Is this study being carried out with an established data source?No
Sources of data
Prospective patient-based data collection
Spontaneous reporting
11. Scope of the study
What is the scope of the study?
Genome-wide association study
Primary scope : Genome-wide association study
12. Main objective(s)
What is the main objective of the study?
To identify genetic factors that predispose to drug-induced agranulocytosis.
Are there primary outcomes?Yes
Proportion of individuals who are carriers of investigated genetic polymorphisms.
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Case-control study
14. Follow-up of patients
Will patients be followed up?Not applicable/no follow-up
15. Data analysis plan
Please provide a brief summary of the analysis method
Association analyses with genetic and clinical factors will be performed for the agranulocytosis group as a whole and stratified for each drug or class of drugs. A total of about 4000 population and treated controls will be used. To correct for population stratification, controls will be recruited from all countries and principal component analysis will be performed. To correct for multiple testing, the level of significance will be set at around p<1*10-8, which is equivalent to a Bonferroni correction for 1 million independent tests. We will make an effort to collect 100 new cases and controls for replication of the 10-20 top hits. We will then need to correct for 10-20 multiplied tests, i.e. a p-value of 0.0025-0.005 will suffice. We will perform single SNP tests with logistic regression with adjustment for population stratification by including significant principal components as covariates in the logistic-regression model. Results are illustrated with Q-Q and Manhattan plots.