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Immune Thrombocytopenia With Positive ANA AntibodiesNCT06479304

The Efficacy and Safety of HCQ Plus Pred in ANA Positive ITP

A study testing Hydroxychloroquine Oral Tablet and Prednisone tablet in people with Immune Thrombocytopenia With Positive ANA Antibodies, run by Yunfeng Cheng at 7 sites in 3 countries.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to learn if hydroxychloroquine (HCQ) plus prednisone (Pred) works to treat primary immune thrombocytopenia with positive anti-nuclear antibodies in adults. It will also learn about the safety of HCQ plus Pred. Read more about this study

Who is it for?
Ages 15 to 99 years
What is being tested?
Hydroxychloroquine Oral Tablet and Prednisone tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
129 participants
Where
7 sitesin 3 countries
Study dates
24 Apr 2024to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 15 to 99 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Age is above 75 years old, or participants with uncontrolled hypertension and diabetes mellitus at the age between 15-75 years old, gender is unlimited.
  • Before randomization, the clinical diagnosis is primary immune thrombocytopenia. The platelet count is less than 30×10^9 / L within 1 week before enrollment, or platelet count is less than 50×10^9 / L with bleeding symptoms within 1 week before enrollment.
  • The antinuclear antibody is positive.
  • Other autoantibodies (mainly including dsDNA antibodies, SSA, SSB, RNP, β 2-GP, ACA, ANCA) are negative.
  • Prothrombin time does not exceed ± 3s of the normal value ranget, activated partial thrombin time is not outside normal range ± 10s; no history of coagulopathy except ITP.
  • Understand the study procedures and sign the written informed consent form.

Who cannot join

  • Secondary thrombocytopenia caused by myelodysplastic syndrome, immune diseases such as systemic lupus erythematosus, early aplastic anemia, atypical reanemia, antiphospholipid syndrome, thrombotic thrombocytopenic purpura and various other causes.
  • The participant has experienced any arterial or venous thrombosis (stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis or pulmonary embolism), or clinical symptoms and medical history indicate thrombophilia.
  • Congestive heart disease, including New York Heart Association (NHYA) Grade III / IV, occurred within 3 months prior to screening, arrhythmia requiring medication or myocardial infarction, or arrhythmia known to increase the risk of thrombotic events (such as atrial fibrillation), or corrected QT interval (QTc) is longer than 450 ms, or QTc> 480 ms in paricipants with bundle branch block.
  • With severe hemorrhage (intracranial hemorrhage) or coagulation dysfunction (INR and APTT> 125% upper limit of normal).
  • With severe digestive tract diseases affecting drug absorption.
  • With serious mental illness patient.
Show all 18Show fewer
  • Having participated in other clinical trials within 3 months prior to screening.
  • Having received any immunomodulatory medication for other diseases 3 months before screening.
  • Having received any medication affecting platelet function ( Including but not limited to aspirin, aspirin-containing complexes, clopidogrel, salicylates, and / or non-steroidal anti-inflammatory drugs NSAIDs ) or anticoagulant therapy for over consecutive 3 days within 2 weeks before screening.
  • With Glucose-6-phosphate dehydrogenase deficiency.
  • With retinal or visual field changes caused by 4-aminoquinoline compounds.
  • Being allergic to 4-aminoquinoline compounds.
  • Having evidence of Human Immunodeficiency Virus (HIV)/ hepatitis C virus(HCV)/ hepatitis B virus(HBV) infection (HIV antibody or HCV antibody is positive, HBV surface antigen is positive, or HBV surface antigen is negative but HBV-DNA indicating viral replication.
  • Glutamate transaminotransferase (ALT) or glutamate transaminase (AST) is higher than 1.5 times the upper limit of normal value (ULN), or total bilirubin or blood creatinine is higher than 1.2 times the ULN.
  • With liver cirrhosis or portal hypertension.
  • With evidence of malignant tumor activity, or receiving anti-tumor treatment within 5 years prior to the screening.
  • Addicted to alcohol or drugs.
  • Participants being pregnant or lactating, or with potential fertility, reluctance to use effective contraception within the entire trial cycle and within 28 days after the end of the trial (or within 28 days after premature withdraw).

Trial locations and contacts

7 sites in 3 countries. Contact the study team or a site near you to ask about taking part.

7 sites in 3 countries

China4 sites, 4 recruiting
  • Shanghai Zhongshan Hospital

    Shanghai, Shanghai Municipality, 200032

    Lili Ji, 086-021-64041990, ji.lili@zs-hospital.sh.cn

    Yunfeng Cheng

    Recruiting
  • Zhongshan Wusong Hospital, Fudan University

    Shanghai, Shanghai Municipality, 200094

    Hongjuan Lu, 13564618950, 13564618950@163.com

    Recruiting
  • Shanghai Jinshan Hospital

    Shanghai, Shanghai Municipality, 201508

    Yunfeng Cheng, 15921398238, yfcheng@fudan.edn.cn

    Recruiting
  • Zhongshan Qingpu Hospital, Fudan University

    Shanghai, Shanghai Municipality, 201700

    Fanli Hua, 18116017032, hua_fanli@fudan.edu.cn

    Recruiting

Other trials in China

Macau2 sites, 2 recruiting
  • Dr. Stanley Ho Medical Foundation

    Macao, 999078

    Gregory Cheng, 852-60269018, gregorycheng@um.edu.mo

    Recruiting
  • University Hospital, Macau University of Science and Technology.

    Macao, 999078

    Gregory Cheng, 852-60269018, gregorycheng@um.edu.mo

    Recruiting
Hong Kong1 site, 1 recruiting
  • Health and Humanity Research Centre, Hongkong, China.

    Hong Kong, 999077

    Gregory Cheng, 852-60269018, gregorycheng@um.edu.mo

    Recruiting

Other trials in Hong Kong

About this study

Official title: The Efficacy and Safety of Hydroxychloroquine Plus Prednisone in Antinuclear Antibody-positive Patients With Primary Immune Thrombocytopenia-- The Multicenter, Randomized, Open-lable Clinical Trial

The goal of this clinical trial is to learn if hydroxychloroquine (HCQ) plus prednisone (Pred) works to treat primary immune thrombocytopenia with positive anti-nuclear antibodies in adults. It will also learn about the safety of HCQ plus Pred. The main questions it aims to answer are:

Does HCQ plus Pred raise the response rate in participants, compared to Pred alone? Does HCQ plus Pred prolong the response duration in participants, compared to Pred alone? What medical problems do participants have when taking HCQ plus Pred? Researchers will compare HCQ plus Pred with Pred alone to see if HCQ plus Pred works better to treat primary immune thrombocytopenia with positive anti-nuclear antibodies.

Read more

Participants will:

Take Pred every day for 6 weeks, with or without HCQ twice a day for 1 year , Visit the clinic once every 1 weeks for the first 4 weeks, and once every 2-4 weeks in the following 11 months for checkups and tests, Keep a diary of their symptoms.

Read the detailed description

Primary immune thrombocytopenia (Primary immune thrombocytopenia, ITP) is an acquired autoimmune hemorrhagic disease characterized by a decreased peripheral platelet count and an increased risk of bleeding. It has been reported that 33.3% -39.2% of ITP patients have positive antinuclear antibodies (ANA) in the course of the disease.In the meantime, they do not meet the diagnostic criteria for rheumatic diseases such as lupus erythematosus(SLE). ITP patients with positive ANA are prone to relapse and chronicity. Therefore, it is necessary to explore new clinical treatments to attain long-term remission in these patients.

Hydroxychloroquine (HCQ) has immune modulating role on a variety of immune cells.A clinical trial enrolled immune thrombocytopenia secondary to SLE, and ITP with positive anti-nuclear antibodiy (ANA) were treated with HCQ combined with glucocorticoids. The results showed an overall response rate of 60% (24 / 40), including 18 continuous complete response (CR) and 6 continuous response (R), and some patients had continued elevated platelet counts 3 months after treatment initiation. The above studies illustrate that HCQ contributes to the treatment of chronic ITP, especially as a long-term therapeutic agent with low economic burden and good tolerance. In conclusion, it can be seen that HCQ and prednisone have complementary mechanism of action and complementary time window, which can be used as a combination for the treatment of ITP select.

Being tested
Hydroxychloroquine Oral Tablet, Prednisone tablet

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hydroxychloroquine Oral TabletDrug

    Also called Hydroxychloroquine

    Hydroxychloroquine is taken at the dose of 0.1g / dose, twice a day for 1 year, regardless of food intake.

  • Prednisone tabletDrug

    Also called Prednisone

    Prednisone is given at the dose of 1mg/kg every morning after meals for 2 weeks ( if platelet count does not recover higher than 30×10^9/L after 2 weeks, prednisone will be given at the dose for 2 more weeks ), then tapering off.

Study groups in NCT06479304
Study groupRoleWhat they receive
HCQ plus Pred groupExperimentalThis group is experiment group. Participants will take Pred every day for 6 weeks with HCQ twice a day for 1 year
Receives: Drug: Hydroxychloroquine Oral Tablet; Drug: Prednisone tablet
Pred groupPlacebo comparatorThis group is control group. Participants will take Pred every day for 6 weeks.
Receives: Drug: Prednisone tablet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall response rate

    The percentage of participants with platelet counts higher than 30×10^9/L and at least twice the baseline platelet count , for at least two consecutive tests (7 days apart).

    Measured: 4 weeks

Secondary outcomes (8)
  1. Complete response rate

    The percentage of participants with platelet counts higher than 100×10^9/L , for at least two consecutive tests (7 days apart).

    Measured: 1 year

  2. Duration of response

    Time from response to disease relapse (platelet count ≤ 30×10^9/L on any test or occurance of bleeding symptoms )

    Measured: 1 year

  3. Durable response rate

    Percentage of patients with complete remission lasting at least 6 months without any additional ITP-specific therapy

    Measured: 1 year

  4. Platelet count at each visit

    Average platelet count at each visit

    Measured: 1 year

  5. Time to response

    Time from starting treatment to response

    Measured: 4 weeks

  6. Response rate throughout the trial

    The percentage of response participants (platelet counts higher than 30×10^9/L and at least twice the baseline platelet count ) at each visit

    Measured: 1 year

  7. WHO bleeding score

    WHO bleeding score at each visit; World Health Organization,minimum values was 0 , means no bleeding, and maximum value was 4, means Debilitating blood loss

    Measured: 1 year

  8. Adverse reaction

    Adverse reaction at each visit

    Measured: 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Jun 2024
  2. Study start24 Apr 2024
  3. Primary completionJan 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
129 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06479304
Sponsor's protocol ID
B2024-028R2
Status last verified
Jun 2024
First submitted
22 Jun 2024
Last updated
28 Jun 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Neunert C, Terrell DR, Arnold DM, Buchanan G, Cines DB, Cooper N, Cuker A, Despotovic JM, George JN, Grace RF, Kuhne T, Kuter DJ, Lim W, McCrae KR, Pruitt B, Shimanek H, Vesely SK. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019 Dec 10;3(23):3829-3866. doi: 10.1182/bloodadvances.2019000966.

    PubMed 31794604
  • Khellaf M, Chabrol A, Mahevas M, Roudot-Thoraval F, Limal N, Languille L, Bierling P, Michel M, Godeau B. Hydroxychloroquine is a good second-line treatment for adults with immune thrombocytopenia and positive antinuclear antibodies. Am J Hematol. 2014 Feb;89(2):194-8. doi: 10.1002/ajh.23609. Epub 2013 Nov 20.

    PubMed 24254965
  • Mejdoub S, Hachicha H, Gargouri L, Feki S, Mahfoudh A, Masmoudi H. Antinuclear antibodies in children: clinical signification and diagnosis utility. Tunis Med. 2021 Octobre;99(10):980-984.

    PubMed 35288899
  • Lambert MP, Gernsheimer TB. Clinical updates in adult immune thrombocytopenia. Blood. 2017 May 25;129(21):2829-2835. doi: 10.1182/blood-2017-03-754119. Epub 2017 Apr 17.

    PubMed 28416506

Questions about this trial

What is this clinical trial studying?

A study testing Hydroxychloroquine Oral Tablet and Prednisone tablet in people with Immune Thrombocytopenia With Positive ANA Antibodies, run by Yunfeng Cheng at 7 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 28 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in China, Macau, Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Lili Ji (86-021-64041990, ji.lili@zs-hospital.sh.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall response rate (time frame: 4 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06479304, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jun 2024.

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