RAISE: Randomized Placebo-Controlled Idiopathic Thrombocytopenic Purpura (ITP) Study With Eltrombopag (RAISE)

March 21, 2017 updated by: GlaxoSmithKline

A Randomized, Double-blind, Placebo-controlled Phase III Study, to Evaluate the Efficacy, Safety and Tolerability of Eltrombopag Olamine (SB-497115-GR), a Thrombopoietin Receptor Agonist, Administered for 6 Months as Oral Tablets Once Daily in Adult Subjects With Previously Treated Chronic ITP.

The rationale for this Phase III study is to evaluate the 6 month safety and efficacy of eltrombopag in the treatment of previously treated subjects with chronic ITP. The starting dose of eltrombopag, 50 mg, once daily was selected based upon the observed efficacy, safety and pharmacokinetics in a dose-finding Study (TRA100773). This Phase III study is a randomized, double-blind, placebo-controlled, Phase III study, to evaluate efficacy, safety and tolerability of eltrombopag, initially administered as 50 mg oral tablets once daily for six months in adult subjects with previously treated chronic ITP. Subjects will be randomized 2:1, eltrombopag to placebo, and will be stratified based upon splenectomy status, use of ITP medication at baseline and baseline platelet count less than or equal to 15,000/µL. Subjects will receive study medication for 6 months, during which the dose of study medication may be adjusted based upon individual platelet counts. In addition, subjects may taper off concomitant ITP medications and may receive any rescue treatments as dictated by local standard of care. After discontinuation of study medication, subjects will complete follow-up visits at weeks 1, 2, 4 and months 3 and 6.

Study Overview

Status

Completed

Intervention / Treatment

Detailed Description

A randomized, double-blind, placebo-controlled phase III study, to evaluate the efficacy, safety and tolerability of eltrombopag olamine (SB-497115-GR), a thrombopoietin receptor agonist, administered for 6 months as oral tablets once daily in adult subjects with previously treated chronic idiopathic thrombocytopenic purpura (ITP).

Study Type

Interventional

Enrollment (Actual)

197

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Vienna, Austria, A-1090
        • GSK Investigational Site
    • British Columbia
      • Burnaby, British Columbia, Canada, V5H 4K7
        • GSK Investigational Site
    • Newfoundland and Labrador
      • Saint John's, Newfoundland and Labrador, Canada, A1B 3V6
        • GSK Investigational Site
    • Ontario
      • Hamilton, Ontario, Canada, L8N 3Z5
        • GSK Investigational Site
      • Weston, Ontario, Canada, M9N 1N8
        • GSK Investigational Site
    • Quebec
      • Greenfield Park, Quebec, Canada, J4V 2H1
        • GSK Investigational Site
      • Laval, Quebec, Canada, H7M 3L9
        • GSK Investigational Site
      • Montreal, Quebec, Canada, H3T 1E2
        • GSK Investigational Site
      • Montreal, Quebec, Canada, H2L 4M1
        • GSK Investigational Site
      • Jiang Su Province, China, 215006
        • GSK Investigational Site
      • Shanghai, China, 200025
        • GSK Investigational Site
      • Tianjin, China, 300020
        • GSK Investigational Site
      • Brno, Czech Republic, 625 00
        • GSK Investigational Site
      • Hradec Kralove, Czech Republic, 500 05
        • GSK Investigational Site
      • Olomouc, Czech Republic, 775 20
        • GSK Investigational Site
      • Praha 2, Czech Republic, 128 20
        • GSK Investigational Site
      • Odense, Denmark, 5000
        • GSK Investigational Site
      • Kuopio, Finland, 70210
        • GSK Investigational Site
      • Bobigny, France, 93003
        • GSK Investigational Site
      • Caen, France, 14033
        • GSK Investigational Site
      • Créteil, France, 94010
        • GSK Investigational Site
      • Pessac, France, 33604
        • GSK Investigational Site
      • Berlin, Germany, 13353
        • GSK Investigational Site
    • Bayern
      • Muenchen, Bayern, Germany, 80639
        • GSK Investigational Site
    • Hessen
      • Giessen, Hessen, Germany, 35392
        • GSK Investigational Site
    • Niedersachsen
      • Hannover, Niedersachsen, Germany, 30625
        • GSK Investigational Site
    • Saarland
      • Saarbruecken, Saarland, Germany, 66113
        • GSK Investigational Site
      • Athens, Greece, 10676
        • GSK Investigational Site
      • Athens, Greece, 11527
        • GSK Investigational Site
      • Athens, Greece, 15123
        • GSK Investigational Site
      • Heraklion, Crete, Greece, 71201
        • GSK Investigational Site
      • Thessaloniki, Greece, 57010
        • GSK Investigational Site
      • Shatin, Hong Kong
        • GSK Investigational Site
      • Bangalore, India, 560002
        • GSK Investigational Site
      • Manipal, India, 576 104
        • GSK Investigational Site
    • Campania
      • Napoli, Campania, Italy, 80131
        • GSK Investigational Site
    • Emilia-Romagna
      • Bologna, Emilia-Romagna, Italy, 40138
        • GSK Investigational Site
    • Lazio
      • Albano Laziale (Roma), Lazio, Italy, 00041
        • GSK Investigational Site
    • Lombardia
      • Milano, Lombardia, Italy, 20132
        • GSK Investigational Site
    • Veneto
      • Padova, Veneto, Italy, 35128
        • GSK Investigational Site
      • Vicenza, Veneto, Italy, 36100
        • GSK Investigational Site
      • Amersfoort, Netherlands, 3816 CP
        • GSK Investigational Site
      • Nijmegen, Netherlands, 6525 GA
        • GSK Investigational Site
      • Zwolle, Netherlands, 8025 AB
        • GSK Investigational Site
      • Auckland, New Zealand, 1701
        • GSK Investigational Site
      • Auckland, New Zealand, 1309
        • GSK Investigational Site
      • Christchurch, New Zealand, 8011
        • GSK Investigational Site
      • Grafton, New Zealand, 1003
        • GSK Investigational Site
      • Lima, Peru, Lima 27
        • GSK Investigational Site
      • Lima, Peru, Lima 41
        • GSK Investigational Site
      • Gdansk, Poland, 80-952
        • GSK Investigational Site
      • Krakow, Poland, 31-501
        • GSK Investigational Site
      • Legnica, Poland, 59-200
        • GSK Investigational Site
      • Opole, Poland, 45-372
        • GSK Investigational Site
      • Slupsk, Poland, 76-200
        • GSK Investigational Site
      • Torun, Poland, 87-100
        • GSK Investigational Site
      • Wroclaw, Poland, 50-367
        • GSK Investigational Site
      • Moscow, Russian Federation, 125167
        • GSK Investigational Site
      • Novosibirsk, Russian Federation, 630087
        • GSK Investigational Site
      • St Petersburg, Russian Federation, 193024
        • GSK Investigational Site
      • Kosice, Slovakia, 041 90
        • GSK Investigational Site
      • Martin, Slovakia, 036 59
        • GSK Investigational Site
      • Presov, Slovakia, 080 01
        • GSK Investigational Site
      • Madrid, Spain, 28006
        • GSK Investigational Site
      • Madrid, Spain, 28040
        • GSK Investigational Site
      • Palma de Mallorca, Spain, 07014
        • GSK Investigational Site
      • Taipei, Taiwan, 100
        • GSK Investigational Site
      • Taipei, Taiwan
        • GSK Investigational Site
      • Taipei, Taiwan, 114
        • GSK Investigational Site
      • Taipei, Taiwan, 110
        • GSK Investigational Site
      • Sfax, Tunisia, 3029
        • GSK Investigational Site
      • Sousse, Tunisia, 4000
        • GSK Investigational Site
      • Tunis, Tunisia, 1008
        • GSK Investigational Site
      • Dnipropetrovsk, Ukraine, 49102
        • GSK Investigational Site
      • Kyiv, Ukraine, 04112
        • GSK Investigational Site
      • Kyiv, Ukraine, 03150
        • GSK Investigational Site
      • Lviv, Ukraine, 79044
        • GSK Investigational Site
      • Odessa, Ukraine, 65025
        • GSK Investigational Site
      • Leed, United Kingdom, LS1 3EX
        • GSK Investigational Site
      • London, United Kingdom, E1 1BB
        • GSK Investigational Site
      • London, United Kingdom, SE5 9RS
        • GSK Investigational Site
      • London, United Kingdom, NW1 2BU
        • GSK Investigational Site
      • Manchester, United Kingdom, M13 9WL
        • GSK Investigational Site
      • Morriston, United Kingdom, SA6 6NL
        • GSK Investigational Site
      • Reading, United Kingdom, RG1 5AN
        • GSK Investigational Site
      • Rhyl, Denbighshire, United Kingdom
        • GSK Investigational Site
    • Devon
      • Plymouth, Devon, United Kingdom, PL6 8DH
        • GSK Investigational Site
    • Somerset
      • Taunton, Somerset, United Kingdom, TA1 5DA
        • GSK Investigational Site
    • California
      • Duarte, California, United States, 91010
        • GSK Investigational Site
      • Los Angeles, California, United States, 90033
        • GSK Investigational Site
      • San Francisco, California, United States, 94143
        • GSK Investigational Site
    • District of Columbia
      • Washington, District of Columbia, United States, 20007
        • GSK Investigational Site
      • Washington, District of Columbia, United States, 20010-2975
        • GSK Investigational Site
    • Florida
      • Hollywood, Florida, United States, 33021
        • GSK Investigational Site
    • Georgia
      • Atlanta, Georgia, United States, 30341
        • GSK Investigational Site
      • Savannah, Georgia, United States, 31405
        • GSK Investigational Site
    • Hawaii
      • Honolulu, Hawaii, United States, 96813
        • GSK Investigational Site
    • Massachusetts
      • Boston, Massachusetts, United States, 02114
        • GSK Investigational Site
      • Worcester, Massachusetts, United States, 01655
        • GSK Investigational Site
    • Missouri
      • St. Louis, Missouri, United States, 63110
        • GSK Investigational Site
    • New York
      • Buffalo, New York, United States, 14215
        • GSK Investigational Site
      • New York, New York, United States, 10065
        • GSK Investigational Site
      • New York, New York, United States, 10029
        • GSK Investigational Site
    • Ohio
      • Cleveland, Ohio, United States, 44106
        • GSK Investigational Site
    • Oklahoma
      • Lawton, Oklahoma, United States, 73505
        • GSK Investigational Site
    • Oregon
      • Portland, Oregon, United States, 97227
        • GSK Investigational Site
    • Pennsylvania
      • Willow Grove, Pennsylvania, United States, 19090
        • GSK Investigational Site
    • Texas
      • Dallas, Texas, United States, 75137
        • GSK Investigational Site
      • Houston, Texas, United States, 77030
        • GSK Investigational Site
      • Lubbock, Texas, United States, 79415
        • GSK Investigational Site
      • Lubbock, Texas, United States, 79410
        • GSK Investigational Site
    • Virginia
      • Arlington, Virginia, United States, 22205
        • GSK Investigational Site
    • Washington
      • Seattle, Washington, United States, 98109
        • GSK Investigational Site
      • Tacoma, Washington, United States, 98405
        • GSK Investigational Site
      • Ho Chi Minh, Vietnam
        • GSK Investigational Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion criteria:

  • A subject will be eligible for inclusion in this study only if all of the following criteria apply:
  • Subject has signed and dated a written informed consent.
  • Adults (≥18 years) diagnosed with chronic ITP according to the American Society for Hematology/British Committee for Standards in Hematology (ASH/BCSH) guidelines [George, 1996; BCSH, 2003], and platelet count < 30,000/μL on Day 1 (or within 24 hours prior to dosing on Day 1). In addition, a peripheral blood smear should support the diagnosis of ITP with no evidence of other causes of thrombocytopenia (e.g. pseudothrombocytopenia, myelofibrosis). The physical examination should not suggest any disease which may cause thrombocytopenia other than ITP.
  • Subjects who have previously received one or more prior ITP therapies. Previous treatments for ITP include but are not limited to corticosteroids, immunoglobulins, azathioprine, danazol, cyclophosphamide and/or rituximab.
  • Subjects must have either initially responded (platelet count > 100,000/μL) to a previous ITP therapy or have had a bone marrow examination consistent with ITP within 3 years to rule out myelodysplastic syndromes or other causes of thrombocytopenia.
  • Previous therapy for ITP with immunoglobulins (IVIg and anti-D) must have been completed at least 1 week prior to randomization and the platelet count must show a clear downward trend after the last treatment with immunoglobulins. Previous treatment for ITP with splenectomy, rituximab and cyclophosphamide must have been completed at least 4 weeks prior to randomization, or clearly be ineffective.
  • Subjects treated with concomitant ITP medication (e.g. corticosteroids or azathioprine) must be receiving a dose that has been stable for at least 4 weeks prior to randomization. Subjects treated with cyclosporine A, mycophenolate mofetil or danazol must be receiving a dose that has been stable for at least 3 months prior to randomization. The medication should be continued with a stable dose for the initial 6 weeks of study "Concomitant ITP Therapy")
  • Prothrombin time (PT/INR) and activated partial thromboplastin time (aPTT) must be within 80 to 120% of the normal range with no history of hypercoagulable state.
  • A complete blood count (CBC), within the reference range (including WBC differential not indicative of a disorder other than ITP), with the following exceptions:
  • < 30,000 platelets/μL on Day 1 (or within 24 hours of Day 1) is required for inclusion,
  • Hemoglobin: Subjects with hemoglobin levels between 10 g/dL (100 g/L) and the lower limit of normal are eligible for inclusion, if anemia is clearly attributable to ITP (excessive blood loss).
  • ANC ≥ 1500/μL (1.5 x 10^9/L) is required for inclusion (elevated WBC/ANC due to steroid treatment is acceptable).
  • The following clinical chemistries MUST NOT exceed the upper limit of normal (ULN) reference range by more than 20%: creatinine, ALT, AST, total bilirubin, and alkaline phosphatase. In addition, total albumin must not be below the lower limit of normal (LLN) by more than 10%.
  • Subject is practicing an acceptable method of contraception (documented in chart). Female subjects (or female partners of male subjects) must either be of non-childbearing potential (hysterectomy, bilateral oophorectomy, bilateral tubal ligation or post-menopausal > 1 year), or of childbearing potential and use one of the following highly effective methods of contraception (i.e., Pearl Index <1.0%) from two weeks prior to administration of study medication, throughout the study, and 28 days after completion or premature discontinuation from the study:
  • Complete abstinence from intercourse;
  • Intrauterine device (IUD);
  • Two forms of barrier contraception (diaphragm plus spermicide, and for males condom plus spermicide);
  • Male partner is sterile prior to entry into the study and is the only partner of the female;
  • Systemic contraceptives (combined or progesterone only). Subject is able to understand and comply with protocol requirements and instructions and intends to complete the study as planned.

Exclusion criteria:

  • A subject will NOT be eligible for inclusion in this study if any of the following criteria apply:
  • Any clinically relevant abnormality, other than ITP, identified on the screening examination or any other medical condition or circumstance, which in the opinion of the investigator makes the subject unsuitable for participation in the study or suggests another primary diagnosis (e.g., thrombocytopenia is secondary to another disease).
  • Concurrent malignant disease and/or history of cancer treatment with cytotoxic chemotherapy and/or radiotherapy.
  • Any prior history of arterial or venous thrombosis (stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis or pulmonary embolism), AND ≥ two of the following risk factors: hormone replacement therapy, systemic contraception (containing estrogen), smoking, diabetes, hypercholesterolemia, medication for hypertension, cancer, hereditary thrombophilic disorders (e.g., Factor V Leiden, ATIII deficiency, etc), or any other family history of arterial or venous thrombosis.
  • Pre-existing cardiovascular disease (congestive heart failure, New York Heart Association [NYHA] Grade III/IV), or arrhythmia known to increase the risk of thromboembolic events (e.g. atrial fibrillation), or subjects with a QTc >450 msec.
  • Female subjects who are nursing or pregnant (positive serum or urine b-human chorionic gonadotrophin pregnancy test) at screening or pre-dose on Day 1.
  • History of alcohol/drug abuse.
  • Treatment with an investigational drug within 30 days or five half-lives (whichever is longer) preceding the first dose of study medication.
  • Subject treated with drugs that affect platelet function (including but not limited to aspirin, clopidogrel and/or NSAIDs) or anti-coagulants for > 3 consecutive days within 2 weeks of the study start and until the end of the study.
  • History of platelet agglutination abnormality that prevents reliable measurement of platelet counts.
  • All subjects with secondary immune thrombocytopenia, including those with laboratory or clinical evidence of HIV infection, anti-phospholipid antibody syndrome, chronic hepatitis B infection, hepatitis C virus infection, or any evidence for active hepatitis at the time of subject screening. If a potential subject has no clinical history that would support HIV infection or hepatitis infection, no further laboratory screening is necessary; however, standard medical practice would suggest further evaluation of patients who have risk factors for these infections.
  • Previous participation in a clinical study with eltrombopag.
  • Patients planning to have cataract surgery.
  • In France, a subject is neither affiliated with nor a beneficiary of a social security category.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Treatment arm plus standard of care
Subjects will initiate treatment with 50 mg eltrombopag or matching placebo once daily. Based upon the subjects platelet count at each visit, the dose of eltrombopag may be adjusted either up or down.
Subjects will initiate treatment with either 50 mg eltrombopag or matching placebo once daily. Based upon the subjects platelet count at each visit, the dose of eltrombopag may be adjusted either up or down.
Placebo Comparator: placebo plus standard of care
Subjects will initiate treatment with 50 mg eltrombopag or matching placebo once daily. Based upon the subjects platelet count at each visit, the dose of eltrombopag may be adjusted either up or down.
Subjects will initiate treatment with either 50 mg eltrombopag or matching placebo once daily. Based upon the subjects platelet count at each visit, the dose of eltrombopag may be adjusted either up or down

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Responders
Time Frame: Baseline; each on-therapy treatment day; Weeks 10, 14, 18, 22, and 26; and Weeks 1, 2, and 4 post-treatment
The percentage of evaluable participants who achieved a platelet response (defined as a platelet count between 50,000 and 400,000 microliter) at each nominal on-therapy day and 4 weeks post-treatment
Baseline; each on-therapy treatment day; Weeks 10, 14, 18, 22, and 26; and Weeks 1, 2, and 4 post-treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Summary of Median Platelet Counts
Time Frame: Baseline; Day 8 through Week 26 on-treatment; and 1, 2, 4 week follow-up visits
Platelet counts were measured by blood draw.
Baseline; Day 8 through Week 26 on-treatment; and 1, 2, 4 week follow-up visits
Percentage of Participants Initiating Rescue Treatment On-therapy
Time Frame: Anytime from Day 1 to Week 26
Percentage of participants initiating new ITP medication, an increased dose of concomitant ITP medication from baseline, platelet transfusion, or splenectomy.
Anytime from Day 1 to Week 26
Maximum and Total Weeks of Platelet Response
Time Frame: Day 1 through Week 26 on-treatment
Response is defined as a platelet count between 50,000 and 400,000 platelets per microliter.
Day 1 through Week 26 on-treatment
Percentage of Participants With a Reduction in Use of Baseline ITP Medication
Time Frame: From Day 1 through Week 26 on-treatment
Percentage of participants who experienced a reduction in their baseline concomitant ITP medication use
From Day 1 through Week 26 on-treatment
WHO Bleeding Scale
Time Frame: Baseline, all nominal visits on-therapy defined as Day 8, Day 15, Day 22, Day 29, Day 36, Day 43, Week 10, Week 14, Week 18, Week 22, Week 26, and 1, 2 and 4 week follow-up visits
Summary of World Health Organization (WHO) bleeding scores at each nominal visit. WHO Grades 1-4 = any bleeding; WHO Grades 2-4 = clinically significant bleeding
Baseline, all nominal visits on-therapy defined as Day 8, Day 15, Day 22, Day 29, Day 36, Day 43, Week 10, Week 14, Week 18, Week 22, Week 26, and 1, 2 and 4 week follow-up visits
HR-QoL Instrument and Domain Scores From the SF-36v2 Questionnaire at Baseline, Week 6, Week 14, and Week 26 or Early Discontinuation From Study Treatment
Time Frame: Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
Health-related quality of life (HR-QoL) patient reported outcomes from the short form-36v2 (SF-36v2) questionnaire. Scores could range from 0 (worst possible) to 100 (best possible).
Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
HR-QoL Instrument and Domain Scores From the FACIT-F Questionnaire at Baseline, Week 6, Week 14, and Week 26 or Early Discontinuation From Study Treatment
Time Frame: Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
Health-related quality of life (HR-QoL) patient reported outcomes from the functional assessment of chronic illness therapy fatigue (FACIT-F) questionnaire. Scores could range from 0 (worst possible) to 52 (best possible).
Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
HR-QoL Instrument and Domain Scores for the FACT-Th Questionnaire at Baseline, Week 6, Week 14, and Week 26 or Early Discontinuation From Study Treatment
Time Frame: Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
Health-related quality of life (HR-QoL) patient reported outcomes from the functional assessment of cancer therapy thrombocytopenia (FACT-Th) questionnaire (six selected items). Scores could range from 0 (worst possible) to 24 (best possible).
Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
HR-QoL Instrument and Domain Scores From the MEI-SF Questionnaire at Baseline, Week 6, Week 14, and Week 26 or Early Discontinuation From Study Treatment
Time Frame: Baseline, Week 6, Week 14, and Week 26/Early Withdrawal
Health-related quality of life (HR-QoL) patient reported outcomes from the motivation and energy inventory-short form (MEI-SF) questionnaire. Scores could range from 0 (worst possible) to 72 (best possible).
Baseline, Week 6, Week 14, and Week 26/Early Withdrawal

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2006

Primary Completion (Actual)

July 1, 2008

Study Completion (Actual)

July 1, 2008

Study Registration Dates

First Submitted

August 29, 2006

First Submitted That Met QC Criteria

August 29, 2006

First Posted (Estimate)

August 31, 2006

Study Record Updates

Last Update Posted (Actual)

April 18, 2017

Last Update Submitted That Met QC Criteria

March 21, 2017

Last Verified

March 1, 2017

More Information

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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