Safety of saxagliptin: rationale for and design of a series of postmarketing observational studies
Article first published online: 4 JUL 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 21, Issue 11, pages 1202–1215, November 2012
How to Cite
Lo Re, V., Haynes, K., Ming, E. E., Wood Ives, J., Horne, L. N., Fortier, K., Carbonari, D. M., Hennessy, S., Cardillo, S., Reese, P. P., Reddy, K. R., Margolis, D., Apter, A., Kimmel, S. E., Roy, J., Freeman, C. P., Razzaghi, H., Holick, C. N., Esposito, D. B., Van Staa, T.-P., Bhullar, H. and Strom, B. L. (2012), Safety of saxagliptin: rationale for and design of a series of postmarketing observational studies. Pharmacoepidem. Drug Safe., 21: 1202–1215. doi: 10.1002/pds.3318
- Issue published online: 29 OCT 2012
- Article first published online: 4 JUL 2012
- Manuscript Accepted: 5 JUN 2012
- Manuscript Revised: 2 APR 2012
- Manuscript Received: 26 OCT 2011
- diabetes mellitus;
- dipeptidyl peptidase-4 inhibitor;
- adverse event
To describe the design and rationale of a series of postmarketing studies to examine the safety of saxagliptin, an oral dipeptidyl peptidase-4 inhibitor for the treatment of type 2 diabetes mellitus, in real-world settings.
We are conducting a series of retrospective cohort studies using two UK (General Practice Research Database, and The Health Improvement Network) and two US (Medicare, HealthCore Integrated Research DatabaseSM) data sources. The primary outcomes of interest will include (i) hospitalization with acute liver failure, (ii) hospitalization for acute kidney injury, (iii) hospitalization for severe hypersensitivity reactions, (iv) hospitalization for severe infections, (v) hospitalization with infections associated with T-lymphocyte dysfunction (i.e., herpes zoster, tuberculosis, or nontuberculous mycobacteria), and (vi) major cardiovascular events. Diagnosis codes for the outcomes of interest will be validated by medical record review within each data source. Projected use and estimated incidence rates of outcomes of interest suggest there will be at least 80% statistical power to detect a minimum hazard ratio of 1.5 for major cardiovascular events, 2.0 for acute kidney injury and severe infections, 2.4 for acute liver failure, and 4.0 for severe hypersensitivity reactions.
This postmarketing safety assessment will provide important information regarding the safety of saxagliptin and could potentially identify important dipeptidyl peptidase-4 inhibitor class effects. The methods described may be useful to others planning similar evaluations. Copyright © 2012 John Wiley & Sons, Ltd.