Treatment of immune thrombocytopenia with hydroxychloroquine and prednisone

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the efficacy and safety of hydroxychloroquine (HCQ) combined with prednisone (Pred) in treating adults with primary immune thrombocytopenia (ITP) who test positive for anti-nuclear antibodies (ANA). Participants will receive Pred daily for six weeks, with the option of taking HCQ twice daily for one year. The study will assess whether the combination treatment improves response rates and prolongs response duration compared to Pred alone, while also monitoring any associated medical issues. Regular clinic visits and symptom diaries will be part of the participant's involvement.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age is above 75 years old, or participants with uncontrolled hypertension and diabetes mellitus at the age between 15-75 years old, gender is unlimited.
2. Before randomization, the clinical diagnosis is primary immune thrombocytopenia. The platelet count is less than 30×10\^9 / L within 1 week before enrollment, or platelet count is less than 50×10\^9 / L with bleeding symptoms within 1 week before enrollment.
3. The antinuclear antibody is positive.
4. Other autoantibodies (mainly including dsDNA antibodies, SSA, SSB, RNP, β 2-GP, ACA, ANCA) are negative.
5. Prothrombin time does not exceed ± 3s of the normal value ranget, activated partial thrombin time is not outside normal range ± 10s; no history of coagulopathy except ITP.
6. Understand the study procedures and sign the written informed consent form.

Exclusion Criteria:

1. Secondary thrombocytopenia caused by myelodysplastic syndrome, immune diseases such as systemic lupus erythematosus, early aplastic anemia, atypical reanemia, antiphospholipid syndrome, thrombotic thrombocytopenic purpura and various other causes.
2. The participant has experienced any arterial or venous thrombosis (stroke, transient ischemic attack, myocardial infarction, deep vein thrombosis or pulmonary embolism), or clinical symptoms and medical history indicate thrombophilia.
3. Congestive heart disease, including New York Heart Association (NHYA) Grade III / IV, occurred within 3 months prior to screening, arrhythmia requiring medication or myocardial infarction, or arrhythmia known to increase the risk of thrombotic events (such as atrial fibrillation), or corrected QT interval (QTc) is longer than 450 ms, or QTc\> 480 ms in paricipants with bundle branch block.
4. With severe hemorrhage (intracranial hemorrhage) or coagulation dysfunction (INR and APTT\> 125% upper limit of normal).
5. With severe digestive tract diseases affecting drug absorption.
6. With serious mental illness patient.
7. Having participated in other clinical trials within 3 months prior to screening.
8. Having received any immunomodulatory medication for other diseases 3 months before screening.
9. Having received any medication affecting platelet function ( Including but not limited to aspirin, aspirin-containing complexes, clopidogrel, salicylates, and / or non-steroidal anti-inflammatory drugs NSAIDs ) or anticoagulant therapy for over consecutive 3 days within 2 weeks before screening.
10. With Glucose-6-phosphate dehydrogenase deficiency.
11. With retinal or visual field changes caused by 4-aminoquinoline compounds.
12. Being allergic to 4-aminoquinoline compounds.
13. Having evidence of Human Immunodeficiency Virus (HIV)/ hepatitis C virus(HCV)/ hepatitis B virus(HBV) infection (HIV antibody or HCV antibody is positive, HBV surface antigen is positive, or HBV surface antigen is negative but HBV-DNA indicating viral replication.
14. Glutamate transaminotransferase (ALT) or glutamate transaminase (AST) is higher than 1.5 times the upper limit of normal value (ULN), or total bilirubin or blood creatinine is higher than 1.2 times the ULN.
15. With liver cirrhosis or portal hypertension.
16. With evidence of malignant tumor activity, or receiving anti-tumor treatment within 5 years prior to the screening.
17. Addicted to alcohol or drugs.
18. Participants being pregnant or lactating, or with potential fertility, reluctance to use effective contraception within the entire trial cycle and within 28 days after the end of the trial (or within 28 days after premature withdraw).

Where it's running

• Shanghai Zhongshan Hospital
  Shanghai, Shanghai Municipality, China Recruiting
• Zhongshan Wusong Hospital, Fudan University
  Shanghai, Shanghai Municipality, China Recruiting
• Shanghai Jinshan Hospital
  Shanghai, Shanghai Municipality, China Recruiting
• Zhongshan Qingpu Hospital, Fudan University
  Shanghai, Shanghai Municipality, China Recruiting
• Health and Humanity Research Centre, Hongkong, China.
  Hong Kong, Hong Kong Recruiting
• Dr. Stanley Ho Medical Foundation
  Macao, Macau Recruiting

Study contacts

• Principal investigator: Yunfeng Cheng — Shanghai Zhongshan Hospital
• Study coordinator: Lili Ji
• Email: ji.lili@zs-hospital.sh.cn
• Phone: 86-021-64041990

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.