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This Clinical Study is to Test Efficacy and Safety of BT595 in Chronic Primary Immune Thrombocytopenia (ITP)

Primary Purpose

Immune Thrombocytopenia

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
BT595
Sponsored by
Biotest
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immune Thrombocytopenia

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Main Inclusion Criteria:

  • Diagnosis of chronic ITP (>12 months' duration), including diagnosis of refractory ITP, and as defined by the International Working Group (Rodeghiero et al, 2009), where ITP is described as an autoimmune disorder characterized by isolated thrombocytopenia in the absence of other causes or disorders that may be associated with thrombocytopenia
  • Treatment is indicated because of a high risk of bleeding or a need to raise the platelet count
  • Mean screening platelet count of <30×10^9/L from 3 qualifying platelet counts performed within approximately 7 to 14 days before the start of treatment, with no individual platelet count above 35×10^9/L. The subject may be rescreened if the mean screening platelet count is ≥30×10^9/L. (Note: If a subject is rescreened, all screening laboratory tests must be repeated.)

Main Exclusion Criteria:

  • Secondary thrombocytopenia or acquired medical conditions known to be associated with secondary thrombocytopenia, such as chronic lymphocytic leukemia; lymphoma; multiple myeloma; thyroid disease; or other forms of thrombocytopenia, such as drug induced thrombocytopenia; cirrhotic liver diseases; antiphospholipid syndrome; environmental thrombocytopenia; and bone marrow diseases
  • Severe concomitant diseases that in the judgment of the investigator will interfere with the study, such as autoimmune hemolytic anemia, acute renal failure, and noncontrolled arterial hypertension
  • Laboratory findings (e.g., abnormal laboratory values for hemoglobin, transaminase levels [alanine aminotransferase, aspartate aminotransferase], total bilirubin, creatinine, blood urea nitrogen, and immunoglobulins G, A, M) that preclude participation
  • Positive Coombs test (direct and indirect)
  • Planned invasive procedures during the time frame of the study
  • Maintenance therapy with intravenous immunoglobulins (IVIgs) or infusion of IVIgs within 3 months before start of the study
  • Unresponsive to previous IVIg treatment
  • Additional therapy with high dose corticosteroids (equivalent to >30 mg prednisone/day), thrombopoietin receptor agonists, and/or immunosuppressives and/or other therapies (e.g., infusion of platelets) within 1 month before the start of the study (Note: Subjects on stable doses of ITP active treatment must not have modified the dose in the preceding 2 weeks and must maintain their prestudy dose during the study. Corticosteroids should not be given as a premedication. Rescue therapy with short courses [i.e., 1 to 4 days] of high dose steroids and IVIgs are allowed up to 2 weeks before study inclusion.)
  • History of thrombotic events (including myocardial infarction, cerebral vascular accident [including stroke], pulmonary embolism, and deep vein thrombosis) 6 months before treatment start with BT595 or the presence of significant risk factors for thrombotic events
  • Therapy with live attenuated virus vaccines 3 months before start of the study
  • Selective, absolute immunoglobulin A (IgA) deficiency or known antibodies to IgA

Sites / Locations

  • Investigational site # 3597
  • Investigational site # 3593
  • Investigational site # 3598
  • Investigational site # 3591
  • Investigational site # 3596
  • Investigational site # 4202
  • Investigational site # 4901
  • Investigational Site #4902
  • Investigational site # 3601
  • Investigational site # 3604
  • Investigational site # 3607
  • Investigational site # 3602
  • Investigational site # 3603
  • Investigational site # 3606
  • Investigational site # 3811
  • Investigational site # 3813
  • Investigational site #3814
  • Investigational site # 3812
  • Investigational site # 3403
  • Investigational site # 3404
  • Investigational site #3401
  • Investigational site # 3402

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

2 day treatment schedule

5 day treatment schedule

Arm Description

Patients will receive a dosage of 1 g/kg bw per day of BT595 for 2 consecutive days

Patients will receive a dosage of 0.4 g/kg bw per day of BT595 for 5 consecutive days

Outcomes

Primary Outcome Measures

Rate of subjects with response (R)
The rate of subjects with response is defined as subjects with a platelet count of ≥30×10^9/L and at least a 2 fold increase of the baseline count, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding

Secondary Outcome Measures

The number of subjects with complete response (CR)
The number of subjects with CR, which is defined as a platelet count ≥100×10^9/L, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding
The percentage of subjects with complete response (CR)
The percentage of subjects with CR, which is defined as a platelet count ≥100×10^9/L, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding
The number of subjects with no response (NR)
The number of subjects with NR, which is defined as subjects without R, i.e. a platelet count <30×10^9/L or less than a 2 fold increase of baseline platelet count, confirmed on at least 2 separate occasions, approximately 1 day apart, or bleeding
The percentage of subjects with no response (NR)
The percentage of subjects with NR, which is defined as subjects without R, i.e. a platelet count <30×10^9/L or less than a 2 fold increase of baseline platelet count, confirmed on at least 2 separate occasions, approximately 1 day apart, or bleeding
The number of subjects with a loss of response
The number of subjects with a loss of response (only in subjects who previously had CR or R), which is defined as a platelet count <100×10^9/L or bleeding (from CR) or platelet count <30×10^9/L or less than 2 fold increase of the baseline platelet count, or bleeding (from R). Platelet counts will be confirmed on at least 2 separate occasions approximately 1 day apart
The percentage of subjects with a loss of response
The percentage of subjects with a loss of response (only in subjects who previously had CR or R), which is defined as a platelet count <100×10^9/L or bleeding (from CR) or platelet count <30×10^9/L or less than 2 fold increase of the baseline platelet count, or bleeding (from R). Platelet counts will be confirmed on at least 2 separate occasions approximately 1 day apart
Time to Response (R)
Time to response (R), which is defined as the time from the start of treatment to the time of achievement of CR or R
Duration of response (R),
Duration of response (R), which is defined as the time from the achievement of CR or R to loss of CR or R
The number of subjects with response to ≥50×10^9/L
The number of subjects with response to ≥50×10^9/L, which is defined as a platelet count increase to at least ≥50×10^9/L within 7 days of the first BT595 infusion
The percentage of subjects with response to ≥50×10^9/L
The percentage of subjects with response to ≥50×10^9/L, which is defined as a platelet count increase to at least ≥50×10^9/L within 7 days of the first BT595 infusion
Subject's maximum platelet count achieved
Time to subject's maximum platelet count
Time course of platelet count
Occurrence of bleeding symptoms

Full Information

First Posted
July 25, 2016
Last Updated
August 12, 2019
Sponsor
Biotest
Collaborators
Syneos Health
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1. Study Identification

Unique Protocol Identification Number
NCT02859909
Brief Title
This Clinical Study is to Test Efficacy and Safety of BT595 in Chronic Primary Immune Thrombocytopenia (ITP)
Official Title
An Open Label, Prospective, Randomized, Multicenter Study Investigating Clinical Efficacy and Safety of the Human Normal Immunoglobulin for Intravenous Administration BT595 in Patients With Chronic Primary Immune Thrombocytopenia (ITP)
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
November 2016 (Actual)
Primary Completion Date
December 2018 (Actual)
Study Completion Date
December 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Biotest
Collaborators
Syneos Health

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The main purpose of this study is to assess the efficacy and safety of BT595 in adult subjects with chronic ITP. The primary objective of this study is to determine the rate of subjects with a response. A response is defined as a platelet count of ≥30×10^9/L and at least a 2 fold increase of the baseline count, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding. The secondary objectives of this study, in addition to further efficacy assessments, are to evaluate the safety of BT595.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immune Thrombocytopenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
34 (Actual)

8. Arms, Groups, and Interventions

Arm Title
2 day treatment schedule
Arm Type
Experimental
Arm Description
Patients will receive a dosage of 1 g/kg bw per day of BT595 for 2 consecutive days
Arm Title
5 day treatment schedule
Arm Type
Experimental
Arm Description
Patients will receive a dosage of 0.4 g/kg bw per day of BT595 for 5 consecutive days
Intervention Type
Biological
Intervention Name(s)
BT595
Other Intervention Name(s)
Human Immunoglobulin
Primary Outcome Measure Information:
Title
Rate of subjects with response (R)
Description
The rate of subjects with response is defined as subjects with a platelet count of ≥30×10^9/L and at least a 2 fold increase of the baseline count, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding
Time Frame
1 month
Secondary Outcome Measure Information:
Title
The number of subjects with complete response (CR)
Description
The number of subjects with CR, which is defined as a platelet count ≥100×10^9/L, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding
Time Frame
1 month
Title
The percentage of subjects with complete response (CR)
Description
The percentage of subjects with CR, which is defined as a platelet count ≥100×10^9/L, confirmed on at least 2 separate occasions at least 7 days apart, and the absence of bleeding
Time Frame
1 month
Title
The number of subjects with no response (NR)
Description
The number of subjects with NR, which is defined as subjects without R, i.e. a platelet count <30×10^9/L or less than a 2 fold increase of baseline platelet count, confirmed on at least 2 separate occasions, approximately 1 day apart, or bleeding
Time Frame
1 month
Title
The percentage of subjects with no response (NR)
Description
The percentage of subjects with NR, which is defined as subjects without R, i.e. a platelet count <30×10^9/L or less than a 2 fold increase of baseline platelet count, confirmed on at least 2 separate occasions, approximately 1 day apart, or bleeding
Time Frame
1 month
Title
The number of subjects with a loss of response
Description
The number of subjects with a loss of response (only in subjects who previously had CR or R), which is defined as a platelet count <100×10^9/L or bleeding (from CR) or platelet count <30×10^9/L or less than 2 fold increase of the baseline platelet count, or bleeding (from R). Platelet counts will be confirmed on at least 2 separate occasions approximately 1 day apart
Time Frame
1 month
Title
The percentage of subjects with a loss of response
Description
The percentage of subjects with a loss of response (only in subjects who previously had CR or R), which is defined as a platelet count <100×10^9/L or bleeding (from CR) or platelet count <30×10^9/L or less than 2 fold increase of the baseline platelet count, or bleeding (from R). Platelet counts will be confirmed on at least 2 separate occasions approximately 1 day apart
Time Frame
1 month
Title
Time to Response (R)
Description
Time to response (R), which is defined as the time from the start of treatment to the time of achievement of CR or R
Time Frame
1 month
Title
Duration of response (R),
Description
Duration of response (R), which is defined as the time from the achievement of CR or R to loss of CR or R
Time Frame
1 month
Title
The number of subjects with response to ≥50×10^9/L
Description
The number of subjects with response to ≥50×10^9/L, which is defined as a platelet count increase to at least ≥50×10^9/L within 7 days of the first BT595 infusion
Time Frame
1 month
Title
The percentage of subjects with response to ≥50×10^9/L
Description
The percentage of subjects with response to ≥50×10^9/L, which is defined as a platelet count increase to at least ≥50×10^9/L within 7 days of the first BT595 infusion
Time Frame
1 month
Title
Subject's maximum platelet count achieved
Time Frame
1 month
Title
Time to subject's maximum platelet count
Time Frame
1 month
Title
Time course of platelet count
Time Frame
1 month
Title
Occurrence of bleeding symptoms
Time Frame
1 month

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Main Inclusion Criteria: Diagnosis of chronic ITP (>12 months' duration), including diagnosis of refractory ITP, and as defined by the International Working Group (Rodeghiero et al, 2009), where ITP is described as an autoimmune disorder characterized by isolated thrombocytopenia in the absence of other causes or disorders that may be associated with thrombocytopenia Treatment is indicated because of a high risk of bleeding or a need to raise the platelet count Mean screening platelet count of <30×10^9/L from 3 qualifying platelet counts performed within approximately 7 to 14 days before the start of treatment, with no individual platelet count above 35×10^9/L. The subject may be rescreened if the mean screening platelet count is ≥30×10^9/L. (Note: If a subject is rescreened, all screening laboratory tests must be repeated.) Main Exclusion Criteria: Secondary thrombocytopenia or acquired medical conditions known to be associated with secondary thrombocytopenia, such as chronic lymphocytic leukemia; lymphoma; multiple myeloma; thyroid disease; or other forms of thrombocytopenia, such as drug induced thrombocytopenia; cirrhotic liver diseases; antiphospholipid syndrome; environmental thrombocytopenia; and bone marrow diseases Severe concomitant diseases that in the judgment of the investigator will interfere with the study, such as autoimmune hemolytic anemia, acute renal failure, and noncontrolled arterial hypertension Laboratory findings (e.g., abnormal laboratory values for hemoglobin, transaminase levels [alanine aminotransferase, aspartate aminotransferase], total bilirubin, creatinine, blood urea nitrogen, and immunoglobulins G, A, M) that preclude participation Positive Coombs test (direct and indirect) Planned invasive procedures during the time frame of the study Maintenance therapy with intravenous immunoglobulins (IVIgs) or infusion of IVIgs within 3 months before start of the study Unresponsive to previous IVIg treatment Additional therapy with high dose corticosteroids (equivalent to >30 mg prednisone/day), thrombopoietin receptor agonists, and/or immunosuppressives and/or other therapies (e.g., infusion of platelets) within 1 month before the start of the study (Note: Subjects on stable doses of ITP active treatment must not have modified the dose in the preceding 2 weeks and must maintain their prestudy dose during the study. Corticosteroids should not be given as a premedication. Rescue therapy with short courses [i.e., 1 to 4 days] of high dose steroids and IVIgs are allowed up to 2 weeks before study inclusion.) History of thrombotic events (including myocardial infarction, cerebral vascular accident [including stroke], pulmonary embolism, and deep vein thrombosis) 6 months before treatment start with BT595 or the presence of significant risk factors for thrombotic events Therapy with live attenuated virus vaccines 3 months before start of the study Selective, absolute immunoglobulin A (IgA) deficiency or known antibodies to IgA
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Judit Demeter, MD, PhD, DSc
Organizational Affiliation
Semmelweis University Medical School, First Department of Medicine, Department of Hematology, 1083 Budapest, Korányi S. u. 2/a, Hungary
Official's Role
Principal Investigator
Facility Information:
Facility Name
Investigational site # 3597
City
Pleven
ZIP/Postal Code
5800
Country
Bulgaria
Facility Name
Investigational site # 3593
City
Plovdiv
ZIP/Postal Code
4000
Country
Bulgaria
Facility Name
Investigational site # 3598
City
Sofia
ZIP/Postal Code
1431
Country
Bulgaria
Facility Name
Investigational site # 3591
City
Sofia
ZIP/Postal Code
1756
Country
Bulgaria
Facility Name
Investigational site # 3596
City
Varna
ZIP/Postal Code
9010
Country
Bulgaria
Facility Name
Investigational site # 4202
City
Praha
ZIP/Postal Code
10034
Country
Czechia
Facility Name
Investigational site # 4901
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Investigational Site #4902
City
München
ZIP/Postal Code
81377
Country
Germany
Facility Name
Investigational site # 3601
City
Budapest
ZIP/Postal Code
1083
Country
Hungary
Facility Name
Investigational site # 3604
City
Debrecen
ZIP/Postal Code
4032
Country
Hungary
Facility Name
Investigational site # 3607
City
Győr
ZIP/Postal Code
9023
Country
Hungary
Facility Name
Investigational site # 3602
City
Miskolc
ZIP/Postal Code
3529
Country
Hungary
Facility Name
Investigational site # 3603
City
Nyiregyhaza
ZIP/Postal Code
4400
Country
Hungary
Facility Name
Investigational site # 3606
City
Pécs
ZIP/Postal Code
7621
Country
Hungary
Facility Name
Investigational site # 3811
City
Belgrade
ZIP/Postal Code
11000
Country
Serbia
Facility Name
Investigational site # 3813
City
Belgrade
ZIP/Postal Code
11080
Country
Serbia
Facility Name
Investigational site #3814
City
Niš
ZIP/Postal Code
18000
Country
Serbia
Facility Name
Investigational site # 3812
City
Novi Sad
ZIP/Postal Code
21000
Country
Serbia
Facility Name
Investigational site # 3403
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
Investigational site # 3404
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Investigational site #3401
City
Malaga
Country
Spain
Facility Name
Investigational site # 3402
City
Palma de Mallorca
ZIP/Postal Code
07012
Country
Spain

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

This Clinical Study is to Test Efficacy and Safety of BT595 in Chronic Primary Immune Thrombocytopenia (ITP)

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