Hydroxyurea to Prevent Organ Damage in Children With Sickle Cell Anemia
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Purpose
The purpose of this study is to determine if hydroxyurea therapy is effective in the prevention of chronic end organ damage in pediatric patients with sickle cell anemia.
| Condition | Intervention | Phase |
|---|---|---|
|
Hematologic Diseases Anemia, Sickle Cell |
Drug: Hydroxyurea Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Prevention |
| Official Title: | Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG) |
- 50% reduction in rates of damage to the major organs with surrogate markers of organ function [ Time Frame: Measured during follow-up evaluations ] [ Designated as safety issue: Yes ]
| Enrollment: | 191 |
| Study Start Date: | August 2000 |
| Study Completion Date: | September 2009 |
| Primary Completion Date: | September 2009 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: 1
Participants will receive hydroxyurea.
|
Drug: Hydroxyurea
Participants will receive hydroxyurea.
|
|
Placebo Comparator: 2
Participants will receive placebo.
|
Drug: Placebo
Participants will receive placebo.
|
Detailed Description:
BACKGROUND:
In 1995, the Multicenter Study of Hydroxyurea (MSH) demonstrated that hydroxyurea is effective in decreasing the frequency of painful crises, hospitalizations for crises, acute chest syndrome, and blood transfusions by 50%. The recently completed phase II study of hydroxyurea in children (PED HUG) demonstrated that children have a response to hydroxyurea similar to that seen in adults in terms of increasing fetal hemoglobin levels and total hemoglobin, and decreasing complications associated with sickle cell anemia. In addition, this study demonstrated that the drug does not adversely affect growth and development between the ages of 5 and 15. A recently completed pilot study of hydroxyurea given to children between the ages of 6 months and 24 months demonstrated that the drug is tolerated well by small infant, and that the fetal hemoglobin switch can be forced to remain in the "on position" by hydroxyurea administration.
A Special Emphasis Panel (SEP) met on April 12, 1996 to review the results of the MSH trial and the progress to date of the PED HUG study. The SEP recommended that NHLBI undertake the BABY HUG trial.
DESIGN NARRATIVE:
BABY HUG is a randomized, double-blind, placebo-controlled study to determine if hydroxyurea can prevent the onset of chronic end organ damage in young children with sickle cell anemia. Approximately 200 children with sickle cell disease will be recruited to receive either hydroxyurea or placebo. The children will be screened at study entry for signs of abnormal brain, kidney, pulmonary, and splenic function, and developmental milestones. They will then be randomly assigned to receive either hydroxyurea or placebo and followed yearly to assess chronic end organ damage of the major organ systems. The primary endpoint will be a 50% reduction in rates of damage to the major organs with surrogate markers of organ function during follow-up in Phase II of the trial.
Eligibility| Ages Eligible for Study: | 9 Months to 18 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Majority fetal and sickle (FS or SF) hemoglobin pattern confirmed centrally by electrophoresis (screening may begin at 7 months of age)
Exclusion Criteria:
- Chronic transfusion therapy
- Cancer
- Less than 5th percentile (10th percentile for the pilot study) height, weight, or head circumference for age
- Severe developmental delay (e.g., cerebral palsy or other mental retardation, Grade III/IV intraventricular hemorrhage)
- Stroke with neurological deficit
- Surgical splenectomy
- Participating in other clinical intervention trials
- Probable or known diagnosis of Hemoglobin S-Hereditary Persistence of Fetal Hemoglobin
- Known hemoglobin S-beta plus thalassemia (hemoglobin A present)
- Any condition or chronic illness, which in the opinion of the principal investigator, makes participation unadvised or unsafe
- Inability or unwillingness to complete baseline (pre-enrollment) studies, including blood or urine specimen collection, liver-spleen scan, abdominal sonogram, neurological examination, neuropsychological testing, or transcranial Doppler ultrasound (interpretable study not required, but confirmed velocity greater than 200 cm/sec results in ineligibility)
- Previous or current treatment with hydroxyurea (HU) or another anti-sickling drug
-
The following exclusion criteria are transient; patients can be re-evaluated for eligibility:
- Hemoglobin less than 6.0 gm/dL
- Reticulocyte count less than 80,000/cu mm if hemoglobin is less than 9 gm/dL
- Neutrophil count less than 2,000/cu mm
- Platelet count less than 130,000/cu mm
- Blood transfusion in the 2 months prior to study entry unless HbA is less than 10%
- ALT greater than twice the upper limit of normal
- Ferritin less than 10 ng/ml
- Serum creatinine greater than twice the upper limit of normal for age
- Bayley standardized mental score below 70
Contacts and LocationsPlease refer to this study by its ClinicalTrials.gov identifier: NCT00006400
| United States, Alabama | |
| University of Alabama at Birmingham | |
| Birmingham, Alabama, United States, 35233 | |
| United States, District of Columbia | |
| Children's National Medical Center | |
| Washington, District of Columbia, United States, 20010 | |
| Howard University | |
| Washington, District of Columbia, United States, 20060 | |
| United States, Florida | |
| University of Miami | |
| Miami, Florida, United States, 33136 | |
| United States, Georgia | |
| Emory University School of Medicine | |
| Atlanta, Georgia, United States, 30342 | |
| United States, Maryland | |
| Johns Hopkins University | |
| Baltimore, Maryland, United States, 21287 | |
| United States, Michigan | |
| Children's Hospital of Michigan/Wayne State Univ. | |
| Detroit, Michigan, United States, 48201 | |
| United States, Mississippi | |
| University of Mississippi Medical Center | |
| Jackson, Mississippi, United States, 39216 | |
| United States, New York | |
| SUNY Health Science Center, Brooklyn | |
| Brooklyn, New York, United States, 11203 | |
| United States, North Carolina | |
| Duke University Medical Center | |
| Durham, North Carolina, United States, 27710 | |
| United States, Pennsylvania | |
| Drexel University | |
| Philadelphia, Pennsylvania, United States, 19134 | |
| United States, South Carolina | |
| Medical University of South Carolina | |
| Charleston, South Carolina, United States, 29425 | |
| United States, Tennessee | |
| St. Jude Children's Research Hospital | |
| Memphis, Tennessee, United States, 38105 | |
| United States, Texas | |
| University of Texas SW Medical Center | |
| Dallas, Texas, United States, 75390 | |
| Principal Investigator: | Sherron Jackson, MD | Medical University of South Carolina | |
| Principal Investigator: | James F. Casella, MD | Johns Hopkins University | |
| Principal Investigator: | Lori Luchtman-Jones, MD | Children's Research Institute | |
| Principal Investigator: | Rathi V. Iyer, MD | University of Mississippi Medical Center | |
| Principal Investigator: | Scott T. Miller, MD | SUNY Health Science Center, Brooklyn | |
| Principal Investigator: | Sohail R. Rana, MD | Howard University | |
| Principal Investigator: | Zora R. Rogers, MD | University of Texas SW Medical Center | |
| Principal Investigator: | Bruce W Thompson, Ph.D. | Clinical Trials and Surveys Corp | |
| Principal Investigator: | Julio Barredo, MD | University of Miami Medical Center | |
| Study Chair: | Winfred C. Wang, MD | St. Jude Children's Research Hospital | |
| Principal Investigator: | Courtney Thornburg, MD | Duke University | |
| Principal Investigator: | Thomas Howard, MD | University of Alabama at Birmingham | |
| Principal Investigator: | Lori Luck, MD | Drexel University | |
| Principal Investigator: | R. Clark Brown, MD, PhD | Emory University | |
| Principal Investigator: | Sharada Sarnaik, MD | Wayne State University |
More Information
Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Jonathan Goldsmith, MD, NHLBI |
| ClinicalTrials.gov Identifier: | NCT00006400 History of Changes |
| Other Study ID Numbers: | 89, N01 HB07150, N01 HB07151, N01 HB07152, N01 HB07153, N01 HB07154, N01 HB07155, N01 HB07156, N01 HB07157, N01 HB07158, N01 HB07159, N01 HB07160 |
| Study First Received: | October 12, 2000 |
| Last Updated: | April 15, 2011 |
| Health Authority: | United States: Federal Government |
Keywords provided by National Heart, Lung, and Blood Institute (NHLBI):
|
Blood Diseases Sickle Cell Anemia |
Additional relevant MeSH terms:
|
Anemia, Sickle Cell Hematologic Diseases Anemia Anemia, Hemolytic Anemia, Hemolytic, Congenital Genetic Diseases, Inborn Hemoglobinopathies Hydroxyurea |
Antineoplastic Agents Antisickling Agents Enzyme Inhibitors Hematologic Agents Molecular Mechanisms of Pharmacological Action Nucleic Acid Synthesis Inhibitors Pharmacologic Actions Therapeutic Uses |
ClinicalTrials.gov processed this record on March 01, 2015