This study is a multicenter interventional research on the first-line treatment of newly diagnosed adult patients with immune thrombocytopenia (ITP) using romiplostim N01 in combination with glucocorticoids. The primary endpoint of this study is to assess the efficacy of romiplostim N01 combined with glucocorticoids in untreated newly diagnosed adult ITP patients after 6 months of administration. The subjects will be divided into the experimental group and the control group for treatment. Experimental group: Dexamethasone (HD-DXM) 40mg/d × 4 days, one cycle. If there is no response on the 10th day, repeat once, administered either orally or intravenously. Simultaneously, romiplostim N01 is administered at an initial dose of 3µg/kg, by subcutaneous injection, once a week, for a maximum of 6 months. Control group: Dexamethasone (HD-DXM) 40mg/d × 4 days, one cycle. If there is no response on the 10th day, repeat once, administered either orally or intravenously.
This study is a multicenter interventional research, and it is planned to incorporate 129 newly diagnosed adult ITP patients who have not undergone treatment. For patients meeting the inclusion criteria, after signing the informed consent and passing the screening, they will be randomly grouped. The study encompasses a screening period (from the signing of the informed consent form by the subject to before the first administration of the drug), a treatment period (including dexamethasone monotherapy and combined treatment of dexamethasone and romiplostim N01), and a follow-up period. Screening period: Assess the inclusion and exclusion criteria. Those who fulfill the conditions can enter the treatment period. Treatment period: Baseline visits are conducted for the screened eligible subjects, and they are randomly assigned to the experimental group and the control group at a ratio of 2:1. Administration protocol: Experimental group: Dexamethasone (HD-DXM) 40mg/d × 4d, one cycle. If there is no response on the 10th day, repeat once, administered orally or intravenously. Simultaneously, romiplostim N01 is administered, with an initial dose of 3µg/kg, by subcutaneous injection once a week, for up to 6 months. Control group: Dexamethasone (HD-DXM) 40mg/d × 4d, one cycle. If there is no response on the 10th day, repeat once, administered orally or intravenously. \*Dosage of romiplostim N01: The initial dose is 3µg/kg and can be initiated within 4 days of dexamethasone treatment. When the platelet count is \< 50 × 10\^9/L, the patient will receive an increment in the dose of romiplostim N01 by 2µg/kg weekly, with a maximum dose of 10µg/kg. When 200 × 10\^9/L \> platelet count ≥ 50 × 10\^9/L, the administration dosage remains unchanged. When 400 × 10\^9/L \> platelet count ≥ 200 × 10\^9/L for two consecutive weeks, the dose is reduced by 1µg/kg. When the platelet count is ≥ 400 × 10\^9/L, discontinue the drug. When the platelet count \< 200 × 10\^9/L, resume administration, and the administration dose is 1µg/kg less than before drug cessation. Follow-up period: Enter the follow-up period after the conclusion of treatment. Follow-up: Collect all adverse events (AEs) considered related to the study drug, follow up until the 14th week after the end of treatment, through clinical follow-up or telephone follow-up, and collect information on AEs, concomitant medications and concomitant treatments of the subjects. The researcher can increase the number of visits as necessary for AE follow-up to monitor the alleviation of AEs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
129
Dexamethasone (HD-DXM) at a dose of 40mg/d for 4 days constitutes one cycle. If there is no response on the 10th day, repeat it once. The administration can be either oral or intravenous. Meanwhile, romiplostim N01 is administered with an initial dose of 3µg/kg by subcutaneous injection once a week for up to 6 months.
Dexamethasone (HD-DXM) 40mg/d × 4 days, one cycle. If there is no response on the 10th day, repeat once, administered either orally or intravenously.
Chinese Academy of Medical Science and Blood Disease Hospital
Tianjin, Tianjin Municipality, China
RECRUITINGThe proportion of patients with continuous remission.
Continuous remission is defined as the maintenance of the therapeutic effect of patients for at least 6 months since achieving remission, without the need for additional ITP-specific treatment.
Time frame: 6 months
The total effective rate GR
The total effective rate GR = CR + R (Complete response CR, platelet count ≥ 100×10\^9/L, and no bleeding symptoms; Effective R, platelet count is between 30×10\^9/L and 100×10\^9/L, and at least doubles compared to the baseline value, and no bleeding symptoms).
Time frame: 6 months
The proportion of patients with the initial response (reaching the effective standard within one month of the start of treatment)
The total effective rate GR = CR + R (Complete response CR, platelet count ≥ 100×10\^9/L, and no bleeding symptoms; Effective R, platelet count is between 30×10\^9/L and 100×10\^9/L, and at least doubles compared to the baseline value, and no bleeding symptoms within one month).
Time frame: one month of the start of treatment
The proportion of patients reaching the effective standard 3 months after the start of treatment.
The total effective rate GR = CR + R (Complete response CR, platelet count ≥ 100×10\^9/L, and no bleeding symptoms; Effective R, platelet count is between 30×10\^9/L and 100×10\^9/L, and at least doubles compared to the baseline value, and no bleeding symptoms within 3 month).
Time frame: 3 months after the start of treatment
The proportion of patients reaching the effective standard 6 months after the start
The total effective rate GR = CR + R (Complete response CR, platelet count ≥ 100×10\^9/L, and no bleeding symptoms; Effective R, platelet count is between 30×10\^9/L and 100×10\^9/L, and at least doubles compared to the baseline value, and no bleeding symptoms within 6 month).
Time frame: 6 months after the start
The maximum consecutive weeks of platelet response
The consecutive weeks with platelet count \> 30×10\^9/L in the absence of any rescue treatment. Adverse events (evaluated using Version 5.0 of the "Common Terminology Criteria for Adverse Events (NCI CTC AE)") etc.
Time frame: 6 months
The proportion of subjects receiving rescue treatment.
The proportion of subjects receiving rescue treatment.
Time frame: 6 months
According to the WHO bleeding score standard, the incidence and severity of bleeding symptoms.
According to the WHO bleeding score standard, the incidence and severity of bleeding symptoms.
Time frame: 6 months
Adverse events
evaluated using Version 5.0 of the "Common Terminology Criteria for Adverse Events (NCI CTC AE)".
Time frame: 6 months
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