Status: Finalised
First registered on:
16/02/2015
Last updated on:
16/02/2015
1. Study identification
EU PAS Register NumberEUPAS8615
Official titleLamotrigine use in Pregnancy and Risk of Orofacial Clefts
Study title acronym
Study typeOther: Case- malformed control study
Brief description of the studyA case-malformed control study evaluating the risk of orofacial clefts in relation to first trimester exposure to the the new anti-epileptic drug (AED) lamotrigine was conducted using data from 19 EUROCAT registries covering a population of 4 million births, 1995-2005. The study found no evidence of a specific increased risk of isolated orofacial clefts relative to other malformations due to lamotrigine monotherapy. This study was conducted following a US Federal Drugs Agency alert in 2006 concerning an increased risk of orofacial cleft associated with lamotrigine exposure.
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
Department/Research groupCentre for Maternal, Fetal and Infant Research
Organisation/affiliationUniversity of Ulster
Details of (Primary) lead investigator
Title Professor
Last name Dolk
First name Helen
Is this study being carried out with the collaboration of a research network?
Yes
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
International study
Belgium
Croatia
Denmark
France
Germany
Ireland
Italy
Malta
Netherlands
Norway
Poland
Spain
Switzerland
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed07/02/200707/02/2007
Start date of data collection15/02/2007
Start date of data analysis18/04/2007
Date of interim report, if expected
Date of final study report31/07/2007
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesGSK100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Dolk
First name Helen
Address line 1Shore Rd
Address line 2
Address line 3
CityNewtownabbey
PostcodeBT370QB
CountryUnited Kingdom
Phone number (incl. country code)442890368540
Alternative phone number
Fax number (incl. country code)442890368341
Public Enquiries
Title Professor
Last name Dolk
First name Helen
Address line 1Shore Rd
Address line 2
Address line 3
CityNewtownabbey
PostcodeBT370QB
CountryUnited Kingdom
Phone number (incl. country code)442890368540
Alternative phone number
Fax number (incl. country code)442890368341
6. Study drug(s) information
Substance class (ATC Code)N03AX09 (lamotrigine)
7. Medical conditions to be studied
Medical condition(s)Yes
Cleft lip and palate
Cleft palate
8. Population under study
Age
Preterm newborns
Term newborns (0-27 days)
Infants and toddlers (28 days - 23 months)
Sex
Male
Female
Other population
Pregnant women
9. Number of subjects
Estimated total number of subjects85563
Additional information
The study population covered 3.9 million births. A total of 85,563 registrations
comprising 5,511 orofacial cleft (OC) cases and 80,052 non-OC controls were included in analysis. Of the 5,511 OC cases, 4,571 were isolated. Of the 1,969 cleft palate (CP) cases, 532 were isolated CP.
There were 495 anti-epileptic drug (AED) exposed cases and controls.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Disease/case 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 investigate in a large dataset whether lamotrigine exposure in the first trimester of pregnancy is associated with an increased risk of orofacial clefts relative to other malformations
Are there primary outcomes?Yes
Odds of lamotrigine (LMT) exposure among OC registrations (cases) was compared with the odds of LTG exposure among malformed non-OC registrations (controls).
Are there secondary outcomes?Yes
An exploratory hypothesis-generating analysis compared the proportion of different malformation subgroups, according to EUROCAT subgroup definitions,among all nonchromosomal registrations, between lamotrigine exposed (all and mono) and AED unexposed registrations.
13. Study design
What is the design of the study?
Case- malformed control
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
Crude ORs were calculated ignoring the registry of origin. In order to analyze the data taking into account the registry and including all registries (even if they had no exposure to lamotrigine (LMG) in either cases or controls) the WinBUGS computer package was used to fit multinomial responses with a logistic link. Maternal age was treated as a categorical variable. Due to the small numbers of exposures to LTG it was not possible to adjust simultaneously for both registry and maternal age.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
Not submitted
18. Study Results
Not submitted
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
Dolk H, Jentink J, Loane M, Morris J, de Jong-van den Berg LTW and EUROCAT Antiepileptic Drug Working Group (2008), “Does Lamotrigine Use in Pregnancy Increase Orofacial Cleft Risk Relative to Other Malformations?”, Neurology, Vol 71, pp 714-722]
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
