E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Thrombotic Thrombocytopenia Purpura |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Time to remission as defined by days until sustained platelet count>150 X 109/L, normal lactate dehydrogenase and number of plasma exchanges required, as defined by No of procedures per admission compared to historical controls. |
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E.2.2 | Secondary objectives of the trial |
- Improved mortality of TTP patients (assessed at 3 months from presentation)
- Safety and toxicity of Rituximab in conjunction with standard therapy for acute TTP
- Effect of Rituximab on B lymphocyte function
- Effect of Rituximab on ADAMTS 13 activity and antibody production and time to relapse
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
-Patients >18 years and < 65 years who present with an acute episode of TTP.
-Evidence of microangiopathic haemolytic anaemia.
-Thrombocytopenia with a normal clotting screen.
-Raised lactate dehydrogenase (one and a half times above upper normal).
-Patients without neurological dysfunction able to give informed consent.
-Patients of reproductive age [must avoid pregnancy for 12 months and or normalised B cell function after receiving Rituximab. Oestrogen containing oral contraceptive pills and the morning after pills should be avoided in female TTP patients].
-Patients with an acute deterioration in neurological function which may include encephalopathy, such as altered personality, problems with short term memory and coma can be included when consent has been given by next of kin or from the appropriate legal representative. |
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E.4 | Principal exclusion criteria |
-All female subjects who are knowingly pregnant or breast feeding or do not use an adequate form of contraception [the effects on the foetus and newborn have not yet been fully established so Rituximab should be avoided in these groups. Male patients receiving Rituximab should ensure adequate contraception for 12 months following treatment.]
-Patients who are HIV positive [which does not appear to be antibody mediated, would be unlikely to benefit from Rituximab].
-Patients with childhood TTP.
-Patients who have haemolytic uraemic syndrome [which is not associated with reduced ADAMTS 13 levels].
-Patients who are Post bone marrow transplant-either autologous or allogeneic
-Patients with a medical or long term psychiatric condition which, in the opinion of the investigator, contraindicates the patients’ participation into the trial.
-Previous or concurrent malignancies at other sites, with exception of appropriately treated localized epithelial or cervical cancer. Patients with a history of cured tumours may be entered (> 5 years).
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E.5 End points |
E.5.1 | Primary end point(s) |
Time to remission as defined by days until sustained platelet count>150 X 109/L, normal lactate dehydrogenase and number of plasma exchanges required. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Information not present in EudraCT |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | Information not present in EudraCT |
E.7.4 | Therapeutic use (Phase IV) | Information not present in EudraCT |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The last visit of last subject undergoing the trial. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 0 |