Status:

UNKNOWN

Efficacy of Avatrombopag in Thrombocytopenic Patients With Chronic Liver Disease Undergoing an Elective Procedure

Lead Sponsor:

Chinese PLA General Hospital

Conditions:

Thrombocytopenia; Drugs

Chronic Liver Disease

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

In this study, investigators aimed to evaluate the efficacy of Avatrombopag in thrombocytopenic patients with chronic liver disease undergoing an elective invasive procedure through a prospective, non...

Detailed Description

Thrombocytopenia is a common complication of chronic liver disease (CLD), which severity increases with the aggravation of CLD. TPO, the primary physiological regulator of platelet production, is main...

Eligibility Criteria

Inclusion

  • Both men and women are at least 18 years old at the time of signing the informed consent;
  • Baseline platelet count\<50×10\^9/L;
  • Patients with chronic liver disease undergo elective invasive procedures with high bleeding risk. The invasive procedures include liver/kidney biopsy or ablation, biliary drainage/stent implantation, cholecystostomy, transjugular intrahepatic portal venous shunt, nephrostomy and catheterization, chemotherapy embolization, abdominal/pelvic/retroperitoneal/mediastinal biopsy or ablation, endoscopic polypectomy, endoscopic stricture dilation or mucosal resection, balloon-assisted enteroscopy, percutaneous endoscopic gastrostomy, endoscopic retrograde cholangiopancreatography with sphincterotomy (ERCP + EST), endoscopic ultrasound with fine-needle aspiration (EUS-FNA), cyst gastrostomy, dental extraction, angiography or interventional venography and therapeutic coronary angiography such as PCI), and intraarticular injection, etc.;
  • Be able to understand the study and is willing to follow all study procedures, and voluntarily sign informed consent before screening;
  • According to the opinions of the researchers, it can meet the requirements of this study.

Exclusion

  • Subjects with a history of arterial or venous thrombosis within six months before baseline;
  • Subjects with a known history of the hereditary prethrombotic syndrome include thrombin factor V Leiden mutation, prothrombin G20210A mutation, or hereditary antithrombin III (ATIII) deficiency;
  • Subjects could not suspend anticoagulants or antiplatelet therapy within one week preoperatively, such as heparin (within 24 hours before the procedure for Low molecular weight heparin), warfarin, rivaroxaban, dipyridamole, non-steroidal anti-inflammatory drugs, aspirin, verapamil, ticlopidine, clopidogrel, glycoprotein IIb/IIIa antagonists, and erythropoietin, etc.;
  • Subjects could not suspend Chinese patent medicines within three days before the procedure to promote blood circulation and remove blood stasis, such as pseudo-ginseng, red-rooted salvia, etc.;
  • Subjects received thrombopoietin receptor agonists within two weeks before enrolment, such as rhuTPO, Romiplostim, Eltrombopag, Avatrombopag, or Lusutrombopag, etc. Subjects received rhIL-11 within two weeks before enrolment. Moreover, subjects received platelet transfusion within one week before enrolment;
  • Subjects with thrombocytopenia caused by primary blood diseases (immune thrombocytopenia, myelodysplastic syndrome, etc.) or drugs (such as chemotherapy drugs, targeted therapy drugs, immune checkpoint inhibitors, etc.). Exceptions: Subjects are allowed to receive targeted drugs that do not cause thrombocytopenia, provided that these targeted therapy drugs are discontinued for a while to reduce the risk of bleeding, as follows: Bevacizumab for four weeks (6 weeks for patients with coagulation abnormality), lumvaritinib, sorafenib, pazopanib, axitinib, cabozantinib, anlotinib, apatinib, nidanib, and sunitinib for one week, and fuquanitinib for two weeks, etc.;
  • Subjects scheduled for splenic embolization (excluding those with persistent low platelet counts after splenic embolization or splenectomy);
  • Concomitant medical histories (e.g., gastrointestinal bleeding within three months; high risk of thrombosis, e.g., portal vein blood flow velocity \< 10cm/s) may prevent subjects from completing the study safely;
  • Subjects are allergic to avatrombopag or any of its excipients;
  • A woman who is pregnant or who intends to become pregnant;
  • Subjects participate in another clinical study using any exploratory drug or device within 30 days before their baseline visit; Participation in observational studies is permitted;
  • The investigator considers that any accompanying medical history of the subject may affect the subject's ability to complete the study safely.

Key Trial Info

Start Date :

June 6 2021

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

July 31 2023

Estimated Enrollment :

476 Patients enrolled

Trial Details

Trial ID

NCT04915287

Start Date

June 6 2021

End Date

July 31 2023

Last Update

November 15 2022

Active Locations (1)

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Chinese PLA General Hospital

Beijing, Beijing Municipality, China, 100853