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A Randomized, Double Blind, Placebo Controlled Study Evaluating the Efficacy and Safety of Romiplostim Treatment of Thrombocytopenia in Subjects With Low or Intermediate-1 Risk Myelodysplastic Syndrome (MDS)


Phase 2
18 Years
90 Years
Not Enrolling
Both
MDS, Myelodysplastic Syndromes, Thrombocytopenia

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Trial Information

A Randomized, Double Blind, Placebo Controlled Study Evaluating the Efficacy and Safety of Romiplostim Treatment of Thrombocytopenia in Subjects With Low or Intermediate-1 Risk Myelodysplastic Syndrome (MDS)


This is a Phase 2, multicenter, randomized, double blind, placebo controlled study designed
to assess the efficacy and safety of romiplostim (formerly, AMG 531) treatment in
thrombocytopenic MDS subjects. The study is composed of a 26-week placebo controlled test
treatment period (romiplostim versus Placebo), a 4 week interim wash-out period, a 24-week
placebo controlled extended treatment period, and a 4-week follow-up period followed by an
End of Study (EOS) visit. During the interim wash-out period, a bone marrow biopsy will be
performed in the absence of growth factor to assess changes in the marrow. In the extended
treatment period, safety assessments will continue and subjects will be allowed to receive
any standard of care treatments for MDS. Subjects will be followed for survival for an
additional 60 months following the End of Study (EOS) visit.


Inclusion Criteria:



- Diagnosis of MDS using the WHO classification for myeloid neoplasms as assessed
during the screening period.

- Per MDS IPSS, low or intermediate-1 risk MDS as assessed during the screening period.

- The mean of the two platelet counts taken within 4 weeks prior to randomization must
be:

- ≤ 20 x 10^9/L, (with no individual count >30 x 10^9/L during the screening
period), with or without a history of bleeding associated with the diagnosis of
MDS, OR

- ≤ 50 x 10^9/L, (with no individual count >60 x 10^9/L during the screening
period) with a history of bleeding associated with the diagnosis of MDS.

- Subjects must be ≥18 and ≤ 90 years of age at the time of informed consent. Subjects
between 85 and 90 years of age must have been diagnosed with MDS ≤ 5 years from study
start.

- Eastern Cooperative Oncology Group (ECOG) performance status of 0-2.

- Adequate liver function, as evidenced by ALT ≤ 3 times the laboratory normal range,
AST ≤ 3 times the laboratory normal range and total bilirubin ≤ 2.0 times the
laboratory normal range.

(Adequate liver function for patients with a confirmed diagnosis of Gilbert's Disease
evidenced by ALT ≤ 3 times the laboratory normal range, and AST ≤ 3 times the laboratory
normal range.)

- A serum creatinine concentration ≤ 2 mg/dl (≤176.8 μmol/L).

- Bone marrow biopsy and aspirate with cytogenetics within 3 months of starting first
dose of investigational product.

- Written Informed Consent.

Exclusion Criteria:

- Have ever received any disease-modifying treatment for MDS.

- Previously diagnosed with intermediate-2 or high risk MDS using the IPSS.

- Prior history of leukemia, aplastic anemia, or other non-MDS related bone marrow stem
cell disorder.

- Prior history of hematopoietic stem cell transplantation.

- Persistent peripheral blood monocytosis (≥ 3 months with an absolute monocyte count
>1,000/μL) or known diagnosis of Chronic Myelomonocytic Leukemia per FAB criteria.

- Prior malignancy (other than in situ cervical cancer, non-melanoma skin cancer, or in
situ carcinoma) unless treated with curative intent and without evidence of disease
for ≥ 3 years before randomization.

- Active or uncontrolled infections.

- Unstable angina, congestive heart failure (NYHA > class II), uncontrolled
hypertension (diastolic >100 mmHg), uncontrolled cardiac arrhythmia, or recent
(within 1 year) myocardial infarction.

- History of arterial thrombosis (eg, stroke or transient ischemic attack) within the
past year.

- History of venous thrombosis that currently requires anti-coagulation therapy.

- Received IL-11 within 4 weeks of the first dose of investigational product.

- Have previously received any thrombopoietic growth factor.

- Receipt of G-CSF, peg-G-CSF, or GM-CSF within 4 weeks of the first dose of
investigational product.

- Planned receipt of peg-G-CSF or GM-CSF after the first dose of investigational
product.

- Pregnant or breast feeding.

- Subjects of reproductive potential who are not using adequate contraceptive
precautions, in the judgment of the investigator. Amgen recommends double barrier
contraception is used for all applicable patients enrolled on this study. A double
barrier method is defined as two methods of contraception, for example 2 actual
barrier methods, or one actual barrier method and one hormonal method.

- Subject has known sensitivity to any recombinant E coli-derived product (eg,
Infergen®, Neupogen®, Somatropin, and Actimmune).

- Previously enrolled into the 20060198 study or another romiplostim study.

- Inability to comply with study procedures.

- Subject currently is enrolled in or has not yet completed at least 30 days since
ending other investigational device or drug study.

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Supportive Care

Outcome Measure:

Number of clinically significant bleeding events

Outcome Time Frame:

Test Treatment Period (Week 1-26)

Safety Issue:

No

Principal Investigator

MD

Investigator Role:

Study Director

Investigator Affiliation:

Amgen

Authority:

Australia: Department of Health and Ageing Therapeutic Goods Administration

Study ID:

20060198

NCT ID:

NCT00614523

Start Date:

May 2008

Completion Date:

March 2016

Related Keywords:

  • MDS
  • Myelodysplastic Syndromes
  • Thrombocytopenia
  • MDS
  • Low Risk MDS
  • Intermediate-1 Risk MDS
  • Thrombocytopenia
  • Myelodysplastic Syndromes
  • Preleukemia
  • Thrombocytopenia

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