A Phase 4 interventional study of Combination of thrombopoietin mimetic and cyclosporin A in Aplastic Anemia, sponsored by Safaa AA Khaled. Completed at 1 site in Egypt. Open to participants aged 16 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-09-29.
Sponsored by Safaa AA Khaled · Phase 4, Interventional, and Treatment
To the investigator's Knowledge this is the first study that will assess Treatment with thrombopoietin Mimetic plus immunosuppressiveTherapy in Egyptian Patients with Aplastic Anaemia.
Aim of the work :
Aplastic anemia (AA) is a bone marrow failure syndrome that, although benign in nature, it influences patients' quality of life and carries poor prognosis.The pathophysiological basis of development of acquired AA include immune-mediated attack, inherent hematopoietic stem cell insufficiency and telomere defects. Bone marrow transplantation (BMT) is the only curative treatment for AA. Unfortunately it is unavailable for many patients due to lack of matched donors furthermore others are ineligible for BMT due to old age or co-morbid conditions. Immunosuppressive therapy was the mainstay of treatment for AA for many years, however many patients developed resistance or refractoriness. Immunosuppressive therapy was in the form of antithymocyte globulin (ATG) which gave hematologic response in nearly 50% of patients , adding cyclosporin A increases this response to 70%. Why some patients became resistant to immunosuppressive therapy ? The answer is not known.
Thrombopoietin mimetic (Eltrombopag) was firstly FDA approved for treatment of immune thrombocytopenic purpura. Numerous clinical trials proved the efficacy of anthropometric mimetic in patients with refractory severe AA, leading to its FDA approval for this group of patients. Some researchers proven the efficacy of thrombopoietin mimetic in patients with moderate aplastic anemia.
This study aimed to asses the combination of thrombopoietin mimetic and immunosuppressive therapy in patients with AA.
1,733 studies on the registry are indexed under Anemia; 246 are open to participants now.
This study's enrollment of 66 is below the median of 94 across 1,291 interventional studies indexed under Anemia.
Browse Anemia studies →Safaa AA Khaled is the lead sponsor of 4 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
The intervention group will be given cyclosporin A plus thrombopoietin (TPO) mimetic starting with 50 mg orally daily that would be increased or decreased according to response, for 3-months. Patients will be kept on weekly follow up visits and assessed by peripheral hemogram .
Drug: Combination of thrombopoietin mimetic and cyclosporin A
A comparative group will be collected retrospectively and treated with cyclosporin A alone as standard.
This is a controlled interventional study that will be carried out in the Clinical Hematology Unit, at the Department of Internal Medicine , Assiut University Hospital. Patients will be recruited among those who attending the outpatient clinic or admitted in the unit.
Also known as: Combination of Eltrombopag plus cyclosporin A
Number of patients with hematologjc response
1. Platelet number ( time frame(2-3 months) : Increase plt count 20, 000 or more from baseline or independence of platelet transfusion for 2 months 2. Hemoglobin percent (time frame (2-3 months): increase Hb by 1.5 g/dl from baseline or reduction 4 units of packed red blood cell transfusions for 2- months C) Absolute neutrophilic count response (time frame (2-3 months): increase absolute neutrophil count by 500 per microliter from baseline. d) Bone marrow cellularity (time frame (2-3 months): increase bone marrow cellularity from baseline
Time frame: 2-3months
Number of patients with one of the following
1. Toxicity: development of toxicity leading to cessation of treatment 2. Evolution: evolution to paroxysmal nocturnal hemoglobinuria , myelodysplastic syndrome or acute leukemia 3. Bleeding and cytopenias that met the criteria for severe aplastic anemia and require transfusions
Time frame: 2-3months
Plan to share: No
This study is completed, as verified in Sep 2021. You cannot join it, but the record below documents what was studied.
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Safaa AA Khaled