Status: Finalised
First registered on:
07/11/2017
Last updated on:
19/09/2022
1. Study identification
EU PAS Register NumberEUPAS21574
Official titleCohort study of cardiovascular events in patients with chronic obstructive pulmonary disease initiating olodaterol or other long-acting beta2-agonists
Study title acronym
Study typeObservational study
Brief description of the studyBoehringer Ingelheim GmbH (BI) developed olodaterol, an inhaled long-acting beta2-agonist (LABA), for the indication of chronic obstructive pulmonary disease (COPD). In the Decentralised Procedure for Striverdi Respimat, the health authorities of the European Union/European Economic Area Member States requested the conduct of a post-authorisation safety study (PASS) to gather additional data on safety in long-term use of olodaterol. The PASS will include evaluation of users of olodaterol monotherapy as well as in fixed-dose combination with tiotropium. The results of this study will provide insight into the absolute and relative frequency of cardiac arrhythmias and myocardial ischaemia events of interest in comparison to alternative LABA therapies for COPD.
Primary study objectives are to: (1) examine the risk of selected cardiac arrhythmias in patients with COPD exposed to olodaterol compared with the risk in patients exposed to other LABAs, and (2) examine the risk of acute myocardial infarction (AMI) and other serious ischaemic heart disease events, including unstable angina, in patients with COPD exposed to olodaterol compared with the risk in patients exposed to other LABAs. The secondary objective is to examine the risk of overall mortality in patients with COPD exposed to olodaterol compared with the risk in patients exposed to other LABAs. The study population will consist of patients with COPD aged 40 years or older in Denmark, a country where olodaterol is available and where a large proportion of the population is included in health care databases used for pharmacoepidemiologic research. Patients will be new users of olodaterol or other LABA, with no dispensing of any LABA in the 6 months before the first prescription of olodaterol or LABA during the study period (index date) and at least 1 year of enrolment in the database.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 2 (specific obligation of marketing authorisation)
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 belongsRTI-HS
Department/Research groupPharmacoepidemiology & Risk Management
Organisation/affiliationRTI Health Solutions
Details of (Primary) lead investigator
Title Dr
Last name Rebordosa
First name Cristina
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?2
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 signed18/08/201518/08/2015
Start date of data collection31/03/202015/07/2019
Start date of data analysis01/07/202003/02/2020
Date of interim report, if expected
Date of final study report30/09/202015/09/2020
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesBoehringer Ingelheim International GmbH100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Rebordosa
First name Cristina
Address line 1Av. Diagonal, 605, 9-1
Address line 2
Address line 3
CityBarcelona
Postcode08024
CountrySpain
Phone number (incl. country code)34933622807
Alternative phone number
Fax number (incl. country code)34937608507
Public Enquiries
Title Dr
Last name Rebordosa
First name Cristina
Address line 1Av. Diagonal, 605, 9-1
Address line 2
Address line 3
CityBarcelona
Postcode08024
CountrySpain
Phone number (incl. country code)34933622807
Alternative phone number
Fax number (incl. country code)34937608507
6. Study drug(s) information
Substance class (ATC Code)R03AC19 (olodaterol)
Substance class (ATC Code)R03AL06 (olodaterol and tiotropium bromide)
Substance class (ATC Code)R03AC18 (indacaterol)
Substance class (ATC Code)R03AL04 (indacaterol and glycopyrronium bromide)
Substance class (ATC Code)R03AC12 (salmeterol)
Substance class (ATC Code)R03AK12 (salmeterol and budesonide)
Substance class (ATC Code)R03AK06 (salmeterol and fluticasone)
Substance class (ATC Code)R03AC13 (formoterol)
Substance class (ATC Code)R03AL05 (formoterol and aclidinium bromide)
Substance class (ATC Code)R03AK08 (formoterol and beclometasone)
7. Medical conditions to be studied
Medical condition(s)Yes
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 subjects150000
Additional information
The number of person-years of olodaterol exposure necessary to demonstrate, with a probability of 0.80, that the upper bound of the 95% CI assuming an IRR of 1 is <3.0 for ventricular tachycardia is 8,380 person-years, and for an upper bound <2.5, 3,940 person-years are necessary for other arrhythmias, 1,220-1,940 for AMI, 1,970-4,670 for atrial fibrillation, and 100 for all-cause mortality.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
Danish National Health Registries, Denmark
Sources of data
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?
To examine the risk of selected cardiac arrhythmias in patients with COPD exposed to olodaterol compared with the risk in patients exposed to other LABAs; and to examine the risk of AMI and other serious ischaemic heart disease events, including unstable angina, in patients with COPD exposed to olodaterol compared with the risk in patients exposed to other LABAs.
Are there primary outcomes?Yes
Incidence of the following: atrial fibrillation or flutter during new use; hospitalisation for ventricular tachycardia, including ventricular fibrillation/flutter and cardiac arrest; supraventricular tachycardia (other than atrial fibrillation/flutter); hospitalisation for acute myocardial infarction; hospitalisation for serious acute coronary heart disease, including unstable angina
Are there secondary outcomes?Yes
Mortality from all causes
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 will be followed from the first dispensing for the index LABA after the patient has fulfilled all other eligibility criteria. Follow up will continue until the earliest of the following possible termination dates: disenrolment from the database; 14 days after estimated discontinuation of the last dispensing for the index LABA; addition of a second LABA; death; or end of study period
15. Data analysis plan
Please provide a brief summary of the analysis method
The incidence rate ratio (IRR) and incidence rate difference (IRD) for each event of interest in the olodaterol-exposed group relative to that in the comparator group will be derived. The effects of demographics and specified baseline characteristics will be assessed, and adjusted IRR will be calculated by adjusting for each covariate one at a time. A fitted propensity score model will be used to estimate a propensity score for each patient, and the IRRs for each event of interest will be stratified by propensity score deciles. For each endpoint, IRR and IRD will be stratified by propensity score deciles, and the overall adjusted IRR and IRD and associated 95% confidence intervals will be derived by weighting each stratum by the prevalence among the olodaterol cohort.
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
Rebordosa C, Farkas DK, Montonen J, Laugesen K, Voss F, Aguado J, Bothner U, Rothman KJ, Zint K, Mines D, Ehrenstein V. Cardiovascular events and all-cause mortality in patients with chronic obstructive pulmonary disease using olodaterol and other long-acting beta2-agonists. Pharmacoepidemiol Drug Saf. 2022 Aug;31(8):827-839. doi: 10.1002/pds.5432. Epub 2022 May 13. PMID: 35320605.https://onlinelibrary.wiley.com/doi/10.1002/pds.5432
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
