Status: Finalised
First registered on:
19/06/2014
Last updated on:
15/05/2015
1. Study identification
EU PAS Register NumberEUPAS6804
Official titleMetabolic effects associated with ICS (inhaled corticosteroid) use in COPD (chronic obstructive pulmonary disease) patients with type II diabetes
Study title acronym
Study typeOther: Retrospective observational study
Brief description of the studyLay Summary: Current international guidelines for the management of chronic obstructive pulmonary disease (COPD; GOLD 2014) recommend inhaled corticosteroids (ICS) are reserved for COPD patients with severe/very severe disease and/or frequent exacerbations. However, research shows widespread use of ICS in patients with mild and moderate disease, meaning more patients are exposed to risks of side effects than would be expected under current guidelines. High doses of ICS as those typically prescribed to COPD patients have been linked to increased risks of diabetes onset and progression, yet no study has investigated this association in a cohort of COPD patients in the UK. The proposed study will investigate whether ICS treatment in COPD patients with comorbid type II diabetes has a negative impact on diabetic control, and determine whether COPD patients treated with ICS outside of guidelines are at unnecessary risk of diabetes progression. The intended audience for this study is prescribers. We plan to publish the results of this study initially at a conference, then as a manuscript in a peer-reviewed journal.
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 to which the investigator belongsRIRL
Department/Research group
Organisation/affiliationResearch in Real Life Ltd.
Details of (Primary) lead investigator
Title Dr
Last name Mares
First name Rafael
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 signed04/06/2014
Start date of data collection01/07/201401/08/2014
Start date of data analysis21/07/201411/08/2014
Date of interim report, if expected31/08/201407/11/2014
Date of final study report15/04/201515/04/2015
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesBoehringer Ingelheim50
Charities
Government body
Research councils
EU funding scheme
OtherRiRL50
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Price
First name David
Address line 1University of Aberdeen
Address line 2
Address line 3
CityAberdeen
PostcodeAB24 3FX
CountryUnited Kingdom
Phone number (incl. country code)441223967855
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Price
First name David
Address line 1University of Aberdeen
Address line 2
Address line 3
CityAberdeen
PostcodeAB24 3FX
CountryUnited Kingdom
Phone number (incl. country code)441223967855
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)R03B (OTHER DRUGS FOR OBSTRUCTIVE AIRWAY DISEASES, INHALANTS)
7. Medical conditions to be studied
Medical condition(s)Yes
Type 2 diabetes mellitus
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 subjects1088
Additional information
The study consists of two cohorts: Inhaled corticosteroids (ICS) treated patients and a control cohort of patients not exposed to ICS. For 90% power and a matched ratio of 3:1, a minimum of 816 individuals treated with ICS are required (plus 272 for the control cohort).
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
OPCRD, United Kingdom
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 assess whether ICS use (within and outside of GOLD guidelines) is associated with an increase in glycated haemoglobin (HbA1c) value (%) in COPD patients with type II diabetes.
Are there primary outcomes?Yes
Change in HbA1c value (%) relative to baseline.
Are there secondary outcomes?Yes
(a) Change in HbA1c with a change in anti-diabetic medication - (b) Change in number of patients on/off HbA1c target (< 7.5% as per UK QOF indicators) with no change in anti-diabetic medication - (c) No change in HbA1c with an increase in GP visits, hospital visits and glucose strip use - (d) Progression of ongoing diabetes treatment to insulin
13. Study design
What is the design of the study?
Cohort 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
This will be a retrospective cohort study with a one year outcome period after an index prescription date. The index prescription date refers to either the first prescription of ICS (ICS-initiating cohort) or the first prescription of LABA or LAMA (no ICS therapy cohort). Patients in the ICS-initiating cohort will be matched to patients in the no ICS therapy cohort (i.e. control cohort), using a set of baseline characteristics. For the primary outcome, mean one-year change in HbA1c value (%) will be compared across the two study cohorts. Internal validity will be addressed by matching patients on baseline characteristics and controlling for potential confounders during statistical analyses. External validity will be achieved by using large primary care databases, which have been shown to be generalizable to the UK population.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
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
