Fixed Low-dose Eltrombopag and rhTPO for Immune Thrombocytopenia (FLOWER)

Combination of Fixed Low-dose Eltrombopag and rhTPO for Treatment of Immune Thrombocytopenia


Lead Sponsor: Peking University People's Hospital

Source Peking University People's Hospital
Brief Summary

This is a prospective, single-arm study to investigate the efficacy and safety of the combination of fixed low-dose eltrombopag plus recombinant human thrombopoietin (rhTPO) as treatment for corticosteroid-resistant or relapsed immune thrombocytopenia (ITP) patients during the COVID-19 pandemic.

Detailed Description

Eltrombopag, a small molecule agonist of thrombopoietin receptor (TPO-RA), was recommended as the subsequent treatment for ITP patients, which also already showed robust efficacy.Recombinant human thrombopoietin (rhTPO) is a full-length glycosylated-TPO produced by Chinese hamster ovary cells, which showed its effectiveness in ITP in a variety of studies. Both eltrombopag and rhTPO demonstrated good safety in ITP patients. Because of their non-immunosuppressive nature, both of them serve as a reasonable choice during the global COVID-19 pandemic. Since they increase the number of platelets through different mechanisms, and previous studies demonstrated that they might exert synergic effect. The investigators hypothesized that the combination of these two agents could be a promising option for treatment of corticosteroid-resistant or relapsed ITP patients.

Overall Status Recruiting
Start Date August 31, 2020
Completion Date June 2022
Primary Completion Date December 2021
Phase Phase 1
Study Type Interventional
Primary Outcome
Measure Time Frame
Complete response 6 weeks
Response 6 weeks
No response 6 weeks
Relapses 6 weeks
Secondary Outcome
Measure Time Frame
Early response 7 days
Initial response 1 month
TOR (time to response) 6 weeks
DOR (duration of response) 6 weeks
Treatments associated adverse events 6 weeks
Reduction in bleeding symptoms 6 weeks
Enrollment 30

Intervention Type: Drug

Intervention Name: Eltrombopag

Description: Fixed dose of eltrombopag oral 25mg daily

Arm Group Label: Fixed Low-dose Eltrombopag and rhTPO

Other Name: Revolade

Intervention Type: Drug

Intervention Name: rhTPO

Description: Rh-TPO 300U/kg subcutaneous injection once daily for 7 consecutive days, followed by a tapering dose in maintenance therapy.

Arm Group Label: Fixed Low-dose Eltrombopag and rhTPO

Other Name: TPIAO, tebiao



Inclusion Criteria: 1. Clinically confirmed corticosteroid-resistant or relapsed immune thrombocytopenic purpura (ITP) 2. Subject has signed and provided written informed consent. 3. Fertile patients must use effective contraception during treatment and observational period 4. Negative pregnancy test Exclusion Criteria: 1. Have an impaired renal function as indicated by a serum creatinine level > 2.0 mg/dL 2. Have an inadequate liver function as indicated by a total bilirubin level > 2.0 mg/dL and/or an aspartate aminotransaminase or alanine aminotransferase level > 3×upper limit of normal 3. Have a New York Heart Classification III or IV heart disease 4. Have a history of severe psychiatric disorder or are unable to comply with study and follow-up procedures 5. Have active hepatitis B or hepatitis C infection 6. Have a HIV infection 7. Have active infection requiring antibiotic therapy within 7 days prior to study entry 8. Are pregnant or lactating women, or plan to become pregnant or impregnated within 12 months of receiving study drug 9. Previous splenectomy 10. Had previous or concomitant malignant disease 11. Not willing to participate in the study. 12. Expected survival of < 2 years 13. Intolerant to murine antibodies 14. Immunosuppressive treatment within the last 2 weeks 15. Connective tissue disease 16. Autoimmune hemolytic anemia 17. Patients currently involved in another clinical trial with evaluation of drug treatment

Gender: All

Minimum Age: 18 Years

Maximum Age: 80 Years

Healthy Volunteers: No

Overall Official
Last Name Role Affiliation
Xiaohui Zhang, MD Principal Investigator Peking University People's Hospital, Peking University Insititute of Hematology
Overall Contact

Last Name: Xiaohui Zhang, MD

Phone: +86-13522338836

Email: [email protected]

Facility: Status: Contact: Peking University Insititute of Hematology, Peking University People's Hospital Xiaohui Zhang [email protected]
Location Countries


Verification Date

August 2020

Responsible Party

Type: Principal Investigator

Investigator Affiliation: Peking University People's Hospital

Investigator Full Name: Xiao Hui Zhang

Investigator Title: Vice president of Peking Univeristy Institute of Hematology

Has Expanded Access No
Condition Browse
Number Of Arms 1
Arm Group

Label: Fixed Low-dose Eltrombopag and rhTPO

Type: Experimental

Description: Fixed Low-dose Eltrombopag and rhTPO

Patient Data No
Study Design Info

Allocation: N/A

Intervention Model: Single Group Assignment

Primary Purpose: Treatment

Masking: None (Open Label)