The Combination of Terbutaline and Danazol as the Treatment of Corticosteroid-resistant/Relapse Immune Thrombocytopenia
Primary Purpose
Immune Thrombocytopenia
Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Terbutaline
Danazol
Sponsored by
About this trial
This is an interventional treatment trial for Immune Thrombocytopenia
Eligibility Criteria
Inclusion Criteria: Patients >18 years old with corticosteroid-resistant or relapsed ITP who had either a platelet count of <30×10^9/L or a platelet count of <50×10^9/L and clinically significant bleeding.
- Not achieving a sustained response to therapy with full-dose corticosteroids for a duration of at least 4 weeks or relapsed during the process of corticosteroid tapering or discontinuation;
- Platelet counts <30×10^9/L or platelet counts < 50×10^9/L and significant bleeding symptoms (WHO bleeding scale 2 or above);
- Willing and able to sign written informed consent.
Exclusion Criteria:
- Pregnant or lactating women;
- Secondary ITP (have a known diagnosis of connective tissue diseases, malignancy, active infection, HIV infections or hepatitis B virus or hepatitis C virus infections);
- Received drugs affecting the platelet counts within 6 months before the screening visit (e.g., chemotherapy, anticoagulants, etc);
- Severe medical condition (lung, heart, hepatic or renal disorder);
- Patients who are deemed unsuitable for the study by the investigator.
- Patients who had hypertension, diabetes mellitus, hyperthyroidism or coronary heart disease.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Terbutaline plus danazol
Danazol monotherapy
Arm Description
Terbutaline: A dose of 2.5 mg three times daily for 16 weeks Danazol: A dose of 200 mg twice daily for 16 weeks
Danazol: A dose of 200 mg twice daily for 16 weeks
Outcomes
Primary Outcome Measures
Overall response
Achieving a platelet count ≥ 30 × 10^9/L confirmed on at least two separate occasions (at least 7 days apart), at least a doubling of the baseline platelet count without any other ITP-specific treatment and the absence of bleeding.
Secondary Outcome Measures
Sustained response
maintenance of a platelet count > 30 × 10^9/L, an absence of bleeding, and no requirement for any other ITP-specific treatment for 6 consecutive months after achievement of OR
Complete response
a platelet count ≥ 100 × 10^9/L measured on two occasions at least 7 days apart and the absence of bleeding
Remission
a durable platelet count > 30 × 109/L without bleeding up to 12 months after randomization
Time to response
the time from starting treatment to the time a response was achieved.
Duration of response
time from OR until loss of response or until the last follow-up visit
Rescue therapy
any new medical intervention taken to increase the platelet count or prevent bleeding events or an increase in the dose of concomitant treatments
Associated factors of treatment failure, OR, SR and remission
Factors that are associated with treatment failure, OR, SR and remission
Number of patients with bleeding
Number of patients with bleeding complication (WHO bleeding score)
Number of patients with side effects
Number of patients with Medication adverse events.
Relapse
Loss of OR
Relapse-free survival
the time interval between achievement of OR and relapse or the end of the follow-up
Full Information
NCT ID
NCT05494307
First Posted
August 6, 2022
Last Updated
August 6, 2022
Sponsor
Peking University People's Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05494307
Brief Title
The Combination of Terbutaline and Danazol as the Treatment of Corticosteroid-resistant/Relapse Immune Thrombocytopenia
Official Title
A Multicenter Randomized Trial of Second Line Treatment for Corticosteroid-Resistant or Relapsed Immune Thrombocytopenia: Combined Terbutaline and Danazol Versus Danazol Monotherapy
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 1, 2022 (Anticipated)
Primary Completion Date
September 1, 2023 (Anticipated)
Study Completion Date
February 28, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University People's Hospital
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
A randomized, open-label, multicenter study to compare the efficacy and safety of terbutaline plus danazol compared to danazol monotherapy for the second-line treatment of adults with corticosteroid-resistant or relapsed primary immune thrombocytopenia (ITP).
Detailed Description
The investigators are undertaking a parallel group, multicenter, randomized controlled trial of 228 adults with ITP in China. Patients were randomized to terbutaline plus danazol compared to danazol monotherapy group. Platelet count, bleeding and other symptoms were evaluated before and after treatment. Adverse events are also recorded throughout the study.
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
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
228 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Terbutaline plus danazol
Arm Type
Experimental
Arm Description
Terbutaline: A dose of 2.5 mg three times daily for 16 weeks Danazol: A dose of 200 mg twice daily for 16 weeks
Arm Title
Danazol monotherapy
Arm Type
Active Comparator
Arm Description
Danazol: A dose of 200 mg twice daily for 16 weeks
Intervention Type
Drug
Intervention Name(s)
Terbutaline
Intervention Description
Orally terbutaline at a dose of 2.5 mg three times daily for 16 weeks
Intervention Type
Drug
Intervention Name(s)
Danazol
Intervention Description
Orally danazol at a dose of 200 mg twice daily for 16 weeks
Primary Outcome Measure Information:
Title
Overall response
Description
Achieving a platelet count ≥ 30 × 10^9/L confirmed on at least two separate occasions (at least 7 days apart), at least a doubling of the baseline platelet count without any other ITP-specific treatment and the absence of bleeding.
Time Frame
From date of randomization until 1 years or the end of follow-up
Secondary Outcome Measure Information:
Title
Sustained response
Description
maintenance of a platelet count > 30 × 10^9/L, an absence of bleeding, and no requirement for any other ITP-specific treatment for 6 consecutive months after achievement of OR
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Complete response
Description
a platelet count ≥ 100 × 10^9/L measured on two occasions at least 7 days apart and the absence of bleeding
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Remission
Description
a durable platelet count > 30 × 109/L without bleeding up to 12 months after randomization
Time Frame
at 12-month follow-up
Title
Time to response
Description
the time from starting treatment to the time a response was achieved.
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Duration of response
Description
time from OR until loss of response or until the last follow-up visit
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Rescue therapy
Description
any new medical intervention taken to increase the platelet count or prevent bleeding events or an increase in the dose of concomitant treatments
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Associated factors of treatment failure, OR, SR and remission
Description
Factors that are associated with treatment failure, OR, SR and remission
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Number of patients with bleeding
Description
Number of patients with bleeding complication (WHO bleeding score)
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Number of patients with side effects
Description
Number of patients with Medication adverse events.
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Relapse
Description
Loss of OR
Time Frame
From date of randomization until 1 years or the end of follow-up
Title
Relapse-free survival
Description
the time interval between achievement of OR and relapse or the end of the follow-up
Time Frame
From date of randomization until 1 years or the end of follow-up
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients >18 years old with corticosteroid-resistant or relapsed ITP who had either a platelet count of <30×10^9/L or a platelet count of <50×10^9/L and clinically significant bleeding.
Not achieving a sustained response to therapy with full-dose corticosteroids for a duration of at least 4 weeks or relapsed during the process of corticosteroid tapering or discontinuation;
Platelet counts <30×10^9/L or platelet counts < 50×10^9/L and significant bleeding symptoms (WHO bleeding scale 2 or above);
Willing and able to sign written informed consent.
Exclusion Criteria:
Pregnant or lactating women;
Secondary ITP (have a known diagnosis of connective tissue diseases, malignancy, active infection, HIV infections or hepatitis B virus or hepatitis C virus infections);
Received drugs affecting the platelet counts within 6 months before the screening visit (e.g., chemotherapy, anticoagulants, etc);
Severe medical condition (lung, heart, hepatic or renal disorder);
Patients who are deemed unsuitable for the study by the investigator.
Patients who had hypertension, diabetes mellitus, hyperthyroidism or coronary heart disease.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Ye-Jun Wu, MD
Phone
13522338836
Email
wyejun1999@pku.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Xiao-Hui Zhang, MD
Organizational Affiliation
Peking University People's Hospital
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
The Combination of Terbutaline and Danazol as the Treatment of Corticosteroid-resistant/Relapse Immune Thrombocytopenia
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