RecruitingPhase 3NCT04116502

MITHRIDATE: Ruxolitinib Versus Hydroxycarbamide or Interferon as First Line Therapy in High Risk Polycythemia Vera

A Phase III, Randomised, Open-label, Multicenter International Trial Comparing Ruxolitinib With Either HydRoxycarbamIDe or Interferon Alpha as First Line ThErapy for High Risk Polycythemia Vera


Sponsor

University of Birmingham

Enrollment

586 participants

Start Date

Oct 25, 2019

Study Type

INTERVENTIONAL

Conditions

Summary

The trial will be a phase III, randomised-controlled, multi-centre, international, open-label trial consisting of ruxolitinib versus best available therapy, where best available therapy is a choice of interferon alpha, any formulation permitted (IFN) or hydroxycarbamide (HC), and which will be elected by the Investigator prior to randomisation.


Eligibility

Min Age: 18 Years

Inclusion Criteria13

  • Population:
  • High risk PV defined as WBC \>11 x 10\^9/l\* AND at least ONE of the following
  • Age \>60 years
  • Prior thrombosis or haemorrhage
  • Platelet count \>1000 x 10\^9/l\*
  • Hypertension or diabetes requiring pharmacological therapy (\*At any time since diagnosis)
  • Patient ≥18 years of age
  • Diagnosis of PV meeting the WHO criteria within the past 15 years
  • Meets criteria of high risk\* PV (see above for specific population)
  • Patients must have a screening haemoglobin of \>8g/dl
  • Patients may have received antiplatelet agents and venesection
  • Patients may have received ONE cytoreductive therapy for PV less than 10 years (BUT they should not be resistant or intolerant to that therapy)
  • Able to provide written informed consent

Exclusion Criteria23

  • Diagnosis of PV \> 15 years previously
  • Absence of JAK-2 mutation
  • Patients with any contraindications to any of the investigational medical products
  • Treatment with \>1 cytoreductive therapy OR a cytoreductive treatment duration exceeding 10 years OR resistance/intolerance to that therapy
  • Active infection including Human Immunodeficiency Virus (HIV), hepatitis B, hepatitis C, autoimmune hepatitis, Tuberculosis
  • Pregnant or lactating patients (Women of childbearing potential must have a negative urine or blood Human Chorionic Gonadotropin pregnancy test prior to trial entry)
  • Patients with lactose allergies, hypersensitivities, or rare hereditary problems, of galactose intolerance, total lactase deficiency or glucose- galactose malabsorption
  • Patients with uncontrolled neuropsychiatric disorders
  • Patients with uncontrolled cutaneous cancers
  • Patients and partners not prepared to adopt highly effective contraception measures (if sexually active) whilst on treatment and for at least 6 months after completion of study medication
  • ECOG Performance Status Score ≥ 3
  • Uncontrolled rapid or paroxysmal atrial fibrillation, uncontrolled or unstable angina, recent (within the last 6 months) myocardial infarction or acute coronary syndrome or any clinically significant cardiac disease \> NYHA ( New York Heart Association) Class II
  • Patients who have transformed to myelofibrosis
  • Previous treatment with ruxolitinib
  • Previous (within the last 12 months) or current platelet count \<100 x 109/L or neutrophil count \< 1 x 109/L not due to therapy
  • Inadequate liver function as defined by ALT/AST \>2.0 x ULN
  • Inadequate renal function as defined by eGFR \< 30 mls/min
  • Unable to give informed consent
  • All women of childbearing potential (as per Appendix 8 definition)
  • No affiliation with the French healthcare system
  • Persons under psychiatric care that would impede understanding of informed consent and optimal treatment and follow-up
  • Adults subject to a legal protection measure (guardianship, curatorship and safeguard of justice)
  • Patients deprived of their liberty by a judicial or administrative decision

Interventions

DRUGRuxolitinib

10mg of ruxolitinib twice daily (bd)

DRUGHydroxycarbamide

Via standard hospital mechanisms

DRUGInterferon-Alpha

Any formulation, via standard hospital mechanisms


Locations(47)

Aberdeen Royal Infirmary

Aberdeen, United Kingdom

Royal United Hospital

Bath, United Kingdom

Belfast City Hospital

Belfast, United Kingdom

Birmingham Heartlands Hospital

Birmingham, United Kingdom

Blackpool Victoria Hospital

Blackpool, United Kingdom

Royal Bournemouth Hospital

Bournemouth, United Kingdom

Southmead Hospital

Bristol, United Kingdom

Addenbrooke's Hospital

Cambridge, United Kingdom

Kent and Canterbury Hospital

Canterbury, United Kingdom

University Hospital of Wales

Cardiff, United Kingdom

St Richard's Hospital

Chichester, United Kingdom

Colchester Hospital

Colchester, United Kingdom

Castle Hill Hospital

Cottingham, United Kingdom

Russells Hall Hospital

Dudley, United Kingdom

Western General Hospital

Edinburgh, United Kingdom

Royal Devon and Exeter Hospital

Exeter, United Kingdom

Gloucestershire Royal Hospital

Gloucester, United Kingdom

Calderdale Royal Hospital

Halifax, United Kingdom

Huddersfield Royal Infirmary

Huddersfield, United Kingdom

Raigmore Hospital

Inverness, United Kingdom

Kettering General Hospital

Kettering, United Kingdom

Leicester Royal Infirmary

Leicester, United Kingdom

St John's Hospital

Livingston, United Kingdom

University College Hospital

London, United Kingdom

Guy's Hospital

London, United Kingdom

St George's Hospital

London, United Kingdom

Wythenshawe Hospital

Manchester, United Kingdom

Arrowe Park Hospital

Metropolitan Borough of Wirral, United Kingdom

The James Cook University Hospital

Middlesbrough, United Kingdom

Freeman Hospital

Newcastle upon Tyne, United Kingdom

Royal Gwent Hospital

Newport, United Kingdom

North Tyneside General Hospital

North Shields, United Kingdom

Northampton General Hospital

Northampton, United Kingdom

Norfolk and Norwich University Hospital

Norwich, United Kingdom

Nottingham City Hospital

Nottingham, United Kingdom

Churchill Hospital

Oxford, United Kingdom

Royal Berkshire Hospital

Reading, United Kingdom

Halton Hospital

Runcorn, United Kingdom

Wexham Park Hospital

Slough, United Kingdom

Southampton General Hospital

Southampton, United Kingdom

Royal Stoke University Hospital

Stoke-on-Trent, United Kingdom

Sunderland Royal Hospital

Sunderland, United Kingdom

Good Hope Hospital

Sutton Coldfield, United Kingdom

Royal Cornwall Hospital

Truro, United Kingdom

Warwick Hospital

Warwick, United Kingdom

New Cross Hospital

Wolverhampton, United Kingdom

Worthing Hospital

Worthing, United Kingdom

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