Status: Finalised
First registered on:
23/05/2014
Last updated on:
22/11/2022
1. Study identification
EU PAS Register NumberEUPAS6616
Official titleReal-life anticoagulants benefit-risk in atrial fibrillation (AF) in France: VKA benefit-risk assessment before DOAC use for AF
Study title acronymENGEL 1 VKA
Study typeOther: Study using the French health insurance and hospital-discharge database
Brief description of the studyThe research question is to assess the baseline short-term, medium-term and long-term benefit-risk of vitamin K antagonists (VKA) for new users in the indication of atrial fibrillation (AF). The main objective is to estimate the 6-month, 1-year, and 3-year risk of major bleeding, arterial thrombotic events (stroke, systemic embolism), myocardial infarction (MI) and death during VKA exposure. This is a cohort study in a national healthcare claims and hospitalisations database including new users of VKA for AF between 01/01/2007 and 31/12/2011 with a follow-up until 31/12/2012, and 2 years history. VKA exposure will start at the date of first VKA dispensation (index date) and end at the date of VKA stop or at the end of follow-up. AF population will be defined as patients with full coverage for AF, hospitalisation or probabilistic AF information in the database, and without other probable cause of VKA prescription. Outcomes will be defined by primary diagnosis ICD-10 codes of hospital-discharge summary and date of death. The cumulative incidence of outcomes will be estimated using Kaplan-Meier estimate and 95% confidence interval.
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 Moore
First name Nicholas
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 signed23/05/2014
Start date of data collection15/04/2014
Start date of data analysis
Date of interim report, if expected
Date of final study report14/11/2014
4. Sources of funding
Please provide estimates of the percentage of funding by source for this study
Names(s)Approximate % funding
Pharmaceutical companiesBoehringer Ingelheim100
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 1146 Rue Leo Saignat
Address line 2
Address line 3
CityBordeaux
Postcode
CountryFrance
Phone number (incl. country code)33557574675
Alternative phone number
Fax number (incl. country code)
Public Enquiries
Title Dr
Last name Blin
First name Patrick
Address line 1146 rue Leo Saignat
Address line 2
Address line 3
CityBordeaux
Postcode
CountryFrance
Phone number (incl. country code)33557574675
Alternative phone number
Fax number (incl. country code)
6. Study drug(s) information
Substance class (ATC Code)B01AA (Vitamin K antagonists)
7. Medical conditions to be studied
Medical condition(s)Yes
Atrial fibrillation
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 subjects5000
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?
Disease epidemiology
Risk assessment
Drug utilisation study
Effectiveness evaluation
Primary scope : Risk assessment
12. Main objective(s)
What is the main objective of the study?
The main objective is to estimate the 3-month, 1-year, and 3-year risk of major bleeding, arterial thrombotic events (stroke, systemic embolism), MI and death during VKA exposure for new VKA users in AF during drug exposure.
Are there primary outcomes?Yes
Major bleeding (MB) as hospitalisation with primary diagnosis of bleeding events including haemorrhagic stroke; Arterial thrombotic events (ATE) as hospitalisation with primary diagnosis of ischemic or undefined stroke or systemic arterial embolism; MI as hospitalisation with primary diagnosis of MI or acute coronary syndrome (ACS); All-cause of death; Composite criterion of MB/ATE/MI/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
The follow-up period will start on the date of the first dispensation of VKA between 01/01/2007 and 31/12/2011 and end 31 December 2012.
15. Data analysis plan
Please provide a brief summary of the analysis method
Statistical analysis will be carried out according to a documented and approved Statistical Analysis Plan (SAP). The SAP describes statistical analysis as foreseen at the time of planning study. Statistical analysis will be performed after database lock using SASĀ® software. Blind double programming will be used for the main outcome measures. The diagnosis of AF will be considered definite if a long-term disease or hospital discharge summary with the ICD-10 code I48 were recorded before the index date, and no other indication for VKA. In the absence of definite AF, probable AF will be defined using an AF disease score, that will be a logit function of patient characteristics, including specialty of first VKA prescriber, medical acts, lab tests and drugs (ATC codes). Primary outcomes will be analysed using survival methods: The Kaplan-Meier estimate for cumulative incidence of events.
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
A population database study of outcomes associated with vitamin K antagonists in atrial fibrillation before DOAC.
Blin P, Dureau-Pournin C, Lassalle R, Abouelfath A, Droz-Perroteau C, Moore N.
Br J Clin Pharmacol. 2016 Mar;81(3):569-78. doi: 10.1111/bcp.12807. Epub 2015 Dec 28.https://doi.org/10.1111/bcp.12807
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
