Phase 2
N=20
Study Assessed the Safety and Efficacy of Eltrombopag in Chinese Refractory or Relapsed Severe Aplastic Anemia (SAA) Subjects.
Aplastic Anemia
Bottom Line
View on ClinicalTrials.gov: NCT03988608 ↗Enrolled (actual)
20
Serious AEs
40.0%
Results posted
Feb 2025
Primary outcome: Primary: Hematologic Response Rate at 6 Months (Week 26) by Investigator — 70.0 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Eltrombopag (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Novartis Pharmaceuticals
- Primary completion
- Jul 2021
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Hematologic Response Rate at 6 Months (Week 26) by Investigator |
70.0 | — |
| SECONDARY Hematologic Response Rate by Investigator |
65.0; 65.0 | — |
| SECONDARY Change From Baseline in Platelet Count |
10.725; 10.265; 26.933; 41.071 | — |
| SECONDARY Change From Baseline in Hemoglobin Levels |
66.9; 22.4; 31.9; 32.9 | — |
| SECONDARY Change From Baseline in Neutrophil Count |
1.199; -0.160; 0.196; 0.447 | — |
| SECONDARY Time to Hematologic Response by Investigator |
10.0 | — |
| SECONDARY Duration of Hematologic Response by Investigator |
NA | — |
| SECONDARY Frequency of Platelets Transfusion |
1.8; 0.4; 0.1; 0.0 | — |
| SECONDARY Amount of Platelets Transfusion |
3.7; 0.4; 0.1; 0.0 | — |
| SECONDARY Frequency of Red Blood Cells (RBC) Transfusion |
3.0; 1.8; 1.5; 0.5 | — |
| SECONDARY Amount of Red Blood Cells (RBC) Transfusion |
6.6; 3.8; 3.0; 1.4 | — |
| SECONDARY Plasma PK Parameters of Eltrombopag: Cmax |
3450 | — |
| SECONDARY Plasma PK Parameters of Eltrombopag: Tmax |
3.73 | — |
| SECONDARY Plasma PK Parameters of Eltrombopag: AUCtau & AUClast |
67900; 62700 | — |
| SECONDARY Plasma PK Parameters of Eltrombopag: CLss/F |
0.441 | — |
| SECONDARY Plasma Trough Concentration of Eltrombopag |
2180; 5180; 11300; 14700; 20300; 23800 | — |
| SECONDARY Number of Participants With Clonal Evolution |
2 | — |
Summary
This was a non-randomized, open-label, phase II study to assess the efficacy and safety of eltrombopag in Chinese subjects with refractory or relapsed severe aplastic anemia (SAA). Treatment with eltrombopag was started at 25 mg/day and increased by 25 mg/day every 2 weeks according to the platelet count up to 150 mg/day. The hematological response rate was assessed at 3, 6 months and 1 year after starting the study treatment (Week 13, 26 and 52).
Eligibility Criteria
Inclusion Criteria
- Chinese patients aged greater than or equal to 18 years old.
- Patient with a previous diagnosis of severe aplastic anemia and had insufficient response following at least one treatment course in the period time of > 6 months of immunosuppression with a regimen containing anti-thymocyte globulin (ATG), anti-lymphocyte globulin (ALG), and/or cyclophosphamide, or alemtuzumab.
- Platelet count ≤ 30 × 10^9/L at screening.
- Patient must not currently have the option of stem cell transplantation.
- Patient has an Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
- Patient with QTcF (Fridericia's QT correction formula) at screening <450 msec, or <480 msec with bundle branch block, as determined via the mean of a triplicate ECG and assessed at site.
Exclusion Criteria
- Treatment with ATG/ALG, cyclophosphamide or alemtuzumab in the past 6 months.
- Congenital aplastic anemia
- AST or ALT ≥3 times the upper limit of normal.
- Creatinine, total bilirubin, and alkaline phosphatase (ALP) ≥ 1.5× local ULN (total bilirubin ≥ 2.5 × local ULN with Gilbert's Syndrome).
- Paroxysmal nocturnal hemoglobinuria (PNH) granulocyte clone size determined by flow cytometry ≥ 50%.
- Presence of chromosomal aberration (-7/7q- detected by fluorescence in situ hybridization (FISH), or other aberrations detected by G-band staining).
- Evidence of a clonal hematologic bone marrow disorder on cytogenetics.
- Past medical history of thromboembolism within 6 months or current use of anticoagulants.
- Have any concomitant malignancies and must be fully recovered from treatment for any other malignancy and have been disease-free for 5 years.
- Patient with clinically significant (of such severity that it would preclude the patient's ability to consent, be compliant with study procedures, tolerate protocol therapy) bacterial, fungal, mycobacterial, parasitic or viral infection (Patient with acute bacterial infections requiring antibiotic use should delay Screening/enrollment until the course of antibiotic therapy has been completed).
- Patient with known hepatocellular disease
- Presences of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening.
- Cardiac disorder (NYHA) functional classification Grade II/III/IV
- Past medical history of immediate or delayed hypersensitivity to compounds chemically similar to eltrombopag or their excipients.
- Treatment with another investigational product within 30 days.
- Prior treatment with eltrombopag, romiplostim, or any other TPO (thrombopoietin) receptor agonist.
- Positive result for HIV (Human Immunodeficiency Virus) antibody test.
- Pregnant or nursing (lactating) woman.
- Woman of child-bearing potential.
Data sourced from ClinicalTrials.gov (NCT03988608). 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.