Bruton's Tyrosine Kinase, Immune Thrombocytopenia
Conditions
Keywords
Orelabrutinib
Brief summary
BTK participates in a variety of signal transduction of innate and adaptive immunity, and has an important role in cell proliferation, differentiation and apoptosis. The impact of BTK inhibitors on hematological malignancies and autoimmune diseases has been well studied. This project was undertaking by Qilu Hospital of Shandong University in China. In order to report the efficacy and safety of the selective BTK inhibitor Orelabrutinib in the management of refractory ITP.
Detailed description
The investigators are undertaking a prospective, open-lable, multicentre trial of 40 refractory ITP adult patients in China. Eligible participants will receive Orelabrutinib in 50 mg po. qd, every 4 weeks for one cycle and it will be given 3 cycles. For non-responders who were well tolerated at 12 weeks of follow-up, the treatment could be extended to 6 cycles. The treatment will be discontinued after 6 months without blood index reaction. In order to report the efficacy and safety of Orelabrutinib in the management of refractory ITP, platelet count, bleeding and other symptoms will be evaluated before and after treatments. Adverse events are also recorded throughout the study.
Interventions
DRUGOrelabrutinib
Orelabrutinib 50mg po qd, every four weeks for one cycle. It will be given three cycles.
Sponsors
Shandong University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Meet the diagnostic criteria for primary immune thrombocytopenia * To show a platelet count \< 30 \* 10\^9/L, or with bleeding manifestations, or both * Willing and able to sign written informed consent * Meet the diagnostic criteria of refractory ITP according to Chinese guidelines
Exclusion criteria
* Secondary thrombocytopenia * severe immune-deficiency or history of primary immunodeficiency * active or previous malignancy * HIV virus infection, tuberculosis, or other active infection (sepsis, pneumonia, or abscess) * pregnancy or lactation * diabetes * hypertension * cardiovascular diseases * severe liver or kidney function impairment * psychosis * osteoporosis * inflammatory bowel disease or gastric disease * arterial or venous thromboembolism within the 6 months before screening or patients who required anticoagulant treatment * an organ or haematopoietic stem-cell transplantation * neutrophil count of less than 1500 cells per mm³; glycosylated haemoglobin less than 8%; partial thromboplastin time 1∙5 times or less the upper limit of normal (ULN) * clinical electrocardiogram changes * neoplastic disease within the past 5 years * corrected QT interval greater than 450 ms for men and greater than 470 ms for women; * substance misuse within the previous 12 months; and those who could not adhere to the protocol or were planning to have a surgical procedure in 6 months.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Initial overall response to Orelabrutinib | 14 days after the first dose of Orelabrutinib | Complete response was defined as a platelet count of 100×10⁹ cells per L or higher and an absence of bleeding. Partial response was defined as a platelet count of 30×10⁹ cells per L or higher, but less than 100×10⁹ cells per L, and at least a doubling of the baseline platelet count and an absence of bleeding. Platelet counts were confirmed on two separate occasions at least 7 days apart when defining complete response or partial response. No response was defined as a platelet count of less than 30×10⁹ cells per L, or less than two-times increase from baseline platelet count, or bleeding. |
| Sustained overall response to Orelabrutinib | A response lasting for at least 6 months without any additional intervention specific to primary immune thrombocytopenia was defined as a sustained response | Complete response was defined as a platelet count of 100×10⁹ cells per L or higher and an absence of bleeding. Partial response was defined as a platelet count of 30×10⁹ cells per L or higher, but less than 100×10⁹ cells per L, and at least a doubling of the baseline platelet count and an absence of bleeding. Platelet counts were confirmed on two separate occasions at least 7 days apart when defining complete response or partial response. No response was defined as a platelet count of less than 30×10⁹ cells per L, or less than two-times increase from baseline platelet count, or bleeding. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to response | An average of 6 months | Time from treatment initiation to achieve a complete response or a partial response |
| Duration of response | through study completion, an average of 1 year | Time from achievement of a complete response or a partial response to the loss of response (platelet count \<30×10⁹ cells per L; measured on two occasions more than 1 day apart or the presence of bleeding). |
| Therapy associated adverse events | Up to 1 year | Potential adverse events: leukopenia (report in number \* 10\^9/L, time of occurrence and duration); nausea and diarrhea (report in frequency); infection (report pathogens and infectious diseases). |
Contacts
Primary ContactMing Hou, MD,PhD
Outcome results
None listed