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Interventional Study in Adults With Immune Thrombocytopenia Purpura (ITP) Receiving Romiplostim

Primary Purpose

Idiopathic Thrombocytopenic Purpura

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Romiplostim
Sponsored by
Amgen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Thrombocytopenic Purpura focused on measuring ITP

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

- Subject has been diagnosed with primary ITP according to the American Society of Hematology (ASH) guidelines (George et al, 1996) and previously received only 1st line therapies.

First line therapy is defined as corticosteroids, immunoglobulin G (IVIG), anti-D and vinca alkaloids (used for the treatment of ITP related thrombocytopenia only). A platelet transfusion at any time during the six month period since the original diagnosis would not exclude the subject from study participation

  • Initial diagnosis of primary ITP within 6 months of enrollment
  • Age ≥ 18 years at screening
  • A single platelet count ≤ 30 x 10⁹/L at any time during the screening period
  • Subject or subject's legally acceptable representative has provided informed consent

Exclusion Criteria:

  • Known history of a bone marrow stem cell disorder
  • Surgical resection of the spleen
  • Subject has a history of cancer or current malignancy other than basal cell carcinoma or cervical cancer in-situ with active treatment or disease within 5 years of screening
  • Known history of congenital thrombocytopenia
  • Known history of hepatitis B, hepatitis C, or human immunodeficiency virus
  • Positive H. pylori by urea breath test or stool antigen test at screening
  • Known history of systemic lupus erythematosus, Evans syndrome, or autoimmune neutropenia
  • Known history of antiphospholipid antibody syndrome or positive for lupus anticoagulant
  • Known history of disseminated intravascular coagulation, hemolytic uremic syndrome, or thrombotic thrombocytopenic purpura
  • Previous history of recurrent venous thromboembolism or thrombotic events or an occurrence within 5 years of enrollment.
  • Previous use of romiplostim, pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF), eltrombopag, recombinant human thrombopoietin (rHuTPO) or any platelet producing agent
  • Rituximab (for any indication) or mercaptopurine (6-MP) or anticipated use during the time of the proposed study
  • All hematopoietic growth factors including interleukin-11 (IL-11) (oprelvekin) within 4 weeks before the screening visit
  • Alkylating agents use at any time before or during the screening visit or anticipated during the time of the proposed study
  • Known hypersensitivity to any recombinant E. coli-derived product (eg, Infergen, Neupogen, Somatropin, and Actimmune)
  • Currently enrolled in another investigational device or drug study, or less than 30 days since ending another investigational device or drug study(s), or receiving other investigational agent(s)
  • Subject will have any other investigational procedures performed while enrolled in this clinical study
  • Subject is pregnant or breast feeding, or planning to become pregnant within 5 weeks after the end of treatment
  • Female subject of child bearing potential is not willing to use, in combination with her partner, highly effective contraception during treatment and for 4 weeks after the end of treatment
  • Subject has previously enrolled into a romiplostim study
  • Subject will not be available for protocol required study visits, to the best of the subject's and investigator's knowledge
  • Subject has any kind of disorder that, in the opinion of the investigator, may compromise the ability of the subject to give written informed consent and/or to comply with all required study procedures

Sites / Locations

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Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Romiplostim

Arm Description

Participants received romiplostim administered weekly by subcutaneous injection during the 12-month treatment period. The starting dose was 1 μg/kg with weekly dose increases continued in increments of 1 μg/kg/week to a maximum dose of 10 μg/kg in an attempt to reach a target platelet count of ≥ 50 x 10^9/L.

Outcomes

Primary Outcome Measures

Number of Months With Platelet Response During the 12-Month Treatment Period
The primary endpoint was the number of months a participant achieved a platelet response during the 12-month treatment period. A platelet response for any 1 month was defined as the median of platelet counts measured in the month ≥ 50 x 10^9/L. Platelet counts within 4 weeks following a rescue medication use or following splenectomy were considered non-response. Months without any platelet count measurement were considered as months with no platelet response.

Secondary Outcome Measures

Percentage of Participants With ITP Remission
ITP remission was defined as maintaining every platelet count ≥ 50 x 10^9/L for at least 6 months in the absence of romiplostim and any other therapies to treat ITP.
Percentage of Participants With Splenectomy During the 12-month Treatment Period
If treatment with romiplostim was deemed ineffective or intolerable by the investigator, a splenectomy may have been performed.
Number of Participants With Adverse Events
An adverse event (AE) is defined as any untoward medical occurrence in a clinical trial participant. The event does not necessarily have a causal relationship with study treatment. A serious adverse event is defined as an adverse event that meets at least one of the following serious criteria: • fatal • life threatening • requires in-patient hospitalization or prolongation of existing hospitalization • results in persistent or significant disability/incapacity • congenital anomaly/birth defect • other significant medical hazard. Whether an adverse event was treatment-related (TRAE) or not was determined by investigator.
Number of Participants Who Developed Antibodies to Romiplostim
The number of participants who developed antibody formation (defined as negative at baseline and positive at post-baseline, transient or persistent) to romiplostim, endogenous thrombopoietin (eTPO), and thrombopoietin mimetic peptide (TMP, the peptide component of romiplostim) was summarized.

Full Information

First Posted
June 10, 2010
Last Updated
September 8, 2022
Sponsor
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT01143038
Brief Title
Interventional Study in Adults With Immune Thrombocytopenia Purpura (ITP) Receiving Romiplostim
Official Title
A Phase 2 Interventional Single Arm Study Describing Platelet Responses and ITP Remission Rates in Adult Subjects With Immune Thrombocytopenia Purpura Receiving Romiplostim
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Completed
Study Start Date
November 30, 2010 (Actual)
Primary Completion Date
September 20, 2013 (Actual)
Study Completion Date
December 26, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amgen

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to describe the number of months with a platelet response over a 12 month treatment period and to describe ITP remission rates in adults with ITP receiving romiplostim.
Detailed Description
The study includes a 4-week screening period, a 12-month romiplostim treatment period, and a romiplostim dose-tapering period. During the 12-month treatment period romiplostim doses could be increased or decreased to maintain a platelet count between ≥ 50 x 10^9/L and ≤ 200 x 10^9/L. Participants who dose reduce such that they no longer require treatment with romiplostim during the 12-month treatment period will continue with all required study procedures up to 12 months and will be monitored for ITP remission for at least 6 months. At the completion of the 12-month treatment period, participants receiving only romiplostim and with a platelet count ≥ 50 x 10^9/L will enter the tapering period, during which the romiplostim dose will be decreased by 1 µg/kg every 2 weeks, for up to 19 weeks. If a participant maintains a platelet count of ≥ 50 x 10^9/L in the absence of romiplostim and all medications for ITP (concomitant or rescue), the participant will be followed for at least 6 months to confirm the incidence of ITP remission. If a participant's platelet count falls below 50 x 10^9/L and the participant has tapered off treatment with romiplostim, the participant will enter the stabilization period and reinitiate romiplostim for up to 8 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Thrombocytopenic Purpura
Keywords
ITP

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Romiplostim
Arm Type
Experimental
Arm Description
Participants received romiplostim administered weekly by subcutaneous injection during the 12-month treatment period. The starting dose was 1 μg/kg with weekly dose increases continued in increments of 1 μg/kg/week to a maximum dose of 10 μg/kg in an attempt to reach a target platelet count of ≥ 50 x 10^9/L.
Intervention Type
Biological
Intervention Name(s)
Romiplostim
Other Intervention Name(s)
AMG 531, Nplate
Intervention Description
Romiplostim will be administered weekly by subcutaneous injection
Primary Outcome Measure Information:
Title
Number of Months With Platelet Response During the 12-Month Treatment Period
Description
The primary endpoint was the number of months a participant achieved a platelet response during the 12-month treatment period. A platelet response for any 1 month was defined as the median of platelet counts measured in the month ≥ 50 x 10^9/L. Platelet counts within 4 weeks following a rescue medication use or following splenectomy were considered non-response. Months without any platelet count measurement were considered as months with no platelet response.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Percentage of Participants With ITP Remission
Description
ITP remission was defined as maintaining every platelet count ≥ 50 x 10^9/L for at least 6 months in the absence of romiplostim and any other therapies to treat ITP.
Time Frame
Up to 24 months
Title
Percentage of Participants With Splenectomy During the 12-month Treatment Period
Description
If treatment with romiplostim was deemed ineffective or intolerable by the investigator, a splenectomy may have been performed.
Time Frame
12 months
Title
Number of Participants With Adverse Events
Description
An adverse event (AE) is defined as any untoward medical occurrence in a clinical trial participant. The event does not necessarily have a causal relationship with study treatment. A serious adverse event is defined as an adverse event that meets at least one of the following serious criteria: • fatal • life threatening • requires in-patient hospitalization or prolongation of existing hospitalization • results in persistent or significant disability/incapacity • congenital anomaly/birth defect • other significant medical hazard. Whether an adverse event was treatment-related (TRAE) or not was determined by investigator.
Time Frame
From first dose date of romiplostim to end of study (up to 24 months).
Title
Number of Participants Who Developed Antibodies to Romiplostim
Description
The number of participants who developed antibody formation (defined as negative at baseline and positive at post-baseline, transient or persistent) to romiplostim, endogenous thrombopoietin (eTPO), and thrombopoietin mimetic peptide (TMP, the peptide component of romiplostim) was summarized.
Time Frame
Baseline and at end of treatment (based on response to treatment, this could occur between 12 months and approximately 18 months)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - Subject has been diagnosed with primary ITP according to the American Society of Hematology (ASH) guidelines (George et al, 1996) and previously received only 1st line therapies. First line therapy is defined as corticosteroids, immunoglobulin G (IVIG), anti-D and vinca alkaloids (used for the treatment of ITP related thrombocytopenia only). A platelet transfusion at any time during the six month period since the original diagnosis would not exclude the subject from study participation Initial diagnosis of primary ITP within 6 months of enrollment Age ≥ 18 years at screening A single platelet count ≤ 30 x 10⁹/L at any time during the screening period Subject or subject's legally acceptable representative has provided informed consent Exclusion Criteria: Known history of a bone marrow stem cell disorder Surgical resection of the spleen Subject has a history of cancer or current malignancy other than basal cell carcinoma or cervical cancer in-situ with active treatment or disease within 5 years of screening Known history of congenital thrombocytopenia Known history of hepatitis B, hepatitis C, or human immunodeficiency virus Positive H. pylori by urea breath test or stool antigen test at screening Known history of systemic lupus erythematosus, Evans syndrome, or autoimmune neutropenia Known history of antiphospholipid antibody syndrome or positive for lupus anticoagulant Known history of disseminated intravascular coagulation, hemolytic uremic syndrome, or thrombotic thrombocytopenic purpura Previous history of recurrent venous thromboembolism or thrombotic events or an occurrence within 5 years of enrollment. Previous use of romiplostim, pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF), eltrombopag, recombinant human thrombopoietin (rHuTPO) or any platelet producing agent Rituximab (for any indication) or mercaptopurine (6-MP) or anticipated use during the time of the proposed study All hematopoietic growth factors including interleukin-11 (IL-11) (oprelvekin) within 4 weeks before the screening visit Alkylating agents use at any time before or during the screening visit or anticipated during the time of the proposed study Known hypersensitivity to any recombinant E. coli-derived product (eg, Infergen, Neupogen, Somatropin, and Actimmune) Currently enrolled in another investigational device or drug study, or less than 30 days since ending another investigational device or drug study(s), or receiving other investigational agent(s) Subject will have any other investigational procedures performed while enrolled in this clinical study Subject is pregnant or breast feeding, or planning to become pregnant within 5 weeks after the end of treatment Female subject of child bearing potential is not willing to use, in combination with her partner, highly effective contraception during treatment and for 4 weeks after the end of treatment Subject has previously enrolled into a romiplostim study Subject will not be available for protocol required study visits, to the best of the subject's and investigator's knowledge Subject has any kind of disorder that, in the opinion of the investigator, may compromise the ability of the subject to give written informed consent and/or to comply with all required study procedures
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
Facility Information:
Facility Name
Research Site
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Research Site
City
Orange
State/Province
California
ZIP/Postal Code
92868
Country
United States
Facility Name
Research Site
City
Boynton Beach
State/Province
Florida
ZIP/Postal Code
33435
Country
United States
Facility Name
Research Site
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20817
Country
United States
Facility Name
Research Site
City
Hickory
State/Province
North Carolina
ZIP/Postal Code
28602
Country
United States
Facility Name
Research Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
Research Site
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29414
Country
United States
Facility Name
Research Site
City
Richlands
State/Province
Virginia
ZIP/Postal Code
24641
Country
United States
Facility Name
Research Site
City
Randwick
State/Province
New South Wales
ZIP/Postal Code
2031
Country
Australia
Facility Name
Research Site
City
Woolloongabba
State/Province
Queensland
ZIP/Postal Code
4102
Country
Australia
Facility Name
Research Site
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
Research Site
City
Brno
ZIP/Postal Code
625 00
Country
Czechia
Facility Name
Research Site
City
Ostrava-Poruba
ZIP/Postal Code
708 52
Country
Czechia
Facility Name
Research Site
City
Praha 10
ZIP/Postal Code
100 34
Country
Czechia
Facility Name
Research Site
City
Praha 2
ZIP/Postal Code
128 08
Country
Czechia
Facility Name
Research Site
City
Praha 2
ZIP/Postal Code
128 20
Country
Czechia
Facility Name
Research Site
City
Bondy Cedex
ZIP/Postal Code
93143
Country
France
Facility Name
Research Site
City
Créteil Cedex
ZIP/Postal Code
94010
Country
France
Facility Name
Research Site
City
Dijon
ZIP/Postal Code
21000
Country
France
Facility Name
Research Site
City
Pessac Cedex
ZIP/Postal Code
33604
Country
France
Facility Name
Research Site
City
Toulouse Cedex 9
ZIP/Postal Code
31059
Country
France
Facility Name
Research Site
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
Research Site
City
Duisburg
ZIP/Postal Code
47166
Country
Germany
Facility Name
Research Site
City
Düsseldorf
ZIP/Postal Code
40479
Country
Germany
Facility Name
Research Site
City
Köln
ZIP/Postal Code
50674
Country
Germany
Facility Name
Research Site
City
Bari
ZIP/Postal Code
70124
Country
Italy
Facility Name
Research Site
City
Catania
ZIP/Postal Code
95124
Country
Italy
Facility Name
Research Site
City
Monza (MB)
ZIP/Postal Code
20900
Country
Italy
Facility Name
Research Site
City
Napoli
ZIP/Postal Code
80131
Country
Italy
Facility Name
Research Site
City
Novara
ZIP/Postal Code
28100
Country
Italy
Facility Name
Research Site
City
Roma
ZIP/Postal Code
00161
Country
Italy
Facility Name
Research Site
City
San Giovanni Rotondo FG
ZIP/Postal Code
71013
Country
Italy
Facility Name
Research Site
City
Vicenza
ZIP/Postal Code
36100
Country
Italy
Facility Name
Research Site
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Research Site
City
Katowice
ZIP/Postal Code
40-032
Country
Poland
Facility Name
Research Site
City
Lublin
ZIP/Postal Code
20-080
Country
Poland
Facility Name
Research Site
City
Poznan
ZIP/Postal Code
61-505
Country
Poland
Facility Name
Research Site
City
Wroclaw
ZIP/Postal Code
50-367
Country
Poland
Facility Name
Research Site
City
Málaga
State/Province
Andalucía
ZIP/Postal Code
29010
Country
Spain
Facility Name
Research Site
City
Barcelona
State/Province
Cataluña
ZIP/Postal Code
08035
Country
Spain
Facility Name
Research Site
City
A Coruña
State/Province
Galicia
ZIP/Postal Code
15006
Country
Spain
Facility Name
Research Site
City
Alcorcon
State/Province
Madrid
ZIP/Postal Code
28922
Country
Spain
Facility Name
Research Site
City
Majadahonda
State/Province
Madrid
ZIP/Postal Code
28222
Country
Spain
Facility Name
Research Site
City
Coventry
ZIP/Postal Code
CV2 2DX
Country
United Kingdom
Facility Name
Research Site
City
Leeds
ZIP/Postal Code
LS9 7TF
Country
United Kingdom
Facility Name
Research Site
City
London
ZIP/Postal Code
E1 2ES
Country
United Kingdom
Facility Name
Research Site
City
London
ZIP/Postal Code
SW17 0QT
Country
United Kingdom
Facility Name
Research Site
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
26537623
Citation
Newland A, Godeau B, Priego V, Viallard JF, Lopez Fernandez MF, Orejudos A, Eisen M. Remission and platelet responses with romiplostim in primary immune thrombocytopenia: final results from a phase 2 study. Br J Haematol. 2016 Jan;172(2):262-73. doi: 10.1111/bjh.13827. Epub 2015 Nov 5.
Results Reference
background
PubMed Identifier
28411254
Citation
Cines DB, Wasser J, Rodeghiero F, Chong BH, Steurer M, Provan D, Lyons R, Garcia-Chavez J, Carpenter N, Wang X, Eisen M. Safety and efficacy of romiplostim in splenectomized and nonsplenectomized patients with primary immune thrombocytopenia. Haematologica. 2017 Aug;102(8):1342-1351. doi: 10.3324/haematol.2016.161968. Epub 2017 Apr 14.
Results Reference
background
PubMed Identifier
30793285
Citation
Kuter DJ, Newland A, Chong BH, Rodeghiero F, Romero MT, Pabinger I, Chen Y, Wang K, Mehta B, Eisen M. Romiplostim in adult patients with newly diagnosed or persistent immune thrombocytopenia (ITP) for up to 1 year and in those with chronic ITP for more than 1 year: a subgroup analysis of integrated data from completed romiplostim studies. Br J Haematol. 2019 May;185(3):503-513. doi: 10.1111/bjh.15803. Epub 2019 Feb 21.
Results Reference
background
PubMed Identifier
32129511
Citation
Kuter DJ, Arnold DM, Rodeghiero F, Janssens A, Selleslag D, Bird R, Newland A, Mayer J, Wang K, Olie R. Safety and efficacy of self-administered romiplostim in patients with immune thrombocytopenia: Results of an integrated database of five clinical trials. Am J Hematol. 2020 Jun;95(6):643-651. doi: 10.1002/ajh.25776. Epub 2020 Mar 21.
Results Reference
background
Links:
URL
http://www.amgentrials.com
Description
AmgenTrials clinical trials website

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Interventional Study in Adults With Immune Thrombocytopenia Purpura (ITP) Receiving Romiplostim

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