Mathias Susan D, Li Xiaoyan, Eisen Melissa, Carpenter Nancy, Crosby Ross D, Blanchette Victor S
Health Outcomes Solutions, Winter Park, Florida.
Amgen Inc, Thousand Oaks, California.
Pediatr Blood Cancer. 2016 Jul;63(7):1232-7. doi: 10.1002/pbc.25984. Epub 2016 Apr 1.
Chronic immune thrombocytopenia (ITP) in children can negatively impact their health-related quality of life (HRQoL) and impose a burden on their parents. This study sought to examine the effect of romiplostim on HRQoL and parental burden in children with primary ITP.
This was a phase 3, randomized, double-blind, placebo-controlled study. Children aged <18 years with ITP ≥6 months were randomly assigned to receive romiplostim or placebo for 24 weeks. The Kids' ITP Tool (KIT) was used to measure HRQoL and was administered to patients and/or their parents at baseline and weeks 8, 16, and 25. Mean KIT scores at each assessment and mean changes in KIT scores from baseline were calculated overall by treatment group and platelet response status. Psychometric properties of the KIT were evaluated and the minimally important difference (MID) was estimated for different KIT versions.
Sixty-two patients (42 romiplostim and 20 placebo) were enrolled. Changes in KIT scores by treatment group showed numerically greater and more often statistically significant improvements from baseline to each assessment for children receiving romiplostim versus placebo. Mixed-effects analysis demonstrated statistically significantly greater reduction in parental burden from baseline in the romiplostim group versus placebo. Ranges for the MID were estimated as 9-13 points for the Child Self-Report version and 11-13 points for the Parent Impact version.
The treatment with romiplostim may be associated with improved HRQoL in children with primary ITP and reduced burden to their parents.
儿童慢性免疫性血小板减少症(ITP)会对其健康相关生活质量(HRQoL)产生负面影响,并给其父母带来负担。本研究旨在探讨罗米司亭对原发性ITP患儿HRQoL及父母负担的影响。
这是一项3期随机双盲安慰剂对照研究。年龄小于18岁、ITP病程≥6个月的儿童被随机分配接受罗米司亭或安慰剂治疗24周。使用儿童ITP工具(KIT)测量HRQoL,并在基线、第8周、第16周和第25周对患者和/或其父母进行评估。总体上按治疗组和血小板反应状态计算每次评估时的平均KIT评分以及KIT评分相对于基线的平均变化。评估了KIT的心理测量特性,并估计了不同KIT版本的最小重要差异(MID)。
共纳入62例患者(42例接受罗米司亭治疗,20例接受安慰剂治疗)。与安慰剂组相比,接受罗米司亭治疗的儿童从基线到每次评估时,治疗组KIT评分的变化在数值上更大,且在统计学上更常显示出显著改善。混合效应分析表明,与安慰剂组相比,罗米司亭组父母负担从基线开始的降低在统计学上有显著差异。儿童自我报告版本的MID范围估计为9 - 13分,父母影响版本的MID范围估计为11 - 13分。
罗米司亭治疗可能与原发性ITP患儿HRQoL改善及父母负担减轻有关。