Hypercholesterolemia; ASCVD; Pregnancy
Conditions
Keywords
Pregnancy; Cardiovascular Diseases; High serum cholesterol; FH; ASCVD
Brief summary
This is a prospective observational registry study to evaluate fetal, infant and childhood outcomes in women exposed to evolocumab during pregnancy
Detailed description
This pregnancy registry will be conducted by University of California Research Center for the Organization of Teratology Information Specialists (OTIS) which is a network of university and health department based telephone information centers serving pregnant women and healthcare providers throughout North America. Participants will be enrolled on an ongoing basis through year 10 of the study and each will be followed from the time they enroll, through the 5-year postnatal follow up period for an overall study period of 15 years. Participants are recruited concurrently from callers to OTIS centers, from healthcare providers and through direct to consumer marketing efforts.
Interventions
DRUGevolocumab
Pregnant women exposed to evolocumab. Evolocumab is not administered in this non-interventional study.
Sponsors
Organization of Teratology Information Specialists (OTIS) Research Center - tel: 1-866-626-6847 or www.mothertobaby.org
Amgen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
1 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* For all groups: Qualified subjects will agree to the conditions and requirements of the study including the interview schedule, release of medical records, the physical examination of live born infants, and 5 years of follow-up. * For the Specific Evolocumab-Exposed Cohort: Currently pregnant women (maternal report validated by medical records) diagnosed with ASCVD, or hypercholesterolemia associated with FH who have been exposed to evolocumab for any number of days, at any dose, and at any time from the first day of the LMP up to and including the end of pregnancy. * For Comparison Group I: Currently pregnant women (maternal report validated by medical records) diagnosed with ASCVD, or hypercholesterolemia associated with FH but who were not exposed to evolocumab during pregnancy or any time within 90 days prior to the first day of the LMP. * For Comparison Group II: Currently pregnant women not diagnosed with ASCVD, or hypercholesterolemia associated with FH who have not been exposed to evolocumab during pregnancy or any time within 90 days prior to the first day of the LMP, and who have no exposure to any known human teratogens as determined by the OTIS Research Center * For General Evolocumab-Exposed Case Series group: Women with exposure to evolocumab during pregnancy who do not meet the criteria for the Specific Evolocumab-Exposed cohort for reasons including (but not limited to): they do not have ASCVD and/or hypercholesterolemia associated with FH (off-label use), they were exposed to evolocumab but the pregnancy has already completed, they enrolled in the cohort study with a previous pregnancy, or they already have a prenatal diagnosis of a major birth defect
Exclusion criteria
For all groups except the General Evolocumab Exposed Case Series Group: * Women who first contact the Registry after prenatal diagnosis of a major structural defect * Women who were exposed to a different PCSK9 inhibitor during their current pregnancy or at any time within 5 half-lives prior to the first day of the LMP * Women who have enrolled in this Registry with a previous pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of major structural defects | Up to 1 year of age | Rate of major structural defects, defined and classified by the Centers for Disease Control and Prevention (CDC) Metropolitan Atlanta Congenital Defects Program (MACDP) 6 Digit Code Defects List coding manual (CDC, 2007) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pregnancy Outcome: Rate of spontaneous abortion | Up to 19 wks post LMP | Rate of spontaneous abortion where spontaneous abortion is defined as non-deliberate fetal death which occurs prior to 19 completed weeks post-last menstrual period (LMP) |
| Pregnancy Outcome: Rate of elective abortion | Through 9 month pregnancy period | Rate of elective abortion where elective abortion is defined as deliberate termination of pregnancy at any time in gestation |
| Pregnancy Outcome: Rate of stillbirth | At or after 19 completed weeks post LMP | Rate of stillbirth where stillbirth is defined as non-deliberate fetal death anytime in gestation at or after 19 completed weeks post-LMP |
| Infant Outcome: Rate of minor structural defects | Between birth and 12 months post natal | Rate of minor structural defects where a minor structural defect is defined as a structural anomaly which has neither cosmetic nor functional significance to the child. |
| Infant Outcome: Rate of small for gestational age | At birth | Rate of small for gestational age where small for gestational age is defined as birth size (weight, length, or head circumference) less than/equal to the 10th centile for sex and gestational age using standard pediatric CDC growth curves for full term or preterm infants |
| Infant Outcome: Rate of postnatal growth deficiency | Up to 1 year of age | Rate of postnatal growth deficiency where postnatal growth deficiency is defined as postnatal size (weight, length, or head circumference) less than/equal to the 10th centile for sex and age using standard pediatric growth curves, and adjusted for postnatal age for premature infants if the postnatal measurement is obtained at less than 1 year of age. |
| Infant Outcome: Rate of postnatal hospitalizations | Through 5 years postnatal | Rate of postnatal hospitalizations as assessed throughout the 5-year postnatal follow-up period. |
| Pregnancy Outcome: Rate of premature delivery | Prior to 37 weeks of gestation | Rate of premature delivery where premature delivery is defined as live birth prior to 37.0 weeks gestation as counted from LMP (or ultrasound adjusted date) |
| Infant Outcome: Infant response to IgG-tetanus antibody | Between 6-12 months of age | Infant response to IgG-tetanus antibody as a biological marker to evaluate humoral immune response via a standardized assay test. |
| Infant Outcome: Adverse neurodevelopment outcomes | Between 16 months to 17 months 30 days of age and between 3.5-5 years of age | Adverse neurodevelopmental outcomes as assessed during 2 periods (between 16 months to 17 months 30 days of age and between 3.5-5 years of age) via standardized tests of performance |
| Breastfeeding/Lactation Outcome: Proportion of women who breastfed | Through 6 weeks post delivery | Proportion of women who breastfed (at all) in the first 6 weeks after delivery |
| Breastfeeding/Lactation Outcome: Proportion who breastfed exclusively | Through the first 2 weeks postnatal | Among women who breastfed (in the first 6 weeks after delivery), the proportion who breastfed exclusively during the first 2 weeks of life |
| Infant Outcome: Pattern of minor structural defects | Between birth and 12 months postnatal | Pattern of minor structural defects where a minor structural defect is defined as a structural anomaly which has neither cosmetic nor functional significance to the child and a pattern is defined as the same 3 or more minor structural defects in 2 or more children. |
| Infant Outcome: Rate of postnatal serious infections | Through 5 years postnatal | Rate of postnatal serious infections as assessed throughout the 5-year postnatal follow-up period. |
| Infant Outcome: Rate of infant reactions to scheduled vaccinations | Through 5 years postnatal | Rate of infant reactions to scheduled vaccinations as assessed throughout the 5-year postnatal follow-up period. |
Outcome results
None listed