- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03715725
A Nationwide Observational Study Looking at Effectiveness and Bleeding Complications of NOACs vs. VKA in Non-valvular Atrial Fibrillation Patients. (PROTECT-AF)
A Post-marketing Retrospective Non-interventional Study Using Nationwide Registries and Electronic Medical Records to Investigate the Real-life Effectiveness and Major Bleeding Complications of Oral Anticoagulants in Norwegian Non-valvular Atrial Fibrillation Patients
Study Overview
Status
Conditions
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
-
Multiple Locations, Norway
- Many Locations
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
Registry cohort (Cohort 1)
Cohort 1a:
- Age ≥18 at the date of first OAC (Oral Anti-Coagulants) dispensation (index date)
- Diagnosed with atrial fibrillation or flutter in the period 5-year pre-index period. Defined as ICD10 codes; I480 (paroxysmal AF), I481 (persisting AF), I482 (chronic AF), I483 (typical AF), I484 (atypical AF) or I489 (unspecified atrial fibrillation or flutter) as given by either NPR (Norwegian Patient Register) or as a OAC (warfarin, dabigatran, rivaroxaban or apixaban) dispensed on the reimbursement code for AF in NorPD (Norwegian Prescription Database) (ICD10 I48 or ICPC-2 K78)
- Dispensation of a first-time prescription for an OAC during the study period 1 January 2014 to 31 May 2018. This initiation of an OAC is the index event and requires that there is no previous prescription for any OAC in the preceding 365 days (counted from the date of the first dispensation backward to the end of OAC supply).
Cohort 1b:
- Age ≥18 at the beginning of the study period (1 January 2014).
- Diagnosed with atrial fibrillation or flutter prior or during the study period. Defined as ICD10 codes; I480 (paroxysmal AF), I481 (persisting AF), I482 (chronic AF), I483 (typical AF), I484 (atypical AF) or I489 (unspecified atrial fibrillation or flutter) as given by NPR.
- No dispensation of a prescription for an OAC (warfarin, dabigatran, rivaroxaban or apixaban) during the study period 1 January 2014 to 30 June 2018. The index event will be the beginning of the study period (1 January 2014) and requires that there is no previous prescription for an OAC in the preceding 365 days.
EMR cohort (Cohort 2):
- Age ≥18 at the date of first OAC dispensation (index date).
- Diagnosed with atrial fibrillation or flutter in the 5-year pre-index period defined as one of the following ICD10 codes in the EMRs obtained from the hospitals in the South-Eastern Health Region; I480 (paroxysmal AF), I481 (persisting AF), I482 (chronic AF), I483 (typical AF), I484 (atypical AF) or I489 (unspecified atrial fibrillation or flutter).
- Dispensation of a first-time prescription for an OAC (warfarin, dabigatran, rivaroxaban or apixaban) during the study period 1 January 2014 to 31 May 2018. This initiation of an OAC is the index event and requires that there is no previous prescription of any OAC in the preceding 365 days (counted from the date of the first dispensation backward to the end of OAC supply).
Exclusion Criteria:
- Valvular atrial fibrillation defined as presence of ICD10 codes in NPR; I05.2 mitral stenosis with insufficiency, I05.8 other mitral valve diseases (mitral (valve) failure), I342 (non-rheumatic mitral valve stenosis), Z952 (presence of prosthetic heart valve) and procedure codes FKD (prosthetic replacement of mitral valve), FKA (Repair of mitral valve for stenosis), FKB (Annuloplasty of mitral valve for insufficiency), FKC (Repair of mitral valve for insufficiency), FKW (Other operations on mitral valve) and FMD (replacement of aortic valve).
- Deep Venous Thrombosis (DVT) as defined by ICD10 codes I80 (Phlebitis and thrombophlebitis), Pulmonary Embolism (PE) as defined by ICD10 code I26 or I82 (other venous embolism and thrombosis), Other venous embolism and thrombosis within last 6 months before index date.
- Knee and/or hip replacement surgery (NCSP (Nordic Classification of Surgical Procedures) procedure codes; NGB, NGC, NFB or NFC) 5 weeks before index date.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Registry cohort
Registries in Norway are nation-wide and provision of the information is mandatory, which eliminates the risk of both selection and re-call bias.
The large and detailed dataset also makes it possible to adjust for other risk factors on which information is available.
|
Administration according to clinical practice
Administration according to clinical practice
Administration according to clinical practice
Administration according to clinical practice
|
Electronic Medical Records (EMR) cohort
Patients with NVAF diagnosis will be identified through extraction of patient-level data from EMRs from a number of hospitals in Norway, in order to describe these patients more closely regarding their clinical characteristics that are not available in nation-wide registers (e.g., in-patient treatments, anthropometric data and laboratory test results).
|
Administration according to clinical practice
Administration according to clinical practice
Administration according to clinical practice
Administration according to clinical practice
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Ischemic stroke
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Ischemic stroke is defined by the following ICD10 (International Classification of Diseases) codes: I63x: Cerebral infarction |
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Intracranial hemorrhage
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Intracranial haemorrhage (ICH) is defined by the following ICD10 codes: I60x Subarachnoid haemorrhage I61x Intracerebral haemorrhage I62x Other non-traumatic intracranial haemorrhage |
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall stroke
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Overall stroke is defined by the following ICD10 codes: I60x: Subarachnoid haemorrhage I61x: Intracerebral haemorrhage I62x: Other nontraumatic intracranial haemorrhage I63x: Cerebral infarction I64x: Stroke, not specified as haemorrhage or infarction |
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Systemic embolism
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Systemic embolism is defined by the following ICD10 codes: I74x: Arterial embolism and thrombosis |
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Myocardial infarction
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Myocardial infarction is defined by the following ICD10 codes: I21x: Acute myocardial infarction I22x: Subsequent myocardial infarction |
Retrospective analysis from 1 January 2014 to 30 June 2018
|
All-cause mortality
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Retrospective analysis from 1 January 2014 to 30 June 2018
|
|
Major bleeding
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
As defined by Cunningham algorithm and Internation Society of Thrombosis and Hemostasis (ISTH) for EMR cohort.
|
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Demographic characteristics
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Retrospective analysis from 1 January 2014 to 30 June 2018
|
|
Clinical characteristics
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Age, gender, CHA2DS2-VASc and HAS-BLED score, bleeding history, concomitant medications and co-morbidities
|
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Drug utilization patterns
Time Frame: Retrospective analysis from 1 January 2014 to 30 June 2018
|
Retrospective analysis from 1 January 2014 to 30 June 2018
|
Collaborators and Investigators
Sponsor
Collaborators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Heart Diseases
- Cardiovascular Diseases
- Arrhythmias, Cardiac
- Atrial Fibrillation
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Protease Inhibitors
- Factor Xa Inhibitors
- Antithrombins
- Serine Proteinase Inhibitors
- Anticoagulants
- Rivaroxaban
- Dabigatran
- Apixaban
- Warfarin
Other Study ID Numbers
- 19468
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Non-valvular Atrial Fibrillation
-
Boston Scientific CorporationRecruiting
-
Abbott Medical DevicesRecruiting
-
Conformal Medical, IncCompleted
-
University Hospital, MontpellierCompletedNon-valvular Atrial FibrillationFrance
-
PfizerCompletedNon-valvular Atrial FibrillationJapan
-
Xijing HospitalThe First Affiliated Hospital with Nanjing Medical University; Peking University... and other collaboratorsNot yet recruitingNon-valvular Atrial FibrillationChina
-
BayerJanssen Research & Development, LLCCompletedNon-valvular Atrial FibrillationItaly
-
Daiichi Sankyo, Inc.Daiichi Sankyo (China) Holdings Co., Ltd.Active, not recruitingNon-valvular Atrial FibrillationChina
-
Saint Luke's Health SystemBristol-Myers Squibb; AliveCorCompletedNon-valvular Atrial FibrillationUnited States
-
PfizerCompleted
Clinical Trials on Rivaroxaban (Xarelto, BAY59-7939)
-
BayerJanssen Research & Development, LLCCompletedCoronary Artery Disease | Cardiovascular DiseaseBelgium, Netherlands
-
BayerJanssen Research & Development, LLCCompletedVenous ThrombosisFrance, United States, Switzerland, Netherlands, Canada, Germany, Austria, Australia, Israel, Italy
-
BayerJanssen Research & Development, LLCCompletedNon-valvular Atrial FibrillationItaly
-
BayerJanssen Research & Development, LLCCompletedAtrial FibrillationAustria, Czechia, Hungary, Israel, Russian Federation, Slovakia, Slovenia, Germany, United Kingdom, France, Belgium, Canada, Netherlands, Poland, Denmark, Sweden, Portugal, Ireland, Norway, Moldova, Republic of, Ukraine
-
BayerJanssen Research & Development, LLC; RTI Health SolutionsCompletedAnticoagulationGermany, United Kingdom, France, Spain
-
BayerJanssen Research & Development, LLCCompleted
-
BayerJanssen Research & Development, LLCCompletedThrombosisCanada, United States, Belgium, Spain, Italy, France, Finland, Hungary
-
BayerJanssen Research & Development, LLCCompleted
-
BayerJanssen Research & Development, LLCCompletedVenous ThromboembolismSwitzerland, Spain, United States, Austria, Italy, Russian Federation, United Kingdom, Brazil, Australia, Canada, Hungary, Netherlands, Israel, Poland, Japan
-
BayerJanssen Research & Development, LLCCompletedAtrial FibrillationIndonesia, Korea, Republic of, Malaysia, Singapore, Thailand, Philippines, Taiwan, Hong Kong, India, Pakistan, Vietnam