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Trial record 60 of 335 for:    DABIGATRAN

The Comparative Safety and Effectiveness of Dabigatran, Versus Rivaroxaban, and Apixaban Utilized in the Department of Defense Non-Valvular Atrial Fibrillation Patient Population: A Retrospective Database Analysis

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ClinicalTrials.gov Identifier: NCT03026556
Recruitment Status : Completed
First Posted : January 20, 2017
Results First Posted : June 3, 2019
Last Update Posted : June 3, 2019
Sponsor:
Collaborators:
Health ResearchTx, LLC (HRTX)
inVentiv Health Clinical (iVH)
United States Department of Defense (DOD)
Information provided by (Responsible Party):
Boehringer Ingelheim

Tracking Information
First Submitted Date January 18, 2017
First Posted Date January 20, 2017
Results First Submitted Date August 20, 2018
Results First Posted Date June 3, 2019
Last Update Posted Date June 3, 2019
Actual Study Start Date December 29, 2016
Actual Primary Completion Date August 23, 2017   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: February 20, 2019)
  • Stroke Overall (Hemorrhagic, Ischemic, Uncertain) [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of overall stroke (hemorrhagic, ischemic, uncertain) in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Length of Follow-up: The post-index follow-up period began the day following the NOAC index date and ended on whichever of the following occurred earliest:
    1. The day of discontinuation of the index NOAC exposure;
    2. The day before a switch to an anticoagulant different from the index exposure;
    3. The day before a change in dose for the index NOAC;
    4. The end of continuous eligibility of a patient in the health plan (disenrollment);
    5. The end of the study observation period; or
    6. The date of death of the patient.
  • Overall Major Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of overall Major bleeding (Hemorrhagic Stroke, Major Intracranial Bleeding and Major Extracranial Bleeding) in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first.
Original Primary Outcome Measures
 (submitted: January 18, 2017)
Stroke Overall (Hemorrhagic, Ischemic, Uncertain) [ Time Frame: 6 years ]
Change History Complete list of historical versions of study NCT03026556 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures
 (submitted: February 20, 2019)
  • Ischemic Stroke [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of ischemic stroke in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Hemorrhagic Stroke [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of Hemorrhagic stroke in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first.
  • Major Intracranial Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of major intracranial bleeding in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Major Extracranial Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of major extracranial bleeding (Major GI bleeding, Major urogenital bleeding and Major other bleeding) in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Major GI Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of major GI bleeding (Upper GI Bleeding and Lower GI Bleeding) in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Major Urogenital Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of major urogenital bleeding in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first.
  • Major Other Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of major other bleeding in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Upper GI Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of Upper GI Bleeding in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • Lower GI Bleeding [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of Lower GI Bleeding in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • TIA [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of transient ischemic attack (TIA) in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
  • All-cause Mortality [ Time Frame: Baseline (July 1, 2010) until end of the observation period (June 30, 2016), 6 Years ]
    The event rate of all-cause mortality in patients matched on propensity scores without index year. Event rates were calculated as the total number of patients in each treatment group who had the outcome during follow-up divided by the total person-years at risk in the cohort. Follow-up time was the time elapsed from the index date to the date of the outcome of interest, disenrollment, end of the observation period (available data), death, discontinuation of the NOAC, or switch to a different NOAC, whichever came first
Original Secondary Outcome Measures
 (submitted: January 18, 2017)
Ischemic Stroke [ Time Frame: 6 years ]
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title The Comparative Safety and Effectiveness of Dabigatran, Versus Rivaroxaban, and Apixaban Utilized in the Department of Defense Non-Valvular Atrial Fibrillation Patient Population: A Retrospective Database Analysis
Official Title Safety and Effectiveness Study Comparing Dabigatran, Rivaroxaban & Apixaban in Non-valvular Atrial Fibrillation Patients Enrolled in the US Department of Defense Military Health System
Brief Summary The purpose of this study is to assess the safety and effectiveness of newly initiated dabigatran among patients diagnosed with non valvular atrial fibrillation (NVAF) in comparison to newly initiated rivaroxaban users and newly initiated apixaban users
Detailed Description Not Provided
Study Type Observational
Study Design Observational Model: Cohort
Time Perspective: Retrospective
Target Follow-Up Duration Not Provided
Biospecimen Not Provided
Sampling Method Non-Probability Sample
Study Population NVAF patients, ≥18 years of age, enrolled within the DoD Military Health System, who have newly initiated dabigatran, rivaroxaban, or apixaban. Patients must be treatment naïve from OAC use prior to first (index) NOAC.
Condition Atrial Fibrillation
Intervention
  • Drug: Dabigatran vs. Rivaroxaban
    observed for 6 years
  • Drug: Dabigatran vs. Apixaban
    Observed for 6 years
Study Groups/Cohorts
  • Dabigatran vs. Rivaroxaban
    OAC treatment naïve NVAF patients with at least one prescription claim for dabigatran, rivaroxaban (new oral anticoagulant or NOAC).
    Intervention: Drug: Dabigatran vs. Rivaroxaban
  • Dabigatran vs. Apixaban
    OAC treatment naïve NVAF patients with at least one prescription claim for dabigatran, or apixaban (new oral anticoagulant or NOAC).
    Intervention: Drug: Dabigatran vs. Apixaban
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Completed
Actual Enrollment
 (submitted: February 20, 2019)
42534
Original Estimated Enrollment
 (submitted: January 18, 2017)
47000
Actual Study Completion Date August 23, 2017
Actual Primary Completion Date August 23, 2017   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria:

  • Age 18+ on index date
  • Patients must have been prescribed either dabigatran, rivaroxaban, or apixaban identified by pharmacy claim during the study period. The first dispensing date of either study drug will be defined as the index date;
  • Patients must be treatment naïve from all OAC use prior to the first NOAC prescription, during study period.
  • Patients must have at least 12 months of continuous eligibility prior to the index date;
  • Patients must have at least one diagnosis code of atrial fibrillation, defined as International Classification of Diseases (ICD)-9-CM diagnosis of 427.31 or ICD-10-CM diagnosis of I48.0, I48.1, I48.2, I48.91 on the index date or during the pre-index period.

Exclusion Criteria:

Less than 12 months of continuous eligibility in the pre-index period Any claim for OAC drug (oral use only) in the pre-index period Diagnosis of hyperthyroidism during the pre-index period

Having at least one claim for alternative indications; orthopedic procedures, Venous thromboembolism (VTE) (includes deep vein thrombosis (DVT ) & PE)) and the index NOAC prescription at the same time, or, the alternative indication for anticoagulant occurring within 3 months prior to index date in pre-period Having at least one claim with any of the following diagnoses or procedure codes in order to exclude patients with "transient" causes of Afib (3 months prior to index date in pre-period):

  • Cardiac surgery
  • Pericarditis
  • Myocarditis Having at least one medical claim with any of the following diagnoses or procedures codes in order to exclude patients with "valvular" Afib (pre-period):
  • Mitral stenosis
  • Mitral stenosis with insufficiency
  • Mitral valve stenosis and aortic valve stenosis
  • Mitral valve stenosis and aortic valve insufficiency
  • Diseases of other endocardial structures
  • Other and unspecified rheumatic heart diseases
  • Open heart valvuloplasty without replacement
  • Open and other replacement of unspecified heart valve
  • Open and other replacement of aortic valve
  • Open and other replacement of mitral valve
  • Open and other replacement of pulmonary valve
  • Open and other replacement of tricuspid valve
  • Heart valve replaced by transplant
  • Heart valve replaced by a mechanical device/prosthesis
  • Atrioventricular valve repair
  • Aortic valve valvuloplasty
  • Unlisted procedure, cardiac surgery
  • Implantation of catheter-delivered prosthetic aortic heart valve; open thoracic approach
  • Transthoracic cardiac exposure (e.g., sternotomy, thoracotomy, subxiphoid) for catheter-delivered aortic valve replacement; without cardiopulmonary bypass
  • Transthoracic cardiac exposure (e.g., sternotomy, thoracotomy, subxiphoid) for catheter-delivered aortic valve replacement; with cardiopulmonary bypass
  • Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve other than homograft or stentless valve
  • Valvuloplasty, mitral valve, with cardiopulmonary bypass
  • Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring
  • Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring
  • Replacement, mitral valve, with cardiopulmonary bypass
  • Implantation of catheter-delivered prosthetic pulmonary valve, endovascular approach
  • Replacement, pulmonary valve
  • Valvectomy, tricuspid valve, with cardiopulmonary bypass
  • Valvuloplasty, tricuspid valve; without ring insertion
  • Valvuloplasty, tricuspid valve; with ring insertion
  • Replacement, tricuspid valve, with cardiopulmonary bypass
Sex/Gender
Sexes Eligible for Study: All
Ages 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT03026556
Other Study ID Numbers 1160-0274
Has Data Monitoring Committee Not Provided
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement Not Provided
Responsible Party Boehringer Ingelheim
Study Sponsor Boehringer Ingelheim
Collaborators
  • Health ResearchTx, LLC (HRTX)
  • inVentiv Health Clinical (iVH)
  • United States Department of Defense (DOD)
Investigators Not Provided
PRS Account Boehringer Ingelheim
Verification Date February 2019