Idiopathic Thrombocytopenic Purpura Clinical Trial
Official title:
Triple Therapy in Patients With Idiopathic Thrombocytopenic Purpura : What is Behind?
Idiopathic thrombocytopenic purpura (ITP) is a benign hematological disorder characterized by
isolated thrombocytopenia. Development of antiplatelet autoantibodies is the main
pathogenetic mechanism in patients with ITP. However the exact pathogenesis of ITP is complex
in which megakaryocyte immune injury and T-cell mediated platelet destruction play
significant role. Accordingly treatment of ITP relies mainly on immunosuppression. Recently
triple regimen of high dose dexamethasone together with cyclosporine and rituximab was found
to induce prolonged remission in patients with ITP compared with single agent
immunosuppression. On the other hand this regimen suppresses all immune cells thus
predisposing patient to serious infections, which is the main cause of morbidity in ITP
furthermore infection enhances autoimmunity.
This study will focus on viral hepatitis C and B infection in Egyptian patients with
idiopathic thrombocytopenic purpura on Triple therapy and aims to:
- Assess and improve preventive measures of blood born hepatitis infection in the
hematology ward in Egypt.
- Investigate influence of immunosuppression on infection with blood born hepatitis on
Egyptian patients with ITP on Triple therapy.
- Study the impact of blood born hepatitis infection on clinical outcome on those
patients.
- Identify risk factors and routes of transmission of blood born viral hepatitis in the
hematology ward in Egypt
Status | Not yet recruiting |
Enrollment | 180 |
Est. completion date | June 2021 |
Est. primary completion date | December 2020 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility |
Inclusion Criteria: - Normal healthy Egyptians on the age range from 18-85. - Egyptian patients with ITP in age range from 18- 65 on high dose dexamethasone together with cyclosporin and rituximab . - Egyptian patients with ITP in age range from 18- 65 on parenteral or oral steriods. Exclusion Criteria: - Age less than 18 years old. - Pregnancy - Thrombocytopenia other than ITP. - Patients with ITP but on other modalities of treatment. - Patients with blood born viral hepatitis infection before treatment with high dose dexamethasone together with cyclosporin and rituximab |
Country | Name | City | State |
---|---|---|---|
Egypt | Assiut University | Assiut |
Lead Sponsor | Collaborator |
---|---|
Assiut University |
Egypt,
Aref S, Sleem T, El Menshawy N, Ebrahiem L, Abdella D, Fouda M, Samara NA, Menessy A, Abdel-Ghaffar H, Bassam A, Abdel Wahaab M. Antiplatelet antibodies contribute to thrombocytopenia associated with chronic hepatitis C virus infection. Hematology. 2009 Oct;14(5):277-81. doi: 10.1179/102453309X439818. — View Citation
Ennishi D, Terui Y, Yokoyama M, Mishima Y, Takahashi S, Takeuchi K, Okamoto H, Tanimoto M, Hatake K. Monitoring serum hepatitis C virus (HCV) RNA in patients with HCV-infected CD20-positive B-cell lymphoma undergoing rituximab combination chemotherapy. Am J Hematol. 2008 Jan;83(1):59-62. — View Citation
Gudbrandsdottir S, Birgens HS, Frederiksen H, Jensen BA, Jensen MK, Kjeldsen L, Klausen TW, Larsen H, Mourits-Andersen HT, Nielsen CH, Nielsen OJ, Plesner T, Pulczynski S, Rasmussen IH, Rønnov-Jessen D, Hasselbalch HC. Rituximab and dexamethasone vs dexamethasone monotherapy in newly diagnosed patients with primary immune thrombocytopenia. Blood. 2013 Mar 14;121(11):1976-81. doi: 10.1182/blood-2012-09-455691. Epub 2013 Jan 4. — View Citation
Kouyoumjian SP, Chemaitelly H, Abu-Raddad LJ. Characterizing hepatitis C virus epidemiology in Egypt: systematic reviews, meta-analyses, and meta-regressions. Sci Rep. 2018 Jan 26;8(1):1661. doi: 10.1038/s41598-017-17936-4. Review. — View Citation
Kuwana M, Ikeda Y. The role of autoreactive T-cells in the pathogenesis of idiopathic thrombocytopenic purpura. Int J Hematol. 2005 Feb;81(2):106-12. Review. — View Citation
Patel VL, Mahévas M, Lee SY, Stasi R, Cunningham-Rundles S, Godeau B, Kanter J, Neufeld E, Taube T, Ramenghi U, Shenoy S, Ward MJ, Mihatov N, Patel VL, Bierling P, Lesser M, Cooper N, Bussel JB. Outcomes 5 years after response to rituximab therapy in children and adults with immune thrombocytopenia. Blood. 2012 Jun 21;119(25):5989-95. doi: 10.1182/blood-2011-11-393975. Epub 2012 May 7. — View Citation
Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol. 2017 Mar;2(3):161-176. doi: 10.1016/S2468-1253(16)30181-9. Epub 2016 Dec 16. Review. — View Citation
Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, Bussel JB, Cines DB, Chong BH, Cooper N, Godeau B, Lechner K, Mazzucconi MG, McMillan R, Sanz MA, Imbach P, Blanchette V, Kühne T, Ruggeri M, George JN. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009 Mar 12;113(11):2386-93. doi: 10.1182/blood-2008-07-162503. Epub 2008 Nov 12. — View Citation
Wang CS, Yao WJ, Wang ST, Chang TT, Chou P. Strong association of hepatitis C virus (HCV) infection and thrombocytopenia: implications from a survey of a community with hyperendemic HCV infection. Clin Infect Dis. 2004 Sep 15;39(6):790-6. Epub 2004 Aug 27. — View Citation
Wedemeyer H, Duberg AS, Buti M, Rosenberg WM, Frankova S, Esmat G, Örmeci N, Van Vlierberghe H, Gschwantler M, Akarca U, Aleman S, Balik I, Berg T, Bihl F, Bilodeau M, Blasco AJ, Brandão Mello CE, Bruggmann P, Calinas F, Calleja JL, Cheinquer H, Christensen PB, Clausen M, Coelho HS, Cornberg M, Cramp ME, Dore GJ, Doss W, El-Sayed MH, Ergör G, Estes C, Falconer K, Félix J, Ferraz ML, Ferreira PR, García-Samaniego J, Gerstoft J, Giria JA, Gonçales FL Jr, Guimarães Pessôa M, Hézode C, Hindman SJ, Hofer H, Husa P, Idilman R, Kåberg M, Kaita KD, Kautz A, Kaymakoglu S, Krajden M, Krarup H, Laleman W, Lavanchy D, Lázaro P, Marinho RT, Marotta P, Mauss S, Mendes Correa MC, Moreno C, Müllhaupt B, Myers RP, Nemecek V, Øvrehus AL, Parkes J, Peltekian KM, Ramji A, Razavi H, Reis N, Roberts SK, Roudot-Thoraval F, Ryder SD, Sarmento-Castro R, Sarrazin C, Semela D, Sherman M, Shiha GE, Sperl J, Stärkel P, Stauber RE, Thompson AJ, Urbanek P, Van Damme P, van Thiel I, Vandijck D, Vogel W, Waked I, Weis N, Wiegand J, Yosry A, Zekry A, Negro F, Sievert W, Gower E. Strategies to manage hepatitis C virus (HCV) disease burden. J Viral Hepat. 2014 May;21 Suppl 1:60-89. doi: 10.1111/jvh.12249. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Incidence | Number of ITP patients on Triple therapy became infected with blood born viral hepatitis. | 6-months | |
Primary | Platelet count | Number of ITP patients on Triple therapy infected with HCV or HBV and their platelet count | 6-months | |
Primary | Primary prevention | Number of medical and paramedical staff who follow preventive measures for HCV and HBV in the hematology ward before and after an educational program | One month | |
Primary | Risk factors | Number of ITP patients who became infected with HCV or HBV after exposure to a risk factor | 6-months |
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