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ICON1: Treatment Decisions and Outcomes in Pediatric Refractory ITP (ICON1)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01971684
Recruitment Status : Completed
First Posted : October 29, 2013
Last Update Posted : May 21, 2020
Terrana ITP Research Fund
Information provided by (Responsible Party):
Rachael Grace, Boston Children's Hospital

Brief Summary:
The purpose of this study is to understand physician treatment decisions in selecting specific second line treatments in pediatric ITP and to determine the effectiveness of different second line ITP treatments. Eligible patients are those ages 1-18 years who are starting on a new second line treatment for ITP, defined as any treatment other than IVIG, steroids, anti-D globulin, or aminocaproic acid. Enrolled patients remain on the study for approximately one year.

Condition or disease Intervention/treatment
Immune Thrombocytopenia Drug: Second Line ITP agents

Detailed Description:

The purpose of this observational study is to model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP and to determine the comparative effectiveness of second line ITP treatments by bleeding measures, platelet counts, and patient reported outcome measures. This prospective observational, longitudinal, multicenter cohort study will aim to collect routine clinical care data, quality of life information from patients, and decision making data from clinicians at enrollment and at regular clinical intervals for at least one year. The primary and secondary objectives are as follows:

Primary Objectives:

  1. To model factors that determine physician treatment decisions in selecting specific second line agents in pediatric ITP.
  2. To assess patient reported outcomes with relation to specific second line pediatric ITP therapies.
  3. To determine the comparative effectiveness of second line ITP treatments in terms of bleeding and platelet counts.

Secondary Objectives:

  1. To describe phenotypic variation among patients with refractory ITP;
  2. To assess side effects and complications related to specific treatments for refractory ITP;
  3. To describe monitoring and follow up practices among pediatric hematologists with each second line agent;
  4. To weight factors that physicians use when deciding to treat pediatric ITP patients with second line agents;
  5. To determine whether physician perception of patient quality of life correlates with patient derived quality of life measures;
  6. To measure the correlation between the ITP Bleeding Scale and the Bleeding Assessment Tool in refractory pediatric ITP patients.

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Study Type : Observational
Actual Enrollment : 120 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: ICON1: Physician Treatment Decisions and Patient-Reported Outcomes in Pediatric Refractory Immune Thrombocytopenia
Study Start Date : August 2013
Actual Primary Completion Date : April 2017
Actual Study Completion Date : April 2017

Group/Cohort Intervention/treatment
Refractory Pediatric ITP Patients
Pediatric ITP patients, ages 1-18, starting a new second line ITP therapy, defined as not IVIG, steroids, anti-D, or aminocaproic acid.
Drug: Second Line ITP agents
The treating physicians will select the second line agent and clinical data will be collected.
Other Names:
  • rituximab
  • 6-mercaptopurine
  • mycophenolate mofetil
  • sirolimus
  • splenectomy
  • romiplostim
  • eltrombopag

Primary Outcome Measures :
  1. change from baseline in patient reported outcomes [ Time Frame: Enrollment, 1 and 12 months ]
    Kids ITP Tool, Memorial Symptom Assessment Scale, Fatigue Scale

  2. change from baseline in bleeding assessment [ Time Frame: Enrollment, 1, 6, and 12 months ]
    ITP Bleeding Scale, Bleeding Assessment Tool

  3. change from baseline in platelet count [ Time Frame: over 1 year ]

Secondary Outcome Measures :
  1. side effects and complications of treatments [ Time Frame: 1 year ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   1 Year to 18 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Pediatric refractory ITP patients starting on a new second line therapy

Inclusion Criteria:

  • Immune Thrombocytopenia or Evans Syndrome
  • Ages > 12 months to <18 years
  • Starting a new second line therapy as defined as any therapy except IVIG, steroids, anti-D globulin, or aminocaproic acid
  • Starting a single agent/monotherapy

Exclusion Criteria:

  • Evans Syndrome with a history of or current evidence of autoimmune hemolytic anemia
  • Unwillingness to be followed for 1 year
  • Physician providing care is unwilling to participate
  • Patient is starting multiple second line agents simultaneously

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 identifier (NCT number): NCT01971684

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Sponsors and Collaborators
Boston Children's Hospital
Terrana ITP Research Fund
Publications of Results:
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Responsible Party: Rachael Grace, Principal Investigator, PKD Natural History Study, Boston Children's Hospital Identifier: NCT01971684    
Other Study ID Numbers: P00008709
First Posted: October 29, 2013    Key Record Dates
Last Update Posted: May 21, 2020
Last Verified: May 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Rachael Grace, Boston Children's Hospital:
idiopathic thrombocytopenic purpura
bleeding score
platelet count
health-related quality of life
Purpura, Thrombocytopenic
Purpura, Thrombocytopenic, Idiopathic
Blood Coagulation Disorders
Hematologic Diseases
Skin Manifestations
Blood Platelet Disorders
Immune System Diseases
Hemorrhagic Disorders
Autoimmune Diseases
Therapeutic Uses
Additional relevant MeSH terms:
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Purpura, Thrombocytopenic, Idiopathic
Blood Platelet Disorders
Hematologic Diseases
Purpura, Thrombocytopenic
Blood Coagulation Disorders
Thrombotic Microangiopathies
Hemorrhagic Disorders
Autoimmune Diseases
Immune System Diseases
Pathologic Processes
Skin Manifestations
Mycophenolic Acid
Antineoplastic Agents
Immunologic Factors
Physiological Effects of Drugs
Antibiotics, Antineoplastic
Antibiotics, Antitubercular
Antitubercular Agents
Anti-Bacterial Agents
Anti-Infective Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Antifungal Agents
Immunosuppressive Agents