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Completed

NCT Number: NCT00540423

Clinical Evaluation of SB-497115-GR in Chronic Idiopathic Thrombocytopenic Purpura (ITP)

This is a Phase II/III multicenter study comprising of the double-blind, followed by open-label phases to evaluate and compare the efficacy and tolerability of eltrombopag (SB-497115-GR) in chronic ITP patients

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Key information

Conditions

Chronic Idiopathic Thrombocytopenic Purpura Autoimmune Diseases Blood Coagulation Disorders Blood Platelet Disorders Cytopenia Hematologic Diseases Hemic and Lymphatic Diseases Hemorrhage Hemorrhagic Disorders Immune System Diseases Jacobs syndrome Pathologic Processes Pathological Conditions, Signs and Symptoms Purpura Purpura, Thrombocytopenic Purpura, Thrombocytopenic, Idiopathic Signs and Symptoms Skin Manifestations Thrombocytopenia Thrombotic Microangiopathies

Age range

20 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

GSK Investigational Site, Gifu, Japan

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Subjects eligible for enrollment in the study must meet all of the following criteria.

At Screening (Week -4 or -3)

  • Diagnosed with ITP for at least 6 months prior to screening.
  • Have a platelet count of <30,000/µL.
  • Previously treated refractory or relapsed patients who have failed to achieve a platelet count of >=30,000/µL despite one or more prior therapies (either H. pylori eradication, corticosteroids, splenectomy, danazol or immunosuppressive drugs). (Note: Previous H. pylori eradication must have been completed at least 3 months prior to screening and clearly be ineffective).
  • Previous treatment for ITP with splenectomy, rituximab, and cyclophosphamide must have been completed at Week -4 and clearly be ineffective.
  • Subjects treated with cyclosporine A, mycophenolate mofetil or danazol must be receiving a dose that has been stable for at least 3 months prior to screening."
  • A complete blood count (CBC) within the reference range, with the following exceptions
  • Hemoglobin: females >=9g/dL and males >=10g/dL are eligible for inclusion if hemorrhage is present.
  • Neutrophil count >=1,500/µL (1.5x109/L) is required for inclusion.
  • The following clinical chemistries MUST NOT exceed 1.2 times the normal reference range:creatinine, ALT, AST, total bilirubin and alkaline phosphatase.
  • Albumin must be within 80 to 120% of normal range.
  • Subject is >=20 years old.
  • Female subjects must either be:
  • of non-childbearing potential (bilateral tubal ligation or post-menopausal), or
  • of childbearing potential and have a negative pregnancy test and agree to use contraceptive methods specified in the GSK List of Highly Effective Methods for Avoidance of Pregnancy
  • Hospitalization status: No restriction.
  • Gender: No restriction.
  • Subject has signed and dated written informed consent. At Randomization (Week 0)
  • Have a platelet count of <30,000/µL.
  • Previous therapy for ITP with immunoglobulins (IVIG and anti-D) and vincristine must have been completed at least 2 weeks prior to randomization and the platelet count must show a clear downward trend after the last treatment with immunoglobulins.
  • Subjects treated with corticosteroids or azathioprine must be receiving a dose that has been stable for at least 4 weeks prior to randomization.
  • Prolongation of prothrombin time and activated partial thromboplastin time (aPTT) must not exceed 1.2 times the upper limit of the normal range with no history of hypercoagulable state. (Note: These parameters will be measured at screening or at randomization.)
  • CBC and clinical chemistries fulfill the same criteria as those at screening.
  • Reticulocyte count within the reference range or elevated in case of bleeding. (Note: This parameter will be measured at screening or at randomization.)

Exclusion criteria

Subjects meeting any of the following criteria must not be enrolled in the study.

At Screening (Week -4 or -3)

  • Any severe medical condition (cardiac, hepatic or renal disorder) other than chronic ITP. (Note: ""Severe"" is defined as >=Grade 3 as a rule according to the ""Classification of the Severity of Adverse Experiences (PAB/SD Notification No.80, dated 29 June 1992) (Appendix X).)
  • History of suspected or confirmed arterial or venous thrombosis (e.g., myocardial infarction, deep vein thrombosis) within the last 1 year.
  • History of drug/alcohol abuse or dependence within 1 year prior to screening.
  • Previous treatment with SB-497115-GR.
  • Suspected blood disorder other than ITP.
  • Suspected platelet aggregation abnormality.
  • Suspected cyclic thrombocytopenia
  • Current or history of HIV infection or hepatitis B virus or hepatitis C virus infections.
  • Current or history of malignancy (Exception: Subjects with a history of completely resected non-melanomatous skin carcinoma or successfully treated in situ carcinoma are eligible).
  • Female subjects who are nursing or pregnant, who may be pregnant, or who contemplate pregnancy during the study period.
  • Subjects who are deemed unsuitable for the study by the investigator (or sub investigator).
  • Subjects who are participating in any other clinical trials at present or ones who previously participated in clinical trials and were treated with investigational products within last one month." At Randomization (Week 0)
  • Subject wishes to withdraw consent.
  • Subject is lost to follow-up.
  • Subject has consumed anti-platelet agents (e.g., ticlopidine and aspirin), anticoagulants, or non-steroidal anti-inflammatory drugs (NSAIDs) for 7days prior to the first dose of study medication and will require these medications during the study period.
  • Subjects who are deemed unsuitable for the study by the investigator (or sub investigator).

Treatment and study plan

SB-497115-GR 12.5mg

Drug

SB-497115-GR 12.5mg tablet once a day

SB-497115-GR 25mg

Drug

SB-497115-GR 25mg tablet once a day

SB-497115-GR 12.5mg matching placebo

Drug

SB-497115-GR 12.5mg matching placebo x1 or 2 tablet once a day

SB-497115-GR 50 mg

Drug

SB-497115-GR 25mg tablet x2 once a day

Other names: SB-497115-GR 50mg

Primary outcomes

  1. Number of Responders at Week 6

    Time frame: Week 6

    A responder was defined as a participant with a platelet count within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter).

  2. Percentage of Participants for Whom at Least 75% of Their Assessments During the Course of 26 Weeks of SB-497115-GR Treatment Met the Definition of Responders

    Time frame: Week 26

    A responder was defined as a participant with a platelet count within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

Secondary outcomes

  1. Number of Participants Assessed as Responders in at Least 4 Assessments Between Weeks 2 and 6

    Time frame: Weeks 2 through 6

    A responder was defined as a participant with a platelet count within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter) at at least 4 out of 5 scheduled visits.

  2. Percentage of Responders at Each Visit

    Time frame: Days 8, 15, 22, 29, 36, and 43

    A responder was defined as a participant with a platelet count within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter).

  3. Mean Platelet Count at Each Visit

    Time frame: Baseline and Days 8, 15, 22, 29, 36, and 43

    Blood taken from peripheral blood vessels was used for the measurement of platelet counts.

  4. Mean Change From Baseline in Platelet Counts at Each Visit

    Time frame: Baseline and Days 8, 15, 22, 29, 36, and 43

    Change from baseline was calculated as values at Days 8, 15, 22, 29, 36, and 43 minus baseline value

  5. Percentage of Participants With Bleeding Episodes Since the Last Visit

    Time frame: Days 1, 8, 15, 22, 29, 36, and 43

    When abnormal bleeding(s) was found since the last visit, it was recorded as a bleeding episode(s).

  6. Number of Participants at Baseline and Days 8, 15, 22, 29, 36, and 43 of Treatment by Platelet Count Category

    Time frame: Baseline and Days 8, 15, 22, 29, 36, and 43

    Blood taken from peripheral blood vessels was used for the measurement of platelet counts.

  7. Percentage of Responders at Each Visit

    Time frame: Days 8, 15, 22, 29, 36, and 43; Weeks 10, 14, 18, 22, and 26

    A responder was defined as a participant with a platelet count within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  8. Mean Platelet Counts of Participants at Each Visit

    Time frame: Baseline; Days 8, 15, 22, 29, 36, and 43; Weeks 10, 14, 18, 22, and 26

    Blood taken from peripheral blood vessels was used for the measurement of platelet counts. Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  9. Mean Change From Baseline in Platelet Counts at Each Visit

    Time frame: Baseline; Days 8, 15, 22, 29, 36, and 43; Weeks 10, 14, 18, 22, and 26

    Change from baseline was calculated as values at Days 8, 15, 22, 29, 36, and 43 and Weeks 10, 14, 18, 22, and 26 minus baseline value. Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  10. Mean Maximum Duration for Which Participants Maintained Platelet Counts >=50 x 10^9/Liter and <=400 x 10^9/Liter

    Time frame: Weeks 1 through 26

    Maximum duration is measured as the longest period (days) for which a participant continuously maintained platelet counts within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  11. Mean Total Time for Which Participants Maintained Platelet Counts >=50 x 10^9/Liter and <=400 x 10^9/Liter

    Time frame: Weeks 1 through 26

    Total time is measured as the cumulative number of days over which platelet counts were maintained within the target range (>=50 x 10^9/Liter and <=400 x 10^9/Liter). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  12. Percentage of Participants With Bleeding Episode Since the Last Visit

    Time frame: Days 1, 8, 15, 22, 29, 36, and 43; Weeks 10, 14, 18, 22, and 26

    When abnormal bleeding(s) was found since the last visit, it was recorded as a bleeding episode(s). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  13. Percentage of Participants With a Reduction in Dose and/or Number of Drugs of Concomitant ITP Medications From Baseline

    Time frame: Baseline through Week 26

    ITP medications are drugs, such as steroids or immunoglobulin, to be used for ITP. Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  14. Percentage of Participants Who Received Rescue Treatment for ITP

    Time frame: Weeks 1 through 26

    Rescue treatment for ITP is treatment applied to participants at high bleeding risk, such as those undergoing platelet transfusion or dose increase of steroids. Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  15. Mean Number of Days of Concomitant ITP Medication Use Per Month

    Time frame: Weeks 1 through 26

    Cumulative number of days for which a participant received ITP medication during the treatment/total treatment period (months). Participants receiving placebo in the double-blind phase received SB-497115-GR in the open-label phase for up to 26 weeks. Participants receiving SB-497115-GR in the double-blind phase for 7 weeks continued to receive SB-497115-GR in the open-label phase for 19 weeks. The data from these two groups were pooled as a 26 week treatment of SB-497115-GR group and analyzed for the efficacy and safety.

  16. Pharmacokinetics of SB-497115-GR, Cmax

    Time frame: Week 9 or 10

    Cmax: Peak plasma concentration of SB-497115

  17. Pharmacokinetics of SB-497115-GR, Tmax

    Time frame: Week 9 or 10

    tmax: Time when Cmax was achieved

  18. Pharmacokinetics of SB-497115, t1/2

    Time frame: Week 9 or 10

    t1/2 is half life based on the terminal phase

  19. Pharmacokinetics of SB-497115-GR, Lambda z

    Time frame: Week 9 or 10

    Lambda z is first order rate constant associated with the terminal portion of the plasma concentration curve.

  20. Pharmacokinetics of SB-497115-GR, AUClast and AUC0-24

    Time frame: Week 9 or 10

    AUC is area under a concentration vs. time curve.

    AUC0-24 (Area under the plasma concentration-time curve between 0 to 24 hrs) is calculated using the following equation:

    AUC0-24= AUClast + Clast × (1 - e-λz × [24-tlast])/λz. AUClast is AUC (area under a curve) computed to the last observation. Clast is concentration of last observation.

  21. Pharmacokinetics of SB-497115-GR, CL/F

    Time frame: Week 9 or 10

    CL/F: CL is an estimate of the total body clearance, and F is the fraction of dose absorbed.

  22. Pharmacokinetics of SB-497115-GR, Vz/F

    Time frame: Week 9 or 10

    VZ/F: VZ is the volume of distribution based on the terminal phase, and F is the fraction of dose absorbed.

Sponsors and collaborators

Lead sponsor

GlaxoSmithKline

Industry

Registry information

Official study title

Clinical Evaluation of SB-497115-GR in Chronic Idiopathic Thrombocytopenic Purpura (ITP) -A Multicenter Study in Subjects With Chronic ITP Receiving a Double-Blind, Placebo-Controlled, Short-Term Treatment Followed by an Open-Label, Uncontrolled, Long-Term Treatment- <Phase II/III Study>

Important dates

Study start
2007
Primary completion
2008
Study completion
2008
First posted
Oct 8, 2007
Registry last updated
Mar 30, 2011

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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