Atrial FibrillationPROVECTNCT05116267
Assessment of the Effectiveness and Safety Outcome in Patients With Atrial Fibrillation Treated by Apixaban in Belgium
An observational study of Atrial Fibrillation, run by Pfizer at 1 site in Belgium.
Trial summary
The PROVECT study is a retrospective, multicentre study assessing the effectiveness and the safety outcomes in patients with non-valvular atrial fibrillation (NVAF) treated by apixaban between 2015 and 2019 (5 years follow up). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Atrial Fibrillation
- How many people
- 0 participants
- Where
- 1 siteBelgium
- Study dates
- 1 Oct 2021to 31 Dec 2022
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study is an observational retrospective cohort generated from the Belgian hospitals EHRs. The cohort will consist in anticoagulant (AC)-naive patients (patients that did not receive other oral AC 6 months prior to the apixaban treatment initiation) and AC-experienced patients (patients treated by AC before the inclusion date) diagnosed with non-valvular AF. The study will cover the period from 01/01/2015 to 31/12/2019 (i.e. maximum of 5 years follow up, noting that all patients will not have this follow up).
Who may be able to join
- is 18 years or older at the index date.
- had ≥1 apixaban prescription during the study period from January 1st, 2015 to December 31, 2019.
- had ≥1 medical diagnosis for Atrial Fibrillation, AF (International Classification of Diseases, 10th Revision, Clinical Modification [ICD-10-CM]10 diagnosis codes I48.0, I48.1X, I48.11, I48.19, I48.2X, I48.20, I48.21, I48.9X, I48.91, I49.1) any time before or on index date
- had >1 encounter (visits, prescriptions, etc) within the EHRs.
Who cannot join
- Medical EHRs indicating a diagnosis code indicative of rheumatic mitral valvular heart disease, mitral valve stenosis (ICD-10-CM diagnosis codes I05.x, I06.x, I07.x, I08.x, I34.x, I35.x, I36.x, I37.x, I38.x, I39.x, I37.x, Q23.x) during the 12-month baseline period,
- Medical EHRs indicating a diagnosis code of VTE (DVT: ICD-10-CM codes: I80.xx, I81.xx, I82.xx, I82.40x, I82.41x, I82.42x, I82.43x, I82.44x, I82.49x, I82.4Yx, I82.4Zx, I82.5xx, I82.51x, I82.52x, I82.53x, I82.54x, I82.55x, I82.56x, I82.59x, I82.5Yx, I82.5Zx, I82.62x, I82.72x, O22.0x, O22.2x, O22.3x; or PE: ICD-10-CM codes I26.01, I26.02, I26.09, I26.90, I26.92, I26.93, I26.94, I26.99) during the 12-month baseline period,
- Medical EHRs indicating a diagnosis (ICD-10-CM) or procedure code (International Classification of Diseases, 10th Revision, Procedure Coding System [ICD-10-PCS]10) of transient AF, or cardiac surgery: Heart valve replacement/transplant: 02YA0Zxx, 02RF0xx, 02RJ0xx, 02RG0xx, 02RH0xx, Z95.2, Z95.3, Z95.4; Pericarditis: I00, I01, I02, I24.1, I30.x, I31.x, I32*coding first the associated cause/etiology; Hyperthyroidism and Thyrotoxicity: E05.0, E05.1, E05.2, E05.3, E05.4, E05.8, E05.9) during the 12-month baseline period;
- Medical EHRs indicating pregnancy during the study period (ICD-10-CM diagnosis codes O00-O9A, Z31, Z32, Z33, Z34, Z36, Z37, Z38, O20-O29, ICD-10 CPS code 109xxx, 10Axxx, 10Dxxx, 10Exxx, 10Hxxx, 10Pxxx, 10Sxxx);
- Medical EHRs indicating diagnosis or procedure for hip/knee replacement surgery within 6 weeks prior to index date (0SR90xx, 0SRA0xx, 0SRB0xx, 0SRC0xx, 0SRD0xx, 0SRE0xx, 0SQ0xx, 0SQB0xx, 0SQB0xx, 0SQB0xx)
- Patients with a prescription for >1 anticoagulants at index date.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Retrospective, Multicenter Study to Assess Effectiveness and Safety Outcome in Patients With Non-valvular Atrial Fibrillation (NVAF) Treated by Apixaban Using Harmonized and Federated Hospital Electronic Health Records (EHRs) in Belgium (PROVECT Study).
The PROVECT study is a retrospective, multicentre study assessing the effectiveness and the safety outcomes in patients with non-valvular atrial fibrillation (NVAF) treated by apixaban between 2015 and 2019 (5 years follow up). The study will use harmonized and federated hospital electronic health records (EHRs) from 10 Belgian hospitals. Outcomes of interest are major bleeding events leading to hospitalization (safety), stroke and systemic thromboembolic events (effectiveness), and all-cause mortality (as an exploratory endpoint, and after confirming the data availability because the death events are not always recorded into hospital EHRs). The study will analyse the outcomes by patient characteristics including the age groups focusing on elderly, thromboembolism risk factors (CHAR2RDSR2R-VASc score), bleeding risk factors (HAS-BLED score), comorbidities (Deyo-Charlson Comorbidity Index, DCCI) score and frailty.
Read the detailed description
Apixaban is an antithrombotic agent that directly inhibits factor Xa, and which has obtained market authorization in the indication "prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF), with one or more risk factors, such as prior stroke or transient ischaemic attack (TIA), age ≥75 years, hypertension, diabetes mellitus, and symptomatic heart failure (NYHA ≥ class II)." Among other direct oral anti-coagulants (DOACs) only apixaban has shown a triple beneficial profile (on stroke/systemic embolisms, major bleedings, and all-cause mortality) supported by data from pivotal randomized clinical trials (RCTs). This differentiation has been consistently found in multiple real-world data (RWD) studies including the NAXOS study in France5 and the ARISTOPHANES study in US particularly in terms of incidence of major bleedings for apixaban vs. others DOACs or vitamin K antagonists (VKAs). Although such data can be generalized to different populations, healthcare professionals in Belgium and healthcare authorities have been frequently requesting local scientific data to support the effectiveness and safety outcomes in patients treated by apixaban in local Belgium settings. This scientific data gap is particularly evident for routine care data allowing to understand the apixaban use patterns in the Belgian poly-medicated, frail and new patients starting an apixaban treatment. The PROVECT study aims to address this particular local data gap and its results may help to guide practical clinical decisions .
- Conditions
- Atrial Fibrillation
- Keywords
- Non-valvular atrial fibrillation, Belgium, Apixaban, NVAF
- Medical subject headings
- Atrial Fibrillation
What is being measured
The primary outcome is the main question the study is designed to answer.
Event Rate of Stroke/Systemic Embolism Requiring Hospitalization: Apixaban treated patients
StroStroke/SE will be identified using hospital EHR which had a stroke/SE diagnosis code as the first listed ICD-10-CM diagnosis code. (Codes list defined) Stroke/SE will be classified into 3 categories: ischemic stroke, hemorrhage stroke, and SE. Time to stroke will be defined as the number of days from the index date to the occurrence of the first stroke/SE requiring hospitalization
Measured: Up to 60 months
Event Rate of Major Bleeding Requiring Hospitalization: Apixaban treated patients
Major bleeding will be identified using hospital EHR which had a bleeding diagnosis code as the first listed ICD-10-CM diagnosis or procedure code (Code list defined). Time to major bleeding will be defined as the number of days from the index date to the occurrence of the first major bleeding event requiring hospitalization
Measured: Up to 60 months
Event Rate of Gastrointestinal (GI) Bleeding Requiring Hospitalization: Apixaban treated patients
Event rate was defined as number of events divided by 100 participant-years for first occurrence of GI bleeding events after index date was reported. GI bleeding requiring hospitalization was identified using hospital claims which had a GI bleeding ICD code (Code list defined). Index date = the first prescription date of study drugs during intake duration.
Measured: Up to 60 months
Event Rate of Intracranial Hemorrhage Requiring Hospitalization: Apixaban treated patients
Event rate was defined as number of events divided by 100 participant-years for first occurrence of intracranial hemorrhage events after index date was reported. Intracranial hemorrhage requiring hospitalization was identified using hospital claims which had an intracranial haemorrhage ICD code (Code list defined) and brain CT or MRI codes. Index date = the first prescription date of study drugs during intake duration
Measured: Up to 60 months
Event Rate of Other Bleeding Requiring Hospitalization: Apixaban treated patients
Event rate was defined as number of events divided by 100 participant-years for first occurrence of other bleeding events after index date was reported. Other bleeding requiring hospitalization was identified using hospital claims which had other bleeding ICD code (Code list defined). Index date = the first prescription date of study drugs during intake duration.
Measured: Up to 60 months
Mortality rates
Patients who died during a hospitalization during the follow-up period will be labelled by binary indicators.
Measured: Up to 60 months
Secondary outcomes (3)
Rate of discontinuation
Discontinuation is defined as the first day of a period of at least 30 consecutive days (grace period) in which 0 days' supply for the index OAC is detected. Sensitivity analysis with 60-day grace period will be included. The date of discontinuation will be the end date of the last filled prescription before the treatment gap. The mean and median (days) duration of treatment before discontinuation will be calculated.
Measured: Up to 60 months
Time-to-discontinuation
Time to discontinuation will be defined as the number of days from the date of index apixaban prescription to the date of discontinuation.
Measured: Up to 60 months
Hospital Length of Stay (LOS)
Length of stay will be defined as the number of days a patient received care during an inpatient stay. LOS will be a continuous and categorical variable.
Measured: Up to 60 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Nov 2021
- Study start1 Oct 2021 (estimated)
- Primary completion31 Dec 2022 (estimated)
- Study completion31 Dec 2022 (estimated)
Why it stopped: Protocol is not feasible based on the available hospital records
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Atrial FibrillationStudies of the same condition, open and under way.
- More trials run by PfizerThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Retrospective
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pfizer
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Pfizer CT.gov Call Center, Study director, Pfizer
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05116267
- Sponsor's protocol ID
- B0661166
- Other IDs
- PROVECT Study
- Acronym
- PROVECT
- Status last verified
- May 2023
- First submitted
- 22 Sep 2021
- Last updated
- 17 May 2023
- Results posted
- No
- Individual data sharing
- No: Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical\_trials/trial\_data\_and\_results/data\_requests.
Study at a glance
From the registry record, last updated by the sponsor on 17 May 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Retrospective, Multicenter Study to Assess Effectiveness and Safety Outcome in Patients With Non-valvular Atrial Fibrillation (NVAF) Treated by Apixaban Using Harmonized and Federated Hospital Electronic Health Records (EHRs) in Belgium (PROVECT Study).
- ClinicalTrials.gov ID
- NCT05116267
- Acronym / sponsor ID
- PROVECT / B0661166
- Conditions
- Atrial Fibrillation
- Keywords
- Non-valvular atrial fibrillation, Belgium, Apixaban, NVAF
- Study type
- Observational
- Recruitment status
- WithdrawnReason stopped: Protocol is not feasible based on the available hospital records
- Enrolment
- 0 participants (actual)
- Lead sponsor
- PfizerIndustry (pharma, biotech, devices)
- Study start
- 1 Oct 2021 (estimated)
- Primary completion
- 31 Dec 2022 (estimated)
- Study completion
- 31 Dec 2022 (estimated)
- First posted
- 10 Nov 2021 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The PROVECT study is a retrospective, multicentre study assessing the effectiveness and the safety outcomes in patients with non-valvular atrial fibrillation (NVAF) treated by apixaban between 2015 and 2019 (5 years follow up). The study will use harmonized and federated hospital electronic health records (EHRs) from 10 Belgian hospitals. Outcomes of interest are major bleeding events leading to hospitalization (safety), stroke and systemic thromboembolic events (effectiveness), and all-cause mortality (as an exploratory endpoint, and after confirming the data availability because the death events are not always recorded into hospital EHRs). The study will analyse the outcomes by patient characteristics including the age groups focusing on elderly, thromboembolism risk factors (CHAR2RDSR2R-VASc score), bleeding risk factors (HAS-BLED score), comorbidities (Deyo-Charlson Comorbidity Index, DCCI) score and frailty.
Detailed description
Apixaban is an antithrombotic agent that directly inhibits factor Xa, and which has obtained market authorization in the indication "prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation (AF), with one or more risk factors, such as prior stroke or transient ischaemic attack (TIA), age ≥75 years, hypertension, diabetes mellitus, and symptomatic heart failure (NYHA ≥ class II)." Among other direct oral anti-coagulants (DOACs) only apixaban has shown a triple beneficial profile (on stroke/systemic embolisms, major bleedings, and all-cause mortality) supported by data from pivotal randomized clinical trials (RCTs). This differentiation has been consistently found in multiple real-world data (RWD) studies including the NAXOS study in France5 and the ARISTOPHANES study in US particularly in terms of incidence of major bleedings for apixaban vs. others DOACs or vitamin K antagonists (VKAs). Although such data can be generalized to different populations, healthcare professionals in Belgium and healthcare authorities have been frequently requesting local scientific data to support the effectiveness and safety outcomes in patients treated by apixaban in local Belgium settings. This scientific data gap is particularly evident for routine care data allowing to understand the apixaban use patterns in the Belgian poly-medicated, frail and new patients starting an apixaban treatment. The PROVECT study aims to address this particular local data gap and its results may help to guide practical clinical decisions .
Study design
- Observational model
- Cohort
- Time perspective
- Retrospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study is an observational retrospective cohort generated from the Belgian hospitals EHRs. The cohort will consist in anticoagulant (AC)-naive patients (patients that did not receive other oral AC 6 months prior to the apixaban treatment initiation) and AC-experienced patients (patients treated by AC before the inclusion date) diagnosed with non-valvular AF. The study will cover the period from 01/01/2015 to 31/12/2019 (i.e. maximum of 5 years follow up, noting that all patients will not have this follow up).
Key inclusion criteria (4 listed)
- is 18 years or older at the index date.
- had ≥1 apixaban prescription during the study period from January 1st, 2015 to December 31, 2019.
- had ≥1 medical diagnosis for Atrial Fibrillation, AF (International Classification of Diseases, 10th Revision, Clinical Modification [ICD-10-CM]10 diagnosis codes I48.0, I48.1X, I48.11, I48.19, I48.2X, I48.20, I48.21, I48.9X, I48.91, I49.1) any time before or on index date
- had >1 encounter (visits, prescriptions, etc) within the EHRs.
Key exclusion criteria (6 listed)
- Medical EHRs indicating a diagnosis code indicative of rheumatic mitral valvular heart disease, mitral valve stenosis (ICD-10-CM diagnosis codes I05.x, I06.x, I07.x, I08.x, I34.x, I35.x, I36.x, I37.x, I38.x, I39.x, I37.x, Q23.x) during the 12-month baseline period,
- Medical EHRs indicating a diagnosis code of VTE (DVT: ICD-10-CM codes: I80.xx, I81.xx, I82.xx, I82.40x, I82.41x, I82.42x, I82.43x, I82.44x, I82.49x, I82.4Yx, I82.4Zx, I82.5xx, I82.51x, I82.52x, I82.53x, I82.54x, I82.55x, I82.56x, I82.59x, I82.5Yx, I82.5Zx, I82.62x, I82.72x, O22.0x, O22.2x, O22.3x; or PE: ICD-10-CM codes I26.01, I26.02, I26.09, I26.90, I26.92, I26.93, I26.94, I26.99) during the 12-month baseline period,
- Medical EHRs indicating a diagnosis (ICD-10-CM) or procedure code (International Classification of Diseases, 10th Revision, Procedure Coding System [ICD-10-PCS]10) of transient AF, or cardiac surgery: Heart valve replacement/transplant: 02YA0Zxx, 02RF0xx, 02RJ0xx, 02RG0xx, 02RH0xx, Z95.2, Z95.3, Z95.4; Pericarditis: I00, I01, I02, I24.1, I30.x, I31.x, I32*coding first the associated cause/etiology; Hyperthyroidism and Thyrotoxicity: E05.0, E05.1, E05.2, E05.3, E05.4, E05.8, E05.9) during the 12-month baseline period;
- Medical EHRs indicating pregnancy during the study period (ICD-10-CM diagnosis codes O00-O9A, Z31, Z32, Z33, Z34, Z36, Z37, Z38, O20-O29, ICD-10 CPS code 109xxx, 10Axxx, 10Dxxx, 10Exxx, 10Hxxx, 10Pxxx, 10Sxxx);
- Medical EHRs indicating diagnosis or procedure for hip/knee replacement surgery within 6 weeks prior to index date (0SR90xx, 0SRA0xx, 0SRB0xx, 0SRC0xx, 0SRD0xx, 0SRE0xx, 0SQ0xx, 0SQB0xx, 0SQB0xx, 0SQB0xx)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Event Rate of Stroke/Systemic Embolism Requiring Hospitalization: Apixaban treated patients
Time frame: Up to 60 months
StroStroke/SE will be identified using hospital EHR which had a stroke/SE diagnosis code as the first listed ICD-10-CM diagnosis code. (Codes list defined) Stroke/SE will be classified into 3 categories: ischemic stroke, hemorrhage stroke, and SE. Time to stroke will be defined as the number of days from the index date to the occurrence of the first stroke/SE requiring hospitalization
Event Rate of Major Bleeding Requiring Hospitalization: Apixaban treated patients
Time frame: Up to 60 months
Major bleeding will be identified using hospital EHR which had a bleeding diagnosis code as the first listed ICD-10-CM diagnosis or procedure code (Code list defined). Time to major bleeding will be defined as the number of days from the index date to the occurrence of the first major bleeding event requiring hospitalization
Event Rate of Gastrointestinal (GI) Bleeding Requiring Hospitalization: Apixaban treated patients
Time frame: Up to 60 months
Event rate was defined as number of events divided by 100 participant-years for first occurrence of GI bleeding events after index date was reported. GI bleeding requiring hospitalization was identified using hospital claims which had a GI bleeding ICD code (Code list defined). Index date = the first prescription date of study drugs during intake duration.
Event Rate of Intracranial Hemorrhage Requiring Hospitalization: Apixaban treated patients
Time frame: Up to 60 months
Event rate was defined as number of events divided by 100 participant-years for first occurrence of intracranial hemorrhage events after index date was reported. Intracranial hemorrhage requiring hospitalization was identified using hospital claims which had an intracranial haemorrhage ICD code (Code list defined) and brain CT or MRI codes. Index date = the first prescription date of study drugs during intake duration
Event Rate of Other Bleeding Requiring Hospitalization: Apixaban treated patients
Time frame: Up to 60 months
Event rate was defined as number of events divided by 100 participant-years for first occurrence of other bleeding events after index date was reported. Other bleeding requiring hospitalization was identified using hospital claims which had other bleeding ICD code (Code list defined). Index date = the first prescription date of study drugs during intake duration.
Mortality rates
Time frame: Up to 60 months
Patients who died during a hospitalization during the follow-up period will be labelled by binary indicators.
3 secondary outcomes
Rate of discontinuation
Time frame: Up to 60 months
Time-to-discontinuation
Time frame: Up to 60 months
Hospital Length of Stay (LOS)
Time frame: Up to 60 months
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 May 2023.
- To obtain contact information for a study center near you, click here.Link provided by the sponsor.
- Individual participant dataSharing planned: No. Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Pfizer CT.gov Call Center study director
Pfizer
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Atrial Fibrillation, run by Pfizer at 1 site in Belgium.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 17 May 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Event Rate of Stroke/Systemic Embolism Requiring Hospitalization: Apixaban treated patients (time frame: Up to 60 months). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 May 2023.