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Clinical Trial in Patients Diagnosed With Immune Thrombocytopenic Purpura (ITP)

Primary Purpose

Immune (Idiopathic) Thrombocytopenic Purpura

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
IGIV3I Grifols
Sponsored by
Instituto Grifols, S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Immune (Idiopathic) Thrombocytopenic Purpura

Eligibility Criteria

18 Years - 82 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Be aged between 18 and 82 at the time of written consent.
  2. Have confirmed diagnosis of chronic ITP and fulfil all the following criteria:

    • irrelevant history except for the symptoms of bleeding,
    • pattern of bleedings associated with platelet disorders,
    • physical examination irrelevant for the ITP, except for the signs of bleeding,
    • isolated thrombocytopenia in the blood count; apart from thrombocytopenia, the blood count is normal for the patient's age, or if abnormal, readily explained,
    • peripheral blood smear consistent with ITP: thrombocytopenia with platelets of normal size or slightly larger than normal, with absence of platelet clumps and giant platelets; normal red blood cell and white blood cell morphology,
    • confirmed diagnosis of immune thrombocytopenic purpura or, when any abnormal finding is present, additional diagnostic evaluation excludes other causes of thrombocytopenia.
    • Previous known diagnosis of ITP for at least 3 months.
  3. To show a platelet count platelet count ≤ 20x10^9/L at the moment of the first infusion with the study product.
  4. Have read the patient information and consent sheet, agreed to participate in the trial, and signed the consent sheet.
  5. Be expected to receive treatment over 5 days and follow-up for 3 months.
  6. For women of childbearing age, use adequate contraceptive method such as oral contraceptives, intrauterine device or tubal ligation during one-month period after the first infusion in the study.

Exclusion Criteria:

  1. Have immune thrombocytopenia secondary to other pathologies or drug mediated thrombocytopenia.
  2. Have a known diagnosis of other autoimmune diseases, established in the medical history and laboratory findings with positive results for the determination of antinuclear antibodies, anti-cardiolipin antibodies, lupus anticoagulant or direct Coombs test.
  3. Present important active bleeding due to other reasons apart from the ITP.
  4. Exhibit an identifiable alternative cause of their thrombocytopenia, such as splenomegaly, family thrombocytopenia, bacteraemia, sepsis or active infection requiring or not therapy.
  5. Are presenting renal dysfunction.
  6. Have non-controlled arterial hypertension.
  7. Have documented liver cirrhosis or any hepatic disorder with alanine aminotransferase (ALT) levels 2.5 times or more than the normal upper limit or bilirubin greater than 2 mg/dL.
  8. Are presenting a cardiac disease including a history of coronary artery disease, angina pectoris or congestive heart failure.
  9. Present known infection due to HIV or hepatitis C virus (HCV).
  10. Have been previously treated with IVIG or anti-D immunoglobulin being unresponsive.
  11. Have a history of serious adverse reactions or non-serious but frequent adverse reactions to intravenous immune globulin (IVIG) preparations or other products derived from blood.
  12. Have known allergies to any IGIV3I Grifols components, such as D-sorbitol.
  13. Are simultaneously participating in other clinical studies or have received an investigational drug in the 3 months prior to the start of the study.
  14. Have been involved in the present study and being treated with the formulation at 5% (IGIV3I Grifols 5%).
  15. Have conditions that might affect patient compliance.
  16. Are unable to provide a storage serum sample just before the first dose of IGIV3I Grifols.
  17. Are pregnant or nursing an infant child or unwilling to practice adequate birth control in 1-month period after the first infusion in the study.

Sites / Locations

  • Federal Research Clinical Centre of Pediatric Hematology, Oncology and Immunology Roszdrava
  • Haematology Research Centre of Russian Academy of Medical Science
  • Hospital General Vall d´Hebron
  • . Hospital de León
  • Hospital General Universitario La Paz
  • Hospital Universitario La Fe
  • Hillingdon Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

1 treatment group with IGIV3I Grifols

Arm Description

Open label, non-randomized treatment group with IGIV3I Grifols Each patient received a total dose of 2 g/kg IGIV3I Grifols, given intravenously over either 2 days or 5 days in divided doses.

Outcomes

Primary Outcome Measures

Responder Patients
The primary efficacy endpoint was the proportion of patients who reached a platelet count ≥ 50x10^9/L.

Secondary Outcome Measures

Maximum Platelet Level Reached During the Follow-up Period
Platelet count was measured at various time points in the follow-up period after infusion.
Time to Reach Platelet Count ≥ 50x10^9/L (≤ Days)
The time taken for the platelet count to reach ≥ 50x10^9/L from first dose
Length of Time Platelet Count Remains ≥ 50x10^9/L (≥ Days)
Length of time platelet count remained ≥ 50x10^9/L from first dose (Day 1)
Regression of Hemorrhages.
Percentage of subjects with regression of hemorrhages of Types 1 to 3: Type 0: Patients without symptoms of bleeding at the first infusion continue without presenting spontaneous bleeding Type 1: Patients with bleeding symptoms at the first infusion had a reduction of the size of large ecchymoses, and no spontaneous appearance of new ecchymoses Type 2: Patients with bleeding symptoms at the first infusion had a decrease in the number of cutaneous petechiae, or the extent of the affected area of the body decreased Type 3: Patients had active mucosal bleedings at the first infusion, these episodes stopped without re-bleeding, and there was no occurrence of new spontaneous mucosal hemorrhages (e.g., gingival bleeding, epistaxis)
Frequency of Adverse Reactions During and After Infusions by Percentage of Patients
All adverse events (AEs) are tabulated and summarized. The incidence, severity, and causal relationship of the AEs to IGIV3I Grifols are presented by system organ class after medical coding according to the version 15.0 of Medical Dictionary for Regulatory Activities (MedDRA). The frequency of patients with at least one AE and adverse drug reactions are estimated.
Frequency of Adverse Reactions During and After Infusions by Percentage of Infusions
All adverse events (AEs) are tabulated and summarized. The incidence, severity, and causal relationship of the AEs to IGIV3I Grifols are presented by system organ class after medical coding according to the version 15.0 of Medical Dictionary for Regulatory Activities (MedDRA). The frequency of infusions associated with at least one AE and adverse drug reactions are estimated.
Changes in Vital Signs and Clinically Relevant Changes in Laboratory Parameters After the Infusions, Including Renal Function (Creatinine Levels)
Laboratory parameters at each treatment day and visit are summarized by patient. Results were marked as normal/abnormal (whether the result is below, within or above the respective reference range) and relevant/irrelevant (as determined by the investigator). The number of abnormal values considered clinically relevant changes (based on the investigator's judgment) was listed.
Viral Safety Through the Investigation of Patients Virology Status (Hepatitis A Virus [HA
The results of HIV-1 and -2 antibodies, HCV antibody, HBsAg, HBV antibodies, HAV antibodies, HIV nucleic acid amplification test [NAT], and HCV NAT on Day 1, Day 14, and at Month 1, Month 2 and Month 3 were recorded for several of these markers (as appropriate). A comparison of negative viral markers on Day 1 and Month 3 was performed

Full Information

First Posted
June 16, 2008
Last Updated
January 9, 2016
Sponsor
Instituto Grifols, S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT00699140
Brief Title
Clinical Trial in Patients Diagnosed With Immune Thrombocytopenic Purpura
Acronym
ITP
Official Title
Clinical Trial to Evaluate the Efficacy and the Safety of IGIV3I Grifols 10% (Human Intravenous Immunoglobulin) in Patients Diagnosed With Immune Thrombocytopenic Purpura
Study Type
Interventional

2. Study Status

Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
February 2008 (undefined)
Primary Completion Date
December 2013 (Actual)
Study Completion Date
December 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Instituto Grifols, S.A.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether IGIV3I Grifols 10% is effective in the treatment of immune thrombocytopenic purpura.
Detailed Description
To determine if IGIV3I Grifols 10% is a consistently effective treatment in patients diagnosed with immune thrombocytopenic purpura with respect to: Increase of platelet count ≥ 50x10^9/L (primary objective). Time taken for the platelet count to reach ≥ 50x10^9/L. The length of time the platelet count remains ≥ 50x10^9/L. The maximum platelet level. Regression of bleeding episodes during the first 10 or 14 days. To determine if IGIV3I Grifols 10% is safe with respect to: Nature, severity and frequency of adverse reactions during and after infusions by percentage of subjects and percentage of infusions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immune (Idiopathic) Thrombocytopenic Purpura

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1 treatment group with IGIV3I Grifols
Arm Type
Experimental
Arm Description
Open label, non-randomized treatment group with IGIV3I Grifols Each patient received a total dose of 2 g/kg IGIV3I Grifols, given intravenously over either 2 days or 5 days in divided doses.
Intervention Type
Biological
Intervention Name(s)
IGIV3I Grifols
Other Intervention Name(s)
IGIV
Intervention Description
Immune Globulin Intravenous (Human)
Primary Outcome Measure Information:
Title
Responder Patients
Description
The primary efficacy endpoint was the proportion of patients who reached a platelet count ≥ 50x10^9/L.
Time Frame
At any time during the study period (The platelet count was measured at Days 1-6, 10, 14. 21, 30, 60, 90).
Secondary Outcome Measure Information:
Title
Maximum Platelet Level Reached During the Follow-up Period
Description
Platelet count was measured at various time points in the follow-up period after infusion.
Time Frame
During the follow-up period (time points: Days 6, 10, 14, 21, 30, 60, 90 post-first infusion day [Day 1])
Title
Time to Reach Platelet Count ≥ 50x10^9/L (≤ Days)
Description
The time taken for the platelet count to reach ≥ 50x10^9/L from first dose
Time Frame
At any time during the study period (time points: Days 1-6, 10, 14, 21, 30, 60, 90 post-first infusion day [Day 1])
Title
Length of Time Platelet Count Remains ≥ 50x10^9/L (≥ Days)
Description
Length of time platelet count remained ≥ 50x10^9/L from first dose (Day 1)
Time Frame
At any time during the study period (up to 3 months [90 days])
Title
Regression of Hemorrhages.
Description
Percentage of subjects with regression of hemorrhages of Types 1 to 3: Type 0: Patients without symptoms of bleeding at the first infusion continue without presenting spontaneous bleeding Type 1: Patients with bleeding symptoms at the first infusion had a reduction of the size of large ecchymoses, and no spontaneous appearance of new ecchymoses Type 2: Patients with bleeding symptoms at the first infusion had a decrease in the number of cutaneous petechiae, or the extent of the affected area of the body decreased Type 3: Patients had active mucosal bleedings at the first infusion, these episodes stopped without re-bleeding, and there was no occurrence of new spontaneous mucosal hemorrhages (e.g., gingival bleeding, epistaxis)
Time Frame
First 10 to14 days since the first infusion day (Day 1)
Title
Frequency of Adverse Reactions During and After Infusions by Percentage of Patients
Description
All adverse events (AEs) are tabulated and summarized. The incidence, severity, and causal relationship of the AEs to IGIV3I Grifols are presented by system organ class after medical coding according to the version 15.0 of Medical Dictionary for Regulatory Activities (MedDRA). The frequency of patients with at least one AE and adverse drug reactions are estimated.
Time Frame
At any time during the study period (from patient's signature of the informed consent form until 3 months of follow-up)
Title
Frequency of Adverse Reactions During and After Infusions by Percentage of Infusions
Description
All adverse events (AEs) are tabulated and summarized. The incidence, severity, and causal relationship of the AEs to IGIV3I Grifols are presented by system organ class after medical coding according to the version 15.0 of Medical Dictionary for Regulatory Activities (MedDRA). The frequency of infusions associated with at least one AE and adverse drug reactions are estimated.
Time Frame
At any time during the study period (from patient's signature of the informed consent form until 3 months of follow-up)
Title
Changes in Vital Signs and Clinically Relevant Changes in Laboratory Parameters After the Infusions, Including Renal Function (Creatinine Levels)
Description
Laboratory parameters at each treatment day and visit are summarized by patient. Results were marked as normal/abnormal (whether the result is below, within or above the respective reference range) and relevant/irrelevant (as determined by the investigator). The number of abnormal values considered clinically relevant changes (based on the investigator's judgment) was listed.
Time Frame
At any time during the study period (from patient's signature of the informed consent form until 3 months of follow-up)
Title
Viral Safety Through the Investigation of Patients Virology Status (Hepatitis A Virus [HA
Description
The results of HIV-1 and -2 antibodies, HCV antibody, HBsAg, HBV antibodies, HAV antibodies, HIV nucleic acid amplification test [NAT], and HCV NAT on Day 1, Day 14, and at Month 1, Month 2 and Month 3 were recorded for several of these markers (as appropriate). A comparison of negative viral markers on Day 1 and Month 3 was performed
Time Frame
At any time during the study period (from patient's signature of the informed consent form until 3 months of follow-up)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
82 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be aged between 18 and 82 at the time of written consent. Have confirmed diagnosis of chronic ITP and fulfil all the following criteria: irrelevant history except for the symptoms of bleeding, pattern of bleedings associated with platelet disorders, physical examination irrelevant for the ITP, except for the signs of bleeding, isolated thrombocytopenia in the blood count; apart from thrombocytopenia, the blood count is normal for the patient's age, or if abnormal, readily explained, peripheral blood smear consistent with ITP: thrombocytopenia with platelets of normal size or slightly larger than normal, with absence of platelet clumps and giant platelets; normal red blood cell and white blood cell morphology, confirmed diagnosis of immune thrombocytopenic purpura or, when any abnormal finding is present, additional diagnostic evaluation excludes other causes of thrombocytopenia. Previous known diagnosis of ITP for at least 3 months. To show a platelet count platelet count ≤ 20x10^9/L at the moment of the first infusion with the study product. Have read the patient information and consent sheet, agreed to participate in the trial, and signed the consent sheet. Be expected to receive treatment over 5 days and follow-up for 3 months. For women of childbearing age, use adequate contraceptive method such as oral contraceptives, intrauterine device or tubal ligation during one-month period after the first infusion in the study. Exclusion Criteria: Have immune thrombocytopenia secondary to other pathologies or drug mediated thrombocytopenia. Have a known diagnosis of other autoimmune diseases, established in the medical history and laboratory findings with positive results for the determination of antinuclear antibodies, anti-cardiolipin antibodies, lupus anticoagulant or direct Coombs test. Present important active bleeding due to other reasons apart from the ITP. Exhibit an identifiable alternative cause of their thrombocytopenia, such as splenomegaly, family thrombocytopenia, bacteraemia, sepsis or active infection requiring or not therapy. Are presenting renal dysfunction. Have non-controlled arterial hypertension. Have documented liver cirrhosis or any hepatic disorder with alanine aminotransferase (ALT) levels 2.5 times or more than the normal upper limit or bilirubin greater than 2 mg/dL. Are presenting a cardiac disease including a history of coronary artery disease, angina pectoris or congestive heart failure. Present known infection due to HIV or hepatitis C virus (HCV). Have been previously treated with IVIG or anti-D immunoglobulin being unresponsive. Have a history of serious adverse reactions or non-serious but frequent adverse reactions to intravenous immune globulin (IVIG) preparations or other products derived from blood. Have known allergies to any IGIV3I Grifols components, such as D-sorbitol. Are simultaneously participating in other clinical studies or have received an investigational drug in the 3 months prior to the start of the study. Have been involved in the present study and being treated with the formulation at 5% (IGIV3I Grifols 5%). Have conditions that might affect patient compliance. Are unable to provide a storage serum sample just before the first dose of IGIV3I Grifols. Are pregnant or nursing an infant child or unwilling to practice adequate birth control in 1-month period after the first infusion in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
María Teresa Álvarez, MD
Organizational Affiliation
Hospital General Universitario La Paz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Federal Research Clinical Centre of Pediatric Hematology, Oncology and Immunology Roszdrava
City
Moscow
Country
Russian Federation
Facility Name
Haematology Research Centre of Russian Academy of Medical Science
City
Moscow
Country
Russian Federation
Facility Name
Hospital General Vall d´Hebron
City
Barcelona
Country
Spain
Facility Name
. Hospital de León
City
Leon
Country
Spain
Facility Name
Hospital General Universitario La Paz
City
Madrid
Country
Spain
Facility Name
Hospital Universitario La Fe
City
Valencia
Country
Spain
Facility Name
Hillingdon Hospital
City
Middlesex
ZIP/Postal Code
UB8 3NN
Country
United Kingdom

12. IPD Sharing Statement

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Clinical Trial in Patients Diagnosed With Immune Thrombocytopenic Purpura

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