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RecruitingNCT07535645BAPTUpdated Sep 16, 2026

Baricitinib for Post-HSCT Persistent Thrombocytopenia

A Phase 1/2 interventional study of Baricitinib in Persistent Thrombocytopenia and Allogeneic Hematopoietic Stem Cell Transplantation, sponsored by Peking University People's Hospital. Recruiting at 1 site in China. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-09-16.

Sponsored by Peking University People's Hospital · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
28
Allocation
Not applicable
Ages
18 Years to 70 Years
Sex
All
01

Study summary

This is a prospective, open-label phase 1b/2 clinical trial to explore the safety and efficacy profiles of baricitinib in patients with thrombopoietin-receptor-agonist-refractory persistent thrombocytopenia after allogeneic hematopoietic stem cell transplantation.

Read the detailed description

Phase 1 part:

The phase 1b part will use a standard 3+3 design to explore the safety profiles and to establish the recommended phase 2 dose (RP2D) of baricitinib. The initial dose is 2 mg once daily, and the maximum dose is 4 mg once daily. Additional patients may be enrolled to further explore a selected dose defined by dose escalation cohorts (up to 9 patients in each dose level).

Phase 2 part:

The phase 2 part is a single-arm, open-label study to assess the efficacy and safety of baricitinib at RP2D in patients with thrombopoietin-receptor-agonist-refractory persistent thrombocytopenia after allogeneic hematopoietic stem cell transplantation. Patients in phase 1b who were treated with baricitinib at the RP2D will be included in the phase 2 efficacy endpoint analyses.

02

Conditions studied

  • Persistent Thrombocytopenia
  • Allogeneic Hematopoietic Stem Cell Transplantation

Keywords

  • Persistent thrombocytopenia
  • Allogeneic Hematopoietic Stem Cell Transplantation
  • Baricitinib
03

Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Aged 18-70 years;
  • Underwent allo-HSCT;
  • Meet the diagnostic criteria for delayed platelet engraftment (DPE) or secondary failure of platelet recovery (SFPR);
  • Have platelet counts consistently \<20 ×10\^9/L or transfusion-dependent within 14 days prior to enrollment;
  • Have received adequate corticosteroid and TPO-RA therapy for persistent thrombocytopenia for no less than 4 weeks, with treatment failure or intolerance;
  • Complete donor chimerism.

Exclusion criteria

Exclusion Criteria:

  • Relapse of hematologic malignancy or MRD positivity;
  • Active infection;
  • Active graft-versus-host disease;
  • Thrombotic microangiopathy;
  • Primary graft failure or poor graft function;
  • Presence of other factors that may lead to secondary thrombocytopenia at the time of PT diagnosis;
  • History of systemic herpes zoster infection within 12 weeks prior to enrollment screening;
  • Acute or chronic infection with HBV, HCV, or HIV;
  • Evidence of active tuberculosis, or history of active tuberculosis without documented standard anti-tuberculosis treatment, or close contact with active tuberculosis without documented standard tuberculosis prophylaxis;
  • Receipt of a live vaccine within 12 weeks prior to enrollment screening, or planned receipt of a live vaccine during the study period;
  • Clinically significant thromboembolic event within 24 weeks prior to enrollment screening, or current use of anticoagulant medications deemed by the investigator to carry an uncontrollable risk;
  • Estimated glomerular filtration rate \<50 mL/min/1.73 m\^2;
  • Severe pre-existing or current conditions involving the cardiovascular, respiratory, hepatic, gastrointestinal, endocrine, nervous, or neuropsychiatric systems, or other severe or unstable illnesses or laboratory abnormalities that will make the study drug unacceptable for the patient or can interfere study data;
  • Participation in another clinical trial within 30 days prior to enrollment.
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
28 participants (estimated)

Study arms

  • Experimental
    Baricitinib

    Group A: Open label baricitinib at 2 mg daily (Phase 1) Group B: Open label baricitinib at 4 mg daily (Phase 1) Group C: Open label baricitinib at the RP2D (Phase 2)

    Drug: Baricitinib

Interventions

  • DrugBaricitinib

    Baricitinib, an orally administered, selective, reversible JAK1/2 inhibitor.

05

What researchers measure

Primary outcomes

  1. Adverse events in the Ib part

    The incidence and severity of adverse events are assessed using the criteria of CTCAE 5.0.

    Time frame: 24 weeks

  2. Overall response rate (ORR) for the IIa part

    The proportion of patients achieving an overall response (OR), defined as a platelet count ≥20×10\^9/L maintained for more than 7 days without transfusion support. Platelet counts obtained within 4 weeks after rescue therapy were not included in the efficacy assessment.

    Time frame: 12 weeks

Secondary outcomes

  1. Overall response rate (ORR) for the Ib part

    The proportion of patients achieving an overall response (OR), defined as a platelet count ≥20×10\^9/L maintained for more than 7 days without transfusion support. Platelet counts obtained within 4 weeks after rescue therapy were not included in the efficacy assessment.

    Time frame: 12 weeks

  2. Complete response (CR)

    The proportion of patients achieving a complete response (CR), defined as a platelet count ≥50×10\^9/L maintained for more than 7 days without transfusion support. Platelet counts obtained within 4 weeks after rescue therapy were not included in the efficacy assessment.

    Time frame: 12 weeks

  3. Durable response

    The proportion of patients achieving a durable response (DR), defined as a platelet count ≥20×10\^9/L maintained for more than 8 weeks without transfusion. Platelet counts obtained within 4 weeks after rescue therapy were not included in the efficacy assessment.

    Time frame: 24 weeks

  4. Time to response

    The time from the date of the first dose of baricitinib to the date of OR or CR.

    Time frame: 12 weeks

  5. Bleeding events

    Clinically significant bleeding as assessed using the world health organization (WHO) bleeding scale: 0, no bleeding; 1, petechiae; 2, mild blood loss; 3, gross blood loss; and 4, debilitating blood loss.

    Time frame: 24 weeks

  6. Rescue medication

    Time and type of rescue medications, defined as any additional treatment intended to prevent bleeding or raise the platelet counts, including a dose increase of more than 10% above baseline of the concomitant medication and any additional PT-modifying agents (e.g., corticosteroids, intravenous immunoglobulin, and platelet transfusions).

    Time frame: 24 weeks

  7. Adverse events in the IIa part

    Adverse events (AEs) are reported and graded in accordance with the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.

    Time frame: 24 weeks

  8. Overall Survival (OS)

    The overall survival of patients who received at least one dose of baricitinib in the study.

    Time frame: 104 weeks

  9. Transplantation-related mortality (TRM)

    All deaths without relapse or disease progression occurring after transplantation as a direct or indirect consequence of the transplant procedure or associated complications in patients who received at least one dose of baricitinib in the study.

    Time frame: 104 weeks

  10. Relapse or progression of underlying disease

    Relapse or progression of underlying disease of patients who received at least one dose of baricitinib in the study.

    Time frame: 104 weeks

  11. Graft-versus-host disease

    The incidence and severity of acute graft-versus-host disease and chronic graft-versus-host disease in patients who received at least one dose of baricitinib in the study.

    Time frame: 104 weeks

06

Study locations

1 of 1 sites recruiting
  • Peking University People's Hospital
    Beijing, Beijing Municipality 100044, China
    Recruiting
07

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07535645
Lead sponsor
Peking University People's Hospital
Responsible party
Peng Zhao (Associate Research Fellow, Peking University People's Hospital) — Principal investigator
First posted
Apr 17, 2026
Start date
Mar 9, 2026
Primary completion
Dec 31, 2027 (estimated)
Completion
Sep 15, 2029 (estimated)
Last update
Sep 16, 2026

Study contacts

Peng Zhao
Contact
zpeng702@163.com
+86-18810323668

Oversight

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

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