The purpose of this study is to understand physician treatment decisions in selecting specific second line treatments in pediatric ITP and to determine the effectiveness of different second line ITP treatments. Eligible patients are those ages 1-18 years who are starting on a new second line treatment for ITP, defined as any treatment other than IVIG, steroids, anti-D globulin, or aminocaproic acid. Enrolled patients remain on the study for approximately one year.
The purpose of this observational study is to model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP and to determine the comparative effectiveness of second line ITP treatments by bleeding measures, platelet counts, and patient reported outcome measures. This prospective observational, longitudinal, multicenter cohort study will aim to collect routine clinical care data, quality of life information from patients, and decision making data from clinicians at enrollment and at regular clinical intervals for at least one year. The primary and secondary objectives are as follows: Primary Objectives: 1. To model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP. 2. To assess patient reported outcomes with relation to specific second line pediatric ITP therapies. 3. To determine the comparative effectiveness of second line ITP treatments in terms of bleeding and platelet counts. Secondary Objectives: 1. To describe phenotypic variation among patients with refractory ITP; 2. To assess side effects and complications related to specific treatments for refractory ITP; 3. To describe monitoring and follow up practices among pediatric hematologists with each second line agent; 4. To weight factors that physicians use when deciding to treat pediatric ITP patients with second line agents; 5. To determine whether physician perception of patient quality of life correlates with patient derived quality of life measures; 6. To measure the correlation between the ITP Bleeding Scale and the Bleeding Assessment Tool in refractory pediatric ITP patients.
Study Type
OBSERVATIONAL
Enrollment
120
The treating physicians will select the second line agent and clinical data will be collected.
change from baseline in patient reported outcomes
Kids ITP Tool, Memorial Symptom Assessment Scale, Fatigue Scale
Time frame: Enrollment, 1 and 12 months
change from baseline in bleeding assessment
ITP Bleeding Scale, Bleeding Assessment Tool
Time frame: Enrollment, 1, 6, and 12 months
change from baseline in platelet count
Time frame: over 1 year
side effects and complications of treatments
Time frame: 1 year
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Arkansas Children's Hospital
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Oakland, California, United States
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Orange, California, United States
Lucile Packard Children's Hospital
Palo Alto, California, United States
UC Davis Medical Center
Sacramento, California, United States
UCSF School of Medicine
San Francisco, California, United States
Colorado Children's Hospital
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Children's Healthcare of Atlanta
Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
...and 19 more locations