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Article History

Received: 26 June 2025

Accepted: 18 November 2025

First Online: 9 December 2025

Declarations

:

: The present research was conducted in accordance with relevant guidelines and regulations. Clinical Practice Research Datalink (CPRD) has NHS Health Research Authority (HRA) Research Ethics Committee (REC) approval to allow the collection and release of anonymised primary care data for observational research [NHS HRA REC reference number: 21/EM/0265]. Each year CPRD obtains Section 251 regulatory support through the HRA Confidentiality Advisory Group (CAG), to enable patient identifiers, without accompanying clinical data, to flow from CPRD contributing GP practices in England to NHS Digital, for the purposes of data linkage. This study was approved by CPRD’s Research Data Governance Process (protocol reference ID: 22_002459, approved 17 January 2023) and no direct subject contact or primary collection of individual human subject data occurred. Linked pseudonymised data were provided for this study by CPRD. Data were linked by NHS Digital, the statutory trusted third party for linking data, using identifiable data held only by NHS Digital. Select general practices consent to this process at a practice level, with individual patients having the right to opt out.

: Not applicable.

: AA, RP and SC are employees of Pfizer Ltd. AP, HG, SL are employees of Adelphi Real World, the company received funding from Pfizer Ltd to conduct this study. RW was an employee of Adelphi Real World at the time of study design and analysis. SA was paid by Pfizer Ltd for clinical advice.