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ICON1: Treatment Decisions and Outcomes in Pediatric Refractory ITP

Completed
Conditions
Immune Thrombocytopenia
Interventions
Drug: Second Line ITP agents
Registration Number
NCT01971684
Lead Sponsor
Boston Children's Hospital
Brief Summary

The purpose of this study is to understand physician treatment decisions in selecting specific second line treatments in pediatric ITP and to determine the effectiveness of different second line ITP treatments. Eligible patients are those ages 1-18 years who are starting on a new second line treatment for ITP, defined as any treatment other than IVIG, steroids, anti-D globulin, or aminocaproic acid. Enrolled patients remain on the study for approximately one year.

Detailed Description

The purpose of this observational study is to model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP and to determine the comparative effectiveness of second line ITP treatments by bleeding measures, platelet counts, and patient reported outcome measures. This prospective observational, longitudinal, multicenter cohort study will aim to collect routine clinical care data, quality of life information from patients, and decision making data from clinicians at enrollment and at regular clinical intervals for at least one year. The primary and secondary objectives are as follows:

Primary Objectives:

1. To model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP.

2. To assess patient reported outcomes with relation to specific second line pediatric ITP therapies.

3. To determine the comparative effectiveness of second line ITP treatments in terms of bleeding and platelet counts.

Secondary Objectives:

1. To describe phenotypic variation among patients with refractory ITP;

2. To assess side effects and complications related to specific treatments for refractory ITP;

3. To describe monitoring and follow up practices among pediatric hematologists with each second line agent;

4. To weight factors that physicians use when deciding to treat pediatric ITP patients with second line agents;

5. To determine whether physician perception of patient quality of life correlates with patient derived quality of life measures;

6. To measure the correlation between the ITP Bleeding Scale and the Bleeding Assessment Tool in refractory pediatric ITP patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Immune Thrombocytopenia or Evans Syndrome
  • Ages > 12 months to <18 years
  • Starting a new second line therapy as defined as any therapy except IVIG, steroids, anti-D globulin, or aminocaproic acid
  • Starting a single agent/monotherapy
Exclusion Criteria
  • Evans Syndrome with a history of or current evidence of autoimmune hemolytic anemia
  • Unwillingness to be followed for 1 year
  • Physician providing care is unwilling to participate
  • Patient is starting multiple second line agents simultaneously

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Refractory Pediatric ITP PatientsSecond Line ITP agentsPediatric ITP patients, ages 1-18, starting a new second line ITP therapy, defined as not IVIG, steroids, anti-D, or aminocaproic acid.
Primary Outcome Measures
NameTimeMethod
change from baseline in patient reported outcomesEnrollment, 1 and 12 months

Kids ITP Tool, Memorial Symptom Assessment Scale, Fatigue Scale

change from baseline in bleeding assessmentEnrollment, 1, 6, and 12 months

ITP Bleeding Scale, Bleeding Assessment Tool

change from baseline in platelet countover 1 year
Secondary Outcome Measures
NameTimeMethod
side effects and complications of treatments1 year

Trial Locations

Locations (29)

Children's Healthcare of Atlanta

🇺🇸

Atlanta, Georgia, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Ann & Robert H. Lurie Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

St. Jude's Hospital

🇺🇸

Memphis, Tennessee, United States

James Whitcomb Riley Hospital for Children

🇺🇸

Indianapolis, Indiana, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Cincinnati Children's Hospital

🇺🇸

Cincinnati, Ohio, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Seattle Children's

🇺🇸

Seattle, Washington, United States

UCSF School of Medicine

🇺🇸

San Francisco, California, United States

Oregon Health and Sciences University

🇺🇸

Portland, Oregon, United States

Colorado Children's Hospital

🇺🇸

Denver, Colorado, United States

St. John Hospital & Medical Center

🇺🇸

Detroit, Michigan, United States

Mattel Children's Hospital

🇺🇸

Los Angeles, California, United States

Children's Hospital of Orange County

🇺🇸

Orange, California, United States

Children's Hospital of Oakland

🇺🇸

Oakland, California, United States

Arkansas Children's Hospital

🇺🇸

Little Rock, Arkansas, United States

Lucile Packard Children's Hospital

🇺🇸

Palo Alto, California, United States

UC Davis Medical Center

🇺🇸

Sacramento, California, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Goryeb Children's Hospital

🇺🇸

Morristown, New Jersey, United States

New York-Presbyterian University Hospital of Columbia and Cornell

🇺🇸

New York, New York, United States

University of Texas Southwestern Medical Center at Dallas

🇺🇸

Dallas, Texas, United States

McMaster Children's Hospital

🇨🇦

Hamilton, Ontario, Canada

Children's Hospital of Eastern Ontario

🇨🇦

Ottawa, Ontario, Canada

U. de Montreal CHU St. Justine

🇨🇦

Montreal, Quebec, Canada

Hasbro Children's Hospital

🇺🇸

Providence, Rhode Island, United States

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