Clinical trial NCT02336373: Treatment of Hemoglobin SC Disease With Hydroxyurea
Official title: SC Youth Treatment With Hydroxyurea Effects
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Hemoglobin SC Disease
Keywords: Hemoglobin SC disease
hydroxyurea
quality of life
viscosity
red cell density
Lead sponsor: Baylor College of Medicine
Sponsor class: OTHER
First posted: 2015-01-13
Enrollment: 32
Sex: ALL
Minimum age (years): 5
Maximum age (years): 21
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief 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. 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 children with the most common type of sickle cell, those who are homozygous for the sickle mutation (HbSS), helps children 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 Pediatric Quality of Life Inventory (PedsQL™) Sickle Cell Disease Module version 3.0, measures quality of life. The investigators will also see how hydroxyurea changes laboratory test numbers, and blood thickness.

Detailed description: 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 PedsQL™ Sickle Cell Disease Module version 3.0. This questionnaire will be offered to all patients with HbSC seen in our clinic that consent to this study. If the patient is sexually active, they will be offered birth control. If the patient chooses not to initiate effective birth control, they will be tested at their scheduled vist with a urine pregnancy test. If the patient becomes pregnant they will be removed from the study.

The maximum time 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.

Patients will be assessed in the clinic every two months after starting treatment. Hydroxyurea will be started at 10 mg/kg/day, and increased by 5 mg/kg/day at eight week intervals if needed to reach a maximum tolerated dose (MTD). 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.

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.

Eligibility criteria: Inclusion Criteria:

1. Diagnosis of HbSC disease
2. Score equal or lower than 80 on the PedsQL™ Sickle Cell Disease Module version 3.0
3. Have experienced a sickle cell disease related complication

Exclusion Criteria:

1. Failure to meet inclusion criteria.
2. Hydroxyurea usage in the last 3 months.
3. Chronic RBC transfusion therapy.
4. Packed red blood cell transfusion in the last 3 months (temporary exclusion).
5. Pregnancy, or refusal to use medically effective birth control if female and sexually active.

Primary outcomes:
measure: Change in PedsQL SCDM
timeFrame: 6 months
Secondary outcomes:
measure: Change in HVR at 45s-1
timeFrame: up to 7 months
measure: Change in HVR at 225s-1
timeFrame: up to 7 months
measure: DRBC
timeFrame: up to 7 months
measure: Change in HbF
timeFrame: up to 7 months
measure: Change in MCV
timeFrame: up to 7 months
measure: Change in MCHC
timeFrame: up to 7 months
measure: Change in Hb
timeFrame: up to 7 months
measure: Change in ARC
timeFrame: up to 7 months
measure: Change in ANC
timeFrame: up to 7 months
measure: Change in LDH
timeFrame: up to 7 months
measure: Change in UB Levels
timeFrame: up to 7 months
Other outcomes:
Locations:
city: Houston
country: United States
facility: Texas Children's Hospital
state: Texas
Study officials:
affiliation: Baylor College of Medicine
name: Vivien Sheehan, MD
role: PRINCIPAL_INVESTIGATOR
References: