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A randomized, open-label, multicenter study to compare the efficacy and safety of terbutaline plus danazol compared to danazol monotherapy for the second-line treatment of adults with corticosteroid-resistant or relapsed primary immune thrombocytopenia (ITP).
The investigators are undertaking a parallel group, multicenter, randomized controlled trial of 228 adults with ITP in China. Patients were randomized to terbutaline plus danazol compared to danazol monotherapy group. Platelet count, bleeding and other symptoms were evaluated before and after treatment. Adverse events are also recorded throughout the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Terbutaline plus danazol | Experimental | Terbutaline: A dose of 2.5 mg three times daily for 16 weeks Danazol: A dose of 200 mg twice daily for 16 weeks |
|
| Danazol monotherapy | Active Comparator | Danazol: A dose of 200 mg twice daily for 16 weeks |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Terbutaline | Drug | Orally terbutaline at a dose of 2.5 mg three times daily for 16 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall response | Achieving a platelet count ≥ 30 × 10^9/L confirmed on at least two separate occasions (at least 7 days apart), at least a doubling of the baseline platelet count without any other ITP-specific treatment and the absence of bleeding. | From date of randomization until 1 years or the end of follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Sustained response | maintenance of a platelet count > 30 × 10^9/L, an absence of bleeding, and no requirement for any other ITP-specific treatment for 6 consecutive months after achievement of OR | From date of randomization until 1 years or the end of follow-up |
| Complete response |
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Inclusion Criteria: Patients >18 years old with corticosteroid-resistant or relapsed ITP who had either a platelet count of <30×10^9/L or a platelet count of <50×10^9/L and clinically significant bleeding.
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ye-Jun Wu, MD | Contact | 13522338836 | wyejun1999@pku.edu.cn |
| Name | Affiliation | Role |
|---|---|---|
| Xiao-Hui Zhang, MD | Peking University People's Hospital | Principal Investigator |
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| ID | Term |
|---|---|
| D016553 | Purpura, Thrombocytopenic, Idiopathic |
| ID | Term |
|---|---|
| D011696 | Purpura, Thrombocytopenic |
| D011693 | Purpura |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
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| ID | Term |
|---|---|
| D013726 | Terbutaline |
| D003613 | Danazol |
| ID | Term |
|---|---|
| D004983 | Ethanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
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| Danazol | Drug | Orally danazol at a dose of 200 mg twice daily for 16 weeks |
|
a platelet count ≥ 100 × 10^9/L measured on two occasions at least 7 days apart and the absence of bleeding |
| From date of randomization until 1 years or the end of follow-up |
| Remission | a durable platelet count > 30 × 109/L without bleeding up to 12 months after randomization | at 12-month follow-up |
| Time to response | the time from starting treatment to the time a response was achieved. | From date of randomization until 1 years or the end of follow-up |
| Duration of response | time from OR until loss of response or until the last follow-up visit | From date of randomization until 1 years or the end of follow-up |
| Rescue therapy | any new medical intervention taken to increase the platelet count or prevent bleeding events or an increase in the dose of concomitant treatments | From date of randomization until 1 years or the end of follow-up |
| Associated factors of treatment failure, OR, SR and remission | Factors that are associated with treatment failure, OR, SR and remission | From date of randomization until 1 years or the end of follow-up |
| Number of patients with bleeding | Number of patients with bleeding complication (WHO bleeding score) | From date of randomization until 1 years or the end of follow-up |
| Number of patients with side effects | Number of patients with Medication adverse events. | From date of randomization until 1 years or the end of follow-up |
| Relapse | Loss of OR | From date of randomization until 1 years or the end of follow-up |
| Relapse-free survival | the time interval between achievement of OR and relapse or the end of the follow-up | From date of randomization until 1 years or the end of follow-up |
| D006425 |
| Hemic and Lymphatic Diseases |
| D057049 | Thrombotic Microangiopathies |
| D013921 | Thrombocytopenia |
| D001791 | Blood Platelet Disorders |
| D000095542 | Cytopenia |
| D006474 | Hemorrhagic Disorders |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012877 | Skin Manifestations |
| D012816 | Signs and Symptoms |
| D000588 |
| Amines |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |