A Randomised Platform Trial Evaluating the Role of Interventions to Prevent Infection in Patients With Acquired Hypogammaglobulinemia Secondary to Haematological Malignancies - RATIONAL-PT (Core)
试验速览
- 阶段
- 2 期
- 状态
- 招募中
- 入组人数
- 900
- 试验地点
- 3
- 主要终点
- Event-free survival (EFS)
研究概览
简要总结
This is an adaptive platform study to find out how safe and effective different strategies are in comparison to each other, for preventing infection in patients with blood cancers.
It is a comparison between Immunoglobulin and antibiotics use.
详细描述
This study is being conducted to find out how safe and effective different strategies of infection prevention are in comparison to each other, for preventing infection in patients with blood cancers. The best way to find out this information is to directly compare the effect of different treatment strategies in patients with blood cancers. We want to know how these different treatments impact on your health and your use of healthcare services.
This research project uses an Adaptive Platform Design. This design allows the researchers to compare multiple infection prevention strategies within the same trial at the same time (rather than running separate trials), to analyse results as the trial occurs and to add new research questions during the course of the trial.
The treatments that you may receive as part of the study will be determined by which domain(s) of the platform you participate in. By combining data collected within each domain as part of the platform, the researchers can investigate and compare treatment strategies and infection outcomes across a broader range of participants.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
An independent outcome adjudication committee will meet to review and adjudicate infection outcome data. These committee members will be blinded to treatment allocation.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged greater than or equal to 18 years of age
- •Diagnosis of haematological malignancy, including (CLL) chronic lymphocytic leukemia, (MM) multiple myeloma or (NHL) non-Hodgkin's lymphoma.
- •Eligible to receive or currently receiving Ig (IV or subcutaneous - SCIg) replacement for history of recurrent or severe infection(s) and IgG less than the lower limit of the reference range (excluding paraprotein) OR IgG<4g/L (excluding paraprotein)
- •Life expectancy > 12 months
- •Able to give informed consent
排除标准
- •1. Treating team deems enrolment in the study is not in the best interests of the patient.
研究组 & 干预措施
Dose Immunoglobulin
Patients receiving IVIg are randomly assigned to:
- Continue with standard dose (0.4 g/kg)
- Switch to a lower dose (0.25 g/kg)
干预措施: Intravenous immunoglobulin (IVIG) (Biological)
Start Immunoglobulin
Patients eligible to start immunoglobulin are randomly assigned to:
- receive either prophylactic antibiotic
- or Ig replacement.
干预措施: Intravenous immunoglobulin (Biological)
Start Immunoglobulin
Patients eligible to start immunoglobulin are randomly assigned to:
- receive either prophylactic antibiotic
- or Ig replacement.
干预措施: Trimethoprim / Sulfamethoxazole (Drug)
Stop Immunoglobulin
Patients eligible to stop immunoglobulin are randomly assigned to:
- Stop Ig and take daily antibiotics
- Stop Ig and take antibiotics only when infections occur
- Continue Ig therapy
干预措施: Intravenous immunoglobulin (Biological)
Stop Immunoglobulin
Patients eligible to stop immunoglobulin are randomly assigned to:
- Stop Ig and take daily antibiotics
- Stop Ig and take antibiotics only when infections occur
- Continue Ig therapy
干预措施: Trimethoprim / Sulfamethoxazole (Drug)
Stop Immunoglobulin
Patients eligible to stop immunoglobulin are randomly assigned to:
- Stop Ig and take daily antibiotics
- Stop Ig and take antibiotics only when infections occur
- Continue Ig therapy
干预措施: Amoxicillin clavulanic acid (Drug)
结局指标
主要结局
Event-free survival (EFS)
时间窗: 12 months following randomisation (or, in domains with a single treatment arm, time from registration)
Defined as time from randomisation (or, in domains with a single treatment arm, time from registration) until occurrence of a Grade 3 or higher infection (as defined by CTCAE Version 5), or death from any cause.
次要结局
- Occurrence of at least one Grade 3 or higher infection(s) from randomisation to 12 months(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Occurrence of one or more clinically documented infections (symptoms/signs of infection requiring antimicrobial treatment) from randomisation to 12 months.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Number of clinically documented infections (symptoms/signs of infection requiring antimicrobial treatment) from randomisation to 12 months.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Occurrence of one or more microbiologically documented infections from randomisation to 12 months.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Number of microbiologically documented infections from randomisation to 12 months.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- All-cause mortality at 12 months(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Infection-related mortality at 12 months(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Time free from hospitalisation with antimicrobial administration with therapeutic intent from randomisation to 12 months.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Occurrence of one or more treatment-related adverse events(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Number of treatment-related adverse events.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Isolation of fluoroquinolone resistant organisms, co-trimoxazole resistant organisms, extended spectrum beta lactamases or multidrug resistant organisms from randomisation to 12 months(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Number of infections with fluoroquinolone resistant organisms, co-trimoxazole resistant organisms, extended spectrum beta lactamases or multidrug resistant organisms isolated from randomisation to 12 months(12 months following randomisation (or, in domains with a single treatment arm, time from registration))
- Quality of Life (QoL) measured at randomisation then 3, 6, 9 and 12 months, using the questionnaire.(Randomisation, Month 3, Month 6, Month 9 and Month 12)
- Costs associated with allocated treatment arm and infections during study.(12 months following randomisation (or, in domains with a single treatment arm, time from registration))