Status: Finalised
First registered on:
12/01/2018
Last updated on:
05/04/2022
1. Study identification
EU PAS Register NumberEUPAS21870
Official titleMalignancies in Multiple Sclerosis: multi-country cohort database studies (feasibility study)
Study title acronymMALBEC-f
Study typeOther: Study using data from the Echantillon Généraliste de bénéficiaires or if needed from SNIIRAM will be used
Brief description of the studyThe pattern of malignancies in the cladribine clinical program in multiple sclerosis (MS) (all exposed subjects) did not show an obvious difference compared to the available data on malignancies in the general population, or in MS patients. There is no obvious evidence of an increase of the risk of a particular tumor type in cladribine treated subjects compared to European reference populations. No dose-relationship could be found.
The effect of age, immunomodulators (IM) and immunosuppressants (IS) treatments on the risk of malignancy in patients with MS is currently uncertain. MS patients seem to have a similar risk of malignancy than the general population but further studies using external data sources are needed to estimate the risk in MS as compared to general population.
In this context, this study will provide estimates of malignancies incidence for a cohort of MS patients compared to non-MS patients of the general population, and for a cohort of MS patients newly treated with MS modifying drugs (DMDs), according to the type of medication used. This study will be done in 4 countries: France, the Netherlands, Denmark, United States. The overall results will be used with a view to a later post-marketing evaluation of cladribine.
Was this study requested by a regulator?No
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
Organisation/affiliationUniversity of Bordeaux
Details of (Primary) lead investigator
Title Dr
Last name Blin
First name Patrick
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
Denmark
France
Netherlands
United States
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed08/09/2017
Start date of data collection10/09/2017
Start date of data analysis01/11/2017
Date of interim report, if expected
Date of final study report31/12/201810/12/2018
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesMerck KGaA100
Charities
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Dr
Last name Blin
First name Patrick
Address line 1University of Bordeaux
Address line 2146 Rue Leo Saignat
Address line 3
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557574675
Alternative phone number
Fax number (incl. country code)33557574740
Public Enquiries
Title Dr
Last name Blin
First name Patrick
Address line 1University of Bordeaux
Address line 2146 Rue Leo Saignat
Address line 3
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557574675
Alternative phone number
Fax number (incl. country code)33557574740
6. Study drug(s) information
Multi-Constituent (Substance INN(s))INTERFERON BETA-1A
INTERFERON BETA-1B
GLATIRAMER ACETATE
PEGINTERFERON BETA-1A
DACLIZUMAB
Multi-Constituent (Substance INN(s))TERIFLUNOMIDE
FINGOLIMOD
DIMETHYL FUMARATE
ALEMTUZUMAB
MITOXANTRONE
NATALIZUMAB
METHOTREXATE
CYCLOPHOSPHAMIDE
MYCOPHENOLIC ACID
Multi-Constituent (Substance INN(s))AZATHIOPRINE
RITUXIMAB
7. Medical conditions to be studied
Medical condition(s)Yes
Multiple sclerosis
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 subjects632
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
EGB, France
Sources of data
Administrative database, e.g. claims database
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 the incidence of malignancies stratified by age and gender:
- in the MS cohort compared to a sample of non-MS patients from the general population;
- in untreated patients of the MS cohort;
- in newly treated patients with disease modifying drugs (DMD) according to the DMD group;
To characterize the association between DMD treatment exposure and any occurrence of malignacies.
Are there primary outcomes?Yes
Occurrence of any malignancies (including/excluding Non-melanoma skin cancer) :
- Overall
- Per individual malignancy type.
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
No minimum follow up will be required
15. Data analysis plan
Please provide a brief summary of the analysis method
The statistical analysis will be performed using the SAS software (latest current version), following a detailed statistical analysis plan.
Descriptive analyses will be conducted on the MS population, the untreated MS population and the MS population newly treated with a DMD.
Crude and adjusted incidence rates of malignancy will also be calculated stratified on age and gender, in the MS, the untreated MS and the MS newly treated populations. The malignancy incidence estimated in the MS cohort will be then compared to the malignancy incidence estimated after age- and sex-standardization in a sample of non-MS patients from the general population.
In the MS newly treated population, the association between DMD and risk of malignancy will be assessed with a time varying cox model.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
Not submitted
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
