A Trial of Antenatal Treatment of Alloimmune Thrombocytopenia

NCT ID: NCT00194987

Last Updated: 2018-11-07

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

102 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-04-30

Study Completion Date

2015-06-30

Brief Summary

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The purposes of this study are to provide medical management by giving treatment to the mother that will bring up the fetal platelet count and to minimize the number of invasive procedures to the fetus (which may result in serious fetal injuries).

Detailed Description

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Conditions

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Alloimmune Thrombocytopenia Fetal Alloimmune Thrombocytopenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

randomization between 2 groups
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

participants and their physicians will know if they are receiving IVIG x 2 or IVIG x1 plus prednisone

Study Groups

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IVIG x 2

IVIG 2 g/kg/wk divided into 2 infusions per week for women with a fetus affected by FNAIT

Group Type EXPERIMENTAL

IVIG (Intravenous Immunoglobulin)

Intervention Type DRUG

one gram per kg of IVIG per infusion given either once or twice

IVIG x 1 + prednisone

IVIG 1 g/kg/wk in 1 infusion per week + prednisone 0.5 mg po daily for women with a fetus affected by FNAIT

Group Type EXPERIMENTAL

IVIG (Intravenous Immunoglobulin)

Intervention Type DRUG

one gram per kg of IVIG per infusion given either once or twice

prednisone

Intervention Type DRUG

in arm with IVIG 1 gm/kg/wk will also receive prednisone 0.5 mg/kg/day

Interventions

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IVIG (Intravenous Immunoglobulin)

one gram per kg of IVIG per infusion given either once or twice

Intervention Type DRUG

prednisone

in arm with IVIG 1 gm/kg/wk will also receive prednisone 0.5 mg/kg/day

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

Pregnant women are eligible for inclusion into the Very High Risk Group if they:

* are PLA-1 (platelet antigen A1) negative and have known platelet incompatibility with their fetus
* have had a previous child who suffered an antenatal hemorrhage prior to 28 weeks gestation (as best as could be estimated)
* are less than 19 weeks gestation

Pregnant women are eligible for inclusion into the High Risk Group if they:

* are PLA-1 negative and have known platelet incompatibility with the fetus
* have had a previous child who suffered an antenatal hemorrhage after 28 weeks gestation (as best as could be estimated)
* are between 12-30 weeks gestation

Pregnant women are eligible for inclusion into the Standard Risk Group if they:

* are PLA-1 negative and have known platelet incompatibility with the fetus
* have not had a previous child who suffered an antenatal hemorrhage
* are between 20-30 weeks gestation

Exclusion Criteria

Women are not eligible for inclusion into the Very High Risk Group if they:

* have had a previous child who suffered an antenatal hemorrhage after 28 weeks gestation
* are greater than 19 weeks gestation

Women are not eligible for inclusion into the High Risk Group if they:

* have had a previous child who suffered an antenatal hemorrhage prior to 28 weeks gestation
* are greater than 30 weeks gestation

Women are not eligible for inclusion into the Standard Risk Group if they:

* have had a previous child who suffered an antenatal hemorrhage
* are greater than 30 weeks gestation
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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New York Presbyterian Hospital

OTHER

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role collaborator

Weill Medical College of Cornell University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James B Bussel, M.D.

Role: PRINCIPAL_INVESTIGATOR

Weill Medical College of Cornell University

Locations

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New York Presbyterian Hospital-Weill Cornell Medical Center

New York, New York, United States

Site Status

Countries

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United States

References

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Lakkaraja M, Jin JC, Manotas KC, Vinograd CA, Ferd P, Gabor J, Wissert M, Berkowitz RL, McFarland JG, Bussel JB. Blood group A mothers are more likely to develop anemia during antenatal intravenous immunoglobulin treatment of fetal and neonatal alloimmune thrombocytopenia. Transfusion. 2016 Oct;56(10):2449-2454. doi: 10.1111/trf.13779. Epub 2016 Sep 9.

Reference Type DERIVED
PMID: 27611703 (View on PubMed)

Berkowitz RL, Lesser ML, McFarland JG, Wissert M, Primiani A, Hung C, Bussel JB. Antepartum treatment without early cordocentesis for standard-risk alloimmune thrombocytopenia: a randomized controlled trial. Obstet Gynecol. 2007 Aug;110(2 Pt 1):249-55. doi: 10.1097/01.AOG.0000270302.80336.dd.

Reference Type DERIVED
PMID: 17666597 (View on PubMed)

Other Identifiers

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0102004801

Identifier Type: -

Identifier Source: org_study_id

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