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| ID | Type | Description | Link |
|---|---|---|---|
| 2021-A02780-41 | Other Identifier | ANSM |
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Glanzmann thrombasthenia is a rare genetic disorder caused by the absence or the dysfunction of the main receptor present on the surface of platelets, integrin αIIbβ3 or GPIIb-IIIa.
The lack of this protein on the surface of platelets no longer allows these blood cells to bind to each other. This binding corresponds to the process of platelet aggregation.
Generally, local measures will control nasal and superficial bleeding whereas platelet transfusions are used to control or prevent life-threatening.
The main complication of this treatment is the risk of developing anti-αIIbβ3 antibodies directed against the absent protein and platelet transfusion therapy can become ineffective.
Activated recombinant factor VII (rFVIIa) provides an alternative treatment for GT patients who develop such antibodies. However, this therapy has a short duration of efficacy, requiring repeated intravenous administrations every 2 to 3 hours.
There is a new treatment, Concizumab, which has not yet been marketed. This treatment acts on TFPI (tissue factor pathway inhibitor). TFPI is a protein that occurs naturally in the body and prevents blood cells from binding to each other.
Concizumab works by blocking TFPI, which may allow sufficient clotting to prevent bleeding.
This treatment could replace recombinant activated factor VII (rFVIIa) because it has the advantage of a much longer duration of efficacy (about 3 days) and is administered subcutaneously.
This is in vitro research. The treatment will be tested on blood samples. This will allow us to evaluate in vitro the ability of Concizumab to restore coagulation compared to the usual treatments of platelet transfusions and recombinant activated factor VII (rFVIIa).
This is a single-center study conducted at the Bordeaux University Hospital, which included 10 with Glanzmann thrombasthenia patients and 10 healthy donors over a period of 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Glanzmann Thrombasthenia Group | Experimental | Patient with a clear diagnosis of Glanzmann Thrombasthenia, whatever the subtype of disease |
|
| Healthy donors | Active Comparator | Healthy donor without haemorrhagic ant thrombotic medical history |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clot formation in whole blood under flow in a microfluidic flow chamber coated with tissue factor and collagen | Other | TTAS (single measurements) Clot formation in whole blood under flow (2000 s-1) in a microfluidic flow chamber coated with tissue factor and collagen (T-TAS with AR chip)
|
| Measure | Description | Time Frame |
|---|---|---|
| Effects of mixing concizumab compared with the main bleed treatment options for persons with GT | The samples will be analysed by measurement of in vitro hemostatic capacity :
| One point at the inclusion |
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Inclusion Criteria:
Glanzmann Thrombasthenia Group:
Control Group:
Exclusion Criteria:
For both patient groups:
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| Name | Affiliation | Role |
|---|---|---|
| Mathieu FIORE | University Hospital, Bordeaux | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Bordeaux - Laboratoire Hématologie | Bordeaux | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38880178 | Result | Dubut J, Goin V, Derray C, Huguenin Y, Fiore M. Targeting tissue factor pathway inhibitor with concizumab to improve hemostasis in patients with Glanzmann thrombasthenia: an in vitro study. J Thromb Haemost. 2024 Sep;22(9):2589-2600. doi: 10.1016/j.jtha.2024.05.033. Epub 2024 Jun 14. |
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|
| : PRP viscoelastic changes under clot formation measured by thromboelastometry using RoTEM | Other | ROTEM (single measurements)
|
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| Thrombin Generation Assay (TGA) in PRP using TF trigger | Other | TGA (single measurements)
|
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| Global fibrinolytic capacity in PRP using reagents for in vitro triggering of the clot and its lysis | Other | Global fibrinolytic capacity (Lysis Timer) in 100 µL of PRP (250 G/L) using reagents for in vitro triggering of the clot (thrombin and calcium) and its lysis (tissue-plasminogenactivator (t-PA). Around 1 mL of PRP in total Lysis time in min |
|
| Concizumab | Other | Thrombin generation assay (TGA), microchip flow-chamber assay (T-TAS, rotational thromboelastometry and global fibrinolytic capacity to investigate and compare the effects of mixing concizumab (200, 1000 and 4000 ng/mL) with the main bleed treatment options for persons with GT |
|
| ID | Term |
|---|---|
| D013915 | Thrombasthenia |
| ID | Term |
|---|---|
| D025861 | Blood Coagulation Disorders, Inherited |
| D001778 | Blood Coagulation Disorders |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D001791 | Blood Platelet Disorders |
| D006474 | Hemorrhagic Disorders |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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| ID | Term |
|---|---|
| D013925 | Thromboplastin |
| D003094 | Collagen |
| C574488 | concizumab |
| ID | Term |
|---|---|
| D001779 | Blood Coagulation Factors |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D001685 | Biological Factors |
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D016326 | Extracellular Matrix Proteins |
| D012596 | Scleroproteins |
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