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Phase 2 N=54 Treatment

Eltrombopag Combined With Cyclosporine as First Line Therapy in Patients With Severe Acquired Aplastic Anemia

Severe Aplastic Anemia

Enrolled (actual)
54
Serious AEs
50.0%
Results posted
Dec 2023
Primary outcome: Primary: Overall Hematologic Response Rate by 6 Months — 46.3 Percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
eltrombopag (Drug); Cyclosporine (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Novartis Pharmaceuticals
Primary completion
Nov 2020

Outcome Measures

OutcomeResultp-value
PRIMARY
Overall Hematologic Response Rate by 6 Months
46.3
SECONDARY
Overall Hematologic Response Rate by 3 Months
40.7
SECONDARY
Overall Hematologic Response Rate at 12 and 24 Months
18.5; 18.5
SECONDARY
Duration of First Hematologic Response
351.0
SECONDARY
Relapse Rate by 6 and 24 Months
32.0; 44.0
SECONDARY
Percentage of Participants With Evolution to Myelodysplasia, Paroxysmal Nocturnal Hemoglobinuria (PNH) and Leukemia
SECONDARY
Percentage of Participants Who Were Red Blood Cells (RBC) Transfusion Independent
17; 20; 5
SECONDARY
Percentage of Participants Who Were Platelet Transfusion Independent
25; 25; 13
SECONDARY
Longest Duration of Transfusion Independence (Platelet or RBC)
NA; NA; 87.0
SECONDARY
Change From Baseline in Scores of Functional Assessment of Cancer Therapy - General (FACT-G) Patient Reported Outcome
-2.0; -3.0; -0.3; 0.0; -1.3; 0.8
SECONDARY
Change From Baseline in Scores of FACT - Thrombocytopenia 18 (FACT-TH18) Patient Reported Outcome
2.3; -1.5; 8.4; 9.0; 3.4; 9.3
SECONDARY
Change From Baseline in Scores of Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT- Fatigue) Patient Reported Outcome
3.0; 2.0; 4.0; 6.0; 4.5; 5.5
SECONDARY
Pharmacokinetic Parameter- Cmax of Eltrombopag When Combined With Cyclosporine
29.1; 38.7
SECONDARY
Pharmacokinetic Parameter-AUClast of Eltrombopag When Combined With Cyclosporine
583; 702
SECONDARY
Pharmacokinetic Parameter- AUCtau of Eltrombopag When Combined With Cyclosporine
686; 727
SECONDARY
Pharmacokinetic Parameter- Ctrough of Eltrombopag When Combined With Cyclosporine
19.3; 27.2
SECONDARY
Pharmacokinetic Parameter- Tmax of Eltrombopag When Combined With Cyclosporine
5.79; 3.75
SECONDARY
Pharmacokinetic Parameter- CLss/F of Eltrombopag When Combined With Cyclosporine
146; 206

Summary

The purpose of this study was to evaluate the efficacy and safety of eltrombopag in combination with cyclosporine alone as first-line therapy on overall hematologic response

Eligibility Criteria

Inclusion Criteria

  • Patient had signed the Informed Consent (ICF) prior to any screening procedures
  • Patient was male/female ≥18 years old at the time of informed consent and able to swallow a tablet.
  • Patient had SAA characterized by:
  • Bone marrow cellularity 3 x ULN.
  • Serum creatinine, total bilirubin, or alkaline phosphatase >1.5 x ULN.
  • Patient with liver cirrhosis.
  • Patients who were human immune deficiency virus (HIV), hepatitis C virus or hepatitis B surface antigen (HBsAg) positive. HCV-RNA negative patients were allowed to be enrolled.
  • Moribund status or concurrent hepatic, renal, cardiac, neurologic, pulmonary, infectious, or metabolic disease of such severity that it would preclude the patient's ability to consent, be compliant with study procedures, tolerate protocol therapy, or that death within 30 days is likely.
  • Patients with cancer who were not considered cure, were on active chemotherapeutic treatment or who took drugs with hematological effects.
  • Administration of an investigational drug within 30 days or 5 half-lives, whichever was longer, preceding the first dose of study treatment.
  • Pregnancy statements and contraception requirements:

Pregnancy or nursing (lactating) women Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant (or female partners of male patients), unless they were using highly effective methods of contraception during dosing and for 3 months after stopping medication.

  • Not able to understand the investigation nature of the study or to give informed consent.
  • Clinically significant ECG abnormality including cardiac arrhythmias (e. g. ventricular tachycardia) complete left bundle branch block, high grade atrioventricular block, or inability to determine the QTcF interval on the ECG.
  • Presence of cardiac disease, or family history of idiopathic sudden death or congenital long QT syndrome.
  • Risk factors for Torsades de Pointe including uncorrected hypokalemia or hypomagnesemia, or use of concomitant medication(s) with a known risk to prolong the QT interval that could not be discontinued or replaced by safe alternative medication per www.qtdrugs.org.
  • ECOG performance status of ≥2.
  • Patients under the age of 40 must be referred for consideration of allogeneic bone marrow transplantation (HSCT) if (human leukocyte antigen) HLA matching had been done and a suitable matched sibling donor was available and the patient was willing to undergo transplantation (i.e. patients who did not have a HLA match or were not medically fit, not willing or unable to undergo transplantation were considered for enrollment).
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02998645). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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