Efficacy and Safety of Avatrombopag for Treating TCP in HBV-ACLF Patients Receiving ALSS Treatment

NCT ID: NCT05382013

Last Updated: 2022-11-10

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-27

Study Completion Date

2024-04-30

Brief Summary

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This study aims to investigate the efficacy and safety of avatrombopag for treating thrombocytopenia in hepatitis b virus related acute-on-chronic liver failure patients receiving artificial liver support system treatment.

Detailed Description

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Artificial liver support system (ALSS) is an optimal therapy in patients with hepatitis b virus (HBV) related acute-on-chronic liver failure (ACLF). But a lot of patients encount thrombocytopenia (TCP) due to the mechanical damage of thrombocyte and use of heparin during the treatment. Avatrombopag is an oral thrombopoietin receptor agonist that has been recently approved for treating TCP in chronic liver disease patients needing invasive procedures. Therefore, this study aims to investigate the efficacy and safety of avatrombopag for treating TCP in HBV related ACLF patients receiving ALSS treatment. Sixty patients with HBV related ACLF receiving ALSS will be enrolled in this study. The participants are divided into trial group (avatrombopag, double plasma molecular adsorption system (DPMAS) , low volume plasma exchange (LPE), and comprehensive internal medical treatment) and control group (DPMAS, LPE, comprehensive internal medical treatment). Symptoms, signs, laboratory tests results, adverse events, mortality rates are recorded from treatment baseline to 3 weeks.

Conditions

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Thrombocytopenia Hepatitis B, Chronic Acute-On-Chronic Liver Failure

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Trial Group

30 patients receive treatment of avatrombopag, DPMAS, LPE, and comprehensive internal medical treatment.

Group Type EXPERIMENTAL

Avatrombopag

Intervention Type DRUG

Patients will receive treatment of oral avatrombopag 20mg per day for the first 5 days

Artificial Liver Support System

Intervention Type OTHER

Patients will receive treatment of double plasma molecular adsorption system (DPMAS) and low volume plasma exchange (LPE) for three times. The volume of plasma adsorption in DPMAS is 5000\~6000 millilitre. The volume of fresh frozen plasma used in LPE is 1000 millilitre.

Comprehensive internal medical treatment.

Intervention Type OTHER

Patients will receive comprehensive internal medical treatment.

Control Group

30 patients receive treatment of DPMAS, LPE, and comprehensive internal medical treatment.

Group Type ACTIVE_COMPARATOR

Artificial Liver Support System

Intervention Type OTHER

Patients will receive treatment of double plasma molecular adsorption system (DPMAS) and low volume plasma exchange (LPE) for three times. The volume of plasma adsorption in DPMAS is 5000\~6000 millilitre. The volume of fresh frozen plasma used in LPE is 1000 millilitre.

Comprehensive internal medical treatment.

Intervention Type OTHER

Patients will receive comprehensive internal medical treatment.

Interventions

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Avatrombopag

Patients will receive treatment of oral avatrombopag 20mg per day for the first 5 days

Intervention Type DRUG

Artificial Liver Support System

Patients will receive treatment of double plasma molecular adsorption system (DPMAS) and low volume plasma exchange (LPE) for three times. The volume of plasma adsorption in DPMAS is 5000\~6000 millilitre. The volume of fresh frozen plasma used in LPE is 1000 millilitre.

Intervention Type OTHER

Comprehensive internal medical treatment.

Patients will receive comprehensive internal medical treatment.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Age from 18 to 65 years old;
2. Clinical diagnosis of chronic hepatitis b virus infection (positive hepatitis b surface antigen or positive hepatitis b virus DNA \> 0.5 year);
3. Clinical diagnosis of liver failure (serum total bilirubin level \> 10 times upper limit of normal; prothrombin time activity \< 40% and ≥20%, or prothrombin time international ratio ≤ 2.6 and \> 1.5);
4. Platelets \< 80\*10 E9/L and \> 50\*10 E9/L.
5. Signed informed consent form.

Exclusion Criteria

1. Other active liver diseases;
2. Hepatocellular carcinoma or other malignancy;
3. Pregnancy or lactation;
4. Human immunodeficiency virus infection or congenital immune deficiency diseases;
5. Severe diabetes, autoimmune diseases; unstable infarction due to cardio-cerebrovascular events; other important organ dysfunctions or transplantation;
6. Severe complications including severe infection, gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome;
7. Patients with ALSS treatment in one week;
8. Thrombotic disease;
9. Patients can not follow-up;
10. Investigator considering inappropriate.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Third Affiliated Hospital, Sun Yat-Sen University

OTHER

Sponsor Role lead

Responsible Party

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Liang Peng

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Liang Peng, Doctor

Role: PRINCIPAL_INVESTIGATOR

Third Affiliated Hospital, Sun Yat-Sen University

Locations

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Third Affiliated Hospital of Sun Yat-sen University

Guangzhou, Guangdong, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Wenxiong Xu, Doctor

Role: CONTACT

+8613760783281

Liang Peng, Doctor

Role: CONTACT

+8613533978874

Facility Contacts

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Liang Peng, Doctor

Role: primary

+8613533978874

Other Identifiers

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PL16

Identifier Type: -

Identifier Source: org_study_id

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