Exenatide is a new treatment for type 2 diabetes mellitus (T2DM) in adult patients and is used in combination with other glucose-lowering drugs (GLDs) when previous treatment regimens have resulted in inadequate responses. It is available as a twice-daily injectable product (Byetta®) and a once-weekly injectable product (Bydureon®). Byetta® was approved by the European Medicine Agency (EMA) in 2006, while Bydureon® was approved by the EMA in 2011. Both Byetta® and Bydureon® were subsequently launched in Spain.
As part of risk assessment of new drugs, EMA requires that the marketing authorisation holder of exenatide, Astra Zeneca, performs a post-authorisation safety (PAS) study, to assess the incidence of pancreatic cancer and thyroid neoplasm among patients with T2DM who initiated exenatide, twice-daily or once-weekly formulations, as compared with those who initiated other GLDs.
This data request is a part of a feasibility study for the required PAS study, to assess in which countries the required study could be conducted. The feasibility study includes several European countries, including Spain. Through this aggregate data request, we aim to determine in the SIDIAP database from Spain the total number of individuals in three different drug user groups and a comparison group, depending on the stepwise addition of specific inclusion or exclusion criteria. Therefore, it is important that the total number of individuals per year is obtained in the specified order given in Tables 1-4 (below), such that the number of individuals who fulfil criteria 1 are then examined to determine if they fulfil criteria 2, and so on. We also hope to estimate the length of exposure to the drug of interest to be able to estimate average follow-up time in power calculations (Table 5).