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Acquired Thrombotic Thrombocytopenic PurpuraNCT05046717

Improvement of Immunologic and Molecular Techniques for the Diagnosis and Follow-up of Patients With Thrombotic Thrombocytopenic Purpura

An observational study of Acquired Thrombotic Thrombocytopenic Purpura, run by Fundación Española de Hematología y Hemoterapía at 6 sites in 2 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The lack of ADAMTS13 is the only biological marker that is specific for aTTP diagnosis8 and the assessment of ADAMTS13 is of clinical importance because it is essential for the rapid differential diagnosis between aTTP and other TMA. Read more about this study

Who is it for?
Ages 0 to 99 years
What is being tested?
ADAMTS13 Activity Assays
Type of treatment
Medical device
How many people
500 participants
Where
6 sitesin 2 countries
Study dates
13 Oct 2022to Jun 2026
Phase
Observational
Are there results?
Not yet: the study is under way

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 0 to 99 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: The study population will be all consecutive patients who meet the following inclusion criteria and none of the following exclusion criteria until reaching the number of patients determined for the study.

Who may be able to join

  • Patients with confirmed thrombotic microangiopathy (TMA) based on citrated blood samples meeting both of the following criteria:
  • Thrombocytopenia [drop in platelet count ≥50% or platelet count < 100x109/L and
  • Microangiopathic haemolytic anaemia (elevation of lactate dehydrogenase (LDH) >2- fold or by presence or increase of schistocytes in peripheral blood smear)
  • Patients that voluntarily sign informed consent. For subjects unable to provide consent, a fully recognized medical proxy may be used according to local laws.
  • Patients between 0 to 99 years old at the time of screening.

Who cannot join

  • -

Trial locations and contacts

6 sites in 2 countries.

6 sites in 2 countries

Spain5 sites
  • Complejo Hospitalario Universitario A Coruña

    A Coruña, A Coruña, 15006

  • Hospital Clinic de Barcelona

    Barcelona

  • Hospital Clínico San Carlos

    Madrid

  • Hospital Gregorio Marañon

    Madrid

  • Hospital La Fe de Valencia

    Valencia

Other trials in Spain

Portugal1 site
  • Centro Hospitalar e Universitario de Coimbra

    Coimbra, Coimbra District, 3004-561

Other trials in Portugal

About this study

Official title: Improvement of Immunologic and Molecular Techniques for the Diagnosis and Follow-up of Patients With Thrombotic Thrombocytopenic Purpura: a Collaborative Study Proposal of the Spanish Apheresis Group (GEA) in Collaboration With the Spanish Foundation of Hematology and Hemotherapy (FEHH)

The lack of ADAMTS13 is the only biological marker that is specific for aTTP diagnosis8 and the assessment of ADAMTS13 is of clinical importance because it is essential for the rapid differential diagnosis between aTTP and other TMA. Furthermore, monitoring of ADAMTS13 activity is useful to ensure biological remission (ADAMTS13 levels > 10%) as well as predicting relapses.

Due to the high mortality rate of aTTP, treatment should be started as soon as the disease is suspected, sometimes even before confirmation with the ADAMTS13 test results. This situation may lead to misdiagnose some patients and leave them without the appropriate treatment. In conclusion, ADAMTS13 activity assay is crucial for an early diagnosis and optimal management of acute aTTP and any delay in ADAMTS13 results will have a negative impact on the diagnosis, treatment and prognosis of the patient.

Read more

There are currently 2 techniques available for the ADAMTS13 activity determination, the fluorescence resonance energy transfer (FRET) and the Technozym chromogenic enzyme-linked immunosorbent assay (ELISA). Both are considered reference methods but they require considerable skill because they are highly manual and this increases the risk of error. Furthermore, these methods are time-consuming, not widely available and, in case of the ELISA method, it requires a new calibration at each run. The inter-laboratory variability is also a challenge and therefore a validation and/or interpretation method could be needed.

Recently, a new and first fully automated HemosIL AcuStar ADAMTS13 Activity assay (Instrumentation Laboratory, Bedford, Massachusetts, United States) has been developed. HemosIL AcuStar ADAMTS13 Activity assay is a two steps chemiluminescent immunoassay (CLIA) with an analytical time of 33 minutes for the quantitative measurement of ADAMTS13 activity in human-citrated plasma on the ACL AcuStar analyser. The immunoassay uses the GST-VWF73 substrate in combination with magnetic particles for rapid separation and chemiluminescence technology detection. The ADAMTS13 present in the plasma sample cleavages the GST-VWF73 substrate and the detection of the generated fragments is based upon an isoluminol-labelled monoclonal antibody that specifically reacts with the cleaved peptide. The emitted light is proportional to the ADAMTS13 activity in the sample.

This new ADAMTS13 assay method has been compared with the other two available techniques in two different studies. First, Favresse et al. published the results of the comparison between Technozym activity ELISA assay and the new HemosIL AcuStar chemiluminescent assay. On the other hand, Valsecchi et al. have recently published the results of validation of this new technique in comparison with ELISA and FRETS in 176 samples. Both studies conclude that the new chemiluminescent ADAMTS13 activity assay showed a good correlation and excellent clinical performance for the diagnosis of severe ADAMTS13 deficiency with the FRETS-VWF73 assay and a commercial ELISA when considering only ADAMTS13 activity values below 10% (the internationally accepted cut-off for a diagnosis of severe ADAMTS13 deficiency typical of aTTP). Finally, Stratmann et al. have just published another study comparing the HemosIL AcuStar chemiluminescent assay with two commercially available ADAMTS13 assay kits using 24 paired test samples derived from 10 consecutively recruited patients13 and their results corroborate the previously published data suggesting that the AcuStar assay could be a valuable and accurate tool for ADAMTS13 activity testing and aTTP diagnostic.

In this context, a unique opportunity to validate this new technique is generated, both retrospectively with our already available data from frozen samples and also in the context of a large prospective study. This will be the first study worldwide testing HemosIL AcuStar method in real clinical practice aTTP population (Spanish and Portuguese aTTP populations) with the aim to standardize the diagnosis and follow-up methodology for the disease.

Being tested
ADAMTS13 Activity Assays
Medical subject headings
Purpura, Thrombotic Thrombocytopenic

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ADAMTS13 Activity AssaysDevice

    In this study the measurement of ADAMTS13 activity will be assessed with three different commercial kits:

    1. HemosIL AcuStar ADAMTS13 Activity Assay (Instrumentation Laboratory, Bedford, Massachusetts, United States)
    2. ELISA, DG-EIA ADAMTS13 Activity (Diagnostic Grifols®, Spain)
    3. FRETS-VWF73 for ADAMTS13 Activity Assay

    Three kits will be used with all patients.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At diagnosis of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  2. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (10 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  3. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (30 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  4. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (60 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  5. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (90 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  6. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (180 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  7. Correlation of a new diagnostic test and standard test

    Correlation of a new diagnostic test, HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS in the measurement of activity and antibody of ADAMTS13 in IU/mL

    Measured: At follow up (365 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

Secondary outcomes (21)
  1. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients at diagnosis based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At diagnosis of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  2. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (10 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  3. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (30 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  4. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (60 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  5. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (90 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  6. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (180 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  7. Concordance of classification of aTTP

    To evaluate the concordance of classification of aTTP patients based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (365 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  8. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At diagnosis of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  9. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (10 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  10. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (30 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  11. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (60 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  12. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (90 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  13. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (180 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  14. Sensitivity and specificity of classification of aTTP

    To evaluate the sensitivity and specificity of classification of aTTP patients visits based on HemosIL AcuStar chemiluminescent assay, in comparison with ELISA and/or FRETS.

    Measured: At follow up (365 days) of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  15. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At diagnosis of patients with acquired thrombotic thrombocytopenic purpura (aTTP).

  16. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (10 days)

  17. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (30 days)

  18. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (60 days)

  19. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (90 days)

  20. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (180 days)

  21. Clinical characteristics

    Describe clinical characteristics of patients with TMA at the diagnosis and those with aTTP at the diagnosis and follow up based on ADAMTS13 cut-off < 10%.

    Measured: At follow up (365 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2021
  2. Study start13 Oct 2022
  3. Primary completion14 Nov 2025
  4. Study completionJun 2026 (estimated)

Resources

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
500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05046717
Sponsor's protocol ID
INSPIRER
Status last verified
Feb 2026
First submitted
8 Sep 2021
Last updated
11 Feb 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Acquired Thrombotic Thrombocytopenic Purpura, run by Fundación Española de Hematología y Hemoterapía at 6 sites in 2 countries.

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 5 inclusion and 1 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: under way, not looking for participants, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in Spain, Portugal. Whether a site is taking part right now should be confirmed with that site. See every site.

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?

This study is still under way. Results are not available in the source record yet.

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?

Correlation of a new diagnostic test and standard test (time frame: At diagnosis of patients with acquired thrombotic thrombocytopenic purpura (aTTP).). The study lists 7 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 11 Feb 2026.

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