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Atorvastatin Combined With NAC Plus Romiplostim for Management of ITP

19 juni 2026 bijgewerkt door: 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.

Studie Overzicht

Toestand

Nog niet aan het werven

Gedetailleerde beschrijving

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.

Studietype

Ingrijpend

Inschrijving (Geschat)

50

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

      • Beijing, China
        • Peking University People's Hospital

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Nee

Beschrijving

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.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: NVT
  • Interventioneel model: Opdracht voor een enkele groep
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: combined therapy
atorvastatin 20mg qd , N-acetyl-L-cysteine (NAC) 400mg tid, 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.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
24-week SRoT rate
Tijdsspanne: 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

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
24-week SCRoT rate
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 juni 2026

Primaire voltooiing (Geschat)

30 december 2027

Studie voltooiing (Geschat)

30 december 2028

Studieregistratiedata

Eerst ingediend

16 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

19 juni 2026

Eerst geplaatst (Werkelijk)

23 juni 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

23 juni 2026

Laatste update ingediend die voldeed aan QC-criteria

19 juni 2026

Laatst geverifieerd

1 juni 2026

Meer informatie

Termen gerelateerd aan deze studie

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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