ClinicalTrials.gg
Not yet recruitingNCT07051915Updated Sep 9, 2025

The Holistic Study

A Phase 3 interventional study of Avatrombopag and Rituximab (Arm B) in Thrombocytopenia Purpura, sponsored by Ostfold Hospital Trust. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-09-09.

Primary conditionPurpura, Thrombocytopenic, IdiopathicRegistry: Purpura, ThrombocytopenicReclassifiedWhy we changed it
Registry
Purpura, Thrombocytopenic — the first condition term the registry derived for this study.
ClinicalTrials.gg
Purpura, Thrombocytopenic, Idiopathic
Why
  1. The study's title name Purpura, Thrombocytopenic, Idiopathic, a narrower term within Purpura, Thrombocytopenic.
Confidence
High: the new condition is named in the study's own title. Of 46 hand-checked studies reclassified this way, 72% were exactly right and 89% in the right disease family; the registry's first term was right for 4% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Ostfold Hospital Trust · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
220
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study is a phase 3 study where eligible patients will be randomized 1:1 to one of two treatment strategies: receiving a thrombopoietin receptor agonist (Avatrombopag), or anti-CD20 (Rituximab).

Read the detailed description

This is a multi-center, international, open label randomized, controlled pragmatic trial consisting of 3 phases:

  1. First phase extends from randomization to week 28
  2. Second phase extends from week 28 to 78
  3. Third phase extends from week 78 to the end of the trial (i.e. the last patient completing week 78)
02

Conditions studied

  • Thrombocytopenia Purpura

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Keywords

  • Avatrombopag
  • Rituximab
  • Thrombocytopenia
  • Immune thrombocytopenia
03

In context

Purpura, Thrombocytopenic, Idiopathic Reclassified

503 studies on the registry are indexed under Purpura, Thrombocytopenic, Idiopathic; 158 are open to participants now.

This study's planned enrollment of 220 is above the median of 58 across 376 interventional studies indexed under Purpura, Thrombocytopenic, Idiopathic.

Browse Purpura, Thrombocytopenic, Idiopathic studies →

Lead sponsor

Ostfold Hospital Trust is the lead sponsor of 50 studies on the registry; 9 are open to participants now.

Compared within Purpura, Thrombocytopenic, Idiopathic, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Purpura, Thrombocytopenic. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
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

  1. Male or female aged ≥18 years.
  2. Diagnosis of primary ITP of less than one-year duration and having a count of \< 30 x109/L measured within two weeks prior to inclusion with failure to achieve response or relapse after at least one cycle of dexamethasone (20-40 mg daily for 4 days) or prednisone /prednisolone (1 mg/kg for at least two weeks). Shorter courses or lower doses are allowed if discontinued or modified due to side effects.
  3. Clinical need for subsequent platelet elevating therapy assessed by the physician in charge.
  4. Signed and dated written .

Exclusion criteria

Exclusion Criteria:

  1. Previous treatment for ITP with: Rituximab, other immune suppressants (including mycophenolate mofetil, azathioprine, cyclosporine), dapsone, danazol, chemotherapy (apart from vincristine as rescue therapy) or splenectomy. Short treatment with any thrombopoietic agent is allowed if given for a limited duration of a maximum of 2 weeks as rescue therapy for quick elevation of count in emergency situations e.g. bleeding.
  2. Pregnancy or lactation.
  3. Females of refusing to follow effective methods for at least 12 months following the last administration of Rituximab or during treatment with Avatrombopag.
  4. Secondary ITP: ITP secondary to lymphoma or chronic lymphocytic leukemia; ITP secondary to the following disorders: Systemic Lupus Erythematosus, Antiphospholipid Syndrome, or Common Variable Immune Deficiency; ITP secondary the following viral infections: or Virus.
  5. Concomitant autoimmune hemolytic anemia.
  6. Active virus (positive HBsAg). Patients with HBsAg negative and HBV core antigen antibody positive (HBcAb) should accept to receive entecavir (Baraclude) for 12 months if they will be allocated to Rituximab. Monthly HBV DNA monitoring will be required while on treatment and for the 6 months after the last dose of the study drug.
  7. Presence of any serious comorbidity where the condition may worsen by and of the study drugs.
  8. Known allergy, sensitivity or to Rituximab or Avatrombopag.
  9. Patients in a severely immune compromised state.
  10. Presence of active unless deemed cured by adequate treatment. Participants with the following neoplastic conditions can be included:

    1. Monoclonal gammopathy of undetermined significance (MGUS) or monoclonal B lymphocytosis of undetermined significance (MBUS).
    2. Basal/squamous cell carcinoma of the skin
    3. Carcinoma in situ of the cervix
    4. Carcinoma in situ of the breast
    5. Incidental histological finding of prostate cancer (TNM stage T1a or T1b).
  11. Patients with history of poor compliance or history of alcohol/drug abuse or excessive alcohol beverage consumption that would interfere with the ability to comply with the study protocol, or current or past psychiatric disease that might interfere with the ability to comply with the study protocol or give .
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.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

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.

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.

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.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
220 participants (estimated)

Study arms

  • Experimental
    Avatrombopag

    Open label, oral Avatrombopag 20 mg tablets taken daily during the first week. Dose tapering period commencing from week 28 for up to 8 weeks.

    Drug: Avatrombopag · Drug: Rituximab (Arm B)

  • Active comparator
    Rituximab

    Open label, intravenous infusions of 1000mg Rituximab 2 weeks apart

    Drug: Avatrombopag · Drug: Rituximab (Arm B)

Interventions

06

What researchers measure

Primary outcomes

  1. Efficacy of the oral TPO-RA, Avatrombopag, to Rituximab

    To compare the efficacy of the oral TPO-RA, Avatrombopag to Rituximab by measuring the rates of durable responses defined as achieving platelet counts ≥ 50 X109/L in ≥3 of the bi-weekly measurements between weeks 20 and 28 including the last count without having received any other platelet elevating agents after randomization apart from rescue therapy received before end of week 10.

    Time frame: Assessed at week 28

Secondary outcomes

  1. The changes in the disease specific HRQoL

    The changes in the disease specific HRQoL from baseline to weeks 28 and 78 measured by ITP-PAQ (Overall Quality of Life Scale) score.

    Time frame: Baseline to weeks 28 and weeks 78

  2. Changes in the level of fatigue

    The changes in the level of fatigue from baseline to weeks 28 and 78 measured by FACIT-Fatigue score

    Time frame: Baseline to weeks 28 and weeks 78

  3. Rates of Sustained Response Off-Treatment (SROT)

    The rates of Sustained Response Off-Treatment (SROT) at 78 weeks where the occurrence of SROT defined as * A platelet count \> 50 X109/L in at least 3 of the 4 planned visits between weeks 36 and 78 including week 78 * No administration of platelet elevating agent between weeks 36 and 78.

    Time frame: At 78 weeks

07

Study locations

No study locations are listed for this record.

08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Sep 2025; primary completion for Jan 2028, 28 months later.

Of 57 phase 3 interventional studies under Purpura, Thrombocytopenic, Idiopathic, half reached primary completion within 28 months of starting (the median), counting those still running; a quarter within 22 and three quarters within 49. This study's planned 28 months is close to that.

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

Registered
Jun 23, 2025
First posted
Jul 4, 2025
StartEst.
Sep 15, 2025
Primary completionEst.
Jan 31, 2028
CompletionEst.
Dec 31, 2029
Last update
Sep 9, 2025
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 Sep 9, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07051915
Lead sponsor
Ostfold Hospital Trust
Collaborators
Oslo University Hospital, University Hospital, Akershus, Sykehuset i Vestfold HF, St. Olavs Hospital, Helse Stavanger HF, Sorlandet Hospital HF, University Hospital of North Norway, Haukeland University Hospital, Helse Nord-Trøndelag HF, Helse Fonna, Nordlandssykehuset HF
Responsible party
Sponsor
First posted
Jul 4, 2025
Start date
Sep 15, 2025 (estimated)
Primary completion
Jan 31, 2028 (estimated)
Completion
Dec 31, 2029 (estimated)
Last update
Sep 9, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2025. You cannot join it, but the record below documents what was studied.

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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.

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Studies of the drugs tested here: Avatrombopag · Rituximab

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