罗米普洛司姆在患有免疫血小板缺血的儿童中:3期随机,双盲,安慰剂对照研究
Michael D Tarantino1, James B Bussel2, Victor S Blanchette3
1The Bleeding and Clotting Disorders Institute, University of Illinois College of Medicine-Peoria, IL, USA.
Lancet (London, England)
|April 23, 2016
概括
在患有慢性免疫血小板缺血的儿童中,罗米普洛司姆有效地增加了血小板数量,显示出显著的持续性血小板反应. 在这项儿科研究中没有发现新的安全问题.
科学领域:
- 儿童血液学
- 药理学
- 临床试验
背景情况:
- 儿童的持续性或慢性免疫血小板缺血 (ITP) 可能具有症状.
- 罗米普洛司姆是一种血栓蛋白受体激动剂,是ITP的潜在治疗选择.
- 这项研究评估了romiplostim在儿童中持续超过6个月的安全性和有效性.
研究的目的:
- 评估罗米普洛司姆在被诊断为免疫血小板缺血超过六个月的儿童的安全性和有效性.
- 确定与安慰剂相比,用罗米普洛司姆治疗的儿科患者的持续血小板反应率.
主要方法:
- 这是一项涉及62名患有ITP的儿童的3期双盲随机研究.
- 参与者每周接受罗米普洛司姆 (n=42) 或安慰剂 (n=20),每周调整罗米普洛司姆剂量 (1-10μg/ kg).
- 主要终点:持续的血小板反应 (血小板计数≥50 × 10^9/ L,在最后8周中的6周没有救援药物).
主要成果:
- 罗米普洛司姆在52%的患者中实现了持久的血小板反应,而在安慰剂组中达到10% (p=0. 002).
- 在罗米普洛司姆组的24%报告了严重的不良反应,而在安慰剂组的5%报告了严重的不良反应;在1名患者中,头痛和血栓塞瘤与治疗有关.
- 没有患者因不良事件而中止该研究.
结论:
- 在患有慢性免疫血小板缺血的儿童中,罗米普洛司姆的血小板反应率很高.
- 该研究表明,在此小儿群体中,没有与罗米普洛司姆使用相关的新安全信号.
- 目前正在进行进一步的研究,以评估长期疗效,安全性和缓解率.
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