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The Combination of Terbutaline and Danazol as the Treatment of Steroid-resistant/Relapse Immune Thrombocytopenia

Phase 2
Conditions
Immune Thrombocytopenia
Interventions
Registration Number
NCT04481282
Lead Sponsor
Peking University People's Hospital
Brief Summary

Single-arm, open-label, single center study to assess the efficacy and safety of terbutaline plus danazol in patients with corticosteroid resistant/relapsed ITP.

Detailed Description

Immune thrombocytopenia (ITP) is a severe bleeding disorder. Approximately 2/3 of patients achieve remission from first-line therapies. However, the underlying mechanism of corticosteroid-resistant or relapsed ITP is not well understood; thus, treatment remains a great challenge. β2-AR agonist terbutaline modulates T cell differentiation and effector cell function.

A single center prospective study was performed in non-splenectomized ITP patients who were either resistant to a standard dose of corticosteroids or had relapsed. Patients were assigned to terbutaline plus danazol group. Platelet count, bleeding and other symptoms were evaluated before and after treatment. Adverse events are also recorded throughout the study, in order to assess the efficacy and safety of terbutaline plus danazol in patients with corticosteroid-resistant/relapsed ITP.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • ITP confirmed by excluding other supervened causes of thrombocytopenia;
  • Platelet count of less than 30×10^9/L at enrollment;
  • Patients who did not achieve a sustained response to treatment with full dose corticosteroids for a minimum duration of 4 weeks or who relapsed during steroid-tapering or after its discontinuation;
  • Subject has signed and dated written informed consent.
  • Fertile patients must use effective contraception during treatment and observational period
  • Negative pregnancy test.
Exclusion Criteria
  • Secondary immune thrombocytopenia (e.g., patients with HIV, HCV, Helicobacter pylori infection or patients with systemic lupus erythematosus)
  • congestive heart failure
  • severe arrhythmia
  • nursing or pregnant women
  • aspartate aminotransferase and alanine transaminase levels ≥ 3× the upper limit of the normal threshold criteria
  • creatinine or serum bilirubin levels each 1•5 times or more than the normal range
  • active or previous malignancy
  • Unable to do blood routine test for the sake of time, distance, economic issues or other reasons.
  • diagnosis with any of the following diseases: chronic hypertension, hyperthyroidism, diabetes, or seizure disorder.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Terbutaline plus Danazol groupTerbutalineTerbutaline 2.5mg tid po plus danazol 200mg bid po for 12weeks
Terbutaline plus Danazol groupDanazolTerbutaline 2.5mg tid po plus danazol 200mg bid po for 12weeks
Primary Outcome Measures
NameTimeMethod
Sustained response6 months

The maintenance of platelet count ≥ 30 x 10\^9/L, at least 2-fold increase of the baseline count, the absence of bleeding, and no need for rescue medication at the 6-month follow-up. Interim analysis was scheduled at 50% through recruitment.

Secondary Outcome Measures
NameTimeMethod
complete remission6 months

The number of participants (responders) with platelet count\>=100x10\^9/L (CR) and the absence of bleeding.

partial remission6 months

The number of participants (responders) with platelet count \>=30x10\^9/L and at least a 2-fold increase in the baseline count (PR) without the administration of any other platelet increasing therapy.

duration of response6 months

Duration of response was measured from the achievement of response to the loss of response.

time to response6 months

Time to response was defined as the time from starting treatment to the time to achieve the response. Interim analysis

incidence of treatment-emergent adverse events6 months

Adverse events were scaled according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

Trial Locations

Locations (1)

Peking University Insititute of Hematology, Peking University People's Hospital

🇨🇳

Beijing, Beijing, China

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