Status: Finalised
First registered on:
25/10/2013
Last updated on:
18/11/2020
1. Study identification
EU PAS Register NumberEUPAS5035
Official titleMultinational, multi-database cohort study to assess adverse cardiovascular and cerebrovascular outcomes and mortality in association with inhaled NVA237 in Europe
Study title acronymNVA237 PASS
Study typeObservational study
Brief description of the studyIn the context of the NVA237 marketing application in Europe, the Committee for Medicinal Products for human use (CHMP) required the conduct of a post-authorization safety study (PASS) to assess the association between the use of NVA237 and cardiovascular and cerebrovascular events.
The objectives of this study are to assess the incidence rates and hazard ratio of 1) cardiovascular and cerebrovascular outcomes and 2) mortality among new users of inhaled NVA237 with COPD compared to new users of comparator drugs (long acting antimuscarinic antagonists [LAMAs] excluding NVA237) or long acting β2 agonists (LABAs) with COPD.
This study will be a multinational, multi-database cohort study using information from five European electronic health care databases from the Netherlands, Italy, United Kingdom (UK), Denmark and Spain in new users of NVA237 vs. new users of two comparator drug classes.
Was this study requested by a regulator?Yes:
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 1 (imposed as condition of marketing authorisation)
Regulatory procedure number (RMP Category 1 and 2 studies only)
Other study registration identification numbers and URLs as applicableCNVA237A2402T
2. Research centres and Investigator details
Coordinating study entity
Centre nameNovartis Pharmaceuticals
Centre locationEast Hanover, NJ
Details of (Primary) lead investigator
Title Ms
Last name Novartis
First name Clinical Disclosure Officer
Is this study being carried out with the collaboration of a research network?
Yes
EU-ADR Alliance
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?4
SIDIAP Jordi Gol, Spain
Countries in which this study is being conducted
International study
Denmark
Italy
Netherlands
Spain
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed07/05/2013
Start date of data collection01/11/2012
Start date of data analysis25/10/201325/10/2013
Date of interim report, if expected04/12/2013
Date of final study report30/11/201717/11/2017
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesNovartis100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Ms
Last name Novartis
First name Clinical Disclosure Officer
Address line 1Novartis Pharma AG
Address line 2
Address line 3
CityBasel
PostcodeCH-4002
CountrySwitzerland
Phone number (incl. country code)44613241111
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Ms
Last name Novartis
First name Clinical Disclosure Officer
Address line 1Novartis Pharma AG
Address line 2
Address line 3
CityBasel
PostcodeCH-4002
CountrySwitzerland
Phone number (incl. country code)44613241111
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)R03BB06 (glycopyrronium bromide)
7. Medical conditions to be studied
Medical condition(s)Yes
Chronic obstructive pulmonary disease
8. Population under study
Age
Adults (45 - 64 years)
Adults (65 - 74 years)
Adults (75 years and over)
Sex
Male
Female
9. Number of subjects
Estimated total number of subjects3000
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources registered with ENCePP
Sources of data
Administrative database, e.g. claims database
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 the incidence rates and hazard ratio of cardiovascular and cerebrovascular outcomes, and of mortality among new users of inhaled NVA237 with COPD compared to new users of LAMA (non-NVA237) or new users of LABA in patients with COPD.
Are there primary outcomes?Yes
• Major cardiovascular events
•Ischemic heart disease including myocardial infarction and angina pectoris
•Cardiac arrhythmias
•Atrial fibrillation/flutter
•Cerebrovascular disorders
•Mortality
Are there secondary outcomes?No
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
For the primary analysis, patients initiating NVA237 or any single ingredient comparator drug (LABA or LAMA (excluding NVA237)) will be followed from the time of first prescription (index date) until the earliest of (i) end of treatment episode +30 days, (ii) end of study or disenrollment from the database, (iii) any cardiovascular or cerebro-vascular endpoint or (iv) death.
15. Data analysis plan
Please provide a brief summary of the analysis method
As primary analysis, the risk of overall mortality as well as the risk of the different endpoints of interest among new users of NVA237 will be compared to the risk in the new users of LABA and other LAMA using Cox regression analysis.
Cox regression analyses will be conducted to estimate both crude and adjusted relative risks (expressed as hazard ratios [HRs] with 95% confidence intervals [95% CIs]), allowing for time-varying exposures. All analyses will at first be performed for each database separately. Effect estimates will be pooled across the databases, using a random effects meta-analytical approach. In addition, a pooled mega-analysis will be done by combining the data sources on a patient-level and adjusting for the database.
As secondary analysis, subsequent episodes, with or without treatment, will be taken into account. For this analysis, the HR of the events of interest will be estimated for NVA237 vs. no use of NVA237.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
18. Study Results
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
