Peripheral Arterial Disease, Paclitaxel Adverse Reaction, Safety Issues
Conditions
Brief summary
The SAFE-PAD Study aims to evaluate the long-term safety of paclitaxel-coated devices compared with non-paclitaxel-coated devices for femoropopliteal artery revascularization among a broad, real-world population of patients with peripheral artery disease. This multi-year analysis aims to create an ongoing mechanism to evaluate the safety of paclitaxel-coated devices in real world practice. The null hypothesis is that the paclitaxel-coated devices are associated with an increase in mortality relative to the non-drug-coated devices beyond an acceptable magnitude (i.e. the non-inferiority margin), and the alternative hypothesis is that paclitaxel-coated devices are not associated with an increase in mortality relative to the non-drug-coated devices beyond the non-inferiority margin.
Detailed description
This is an observational retrospective cohort study using claims data to evaluate the long-term safety of paclitaxel-coated devices compared with non-drug coated devices for femoropopliteal artery revascularization, with median follow-up time for the population surpassing 5 years. A series of supplemental sensitivity analyses will be conducted to assess and mitigate the potential for unmeasured confounding and to determine the impact of repeat interventions and paclitaxel exposure on survival. Finally, sub-group analyses will be performed to investigate whether there is differential safety of paclitaxel-coated devices across different patient profiles.
Interventions
No intervention; retrospective data collection
Sponsors
Medtronic
Philips Healthcare
Bard Peripheral Vascular, Inc.
Boston Scientific Corporation
Cook Medical
Beth Israel Deaconess Medical Center
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
66 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* All fee-for-service Medicare beneficiaries who underwent femoropopliteal artery revascularization. Patients are allowed to undergo simultaneous revascularization of lesions outside this target vessel during the same procedure. * All patients with ≥1 year of Medicare claims data prior to their index procedure.
Exclusion criteria
* Patients without 1 year of Medicare claims data prior to their index revascularization procedure. * Patients that do not have both a carrier file charge and an institutional file charge on the date of an outpatient procedure. This removes procedures performed in certain clinical settings, such as office-based clinics, that do not submit the Healthcare Common Procedure Coding System (HCPCS) code needed to identify drug-coated devices.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| All-cause mortality | Time from index procedure date to the date of death, to be updated periodically until the median duration of follow-up for the cohort reaches 5 years | All-cause mortality of patients who underwent femoropopliteal artery revascularization with drug-coated devices or non-drug-coated devices |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Repeat hospitalization | 1, 2 and 3 years after index procedure | Rates of repeat hospitalization |
| Repeat endovascular or surgical revascularization | 1, 2 and 3 years after index procedure | Rates of repeat endovascular or surgical revascularization |
| Target vessel revascularization | 1, 2 and 3 years after index procedure | Rates of target vessel revascularization among inpatient procedures |
| Lower extremity amputation | 1, 2 and 3 years after index procedure | Rates of lower extremity amputation |
| Optimal medical therapy | 1, 2 and 3 years after index procedure | Rates of optimal medical therapy |
Countries
United States
Outcome results
None listed