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Atorvastatin Combined With NAC Plus Romiplostim for Management of ITP

19. juni 2026 opdateret af: Fu Haixia, Peking University People's Hospital

Atorvastatin Combined With N-Acetyl-L-Cysteine Plus Romiplostim for Management of Steroid-Resistant/Relapsed Immune Thrombocytopenia

This is a prospective, single-arm, open-lable, single-center study and we aimed to determine whether atorvastatin combined with N-acetyl-L-cysteine (NAC) plus romiplostim could induce sustained response off-treatment (SRoT) in adult patients with ITP following CS failure.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a prospective, single-arm trial designed to investigate whether atorvastatin combined with N-acetyl-L-cysteine (NAC) plus romiplostim can induce a sustained response off-treatment (SRoT) in adult patients with immune thrombocytopenia (ITP) who experienced failure of first-line corticosteroid therapy. In this study, SRoT is defined as an off-treatment period during which the platelet count remains above 30×10⁹/L in the absence of bleeding events or rescue therapy. The primary endpoint was the proportion of patients who achieved SRoT by Week 24 after the discontinuation of romiplostim. From Week 1 to Week 24, atorvastatin and NAC was administrated as the dose of 20mg qd and 400mg tid,respectively, and were discontinued at the end of Week 24. During the initial 24 weeks, romiplostim was initiated at a starting dose of 3 μg/kg per week. The weekly dose was adjusted based on platelet counts, with a maximum dose of 10 μg/kg per week, to maintain platelet levels within the range of 100-200×10⁹/L. From Week 25 to Week 35, romiplostim was gradually tapered and discontinued, with the goal of maintaining a platelet count ≥30×10⁹/L and no less than twice the baseline level. After all medications (including atorvastatin, NAC, and romiplostim) were discontinued (no later than Week 36), patients were followed up for an additional 24 weeks to evaluate the sustained response rate at 24 weeks post-treatment cessation.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

50

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Kina
      • Beijing, Kina
        • Peking University People's Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Diagnosed with primary ITP;
  • Aged ≥18 years;
  • Patients with treatment failure or relapse after first-line corticosteriod therapy for ITP;
  • Platelet count <30×10⁹/L.

Exclusion Criteria:

  • Pregnant or lactating women, and who were possibly pregnant, planning to become pregnant, or who had partners planning to become pregnant;
  • Presence of active malignant tumors;
  • Active HBV, HCV or HIV infection;
  • Active infection requiring systematic treatment;
  • Leukemia, myelodysplastic syndrome, aplastic anemia, myelofibrosis or other hematological disorders that may cause thrombocytopenia;
  • History or presence of myocardial infarction, unstable ischemic heart disease, stroke, or NYHA Class IV heart failure;
  • AST > 2 times the upper limit of normal (ULN), ALT > 2×ULN, or TBIL ≥ 1.5×ULN;
  • eGFR < 50 mL/min/1.73m²;
  • Any other subjects deemed ineligible for enrollment by the investigator.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: combined therapy
atorvastatin 20mg qd , N-acetyl-L-cysteine (NAC) 400mg tid, and romiplostim
Medicin: atorvastatin, NAC, and romiplostim
From Week 1 to Week 24, atorvastatin and NAC was administrated as the dose of 20mg qd and 400mg tid,respectively, and were discontinued at the end of Week 24. For romiplostim, the initial dose was 3 μg/kg per week. The weekly dose was adjusted based on platelet counts, with a maximum dose of 10 μg/kg per week, to maintain platelet levels within the range of 100-200×10⁹/L during the initial 24-week period. From Week 25 to Week 35, romiplostim was gradually tapered and discontinued with the goal of maintaining a platelet count ≥30×10⁹/L and no less than twice the baseline level. After all medications (including atorvastatin, NAC, and romiplostim) were discontinued (no later than Week 36), patients were followed up for an additional 24 weeks to evaluate the sustained response rate at 24 weeks post-treatment cessation.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
24-week SRoT rate
Tidsramme: 24 weeks post-treatment cessation
Sustained response off-treatment (SRoT) rate is defined as the proportion of patients who maintain a platelet count ≥30×10^9/L and at least a two-fold increase from the baseline count without active bleeding following treatment discontinuation.
24 weeks post-treatment cessation

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
24-week SCRoT rate
Tidsramme: 24 weeks after treatment discontinuation
Sustained complete response off-treatment (SCRoT) rate was defined as the proportion of patients who maintain a platelet count of ≥100×10⁹/L without active bleeding after treatment discontinuation.
24 weeks after treatment discontinuation
ORR
Tidsramme: Up to the end of week 24
Overall response rate (ORR) is defined as the proportion of patients who achieve platelet count ≥30×10^9/L and more than twice the baseline level, with no signs of active bleeding.
Up to the end of week 24
CR rate
Tidsramme: Up to the end of week 24
Complete response (CR) rate is defined as the proportion of patients who achieve a platelet count ≥100×10⁹/L with no signs of active bleeding.
Up to the end of week 24
TTR
Tidsramme: Up to the end of week 24
Time to response (TTR) is defined as the days from treatment initiation to first platete count reaching ≥30×10^9/L
Up to the end of week 24
Sustained response
Tidsramme: Up to the end of week 24
Platelet count ≥30×10⁹/L and at least doubled from baseline on at least three of four scheduled visits during the final 8 weeks of the initial 24-week treatment phase without active bleeding.
Up to the end of week 24
Bleeding events
Tidsramme: Up to the end of week 24; Week 25 to 24 weeks post-treatment cessation
Bleeding incidence and severity per WHO bleeding score
Up to the end of week 24; Week 25 to 24 weeks post-treatment cessation
Adverse Events
Tidsramme: Up to the end of week 24; Week 25 to 24 weeks post-treatment cessation
The proportion of patients with adverse events
Up to the end of week 24; Week 25 to 24 weeks post-treatment cessation

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Peking University People's Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

30. december 2027

Studieafslutning (Anslået)

30. december 2028

Datoer for studieregistrering

Først indsendt

16. maj 2026

Først indsendt, der opfyldte QC-kriterier

19. juni 2026

Først opslået (Faktiske)

23. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

23. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2025PHD049-001

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