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A Study of Efgartigimod IV in Participants From 12 Years to Less Than 18 Years of Age With Chronic Immune Thrombocytopenia (ITP)

Not Applicable
Not yet recruiting
Conditions
Immune Thrombocytopenia (ITP)
Immune Thrombocytopenic Purpura
Immune Thrombocytopenic Purpura ( ITP )
ITP - Immune Thrombocytopenia
ITP
Idiopathic Thrombocytopenic Purpura
Idiopathic Thrombocytopenic Purpura (ITP)
Interventions
Biological: Efgartigimod IV
Other: Placebo IV
Registration Number
NCT07194850
Lead Sponsor
argenx
Brief Summary

The main purpose of this study is to confirm the correct dose of efgartigimod IV for treating patients aged 12 to younger than 18 years with chronic immune thrombocytopenia (ITP).

The study consists of a double-blinded treatment period (DBTP) in which the participants will be randomized in a 2:1 ratio to receive either efgartigimod IV or placebo IV. At the end of the treatment period (up to 24 weeks), all participants will receive efgartigimod IV during the first year open-label treatment period (OLTP1). At the end of the first OLTP1, participants may begin a second year (OLTP2). After the OLTP2, the participants will enter a follow-up period (approximately 8 weeks) while off study drug. The participants will be in the study for up to 138 weeks

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
24
Inclusion Criteria
  • Is aged 12 to less than 18 years when completing the informed consent process
  • Has a documented duration of primary ITP of more than 12 months on the date the informed consent process is complete
  • Has documented prior ITP treatment with at least 1 of the following treatments: corticosteroids, IVIg, anti-D immunoglobulin, thrombopoietin receptor agonist (TPO-RAs), or rituximab.
  • Has documented prior response, defined as 1 platelet count of ≥50 × 10^9/L to at least 1 of the following ITP treatments: prednisone, other or nonspecified corticosteroids, IVIg, or anti-D immunoglobulin
  • Has documented insufficient response to a prior ITP treatment with corticosteroids, IVIg, anti-D immunoglobulin, TPO-RAs, rituximab, or splenectomy
  • Has documented mean platelet count of less than 30 x10^9/L
Exclusion Criteria
  • Secondary ITP according to the following definition by the International Working Group (IWG): all forms of immune-mediated thrombocytopenia except primary ITP
  • Nonimmune thrombocytopenia
  • ITP-associated critical or severe bleeding
  • History of hereditary thrombocytopenia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Efgartigimod IVEfgartigimod IVParticipants receiving efgartigimod IV during the double-blinded treatment period and the open-label treatment period(s)
Placebo IVEfgartigimod IVParticipants receiving placebo IV during the double-blinded treatment period and receiving efgartigimod IV during the open-label treatment period(s)
Placebo IVPlacebo IVParticipants receiving placebo IV during the double-blinded treatment period and receiving efgartigimod IV during the open-label treatment period(s)
Primary Outcome Measures
NameTimeMethod
Efgartigimod serum concentrations in the DBTPUp to 24 weeks
Total IgG levels in the DBTPUp to 24 weeks
Secondary Outcome Measures
NameTimeMethod
Efgartigimod serum concentrations over time during the DBTPUp to 24 weeks
Percent change from baseline in total IgG levels in serum over time during the DBTPUp to 24 weeks
Incidence of AEs, SAEs and AEs leading to IMP discontinuationUp to 136 weeks

SAE: Serious adverse event; AE: adverse event

Sustained platelet count response between study weeks 19 and 24 of the DBTP and in OLTP1 for participants receiving placebo in the DBTPUp to 48 weeks

Sustained platelet count defined as achieving platelet counts of ≥50 × 10\^9/L for at least 4 of the 6 study visits

Extent of disease control during the DBTP and during the first 24 weeks of OLTP1 for those participants receiving placebo in the DBTPUp to 48 weeks

Extend of disease defined as the number of cumulative weeks with a platelet count of ≥50 × 10\^9/L

Changes from baseline for platelet counts over timeUp to 76 weeks
Incidence of bleeding, assessed by the Modified Buchanan and Adix Bleeding Score for pediatric ITPUp to 76 weeks

The Modified Buchanan and Adix Bleeding Score for pediatric ITP is a semiquantitative assessment tool that measures bleeding signs and symptoms, comprising a score based on a scale of 0 to 5, each representing a different level of severity (0 = no risk; 5 = highest severity).

Incidence of ADA and Nab against efgartigimod in serumUp to 76 weeks

ADA: anti-drug antibodies; Nab: neutralizing antibodies

Change from baseline in EQ-5D-5LUp to 76 weeks

The European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L) is a questionnaire comprised of 5 dimensions. Participants are asked to select the statement in each dimension which best describes their health on the day they complete the questionnaire. Responses in each dimension are coded as a 1-digit number ranging from 1 (no problems) to 5 (extreme problems).

Change from baseline in KIT Child Self-Report and KIT Parent Impact ReportUp to 76 weeks

The Kids' ITP Tools (KIT) comprises two disease- specific tools: a self-report form for children aged 12 and older, and a parent impact form. Respondents provide insights into their disease experience using a 1-week recall period. The instrument generates a total score, calculated by summing the items and converting them to a scale of 0 to 100, where higher scores reflect a better disease-specific quality of life (QoL).

Change from baseline in peds FACIT-FUp to 76 weeks

In all participants, the pediatric Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) will use to assess health-related quality of life (HRQoL) before and after treatment. The FACIT-F questionnaire has a score range of 0 to 52, where 0 represents the worst possible fatigue and 52 indicates no fatigue.

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