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Determination of Safe and Effective Dose of Romiplostim (AMG 531) in Subjects With Myelodysplastic Syndrome (MDS)Receiving Hypomethylating Agents

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ClinicalTrials.gov Identifier: NCT00321711
Recruitment Status : Completed
First Posted : May 4, 2006
Results First Posted : April 5, 2011
Last Update Posted : August 8, 2013
Sponsor:
Information provided by (Responsible Party):
Amgen

Brief Summary:
The purpose of this study is to evaluate the effect of Romiplostim (AMG 531) on the incidence of clinically significant thrombocytopenic events (grade 3 or 4 and/or receipt of platelet transfusions) in subjects with low or intermediate risk Myelodysplastic Syndrome (MDS) receiving hypomethylating agents. It is hypothesized that Romiplostim administration, at the appropriate dose and schedule, will result in reduction in the incidence of clinically significant thrombocytopenic events in low or intermediate risk MDS subjects receiving hypomethylating agents.

Condition or disease Intervention/treatment Phase
MDS Myelodysplastic Syndromes Thrombocytopenia Drug: Placebo Biological: AMG 531 (Romiplostim) Drug: Azacitidine Drug: Decitabine Phase 2

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 69 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Supportive Care
Official Title: A Randomized, Double Blind, Placebo Controlled Study Evaluating the Efficacy and Safety of Romiplostim (AMG 531) Treatment of Subjects With Low or Intermediate Risk Myelodysplastic Syndrome (MDS) Receiving Hypomethylating Agents
Study Start Date : October 2006
Primary Completion Date : April 2009
Study Completion Date : October 2010

Resource links provided by the National Library of Medicine

Drug Information available for: Romiplostim
U.S. FDA Resources

Arm Intervention/treatment
Active Comparator: Dose level 1 500 AMG 531 (Part A - azacitidine)
500 mcg AMG 531 weekly via subcutaneous injection + 75 mg/m2 azacitidine for 4 cycles
Biological: AMG 531 (Romiplostim)
AMG 531 (Romiplostim) will be administered weekly by subcutaneous injection at a dose of 500 or 750 μg during Part A and 750 μg during Part B for the 4 cycle treatment period, depending on randomization.
Drug: Azacitidine
hypomethylating agent
Active Comparator: Dose level 1 750 AMG 531 (Part B - decitabine)
750 mcg AMG 531 weekly via subcutaneous injection + 20 mg/m2 decitabine for 4 cycles
Biological: AMG 531 (Romiplostim)
AMG 531 (Romiplostim) will be administered weekly by subcutaneous injection at a dose of 500 or 750 μg during Part A and 750 μg during Part B for the 4 cycle treatment period, depending on randomization.
Drug: Decitabine
hypomethylating agent
Active Comparator: Dose level 2 750 AMG 531 (Part A - azacitidine)
750 mcg AMG 531 weekly via subcutaneous injection + 75 mg/m2 azacitidine for 4 cycles
Biological: AMG 531 (Romiplostim)
AMG 531 (Romiplostim) will be administered weekly by subcutaneous injection at a dose of 500 or 750 μg during Part A and 750 μg during Part B for the 4 cycle treatment period, depending on randomization.
Drug: Azacitidine
hypomethylating agent
Placebo Comparator: Placebo (Part A - azacitidine)
Placebo weekly via subcutaneous injection + 75 mg/m2 azacitidine for 4 cycles
Drug: Placebo
Subjects in the control group will receive a placebo subcutaneous injection on a weekly basis during the 4 cycle treatment period.
Drug: Azacitidine
hypomethylating agent
Placebo Comparator: Placebo (Part B - decitabine)
Placebo weekly via subcutaneous injection + 20 mg/m2 decitabine for 4 cycles
Drug: Placebo
Subjects in the control group will receive a placebo subcutaneous injection on a weekly basis during the 4 cycle treatment period.
Drug: Decitabine
hypomethylating agent



Primary Outcome Measures :
  1. Occurrence of a Clinically Significant Thrombocytopenic Event [ Time Frame: Treatment period (up to 20 weeks) ]
    Occurrence of a clinically significant thrombocytopenic event within the participant, defined as any platelet count obtained from day 15 of cycle 1 through the end of the interim follow-up visit that was less than 50 x 10^9/L or receipt of platelet transfusions at any time through the interim follow-up visit.


Secondary Outcome Measures :
  1. Hypomethylating Agent Dose Reduction and Delay Due to Thrombocytopenia [ Time Frame: Treatment period (up to 20 weeks) ]
    Occurrence of hypomethylating agent dose reduction and delay due to thrombocytopenia

  2. Achieving an Overall Response (Complete or Partial Response, CR or PR) at the End of the Treatment Period [ Time Frame: Treatment period (up to 20 weeks) ]
    CR = decrease in bone marrow blast (≤5%) and improvement in peripheral blood counts (Hgb ≥ 11 g/dL, platelets ≥ 100x10^9/L, neutrophils ≥ 1x10^9/L, peripheral blasts=0%). PR = improvement in peripheral blood counts plus a decrease in bone marrow blasts ≥50% but not ≤5, or decrease in International Prognostic Scoring System score.

  3. Platelet Transfusion [ Time Frame: Study day 1 through the interim follow-up visit (up to 20 weeks) ]
    Occurrence of one or more platelet transfusions from study day 1 through the interim follow-up visit (16 weeks)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria: - Diagnosis of MDS by bone marrow biopsy based on the World Health Organization (WHO) classification - Low, Intermediate-1 or Intermediate-2 risk category MDS using the IPSS (International Prognostic Scoring System) - Planned to receive either azacytidine 75 mg/m2 by subcutaneous administration each day for 7 days or decitabine 20 mg/m2 by intravenous administration each day for 5 days for at least 4 cycles Exclusion Criteria:

  • Prior exposure to >3 cycles hypomethylating agents
  • Prior history of leukemia or aplastic anemia
  • Prior history of bone marrow transplantation
  • Prior malignancy (other than in situ cervical cancer or basal cell cancer of the skin) unless treated with curative intent and without evidence of disease for ³ 3 years before randomization
  • Active or uncontrolled infections
  • Unstable angina, congestive heart failure [NYHA (New York Heart Association) > 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) in the past year
  • History of venous thrombosis that currently requires anti-coagulation therapy
  • Received IL-11 within 4 weeks of screening
  • Less than 4 weeks since receipt of any therapeutic drug or device that is not FDA approved for any indication
  • Have previously received any other thrombopoietic growth factor

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00321711


Sponsors and Collaborators
Amgen
Investigators
Study Director: MD Amgen

Additional Information:
Publications:
Responsible Party: Amgen
ClinicalTrials.gov Identifier: NCT00321711     History of Changes
Other Study ID Numbers: 20050232
First Posted: May 4, 2006    Key Record Dates
Results First Posted: April 5, 2011
Last Update Posted: August 8, 2013
Last Verified: July 2013

Keywords provided by Amgen:
MDS
Myelodysplastic Syndromes
Refractory Cytopenias
Thrombocytopenia

Additional relevant MeSH terms:
Syndrome
Myelodysplastic Syndromes
Preleukemia
Thrombocytopenia
Disease
Pathologic Processes
Bone Marrow Diseases
Hematologic Diseases
Precancerous Conditions
Neoplasms
Blood Platelet Disorders
Azacitidine
Decitabine
Antimetabolites, Antineoplastic
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Antineoplastic Agents
Enzyme Inhibitors