Prediction of Findings From the Ongoing CAROLINA Trial Using Healthcare Database Analyses
研究概览
地位
条件
详细说明
The CARdiovascular Outcome Trial of LINAgliptin Versus Glimepiride in Type 2 Diabetes (CAROLINA) is an ongoing randomized controlled trial (RCT) designed to assess whether linagliptin is non-inferior, and if so, superior compared with glimepiride 1-4 mg once daily with respect to cardiovascular (CV) events in adults with relatively early Type 2 Diabetes at increased risk of CV events and with less than optimized glycaemic control. Given that medications of both classes are currently advocated as second-line therapy after metformin, and since sulfonylureas have been associated with concerns regarding their CV safety, while dipeptidyl peptidase-4 inhibitors have been suggested to exhibit CV benefits in preclinical and mechanistic trials, the results of this trial will provide answers to several clinically relevant questions and have a significant impact on clinical practice.
This cohort study was initiated to predict the findings of CAROLINA trial in a real world setting using electronic claims data from insurance databases with results anticipated prior to the completion of CAROLINA. Trial eligibility criteria were adapted in claims data to generate a comparable study cohort (of linagliptin and glimepiride initiators) to that of the trial population. Using 1:1 propensity score-matching was used to control for >120 baseline characteristics. Patients were followed up for a composite cardiovascular outcome adapted from the primary end-point of the CAROLINA trial.
研究类型
注册 (实际的)
联系人和位置
学习地点
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Massachusetts
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Boston、Massachusetts、美国、02120
- Brigham and Women's Hospital
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
Patients with Type 2 diabetes who were new users of Linagliptin or new users of Glimepiride and:
- Had no more than 3 anti-diabetic drugs including index drug
AND at elevated risk of cardiovascular (CV) events according to specific criteria:
- Previous vascular disease
- Evidence of vascular-related end-organ damage
- Age ⩾ 70 years
⩾ 2 CV risk factors:
- Treated hypertension
- Smoking
- Using any lipid lowering treatment
- Age ≥ 40 and ≤ 85 years at treatment initiation
Exclusion Criteria:
- Patients with Type 1 Diabetes Mellitus
- Previous exposure to dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, thiazolidinediones (TZDs), insulin or sodium glucose co-transporter-2 (SGLT-2s).
- Exclude anti-diabetic background therapy if initiated in 2 months prior
- Morbid obesity or treatment with anti-obesity drugs 3 months prior to treatment initiation
- Severe hyperglycemia
- Active liver disease or impaired hepatic function
- Any previous bariatric surgery
- Coronary artery re-vascularisation ≤ 6 weeks prior to treatment initiation
- Prior hospitalization for congestive heart failure
- Acute or chronic metabolic acidosis
- Hereditary galactose intolerance
- Alcohol or drug abuse within the 3 months prior to treatment initiation
- Use of oral corticosteroids
- Pregnant women
- Patients with cancer
- Acute coronary syndrome ≤ 6 weeks prior to treatment initiation
- Stroke or Transient ischemic attack ≤ 3 months prior to treatment initiation
学习计划
研究是如何设计的？
设计细节
队列和干预
团体/队列 |
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Linagliptin
Patients who initiate Linagliptin with no use in the prior 180 days
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Glimepiride
Patients who initiate Glimepiride with no use in the prior 180 days
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Composite Cardiovascular (CV) Outcome
大体时间：From treatment initiation to end of follow-up, up to 53 months
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Composite CV Outcome includes Myocardial infarction, Stroke, hospitalization for unstable angina and Death
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From treatment initiation to end of follow-up, up to 53 months
|
合作者和调查者
调查人员
- 首席研究员：Elisabetta Patorno, MD DrPH、Brigham and Women's Hospital, Harvard Medical School
出版物和有用的链接
一般刊物
- Franklin JM, Patorno E, Desai RJ, Glynn RJ, Martin D, Quinto K, Pawar A, Bessette LG, Lee H, Garry EM, Gautam N, Schneeweiss S. Emulating Randomized Clinical Trials With Nonrandomized Real-World Evidence Studies: First Results From the RCT DUPLICATE Initiative. Circulation. 2021 Mar 9;143(10):1002-1013. doi: 10.1161/CIRCULATIONAHA.120.051718. Epub 2020 Dec 17.
- Patorno E, Schneeweiss S, Gopalakrishnan C, Martin D, Franklin JM. Using Real-World Data to Predict Findings of an Ongoing Phase IV Cardiovascular Outcome Trial: Cardiovascular Safety of Linagliptin Versus Glimepiride. Diabetes Care. 2019 Dec;42(12):2204-2210. doi: 10.2337/dc19-0069. Epub 2019 Jun 25.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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