此页面是自动翻译的,不保证翻译的准确性。请参阅 英文版 对于源文本。

一项 II 期剂量递增研究,表征艾曲波帕在患有先前未治疗或复发的严重再生障碍性贫血或复发性再生障碍性贫血的儿科患者中的 PK

2026年7月16日 更新者:Novartis Pharmaceuticals

一项 II 期、开放标签、非对照、患者内剂量递增研究,以表征难治性、复发性或未治疗过的重度再生障碍性贫血或复发性再生障碍性贫血儿科患者口服艾曲波帕后的药代动力学

这是一项 II 期、开放标签、多中心、患者体内剂量递增研究,旨在表征口服艾曲波帕联合免疫抑制治疗后对先前未治疗或复发/难治性重度再生障碍性贫血或复发性再生障碍性贫血儿科患者的药代动力学.

所有患者都将接受艾曲波帕治疗 26 周的治疗期,随后是 52 周的随访期。 除艾曲波帕外,先前未接受过免疫抑制治疗的患者将根据护理标准、hATG/环孢菌素进行治疗。 复发/难治性 SAA 或复发性 AA 患者将被纳入两种治疗方案之一:hATG/环孢素加艾曲波帕或环孢素加艾曲波帕,具体取决于先前的免疫抑制治疗。

在开始使用艾曲波帕治疗后,将对患者的剂量进行评估并根据耐受性进行调整,直到达到目标血小板计数或最大剂量。 将在旨在捕获起始剂量和达到的最高剂量的稳态 PK 的时间点进行药代动力学评估。

本研究有四个独立的阶段:筛选(签署书面知情同意书至第 -1 天)、治疗(26 周)、随访(额外 52 周)和长期随访(额外 3 年) ). 前 3 个时期将被视为研究的核心阶段。

当最后一名患者完成 26 周治疗和 52 周随访期 [第 78 周] 时,将完成研究(核心)。

研究概览

地位

完全的

条件

干预/治疗

详细说明

所有患者都将接受 eltrombopag 治疗 26 周的治疗期,然后是 52 周的随访期。 除艾曲波帕外,先前未接受过免疫抑制治疗的患者将根据护理标准、hATG/环孢菌素进行治疗。 复发/难治性 SAA 或复发性 AA 患者将被纳入两种治疗方案之一:hATG/环孢素加艾曲波帕或环孢素加艾曲波帕,具体取决于先前的免疫抑制治疗。

在开始使用艾曲波帕治疗后,将对患者的剂量进行评估并根据耐受性进行调整,直到达到目标血小板计数或最大剂量。 将在旨在捕获起始剂量和达到的最高剂量的稳态 PK 的时间点进行药代动力学评估。

本研究有四个独立的阶段:筛选(签署书面知情同意书至第 -1 天)、治疗(26 周)、随访(额外 52 周)和长期随访(额外 3 年) ). 前 3 个时期将被视为研究的核心阶段。

当最后一名患者完成 26 周治疗和 52 周随访期 [第 78 周] 时,将完成研究(核心)。

研究类型

介入性

注册 (实际的)

51

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Moscow、俄罗斯、117198
        • Novartis Investigative Site
      • Saint Petersburg、俄罗斯、197022
        • Novartis Investigative Site
      • Bangkok、泰国、10700
        • Novartis Investigative Site
      • Bangkok、泰国、10400
        • Novartis Investigative Site
    • THA
      • Khon Kaen、THA、泰国、40002
        • Novartis Investigative Site
    • Arizona
      • Phoenix、Arizona、美国、85016
        • Phoenix Childrens Hospital
    • Arkansas
      • Little Rock、Arkansas、美国、72202
        • Arkansas Childrens Hospital
    • Colorado
      • Aurora、Colorado、美国、80045
        • Childrens Hospital Colorado
    • Georgia
      • Atlanta、Georgia、美国、30342
        • Aflac Cancerand Blood Disorders Ctr
    • Illinois
      • Chicago、Illinois、美国、60611
        • Ann and Robert H Lurie Childs Hosp
    • Indiana
      • Indianapolis、Indiana、美国、46202-5225
        • Indiana University
    • Massachusetts
      • Boston、Massachusetts、美国、02115
        • Childrens Hosp Boston Dept of Heme
    • Michigan
      • Ann Arbor、Michigan、美国、48109
        • University of MI Health System
    • New Jersey
      • Hackensack、New Jersey、美国、07601
        • Hackensack University Medical Center SC-2
    • North Carolina
      • Durham、North Carolina、美国、27710
        • Duke University Medical Center
    • Ohio
      • Cleveland、Ohio、美国、44195
        • Cleveland Clinic Foundation
    • Texas
      • Houston、Texas、美国、77030
        • Texas Childrens Cancer and Hematology Center
      • London、英国、WC1N 3JH
        • Novartis Investigative Site
      • Lisbon、葡萄牙、1649-035
        • Novartis Investigative Site
      • Hong Kong、香港、999077
        • Novartis Investigative Site

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

1年 至 18年 (孩子、成人)

接受健康志愿者

不

描述

纳入标准:

对于队列 A 患者:

  1. SAA的先前诊断史,
  2. 根据第 5.1 节,SAA 治疗后复发/难治性 SAA 或复发性 AA 的诊断。 复发性 AA 患者(例如,失去反应)在研究登记时无需满足 SAA 复发的诊断标准,但必须先前已被诊断患有 SAA。
  3. 同意将艾曲波帕与适当的、研究者选择的 IST 与 hATG + CsA 或 CsA 一起进行治疗。

    对于队列 B 患者:

  4. 入组时诊断为 SAA。
  5. 患者之前不得接受过 IST 治疗,并且必须符合表 5-1 中描述的所有标准。
  6. 患者必须同意同时使用 hATG + CsA 和艾曲波帕进行治疗。

    所有符合纳入本研究条件的患者必须满足以下所有标准:

  7. 年龄 1 至 <18 岁。
  8. 必须在入组前完成评估以排除先天性/遗传性骨髓衰竭综合征和免疫介导的全血细胞减少症的其他原因,这些疾病可以通过移植治疗。
  9. 造血干细胞移植 (HSCT) 不适合或不可用作为治疗选择,或已被患者拒绝。 (HSCT 的候选资格将根据当地惯例或国家指南确定。)
  10. 在艾曲波帕首次给药前 4 周内的任何时间进行骨髓抽吸和活检。

12.体能状态评分:16岁及以上患者Karnofsky≥50或16岁以下患者Lansky≥50。

15. 在开始任何特定研究程序之前,父母或法定监护人必须签署书面知情同意书。

16. 艾曲波帕首次给药前 4 周内核型正常。 如果没有足够的中期 (< 10) 来确定核型,则需要重复骨髓抽吸。 如果在重复骨髓抽吸时,中期细胞数量不足(< 10),则按照协议在骨髓抽吸中进行的 FISH 探针必须正常。

排除标准:

2. 先前和/或当前的病史:

  • Fanconi 贫血(通过染色体断裂试验或通过流式细胞术检测生长停滞)
  • 其他已知的潜在遗传性骨髓衰竭综合征(例如但不限于先天性角化不良、先天性无巨核细胞性血小板减少症或 Shwachman-Diamond 综合征)。
  • 入组时有症状的阵发性睡眠性血红蛋白尿 (PNH) 和/或 PNH 克隆 >50% 的 WBC 或 RBC。
  • 通过核型分析或 FISH 检测的任何细胞遗传学异常。
  • 骨髓增生异常综合征 (MDS)
  • 其他已知或怀疑的潜在原发性免疫缺陷
  • 任何恶性肿瘤 3. 对适当治疗无反应的活动性感染。 4.既往艾曲波帕或其他促血小板生成素受体(TPO-R)激动剂治疗至少2个月且无反应。

    5. 具有以下任何超出范围的实验室值:

  • 血清肌酐 >2.5 × 正常上限 (ULN),
  • 天冬氨酸氨基转移酶 (AST) 或丙氨酸氨基转移酶 (ALT) >3 × ULN。 6. 在入组前 30 天内或研究产品的 5 个半衰期内(以较长者为准)同时参与调查研究。 注意:接受 SAA 或 AA 患者在登记处的平行登记。

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:治疗
  • 分配:非随机化
  • 介入模型:并行分配
  • 屏蔽:无(打开标签)

武器和干预

参与者组/臂
干预/治疗
实验性的:队列 A(选项 2)
CsA 和艾曲波帕从第 1 天开始。
口服片剂,每日一次或口服混悬剂粉剂 (PfOS),每日一次
其他名称:
  • ETB115
Cyclosporine (CsA) was supplied as either oral capsules or oral solution, administered twice a day.
实验性的:Cohort A (Option 1)
hATG (ATGAM®), CsA and eltrombopag begin on Day 1.
口服片剂,每日一次或口服混悬剂粉剂 (PfOS),每日一次
其他名称:
  • ETB115
Horse ATG (ATGAM) (hATG) 不被视为研究性医药产品 (IMP)
Cyclosporine (CsA) was supplied as either oral capsules or oral solution, administered twice a day.
实验性的:Cohort B
hATG (ATGAM®), CsA and eltrombopag begin on Day 1.
口服片剂,每日一次或口服混悬剂粉剂 (PfOS),每日一次
其他名称:
  • ETB115
Horse ATG (ATGAM) (hATG) 不被视为研究性医药产品 (IMP)
Cyclosporine (CsA) was supplied as either oral capsules or oral solution, administered twice a day.

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
Eltrombopag PK Parameters: AUCtau, AUClast
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
AUC tau: Area under the curve calculated to the end of the dosing interval ( tau) (mass*time/volume) AUC last: Area under the curve calculated to the last quantifiable concentration point (Tlast) (mass*time/volume)
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Eltrombopag PK Parameter: Cmax
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Cmax is the observed maximum plasma concentration following administration (mass/volume)
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Eltrombopag PK Parameter: Ctrough at the Highest Dose Level
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Ctrough is the pre-dose plasma concentration (mass/volume).
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78

次要结果测量

结果测量
措施说明
大体时间
Percentage of Participants With an Overall Response Rate and Percentage of Participants With a Platelet Response Rate Based on Per Pediatric Committee of European Medicines Agency (PDCO)
大体时间:Week 12, Week 26, Week 52, Week 78
Overall response rate (ORR) is defined as the percentage of participants who have achieved a complete response (CR) or partial response (PR) or No response (NR) by the Investigator. CR criteria: Platelet (PLT) and red blood cell (RBC) transfusion independence, Normal age-adjusted Hgb, PLT >100 × 10^9/L and absolute neutrophil count (ANC) >1.5 × 10^9/L. PR: PLT and RBC Transfusion independence and at least 2 of the following criteria: Reticulocytes >30 × 10^9/L, PLT >30 × 10^9/L, ANC >1.5 x 10^9L. PLT transfusion independence is defined as a period for at least 28 days without PLT transfusion. Platelet response rate (PRR): Platelet response rate is comprised of CR + PR based on the following criteria: CR: PLT >100 × 10^9/L; PR: PLT >30 × 10^9/L; NR: PLT transfusion within 4 weeks or PLT <= 30 × 10^9/L.
Week 12, Week 26, Week 52, Week 78
Hematologic Counts (Platelets (Blood), Neutrophils (Blood))
大体时间:Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Individual Platelets (PLT) and neutrophil counts were summarized for all participants.
Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Hematologic Counts (Hemoglobin (Blood))
大体时间:Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Individual hemoglobin (Hgb) counts were summarized for all participants.
Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Number of Red Blood Cells (RBC) Transfusions
大体时间:From date of first dose to approx. 4.5 years
Number of transfusions during the treatment period refers to total number of RBC transfusions participants have received while on treatment.
From date of first dose to approx. 4.5 years
Frequency of Red Blood Cell (RBC) Transfusions
大体时间:From date of first dose to approx. 4.5 years
Frequency of transfusions during the treatment period refers to number of RBC transfusions during the treatment period divided by number of months of treatment duration.
From date of first dose to approx. 4.5 years
Number of Platelet (PLT) Transfusions
大体时间:From date of first dose to approx. 4.5 years
Number of transfusions during the treatment period refers to total number of PLT transfusions participants have received while on treatment.
From date of first dose to approx. 4.5 years
Frequency of Platelet (PLT) Transfusions
大体时间:From date of first dose to approx. 4.5 years
Frequency of transfusions during the treatment period refers to number of PLT transfusions during the treatment period divided by number of months of treatment duration.
From date of first dose to approx. 4.5 years
Total Duration of Red Blood Cell (RBC) Transfusion Independence During the Treatment Period
大体时间:From date of first dose to approx. 4.5 years
RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. Duration of RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. First transfusion duration was calculated as the date of the day before the first transfusion after baseline minus the date of first exposure eltrombopag + 1.
From date of first dose to approx. 4.5 years
Total Duration of Platelet (PLT) Transfusion Independence During the Treatment Period
大体时间:From date of first dose to approx. 4.5 years
Platelet transfusion independence during the treatment period is defined as the duration from the first day of the 28-day period without PLT transfusion until the occurrence of a PLT transfusion after the period free from any PLT transfusion. Duration of PLT transfusion independence is defined as a period of time of at least 28 days without platelet transfusion. First transfusion duration was calculated as the date of the day before the first transfusion after baseline minus the date of first exposure eltrombopag + 1.
From date of first dose to approx. 4.5 years
Maximum Duration of Red Blood Cell (RBC) Transfusion Independence
大体时间:From date of first dose to approx. 4.5 years
RBC transfusion independence is defined as a period of time of at least 56 days without RBC transfusion. Maximum duration of RBC transfusion independence is defined as the maximum duration among the durations of RBC transfusion independence. First transfusion duration was calculated as the date of first transfusion after baseline minus the date of first exposure eltrombopag + 1.
From date of first dose to approx. 4.5 years
Maximum Duration of Platelet (PLT) Transfusion Independence
大体时间:From date of first dose to approx. 4.5 years
Maximum duration of PLT transfusion independence is defined as the maximum duration among the durations of PLT transfusion independence. First transfusion duration was calculated as the date of first transfusion after baseline minus the date of first exposure eltrombopag + 1.
From date of first dose to approx. 4.5 years
Overall Bone Marrow Cellularity
大体时间:Screening, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Percentage of cells in bone marrow biopsy - a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
Screening, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Bone Marrow Morphology
大体时间:Screening, Week, 26, Week 52, Week 78, Week 130, Week 182, Week 234
Percentage of morphology (erythropoiesis, granulopoiesis, megakaryopoiesis, CD34+ (blast cells) cells in bone marrow aspirate - a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
Screening, Week, 26, Week 52, Week 78, Week 130, Week 182, Week 234
Bone Marrow Cytogenetics
大体时间:Screening, Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Number of bone marrow cytogenetics (chromosomal structure) by kryotyping and Fluorescence in situ hybridization (FISH). This is a comprehensive diagnostic evaluation to distinguish between the various bone marrow disorders.
Screening, Week 12, Week 26, Week 52, Week 78, Week 130, Week 182, Week 234
Acceptability and Palatability for Both Tablets and Powder Formulation for Oral Solution (PfOS)
大体时间:any day from Day 1 of drug initiation up to Week 78
Standardized (total) summary score, ranged from 0-100, (where 0 means worst and 100 means the best), was derived from all items from the questionnaire based on a scoring matrix. The questionnaire was completed by parents and caregivers of patients under 12 years of age (ObsRO) and a questionnaire completed by patients 12 years and older (PRO).
any day from Day 1 of drug initiation up to Week 78
Clonal Evolution to Paroxysmal Nocturnal Hemoglobinuria (PNH)
大体时间:Baseline, Week (W) 26 Day (D) 1, W52D1, W78D1, W130D1, W182D1, W234D1
Percentage of participants with clonal evolution to Paroxysmal Nocturnal Hemoglobinuria (PNH).
Baseline, Week (W) 26 Day (D) 1, W52D1, W78D1, W130D1, W182D1, W234D1
Exposure (AUCtau) - Response Relationship of Eltrombopag and Best Overall Response Rate by Age Groups
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Pharmacokinetic parameter (AUCtau) of eltrombopag at the highest dose in relationship to best overall response rate in regard to complete response (CR), partial response (PR) and no response (NR). AUC tau: Area under the curve calculated to the end of the dosing interval (tau) (mass*time/volume)
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Exposure (Cmax, Ctrough) - Response Relationship of Eltrombopag and Best Overall Response Rate by Age Groups
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Pharmacokinetic parameters (Cmax and Ctrough) of eltrombopag at the highest dose in relationship to overall response rate in regard to complete response (CR), partial response (PR) and no response (NR). Cmax is the observed maximum plasma concentration following administration (mass/volume). Ctrough is the pre-dose plasma concentration (mass/volume).
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Exposure (AUCtau) - Response Relationship of Eltrombopag and Best Platelet Response Rate by Age Groups
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Pharmacokinetic parameter (AUCtau) of eltrombopag at the highest dose in relationship to platelet response rate. AUC tau: Area under the curve calculated to the end of the dosing interval ( tau) (mass*time/volume)
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Exposure (Cmax, Ctrough) - Response Relationship of Eltrombopag and Best Platelet Response Rate by Age Groups
大体时间:at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Pharmacokinetic parameters (Cmax and Ctrough) of eltrombopag at the highest dose in relationship to platelet response rate. Cmax is the observed maximum plasma concentration following administration (mass/volume). Ctrough is the pre-dose plasma concentration (mass/volume).
at least 11 weeks after dose initiation or later when patients are taking the highest dose, up to Week 78
Alternate Overall Response Rate (aORR)
大体时间:Week 12, Week 26, Week 52, Week 78
Alternate overall responses were derived using hematological parameters (i.e., hemoglobin, platelet, reticulocyte, and ANC). aORR is defined as the percentage of participants who achieved an alternate complete response (aCR) or an alternate partial response (aPR)
Week 12, Week 26, Week 52, Week 78
Pharmacokinetics (PK) of Eltrombopag at the Starting Dose (AUCtau)
大体时间:Week 3 Day 1
PK parameter, AUCtau. AUC tau: Area under the curve calculated to the end of the dosing interval (tau) (mass*time/volume)
Week 3 Day 1
PK of Eltrombopag at the Starting Dose (Cmax)
大体时间:Week 3 Day 1
PK parameter, Cmax Cmax is the observed maximum plasma concentration following administration (mass/volume)
Week 3 Day 1
PK of Eltrombopag at the Starting Dose (Ctrough)
大体时间:Week 3 Day 1
PK parameter, Ctrough Ctrough is the pre-dose plasma concentration (mass/volume).
Week 3 Day 1

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

调查人员

  • 研究主任:Novartis Pharmaceuticals、Novartis Pharmaceuticals

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2017年9月30日

初级完成 (实际的)

2022年4月22日

研究完成 (实际的)

2025年1月27日

研究注册日期

首次提交

2017年1月12日

首先提交符合 QC 标准的

2017年1月16日

首次发布 (估计的)

2017年1月19日

研究记录更新

最后更新发布 (实际的)

2026年8月10日

上次提交的符合 QC 标准的更新

2026年7月16日

最后验证

2026年7月1日

更多信息

与本研究相关的术语

其他研究编号

  • CETB115E2201
  • 2015-003166-91 (EudraCT编号)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)?

是的

IPD 计划说明

Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided are anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations.

This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.