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CTRI Number  CTRI/2025/08/092989 [Registered on: 13/08/2025] Trial Registered Prospectively
Last Modified On: 11/06/2026
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Biological 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   A comparative study of Romiplostim Biosimilar with Nplate in Immune Thrombocytopenia patients. 
Scientific Title of Study   A prospective randomized double-blind multi centre parallel arm comparative clinical study to determine the efficacy and safety of Romiplostim Biosimilar manufactured by Levim Lifetech Private Limited with Nplate manufactured by Amgen in patients with immune thrombocytopenia ITP 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
LBL-CT-20-003 Protocol version 3.2 dated 24 Oct 2024  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Jayashri Krishnan 
Designation  Vice President Operations 
Affiliation  JSS Medical Research Asia Pacific Private Limited 
Address  Tower 2 1st Floor South Wing L&T Business Park Plot no 12 slash 4 Sector 27 D Delhi Mathura Road Near Sarai Khawja Metro Station

Faridabad
HARYANA
121003
India 
Phone  09771407484  
Fax  0129-6613520  
Email  jayashri.krishnan@jssresearch.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Sonika Newar 
Designation  GM Medical Monitoring and Safety 
Affiliation  JSS Medical Research Asia Pacific Private Limited 
Address  Tower 2 1st Floor South Wing L&T Business Park Plot no 12 slash 4 Sector 27 D Delhi Mathura Road Near Sarai Khawja Metro Station

Faridabad
HARYANA
121003
India 
Phone  09771407484  
Fax  01296613520  
Email  sonika.newar@jssresearch.com   
 
Details of Contact Person
Public Query
 
Name  Dr Jayashri Krishnan 
Designation  Vice President Operations 
Affiliation  JSS Medical Research Asia Pacific Private Limited 
Address  Tower 2 1st Floor South Wing L&T Business Park Plot no 12 slash 4 Sector 27 D Delhi Mathura Road Near Sarai Khawja Metro Station

Faridabad
HARYANA
121003
India 
Phone  09771407484  
Fax  01296613520  
Email  jayashri.krishnan@jssresearch.com  
 
Source of Monetary or Material Support  
Levim Lifetech Private Limited TICEL Biopark Limited Phase II 5th Floor CSIR Road, Taramani Chennai 600 113 India 
 
Primary Sponsor  
Name  Levim Lifetech Private Limited  
Address  TICEL Biopark Limited Phase II 5th Floor CSIR Road, Taramani Chennai 600 113 India 
Type of Sponsor  Pharmaceutical industry-Indian 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study
Modification(s)  
No of Sites = 16  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Uttam Kumar Nath  All India Institute of Medical Science  Level 6, Medical College Building, Department of Medical Oncology and Haematology, Veerbhadra road, Rishikesh, Uttarakhand - 249203
Dehradun
UTTARANCHAL 
9433982756

nath.uttam@gmail.com 
Dr Aman Khanna  Aman Hospital and Research centre  Consultation room, Ground floor, Depart of Clinical Research, 15 Shashwat,  Gotri Road, opposite ESI Hospital, Vadodara, Gujarat 390021
Vadodara
GUJARAT 
9904402122

amankhanna170974@gmail.com 
Dr Neeraj Sidharthan  Amrita Institute of Medical Science  Room No 5, 4th floor, G block, Department of Clinical Haematology, Amrita Institute of Medical Science, Ponekkara P.O, Kochi, Kerala, India - 682041
Ernakulam
KERALA 
9946047464

neerajsidharthan@sims.amrita.edu 
Dr Rahaul Naithani  Artemis Hospital  Room no. 3001, Tower 3, Ground floor, Department of Haemato-Oncology, Sector 51, Gurugram, Bindapur, Haryana 122001
Gurgaon
HARYANA 
8800175901

Rahul.Naithani@artemishospitals.com 
Dr Ria Ballikar  Arunodaya Heart and Hematology Centre  OPD Room No 01, Ground Floor, Tamaskar Clinic, Department of Haematology, Plot 17, beside Milestone Building, near Lokmat Square, New Ramdaspeth, Nagpur, Maharashtra 440010, India
Nagpur
MAHARASHTRA 
8334988584

riabalikar86@gmail.com 
Dr Raut lalit   Aureus Institute of Medical Sciences  OPD Romm 3, 1st Floor, Deapartment of Haematology,Aureus Institute of Medical Sciences Plot No. 16, Wanjari Nagar, Medical college road,Nagpur-440003, Maharashtra, India
Nagpur
MAHARASHTRA 
9326992625

lalitraut76@yahoo.com 
Dr Varun Ashok Bafna  Dr Bafnas Star Superspeciality Clinic and Hospital  OPD Room No 1, Ground floor, Department of Haematology, Rukmini Nagar, E Ward, Near LIC Ground, Kolhapur - 416005
Kolhapur
MAHARASHTRA 
9066565353

starresearch22@gmail.com 
Dr Sunit Lokwani  HCG Cancer Centre  OPD Room No 5, Gorund floor, Department of Medical Oncology & Haematology, 142, AB Rd, near LIG Square, Phadnis Colony, Indore – 452008, Madhya Pradesh, India
Indore
MADHYA PRADESH 
9611117398

drsunit85@gmail.com 
Dr Manoj Murlidhar Toshniwal  Jeevan Amrut Hematology Centre India Private Limited  Consultation Room No. 2 , 1st floor, Deapartment of Haematology, Jeevan Amrut Hematology Centre India Private LimitedPlot No.47 Parijat Nagar, Near Gokul sweets, Sector N-4, CIDCO, Aurangabad – 431005, Maharashtra, India
Aurangabad
MAHARASHTRA 
9907014104

contact@jeevanammrut.co.in 
Dr V Sathya Prasad  King George Hospital  Rajendra Prasad ward, 1st Floor, Department of General Medicine, KGH Down Rd, Opp KGH OP Gate, Maharani Peta, Visakhapatnam, Andhra Pradesh 530002, India
Visakhapatnam
ANDHRA PRADESH 
9393104578

drvsatyaprasadresearch@gmail.com 
Dr Miteshkumar D Halvawala  Nirmal Hospital Pvt Ltd  Adult OPD Room No 112, 1st floor, Department of Haematology, Nirmal Hospital Pvt Ltd, Ring Road, Surat, Gujarat 395002
Surat
GUJARAT 
9825109995

dr.mitesh.55@gmail.com 
Dr Tuphan Kanti Dolai  NRS Hospital Kolkata  Room 1, 4th floor, Centrary Buliding, Department of Haematology, 138, A.J.C Bose Road, Kolkata - 700014
Kolkata
WEST BENGAL 
9879890275

tkdolai@hotmail.com 
Dr Sudhir Kumar   PGIMS  Ward No. 9, 2nd Floor, Near to MS Office, Department of Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences Medical Road, Rohtak Haryana -124001.
Rohtak
HARYANA 
9315895272

ssmantri74@yahoo.com 
Dr Apte Shashikant Janardan  Sahyadri Super Specialty Hospital  OPD No. 05, Ground Floor, Department of Hematology and BMT., Sahyadri Super Specialty Hospital Deccan, Plot No. 30 C, Erandawane, Karve Road, Pune – 411004, Maharashtra, India.
Pune
MAHARASHTRA 
9175980913

shashikant.apte@gmail.com 
Dr Siddesh Arun Kalantri  Shree Siddhivinayak Maternity & Nursing Home  OPD Room No. 03, 2nd floor, Deepartment of Haematology, Unity  Campus, Opposite KTHM College, Gangapur Road, Nashik, Maharashtra – 422002, India
Nashik
MAHARASHTRA 
9665494031

sidkalantri@gmail.com 
Dr Ross Cecil Reuban  St Johns Medical College Hospital  OPD Room No. 36, 6th Floor, OPD Buliding, Near Silver Jubilee Block, Department of Clinical Haematology, St. Johns Medical College and Hospital, Sarjapur Road, Koramangala, Bangalore-560034, India
Bangalore
KARNATAKA 
9448493705

cecil.ross@stjohns.in 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 16  
Name of Committee  Approval Status 
Artemis Health Sciences Institutional Ethics Committee  Approved 
Ethics Committee N.R.S. Medical College  Approved 
Ethics Committee relating to Clinical Trial, AIMS Rishikesh   Approved 
IEC King George hospital  Approved 
Institutional Ethics Committee Aureus Institute of Medical Sciences Pvt Ltd.   Approved 
Institutional Ethics Committee St Johns Medical College Hospital  Approved 
Institutional Ethics Committee, Aman Hospital & Research Center  Approved 
Institutional Ethics Committee, Amrita Institute of Medical Sciences  Approved 
Institutional Ethics Committee, PGIMS UHS Rohtak  Approved 
Meditrina Institute Ethics Committee, Arunodaya Heart and Hematology Institute  Approved 
Nirmal Hospital Ethics Committee  Approved 
ORIION Citicare Hospital Institute Ethics Committee, Jeevan Amrut Hospital   Approved 
Rectitude Ethics Committee, HCG Cancer Centre  Approved 
Sahyadri Hospitals Ltd. Ethics Committee  Approved 
Shree Siddhivinayak Hospital Ethics Committee  Approved 
Zenith Institutional Ethics committee, Star Superspeciality Hospital  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: D693||Immune thrombocytopenic purpura,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Nplate Romiplostim for Injection  250 mcg of deliverable Romiplostim Lyophilized Powder for Solution for Injection in single dose vials will be supplied for subcutaneous administration once a week for 12 weeks. The initial dose for Romiplostim will be 1 mcg per kg once weekly based on actual body weight. Subsequent weekly doses will be on the increments of 1 mcg per kg until the patient achieves a platelet count greater than or equal to 50 X 10 to the power of 9 per L as necessary to reduce the risk for bleeding. 
Intervention  Romiplostim   250 mcg of deliverable Romiplostim Lyophilized Powder for Solution for Injection in single dose vials will be supplied for subcutaneous administration once a week for 12 weeks. The initial dose for Romiplostim will be 1 mcg per kg once weekly based on actual body weight. Subsequent weekly doses will be on the increments of 1 mcg per kg until the patient achieves a platelet count greater than or equal to 50 X 10 to the power of 9 per L as necessary to reduce the risk for bleeding. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  Subjects will be enrolled in the study if they meet all the following criteria
1. Male and female subjects of age group 18 to 65 years (both inclusive).
2. Willing and able to provide a written informed consent.
3. Diagnosed with ITP based on the American Society of Haematology (ASH) guidelines.
4. Already received at least one prior treatment for ITP.
5. Subject greater than 60 years of age must have had a documented history of ITP with a confirmatory bone marrow report on the diagnosis.
6. Two weekly platelet count less than or equal to 30 X 10 to the power of 9 per L at any time during the screening period.
7. Haemoglobin greater than or equal to 9.0 g per decilitre
8. Patients who are willing and able to comply with all the study assessments and adhere to the protocol schedule. 
 
ExclusionCriteria 
Details  Subjects will be excluded from the study participation if they fall on any of the below criteria
1. Known history or presence of hypersensitivity reaction to any recombinant E.coli derived products.
2. History of haematological malignancy, myeloproliferative disorder, myelodysplastic syndrome (MDS), or bone marrow stem cell carcinoma
3. Known history of congenital thrombocytopenia, thromboembolic disease, systemic lupus erythematosus, Evans syndrome, or autoimmune neutropenia, antiphospholipid antibody syndrome or positive for lupus anticoagulant or autoimmune haemolytic anaemia
4. Known history of disseminated intravascular coagulation, haemolytic uremic syndrome, or thrombotic thrombocytopenic purpura.
5. Previous use of Romiplostim/ pegylated recombinant human megakaryocyte growth and development factor (PEG-rHuMGDF), TPO-RA drugs such as Eltrombopag, recombinant human thrombopoietin (rHuTPO) or any platelet producing agent
6. Currently receiving any treatment for ITP except corticosteroids, azathioprine, mycophenolate, cyclosporin, vincristine, and/or danazol administered at a constant dose and schedule.
7. Received intravenous immunoglobulin, anti-D immunoglobulin, or any drug administered to increase platelet counts (e.g., immunosuppressants etc.) within 1 week before the screening Visit.
8. Received hematopoietic growth factors (e.g., granulocyte colony stimulating factor, macrophage colony stimulating factor, erythropoietin, interleukin 11) for any reason within 4 weeks before the screening Visit.
9. Subjects with positive laboratory findings of hepatitis B, hepatitis C, or human immunodeficiency virus at screening
10. Known history of infection with H. pylori • Known case of chronic liver disease or hepatic impairment, defined as any serum bilirubin greater than or equal to 1.5 times laboratory normal range at screening
11. Any active malignancy, if prior history of cancer other than basal cell carcinoma or cervical carcinoma in situ, no treatment or active disease within 5 years before randomization
12. Female subjects of child-bearing potential not using adequate contraceptive precautions in the judgement of the investigator
13. Breast-feeding mothers or female subjects of child-bearing potential with positive urine pregnancy test at the time of screening
14. Less than 2 months since major surgery
15. Subjects involved in clinical trials and taken investigational drugs within 30 days of enrolment
16. Creatinine clearance or calculated creatinine clearance less than 45 mL per minute (Cockcroft-Gault Equation). 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Centralized 
Blinding/Masking   Double Blind Double Dummy 
Primary Outcome  
Outcome  TimePoints 
Proportion of patients achieving platelet response (i.e., greater than or equal to 50 X 10 to the power of 9 per L) for any 4 weeks of the 12 weeks of treatment with biosimilar Romiplostim treatment compared to Nplate  12 weeks (Every week including baseline) 
 
Secondary Outcome  
Outcome  TimePoints 
Proportion of patients receiving rescue medications that is Corticosteroids, IVIG, Anti D immunoglobulin, Platelet transfusions etc. during the treatment period, compared to Nplate
Number of weekly Platelet Responses defined as a platelet count of greater than or equal to 50 X 10 to the power of 9 per L on the weekly scheduled dose day from week 1 to week 12 inclusive compared to Nplate
Presence of Anti-Romiplostim Antibodies, compared to Nplate
Incidence of Treatment-Emergent Adverse Events TEAEs & Serious Adverse Events SAEs during the treatment period related to biosimilar Romiplostim or Nplate
Clinical chemistry, haematology, urine analysis & other laboratory findings during the 13 weeks, compared to Nplate.
Single-dose pharmacokinetic PK parameters AUC0-t Cmax & Tmax of Romiplostim biosimilar compared to Nplate 
Platelet Responses - Every week (Including baseline).

Presence of Anti-Romiplostim Antibodies - baseline & week 13.

Pharmacokinetic parameters - Week 2 to Week 11 (At 3 mcg/kg dose)
 
 
Target Sample Size   Total Sample Size="72"
Sample Size from India="72" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   22/12/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="3"
Days="21" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

This is a prospective, randomized, double-blind, multi-centre, parallel arm clinical trial to assess the efficacy and safety of a Romiplostim Biosimilar manufactured by Levim Lifetech Private Limited compared to Nplate (Romiplostim) manufactured by Amgen in patients with immune thrombocytopenia (ITP). Conducted across 15 sites in India, the trial aims to recruit 72 subjects, with a randomization ratio of 3 is to 1 favoring the biosimilar.

The primary objective is to compare the platelet response (greater than or equal to 50 X 10 to the power of 9 per L) between both treatments over a 12-week period. Secondary objectives include analyzing safety through adverse events, measuring the presence of anti-romiplostim antibodies, and assessing pharmacokinetics. The study recognizes ITP as a rare condition with unmet medical needs, justifying the trial for its biosimilar. Each participant’s total study duration is 16 weeks, which includes 2 weeks of screening and 12 weeks of treatment. Ethical compliance will align with ICH-GCP guidelines and local regulations to ensure patient safety and data integrity throughout the study


 
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