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Amgen Megakaryopoiesis Protein 2 (AMG 531) in Thrombocytopenic Subjects With Immune Thrombocytopenic Purpura (ITP)

An Open-label, Unit Dose-finding Study Evaluating the Safety and Efficacy of Amgen Megakaryopoiesis Protein 2 (AMG 531) in Thrombocytopenic Subjects With Immune Thrombocytopenic Purpura (ITP)

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00117143
Enrollment
16
Registered
2005-07-04
Start date
2002-12-02
Completion date
2004-07-19
Last updated
2023-06-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Thrombocytopenic Purpura

Keywords

Immune Thrombocytopenic Purpura, Idiopathic Thrombocytopenic Purpura, ITP, Thrombocytopenia

Brief summary

The purpose of this study is to assess the safety and tolerability of AMG 531 (romiplostim), a novel thrombopoiesis-stimulating peptibody, and its effect on platelet counts in adults with immune thrombocytopenic purpura.

Interventions

DRUGRomiplostim

Administered subcutaneously on day 1 and on day 15 or 22 if the platelet count was ≤ 50 x 10⁹/L and not rising, peak platelet count was ≤ 450 x 10⁹/L and no serious adverse events related to treatment were observed.

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Greater than or equal to 3 months history of ITP, regardless of splenectomy status, and completion of at least 1 prior treatment for ITP * 2 of 3 pretreatment platelet counts that were less than 30 x 10\^9/L (if not currently on ITP therapy) or less than 50 x 10\^9/L (if currently receiving corticosteroids for ITP therapy) * Ability to give informed consent

Exclusion criteria

* Known history of arterial thrombosis, active malignancy, or bone marrow stem cell disorder

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Adverse EventsFrom first dose through 8 weeks after last dose of study drug (11 weeks)
Number of Participants With Positive Anti-Romiplostim AntibodiesDays 29 and 78The presence or development of antibodies to romiplostim and endogenous thrombopoietin was assessed using a neutralizing bioassay. Antibody analyses were conducted on study days 29 and at the end-of-study visit (day 78). The number of participants with positive antibody binding at any time during the study is reported.

Secondary

MeasureTime frameDescription
Number of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22), and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 for all participants)Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.
Number of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22), and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 for all participants)Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.
Number of Participants Who Achieved a Targeted Therapeutic Platelet ResponseBaseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)Targeted therapeutic platelet response was defined as a (single) platelet count that was double the baseline level and between 50 and 450 × 10⁹ cells/L. Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.
Time to Peak Platelet CountFrom first dose of study drug to day 15 or 22, and from the second dose of study drug (day 15 or 22) to day 78Time from the date of study drug administration (day 1, 15 or 22) to the day of peak platelet count after each dose. Platelet count data after the use of rescue medication were not included.
Duration Within the Targeted Therapeutic RangeFrom first dose of study drug to day 15 or 22, and from the second dose of study drug (day 15 or 22) to day 78Targeted therapeutic platelet level was defined as a platelet count that was double the baseline level and between 50 and 450 × 10⁹ cells/L. Platelet count data after the use of rescue medication were not included.
Change From Baseline to Peak Platelet LevelBaseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)Platelet count data after the use of rescue medication were not included.
Number of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineBaseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.

Participant flow

Recruitment details

This was a multicenter study conducted in 6 centers in France, the Netherlands, and the United Kingdom.

Pre-assignment details

Participants were enrolled sequentially into one of four dose cohorts. When the platelet count of the first participant who received the 500 μg dose increased above 650 × 10⁹ cells/L following the first dose, this cohort was discontinued, and subsequent participants were assigned to the 300 μg cohort.

Participants by arm

ArmCount
Romiplostim 30 µg
Participants received 30 µg romiplostim by subcutaneous injection on day 1 and a possible second dose on day 15 or 22 depending on the participant's platelet count.
4
Romiplostim 100 µg
Participants received 100 µg romiplostim by subcutaneous injection on day 1 and a possible second dose on day 15 or 22 depending on the participant's platelet count.
4
Romiplostim 300 µg
Participants received 300 µg romiplostim by subcutaneous injection on day 1 and a possible second dose on day 15 or 22 depending on the participant's platelet count.
7
Romiplostim 500 µg
Participants received 500 µg romiplostim by subcutaneous injection on day 1 and a possible second dose on day 15 or 22 depending on the participant's platelet count.
1
Total16

Baseline characteristics

CharacteristicRomiplostim 30 µgRomiplostim 100 µgRomiplostim 300 µgRomiplostim 500 µgTotal
Age, Continuous60.3 years
STANDARD_DEVIATION 14.9
37.8 years
STANDARD_DEVIATION 13.4
53.9 years
STANDARD_DEVIATION 20.4
45.0 years50.9 years
STANDARD_DEVIATION 17.9
Platelet Count13.0 10⁹cells/L
STANDARD_DEVIATION 6.1
16.5 10⁹cells/L
STANDARD_DEVIATION 10.4
16.4 10⁹cells/L
STANDARD_DEVIATION 7.77
28.8 10⁹cells/L16.3 10⁹cells/L
STANDARD_DEVIATION 8.15
Race/Ethnicity, Customized
Black
0 Participants0 Participants1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White
4 Participants4 Participants6 Participants1 Participants15 Participants
Sex: Female, Male
Female
3 Participants2 Participants4 Participants1 Participants10 Participants
Sex: Female, Male
Male
1 Participants2 Participants3 Participants0 Participants6 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
4 / 44 / 47 / 71 / 1
serious
Total, serious adverse events
0 / 40 / 43 / 71 / 1

Outcome results

Primary

Number of Participants With Adverse Events

Time frame: From first dose through 8 weeks after last dose of study drug (11 weeks)

Population: Participants who received at least 1 dose of romiplostim

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants With Adverse EventsSerious adverse events0 Participants
Romiplostim 30 µgNumber of Participants With Adverse EventsSerious treatment-related adverse events0 Participants
Romiplostim 30 µgNumber of Participants With Adverse EventsDiscontinuations due to adverse events0 Participants
Romiplostim 30 µgNumber of Participants With Adverse EventsAll adverse events4 Participants
Romiplostim 30 µgNumber of Participants With Adverse EventsTreatment-related adverse events1 Participants
Romiplostim 30 µgNumber of Participants With Adverse EventsDeaths0 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsTreatment-related adverse events3 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsSerious treatment-related adverse events0 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsSerious adverse events0 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsAll adverse events4 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsDiscontinuations due to adverse events0 Participants
Romiplostim 100 µgNumber of Participants With Adverse EventsDeaths0 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsTreatment-related adverse events3 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsDeaths0 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsAll adverse events7 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsSerious adverse events3 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsSerious treatment-related adverse events1 Participants
Romiplostim 300 µgNumber of Participants With Adverse EventsDiscontinuations due to adverse events0 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsTreatment-related adverse events1 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsSerious adverse events1 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsDeaths0 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsDiscontinuations due to adverse events0 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsAll adverse events1 Participants
Romiplostim 500 µgNumber of Participants With Adverse EventsSerious treatment-related adverse events1 Participants
Primary

Number of Participants With Positive Anti-Romiplostim Antibodies

The presence or development of antibodies to romiplostim and endogenous thrombopoietin was assessed using a neutralizing bioassay. Antibody analyses were conducted on study days 29 and at the end-of-study visit (day 78). The number of participants with positive antibody binding at any time during the study is reported.

Time frame: Days 29 and 78

Population: Participants who received at least 1 dose of romiplostim

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-romiplostim antibodies0 Participants
Romiplostim 30 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-thrombopoietin antibodies0 Participants
Romiplostim 100 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-thrombopoietin antibodies0 Participants
Romiplostim 100 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-romiplostim antibodies0 Participants
Romiplostim 300 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-romiplostim antibodies0 Participants
Romiplostim 300 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-thrombopoietin antibodies0 Participants
Romiplostim 500 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-romiplostim antibodies0 Participants
Romiplostim 500 µgNumber of Participants With Positive Anti-Romiplostim AntibodiesAnti-thrombopoietin antibodies0 Participants
Secondary

Change From Baseline to Peak Platelet Level

Platelet count data after the use of rescue medication were not included.

Time frame: Baseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)

Population: Participants who received at least 1 dose of romiplostim with available data.

ArmMeasureGroupValue (MEAN)Dispersion
Romiplostim 30 µgChange From Baseline to Peak Platelet LevelAfter First Dose38.75 10⁹ cells/LStandard Deviation 50.5
Romiplostim 30 µgChange From Baseline to Peak Platelet LevelAfter Second Dose11.50 10⁹ cells/LStandard Deviation 14.51
Romiplostim 100 µgChange From Baseline to Peak Platelet LevelAfter First Dose89.98 10⁹ cells/LStandard Deviation 34.44
Romiplostim 100 µgChange From Baseline to Peak Platelet LevelAfter Second Dose46.48 10⁹ cells/LStandard Deviation 25.15
Romiplostim 300 µgChange From Baseline to Peak Platelet LevelAfter Second Dose56.38 10⁹ cells/LStandard Deviation 35
Romiplostim 300 µgChange From Baseline to Peak Platelet LevelAfter First Dose271.3 10⁹ cells/LStandard Deviation 558.4
Romiplostim 500 µgChange From Baseline to Peak Platelet LevelAfter First Dose1033.20 10⁹ cells/L
Secondary

Duration Within the Targeted Therapeutic Range

Targeted therapeutic platelet level was defined as a platelet count that was double the baseline level and between 50 and 450 × 10⁹ cells/L. Platelet count data after the use of rescue medication were not included.

Time frame: From first dose of study drug to day 15 or 22, and from the second dose of study drug (day 15 or 22) to day 78

Population: Participants who received at least 1 dose of romiplostim with a targeted therapeutic response.

ArmMeasureGroupValue (MEDIAN)
Romiplostim 30 µgDuration Within the Targeted Therapeutic RangeAfter First Dose10.0 days
Romiplostim 30 µgDuration Within the Targeted Therapeutic RangeAfter Second Dose1.0 days
Romiplostim 100 µgDuration Within the Targeted Therapeutic RangeAfter First Dose5.5 days
Romiplostim 100 µgDuration Within the Targeted Therapeutic RangeAfter Second Dose2.0 days
Romiplostim 300 µgDuration Within the Targeted Therapeutic RangeAfter First Dose8.0 days
Romiplostim 300 µgDuration Within the Targeted Therapeutic RangeAfter Second Dose8.0 days
Secondary

Number of Participants Who Achieved a Targeted Therapeutic Platelet Response

Targeted therapeutic platelet response was defined as a (single) platelet count that was double the baseline level and between 50 and 450 × 10⁹ cells/L. Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.

Time frame: Baseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)

Population: Participants who received at least 1 dose of romiplostim.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter First Dose1 Participants
Romiplostim 30 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Second Dose1 Participants
Romiplostim 30 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Both Doses1 Participants
Romiplostim 100 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Second Dose3 Participants
Romiplostim 100 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter First Dose4 Participants
Romiplostim 100 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Both Doses3 Participants
Romiplostim 300 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Second Dose3 Participants
Romiplostim 300 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter First Dose4 Participants
Romiplostim 300 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter Both Doses3 Participants
Romiplostim 500 µgNumber of Participants Who Achieved a Targeted Therapeutic Platelet ResponseAfter First Dose0 Participants
Secondary

Number of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From Baseline

Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.

Time frame: Baseline and after first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22) and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 in all participants)

Population: Participants who received at least 1 dose of romiplostim.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter First Dose2 Participants
Romiplostim 30 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Second Dose1 Participants
Romiplostim 30 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Both Doses1 Participants
Romiplostim 100 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Second Dose3 Participants
Romiplostim 100 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter First Dose4 Participants
Romiplostim 100 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Both Doses3 Participants
Romiplostim 300 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Second Dose4 Participants
Romiplostim 300 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter First Dose5 Participants
Romiplostim 300 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter Both Doses3 Participants
Romiplostim 500 µgNumber of Participants With an Increase in Platelet Count of ≥ 20 x 10⁹ Cells/L From BaselineAfter First Dose1 Participants
Secondary

Number of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/L

Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.

Time frame: After first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22), and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 for all participants)

Population: Participants who received at least 1 dose of romiplostim.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter First Dose1 Participants
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Second Dose0 Participants
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Both Doses0 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Second Dose1 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter First Dose3 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Both Doses1 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Second Dose2 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter First Dose3 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter Both Doses1 Participants
Romiplostim 500 µgNumber of Participants With Peak Platelet Counts of ≥ 100 x 10⁹ Cells/LAfter First Dose1 Participants
Secondary

Number of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/L

Platelet count data after the use of rescue medication were not included; participants with no platelet count data were considered non-responders.

Time frame: After first dose (days 3, 5, 8, 10, 12, 15, and days 17 and 19 for participants dosed on day 22), and after second dose (days 17, 19, and 22 for participants dosed on day 15, and days 24, 26, 29, 32, 36, 43, 50, 64, and 78 for all participants)

Population: Participants who received at least 1 dose of romiplostim.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter First Dose0 Participants
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Second Dose0 Participants
Romiplostim 30 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Both Doses0 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Second Dose0 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter First Dose0 Participants
Romiplostim 100 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Both Doses0 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Second Dose0 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter First Dose1 Participants
Romiplostim 300 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter Both Doses0 Participants
Romiplostim 500 µgNumber of Participants With Peak Platelet Counts of ≥ 450 x 10⁹ Cells/LAfter First Dose1 Participants
Secondary

Time to Peak Platelet Count

Time from the date of study drug administration (day 1, 15 or 22) to the day of peak platelet count after each dose. Platelet count data after the use of rescue medication were not included.

Time frame: From first dose of study drug to day 15 or 22, and from the second dose of study drug (day 15 or 22) to day 78

Population: Participants who received at least 1 dose of romiplostim with available data.

ArmMeasureGroupValue (MEDIAN)
Romiplostim 30 µgTime to Peak Platelet CountAfter Second Dose13.5 days
Romiplostim 30 µgTime to Peak Platelet CountAfter First Dose10.5 days
Romiplostim 100 µgTime to Peak Platelet CountAfter First Dose9.0 days
Romiplostim 100 µgTime to Peak Platelet CountAfter Second Dose9.5 days
Romiplostim 300 µgTime to Peak Platelet CountAfter First Dose12.0 days
Romiplostim 300 µgTime to Peak Platelet CountAfter Second Dose9.0 days
Romiplostim 500 µgTime to Peak Platelet CountAfter First Dose17.0 days

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026