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Avatrombopag in Patients With End-stage Liver Disease and Thrombocytopenia

Primary Purpose

Liver Failure, Thrombocytopenia, Decompensated Cirrhosis

Status
Unknown status
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Avatrombopag
Standard medical treatment
Sponsored by
Tongji Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Liver Failure focused on measuring end-stage liver disease, thrombocytopenia, avatrombopag, efficacy, safety

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women greater than or equal to 18 years of age;
  2. Baseline platelet count <50×10^9/L;
  3. End-stage liver disease, including acute-on-chronic liver failure, acute decompensation of liver cirrhosis, chronic liver failure;
  4. Women of childbearing potential must agree to use a highly effective method of contraception from the beginning of Baseline Visit until the end of treatment (includes implantable contraception, injectable contraception, hormonal combination contraception [including vaginal rings], intra-uterine devices or vasectomy). The barrier contraception with or without spermicide alone, double barrier contraception and oral contraceptives are inadequate;
  5. Subject is able to understand the study and willing to follow the protocol and sign informed consent voluntarily before Baseline Visit;
  6. Subject meet the criteria according to the opinion of the researchers.

Exclusion Criteria:

  1. Subject has a history of arterial or venous thrombosis within the previous 6 months of baseline;
  2. Known portal vein blood flow velocity rate <10 cm/second or previous occurrence of a portal vein thrombosis within 6 months of Baseline;
  3. Known any history of primary blood (e.g, immune thrombocytopenia, myelodysplastic syndrome, aplastic anemia);
  4. Subject has a known medical history of genetic prothrombotic syndromes (e.g, Factor V Leiden prothrombin G20210A, antithrombin III (AT III) deficiency);
  5. Subject has a recent history (within the previous 6 months) of significant cardiovascular diseases (e.g., exacerbation of congestive heart failure, arrhythmias known to increase the risk of thromboembolic events [e.g. atrial fibrillation], coronary or peripheral artery stent placement or angioplasty, and coronary or peripheral artery bypass grafting);
  6. Female subjects who are lactating or pregnant at the Baseline Visit (as documented by a positive serum beta-human chorionic gonadotropin [β-hCG] test with a minimum sensitivity of 25 IU/L or equivalent units of β-hCG) or are planning to become pregnant during the study;
  7. The subject has a hypersensitivity to Avatrombopag or any of its excipients;
  8. Subjects with drug-induced thrombocytopenia;
  9. Subjects whose Life expectation ≤6 months;
  10. Subject with a current malignancy;
  11. Subjects with HIV infection;
  12. At screening, active infection was not effectively controlled by systemic antibiotic therapy;
  13. The Investigator believe that any accompanying medical history may affect the safety of the subjects to complete the study;
  14. The Investigator believe that there are any other factors that are not suitable for inclusion or affect participation or completion of the study;
  15. Subject is enrolled in another clinical study with any investigational drug or device within previous 30 days of the Baseline Visit, but are allowed to participate in observational studies.

Sites / Locations

  • Department of infectious disease, Tongji HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

Intervention group

Control group

Arm Description

Avatrombopag+Standard medical treatment

Standard medical treatment

Outcomes

Primary Outcome Measures

Platelet count response time
Platelet count response time(PLT) refers to condition of PLT during 24 weeks between the Intervention group and Control group.

Secondary Outcome Measures

Adverse Event (thrombotic events, bleeding events, etc.) incidence;
Adverse Event refers to the incidence rate of adverse event between the two groups during 24 weeks
Incidence of complications of liver cirrhosis (infection, etc.)
Incidence of complications of liver cirrhosis refers to the incidence rate of complications between the two groups during 24 weeks
Patients without platelet transfusion or rescue due to bleeding
Patients without platelet transfusion or rescue due to bleeding refers to the patients rate without platelet transfusion or rescue due to bleeding between the two groups at 24 week
Proportion of patients readmitted
Proportion of patients readmitted refers to the readmission rate within 24 weeks between the Intervention group and Control group
Changes in total bilirubin level
Changes in total bilirubin level refers to the changes of total bilirubin at 24 week compared to baseline between the Intervention group and Control group.
Changes in alanine aminotransferase level
Changes in alanine aminotransferase level refers to the changes of alanine aminotransferase at 24 week compared to baseline between the Intervention group and Control group.
Changes in albumin level
Changes in albumin level refers to the changes of albumin at 24 week compared to baseline between the Intervention group and Control group.
Changes in prothrombin time level
Changes in prothrombin time level refers to the changes of prothrombin time at 24 week compared to baseline between the Intervention group and Control group.
Changes in international normalized ratio level
Changes in international normalized ratio level refers to the changes of international normalized ratio at 24 week compared to baseline between the Intervention group and Control group.

Full Information

First Posted
May 17, 2021
Last Updated
June 3, 2021
Sponsor
Tongji Hospital
Collaborators
Anhui Provincial Hospital, The First Affiliated Hospital of Nanchang University, Taihe Hospital, Hubei University of Medicine, The First Hospital of Jilin University
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1. Study Identification

Unique Protocol Identification Number
NCT04906083
Brief Title
Avatrombopag in Patients With End-stage Liver Disease and Thrombocytopenia
Official Title
The Efficacy and Safety of Avatrombopag in Patients With End-stage Liver Disease and Thrombocytopenia: A Multicenter, Prospective, Randomized Controlled Trial(EAST)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2021
Overall Recruitment Status
Unknown status
Study Start Date
February 1, 2021 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
December 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Tongji Hospital
Collaborators
Anhui Provincial Hospital, The First Affiliated Hospital of Nanchang University, Taihe Hospital, Hubei University of Medicine, The First Hospital of Jilin University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
End stage liver disease is prone to thrombocytopenia. This study is a multi-center, randomized, prospective, randomized controlled Phase IV Clinical trial to discuss the Efficacy and Safety of Avatrombopag in Patients with End-stage Liver Disease and Thrombocytopenia.
Detailed Description
End stage liver disease is prone to thrombocytopenia. This study aims to discuss the Efficacy and Safety of Avatrombopag in Patients with End-stage Liver Disease and Thrombocytopenia in a multicenter, prospective, randomized controlled trial. The patients were divided into one of the groups according to if receiving avatrombopag. Avatrombopag was taken to maintain platelet count 50~100×10^9/L. Starting dose is recommended according to the patient's baseline platelet count level. Routine treatment was taken in the Control group and Interventional group. This trial will take about 2 to 2.5 years from the first participant signing an informed consent form (ICF) until all study-related telephone follow-ups or visits end.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Failure, Thrombocytopenia, Decompensated Cirrhosis
Keywords
end-stage liver disease, thrombocytopenia, avatrombopag, efficacy, safety

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intervention group
Arm Type
Experimental
Arm Description
Avatrombopag+Standard medical treatment
Arm Title
Control group
Arm Type
Other
Arm Description
Standard medical treatment
Intervention Type
Drug
Intervention Name(s)
Avatrombopag
Intervention Description
Avatrombopag: PLT:30~50×10^9/L patients, 40 mg/d; PLT:<30×10^9/L patients, 60 mg/d.
Intervention Type
Drug
Intervention Name(s)
Standard medical treatment
Other Intervention Name(s)
transmetil, compound glycyrrhizinate, reduced glutathione and hepatocyte growth factor, et. al.
Intervention Description
Standard medical treatment included transmetil, compound glycyrrhizinate, reduced glutathione and hepatocyte growth factor, et. al.
Primary Outcome Measure Information:
Title
Platelet count response time
Description
Platelet count response time(PLT) refers to condition of PLT during 24 weeks between the Intervention group and Control group.
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Adverse Event (thrombotic events, bleeding events, etc.) incidence;
Description
Adverse Event refers to the incidence rate of adverse event between the two groups during 24 weeks
Time Frame
24 weeks
Title
Incidence of complications of liver cirrhosis (infection, etc.)
Description
Incidence of complications of liver cirrhosis refers to the incidence rate of complications between the two groups during 24 weeks
Time Frame
24 weeks
Title
Patients without platelet transfusion or rescue due to bleeding
Description
Patients without platelet transfusion or rescue due to bleeding refers to the patients rate without platelet transfusion or rescue due to bleeding between the two groups at 24 week
Time Frame
24 weeks
Title
Proportion of patients readmitted
Description
Proportion of patients readmitted refers to the readmission rate within 24 weeks between the Intervention group and Control group
Time Frame
24 weeks
Title
Changes in total bilirubin level
Description
Changes in total bilirubin level refers to the changes of total bilirubin at 24 week compared to baseline between the Intervention group and Control group.
Time Frame
24 weeks
Title
Changes in alanine aminotransferase level
Description
Changes in alanine aminotransferase level refers to the changes of alanine aminotransferase at 24 week compared to baseline between the Intervention group and Control group.
Time Frame
24 weeks
Title
Changes in albumin level
Description
Changes in albumin level refers to the changes of albumin at 24 week compared to baseline between the Intervention group and Control group.
Time Frame
24 weeks
Title
Changes in prothrombin time level
Description
Changes in prothrombin time level refers to the changes of prothrombin time at 24 week compared to baseline between the Intervention group and Control group.
Time Frame
24 weeks
Title
Changes in international normalized ratio level
Description
Changes in international normalized ratio level refers to the changes of international normalized ratio at 24 week compared to baseline between the Intervention group and Control group.
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men and women greater than or equal to 18 years of age; Baseline platelet count <50×10^9/L; End-stage liver disease, including acute-on-chronic liver failure, acute decompensation of liver cirrhosis, chronic liver failure; Women of childbearing potential must agree to use a highly effective method of contraception from the beginning of Baseline Visit until the end of treatment (includes implantable contraception, injectable contraception, hormonal combination contraception [including vaginal rings], intra-uterine devices or vasectomy). The barrier contraception with or without spermicide alone, double barrier contraception and oral contraceptives are inadequate; Subject is able to understand the study and willing to follow the protocol and sign informed consent voluntarily before Baseline Visit; Subject meet the criteria according to the opinion of the researchers. Exclusion Criteria: Subject has a history of arterial or venous thrombosis within the previous 6 months of baseline; Known portal vein blood flow velocity rate <10 cm/second or previous occurrence of a portal vein thrombosis within 6 months of Baseline; Known any history of primary blood (e.g, immune thrombocytopenia, myelodysplastic syndrome, aplastic anemia); Subject has a known medical history of genetic prothrombotic syndromes (e.g, Factor V Leiden prothrombin G20210A, antithrombin III (AT III) deficiency); Subject has a recent history (within the previous 6 months) of significant cardiovascular diseases (e.g., exacerbation of congestive heart failure, arrhythmias known to increase the risk of thromboembolic events [e.g. atrial fibrillation], coronary or peripheral artery stent placement or angioplasty, and coronary or peripheral artery bypass grafting); Female subjects who are lactating or pregnant at the Baseline Visit (as documented by a positive serum beta-human chorionic gonadotropin [β-hCG] test with a minimum sensitivity of 25 IU/L or equivalent units of β-hCG) or are planning to become pregnant during the study; The subject has a hypersensitivity to Avatrombopag or any of its excipients; Subjects with drug-induced thrombocytopenia; Subjects whose Life expectation ≤6 months; Subject with a current malignancy; Subjects with HIV infection; At screening, active infection was not effectively controlled by systemic antibiotic therapy; The Investigator believe that any accompanying medical history may affect the safety of the subjects to complete the study; The Investigator believe that there are any other factors that are not suitable for inclusion or affect participation or completion of the study; Subject is enrolled in another clinical study with any investigational drug or device within previous 30 days of the Baseline Visit, but are allowed to participate in observational studies.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Qin Ning, MD., PhD.
Phone
+8602783662391
Email
qning@vip.sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Qin Ning, MD., PhD.
Organizational Affiliation
Department of Infectious Disease, Tongji Hospital, Tongji Medical College, HUST
Official's Role
Study Chair
Facility Information:
Facility Name
Department of infectious disease, Tongji Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430030
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Qin Ning
Phone
+8602783662391
Email
qning@vip.sina.com

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Avatrombopag in Patients With End-stage Liver Disease and Thrombocytopenia

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