ClinicalTrials.gg
CompletedNCT03384277Updated Feb 11, 2026

Trial of Acquired Haemophilia With Steroid Combined With Cyclophosphamide Versus Steroid Combined With Rituximab

A Phase 4 interventional study of Steroid and Rituximab in Acquired Hemophilia A, sponsored by Institute of Hematology & Blood Diseases Hospital, China. Completed at 1 site in China. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-02-11.

Sponsored by Institute of Hematology & Blood Diseases Hospital, China · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
66
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

Purpose:

To evaluate the efficacy when administering steroid combined with single dose rituximab to eliminate the antibody in acquired hemophilia A patients compared to treatment using steroid with cyclophosphamide.

The study will test the hypothesis that steroid combined with small dose rituximab is as effective as steroid combined with cyclophosphamide for FVIII inhibitor eradication in Chinese patients with acquired hemophilia A.

Study design Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment

Read the detailed description

This is a prospective randomized multi-center controlled pilot trial comparing the regimen of steroid with rituximab and steroid with cyclophosphamide to eradicate anti-factor VIII antibodies in Chinese patients with acquired hemophilia A.

Patients will be randomized to two regimens: methylprednisolone 0.8mg/kg/day (or equivalent corticosteroid doses) for 3 weeks (then tapering gradually,8 weeks in total) with rituximab (375mg/m2 for one dose) or methylprednisolone 0.8mg/kg/day (or equivalent corticosteroid doses) for 3 weeks (then tapering gradually,8 weeks in total) with cyclophosphamide 2mg/kg/day until inhibitor negative(no longer than five weeks).

Patients will be randomized to the treatment cohorts according to the biostatistical methods.

02

Conditions studied

  • Acquired Hemophilia A

Keywords

  • Acquired hemophilia A
  • Cyclophosphamide
  • Rituximab
  • Steroid
03

In context

Lead sponsor

Institute of Hematology & Blood Diseases Hospital, China is the lead sponsor of 410 studies on the registry; 291 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • 18-80 years old
  • Men or women
  • Women or with ongoing
  • Diagnosis of acquired hemophilia A
  • Patient must be insured
  • Patient has provided written prior to enrollment
  • Patient compliant

Exclusion criteria

Exclusion Criteria:

  • Congenital hemophilia
  • Ongoing treatment with prednisone > 20mg/d (or equivalent doses) more than 1 month
  • Ongoing treatment with prednisone >0.7mg/kg(or equivalent corticosteroid doses) more than 10 days
  • Pregnant and breastfeeding women
  • Allergy to steroid
  • agents treatment within 30 days
  • Serum transaminase and greater than 1.5 times the value
  • surface antigen or antibody or antibody (I + II) or syphilis antibody positive
  • Patients with diabetes, hypertension, glaucoma, peptic ulcer, herpes zoster, pulmonary infection and so on, who should not be treated with glucocorticoids
  • Patients with poor compliance
  • Those who can not take measures during the test period
  • Patient who is considered by the investigator not suitable for clinical study
  • Thrombocytopenia
  • Leucocytopenia
Terms in these criteria, in plain language(10)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
66 participants (actual)

Study arms

  • Experimental
    Steroid+Rituximab

    Methylprednisolone 0.8 mg/kg/day (or equivalent corticosteroid doses) for 3 weeks(then tapering gradually, 8 weeks in total)+Rituximab 375mg/m2 for one dose.

    Drug: Steroid · Drug: Rituximab

  • Active comparator
    Steroid +Cyclophosphamide

    Methylprednisolone 0.8 mg/kg/day (or equivalent corticosteroid doses) for 3 weeks ( then tapering gradually, 8 weeks in total)+ Cyclophosphamide 2 mg/kg/day until inhibitor negative (no longer than five weeks)

    Drug: Steroid · Drug: Cyclophosphamide

Interventions

  • Methylprednisolone 0.8 mg/kg/day (or equivalent corticosteroid doses) for 3 weeks(then tapering gradually, 8 weeks in total)

    Also known as: Corticosteroid

  • 375mg/m2 for one dose

  • cyclophosphamide 2 mg/kg/day until inhibitor negative (no longer than five weeks)

06

What researchers measure

Primary outcomes

  1. Proportion of inhibitor eradication and time to attain first remission

    The proportion of patients achieving complete remission (CR) defined as titer FVIII inhibitor lower than 0.6 Bethesda unit, factor VIII level\> 50% and no bleeding events without bypass treatments for 24 hours and the time to attain first remission will be evaluated.

    Time frame: During 18 months

Secondary outcomes

  1. Relapse rate and time to relapse

    The proportion of patients who relapse and the time to relapse of each regimen will be measured.

    Time frame: During 18 month

Other outcomes

  1. Infection of two regimens

    The safety outcomes will be the occurrence of infection related to immunosuppressive treatment adverse events.

    Time frame: During 18 months

  2. Hemocytopenia of two regimens

    The safety outcomes will be the occurrence of Hemocytopenia related to immunosuppressive treatment adverse events.

    Time frame: During 18 month

07

Study locations

1 site
  • Ethics Committee of Blood disease hospital, Chinese Academy of Medical Sciences
    Tianjin, Tianjin Municipality 300020, China
08

References and documents

Publications

  • Collins P, Baudo F, Huth-Kuhne A, Ingerslev J, Kessler CM, Castellano ME, Shima M, St-Louis J, Levesque H. Consensus recommendations for the diagnosis and treatment of acquired hemophilia A. BMC Res Notes. 2010 Jun 7;3:161. doi: 10.1186/1756-0500-3-161. PubMed 20529258 ↗
  • Collins PW, Hirsch S, Baglin TP, Dolan G, Hanley J, Makris M, Keeling DM, Liesner R, Brown SA, Hay CR; UK Haemophilia Centre Doctors' Organisation. Acquired hemophilia A in the United Kingdom: a 2-year national surveillance study by the United Kingdom Haemophilia Centre Doctors' Organisation. Blood. 2007 Mar 1;109(5):1870-7. doi: 10.1182/blood-2006-06-029850. Epub 2006 Oct 17. PubMed 17047148 ↗
  • Lottenberg R, Kentro TB, Kitchens CS. Acquired hemophilia. A natural history study of 16 patients with factor VIII inhibitors receiving little or no therapy. Arch Intern Med. 1987 Jun;147(6):1077-81. doi: 10.1001/archinte.147.6.1077. PubMed 3109341 ↗
  • Collins P, Baudo F, Knoebl P, Levesque H, Nemes L, Pellegrini F, Marco P, Tengborn L, Huth-Kuhne A; EACH2 registry collaborators. Immunosuppression for acquired hemophilia A: results from the European Acquired Haemophilia Registry (EACH2). Blood. 2012 Jul 5;120(1):47-55. doi: 10.1182/blood-2012-02-409185. Epub 2012 Apr 18. PubMed 22517903 ↗
  • Stasi R, Brunetti M, Stipa E, Amadori S. Selective B-cell depletion with rituximab for the treatment of patients with acquired hemophilia. Blood. 2004 Jun 15;103(12):4424-8. doi: 10.1182/blood-2003-11-4075. Epub 2004 Mar 2. PubMed 14996701 ↗
  • Wang P, Zhou R, Xue F, Zhou H, Bai J, Wang X, Ma Y, Song Z, Chen Y, Liu X, Fu R, Sun T, Ju M, Dai X, Dong H, Yang R, Liu W, Zhang L. Single-dose rituximab plus glucocorticoid versus cyclophosphamide plus glucocorticoid in patients with newly diagnosed acquired hemophilia A: A multicenter, open-label, randomized noninferiority trial. Am J Hematol. 2024 Jan;99(1):28-37. doi: 10.1002/ajh.27128. Epub 2023 Oct 18. PubMed 37851608 ↗

Individual participant data

Plan to share: Yes — De-identified individual participant data for all primary and secondary outcome will be made available

Supporting information: Study protocol, Statistical analysis plan, Clinical study report, Analytic code

Time frame: Data will be available within 6 month of study completion

Access criteria: Data access requests will be reviewed by an external independent Review Panel. Requests will be required to sign a Data Access Agreement

Data sharing details ↗ · www.medresman.org

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2017 to primary completion in Jun 2022, 53 months.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 28, 2017
First posted
Dec 27, 2017
StartActual
Dec 29, 2017
Primary completionActual
Jun 9, 2022
CompletionActual
Jul 9, 2022
Last update
Feb 11, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Feb 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03384277
Collaborators
Qilu Hospital of Shandong University, Tianjin First Central Hospital, The Second Affiliated Hospital of Kunming Medical University, Henan Cancer Hospital
Responsible party
Sponsor
First posted
Dec 27, 2017
Start date
Dec 29, 2017
Primary completion
Jun 9, 2022
Completion
Jul 9, 2022
Last update
Feb 11, 2026

Study contacts

Lei Zhang, MD
principal investigator · Blood disease hospital, Chinese academy of medical sciences

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2023. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Rituximab

Start the discussion