Clinical trial NCT06469424: An Active Surveillance, Post-Authorization Study to Characterize the Safety of Tofacitinib in Patients With Moderately to Severely Active Ulcerative Colitis in the Real-World Setting Using Data From the United Registries for Clinical Assessment and Research (UR-CARE) in the European Union (EU)
Official title: An Active Surveillance, Post-Authorization Study to Characterize the Safety of Tofacitinib in Patients With Moderately to Severely Active Ulcerative Colitis in the Real-World Setting Using Data From the United Registries for Clinical Assessment and Research (UR-CARE) in the European Union (EU)
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Ulcerative Colitis
Keywords: prospective observational study with medication
Lead sponsor: Grupo Espanol de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa
Sponsor class: OTHER
Collaborators: name: Pfizer
First posted: 2024-06-21
Enrollment: 104
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Adult patients with UC aged ≥18 years treated with tofacitinib compared to patient receiving alternative treatment or not treatment. The study will use secondary data collected in the UR-CARE platform, which is an ongoing, prospective, observational, cohort of European Union (EU) patients with inflammatory bowel disease (IBD) with the primary aim of facilitating daily patient care and research studies in IBD. This study will focus only on patients with UC enrolled in the UR-CARE platform.

Brief summary: The purpose of this study is to estimate the incidence rates of malignancy, excluding non-melanoma skin cancer (NMSC), venous thromboembolic events VTE (deep venous thrombosis \[DVT\] and pulmonary embolism \[PE\]), NMSC, major adverse cardiac events (MACE), progressive multifocal leukoencephalopathy (PML), infections, hospitalization and specific antibiotic or antiviral treatment, lung cancer, lymphoma, herpes zoster, myocardial infarction (MI), gastrointestinal (GI) perforations, fractures, surgery for UC and death; through 4 sub-groups: adult patients with UC who initiate tofacitinib in the course of routine clinical care compared to other medications approved to treat UC.

Detailed description: Rationale and background:

Tofacitinib, an inhibitor of the Janus kinase (JAK) family of kinases, was approved in the European Union (EU) in July 2018 at a dose of 5 mg twice daily or 10 mg twice daily for the treatment of adults with moderate-to-severe ulcerative colitis (UC), who have had an inadequate response, lost response, or were intolerant to either conventional therapy or a biologic agent. Malignancy excluding non-melanoma skin cancer (NMSC) is an important potential risk and venous thromboembolism (VTE) is an important identified risk associated with the use of tofacitinib, and follow-up of large cohorts of patients over a long period is needed to evaluate the risks of these safety events, as well as other potential safety events of interest, that may be associated with tofacitinib treatment. Pfizer will implement a post approval, active surveillance study of tofacitinib exposed and unexposed patients using actively collected prospective data included in the UR-CARE platform.

Research question:

What are the incidence rates of safety events of interest in adult patients with UC treated with tofacitinib in routine clinical care, as compared to the incidence rates in patients with UC treated with other approved systemic agents, and patients with UC naïve to biologics and immunomodulators/immunosuppressants (hereafter referred to as immunosuppressants)?

Study design:

This is an active cohort study of adult patients with UC aged ≥18 years treated with tofacitinib compared to patient receiving alternative treatment or not treatment. The study will use secondary data collected in the UR-CARE platform, which is an ongoing, prospective, observational, cohort of European Union (EU) patients with inflammatory bowel disease (IBD) with the primary aim of facilitating daily patient care and research studies in IBD. This study will focus only on patients with UC enrolled in the UR-CARE platform.

Variables:

The study variables include baseline patient characteristics (i.e., clinical and demographic characteristics, comorbidities, and current and past therapies), the primary outcomes of interest, and other safety events of interest.

Data sources:UR-CARE will be used as the only data source.

Study size:

This study is descriptive, and all eligible patients in UR-CARE registry during the study period who have consented to participate in the study will be included, with no upper limit on the sample size.

Data analysis:

All statistical analysis will be performed by GETECCU using SAS software v9.4, SAS Institute Inc, Cary, NC, USA. Detailed methodology for summary and statistical analyses of data collected in this study will be documented in a statistical analysis plan (SAP).

Eligibility criteria: Inclusion Criteria:

* Adult patients aged ≥18 years,
* With Ulcerative colitis diagnosis per ECCO guidelines,
* Enrolled in UR-CARE registry with 12 months of medical history available in UR-CARE prior to the index date,
* With an informed consent signed. A minimum follow-up duration of 12 months will allow evaluation of safety events of interest.

Exclusion Criteria:

* Patients not meeting the inclusion criteria
* Patients who have any records of Crohn's Diseases (CD) or IBD unspecified in UR-CARE between the last UC diagnosis and index date \[i.e. date of first prescription for tofacitinib\].

Primary outcomes:
measure: Malignancy excluding non-melanoma skin cancer (NMSC)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: venous thromboembolic events (VTE),(deep venous thrombosis [DVT] and pulmonary embolism [PE])
timeFrame: from 01 July 2018 through to 31 March 2025
Secondary outcomes:
measure: Non melanoma skin cancer (NMSC)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Lung cancer
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Lymphoma
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Serious infections
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Opportunistic infections (e.g., tuberculosis)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Herpes zoster(HZ)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Major adverse cardiac events (MACE)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Myocardial infarction (MI)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Progressive multifocal leukoencephalopathy (PML)
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Gastrointestinal (GI) perforations
timeFrame: from 01 July 2018 through to 31 March 2025
measure: Fractures
timeFrame: from 01 July 2018 through to 31 March 2025
measure: All-cause mortality
timeFrame: from 01 July 2018 through to 31 March 2025
measure: surgery for Ulcerative colitis (UC)
timeFrame: from 01 July 2018 through to 31 March 2025
Other outcomes:
Locations:
city: Bonheiden
country: Belgium
facility: Imelda General Hospital
city: Roeselare
country: Belgium
facility: AZ Delta vzw
city: Sofia
country: Bulgaria
facility: Acibadem City Clinic Tokuda University Hospital
city: Elliniko
country: Greece
facility: General Hospital of Athens "Evangelismos"
state: Attiki
city: Kaunas
country: Lithuania
facility: Lithuanian University of Life Sciences
Study officials:
affiliation: Grupo Espanol de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa
name: Manuel MD Barreiro, PhD
role: PRINCIPAL_INVESTIGATOR
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