1. Study identification
EU PAS Register NumberEUPAS5555
Official titleStudy of Acute Liver Transplant-II
Study title acronymSALT-II
Study typeObservational study
Brief description of the studyThe SALT-I study created a network of 55 liver transplant centres in seven European countries. It also accumulated a considerable body of data on drug-exposed acute liver failure in Europe. The national coordinators of these centres have expressed a desire to continue this collaboration and monitor severe acute hepatitis in Europe. Furthermore, the main objective of SALT-I concerned only the risks associated with NSAIDs.
One of the main objectives of the SALT-II study is to assess the risks associated with other drugs than NSAID. The incidence of these very severe drug-induced acute liver failure is very low: we could identify only 40 cases associated with NSAIDs over 2005-2007, and fewer still with other drugs except paracetamol. To improve the precision of the measures of incidence, and to be able to identify emergent risks, it would seem desirable to increase the number of cases identified, by continuing the study for the next six years (2008-2013), and studying the possibility of expanding the network to other countries (Germany, Spain, Nordic or Eastern European countries).
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
Multiple centres
In total how many centres are involved in this Study?21
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 signed20/12/2013
Start date of data collection01/07/201401/07/2014
Start date of data analysis12/02/2016
Date of interim report, if expected27/11/2015
Date of final study report30/12/201613/07/2016
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companies
CharitiesBordeaux University Foundation100
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 CIC Bordeaux CIC1401 Université de Bordeaux Bâtiment Le Tondu - Case 41 146, Rue Léo Saignat
Address line 2
Address line 3
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557579564
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Professor
Last name Gulmez
First name Sinem Ezgi
Address line 1Service de Pharmacologie CIC Bordeaux CIC1401 Université de Bordeaux Bâtiment Le Tondu - Case 41 146, Rue Léo Saignat
Address line 2
Address line 3
CityBordeaux
Postcode33076
CountryFrance
Phone number (incl. country code)33557579564
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Not applicable (disease/epidemiology study)
7. Medical conditions to be studied
Medical condition(s)Yes
Liver transplant
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 subjects360
10. Source of data
Is this study being carried out with an established data source?No
Sources of data
Disease/case registry
National liver transplant registries/waiting lists in France (CRISTAL),
Patient medical files at the participating liver transplant centers
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 risk of drug-exposed ALFT in adults, according to the population exposure to the same drugs.
Are there primary outcomes?Yes
Global frequency of occurrence of the ALFT (without clinically defined cause) listed on the transplant list, in subjects exposed to a drug 30 days prior to index date (ID, date of the onset of the liver disease) in five European countries over the 6-year period (2008-2013).
Are there secondary outcomes?Yes
The relative event rates within drugs of the same class,
Inclusion of data from SALT-I to determine the overall frequency over nine years (2005-2013),
Frequency of occurrence measured using different denominators (number of subjects, DDD, patient-years),
Frequency based on the number of drug-exposed cases aged between 18 and 70 years (age range observed for subjects transplanted).
13. Study design
What is the design of the study?
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 analysis: A descriptive analysis of all drug-exposed cases of ALFT will be performed.
Rate estimations per country: Per country rates of drug-exposed transplantation registered ALF will be computed as the ratio of the number of cases identified in the country to the population exposure. Population exposure will be measured in treatment-years (source: IMS). The estimation of the rate of drug-exposed ALFT cases within 30 days prior to ID, with a 95% CI from a Poisson distribution, expressed in cases per million treatment-years. The frequency of ALFT will be calculated also for people aged 18 to 70 years.
Pooling: Data of SALT-IIEUR will be pooled with data of the previous SALT-I study to estimate the frequency of ALFT identified in nine years (2005-2013). This will allow a greater number of events and a better precision of the risk estimates.