Intravenous Immunoglobulin (IVIG, Bioven) Efficacy and Safety in Chronic Primary Immune Thrombocytopenia (ITP) in Adults
Primary Immune Thrombocytopenia
About this trial
This is an interventional treatment trial for Primary Immune Thrombocytopenia focused on measuring IVIG, ITP, immunomodulatory therapy, intravenous immunoglobulin, chronic primary immune thrombocytopenia
Eligibility Criteria
Inclusion criteria:
- Signed Patient Informed Consent Form for participation in the study;
- Men and women aged 18-65;
- Confirmed primary chronic ITP (lasting > 12 months since diagnosis);
- A full blood count should be normal except for the isolated thrombocytopenia. Patients with low hemoglobin levels (but above 90 g / l) may be included if there are symptoms of bleeding;
- If bleeding symptoms are diagnosed, the reticulocyte count should be measured;
- Platelet count <30 x 109 / L;
- If the patient is taking corticosteroids, the treatment regimen/dose should be stable (at least 2 weeks prior to screening);
- Negative pregnancy test (for women of child-bearing potential);
- Willingness to use effective and reliable methods of contraception throughout the entire study period;
- The results of physical, instrumental, and laboratory examination of patients should be within the normal range or deviations should be regarded by the researcher as clinically insignificant;
- Ability, according to the researcher, to follow all the requirements of the study protocol;
Exclusion criteria:
- Known intolerance to plasma and immunoglobulin preparations;
- Drug allergy or hypersensitivity to immunoglobulin preparations;
- Confirmed deficiency of immunoglobulin A (IgA) and antibodies to IgA.
- Contraindications to immunoglobulin administration according to the instructions for medical use;
- Pregnancy and lactation;
- Any clinically significant hepatic impairment (increase of serum transaminase levels by more than 3 times the upper limit of normal);
- Serum creatinine levels are more than two times higher than the upper limit of normal for a given age and sex;
- Severe cardiovascular insufficiency (HF III);
- History of thrombosis or presence of significant risk factors for thrombosis.
- Patients with preventive splenectomy;
- Hemostatic disorders other than chronic thrombocytopenia;
- Persons with acute or exacerbation of chronic diseases of the gastrointestinal tract associated with the risk of bleeding, acute infectious diseases, pathologies of the respiratory system;
- Proven case of primary immunodeficiency;
- Secondary immune thrombocytopenia;
- Virus infections (Epstein-Barr, Cytomegalovirus, Parvovirus, Hepatitis B and C);
- Documented HIV infection
- Positive reaction of Wassermann (RW) test result;
- Systemic immunopathological diseases (rheumatic diseases, nephritis, etc.);
- Oncological diseases;
- Diabetes mellitus;
- Thyroid diseases;
- History of mental illness;
- Known drug addiction;
- Any other concomitant decompensated diseases or acute conditions, the presence of which, according to the researcher, may significantly affect the results of the study;
- The need to prescribe drugs that are incompatible with the administration of the drug in this study: other immunoglobulin preparations in addition to the study drug, cytostatic drugs, monoclonal antibodies, Avatrombopag);
- Experimental treatment (e.g. Rituximab therapy) for 3 months prior to screening);
- Blood transfusions or transfusions of blood products in the last 6 months prior to inclusion in the study;
- Administration of IVIG 30 days prior to screening;
- Participation in any other study currently or within the last 30 days;
Criteria for exclusion of subjects (discontinuation of treatment with the study drug):
- Patient's wish
- Occurrence of severe and/or unexpected Adverse events (AE) or Adverse reactions (AR) in patient during the study, that require discontinuation of the drug;
- The need to prescribe drugs prohibited in this study.
- Significant deterioration of the patient's condition during the study period;
- Failure of the patient to adhere to the treatment regimen;
- Failure of the patient to follow the procedures established under the protocol;
Sites / Locations
- Municipal non-profit enterprise "City Clinical Hospital No. 4" of the Dnipro City Council
- Municipal non-profit enterprise "Khmelnytskyi Regional Hospital" of the Khmelnytskyi Regional CouncilRecruiting
- Municipal Non-Profit Enterprise "Kirovohrad Regional Hospital of the Kirovohrad Regional Council"Recruiting
- Medical Center "OK!Clinic+" of the Company with Limited Liability "International Institute of Clinical Research"Recruiting
- Municipal Non-Profit Enterprise of Kyiv Regional Council "Kyiv Regional Oncology Dispensary"
- Municipal non-profit enterprise "Kyiv City Clinical Hospital No. 9" of the executive body of the Kyiv City Council (Kyiv City State Administration)Recruiting
- "Arensia Exploratory Medicine" Limited Liability Company Medical CenterRecruiting
- State Institution "Institute of Blood Pathology and Transfusion Medicine of the National Academy of Medical Sciences of Ukraine"Recruiting
- Minicipal enterprise "Rivne regional clinical hospital" of Rivne regional council
- Municipal Non-Profit Enterprise of Sumy Regional Council "Sumy Regional Clinical Hospital"
- Municipal non-profit enterprise "Ternopil University Hospital" of Ternopil Regional CouncilRecruiting
- Municipal Non-Profit Enterprise "Zakarpattia Regional Clinical Hospital named after Andriy Novak" of Zakarpattia Regional CouncilRecruiting
Arms of the Study
Arm 1
Experimental
Main Group
Patients included in the study will receive the intravenous immunoglobulin (IVIG, Bioven), 10% solution for infusion according to the protocol for the use of IVIG in ITP treatment - at a dose of 0.8-1.0 g / kg once a day for 2 consecutive days, the course dose is 1.6-2.0 g / kg. The next day after the administration of the drug, the patient undergoes blood sampling to determine the level of platelets, the level of immunoglobulin G (IgG), and the Coombs test. This procedure will also be carried out on days 7, 14, 21, and 28 after the first injection of the drug to monitor the patient's performance.