Status: Finalised
First registered on:
29/09/2014
Last updated on:
31/08/2020
1. Study identification
EU PAS Register NumberEUPAS7549
Official titleEpidemiology of acute hepatotoxicity from medicines
Study title acronymEPIHAM
Study typeObservational study
Brief description of the studyEPIHAM is to identify in the national healthcare databases all hospital admissions for toxic or unexplained liver injuries. It will be done within the French national health care systems databases, which include all reimbursed health-care expenses, and all hospital admissions with ICD-10 coded admission diagnoses. The overall methodological approach will be initially that of a case-population study to compare event rates with those found in SALT. This will be completed by other methods: a case-crossover approach, a classical case-control study, and a propensity-score adjusted or matched cohort study of products selected from the case-population data.
The routines created for this project may be reused to set up regular surveillance of drug-related hepatic disorders in the French population
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 Professor
Last name Gulmez
First name Sinem Ezgi
Is this study being carried out with the collaboration of a research network?
No
Other centres where this study is being conducted
Not applicable (single centre)
Countries in which this study is being conducted
National study
France
3. Study timelines: initial administrative steps, progress reports and final report
PlannedActual
Date when funding contract was signed17/07/2014
Start date of data collection02/05/201616/10/2014
Start date of data analysis01/09/201616/10/2014
Date of interim report, if expected17/07/2015
Date of final study report31/12/201631/01/2017
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
CharitiesInstitute de Recherche en Santé Publique (IReSP)100
Government body
Research councils
EU funding scheme
5. Contact details for enquiries
Scientific Enquiries
Title Professor
Last name Gulmez
First name Sinem Ezgi
Address line 1Service de Pharmacologie médicale CIC Bordeaux CIC1401 Université de Bordeaux Bâtiment Le Tondu - Case 41 146, Rue Léo Saignat
Address line 2Bat Tondu, Case 41
Address line 3146, rue Leo Saignat
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557579564
Alternative phone number
Fax number (incl. country code)33557574740
Public Enquiries
Title Professor
Last name Gulmez
First name Sinem Ezgi
Address line 1Service de Pharmacologie médicale CIC Bordeaux CIC1401 Université de Bordeaux Bâtiment Le Tondu - Case 41 146, Rue Léo Saignat
Address line 2Bat Tondu, Case 41
Address line 3146, rue Leo Saignat
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557579564
Alternative phone number
Fax number (incl. country code)33557574740
6. Study drug(s) information
Not applicable (disease/epidemiology study)
7. Medical conditions to be studied
Medical condition(s)Yes
Acute hepatic failure
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
Other population
Hepatic impaired
9. Number of subjects
Estimated total number of subjects4800000
Additional information
In France, the main population database for pharmacoepidemiology is SNIIR-AM. SNIIR-AM has developed a permanent 1/97 representative sample of the national database, called EGB. At the time of this project the hospital data will be current to 2012, resulting in 8 years of data, or about 4.8 million person-years of follow-up.
10. Source of data
Is this study being carried out with an established data source?Yes
Data sources not registered with ENCePP
EGB, France
SNIIRAM, France
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 identify the main drugs associated with DILIH in France and the event rates associated with DILIH, for individual drugs and for drug families, in terms of absolute and relative risks
Are there primary outcomes?No
Are there secondary outcomes?No
13. Study design
What is the design of the study?
Cohort study
Case-control study
Case-crossover
case-population 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
Descriptive: For categorical and ordinal variables will provide the number and the frequency of each modality as well as missing data. For quantitative variables will provide mean, standard deviation, first quartile, median, third quartile, and extreme values. Case-population: The main study analysis. Number of cases exposed to a given drug is compared to the number of subjects using the drug within the study time-frame, or to the number of defined daily doses (DDD) dispensed in the database population. Case-crossover: One or more control periods will be selected, one year before ID to take into account possible seasonal variations in drug use, or randomly within the year previous to ID. Case-control: Within the database population, controls will be selected, matched on age, gender, concomitant chronic diseases. Cohort: If events are enough, incident user cohorts and controls, adjusted or matched on propensity scores will be built and followed using cox proportional hazards analyses.
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
Gulmez SE, Unal US, Lassalle R, Chartier A, Grolleau A, Moore N. Risk of hospital admission for liver injury in users of NSAIDs and nonoverdose paracetamol: Preliminary results from the EPIHAM study. Pharmacoepidemiol Drug Saf. 2018 Nov;27(11):1174-1181https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4640
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
