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Vaso-occlusive CrisisPhase 2/3NCT04301336

Different Treatment Modalities in the Management of the Painful Crisis in Pediatric Sickle- Cell Anemia

A Phase 2/3 study testing Omega 3, Vit D and Zinc sulfate in people with Vaso-occlusive Crisis and Sickle Cell Disease, run by Beni-Suef University at 4 sites in 2 countries.

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 aim of the present study is comparing the effectiveness of different treatment regimens for investigating the therapeutic potential for each one in management of Vaso-occlusive pain in pediatric sickle cell disease. Read more about this study

Who is it for?
Ages 5 to 15 years
What is being tested?
Omega 3, Vit D and Zinc sulfate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
350 participants
Where
4 sitesin 2 countries
Study dates
1 Nov 2019to 10 Dec 2020
Phase
Phase 2/3
Are there results?
None posted in the registry

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 5 to 15 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Any case with the full manifestation of sickle cell disease accompanied by acute painful crisis aged from 5-15 years old.

Who cannot join

  • The presence of any other chronic illness.
  • Patient age>18 years old or < 3 years old.
  • Patients with hepatic diseases including cholestasis hepatic encephalopathy and jaundice.
  • Patients with renal impairment
  • Diabetic patients

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

Egypt3 sites
  • Faculty of medicine, Beni-suef univeristy - Beni-Seuf university hospital

    Banī Suwayf

  • Faculty of Pharmacy, Beni-Suef university

    Banī Suwayf

  • Health insurance hospital

    Banī Suwayf

Other trials in Egypt

Saudi Arabia1 site
  • Maternity and Children hospital

    Mecca

Other trials in Saudi Arabia

About this study

Official title: Comparative Effectiveness of the Different Treatment Modalities for Management of Vaso-occlusive Painful Crisis in Pediatric Sickle Cell Disease

The aim of the present study is comparing the effectiveness of different treatment regimens for investigating the therapeutic potential for each one in management of Vaso-occlusive pain in pediatric sickle cell disease. In addition, investigators apply the Cost-effectiveness analysis (CEA) as a form of economic analysis that compares the relative costs and outcomes (effects) for different treatment regimens on vaso-occlusive painful crisis.

Read the detailed description

"Sickle cell disease is an inherited blood disorder characterized by defective hemoglobin (a protein in red blood cells that carries oxygen to the tissues of the body).

Sickle cell disease involves the red blood cells, or hemoglobin, and their ability to carry oxygen. Normal hemoglobin cells are smooth, round, and flexible, like the letter "O," so they can move through the vessels in our bodies easily. Sickle cell hemoglobin cells are stiff and sticky and form into the shape of a sickle, or the letter "C," when they lose their oxygen. These sickle cells tend to cluster together and cannot easily move through the blood vessels. The cluster causes a blockage in small arteries or capillaries and stops the movement of healthy, normal oxygen-carrying blood. This blockage is what causes the painful and damaging complications of sickle cell disease".

"Acute vaso-occlusive crisis (VOC) is a hallmark of sickle cell disease (SCD). Multiple complex pathophysiological processes can result in pain during a VOC. Despite significant improvements in the understanding and management of SCD, little progress has been made in the management of pain in SCD, although new treatments are being explored".

The Painful Episodes:

"The day-to-day management of sickle cell disease often equates with the management of acute and chronic pain. Patients manage many painful events at home so that hospital visits underestimate the frequency of pain

Acute painful episodes are the most commonly encountered vaso-occlusive events in patients of all ages. Presumed to be caused by sickle vaso-occlusion, pain often starts in young children as the hand-foot syndrome or dactylitis, a painful swelling of hands and feet due to inflammation of the metacarpal and metatarsal periosteum. Painful episodes, which last from hours to many days, usually occur with little warning and a clear precipitating event is not often found.

Being tested
Omega 3, Vit D, Zinc sulfate, Statins (Cardiovascular Agents), Hydroxy Urea
Keywords
omega3, Vaso-occlusive painful crisis, Pediatric sickle cell anemia, comparative effective analysis in VOC, Anti-inflammatory effect of Vit-D, Anti-hemolytic effect of Vit-D, Anti-hyperlipidemia of Vit-D, effect of omega-3 on blood rheology, effect of omega-3 on blood viscosity, Antiaggregation effect of omega-3, Anti-inflammatory effect of statins, Anti-inflammatory effect of zinc supplements, effect of zinc supplements on blood viscosity, effect of zinc supplements on blood rheology, Antiaggregation effect of zinc supplements, pediatric sickle cell disease
Medical subject headings
Vaso-Occlusive Crises, Anemia, Sickle Cell

What participants receive

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

  • Omega 3Drug

    Also called omega-3 supplementation capsules

    Omega-3 supplementation (300-400mg EPA \& 200-300mg DHA) per day for 8 consecutive months up to 10 months

  • Vit DDrug

    Also called Vit-D medication oral drops

    50 patients from each participating hospital that will receive Vit-D medication (1500 IU to 3500 IU ) per day for 8 consecutive months up to 10 months.

    in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.

  • Zinc sulfateDrug

    Also called Zinc tablet medication

    50 patients from each participating hospital that will receive Zinc supplements (15 mg to 50 mg ) per day for 8 consecutive months up to 10 months.

    in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.

  • Statins (Cardiovascular Agents)Drug

    Also called Simvastatin 20mg

    50 patients from each participating hospital that will receive Simvastatin orally (20 mg to 40 mg ) per day for 8 consecutive months up to 10 months.

    in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.

  • Hydroxy UreaDrug

    Also called Hydroxy Urea tablet medication 20mg/kg/day

    50 patients from each participating hospital that will receive the ordinary treatment of Hydroxyurea (20 mg/kg/day) with monitoring blood count every 2 weeks maximum daily dose: (40 mg/kg/day) for 8 consecutive months up to 10 months.

  • Folic Acid SupplementationDrug

    Also called Folic Acid tablet medication 1mg/day

    Folic Acid dose of 0.5 to 1 mg daily for 3 to 4 weeks until definite hematologic response

  • Morphine SulfateDrug

    Also called Morphine Sulfate intra venous medication

    Morphine medication as a pain killer is administered, if Patient weight <50 kg: Opioid naïve: Initial: 0.05 mg/kg/dose; usual maximum initial dose: 1 to 2 mg/dose.

  • blood transfusion sessionProcedure or surgery

    Regular blood transfusion session based on patient hematological profile starts from one session every 2 weeks.

Study groups in NCT04301336
Study groupRoleWhat they receive
Omega-3 experimental groupExperimental50 patients from each participating hospital that will receive Omega-3 supplementation (300-400mg EPA \& 200-300mg DHA) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Omega 3; Drug: Hydroxy Urea; Drug: Folic Acid Supplementation; Drug: Morphine Sulfate; Procedure: blood transfusion session
Vit-D experimental groupExperimental50 patients from each participating hospital that will receive Vit-D medication (1500 IU to 3500 IU ) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Vit D; Drug: Hydroxy Urea; Drug: Folic Acid Supplementation; Drug: Morphine Sulfate; Procedure: blood transfusion session
Zinc supplements experimental groupExperimental50 patients from each participating hospital that will receive Zinc supplements (15 mg to 50 mg ) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Zinc sulfate; Drug: Hydroxy Urea; Drug: Folic Acid Supplementation; Drug: Morphine Sulfate; Procedure: blood transfusion session
Statin experimental groupExperimental50 patients from each participating hospital that will receive Simvastatin orally (20 mg to 40 mg ) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of hydroxyurea, Folic acid, pain killer plus regular blood transfusion with a dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Statins (Cardiovascular Agents); Drug: Hydroxy Urea; Drug: Folic Acid Supplementation; Drug: Morphine Sulfate; Procedure: blood transfusion session
Ordinary hospital treatment groupActive comparator50 patients from each participating hospital that will receive the ordinary treatment of Hydroxyurea (20 mg/kg/day) with monitoring blood count every 2 weeks maximum daily dose: (40 mg/kg/day) for 8 consecutive months up to 10 months. in addition, Folic Acid dose of 0.5 to 1 mg daily for 3 to 4 weeks until definite hematologic response in addition, Morphine medication as a pain killer is administered, if Patient weight <50 kg: Opioid naïve: Initial: 0.05 mg/kg/dose; usual maximum initial dose: 1 to 2 mg/dose. This group received regular blood transfusion session.
Receives: Drug: Hydroxy Urea; Drug: Folic Acid Supplementation; Drug: Morphine Sulfate; Procedure: blood transfusion session

What is being measured

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

  1. C-reactive protein mg/L

    C-reactive protein milligrams per deciliter

    Measured: 10 months

  2. Hematocrit %

    Hematocrit level in percentage value

    Measured: 10 months

  3. Fibrinogen mg/dl

    Fibrinogen concentration in milligrams per deciliter

    Measured: 10 months

  4. Total cholesterol Mg/dl

    Total cholesterol milligrams per deciliter

    Measured: 10 months

  5. HDL cholesterol Mg/dl

    HDL cholesterol milligrams per deciliter

    Measured: 10 months

  6. LDL cholesterol Mg/dl

    LDL cholesterol milligrams per deciliter

    Measured: 10 months

  7. Triglycerides Mg/dl

    Triglycerides milligrams per deciliter

    Measured: 10 months

  8. leukocytes count μl

    leukocytes in microliter

    Measured: 10 months

  9. hemoglobin (Hbg) g/dL

    hemoglobin (Hbg) gram/deciliter

    Measured: 10 months

  10. White blood cells count

    White blood cells count in a cubic milliliter of blood

    Measured: 10 months

  11. Lactic acid dehydrogenase U/L

    Lactic acid dehydrogenase unit per litter

    Measured: 10 months

  12. Reticulocyte count %

    Reticulocyte count percentage

    Measured: 10 months

  13. Red blood cell (erythrocyte ) sedimentation rate mm/hr

    erythrocyte sedimentation rate in millimeters (mm) per one hour(hr)

    Measured: 10 months

  14. lymphocyte count µL

    lymphocyte count in 1 microliter (µL) of blood

    Measured: 10 months

  15. Granulocyte absolute count cells/microliter

    Granulocyte cells numbers in microliter

    Measured: 10 months

  16. Granulocytes,percentage (GR, pct)

    percentage of white blood cells with granules in percentage

    Measured: 10 months

Timeline

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

  1. First posted10 Mar 2020
  2. Study start1 Nov 2019
  3. Primary completion1 Nov 2020
  4. Study completion10 Dec 2020

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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Four experimental groups, one control group
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
350 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04301336
Sponsor's protocol ID
Novel TTT of pedia VOC/SCA
Status last verified
Jan 2021
First submitted
6 Mar 2020
Last updated
27 Jan 2021
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Omega 3, Vit D and Zinc sulfate in people with Vaso-occlusive Crisis and Sickle Cell Disease, run by Beni-Suef University at 4 sites in 2 countries.

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 1 inclusion and 5 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 27 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Egypt, Saudi Arabia. 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 combined 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.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

C-reactive protein mg/L (time frame: 10 months). The study lists 16 primary outcomes in all. 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 2021.

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