Phase 3 in primary immune thrombocytopenia in adult patient population

Case study

Primary and secondary endpoint met in top line results

ICON was approached by a drug development sponsor to conduct a global, Phase 3 trial in an adult patients with primary immune thrombocytopenia.

Study description
 

ICON Services:
Full service

Study phase:
Phase 3

No. of clinical sites:
137

No. of subjects:
132 randomised patients (117 chronic)

Regions:

North America
United States

Europe
Austria, Belgium, Bulgaria, Czech Republic, France, Georgia, Germany, Hungary, Italy, Netherlands, Poland, Russian, Federation, Spain, Turkey, Ukraine, United Kingdom,

Asia Pacific
Japan

The challenge

The trial was part of a four-programme study with challenging recruitment timelines due to the COVID impact and disease type. There were inclusion and exclusion criteria differences between site references and central lab for e.g., platelet count. External vendor management was challenging due to multiple vendors (IP, DM, IRT, Lab) assigned which were handled by the sponsor. Several external systems were used including IRT and eCRF which required significant reconciliation. The study also had a high number of protocol amendments.

The solution

Weekly recruitment meetings were scheduled to discuss recruitment capacity on a site level and a recruitment roadmap was implemented. ICON kept very close communication lines with the sponsor including daily meetings during data base lock. A flexible monitoring schedule was used with the objective of reducing the SDV backlog given the short timelines for data base lock activities and calculation of the monitoring needs against the SDV backlog.

ICON’s value add

  • Full-service capabilities from feasibility to investigator payments
  • Specialised eCOA team
  • Local language coordinators to facilitate start-up and recruitment
  • Enhanced communications and coordination across many vendors
  • ITP clinical & study expertise
  • ITP study sites with recent track record of delivery
  • Access to ~400 relevant sites in ICON database
  • Site intelligence start up timelines: Rapid start up with established sites and dedicated networks
  • Maximising patient recruitment & retention: Dedicated Patient Engagement group, involvement with advocacy groups, patient outreach website and patient travel/logistical support
  • Accellacare In-Home Services

The outcome

  • 88%

    of 137 planned sites actively recruited patients
  • 2 weeks

    first patient screened 2 weeks before planned deadline
  • 100%

    milestones achieved on time
MilestoneContractPlanActual
Final protocol18-Sep-201918-Sep-201918-Sep-2019
First EC/CA submission24-Jun-201924-Jun-201924-Jun-2019
First Site Activated4-Dec-20194-Dec-20194-Dec-2019
First subject first visit23-Dec-201923-Dec-20199-Dec-2019
First subject randomised16-Dec-20196-Jan-202016-Dec-2019
Last subject first visit13-Aug-202113-Aug-202113-Aug-2021
Last subject randomised19-Aug-202119-Aug-202119-Aug-2021
Interim Database lock   
Last subject last visit4-Mar-20223-Feb-20223-Feb-2022
Database lock28-Apr-202219-May-202220-May-2022
Final CSR11-Aug-20221-Sep-2022 

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