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Sickle Cell DiseasePhase 2NCT02633397

A Multi-Center Study of Riociguat in Patients With Sickle Cell Diseases

A Phase 2 study testing Riociguat in people with Sickle Cell Disease, run by Mark Gladwin at 20 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The proposed study is a Phase 2 multi-center, randomized, double-blind, placebo-controlled, parallel groups study aimed to evaluate the safety, tolerability and the efficacy of riociguat compared with placebo in patients with sickle cell disease (SCD). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Sickle Cell Disease
What is being tested?
Riociguat
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
130 participants
Where
20 sitesUnited States
Study dates
11 Apr 2017to 4 May 2022
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years
  • Sickling disorder (HbSS, HbSC, HbSbeta-thalassemia, HbSD, HbSO-Arab documented by hemoglobin electrophoresis or HPLC fractionation)
  • At least one of the following findings: a. Systolic blood pressure ≥ 130 mm Hg on at least two occasions at least 1 day apart (one of these may be by history), b. Macroalbuminuria as manifested by urine albumin to creatinine ratio > 300 mg/g, c. Tricuspid regurgitant velocity (TRV) > 2.9 m/sec measured by echocardiography d. NT-proBNP level ≥ 160 pg/mL e. Urinalysis protein 1 + or higher.
  • Females of reproductive potential (FRP) must have a negative, pre-treatment pregnancy test. Post-menopausal women (defined as no menses for at least 1 year or post-surgical from bilateral oophorectomy) are not required to undergo a pregnancy test.
  • Females of reproductive potential must agree to use reliable contraception when sexually active. Adequate contraception is defined as any combination of at least 2 effective methods of birth control, of which at least one is a physical barrier (e.g. condoms with hormonal contraception or implants or combined oral contraceptives, certain intrauterine devices). Adequate contraception is required beginning at the signing of the informed consent form until one month after the last dose of riociguat.
  • Patients must be willing to provide a blood sample for DNA analysis.

Who cannot join

  • Pregnant or breast feeding women
  • Patients with severe hepatic impairment defined as Child Pugh C
  • End stage renal disease requiring dialysis
  • Patients with eGFR <30 mL/min/1.73m, where GFR is estimated based on CKD-epi equation
  • Patients on phosphodiesterase type 5 inhibitors (PDE-5) (such as sildenafil, tadalafil, vardenafil) and nonspecific PDE inhibitors (such as dipyridamole or theophylline) or nitrates
  • Patients on strong cytochrome P450 (CYP) and P-glycoprotein 1(P-gp)/BCRP inhibitors such as systemic azole antimycotics (eg: ketoconazole, itraconazole), or HIV protease inhibitors (such as ritonavir)
Show all 14Show fewer
  • Patients on St. John's Wort
  • If patients are taking antihypertensive drugs, hydroxyurea, L-glutamine, crizanlizumab, or voxelotor prior to enrollment, they are excluded until the dose level is stable for at least three months
  • Systolic blood pressure <95 mm Hg at Screening Visit 1 or 2 or Week 0 before randomization
  • Current enrollment in an investigational new drug trial. Patients are eligible for enrollment 30 days after the last dose of an investigational drug has been received
  • Evidence of qualitative urine drug test at screening for cocaine, phencyclidine (PCP), heroin, or amphetamines within three months prior to enrollment
  • Patients who have recently (last six months) experienced serious bleeding from the lung or have undergone a bronchial arterial embolization procedure.
  • Pulmonary hypertension associated with Idiopathic Interstitial Pneumonias
  • Medical disorder, condition, or history that in the investigator's judgment would impair the patient's ability to participate or complete this study or render the patient to be inappropriate for enrollment

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

United States20 sites
  • Emory University School of Medicine

    Atlanta, Georgia, 30329

  • Johns Hopkins University

    Baltimore, Maryland, 21205

  • Boston University Medical Center

    Boston, Massachusetts, 02118

  • New York Presbyterian Brooklyn Methodist Hospital

    Brooklyn, New York, 11225

  • UNC Comprehensive Sickle Cell Center

    Chapel Hill, North Carolina, 27599-7305

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • University of Illinois, Chicago

    Chicago, Illinois, 60612

  • Ohio State University

    Columbus, Ohio, 43210

  • University of Texas Southwestern

    Dallas, Texas, 75390

  • Duke University

    Durham, North Carolina, 27710

  • East Carolina University

    Greenville, North Carolina, 27834

  • Indiana University

    Indianapolis, Indiana, 46202

  • University of Tennessee Health Science Center

    Memphis, Tennessee, 38163

  • University of Miami

    Miami, Florida, 33136

  • Tulane University

    New Orleans, Louisiana, 70112

  • UCSF Benioff Children's Hospital Oakland

    Oakland, California, 94609

  • UPMC Division of Hematology and Oncology

    Pittsburgh, Pennsylvania, 15233

  • Virginia Commonwealth University Medical Center

    Richmond, Virginia, 23298

  • Albert Einstein University/ Montefiore Medical Center

    The Bronx, New York, 10467

  • Howard University

    Washington D.C., District of Columbia, 20060

Other trials in United States

About this study

Official title: A Phase II Randomized, Double-Blind, Placebo-Controlled Multi-Center Study to Assess the Safety, Tolerability, and Efficacy of Riociguat in Patients With Sickle Cell Diseases

The proposed study is a Phase 2 multi-center, randomized, double-blind, placebo-controlled, parallel groups study aimed to evaluate the safety, tolerability and the efficacy of riociguat compared with placebo in patients with sickle cell disease (SCD).

Read the detailed description

This randomized study involves 12 weeks of treatment with riociguat pills or placebo pills, and a follow-up period of 30 days after treatment. The dose is adjusted every 2 weeks based on systolic blood pressure (SBP) and well-being assessed at that visit. Physical examinations, vital signs, blood tests and questionnaires will be performed at 2 week intervals during the double blinded study treatment. Echocardiogram, urine testing, six-minute walk distance and questionnaires will be assessed at the beginning and end of the treatment phase.

Being tested
Riociguat, Placebo
Keywords
SCD, Sickle Cell Disease, Riociguat, Adempas
Medical subject headings
Anemia, Sickle Cell

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RiociguatDrug

    Also called Adempas

    Riociguat 0.5 mg, 1.0 mg, 1.5 mg, 2.0 mg and 2.5 mg three times a day for 12 weeks

  • PlaceboDrug

    Matching placebo to riociguat 0.5 mg, 1.0 mg, 1.5 mg, 2.0 mg and 2.5 mg three times a day for 12 weeks

Study groups in NCT02633397
Study groupRoleWhat they receive
RiociguatExperimentalTreatment Arm
Receives: Drug: Riociguat
PlaceboPlacebo comparatorPlacebo Arm
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall Incidence of Treatment Emergent Severe Adverse Events (SAE)

    The primary endpoint was the proportion of participants who experienced at least 1 treatment-emergent serious adverse event (SAE), which was defined as any event occurring after the baseline visit (i.e., after initiation of study drug), adjudicated by a designated committee of protocol investigators and outside experts. SAEs were considered to be treatment-emergent if they started or worsened after the first dose of study medication and up to 7 days after end of study treatment.

    Measured: Baseline through 7 days after discontinuation of treatment, up to 13 Weeks

Secondary outcomes (22)
  1. Frequency of SAE Due to Sickle Cell Related Painful Crisis

    The proportion of participants with treatment-emergent SAE for sickle-cell related crises (Vaso-occlusive crises)

    Measured: Baseline through 7 days after discontinuation of treatment, up to 13 Weeks

  2. Overall Incidences of Treatment-emergent Adverse Events (AEs)

    Proportion of participants that experienced treatment-emergent AEs

    Measured: Baseline to Week 12

  3. Incidences of Sickle Cell Related Clinical Complications

    Incidence of Vaso-occlusive Crisis (VOC) between baseline and week 12

    Measured: Baseline to Week 12

  4. Pain Intensity Using the Brief Pain Inventory

    Brief Pain Inventory (BPI) short form - score ranges from 0 (no pain) to 10 (Pain as bad as you can imagine)

    Mean at 12 weeks assessed using ANCOVA adjusting for baseline.

    Measured: Baseline, 12 weeks

  5. 6-minute Walk Distance

    6-minute walk distance was used to assess functional exercise capacity

    Mean at 12 weeks assessed using ANCOVA adjusting for baseline.

    Measured: Baseline, 12 weeks

  6. Changes in the Dyspnea Borg Scale

    Baseline to 12 weeks mean change of the Borg dyspnea scores, post 6MWT, using a linear regression model.

    Dyspnea Borg score was used to measure the level of severity of breathlessness perceived by the patient at the end of the 6MWD Test. The severity is measured on a 10-point scale with 0= nothing at all and 10=maximum severity of breathlessness.

    Measured: Baseline,12 Weeks

  7. Fatigue Borg Scale

    Fatigue Borg score was used to rank the participant's exertion at the end of the 6MWD Test. The rate of exertion was given according to a scale ranging from 0 (nothing at all) to 10=maximum severity of exertion

    Mean at 12 weeks assessed using ANCOVA adjusting for baseline.

    Measured: Baseline,12 weeks

  8. Changes in Blood Pressure as the Main Pharmacodynamic (MAP)

    Baseline to 12 weeks mean change of MAP, estimated with a repeated measures analysis (Baseline, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks) using a linear mixed model.

    Measured: Baseline, 2 weeks, 4 weeks, 6 weeks, 8 weeks, 10 weeks, 12 weeks

  9. Tricuspid Regurgitant Velocity (TRV) Using Non-invasive Echocardiography

    Mean TRV at 12 weeks assessed using ANCOVA, adjusting for baseline.

    Measured: Baseline, 12 Weeks

  10. End-systolic Volume Using Non-invasive Echocardiography

    Mean end-systolic volume (biplane) at 12 weeks, assessed using ANCOVA adjusting for baseline.

    Measured: Baseline,12 weeks

  11. Ejection Fraction (Biplane) Using Non-invasive Echocardiography

    Mean ejection fraction (biplane) at 12 weeks, assessed using ANCOVA adjusting for baseline.

    Measured: Baseline, 12 weeks

  12. Changes in the Levels of Plasma NT-proBNP

    Mean Change in the levels of plasma NT-proBNP from baseline to 12 weeks using a linear regression model.

    Measured: Baseline,12 weeks

  13. Changes in Albumin/Creatinine Ratio

    Albumin/Creatinine Ratio (ACR) mean change from baseline to 12 weeks using linear regression model.

    Measured: Baseline,12 weeks

  14. Microalbuminuria

    Odds ratio per week of microalbuminuria estimated with a repeated measures analysis (baseline, 12 weeks) using a generalized linear mixed model without random slope

    Measured: Baseline,12 weeks

  15. Macroalbuminuria

    Odds ratio per week of macroalbuminuria estimated with a repeated measures analysis (baseline, 12 weeks) using a generalized linear mixed model without random slope.

    Measured: Baseline,12 weeks

  16. Changes in Glomerular Filtration Rate

    Mean change in GFR to 12 weeks, estimated with a repeated measures analysis (Baseline, 4 weeks, 8 weeks, 12 weeks) a using a linear mixed model.

    Measured: Baseline, 4 weeks, 8 weeks, 12 weeks

  17. Chronic Kidney Disease (CKD) Stage - Low Risk Versus at Least Moderately Increased Risk

    Odds ratio (OR) per week of low-risk CKD stage versus at least moderately increased risk (includes moderately increased risk CKD, high increased risk CKD, and very high increased risk CKD) estimated with a repeated measures analysis (baseline, 12 weeks) using a generalized linear mixed model without random slope

    Measured: Baseline,12 weeks

  18. Changes in Hemoglobin

    Mean change in hemoglobin to 12 weeks, estimated with a repeated measures analysis (Baseline, 4 weeks, 8 weeks, 12 weeks) a using a linear mixed model.

    Measured: Baseline, 4 weeks, 8 weeks,12 weeks

  19. Changes in Reticulocyte Count

    Mean change in reticulocyte count to 12 weeks, estimated with a repeated measures analysis (Baseline, 4 weeks, 8 weeks, 12 weeks) a using a linear mixed model.

    Measured: Baseline, 4 weeks, 8 weeks,12 weeks

  20. Changes in White Blood Cell Count

    Mean change in White Blood Cell count to 12 weeks estimated with a repeated measures analysis (Baseline, 4 weeks, 8 weeks, 12 weeks) a using a linear mixed model.

    Measured: Baseline, 4 weeks, 8 weeks,12 weeks

  21. Changes in Lactate Dehydrogenase (LDH)

    Mean change in LDH to 12 weeks estimated with a repeated measures analysis (Baseline, 4 weeks, 8 weeks, 12 weeks) a using a linear mixed model.

    Measured: Baseline, 4 weeks, 8 weeks,12 weeks

  22. Changes in Fetal Hemoglobin

    Mean change in fetal hemoglobin from baseline to 12 weeks using a linear mixed model

    Measured: Baseline,12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Dec 2015 (estimated)
  2. Study start11 Apr 2017
  3. Primary completion4 May 2022
  4. Study completion4 May 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
130 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02633397
Sponsor's protocol ID
PRO15110016
Status last verified
Jul 2023
First submitted
7 Dec 2015
Last updated
19 Jul 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Gladwin MT, Gordeuk VR, Desai PC, Minniti C, Novelli EM, Morris CR, Ataga KI, De Castro L, Curtis SA, El Rassi F, Ford HJ, Harrington T, Klings ES, Lanzkron S, Liles D, Little J, Nero A, Smith W, Taylor JG 6th, Baptiste A, Hagar W, Kanter J, Kinzie A, Martin T, Rafique A, Telen MJ, Lalama CM, Kato GJ, Abebe KZ. Riociguat in patients with sickle cell disease and hypertension or proteinuria (STERIO-SCD): a randomised, double-blind, placebo controlled, phase 1-2 trial. Lancet Haematol. 2024 May;11(5):e345-e357. doi: 10.1016/S2352-3026(24)00045-0. Epub 2024 Mar 27.

    PubMed 38554715
  • Azbell RCG, Desai PC. Treatment dilemmas: strategies for priapism, chronic leg ulcer disease, and pulmonary hypertension in sickle cell disease. Hematology Am Soc Hematol Educ Program. 2021 Dec 10;2021(1):411-417. doi: 10.1182/hematology.2021000275.

    PubMed 34889382

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Riociguat in people with Sickle Cell Disease, run by Mark Gladwin at 20 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Jul 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 19 Jul 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall Incidence of Treatment Emergent Severe Adverse Events (SAE) (time frame: Baseline through 7 days after discontinuation of treatment, up to 13 Weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02633397, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Jul 2023.

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