Low-dose Baricitinib Plus High-dose Dexamethasone for Patients With Newly Diagnosed Immune Thrombocytopenia

NCT ID: NCT05932524

Last Updated: 2023-07-12

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

PHASE2

Total Enrollment

132 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-07

Study Completion Date

2025-06-30

Brief Summary

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A randomized, open-label, multicenter, phase 2 trial to compare the efficacy and safety of baricitinib plus high-dose dexamethasone compared to high-dose dexamethasone monotherapy for the first-line treatment of adults with primary immune thrombocytopenia (ITP).

Detailed Description

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This is a parallel group, multicenter, randomized, controlled trial of patients with ITP in China. Patients were randomly assigned to receive baricitinib plus high-dose dexamethasone or high-dose dexamethasone monotherapy. Treatment will be discontinued if very severe or life-threatening adverse events developed or at the patients' request. The primary endpoint is durable response, defined as the maintenance of platelet count ≥30,000/μL and at least 2-fold increase of the baseline count, the absence of bleeding, and no need for rescue medication at the 6-month follow-up.

Conditions

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Immune Thrombocytopenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients are randomly assigned at a 1:1 ratio to receive baricitinib plus high-dose dexamethasone or high-dose dexamethasone alone. Each group requires 66 patients (considering 10% drop-off).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Low-dose baricitinib plus high-dose dexamethasone

Oral baricitinib is given at a dose of 2 mg daily for 6 consecutive months. Dexamethasone is administrated at 40 mg per day for 4 consecutive days (the 4-day course of dexamethasone will be repeated in the case of lack of response by day 10). Treatment will be discontinued if very severe or life-threatening adverse events developed or at the patients' request.

Group Type EXPERIMENTAL

Baricitinib 2 MG

Intervention Type DRUG

Baricitinib 2 mg q.d., p.o., for 6 consecutive months.

Dexamethasone

Intervention Type DRUG

Dexamethasone 40 mg q.d. for 4 consecutive days (the 4-day course of dexamethasone will be repeated in the case of lack of response by day 10)

High-dose dexamethasone

Dexamethasone is administrated at 40 mg per day for 4 consecutive days (the 4-day course of dexamethasone will be repeated in the case of lack of response by day 10). Treatment will be discontinued if very severe or life-threatening adverse events developed or at the patients' request.

Group Type ACTIVE_COMPARATOR

Dexamethasone

Intervention Type DRUG

Dexamethasone 40 mg q.d. for 4 consecutive days (the 4-day course of dexamethasone will be repeated in the case of lack of response by day 10)

Interventions

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Baricitinib 2 MG

Baricitinib 2 mg q.d., p.o., for 6 consecutive months.

Intervention Type DRUG

Dexamethasone

Dexamethasone 40 mg q.d. for 4 consecutive days (the 4-day course of dexamethasone will be repeated in the case of lack of response by day 10)

Intervention Type DRUG

Other Intervention Names

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Olumiant HD-DXM

Eligibility Criteria

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Inclusion Criteria

1. Confirmed newly-diagnosed, treatment-naive ITP;
2. A platelet count \<30,000/μL, or a platelet count \<50,000/μL with clinically significant bleeding symptoms (WHO bleeding scale 2 or above) at the enrollment;
3. Willing and able to sign written informed consent.

Exclusion Criteria

1. Received chemotherapy or anticoagulants or other drugs affecting the platelet counts within 6 months before the screening visit;
2. Have a known diagnosis of other autoimmune diseases, established in the medical history and laboratory findings with positive results for the determination of antinuclear antibodies, anti-cardiolipin antibodies, lupus anticoagulant or direct Coombs test;
3. Active or a history of malignancy;
4. Pregnancy or lactation;
5. Received first-line and second-line ITP-modifying therapy;
6. Previously received corticosteroids or immunosuppressive agents for non-ITP diseases within 6 months before enrollment;
7. A history of clinically significant adverse reactions to previous corticosteroid therapy;
8. Unstable or uncontrolled disease or condition related to or impacting cardiac function (e.g., unstable angina, congestive heart failure, uncontrolled hypertension or cardiac arrhythmia);
9. Current or recent (\<4 weeks prior to screening) clinically serious viral, bacterial, fungal, or parasitic infection;
10. A history of symptomatic herpes zoster infection within 12 weeks prior to screening;
11. Active or chronic viral infection from hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV);
12. Have evidence of active tuberculosis (TB), or have previously had evidence of active TB and did not receive appropriate and documented treatment, or have had household contact with a person with active TB and did not receive appropriate and documented prophylaxis for TB;
13. Have experienced a clinically significant thrombotic event within 24 weeks of screening or are on anticoagulants and in the opinion of the investigator are not well controlled;
14. Myocardial infarction (MI), unstable ischemic heart disease, stroke, or New York Heart Association Stage IV heart failure;
15. A history or presence of cardiovascular, respiratory, hepatic, gastrointestinal, endocrine, neurological, or neuropsychiatric disorders or any other serious and/or unstable illness that, in the opinion of the investigator, could constitute an unacceptable risk when taking investigational product or interfere with the interpretation of data;
16. Any of the following specific abnormalities on screening laboratory tests:

1\) ALT or AST \>2 x ULN, or total bilirubin ≥1.5 x ULN 2) hemoglobin \<9 g/dL, or total white blood cell (WBC) count \<2,500/µL, or neutropenia (absolute neutrophil count \<1,200/µL), or lymphopenia (lymphocyte count \<750/µL) 3) eGFR \<50 mL/min/1.73 m\^2.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Beijing Luhe Hospital

OTHER

Sponsor Role collaborator

Chinese PLA General Hospital

OTHER

Sponsor Role collaborator

Navy General Hospital, Beijing

OTHER

Sponsor Role collaborator

Beijing Hospital

OTHER_GOV

Sponsor Role collaborator

Beijing Friendship Hospital

OTHER

Sponsor Role collaborator

Peking University First Hospital

OTHER

Sponsor Role collaborator

Peking University Third Hospital

OTHER

Sponsor Role collaborator

China-Japan Friendship Hospital

OTHER

Sponsor Role collaborator

Beijing Tsinghua Changgeng Hospital

OTHER

Sponsor Role collaborator

Peking University People's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xiao Hui Zhang

Vice president of Peking Univeristy Institute of Hematology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xiaohui Zhang

Role: PRINCIPAL_INVESTIGATOR

Peking University Institute of Hematology, Peking University People's Hospital

Locations

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Peking University Insititute of Hematology, Peking University People's Hospital

Beijing, , China

Site Status RECRUITING

Beijing Friendship Hospital

Beijing, , China

Site Status RECRUITING

Beijing Hospital

Beijing, , China

Site Status RECRUITING

Beijing Luhe Hospital

Beijing, , China

Site Status RECRUITING

Beijing Tsinghua Changgeng Hospital

Beijing, , China

Site Status RECRUITING

China-Japan Friendship Hospital

Beijing, , China

Site Status RECRUITING

Chinese PLA General Hospital

Beijing, , China

Site Status RECRUITING

Peking University First Hospital

Beijing, , China

Site Status RECRUITING

Peking University Third Hospital

Beijing, , China

Site Status RECRUITING

The Sixth Medical Center of PLA General Hospital

Beijing, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xiaohui Zhang

Role: CONTACT

+8613522338836

Peng Zhao

Role: CONTACT

+8618810323668

Facility Contacts

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Xiaohui Zhang, MD

Role: primary

+8613522338836

Peng Zhao, MD

Role: backup

+8618810323668

Zhao Wang, MD

Role: primary

+861088324672

Hui Liu, MD

Role: primary

+861088324672

He Bing Zhou, MD

Role: primary

+861088324672

Li Hong Li, MD

Role: primary

+861088324672

Zhen Ling Li, MD

Role: primary

+861088324672

Dai Hong Liu, MD

Role: primary

+861088326666

Yu Jun Dong, MD

Role: primary

+861088324577

Hong Mei Jing, MD

Role: primary

+861088324672

Yi Liu, MD

Role: primary

+861088324577

Other Identifiers

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PKU-BAITP-03

Identifier Type: -

Identifier Source: org_study_id

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