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Safety and Efficacy of Eltrombopag Plus Pulsed Dexamethasone for Subjects With Idiopathic Thrombocytopenic Purpura

Primary Purpose

Immune Thrombocytopenia

Status
Suspended
Phase
Phase 2
Locations
Hong Kong
Study Type
Interventional
Intervention
Eltrombopag
Sponsored by
Humanity & Health Medical Group Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immune Thrombocytopenia

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject has signed and dated a written informed consent.
  2. Adults (≥18 years) diagnosed with ITP according to the American Society for Hematology/British Committee for Standards in Haematology (ASH/BCSH) Guidelines. In addition, the peripheral blood smear should support the diagnosis of ITP with no evidence of other disease causative of thrombocytopenia (e.g., pseudo thrombocytopenia, myelofibrosis). The physical examination should be normal or at least not show signs suggestive of any disease likely to be associated with thrombocytopenia.
  3. No prior ITP treatment except platelet transfusions
  4. Subject has no intercurrent medical event, including evidence of any thrombosis.
  5. Normal prothrombin time (PT/INR) and activated partial thromboplastin time (aPTT), no history of hypercoagulable state.
  6. The following clinical chemistries must be within the normal reference range:

    creatinine, ALT, AST, total bilirubin, total albumin and alkaline phosphatase.

  7. Subject is practicing an acceptable method of contraception (documented in chart).
  8. Subject is able to understand and comply with protocol requirements and instructions.

Exclusion Criteria:

  1. Any clinically relevant abnormality, other than ITP, identified on the screening examination, or any other medical condition or circumstance, which in the opinion of the investigator makes the subject unsuitable for participation in the study or suggests another diagnosis.
  2. History of active malignancy or on cancer therapy. Patients with a history of malignancy in complete remission for longer than 5 years are eligible
  3. History of arterial or venous thrombosis (stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis or pulmonary embolism).
  4. ≥ two of the following risk factors: Factor V Leiden, hormone replacement therapy, systemic contraception containing estrogen, smoking, diabetes, hypercholesterolemia, medications for hypertension or cancer.
  5. Pre-existing cardiac disease (including congestive heart failure, and arrhythmia requiring treatment), or clinically significant findings on resting 12-lead ECG at screening.
  6. Female subjects who are nursing or pregnant (positive serum or urine β-human chorionic gonadotrophin (β-hCG) pregnancy test) at screening or pre-dose on Day 1.
  7. History of alcohol/drug abuse.
  8. Treatment with an investigational drug within 30 days or five half-lives (whichever is longer) preceding the first dose of study medication

Sites / Locations

  • Humanity & Health Research Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single Arm

Arm Description

Eltrombopag Oral Tablet 25-75 mg daily for 12 weeks plus pulsed dexamethasone

Outcomes

Primary Outcome Measures

The prolonged response rate
Defined as proportion of patients with platelet counts > 50,000/μl at 6 months after completion of therapy and free of ITP rescue therapy

Secondary Outcome Measures

Time to relapse
Defined as the interval from completion of 3 months treatment to platelet count<30,000/ul and restarting of ITP therapy including but not limited to platelet transfusion, IVIG, corticosteroids, immunosuppressive drugs, rituximab
Early response rate
Defined as proportion of patients requiring less than 3 courses of pulsed dexamethasone to maintain platelet counts > 150,000/ul
Health related quality of life
Assessed by SV36 HRQoL questionnaires

Full Information

First Posted
February 1, 2019
Last Updated
March 16, 2022
Sponsor
Humanity & Health Medical Group Limited
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1. Study Identification

Unique Protocol Identification Number
NCT03830749
Brief Title
Safety and Efficacy of Eltrombopag Plus Pulsed Dexamethasone for Subjects With Idiopathic Thrombocytopenic Purpura
Official Title
A Pilot Study to Evaluate the Safety and Efficacy of Eltrombopag Plus Pulsed Dexamethasone as First Line Therapy for Subjects With Idiopathic Thrombocytopenic Purpura (ITP)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Suspended
Why Stopped
Due to the COVID-19 pandemic
Study Start Date
July 1, 2018 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
March 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Humanity & Health Medical Group Limited

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Current first line treatments for immune thrombocytopenia (ITP) usually have transient effects and prolonged platelet response rate off therapy remains low. The aim is to evaluate whether a 12-week course of eltrombopag plus pulsed dexamethasone as first line therapy can increase the proportion of patients with prolonged response. Diagnosis of ITP is established according to the American Society of Hematology guidelines. Eligible ITP subjects have platelet counts <30×109/L or counts <50×109/L and significant bleeding symptoms (WHO bleeding scale 2 or above). Subjects must have no prior ITP treatment except platelet transfusions. Treatment consists of eltrombopag 25-75 mg daily according to platelet response for 12 weeks plus pulsed dexamethasone, 40 mg daily for 4 consecutive days every 4 weeks for 1-3 courses. The primary endpoint is prolonged response rate which was defined as the proportion of enrolled subjects maintaining platelet counts >50×109/L for more than 6 months without any ITP therapy after completion of 12-week therapy.

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 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single Arm
Arm Type
Experimental
Arm Description
Eltrombopag Oral Tablet 25-75 mg daily for 12 weeks plus pulsed dexamethasone
Intervention Type
Drug
Intervention Name(s)
Eltrombopag
Intervention Description
Eltrombopag Oral Tablet 25-75 mg daily for 12 weeks plus pulsed dexamethasone
Primary Outcome Measure Information:
Title
The prolonged response rate
Description
Defined as proportion of patients with platelet counts > 50,000/μl at 6 months after completion of therapy and free of ITP rescue therapy
Time Frame
6 months after completion of therapy
Secondary Outcome Measure Information:
Title
Time to relapse
Description
Defined as the interval from completion of 3 months treatment to platelet count<30,000/ul and restarting of ITP therapy including but not limited to platelet transfusion, IVIG, corticosteroids, immunosuppressive drugs, rituximab
Time Frame
6 months after completion of therapy
Title
Early response rate
Description
Defined as proportion of patients requiring less than 3 courses of pulsed dexamethasone to maintain platelet counts > 150,000/ul
Time Frame
6 months after completion of therapy
Title
Health related quality of life
Description
Assessed by SV36 HRQoL questionnaires
Time Frame
6 months after completion of therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject has signed and dated a written informed consent. Adults (≥18 years) diagnosed with ITP according to the American Society for Hematology/British Committee for Standards in Haematology (ASH/BCSH) Guidelines. In addition, the peripheral blood smear should support the diagnosis of ITP with no evidence of other disease causative of thrombocytopenia (e.g., pseudo thrombocytopenia, myelofibrosis). The physical examination should be normal or at least not show signs suggestive of any disease likely to be associated with thrombocytopenia. No prior ITP treatment except platelet transfusions Subject has no intercurrent medical event, including evidence of any thrombosis. Normal prothrombin time (PT/INR) and activated partial thromboplastin time (aPTT), no history of hypercoagulable state. The following clinical chemistries must be within the normal reference range: creatinine, ALT, AST, total bilirubin, total albumin and alkaline phosphatase. Subject is practicing an acceptable method of contraception (documented in chart). Subject is able to understand and comply with protocol requirements and instructions. Exclusion Criteria: Any clinically relevant abnormality, other than ITP, identified on the screening examination, or any other medical condition or circumstance, which in the opinion of the investigator makes the subject unsuitable for participation in the study or suggests another diagnosis. History of active malignancy or on cancer therapy. Patients with a history of malignancy in complete remission for longer than 5 years are eligible History of arterial or venous thrombosis (stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis or pulmonary embolism). ≥ two of the following risk factors: Factor V Leiden, hormone replacement therapy, systemic contraception containing estrogen, smoking, diabetes, hypercholesterolemia, medications for hypertension or cancer. Pre-existing cardiac disease (including congestive heart failure, and arrhythmia requiring treatment), or clinically significant findings on resting 12-lead ECG at screening. Female subjects who are nursing or pregnant (positive serum or urine β-human chorionic gonadotrophin (β-hCG) pregnancy test) at screening or pre-dose on Day 1. History of alcohol/drug abuse. Treatment with an investigational drug within 30 days or five half-lives (whichever is longer) preceding the first dose of study medication
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory Cheng, PhD, MD
Organizational Affiliation
Humanity & Health Research Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Humanity & Health Research Centre
City
Hong Kong
State/Province
Hong Kong SAR
Country
Hong Kong

12. IPD Sharing Statement

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Safety and Efficacy of Eltrombopag Plus Pulsed Dexamethasone for Subjects With Idiopathic Thrombocytopenic Purpura

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