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Transfusion-dependent ThalassemiaPhase 1NCT06098014

Safety & Efficacy of Thalidomide in Children With Transfusion Dependent Thalassemia

A Phase 1 study testing Thalidomide Capsules in people with Transfusion-dependent Thalassemia, run by Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh at 1 site in Bangladesh.

Completed

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

Official record
Search all trials

Trial summary

Transfusion Dependent Thalassemia (TDT) is emerging as a global public health concern. Hemopoietic stem cell transplantation (HSCT) is the only curative treatment. But its adoption is limited due to lack of Human leukocyte antigen (HLA) matched donor, experienced centers and high initial cost. Read more about this study

Who is it for?
Ages 3 to 18 years
Conditions the study is for
Transfusion-dependent Thalassemia
What is being tested?
Thalidomide Capsules
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteBangladesh
Study dates
1 Mar 2023to 28 Feb 2024
Phase
Phase 1
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 3 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Patients diagnosed as transfusion dependent thalassemia
  • Age ranged from 3-18 years
  • Blood transfusion for more than 1 year.

Who cannot join

  • Active systemic illness,
  • Abnormal liver and kidney functions;
  • Severe cardiopulmonary or cerebrovascular diseases;
  • Recent fracture or recent major surgery
  • Use of drugs that might affect Hb levels 3 months before enrollment;
  • Any bleeding disorder .

Trial locations and contacts

1 site in 1 country.

Bangladesh1 site
  • Bangabandhu Sheikh Mujib Medical University

    Dhaka, 1000

Other trials in Bangladesh

About this study

Official title: Safety & Efficacy of Thalidomide in Children With Transfusion Dependent Thalassemia: a Quasi Randomized Control Trial in a Tertiary Care Hospital in Bangladesh

Transfusion Dependent Thalassemia (TDT) is emerging as a global public health concern. Hemopoietic stem cell transplantation (HSCT) is the only curative treatment. But its adoption is limited due to lack of Human leukocyte antigen (HLA) matched donor, experienced centers and high initial cost. So, researches are going on in search of an effective, safe, easily available treatment option. Thalidomide a Fetal Hemoglobin (HbF) inducing drug shown to be effective in treatment of TDT patients in few case reports and small scale prospective and retrospective studies. However, most of these researches were done in adolescent and adult population. No randomized control trial was done to determine the safety and efficacy of Thalidomide in TDT children. So, this study will predict the safety and efficacy of Thalidomide in TDT children and will play an important role in planning a cost effective and affordable treatment option for TDT children.

This single centered non blinded quasi randomized clinical trial will be conducted at the Department of Pediatric Hematology and Oncology in Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh for one year of period. The objective of this study is to assess the safety and efficacy of Thalidomide in TDT children 30 transfusion dependent thalassemia children of 3-18 years old will be included.

Read more

This study will involve minimum physical risk to the patient. Written informed consent will be taken from parents or study subjects after brief explanation of the purpose and procedure. They will also be informed about the freedom to participate or not to participate at any time. Privacy and confidentiality will be safe guarded. History regarding age, sex, height, weight of these patients will be taken. Through physical examinations and laboratory investigations including complete blood count (CBC), Hb electrophoresis, serum Ferritin, serum creatinine, serum glutamic pyruvic transaminase (SGPT), serum lactate dehydrogenase (LDH) will be done.

Data will be collected in a predesigned questionnaire and will be kept confidential. Statistical analysis will be done using the statistical package for social science (SPSS) software .

Read the detailed description

Study design: Quasi-randomized controlled tria

Period of Study: From March 2023 to February 2023

Place of study:

Department of Pediatric Hematology \& Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Study Population:

TDT patients of either gender and 3-18 years of age attending in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka and will receive Thalidomide during the study period.

Sample size will be calculated by using following formula:

((u+v)^2 (σ₁²+σ₀²))/((μ₁-μ₀)²) Here, u = .842 (if power= 80%) v = 1.96 (if significance level= 5%) μ₀ (mean Hb level before treatment with Thalidomide) = 71 μ₁ (mean Hb level in after treatment with Thalidomide) = 95 σ₀ = assumed population standard deviation for Placebo group = 30 σ₁ = assumed population standard deviation for Thalidomide group = 30

Calculated sample size is:

((u+v)^2 (σ₁²+σ₀²))/((μ₁-μ₀)²)

  • (1.96+0.842)2 ( 30² +30²)/ (24)2

= 24.5 ~25

Group sample sizes of 25 in each group, considering 10% drop out it may increase up to 30 as some cases may be lost to follow up during study period.

So, sample size will be 30+30 = 60.

Sampling technique:

From the date of start of study, patient will be selected purposively by inclusion and exclusion criteria during the desired study period. The patients will be randomized 1:1 to receive placebo or thalidomide. Block or restricted randomization will be used to select the intervention group and control. All odd number patients (1,3,7…) will be considered as block \& will be assigned to intervention group by lottery and then all even number patients (2,4,6…) will be assigned to the other group.

Data collection procedure:

This study will be conducted in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU). Children aged 3 to 18 years of both sexes diagnosed as TDT visiting the hematology out patient department (OPD) between March 2023 to February 2024 will be included in this study. Informed written consent from the patients or parents or guardians will be obtained at the time of study enrollment.

After recruitment, subjects will be randomly divided into two groups according to the Thalidomide therapy as follows:

  1. Experimental Group: Patients who will receive Thalidomide along with regular drugs.
  2. Control Group: Patients who will receive placebo with other regular drugs are considered as in the control group.

Data will be collected using a preformed data collection sheet (questionnaire). Demographic data such as age, sex, socio-economic status, family history of thalassemia will be collected from guardian or parents. Medical data regarding age, sex, age at first transfusion, red cell transfusion in last 1 year will be compiled. Clinical information such as pallor, pulse, blood pressure, respiratory rate, spleen size and other systemic clinical parameters will be taken.

Thalidomide and placebo will be given to randomly selected patients as per inclusion criteria attending in the outpatient department. The instruction will be given by the principal investigator according to study design.

Patients diagnosed with transfusion-dependent thalassemia will be randomized to receive placebo or Thalidomide treatment at a dose of 2-5 mg/kg/day.

The initial evaluation will be performed before the patients started Thalidomide. Patients will get transfusion with red blood cells at 10 ml/kg at any time during the study period if their Hb level < 70 g/L. The patients are followed up every 14 days for the first 12 weeks, and every 3 months thereafter. The efficacy will be evaluated after 12 weeks of treatment. Additionally, in patients with an obvious elevation in Hb who are free from blood transfusions for at least 6 weeks, the original treatment will be continuously administered for further evaluation. When the last patient is enrolled and completes their first 12 weeks of follow-up, the placebo-controlled period of the study will end.

Each evaluation will be included in a data collection sheet that will record crucial information such as the evaluation number, age, sex, type of diagnosis, Hb level, transfusion requirement etc. All participants will be asked to report any adverse reactions and will be questioned about adverse events during study visit.

Being tested
Thalidomide Capsules, Placebo
Keywords
Thalidomide,, Thalassemia, Children
Medical subject headings
Thalassemia

What participants receive

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

  • Thalidomide CapsulesDrug

    To see safety and efficacy of Thalidomide in Transfusion depended thalassemia

  • PlaceboDrug

    compare with Thalidomide

Study groups in NCT06098014
Study groupRoleWhat they receive
Thalidomide groupActive comparatorThalidomide group
Receives: Drug: Thalidomide Capsules
Placebo groupPlacebo comparatorPlacebo group
Receives: Drug: Placebo

What is being measured

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

  1. change in Hb level

    gm/dl

    Measured: 12 weeks after treatment initiation.

Secondary outcomes (4)
  1. blood transfusion frequency

    time

    Measured: 3 months from initiation of treatment

  2. change in Hb F

    Measured: 3 months after initiation of treatment

  3. Change in s. Ferritin level

    ng/mL

    Measured: 3 months after initiation of treatment

  4. Adverse effect

    Measured: 3 months after initiation of treatment

Timeline

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

  1. First posted24 Oct 2023
  2. Study start1 Mar 2023
  3. Primary completion28 Feb 2024
  4. Study completion28 Feb 2024

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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06098014
Sponsor's protocol ID
4280
Status last verified
Apr 2024
First submitted
12 Oct 2023
Last updated
9 Apr 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes

Publications

  • Fard AD, Hosseini SA, Shahjahani M, Salari F, Jaseb K. Evaluation of Novel Fetal Hemoglobin Inducer Drugs in Treatment of beta-Hemoglobinopathy Disorders. Int J Hematol Oncol Stem Cell Res. 2013;7(3):47-54.

    PubMed 24505535
  • Farmakis D, Porter J, Taher A, Domenica Cappellini M, Angastiniotis M, Eleftheriou A. 2021 Thalassaemia International Federation Guidelines for the Management of Transfusion-dependent Thalassemia. Hemasphere. 2022 Jul 29;6(8):e732. doi: 10.1097/HS9.0000000000000732. eCollection 2022 Aug.

    PubMed 35928543
  • Fozza C, Pardini S, Giannico DB, Targhetta C, Di Tucci AA, Dessalvi P, Angelucci E, Dore F. Dramatic erythroid response to low-dose thalidomide in two patients with transfusion independent thalassemia and severe post-transfusional alloimmune hemolysis. Am J Hematol. 2015 Jul;90(7):E141. doi: 10.1002/ajh.24030. No abstract available.

    PubMed 25850682
  • Hossain MS, Raheem E, Sultana TA, Ferdous S, Nahar N, Islam S, Arifuzzaman M, Razzaque MA, Alam R, Aziz S, Khatun H, Rahim A, Morshed M. Thalassemias in South Asia: clinical lessons learnt from Bangladesh. Orphanet J Rare Dis. 2017 May 18;12(1):93. doi: 10.1186/s13023-017-0643-z.

    PubMed 28521805
  • Jain M, Chakrabarti P, Dolai TK, Ghosh P, Mandal PK, Baul SN, De R. Comparison of efficacy and safety of thalidomide vs hydroxyurea in patients with Hb E-beta thalassemia - a pilot study from a tertiary care Centre of India. Blood Cells Mol Dis. 2021 May;88:102544. doi: 10.1016/j.bcmd.2021.102544. Epub 2021 Feb 3.

    PubMed 33610115
  • Lu Y, Wei Z, Yang G, Lai Y, Liu R. Investigating the Efficacy and Safety of Thalidomide for Treating Patients With ss-Thalassemia: A Meta-Analysis. Front Pharmacol. 2022 Jan 11;12:814302. doi: 10.3389/fphar.2021.814302. eCollection 2021.

    PubMed 35087410
  • Masera N, Tavecchia L, Capra M, Cazzaniga G, Vimercati C, Pozzi L, Biondi A, Masera G. Optimal response to thalidomide in a patient with thalassaemia major resistant to conventional therapy. Blood Transfus. 2010 Jan;8(1):63-5. doi: 10.2450/2009.0102-09. No abstract available.

    PubMed 20104280
  • Rachmilewitz EA, Giardina PJ. How I treat thalassemia. Blood. 2011 Sep 29;118(13):3479-88. doi: 10.1182/blood-2010-08-300335. Epub 2011 Aug 2.

    PubMed 21813448
  • Shah FT, Sayani F, Trompeter S, Drasar E, Piga A. Challenges of blood transfusions in beta-thalassemia. Blood Rev. 2019 Sep;37:100588. doi: 10.1016/j.blre.2019.100588. Epub 2019 Jul 6.

    PubMed 31324412
  • Taher A, Vichinsky E, Musallam K, Cappellini MD, Viprakasit V, authors. Weatherall D, editor. Guidelines for the Management of Non Transfusion Dependent Thalassaemia (NTDT) [Internet]. Nicosia (Cyprus): Thalassaemia International Federation; 2013. Available from http://www.ncbi.nlm.nih.gov/books/NBK190453/

    PubMed 24672826
  • Thompson AA, Walters MC, Kwiatkowski J, Rasko JEJ, Ribeil JA, Hongeng S, Magrin E, Schiller GJ, Payen E, Semeraro M, Moshous D, Lefrere F, Puy H, Bourget P, Magnani A, Caccavelli L, Diana JS, Suarez F, Monpoux F, Brousse V, Poirot C, Brouzes C, Meritet JF, Pondarre C, Beuzard Y, Chretien S, Lefebvre T, Teachey DT, Anurathapan U, Ho PJ, von Kalle C, Kletzel M, Vichinsky E, Soni S, Veres G, Negre O, Ross RW, Davidson D, Petrusich A, Sandler L, Asmal M, Hermine O, De Montalembert M, Hacein-Bey-Abina S, Blanche S, Leboulch P, Cavazzana M. Gene Therapy in Patients with Transfusion-Dependent beta-Thalassemia. N Engl J Med. 2018 Apr 19;378(16):1479-1493. doi: 10.1056/NEJMoa1705342.

    PubMed 29669226
  • Weatherall DJ. The Evolving Spectrum of the Epidemiology of Thalassemia. Hematol Oncol Clin North Am. 2018 Apr;32(2):165-175. doi: 10.1016/j.hoc.2017.11.008.

    PubMed 29458724
  • Wolman IJ, Ortolani M. Some clinical features of Cooley's anemia patients as related to transfusion schedules. Ann N Y Acad Sci. 1969 Nov 20;165(1):407-14. doi: 10.1111/j.1749-6632.1969.tb27811.x. No abstract available.

    PubMed 5260163
  • Yassin AK. Promising Response to Thalidomide in Symptomatic beta-Thalassemia. Indian J Hematol Blood Transfus. 2020 Apr;36(2):337-341. doi: 10.1007/s12288-019-01231-5. Epub 2019 Nov 18.

    PubMed 32425386
  • Aerbajinai W, Zhu J, Gao Z, Chin K, Rodgers GP. Thalidomide induces gamma-globin gene expression through increased reactive oxygen species-mediated p38 MAPK signaling and histone H4 acetylation in adult erythropoiesis. Blood. 2007 Oct 15;110(8):2864-71. doi: 10.1182/blood-2007-01-065201. Epub 2007 Jul 9.

    PubMed 17620452

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Thalidomide Capsules in people with Transfusion-dependent Thalassemia, run by Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh at 1 site in Bangladesh.

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 3 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: finished, as of the sponsor's last update on 9 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Bangladesh. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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?

change in Hb level (time frame: 12 weeks after treatment initiation.). 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 NCT06098014, which also lists 20 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 9 Apr 2024.

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