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Combination Therapy of Romiplostim and Erythropoiesis-stimulating Agents
Sponsor: Chinese University of Hong Kong
Summary
The goal of this Phase 2 clinical trial is to learn if adding romiplostim to standard erythropoiesis-stimulating agent (ESA) therapy is safe and tolerated in adults with chronic kidney disease who are on hemodialysis and have anemia that has not responded well to ESAs. The study will mainly check platelet counts and side effects. The main questions it aims to answer are: How many participants keep platelet counts within a normal range during and after treatment? How many participants have platelet counts that rise above the normal range? What medical problems or side effects occur after romiplostim is added to ESA therapy? Researchers will study three dose levels of romiplostim (0.2, 0.5, and 1 mg/kg) in small groups of participants. There is no placebo group. All participants will receive romiplostim plus their usual ESA and iron supplement. The study will also measure changes in hemoglobin and iron-related blood markers. Participants will: Receive romiplostim as an injection under the skin once weekly for 3 weeks. Each participant will be assigned to one of three dose groups. Continue their usual ESA therapy (darbepoetin or Mircera) and iron supplement. Have blood tests to check platelet counts, hemoglobin, and other blood and iron measures. Blood tests will be frequent at first and then less often. Visit the clinic regularly for up to 24 weeks, with a follow-up visit about 4 weeks after the end-of-treatment visit. Have other safety checks, such as vital signs, physical exams, and electrocardiograms (ECGs).
Official title: A Clinical Trial to Evaluate the Safety of the Combination Therapy of Romiplostim and Erythropoiesis-stimulating Agents (ESAs) in ESA-resistant Anemic Patients
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
12
Start Date
2026-08-11
Completion Date
2027-09-01
Last Updated
2026-10-02
Healthy Volunteers
No
Interventions
Romiplostim
Romiplostim is a thrombopoietin receptor agonist (TPO-RA) administered as an add-on therapy to erythropoiesis-stimulating agents (ESAs) in patients with ESA-resistant anemia. In this study, romiplostim is given by subcutaneous injection once weekly for 3 consecutive weeks at a dose of 0.2, 0.5, or 1 mg/kg. It is intended to stimulate hematopoietic stem cells and megakaryocyte-erythroid progenitors to correct ESA-induced progenitor depletion while limiting platelet increase through stem cell competition with concomitant ESA therapy.
darbepoetin alfa
Darbepoetin alfa is an erythropoiesis-stimulating agent (ESA) used as standard therapy for anemia in chronic kidney disease. Participants continue their pre-study darbepoetin alfa dose together with iron supplementation. The ESA dose is initially unchanged; it may be reduced according to product labeling if hemoglobin rises too rapidly (e.g., \>1 g/dL over 2 weeks). It is given as part of the combination therapy with romiplostim.
Methoxy Polyethylene Glycol-Epoetin Beta
Methoxy polyethylene glycol-epoetin beta is a long-acting erythropoiesis-stimulating agent (ESA) used for anemia in chronic kidney disease. Participants continue their pre-study Mircera dose together with iron supplementation. The ESA dose is initially unchanged; it may be reduced according to product labeling if hemoglobin rises too rapidly (e.g., \>1 g/dL over 2 weeks). It is given as part of the combination therapy with romiplostim.
Locations (1)
The Chinese University of Hong Kong
Hong Kong, Hong Kong