Status: Finalised
First registered on:
07/03/2013
Last updated on:
30/05/2017
1. Study identification
EU PAS Register NumberEUPAS3626
Official titlePan European Multi-Database Bladder Cancer Risk Characterisation Study
Study title acronym
Study typeObservational study
Brief description of the studyThis observational study is being undertaken to further assess the association between pioglitazone use and bladder cancer risk among patients with type 2 diabetes mellitus in four European countries: Finland, Netherlands, Sweden, and United Kingdom.
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
EU RMP category 3 (required)
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 belongsIQVIA
Department/Research group
Organisation/affiliationEPID Research Oy
Details of (Primary) lead investigator
Title Dr
Last name Korhonen
First name Pasi
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?4
Countries in which this study is being conducted
International study
Finland
Netherlands
Sweden
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed30/03/201230/03/2012
Start date of data collection30/07/201329/07/2014
Start date of data analysis
Date of interim report, if expected
Date of final study report30/09/201630/09/2016
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesTakeda Global Research & Development Centre (Europe) Ltd100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Korhonen
First name Pasi
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-50-3652990
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Korhonen
First name Pasi
Address line 1EPID Research Oy
Address line 2Metsänneidonkuja 12
Address line 3
CityEspoo
Postcode02130
CountryFinland
Phone number (incl. country code)358-50-3652990
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Single-Constituent (Substance INN)PIOGLITAZONE
7. Medical conditions to be studied
Medical condition(s)Yes
Type 2 diabetes mellitus
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 subjects760000
Additional information
Pooling all 4 countries 69000 pioglitazone users with 10 matched controls
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
Finnish Prescription Register, Finland
Finnish Cancer Registry, Finland
Swedish Cancer Registry, Sweden
PHARMO database network, Netherlands
Cause of Death Registry, Finland
Sources of data
Prospective patient-based data collection
Prescription event monitoring
Administrative database, e.g. claims database
Routine primary care electronic patient registry
Pharmacy dispensing records
Population-wide registers in Finland and Sweden contain information e.g. on medication purchases, hospitalisations, cancers and deaths. The PHARMO database network contains info on drug dispensings, hospital morbidity, clinical labs etc. UK CPRD contains the anonymised longitudinal medical records managed by GPs working the NHS primary care setting.
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 estimate and compare the absolute and relative risk of bladder cancer in patients with type 2 diabetes who are ever exposed to pioglitazone vs. never exposed to pioglitazone.
Are there primary outcomes?Yes
Date of diagnosis of the first incidence of bladder cancer after the entry into the study cohort.
Are there secondary outcomes?Yes
- All cause mortality
- Bladder cancer mortality
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
FU starts the date when the baseline therapy (including no pharmacotherapy) was modified to include pioglitazone or another antidiabetic medicine. Each patient will be followed-up from cohort entry until the date of diagnosis of the first incident bladder cancer, start of other tdz at or after cohort entry, end of membership of the database, end of database coverage, death or 30 Jun 2011.
15. Data analysis plan
Please provide a brief summary of the analysis method
Crude bladder cancer incidence and mortality rates with 95% CI will be estimated for each pioglitazone exposure definition separately within the strata of gender, age, year of cohort entry, duration of disease, medication and disease history. Crude incidence rates for each country will be provided separately.
In the propensity score matched cohort analysis HR estimates with 95% CIs for each pioglitazone exposure definition will be estimated using Cox model with a counting process approach which enables the follow-up time of each patient to be split into several periods and thus allows adjustments for relevant baseline and time-dependent covariates in the model specification. Separate analyses of bladder cancer incidence, bladder cancer mortality and all-cause mortality will be performed for each country/dataset.
In meta-analysis the pooled data set will be used and analysed using the similar methods as the individual cohort analyses.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
Yes
17. Full protocol
18. Study Results
Please list the 5 most relevant publications using data from your study
ReferenceLink to web-publication
Korhonen P, Heintjes EM, Williams R, Hoti F, Christopher S, Majak M, Houweling L, Strongman H, Linder M, Dolin P, Bahmanyar S. Bladder cancer risk in relation to exposure to pioglitazone among patients with T2DM in the Pan European Multi-Database Bladder Cancer Risk Characterisation Study. American Diabetes Association's 75th Scientific Session, Boston, USA, 5-9 June, 2015.https://ada.scientificposters.com/epsSearchADA.cfm
Korhonen P, Heintjes EM, Williams R, Hoti F, Christopher S, Majak M, Bezemer I, Houweling L, Strongman H, Williams T, Linder M, Dolin P, Bahmanyar S. Preliminary results of bladder cancer risk in relation to exposure to pioglitazone among patients with
T2DM in the Pan European Multi-Database Bladder Cancer Risk Characterisation Study. 31st International Conference on Pharmacoepidemiology and Therapeutic Risk Management, Boston, USA, 22-26 August, 2015.http://epidresearch.com/assets/AbstractBCIncidenceISPE-2015-Abstract-751217-Preview.pdf
Korhonen P, Heintjes EM, Williams R, Hoti F, Christopher S, Majak M, Kool-Houweling L, Strongman H, Linder M, Dolin P, Bahmanyar S. Pioglitazone use and risk of bladder cancer in patients with type 2 diabetes: retrospective cohort study using datasets from four European countries. BMJ 2016;354:i3903http://www.bmj.com/content/354/bmj.i3903
Strongman H, Korhonen P, Williams R, et al Pioglitazone and risk of mortality in patients with type 2 diabetes: results from a European multidatabase cohort study BMJ Open Diabetes Research and Care 2017;5:e000364. doi: 10.1136/bmjdrc-2016-000364http://drc.bmj.com/cgi/content/abstract/5/1/e000364?ct
19. Other relevant documents
Other documents
DescriptionDocumentLatest version
