Status: Ongoing
First registered on:
07/08/2023
Last updated on:
16/11/2023
1. Study identification
EU PAS Register NumberEUPAS106052
Official titleDARWIN EU® CC - Co-prescribing of endothelin receptor antagonists (ERAs) and phosphodiesterate-5 inhibitors (PDE-5is) in pulmonary arterial hypertension (PAH)
Study title acronym
Study typeObservational study
Brief description of the studyResearch question
What is the utilization pattern of endothelin receptor antagonists (ERAs) and phosphodiesterase-5 inhibitors (PDE-5is) in pulmonary arterial hypertension (PAH)?
Study objectives
Objective 1: To estimate proportions of patients with newly diagnosed pulmonary arterial hypertension (PAH) who initiate treatment with endothelin receptor antagonists (ERAs) or phosphodiesterase-5 inhibitors (PDE-5is), either as monotherapy or in combination, during the period from January 1, 2012, to December 31, 2022.
Objective 2: To estimate the duration of prescription for ERAs and PDE-5is in patients with newly diagnosed PAH between January 1, 2012, and December 31, 2022.
Objective 3: To describe the prescription patterns and sequences of ERAs and PDE-5is in patients with newly diagnosed PAH between January 1, 2012, and December 31, 2022.
Objective 4: To estimate the proportion of patients with newly diagnosed PAH who experience specific events of interest, namely: cardiovascular hospitalization, all-cause hospitalization, and death, after initiating treatment with ERAs and PDE-5isPAH between January 1, 2012, and December 31, 2022.
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
Centre nameDARWIN EU® CC
Centre locationRotterdam, the Netherlands
Details of (Primary) lead investigator
Title Mr
Last name Arinze
First name Johnmary
Is this study being carried out with the collaboration of a research network?
Yes
Other centres where this study is being conducted
Multiple centres
In total how many centres are involved in this Study?4
University of Oxford – CPRD data, United Kingdom
IQVIA DA Germany, Germany
CHUBX France, France
University of Tartu - Estonian Biobank, Estonia
Countries in which this study is being conducted
International study
Estonia
France
Germany
United Kingdom
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed04/05/202304/05/2023
Start date of data collection01/01/201201/01/2012
Start date of data analysis
Date of interim report, if expected
Date of final study report30/11/2023
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 bodyEMA100
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Mr
Last name Arinze
First name Johnmary
Address line 1Dr. Molewaterplein 40
Address line 2
Address line 3
CityRotterdam
Postcode3015GD
CountryNetherlands
Phone number (incl. country code)31107043050
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Ms
Last name Schuemie
First name Ilse
Address line 1Dr. Molewaterplein 40
Address line 2
Address line 3
CityRotterdam
Postcode3015GD
CountryNetherlands
Phone number (incl. country code)31107043050
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)C02KX02 (ambrisentan)
Substance class (ATC Code)C02KX01 (bosentan)
Substance class (ATC Code)C02KX04 (macitentan)
Substance class (ATC Code)C02KX03 (sitaxentan)
Substance class (ATC Code)G04BE03 (sildenafil)
Substance class (ATC Code)G04BE08 (tadalafil)
7. Medical conditions to be studied
Medical condition(s)Yes
Pulmonary arterial hypertension
8. Population under study
Age
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 subjects13800000
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
Clinical Data Warehouse of Bordeaux University Hospital, France
Clinical Practice Research Datalink GOLD, United Kingdom
Estonian Biobank, Estonia
IQVIA DA Germany, Germany
Sources of data
Routine primary care electronic patient registry
Hospital database
Biobank
11. Scope of the study
What is the scope of the study?
Disease epidemiology
Drug utilisation study
Primary scope : Disease epidemiology
12. Main objective(s)
What is the main objective of the study?
To describe the patient characteristics, treatment patterns of ERAs/PDE-5is, and the proportion of patients with newly diagnosed PAH who experience the events of interest (cardiovascular hospitalization, all-cause hospitalization, and death) after initiating treatment with ERAs and PDE-5is, stratified by country/database.
Are there primary outcomes?Yes
Cardiovascular hospitalisation, all-cause hospitalisation, and death.
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
Follow-up will start on the date of treatment initiation (index date) until the earliest of loss to follow-up, end of data availability or death, or end of study period (31st December 2022).
15. Data analysis plan
Please provide a brief summary of the analysis method
The number and % of patients receiving each of a pre-specified list of PAH treatments and treatment combinations will be described. A treatment pattern analysis will be conducted to describe the sequence of prescribing of the specific ERAs/PDE-5is following diagnosis. Index date will be the date of diagnosis of PAH. Sunburst plots and Sankey diagrams will be used to describe treatment patterns and sequences over time.
Large-scale patient-level characterisation will be conducted to describe age and sex at time of PAH diagnosis. The medical history will include clinical symptoms and signs, comorbidities, and important factors possibly related to PAH diagnosis. We will also report the proportion of patients with outcomes of interest. Patient-level ERAs/PDE-5is use: Patient-level features will be characterized, and the treatment duration of interest will be estimated. For all analyses a minimum cell count of 5 will be used when reporting results, with any smaller counts obscured.
16. ENCePP seal
Are you requesting the ENCePP seal for this study?
No
17. Full protocol
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
