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Sickle Cell DiseasePhase 1/2NCT01757418

Intravenous Gammaglobulin for Sickle Cell Pain Crises

A Phase 1/2 study testing Immune Globulin Intravenous (IVIG) and Normal saline in people with Sickle Cell Disease and Pain, run by Albert Einstein College of Medicine at 1 site in United States.

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 purpose of this study is to determine whether Intravenous Immunoglobulin (IVIG) is safe and effective in the acute treatment of pain crises in sickle cell disease. Funding Source: Food and Drug Administration (FDA), Office of Orphan Products Development (OOPD) Read more about this study

Who is it for?
Ages 6 to 13 years
Conditions the study is for
Sickle Cell Disease, Pain
What is being tested?
Immune Globulin Intravenous (IVIG) and Normal saline
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
300 participants
Where
1 siteUnited States
Study dates
Nov 2008to 18 Dec 2024
Phase
Phase 1/2
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 6 to 13 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Documented Sickle Cell Disease (SS or S-β thalassemia genotype)
  • Age 12-65 years for Phase 1 (Completed), 6-13.99 years for Phase 2 (Ongoing)
  • Normal stroke risk as assessed by transcranial Doppler (TCD). A normal TCD in subjects 16 years of age and younger within the year prior to study drug administration are required
  • Uncomplicated acute vaso-occlusive crisis requiring hospital admission and parenteral narcotic analgesics
  • If prescribed Voxelotor: Consistent daily use of voxelotor in the past week AND able to continue Voxelotor inpatient OR no reported use in prior week

Who cannot join

  • Concomitant acute process, including acute chest syndrome, potential serious infection, or clinically significant bleeding
  • Fever > 38.5° C and clinical suspicion of infection
  • Serum alanine aminotransferase >4x Upper Limit of Normal (ULN)
  • Serum creatinine ≥1.3 mg/dL (or > than 95th percentile for age) or >300 mg/dL protein in spot urinalysis
  • Known condition associated with renal dysfunction including but not limited to diabetes mellitus, uncontrolled hypertension, multiple myeloma, and congestive heart failure
  • Any clinical evidence of prior stroke
Show all 22Show fewer
  • Prior thromboses or current estrogen use
  • Current estrogen use
  • Hb < 5 g/dL or > 10 g/dL
  • Known Immunoglobulin A (IgA) deficiency or known allergy to gamma globulin
  • Pregnancy or breastfeeding
  • Current participation in another investigational drug study
  • Current enrollment in a hypertransfusion program
  • Previous participation in current study less than 3 months ago
  • Current treatment with chronic transfusion
  • Vaccination with a live attenuated virus in the preceding 6 weeks
  • Documented history of illicit (e.g., heroin, cocaine) drug abuse
  • Subject is otherwise not an appropriate study candidate, in the investigator's judgement, such as concern for opioid addiction or comorbid psychiatric diagnoses that may contribute to secondary gain in prolonged use of opioids or hospital stay
  • Greater than 24 hours from time of presentation to the hospital for VOC
  • Atrial fibrillation
  • Right to left cardiac shunting due to patent foramen ovale or other anatomic cause
  • Known magnetic resonance imaging/angiography (MRI/A) evidence of stroke or clinically significant central nervous system (CNS) vasculopathy at any age (Imaging done if clinically indicated)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Montefiore Medical Center

    The Bronx, New York, 10467

Other trials in United States

About this study

Official title: Phase 1-2 Trial of Gamunex (Intravenous Gammaglobulin) for Sickle Cell Acute Pain

The purpose of this study is to determine whether Intravenous Immunoglobulin (IVIG) is safe and effective in the acute treatment of pain crises in sickle cell disease.

Funding Source: Food and Drug Administration (FDA), Office of Orphan Products Development (OOPD)

Read the detailed description

Patients will be randomized to a single dose of IVIG versus normal saline placebo during an uncomplicated pain crisis. Length of vaso-occlusive crisis (VOC) and other secondary endpoints will be monitored.

Phase I: To determine the tolerability and obtain preliminary data on the clinical efficacy of IVIG treatment in a randomized, double-blind, placebo-controlled, dose escalation Phase I clinical study of sickle cell disease patients, ages 12-65, admitted for acute vaso-occlusive crisis.

Phase II: To evaluate the effect of a single dose of 400mg/kg of intravenous (IV) Gamunex on length of VOC in subjects 6-13.99 years of age (initially 8-65 years of age, see "NOTES/CLARIFICATION below) hospitalized for sickle cell VOC in a randomized, double blind placebo-controlled Phase II trial. To further evaluate safety of a single dose of 400mg/kg of IV Gamunex in subjects 6-65 years of age hospitalized for sickle cell VOC.

NOTES/CLARIFICATION:

The following is a timeline of the 'evolution' of the required Age Range as per eligibility criteria for this study:

Initial Age Range: 8-65 years of age Effective 1/2/2013: 12-65 years of age Effective 3/31/2015: 8-21 years of age Effective 6/22/2018: 8-13 years of age Effective 7/11/2019: 6-13.99 years of age

Being tested
Immune Globulin Intravenous (IVIG), Normal saline
Keywords
Sickle Cell Disease, Pain, Immune Globulin
Medical subject headings
Anemia, Sickle Cell, Pain

What participants receive

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

  • Immune Globulin Intravenous (IVIG)Drug

    Also called GAMUNEX (Talecris Biotherapeutics)

    A single dose of intravenous immune globulin administered within 24 hours of hospital presentation. The maximum dose in Phase I was 800 mg/kg. The dose for Phase II is 400mg/kg.

  • Normal salineOther

    Also called Placebo

    A single dose of normal saline administered within 24 hours of hospital admission for uncomplicated pain crisis.

Study groups in NCT01757418
Study groupRoleWhat they receive
Intravenous Immune Globulin (IVIG)ExperimentalIVIG used in the trial is the GAMUNEX brand, at doses up through 800 mg/kg in Phase 1 and at 400mg/kg in Phase 2.
Receives: Drug: Immune Globulin Intravenous (IVIG)
Normal salinePlacebo comparatorAn equivalent volume (weight-based) of normal saline
Receives: Other: Normal saline

What is being measured

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

  1. Length of vaso-occlusive crisis (VOC)

    Length (duration) of vaso-occlusive crisis as measured from the time of presentation to the emergency room to end of VOC defined as 12 hours from the last dose of parenteral opioid analgesia for the treatment of VOC prior to hospital discharge. Group results will be summarized in number of days using univariate statistics.

    Measured: Number of days from time of presentation to emergency room to end of crisis, average 4 days and maximum 30 days

Secondary outcomes (10)
  1. Total Opioid Use

    The total intravenous morphine equivalent use from the end of infusion to discharge will be compared between the IVIG and placebo group. This will require conversion of total amount of different opioids to the equivalent amounts of IV morphine in milligrams. Standard tables for equianalgesic opioid dosing will be used for these conversions. These tables account for opioid type, route of administration, and incomplete cross-tolerance, as needed, and are adjusted for body weight. Group results will be summarized in milligrams of opioid per kilogram of body weight (mg/kg) using univariate statistics.

    Measured: From study drug infusion to end of crisis, average 4 days and maximum 30 days

  2. Time to end of vaso-occlusive crisis

    Time to end of vaso-occlusive crisis as measured from start of study drug infusion to end of VOC end of VOC defined as 12 hours from the last dose of parenteral opioid analgesia for the treatment of VOC prior to hospital discharge. Group results will be summarized in number of days using univariate statistics.

    Measured: Number of days from start of study drug infusion to end of crisis, average 4 days and maximum 30 days

  3. Length of Hospitalization

    Length (duration) of Hospitalization will be summarized by study arm in months/days using univariate statistics.

    Measured: From admission to discharge, average 4 days and maximum 30 days

  4. Change in Macrophage-1 Antigen (Mac-1) expression

    Change in Mac-1 expression levels from prior to infusion to 24 hours following infusion will be assessed by the appropriate in vitro adhesion assay to measure adhesion to cellular surfaces. Mac-1 is a cell surface receptor found on lymphocytes and leukocytes and serves as a marker for binding and adhesion. Mac-1 expression levels increase upon activation by inflammatory stimuli leading to a higher concentration of Mac-1 molecules on the cell's surface. Percentage change in Mac-1 from pre-infusion will be summarized by study arm using univariate statistics.

    Measured: From Pre-infusion to 24-hours post-infusion

  5. Change in Lactate Dehydrogenase (LDH) levels

    Change in LDH levels from prior to infusion to 24 hours following infusion will be assessed. Percentage change in LDH concentration (in U/L) from pre-infusion will be summarized by study arm using univariate statistics. While normal LDH ranges vary by age/gender and thresholds have not been established for this study, higher LDH levels may serve as inflammatory biomarkers of hemolysis in patients with sickle cell disease and also be indicators of acute or chronic tissue damage.

    Measured: From Pre-infusion to 24-hours post-infusion

  6. Change in Hemoglobin (Hb) levels

    Change in Hb levels from prior to infusion to 24 hours following infusion will be assessed. Percentage change in Hb concentration (in g/dL) from pre-infusion will be summarized by study arm using univariate statistics. While normal Hb ranges vary by age/gender and thresholds have not been established for this study, in patients with sickle cell disease, decreased Hb levels may be indicative of anemia, increased risk of thromboembolic events, and organ and tissue damage.

    Measured: From Pre-infusion to 24-hours post-infusion

  7. Change in High-sensitivity C-reactive protein (hsCRP) levels

    Change in hsCRP levels from admission to 24 hours following infusion will be assessed. Percentage change in hsCRP concentration (in mg/L) from admission will be summarized by study arm using univariate statistics. hsCRP serves a biomarker for inflammation. While normal ranges for hsCRP vary by age/gender and thresholds have not been established for this study, higher hsCRP levels may serve as a laboratory correlate of hospitalizations for pain or vaso-occlusive events in patients with sickle cell disease.

    Measured: From admission to 24-hours post-infusion, average 4 days

  8. Rate of transfer to Intensive Care Unit (ICU)

    The percentage of patients who are admitted to the hospital's ICU for an emergent condition will be summarized by study arm.

    Measured: From admission to discharge, average 4 days and maximum 30 days

  9. Diagnosis leading to transfer to the ICU

    Diagnoses leading to transfer to the ICU will be summarized by study arm.

    Measured: From admission to discharge, average 4 days and maximum 30 days

  10. Number and type of Transfusions

    The number and types of intervening packed red blood cell transfusions administered during the study will be summarized by study arm. Types of red blood cell transfusions will be categorized (e.g., acute, intermittent, chronic, simple, exchange) and will be administered as clinically indicated and ordered by the physician in accordance with NIH-NHLBI evidence-based management of sickle cell disease guidelines.

    Measured: From study drug infusion to discharge, average 4 days and maximum 30 days

Timeline

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

  1. First posted31 Dec 2012 (estimated)
  2. Study startNov 2008
  3. Primary completion18 Dec 2024
  4. Study completion18 Dec 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 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
1:1 randomization
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
300 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01757418
Sponsor's protocol ID
09-06-172
Other IDs
FD-R-005341-01
Status last verified
Mar 2026
First submitted
8 Nov 2012
Last updated
31 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Chang J, Shi PA, Chiang EY, Frenette PS. Intravenous immunoglobulins reverse acute vaso-occlusive crises in sickle cell mice through rapid inhibition of neutrophil adhesion. Blood. 2008 Jan 15;111(2):915-23. doi: 10.1182/blood-2007-04-084061. Epub 2007 Oct 11.

    PubMed 17932253
  • Turhan A, Jenab P, Bruhns P, Ravetch JV, Coller BS, Frenette PS. Intravenous immune globulin prevents venular vaso-occlusion in sickle cell mice by inhibiting leukocyte adhesion and the interactions between sickle erythrocytes and adherent leukocytes. Blood. 2004 Mar 15;103(6):2397-400. doi: 10.1182/blood-2003-07-2209. Epub 2003 Nov 20.

    PubMed 14630831
  • Shi PA, Manwani D, Olowokure O, Nandi V. Serial assessment of laser Doppler flow during acute pain crises in sickle cell disease. Blood Cells Mol Dis. 2014 Dec;53(4):277-82. doi: 10.1016/j.bcmd.2014.04.001. Epub 2014 May 21.

    PubMed 24857171
  • Manwani D, Frenette PS. Vaso-occlusion in sickle cell disease: pathophysiology and novel targeted therapies. Blood. 2013 Dec 5;122(24):3892-8. doi: 10.1182/blood-2013-05-498311. Epub 2013 Sep 19.

    PubMed 24052549
  • Manwani D, Chen G, Carullo V, Serban S, Olowokure O, Jang J, Huggins M, Cohen HW, Billett H, Atweh GF, Frenette PS, Shi PA. Single-dose intravenous gammaglobulin can stabilize neutrophil Mac-1 activation in sickle cell pain crisis. Am J Hematol. 2015 May;90(5):381-5. doi: 10.1002/ajh.23956. Epub 2015 Apr 1.

    PubMed 25616042
  • Manwani D, Xu C, Lee SK, Amatuni G, Cohen HW, Carullo V, Morrone K, Davila J, Shi PA, Ireland K, Keenan J, Frenette PS. Randomized phase 2 trial of Intravenous Gamma Globulin (IVIG) for the treatment of acute vaso-occlusive crisis in patients with sickle cell disease: Lessons learned from the midpoint analysis. Complement Ther Med. 2020 Aug;52:102481. doi: 10.1016/j.ctim.2020.102481. Epub 2020 Jun 9.

    PubMed 32951731
  • Jang JE, Hidalgo A, Frenette PS. Intravenous immunoglobulins modulate neutrophil activation and vascular injury through FcgammaRIII and SHP-1. Circ Res. 2012 Apr 13;110(8):1057-66. doi: 10.1161/CIRCRESAHA.112.266411. Epub 2012 Mar 13.

    PubMed 22415018

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Immune Globulin Intravenous (IVIG) and Normal saline in people with Sickle Cell Disease and Pain, run by Albert Einstein College of Medicine at 1 site 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 5 inclusion and 22 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 31 Mar 2026. 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 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. 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 combined 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.

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?

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?

Length of vaso-occlusive crisis (VOC) (time frame: Number of days from time of presentation to emergency room to end of crisis, average 4 days and maximum 30 days). 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 NCT01757418, which also lists 7 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 31 Mar 2026.

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