Elective rituximab in TTP

  • Research type

    Research Study

  • Full title

    A phase IV, prospective, randomised single-blind UK multicentre non-inferiority trial of low-dose versus standard dose rituximab for prevention of relapses in acquired TTP

  • IRAS ID

    228923

  • Contact name

    Mari Thomas

  • Contact email

    mari.thomas@uclh.nhs.uk

  • Sponsor organisation

    University College London

  • Eudract number

    2017-001117-86

  • Duration of Study in the UK

    5 years, 0 months, 1 days

  • Research summary

    Acquired thrombotic thrombocytopenic purpura (TTP) is a rare condition, presenting
    suddenly with no specific symptoms and signs. It affects every organ, but critically affects the heart and brain, and patients are very sick with 50% requiring intensive care. Despite intensive treatment, 10-20% of patients die.

    Acquired TTP is an autoimmune disease where antibodies are formed against a specific enzyme, ADAMTS13. Once recovered from TTP, up to 50% patients used to relapse. This has improved with the introduction of rituximab, a treatment that targets B cells (part of the immune system), as part of initial TTP therapy.

    We know that a fall in ADAMTS13 activity in remission can be a sign of upcoming TTP relapse, and we use rituximab therapy before patients get sick to reduce the antibodies against ADAMTS13, normalize the ADAMTS13 activity and prevent potentially life-threatening relapse. Rituximab is given as four separate weekly infusions as an outpatient.

    Using the UK TTP Registry group of UK centres treating TTP, we plan to carry out a study to see if low dose rituximab is as effective as the standard dose in preventing TTP relapses. If so, it may have fewer side effects and we will also look at this.

  • REC name

    London - Westminster Research Ethics Committee

  • REC reference

    17/LO/1055

  • Date of REC Opinion

    19 Jul 2017

  • REC opinion

    Further Information Favourable Opinion