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Efficacy and Safety of Avatrombopag Combined With IST for the Treatment of HAAA and SAA With Abnormal Liver Function

Primary Purpose

Aplastic Anemia

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Avatrombopag 20 MG Oral Tablet
Sponsored by
Institute of Hematology & Blood Diseases Hospital, China
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Aplastic Anemia focused on measuring Avatrombopag, aplastic anemia, abnormal liver function, hepatitis

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. patients with V/SAA with a definite diagnosis.
  2. age between 18-70 years, male or female.
  3. Subjects must complete all screening assessments as outlined in the trial protocol.
  4. Able to swallow or administer the drug orally.
  5. No prior application of TPO receptor agonists (including Thrombopoietin, Eltrombopag, Hetrombopag, etc.) or application of TPO receptor agonists for treatment with ≤ 5 total doses and ≤ 7 days of TPO receptor agonist drugs such as Eltrombopag, Hetrombopag, etc.
  6. Diagnosis as HAAA or abnormal liver function. ALT and AST more than 1.5 times of upper limit.
  7. Informed consent must be signed prior to the start of all specific study procedures, in consideration of the patient's condition, or by a member of the patient's immediate family if the patient's signature is not conducive to the treatment of the condition.

Exclusion Criteria:

  1. Known diagnosis of congenital hematopoietic failure disorders (e.g. Fanconi anemia) and other causes of allogeneic cytopenias and bone marrow hypoproliferative disorders (e.g. hemolytic PNH, hypoproliferative MDS/AML, autoantibody-mediated allogeneic cytopenias, etc.);
  2. Patients with uncontrolled bleeding and/or infection despite standard treatment.
  3. Patients with previous history of hematopoietic stem cell transplantation; previous history of thrombosis.
  4. Patients with concurrent malignancy or potential cancer on immunosuppressive therapy.
  5. Those who are considered unsuitable for enrollment by the investigator.

Sites / Locations

  • Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical SciencesRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Avatrombopag+CsA+ p-ATG

Arm Description

Patients received p-ATG for 5 consecutive days (day 1-5), at a dose of 20 mg/kg/day. CSA is started at 3 mg/kg orally in two doses. Concentrations maintained at 200-250 ng/ml to achieve maximum efficacy and then tapered by 25 mg every 3 months; Avatrombopag: 40 mg orally once daily for a total of 12 weeks. A total of 39 patients were expected to be included.

Outcomes

Primary Outcome Measures

CR rate at 12 weeks of treatment
Percentage of the total number of patients receiving treatment who received a complete response at 12 weeks of treatment
ncidence of Treatment-Emergent Adverse Events as assessed by information on Common Toxicity Criteria (CTC) AE grading at 12 weeks of treatment
Incidence of Treatment-Emergent AE by CTCAE

Secondary Outcome Measures

OR rate at 12 weeks of treatment
Percentage of the total number of patients receiving treatment who received a response at 12 weeks of treatment

Full Information

First Posted
August 28, 2022
Last Updated
October 4, 2022
Sponsor
Institute of Hematology & Blood Diseases Hospital, China
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1. Study Identification

Unique Protocol Identification Number
NCT05571332
Brief Title
Efficacy and Safety of Avatrombopag Combined With IST for the Treatment of HAAA and SAA With Abnormal Liver Function
Official Title
Efficacy and Safety of Avatrombopag Combined With IST for the Treatment of HAAA and SAA With Abnormal Liver Function
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 28, 2022 (Actual)
Primary Completion Date
December 28, 2023 (Anticipated)
Study Completion Date
June 28, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Institute of Hematology & Blood Diseases Hospital, China

4. Oversight

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

5. Study Description

Brief Summary
This is a multicenter, single-arm clinical study. The objective was to evaluate the efficacy and safety of Avatrombopag combined with IST in very/sever aplastic anemia patients with abnormal liver function or HAAA patients treated for the first time. The design was: Patients received p-ATG for 5 consecutive days (day 1-5), at a dose of 20 mg/kg/day. Cyclosporine 3 mg/kg orally in two divided doses, with cyclosporine trough concentrations maintained at 200-250 ng/ml for 3 months to achieve maximum efficacy, and Avatrombopag, which was administered in the dose of 40 mg orally once daily for a total of 12 weeks. Thirty-nine patients are expected to be enrolled in this study. Evaluation endpoint: complete response rate at 12 weeks of treatment.
Detailed Description
This is a multicenter, single-arm clinical study to evaluate the efficacy and safety of Avatrombopag combined with IST as the first-line regimen for aplastic anemia. The patients are diagnosed as hepatitis associated with very sever/sever aplastic anemia(V/SAA) or V/SAA with abnormal liver function before treatment. Patients received p-ATG for 5 consecutive days (day 1-5), at a dose of 20 mg/kg/day. CSA is started at 3 mg/kg orally in two doses. Concentrations maintained at 200-250 ng/ml to achieve maximum efficacy and then tapered by 25 mg every 3 months; Avatrombopag: 40 mg orally once daily for a total of 12 weeks. A total of 39 patients were expected to be included.Complete response rate at 12 weeks of treatment and adverse events are the evaluation endpoint.Secondary study endpoints were: ORR at 12 , CRR and ORR at 24 weeks, survival, and clonal evolution in follow-up.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Aplastic Anemia
Keywords
Avatrombopag, aplastic anemia, abnormal liver function, hepatitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
39 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Avatrombopag+CsA+ p-ATG
Arm Type
Experimental
Arm Description
Patients received p-ATG for 5 consecutive days (day 1-5), at a dose of 20 mg/kg/day. CSA is started at 3 mg/kg orally in two doses. Concentrations maintained at 200-250 ng/ml to achieve maximum efficacy and then tapered by 25 mg every 3 months; Avatrombopag: 40 mg orally once daily for a total of 12 weeks. A total of 39 patients were expected to be included.
Intervention Type
Drug
Intervention Name(s)
Avatrombopag 20 MG Oral Tablet
Other Intervention Name(s)
porcine ATG, Cyclosporine(CsA)
Intervention Description
p-ATG and CsA in combination with Avatrombopag to treat
Primary Outcome Measure Information:
Title
CR rate at 12 weeks of treatment
Description
Percentage of the total number of patients receiving treatment who received a complete response at 12 weeks of treatment
Time Frame
12 weeks of treatment
Title
ncidence of Treatment-Emergent Adverse Events as assessed by information on Common Toxicity Criteria (CTC) AE grading at 12 weeks of treatment
Description
Incidence of Treatment-Emergent AE by CTCAE
Time Frame
12 weeks of treatment
Secondary Outcome Measure Information:
Title
OR rate at 12 weeks of treatment
Description
Percentage of the total number of patients receiving treatment who received a response at 12 weeks of treatment
Time Frame
12 weeks of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: patients with V/SAA with a definite diagnosis. age between 18-70 years, male or female. Subjects must complete all screening assessments as outlined in the trial protocol. Able to swallow or administer the drug orally. No prior application of TPO receptor agonists (including Thrombopoietin, Eltrombopag, Hetrombopag, etc.) or application of TPO receptor agonists for treatment with ≤ 5 total doses and ≤ 7 days of TPO receptor agonist drugs such as Eltrombopag, Hetrombopag, etc. Diagnosis as HAAA or abnormal liver function. ALT and AST more than 1.5 times of upper limit. Informed consent must be signed prior to the start of all specific study procedures, in consideration of the patient's condition, or by a member of the patient's immediate family if the patient's signature is not conducive to the treatment of the condition. Exclusion Criteria: Known diagnosis of congenital hematopoietic failure disorders (e.g. Fanconi anemia) and other causes of allogeneic cytopenias and bone marrow hypoproliferative disorders (e.g. hemolytic PNH, hypoproliferative MDS/AML, autoantibody-mediated allogeneic cytopenias, etc.); Patients with uncontrolled bleeding and/or infection despite standard treatment. Patients with previous history of hematopoietic stem cell transplantation; previous history of thrombosis. Patients with concurrent malignancy or potential cancer on immunosuppressive therapy. Those who are considered unsuitable for enrollment by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Fengkui Zhang, Dr.
Phone
+8602223909229
Email
zhangfenkui@ihcams.ac.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Wenrui Yang, Dr.
Phone
+8602223909223
Email
yangwenrui@ihcams.ac.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wenrui Yang
Organizational Affiliation
Anemia Therapeutic center
Official's Role
Study Director
Facility Information:
Facility Name
Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences
City
Tianjin
State/Province
Tianjin
ZIP/Postal Code
300020
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fengkui Zhang, Doctor
Phone
8602223909229
Email
fkzhang@ihcams.ac.cn
First Name & Middle Initial & Last Name & Degree
Liping Jing, Doctor
Phone
8602223909223
Email
jingliping@ihcams.ac.cn

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
You can ask for the researcher after completing the experiment
IPD Sharing Time Frame
Follow-up and publication of the paper are planned for December 2024
IPD Sharing Access Criteria
After the paper is written and published
Citations:
PubMed Identifier
18379007
Citation
Young NS, Kaufman DW. The epidemiology of acquired aplastic anemia. Haematologica. 2008 Apr;93(4):489-92. doi: 10.3324/haematol.12855. No abstract available.
Results Reference
result
PubMed Identifier
30504345
Citation
Scheinberg P. Activity of eltrombopag in severe aplastic anemia. Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):450-456. doi: 10.1182/asheducation-2018.1.450.
Results Reference
result

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Efficacy and Safety of Avatrombopag Combined With IST for the Treatment of HAAA and SAA With Abnormal Liver Function

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