Immune Thrombocytopenic PurpuraVIGICAIRENCT04057703
Balance Benefit / Risk of Immunomodulatory Treatments at the Child and Adolescent for Autoimmune Cytopenia.
An observational study of Immune Thrombocytopenic Purpura and Autoimmune Hemolytic Anemia, run by University Hospital, Bordeaux.
Trial summary
In France, a national prospective cohort for monitoring children and adolescents with autoimmune cytopenia OBS'CEREVANCE is in place since 2004. It is coordinated in Bordeaux by the Center's team. Reference Rare Diseases CEREVANCE. Read more about this study
- Who is it for?
- Ages Up to 18 years
- Conditions the study is for
- Immune Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia, Evan Syndrome
- How many people
- 454 participants
- Where
- No sites listed yet
- Study dates
- 18 Jan 2016to 4 Dec 2016
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Up to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Study population: Children or adolescents who have received one or more treatments of interest for a Chronic Immune-Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia , or EVANS syndrome, in one of the 30 centers of the CEREVANCE network, will be identified and selected by the team CEREVANCE, in the OBS'CEREVANCE computer database created since 2004. The first second-line treatment they received will be analyzed.
Who may be able to join
- Patient initiating a first second-line immunomodulatory treatment (azathioprine, ciclosporine, eltrombopag, hydroxychloroquine, mycophénolate mofétil, rituximab, romiplostim), registered in the OBS'CEREVANCE database, presenting a Chronic Immune-Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia or simultaneous EVANS syndrome.
Who cannot join
- Patient under immunosuppressant for another immunological pathology at the initiation of the first second line treatment,
- Patient treated with 2 second-line treatments on the same day,
- Oral refusal of participation of the patient or his legal representatives, after reading the information note specific for the study.
About this study
Official title: National Study Backed by a Rare Disease Cohort the Benefit / Risk Balance of Immunomodulatory Treatments Prescribed in the Child and Adolescent for Autoimmune Cytopenia.
In France, a national prospective cohort for monitoring children and adolescents with autoimmune cytopenia OBS'CEREVANCE is in place since 2004. It is coordinated in Bordeaux by the Center's team. Reference Rare Diseases CEREVANCE. It has been validated by the French Data Protection Authority in 2009 (information note and written consent). It had mid 2013 more of 900 patients, and the data collected make it possible to study intentionally to treat the therapeutic management of patients with Chronic Immune-Thrombocytopenic Purpura, from Autoimmune Hemolytic Anemia, or from EVANS syndrome.
This study evaluates efficacy and tolerance at 6 months of treatment immunomodulators prescribed in France in real conditions of use, in children and adolescents under the age of 18, for a Chronic Immune-Thrombocytopenic Purpura, an Autoimmune Hemolytic Anemia or a simultaneous EVANS syndrome.
Read the detailed description
Chronic immunological thrombocytopenic purpura and anemia hemolytic autoimmune are rare autoimmune hematologic diseases, primary or secondary, affecting the child often very young, sometimes associated simultaneously or sequentially (Evans syndrome). They can be life-threatening, they in 20 to 50% of cases of prolonged dependence on immunosuppressants. The incidence of Immune-Thrombocytopenic Purpura is 2 to 5 / 100,000 inhabitants of under 18, the Autoimmune Hemolytic Anemia 5 to 10 times lower.
For the pediatric population, the experience reported in the literature is limited to individual cases or small series often retrospective and not comparative. It does not allow to have in 2013 a reasoning based on on evidence to define the second-line therapeutic strategy, in especially for Autoimmune Hemolytic Anemia where the therapeutic data are almost nonexistent. Splenectomy remains to this day the reference treatment of the Chronic Immune-Thrombocytopenic Purpura of the adult. In children, the therapeutic goal is to avoid it or to prevent it delay it. After failure of first-line treatments (immunoglobulins or corticosteroids) used for treatment of relapses or continuously, the main immunomodulatory treatments used in second line are azathioprine, ciclosporin, hydroxychloroquine, rituximab, mycophenolate mofetil, romiplostim, eltrombopag.
The benefit / risk balance of these 7 immunomodulatory treatments prescribed to the child for autoimmune cytopenia is presumed to be favorable based on the very limited data from the pediatric literature and the experience of most adults do not benefit from a specific marketing authorization.
- Conditions
- Immune Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia, Evan Syndrome, Immunotherapy
- Keywords
- CEREVANCE, Pediatrics, Cohort
- Medical subject headings
- Purpura, Thrombocytopenic, Idiopathic, Anemia, Hemolytic, Autoimmune, Evans Syndrome
What is being measured
The primary outcome is the main question the study is designed to answer.
Haemorrhagic sign - Grade ≥ 3 (Buchanan score) Presence of a haemorrhagic sign ≥grade 3
Presence of a haemorrhagic sign ≥ grade 3 = moderate bleeding (Buchanan score : from 0 to 5)
Measured: At 6 months
Thrombocytopenia Presence of thrombocytopenia <30 G / L
Presence of thrombocytopenia <30 G / L
Measured: At 6 months
Need of a transfusion ?
Performing a transfusion : yes or no ?
Measured: At 6 months
Immunoglobulin IV Immunoglobulin IV
Immunoglobulin IV push
Measured: At 6 months
Corticoids push
Corticoid push (no reduction of their number during treatment follow-up versus non-treatment period)
Measured: At 6 months
Need a splenectomy ?
Performing a splenectomy : yes or no ?
Measured: At 6 months
Clinical signs of anemia
Presence of clinical signs of anemia ≥ grade 2 = Subject bedridden less than 50% of the day (WHO score : from 0 to 4)
Measured: At 6 months
Anemia
Presence of anemia <7g / dl
Presence of anemia <7g / dl
Measured: At 6 months
Introduction of a new immunomodulatory treatment
Introduction of a new immunomodulatory treatment : yes or no ?
Measured: At 6 months
Stop treatment or not ?
Stop treatment because of failure, intolerance or non-compliance
Measured: At 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Aug 2019
- Study start18 Jan 2016
- Primary completion4 Dec 2016
- Study completion4 Dec 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Immune Thrombocytopenic PurpuraStudies of the same condition, open and under way.
- More trials run by University Hospital, BordeauxThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 454 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Bordeaux
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Nathalie ALADJIDI, Dr, Principal investigator, University Hospital, Bordeaux
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04057703
- Sponsor's protocol ID
- CHU BX 2013/24
- Acronym
- VIGICAIRE
- Status last verified
- Aug 2019
- First submitted
- 12 Aug 2019
- Last updated
- 15 Aug 2019
- Results posted
- No
- Individual data sharing
- No: Through this program, a coordinated and centralized analysis of reliable pharmacovigilance data will be transmitted in real time to the National Agency for Medicines. It will enable National Agency for Medicines to ensure the safe use of these treatments for the pediatric population, vulnerable, and optimize monitoring in the short and long term identified or potential risks of these treatments on a developing immune system. It will also ensure the monitoring of off-label or Temporary Therapeutic Protocol / Temporary recommendation for use prescriptions and to argue recommendations for good use. For treatments whose benefit will be confirmed, these results will be useful to the medical community to define the best second-line therapeutic strategy.
Study at a glance
From the registry record, last updated by the sponsor on 15 Aug 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- National Study Backed by a Rare Disease Cohort the Benefit / Risk Balance of Immunomodulatory Treatments Prescribed in the Child and Adolescent for Autoimmune Cytopenia.
- ClinicalTrials.gov ID
- NCT04057703
- Acronym / sponsor ID
- VIGICAIRE / CHU BX 2013/24
- Conditions
- Immune Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia, Evan Syndrome, Immunotherapy
- Keywords
- CEREVANCE, Pediatrics, Cohort
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 454 participants (actual)
- Lead sponsor
- University Hospital, BordeauxUniversity, hospital or other
- Study start
- 18 Jan 2016 (actual)
- Primary completion
- 4 Dec 2016 (actual)
- Study completion
- 4 Dec 2016 (actual)
- First posted
- 15 Aug 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In France, a national prospective cohort for monitoring children and adolescents with autoimmune cytopenia OBS'CEREVANCE is in place since 2004. It is coordinated in Bordeaux by the Center's team. Reference Rare Diseases CEREVANCE. It has been validated by the French Data Protection Authority in 2009 (information note and written consent). It had mid 2013 more of 900 patients, and the data collected make it possible to study intentionally to treat the therapeutic management of patients with Chronic Immune-Thrombocytopenic Purpura, from Autoimmune Hemolytic Anemia, or from EVANS syndrome.
This study evaluates efficacy and tolerance at 6 months of treatment immunomodulators prescribed in France in real conditions of use, in children and adolescents under the age of 18, for a Chronic Immune-Thrombocytopenic Purpura, an Autoimmune Hemolytic Anemia or a simultaneous EVANS syndrome.
Detailed description
Chronic immunological thrombocytopenic purpura and anemia hemolytic autoimmune are rare autoimmune hematologic diseases, primary or secondary, affecting the child often very young, sometimes associated simultaneously or sequentially (Evans syndrome). They can be life-threatening, they in 20 to 50% of cases of prolonged dependence on immunosuppressants. The incidence of Immune-Thrombocytopenic Purpura is 2 to 5 / 100,000 inhabitants of under 18, the Autoimmune Hemolytic Anemia 5 to 10 times lower.
For the pediatric population, the experience reported in the literature is limited to individual cases or small series often retrospective and not comparative. It does not allow to have in 2013 a reasoning based on on evidence to define the second-line therapeutic strategy, in especially for Autoimmune Hemolytic Anemia where the therapeutic data are almost nonexistent. Splenectomy remains to this day the reference treatment of the Chronic Immune-Thrombocytopenic Purpura of the adult. In children, the therapeutic goal is to avoid it or to prevent it delay it. After failure of first-line treatments (immunoglobulins or corticosteroids) used for treatment of relapses or continuously, the main immunomodulatory treatments used in second line are azathioprine, ciclosporin, hydroxychloroquine, rituximab, mycophenolate mofetil, romiplostim, eltrombopag.
The benefit / risk balance of these 7 immunomodulatory treatments prescribed to the child for autoimmune cytopenia is presumed to be favorable based on the very limited data from the pediatric literature and the experience of most adults do not benefit from a specific marketing authorization.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- Up to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
- Study population
- Children or adolescents who have received one or more treatments of interest for a Chronic Immune-Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia , or EVANS syndrome, in one of the 30 centers of the CEREVANCE network, will be identified and selected by the team CEREVANCE, in the OBS'CEREVANCE computer database created since 2004. The first second-line treatment they received will be analyzed.
Key inclusion criteria (1 listed)
- Patient initiating a first second-line immunomodulatory treatment (azathioprine, ciclosporine, eltrombopag, hydroxychloroquine, mycophénolate mofétil, rituximab, romiplostim), registered in the OBS'CEREVANCE database, presenting a Chronic Immune-Thrombocytopenic Purpura, Autoimmune Hemolytic Anemia or simultaneous EVANS syndrome.
Key exclusion criteria (3 listed)
- Patient under immunosuppressant for another immunological pathology at the initiation of the first second line treatment,
- Patient treated with 2 second-line treatments on the same day,
- Oral refusal of participation of the patient or his legal representatives, after reading the information note specific for the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Haemorrhagic sign - Grade ≥ 3 (Buchanan score) Presence of a haemorrhagic sign ≥grade 3
Time frame: At 6 months
Presence of a haemorrhagic sign ≥ grade 3 = moderate bleeding (Buchanan score : from 0 to 5)
Thrombocytopenia Presence of thrombocytopenia <30 G / L
Time frame: At 6 months
Presence of thrombocytopenia <30 G / L
Need of a transfusion ?
Time frame: At 6 months
Performing a transfusion : yes or no ?
Immunoglobulin IV Immunoglobulin IV
Time frame: At 6 months
Immunoglobulin IV push
Corticoids push
Time frame: At 6 months
Corticoid push (no reduction of their number during treatment follow-up versus non-treatment period)
Need a splenectomy ?
Time frame: At 6 months
Performing a splenectomy : yes or no ?
Clinical signs of anemia
Time frame: At 6 months
Presence of clinical signs of anemia ≥ grade 2 = Subject bedridden less than 50% of the day (WHO score : from 0 to 4)
Anemia
Time frame: At 6 months
Presence of anemia <7g / dl Presence of anemia <7g / dl
Introduction of a new immunomodulatory treatment
Time frame: At 6 months
Introduction of a new immunomodulatory treatment : yes or no ?
Stop treatment or not ?
Time frame: At 6 months
Stop treatment because of failure, intolerance or non-compliance
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Aug 2019.
- Individual participant dataSharing planned: No. Through this program, a coordinated and centralized analysis of reliable pharmacovigilance data will be transmitted in real time to the National Agency for Medicines. It will enable National Agency for Medicines to ensure the safe use of these treatments for the pediatric population, vulnerable, and optimize monitoring in the short and long term identified or potential risks of these treatments on a developing immune system. It will also ensure the monitoring of off-label or Temporary Therapeutic Protocol / Temporary recommendation for use prescriptions and to argue recommendations for good use. For treatments whose benefit will be confirmed, these results will be useful to the medical community to define the best second-line therapeutic strategy.
Related trials for Immune Thrombocytopenic Purpura
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RecruitingPhase 1/2
A Study of Pirtobrutinib in Participants With Immune Thrombocytopenia
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RecruitingPhase 3
A Study of Mezagitamab in Adults With Chronic Primary Immune Thrombocytopenia
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RecruitingPhase 2
Study to Assess the Safety and Tolerability of Tafasitamab in Adult Participants With Primary Autoimmune Blood Cell Disorders
Immune Thrombocytopenia
RecruitingPhase 3
A Follow-up Study of Mezagitamab in Adults With Chronic Primary Immune Thrombocytopenia
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nathalie ALADJIDI, Dr principal investigator
University Hospital, Bordeaux
Questions about this trial
What is this clinical trial studying?
An observational study of Immune Thrombocytopenic Purpura and Autoimmune Hemolytic Anemia, run by University Hospital, Bordeaux.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 15 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Haemorrhagic sign - Grade ≥ 3 (Buchanan score) Presence of a haemorrhagic sign ≥grade 3 (time frame: At 6 months). The study lists 10 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Aug 2019.