Status: Finalised
First registered on:
13/04/2012
Last updated on:
25/08/2017
1. Study identification
EU PAS Register NumberEUPAS2361
Official titleArrhythmogenic Potential of Drugs
Study title acronymARITMO
Study typeObservational study
Brief description of the studyCardiac ventricular arrhythmia as a side effect of anti-arrhythmic and non-antiarrhythmic drugs has become a major pharmacological safety concern for the pharmaceutical industry and the health regulatory authorities.
The overall objective of the ARITMO project is to analyse the ventricular arrhythmogenic potential of individual drugs belonging to the following classes (> 400 compounds): antipsychotics (ATC - Anatomical Therapeutic Chemical classification: N05A), anti-infectives (antibacterials (J01), antimycotics (J02), antivirals (J05), and antiprotozoals (P01)) and H1-antihistamines (R06).
The aim of observational database study is to investigate the pro-arrhitmic risk associated to the medications belonging to the following classes: anti-infectives, antihistamines and antipsychotics.
In detail, the primary objective is to estimate the rates and relative risks of (a) ventricular arrhythmia (VA) and (b) sudden unexpected death (SUD)/sudden cardiac death (SCD) associated with the most frequently prescribed individual anti-infectives, antihistamines and antipsychotics. To estimate the comparative risks of the study drugs, different comparators will be selected for each drug class of interest.
Secondary objectives of the study are:
- to explore the effect of dose and duration of use and route of administration on the association between study outcomes and drugs of interest;
- to identify demographic and clinical predictors for the specific drug-induced arrhythmias
- to describe the prescribing pattern of the study drugs in different databases
For each of the two outcomes (VA and SCD/SUD) matched, nested case control studies will be conducted separately to assess the rates and the relative risk associated with anti-infectives, antihistamines and antipsychotics. As regard the anti-infectives, different case control subsets will be created for each drug subgroup (i.e. antibiotics, antivirals, antimycotics and antiprotozoals).
Was this study requested by a regulator?Yes: EMA
Is the study required by a Risk Management Plan (RMP)?
Not applicable
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 groupPharmacoepidemiology Erasmus University
Organisation/affiliationErasmus University Medical Center
Details of (Primary) lead investigator
Title Professor
Last name Sturkenboom
First name Miriam
Is this study being carried out with the collaboration of a research network?
Yes
ARITMO-Consortium
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?10
AARHUS university, Denmark
Uni-HB, Germany
Countries in which this study is being conducted
International study
Denmark
Germany
Italy
Netherlands
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed04/01/201004/01/2010
Start date of data collection01/01/199601/01/1997
Start date of data analysis04/01/201004/01/2010
Date of interim report, if expected
Date of final study report30/09/201308/08/2013
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
Charities
Government body
Research councils
EU funding schemeSeventh Framework Programme100
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Trifiro
First name Gianluca
Address line 1POBOX 2040
Address line 2dep. Medical Informatics
Address line 3
CityRotterdam
Postcode3000CA
CountryNetherlands
Phone number (incl. country code)39-090-2213264
Alternative phone number31-10-7044123
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Sturkenboom
First name Miriam
Address line 1POBOX 2040
Address line 2dep. Medical Informatics
Address line 3
CityRotterdam
Postcode3000 CA
CountryNetherlands
Phone number (incl. country code)31-10-7044123
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)J01 (ANTIBACTERIALS FOR SYSTEMIC USE)
Substance class (ATC Code)J02 (ANTIMYCOTICS FOR SYSTEMIC USE)
Substance class (ATC Code)J04 (ANTIMYCOBACTERIALS)
Substance class (ATC Code)J05 (ANTIVIRALS FOR SYSTEMIC USE)
Substance class (ATC Code)P01 (ANTIPROTOZOALS)
Substance class (ATC Code)N05A (ANTIPSYCHOTICS)
Substance class (ATC Code)R06 (ANTIHISTAMINES FOR SYSTEMIC USE)
7. Medical conditions to be studied
Medical condition(s)Yes
Ventricular arrhythmia
Sudden cardiac death
8. Population under study
Age
Term newborns (0-27 days)
Infants and toddlers (28 days - 23 months)
Children (2 - 11 years)
Adolescents (12 - 17 years)
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 subjects27000000
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
AARHUS, Denmark
GEPARD, Germany
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
Drug utilisation study
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
The aim of this observational database study is to investigate the pro-arrhitmic risk associated with medications belonging to the following classes: anti-infectives, antihistamines and antipsychotics.
Are there primary outcomes?Yes
primary objective is to estimate the incidence rates and incidence rate ratios of (a) ventricular arrhythmia (VA) and (b) sudden unexpected death (SUD)/sudden cardiac death (SCD) associated with the most frequently prescribed individual anti-infectives, antihistamines and antipsychotics.
Are there secondary outcomes?Yes
- to explore the effect of dose and duration of use and route of administration on the association between study outcomes and drugs of interest;
- to identify demographic and clinical predictors for the specific drug-induced arrhythmias
- to describe the prescribing pattern of the study drugs in different databases
13. Study design
What is the design of the study?
Case-control study
Drug utilisation 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
Crude incidence rate [together with 95% Confidence Interval (CI)] for each study outcome will be separately calculated for each drug class and individual medication dividing the number of events occurring during the exposure to the study drug(s) by the total number of person-years of exposure.Age and gender specific incidence rates will also be assessed in an external reference group from general population in order to estimate the background incidence rate for study ouctomes.Case control studies will be conducted separately within each inception cohort of new users of the study drug classes. By means of conditional logistic regression analyses, odds ratios (ORs) together with 95% CI will be calculated for each individual study drug as compared to corresponding reference category, adjusted for potential confounders.
All analyses will first be performed for each database separately and the heterogeneity between databases will be examined.
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
None
19. Other relevant documents
Other documentsNot
submitted
Signed Code of
Conduct Checklist
Submitted
Signed Code of Conduct Declaration
Submitted
Signed Checklist for Study
Protocols
Submitted
