High Dose Dexamethasone Vs. Conventional Dose Prednisolone in Adult ITP

NCT ID: NCT00451594

Last Updated: 2011-01-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

157 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-09-30

Study Completion Date

2010-12-31

Brief Summary

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To determine the long term effects of pulse high dose dexamethasone and conventional dose prednisolone in treatment of adult patients with ITP.

Detailed Description

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Patients will be randomized to one of two study arms:

dexamethasone 40 mg po daily for 4 consecutive days. If the platelet count drops below 30X109/L after response within 6 months, another four-day course of dexamethasone will be given, followed by 15 mg of prednisone daily, with gradual tapering (Arm 1).

Prednisone 1 mg/kg po daily for 4-8 weeks, the drug is then decreased slowly over another few weeks (Arm 2).

Conditions

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Idiopathic Thrombocytopenic Purpura

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Dexamethasone

Pulse high dose dexamethasone (Arm 1)

1. Patients will receive 40 mg of oral dexamethasone daily for four consecutive days.
2. Other treatments should be considered if there was a platelet count of 30X109/L or less by day 14
3. If the patient had a platelet count of more than 30X109/L after four days of dexamethasone treatment, no further treatment will be given.
4. If the platelet count drops below 30X109/L within the first 6 months, another four-day course of dexamethasone will be given, followed by 15 mg of prednisone daily, with gradual tapering.
5. Patients whose platelet counts can not be maintained at 30X109/L will be offered other treatments.

Intervention Type DRUG

Prednisolone

Conventional dose prednisone (Arm 2)

1. Prednisone, 1 mg/kg is started at diagnosis. If the platelet count is more than 100X109/L, the dose should be used for 4 weeks minimally and then tapered by 10 mg/1 wk until the dose reaches 0.5 mg/kg of body weight and by 5 mg/1 wk thereafter. (Ann Intern Med 1997, 126, 307-14). If the platelet count is between 30X109/L and 100X109/L, prednisone 1 mg/kg should be used for 8 weeks maximally and then tapered by 10 mg/2 wk until the dose reaches 0.5 mg/kg of body weight and by 5 mg/2 wk thereafter.
2. Guideline of prednisone tapering Duration of prednisone treatment: 3-6 months

Intervention Type DRUG

Other Intervention Names

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Dexa PD

Eligibility Criteria

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Inclusion Criteria

* a true thrombocytopenia on blood smear
* adequate megakaryopoiesis on bone marrow examination
* the absence of clinically apparent associated conditions or cause of thrombocytopenia
* Age over 16 years
* A platelet count of less than 30x109/L

Exclusion Criteria

* previous treatment for ITP.
* other causes of thrombocytopenia such as HIV infection, lymphproliferative disease, liver disease, or definite SLE.
* Patients with life threatening bleeding and pregnant women should be excluded.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cooperative Study Group A for Hematology

NETWORK

Sponsor Role lead

Responsible Party

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Cooperative Study Group A for Hematology

Principal Investigators

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Sung Hwa Bae, professor

Role: PRINCIPAL_INVESTIGATOR

Daegu Catholic Univertity Hospital, ROK

Jung-Hee Lee, professor

Role: PRINCIPAL_INVESTIGATOR

Asan Medical Center, ROK

Locations

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Asan Medical Center

Seoul, Songpa-gu, South Korea

Site Status

Countries

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South Korea

Related Links

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http://www.google.co.kr

A RANDOMIZED CONTROLLED MULTICENTER TRIAL OF HIGH DOSE DEXAMETHASONE VERSUS CONVENTIONAL DOSE PREDNISONE FOR ADULTS WITH UNTREATED IDIOPATHIC THROMBOCYTOPENIC PURPURA

Other Identifiers

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C-009

Identifier Type: -

Identifier Source: org_study_id

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