Hemoglobin SC DiseasePhase 2NCT02640573
Treatment of Adult Patients With Hemoglobin SC Disease (SCYTHE)
A Phase 2 study testing Hydroxyurea in people with Hemoglobin SC Disease, run by Baylor College of Medicine at 2 sites in United States.
Trial summary
Sickle cell disease (SCD), specifically hemoglobin SC disease (HbSC), is a subtype of sickle cell disease with typically higher hemoglobin and milder or later disease complications. Sickle cell disease is a disorder in which red blood cells (RBCs) are abnormally shaped. Read more about this study
- Who is it for?
- Ages 18 to 69 years
- Conditions the study is for
- Hemoglobin SC Disease
- What is being tested?
- Hydroxyurea
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1 participants
- Where
- 2 sitesUnited States
- Study dates
- 12 Oct 2015to 16 Nov 2017
- 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 to 69 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of HbSC disease
- Score of 80 or lower on the AdultQLTM 3.0 Sickle Cell Disease Module, or any disease related complication, including, but not limited to, one or more pain events per year, proliferative sickle retinopathy, avascular necrosis, cholelithiasis, or any thrombotic event. If the subject has a score >80, they may still enroll on the trial, and be analyzed for secondary endpoints. They will be excluded from analysis of the primary endpoint.
Who cannot join
- Failure to meet inclusion criteria
- Hydroxyurea usage in the last 3 months.
- Chronic RBC transfusion therapy
- Packed red blood cell transfusion in the last 3 months (temporary exclusion).
- Pregnancy, or refusal to use medically effective birth control if female and sexually active.
- Current phlebotomy therapy
Trial locations and contacts
2 sites in 1 country.
United States2 sites
Baylor College of Medicine
Houston, Texas, 77030
University of Texas Houston
Houston, Texas, 77030
About this study
Official title: Treatment of Adult Patients With Hemoglobin SC Disease
Sickle cell disease (SCD), specifically hemoglobin SC disease (HbSC), is a subtype of sickle cell disease with typically higher hemoglobin and milder or later disease complications. Sickle cell disease is a disorder in which red blood cells (RBCs) are abnormally shaped. This can result in painful episodes, serious infections, and damage to body organs. One medication used to treat sickle cell disease is hydroxyurea.
Hydroxyurea therapy offers significant benefits for infants, children, and adolescents with sickle cell anemia. These include a reduction in the frequency of pain crises and acute chest syndrome (inflammation of the lungs). Hydroxyurea has been given to many HbSC patients but HbSC patients were not included in the large clinical trials used to test hydroxyurea in SCD, so less is known about how HbSC patients respond to hydroxyurea.
The purpose of this research study is to see if hydroxyurea, a medication given to many patients with the most common type of sickle cell, those who are homozygous for the sickle mutation (HbSS), helps individuals who have HbSC. The investigators will see if it helps by giving a questionaire when the medication is started, and then every two months at a clinic visit. The questionaire, called the AdultsQLTM 3.0 Sickle Cell Disease Module, measures quality of life. The investigators will also see how hydroxyurea changes laboratory test numbers, and blood thickness.
Read the detailed description
Patients will be recruited from the patient population followed at the Texas Children's Cancer and Hematology Centers (TCC/HC)/Baylor College of Medicine (BCM) and the University of Texas Houston Hematology Center. To be eligible to participate in this study, patients must have HbSC disease, have experienced a sickle cell disease related complication, or have a score of 80 or lower on the AdultQLTM Sickle Cell Disease Module 3.0. This questionnaire will be offered to all patients with HbSC seen in our clinic that consent to this study. Patients must also agree to clinic visits every two months, and to phlebotomy, or blood removal after 6 months on the study if they meet criteria for phlebotomy.
If the patient is a sexually active female, they will be offered birth control. If the patient chooses not to initiate effective birth control, they will be tested at their scheduled visit with a urine pregnancy test. If the patient becomes pregnant they will be removed from the study.
Patients will be assessed in clinic every two months after starting treatment. Hydroxyurea will be started at 10 mg/kg/day, and increased by 5 mg/kg/day if needed to a maximum tolerated dose (MTD) of 35/mg/day. The most common side effect of the drug is a drop in infection fighting cells, or white blood cells, so the medication will be started at a low dose and the dose will be increased only if it is safe to do so. After 6 months at MTD on the study, patients will be evaluated for their response to hydroxyurea. If they have not reached their MTD after 6 months their time on the study will be increased to allow for 6 months observation at MTD. The minimum time the patients will be on the study is 12 months after starting hydroxyurea therapy with an option to participate in a 2 year observation study following the end of the study.
If the patients have had minimal or no benefit from the medication, monthly phlebotomy will be added to their treatment regimen, at 7-10 ml/kg. The first phlebotomy volume will be 7 ml/kg, but may be increased to 10 ml/kg to obtain the target Hb of 9-10 g/dL. Patients will remain on hydroxyurea and phlebotomy for six months. If their Hb is less than or equal to 9.0 g/dL on their phlebotomy visit, phlebotomy will not be performed and their phlebotomy visits will be spaced every 2 months. Patients time on the study will be increased to allow for 6 months observation to ensure that there is no late harmful effects. The minimum time patients will be on the study is 18 months after starting phlebotomy with an option to participate in a 2 year observation study following the end of the study.
Patients will be asked to allow the investigators to review information from their medical records at the start of the study, and throughout the study. If the patient would like to participate in the two year follow-up, their records will be reviewed during that period as well.
- Conditions
- Hemoglobin SC Disease
- Being tested
- Hydroxyurea
- Medical subject headings
- Hemoglobin SC Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
HydroxyureaDrug
Treat symptomatic HbSC patients to MTD on hydroxyurea, and assess for clinical improvement using the AdultsQLTM 3.0 Sickle Cell Disease Module after 6 months at MTD, compared to entrance scores
| Study group | Role | What they receive |
|---|---|---|
| Hydroxurea | Experimental | Initiate hydroxyurea at 10 mg/kg daily and escalate hydroxyurea dose by 5 mg/kg/day every 8 weeks up to a maximum dose of 35 mg/kg/day if blood counts meet escalation criteria. Receives: Drug: Hydroxyurea |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fetal Hemoglobin Response to HU
Change in HbF on hydroxyurea from baseline
Measured: Baseline to 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Dec 2015 (estimated)
- Study start12 Oct 2015
- Primary completion16 Nov 2017
- Study completion16 Nov 2017
Why it stopped: Insufficient accrual
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Hemoglobin SC DiseaseStudies of the same condition, open and under way.
- More trials run by Baylor College of MedicineThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 1 participants (actual)
Sponsor and investigators
- Lead sponsor
- Baylor College of Medicine
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Vivien Sheehan, Baylor College of Medicine
- Investigators
- Vivien Sheehan, MD, Principal investigator, Baylor College of Medicine
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02640573
- Sponsor's protocol ID
- 37290 IM-SCYTHE
- Status last verified
- Jan 2020
- First submitted
- 17 Dec 2015
- Last updated
- 27 Jan 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 27 Jan 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Treatment of Adult Patients With Hemoglobin SC Disease
- ClinicalTrials.gov ID
- NCT02640573
- Acronym / sponsor ID
- 37290 IM-SCYTHE
- Conditions
- Hemoglobin SC Disease
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Insufficient accrual
- Enrolment
- 1 participants (actual)
- Lead sponsor
- Baylor College of MedicineUniversity, hospital or other
- Collaborators
- The University of Texas Health Science Center, Houston
- Study start
- 12 Oct 2015 (actual)
- Primary completion
- 16 Nov 2017 (actual)
- Study completion
- 16 Nov 2017 (actual)
- First posted
- 29 Dec 2015 (estimated)
- Results
- Posted 27 Jan 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Sickle cell disease (SCD), specifically hemoglobin SC disease (HbSC), is a subtype of sickle cell disease with typically higher hemoglobin and milder or later disease complications. Sickle cell disease is a disorder in which red blood cells (RBCs) are abnormally shaped. This can result in painful episodes, serious infections, and damage to body organs. One medication used to treat sickle cell disease is hydroxyurea.
Hydroxyurea therapy offers significant benefits for infants, children, and adolescents with sickle cell anemia. These include a reduction in the frequency of pain crises and acute chest syndrome (inflammation of the lungs). Hydroxyurea has been given to many HbSC patients but HbSC patients were not included in the large clinical trials used to test hydroxyurea in SCD, so less is known about how HbSC patients respond to hydroxyurea.
The purpose of this research study is to see if hydroxyurea, a medication given to many patients with the most common type of sickle cell, those who are homozygous for the sickle mutation (HbSS), helps individuals who have HbSC. The investigators will see if it helps by giving a questionaire when the medication is started, and then every two months at a clinic visit. The questionaire, called the AdultsQLTM 3.0 Sickle Cell Disease Module, measures quality of life. The investigators will also see how hydroxyurea changes laboratory test numbers, and blood thickness.
Detailed description
Patients will be recruited from the patient population followed at the Texas Children's Cancer and Hematology Centers (TCC/HC)/Baylor College of Medicine (BCM) and the University of Texas Houston Hematology Center. To be eligible to participate in this study, patients must have HbSC disease, have experienced a sickle cell disease related complication, or have a score of 80 or lower on the AdultQLTM Sickle Cell Disease Module 3.0. This questionnaire will be offered to all patients with HbSC seen in our clinic that consent to this study. Patients must also agree to clinic visits every two months, and to phlebotomy, or blood removal after 6 months on the study if they meet criteria for phlebotomy.
If the patient is a sexually active female, they will be offered birth control. If the patient chooses not to initiate effective birth control, they will be tested at their scheduled visit with a urine pregnancy test. If the patient becomes pregnant they will be removed from the study.
Patients will be assessed in clinic every two months after starting treatment. Hydroxyurea will be started at 10 mg/kg/day, and increased by 5 mg/kg/day if needed to a maximum tolerated dose (MTD) of 35/mg/day. The most common side effect of the drug is a drop in infection fighting cells, or white blood cells, so the medication will be started at a low dose and the dose will be increased only if it is safe to do so. After 6 months at MTD on the study, patients will be evaluated for their response to hydroxyurea. If they have not reached their MTD after 6 months their time on the study will be increased to allow for 6 months observation at MTD. The minimum time the patients will be on the study is 12 months after starting hydroxyurea therapy with an option to participate in a 2 year observation study following the end of the study.
If the patients have had minimal or no benefit from the medication, monthly phlebotomy will be added to their treatment regimen, at 7-10 ml/kg. The first phlebotomy volume will be 7 ml/kg, but may be increased to 10 ml/kg to obtain the target Hb of 9-10 g/dL. Patients will remain on hydroxyurea and phlebotomy for six months. If their Hb is less than or equal to 9.0 g/dL on their phlebotomy visit, phlebotomy will not be performed and their phlebotomy visits will be spaced every 2 months. Patients time on the study will be increased to allow for 6 months observation to ensure that there is no late harmful effects. The minimum time patients will be on the study is 18 months after starting phlebotomy with an option to participate in a 2 year observation study following the end of the study.
Patients will be asked to allow the investigators to review information from their medical records at the start of the study, and throughout the study. If the patient would like to participate in the two year follow-up, their records will be reviewed during that period as well.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Hydroxurea | Experimental | Drug: HydroxyureaInitiate hydroxyurea at 10 mg/kg daily and escalate hydroxyurea dose by 5 mg/kg/day every 8 weeks up to a maximum dose of 35 mg/kg/day if blood counts meet escalation criteria. |
Who may qualify
- Ages
- 18 to 69 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Diagnosis of HbSC disease
- Score of 80 or lower on the AdultQLTM 3.0 Sickle Cell Disease Module, or any disease related complication, including, but not limited to, one or more pain events per year, proliferative sickle retinopathy, avascular necrosis, cholelithiasis, or any thrombotic event. If the subject has a score >80, they may still enroll on the trial, and be analyzed for secondary endpoints. They will be excluded from analysis of the primary endpoint.
Key exclusion criteria (6 listed)
- Failure to meet inclusion criteria
- Hydroxyurea usage in the last 3 months.
- Chronic RBC transfusion therapy
- Packed red blood cell transfusion in the last 3 months (temporary exclusion).
- Pregnancy, or refusal to use medically effective birth control if female and sexually active.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| HydroxyureaTreat symptomatic HbSC patients to MTD on hydroxyurea, and assess for clinical improvement using the AdultsQLTM 3.0 Sickle Cell Disease Module after 6 months at MTD, compared to entrance scores | Drug | Hydroxurea |
Primary outcome
Fetal Hemoglobin Response to HU
Time frame: Baseline to 6 months
Change in HbF on hydroxyurea from baseline
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jan 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Individual participant dataSharing planned: No
Related trials for Hemoglobin SC Disease
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Active, not recruitingObservational study
Investigating the Mechanistic Effects of Mitapivat in Subjects With Sickle Cell Disease
Sickle Cell Anemia, Sickle Cell Thalassemia
RecruitingObservational study
Sickle Cell Disease and the Genomic and Gene Therapy Needs of Stakeholders
Sickle Cell Disease
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Vivien Sheehan, MD principal investigator
Baylor College of Medicine
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Hydroxyurea in people with Hemoglobin SC Disease, run by Baylor College of Medicine at 2 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 2 inclusion and 6 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: stopped early, as of the sponsor's last update on 27 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 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. 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 27 Jan 2020). 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?
Fetal Hemoglobin Response to HU (time frame: Baseline to 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 27 Jan 2020.