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Prospective Registry Investigating Maternal and Infant Outcomes in Anifrolumab Users

Recruiting
Conditions
Systemic Lupus Erythematosus
Interventions
Registration Number
NCT06659029
Lead Sponsor
AstraZeneca
Brief Summary

PRIMULA Preg (Prospective Registry Investigating Maternal and Infant Outcomes in Anifrolumab Users) is a prospective, observational cohort study designed to evaluate the association between anifrolumab exposure during pregnancy and subsequent adverse maternal, fetal, and infant outcomes. This study will fulfil an FDA post-marketing requirement.

Detailed Description

PRIMULA Preg (Prospective Registry Investigating Maternal and Infant Outcomes in Anifrolumab Users) is a US-based, prospective, observational cohort study designed to evaluate the association between anifrolumab exposure during pregnancy and subsequent adverse maternal, fetal, and infant outcomes. The objective of the pregnancy registry is to compare adverse maternal, fetal, and infant outcomes of pregnant individuals with systemic lupus erythematosus (SLE) who are exposed to anifrolumab during pregnancy with outcomes in an internal comparison cohort of pregnant individuals with moderate/severe SLE who are not exposed to anifrolumab during pregnancy. Participation in the registry is voluntary and participants can withdraw their consent to participate at any time. The study is strictly observational; the schedule of office visits and all treatment regimens will be determined by HCPs. Only data that are documented in patients' medical records during medical care will be actively collected. No additional laboratory tests or HCP assessments will be required as part of this registry. This study will fulfil an FDA post-marketing requirement.

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
442
Inclusion Criteria

Exposed cohort

  1. Currently or recently (within 1 year of pregnancy outcome) pregnant
  2. Diagnosis of SLE
  3. Consent to participate
  4. Authorization for their HCP(s) to provide data to the registry
  5. Exposure to at least 1 dose of anifrolumab at any time during pregnancy

Unexposed cohort

  1. Currently or recently pregnant
  2. Diagnosis of moderate/severe SLE
  3. Consent to participate
  4. Authorization for their HCP(s) to provide data to the registry
  5. Exposure to other products for the treatment of moderate/severe SLE
Exclusion Criteria

Exposed cohort

  1. Occurrence of pregnancy outcome prior to first contact (for enrollment) with the Virtual Research Coordination Center (retrospectively enrolled)
  2. Exposure to known teratogens and/or investigational medications during pregnancy

Unexposed cohort

  1. Occurrence of pregnancy outcome prior to first contact with the Virtual Research Coordination Center (retrospectively enrolled)
  2. Exposure to known teratogens and/or investigational medications during pregnancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Exposed cohortAnifrolumabPregnant individuals with a diagnosis of SLE who are exposed to anifrolumab at any time during pregnancy
Primary Outcome Measures
NameTimeMethod
Composite outcome of all major congenital malformations (MCMs)From date of conception (DOC) to pregnancy outcome for fetal losses or 12 months of infant age for live births

An abnormality of body structure or function that is present at birth, is of prenatal origin (i.e., birth defect), has significant medical, social, or cosmetic consequences for the affected individual, and typically requires medical intervention. Relevant exposure window is limited to 1st trimester of pregnancy.

Secondary Outcome Measures
NameTimeMethod
Composite outcome of all minor congenital malformationsFrom date of conception (DOC) to pregnancy outcome for fetal losses or 12 months of infant age for live births

An anomaly or abnormality of body structure that is present at birth, is of prenatal origin (i.e., birth defect), poses no significant health problem in the neonatal period, and tends to have limited social or cosmetic consequences for the affected individual. Relevant exposure window includes any trimester of pregnancy.

Worsening of underlying diseaseFrom date of conception (DOC) to pregnancy outcome, up to 42 weeks of pregnancy

Any increase in disease activity or severity in the pregnancy period compared to the baseline period (6 months prior to pregnancy) as assessed by the disease flare or disease activity algorithms or as reported by an HCP. Relevant exposure window includes any trimester of pregnancy.

Premature rupture of membranesFrom date of conception (DOC) to pregnancy outcome, up to 42 weeks of pregnancy

A disorder of pregnancy defined as rupture of membranes before the onset of labor. Relevant exposure window includes any trimester of pregnancy.

Pregnancy-induced hypertensionFrom 20 gestational weeks to pregnancy outcome, up to 42 weeks of pregnancy

A disorder of pregnancy defined as a systolic blood pressure 140 mmHg or more or a diastolic blood pressure of 90 mmHg or more, or both, on 2 occasions at least 4 hours apart after 20 weeks gestation, in a woman with a previously normal blood pressure. Relevant exposure window includes any trimester of pregnancy.

Composite outcome of preeclampsia/eclampsiaFrom 20 gestational weeks to pregnancy outcome, up to 42 weeks of pregnancy

Preeclampsia is a disorder of pregnancy associated with new-onset hypertension, which occurs most often after 20 weeks of gestation and frequently near term, and proteinuria. Or, in the absence of proteinuria, it is defined as new-onset hypertension with the new onset of any of the following:

* Thrombocytopenia: platelet count less \<100 ,000/mL

* Renal insufficiency: serum creatinine concentrations \>1.1mg/dL or a doubling of the serum creatinine concentration in the absence of other renal disease

* Impaired liver function: elevated blood concentrations of liver transaminases to twice normal concentration

* Pulmonary edema

* New-onset headache unresponsive to medication and not accounted for by alternative diagnoses or visual symptoms.

Eclampsia is new-onset tonic-clonic, focal, or multifocal seizures in the absence of other causative conditions such as epilepsy, cerebral arterial ischemia and infarction, intracranial hemorrhage, or drug use.

Maternal hospitalization for serious illnessFrom date of conception (DOC) to pregnancy outcome, up to 42 weeks of pregnancy

An inpatient hospital admission unrelated to delivery occurring during pregnancy. Relevant exposure window includes any trimester of pregnancy.

Elective terminationFrom date of conception (DOC) to pregnancy outcome, up to 24 weeks of pregnancy

An intervention that is intended to terminate a suspected or known ongoing intrauterine pregnancy and that does not result in a live birth. Relevant exposure window includes any trimester of pregnancy.

Spontaneous abortionFrom date of conception (DOC) to <20 gestational weeks

An involuntary fetal loss or the expulsion of the products of conception occurring at \<20 gestational weeks.

Emergency caesarean sectionFrom date of conception (DOC) to pregnancy outcome, up to 42 weeks of pregnancy

A cesarean delivery that is performed due an immediate threat to the health or safety of the fetus and/or the mother. Relevant exposure window includes any trimester of pregnancy.

Preterm birthFrom date of conception (DOC) up to 37 gestational weeks

A live birth occurring at \<37 gestational weeks.

Small for gestational ageAt delivery of live birth

Birthweight \<10th percentile for sex and gestational age using standard growth charts for full and preterm live-born infants. Relevant exposure window includes any trimester of pregnancy.

Postnatal growth deficiencyAt 4 and 12 months of infant age

Weight, length, or head circumference in \<10th percentile for sex and chronological age using standard growth charts. Relevant exposure window includes any trimester of pregnancy.

Infant developmental delayAt 4 and 12 months of infant age

Failure to achieve the developmental milestones for chronological age, as defined by the CDC. Relevant exposure window includes any trimester of pregnancy.

Infant hospitalization for serious illnessFrom birth to 1 year of infant age

An inpatient hospital admission occurring in the first year of life. Relevant exposure window includes any trimester of pregnancy.

Infant serious or opportunistic infectionFrom birth to 1 year of infant age

An infection that occurs within an infant's first year of life and is either opportunistic (i.e., occurs more often or is more severe in people with weakened immune systems than in people with healthy immune systems) or serious (i.e., results in significant disability, incapacity, or death; is life-threatening; requires inpatient or prolonged hospitalization; or is considered medically important). Relevant exposure window includes any trimester of pregnancy.

Trial Locations

Locations (1)

Research Site

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Las Vegas, Nevada, United States

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