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Sickle Cell DiseasePhase 1/2HUPKNCT03763656

Pharmacokinetics of Oral Hydroxyurea Solution

A Phase 1/2 study testing Oral Hydroxyurea (100 mg/mL) Solution in people with Sickle Cell Disease and Sickle-Cell; Hemoglobin Disease, Thalassemia, run by Nova Laboratories Limited at 6 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

An open label, safety and pharmacokinetic study of oral hydroxyurea solution administered to children from 6 months to 17.99 years (i.e. to the day before 18th birthday), with a 12 to 15 month treatment period for each participant. Read more about this study

Who is it for?
Ages 6 months to 17 years
What is being tested?
Oral Hydroxyurea (100 mg/mL) Solution
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
33 participants
Where
6 sitesin 2 countries
Study dates
3 Jan 2019to 29 Dec 2021
Phase
Phase 1/2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 months to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Male or female aged from 6 months to 17.99 years of age (i.e. to the day before 18th birthday).
  • Diagnosis of sickle cell anemia (HbSS and HbSβº).
  • Parent(s)/legal guardian able and willing to provide written informed consent for the child to take part in the study.
  • Where applicable, the child should assent to undergo blood sampling for pharmacokinetic and biochemistry purposes and to allow physiological measurements to be made.

Who cannot join

  • Any clinically significant medical condition or abnormality, which, in the opinion of the Investigator, might have compromised the safety of the patient or which might have interfered with the study.
  • Hydroxyurea use within 6 months before enrolment.
  • Renal insufficiency (known creatinine more than twice the upper limit of normal (ULN) for age and >1.0 mg/dL [88.4 μmol/L]).
  • Clinical evidence of hepatic compromise with alanine aminotransferase (ALT) >3 times the ULN (a temporary swing in ALT did not result in exclusion).
  • Other significant organ system dysfunction based on the site Investigators discretion.
  • Severe active infections: fungal, viral or bacterial (as confirmed by culture), examples included tuberculosis, malaria, active hepatitis, osteomyelitis or any other illness that would have precluded the use of HU in normal clinical practice.
Show all 13Show fewer
  • Active chronic leg ulcers.
  • Known allergy to oral HU solution or any of the excipients.
  • Positive pregnancy test for females of child-bearing potential (in post-menarcheal females) before initiation of treatment, unless participant was sexually abstinent. Note: True abstinence was considered as being in line with the preferred and usual lifestyle of the participant. Periodic abstinence (such as calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
  • Inadequate contraception measures in sexually active females (post-menarcheal females) and males of child-bearing age (see Section 9.5.1.10.4).
  • Breastfeeding at study initiation.
  • Participation in another clinical trial of an IMP.
  • Known infection with HIV.

Trial locations and contacts

6 sites in 2 countries.

6 sites in 2 countries

United Kingdom5 sites
  • Birmingham Women's and Children's NHS Foundation Trust

    Birmingham

  • Alder Hey Children's NHS Foundation Trust

    Liverpool

  • Evelina London Children's Hospital

    London

  • King's College Hospital NHS Foundation Trust

    London

  • The Royal London Children's Hospital, Barts Health NHS Trust

    London

Other trials in United Kingdom

Jamaica1 site
  • Dr Angela E Rankine- Mullings

    Kingston

Other trials in Jamaica

About this study

Official title: A Prospective Open Label, Pharmacokinetic Study of an Oral Hydroxyurea Solution in Children With Sickle Cell Anemia.

An open label, safety and pharmacokinetic study of oral hydroxyurea solution administered to children from 6 months to 17.99 years (i.e. to the day before 18th birthday), with a 12 to 15 month treatment period for each participant. The study treatment duration will be for 6 months at the maximum tolerated dose [MTD], which is usually reached by 6 months after initiation of treatment. For patients in whom time to MTD is longer than 6 months or not achieved at all, the maximum duration of study treatment will be 15 months.

Being tested
Oral Hydroxyurea (100 mg/mL) Solution
Keywords
Hydroxyurea, Hydroxycarbamide, Xromi
Medical subject headings
Anemia, Sickle Cell, Hemoglobinopathies, Thalassemia, Hemoglobin SC Disease

What participants receive

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

  • Oral Hydroxyurea (100 mg/mL) SolutionDrug

    Participants received Oral Hydroxyurea 15 mg/kg once daily. Escalated by 5 mg/kg/day every 8-12 weeks until maximum tolerated dose achieved, up to a maximum 35 mg/kg/day.

Study groups in NCT03763656
Study groupRoleWhat they receive
Open LabelExperimentalNovel oral solution formulation of hydroxyurea
Receives: Drug: Oral Hydroxyurea (100 mg/mL) Solution

What is being measured

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

  1. Clearance (CL/F)

    Model estimated Pharmacokinetic Parameter (PK population: n=32, having received at least one dose of study drug).

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

  2. Volume of Distribution (V/F)

    Model estimated Pharmacokinetic Parameter (PK population: n=32, having received at least one dose of study drug).

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

  3. Time to Maximum Concentration (Tmax)

    Mean Tmax (h) pharmacokinetic parameter derived using the final population PK model.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

  4. Maximum Plasma Concentration Cmax (ug/mL)

    Mean Cmax (ug/mL) pharmacokinetic parameter derived using the final population PK model.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

  5. Area Under Plasma Concentration Time Curve (AUC 0-Inf)

    Mean AUC 0-Infinity (hr*ug/mL) pharmacokinetic parameters derived using the final population PK model.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

  6. Terminal Half-life (Hours)

    Mean Terminal Half-life (hours) pharmacokinetic parameter derived using the final population PK model.

    Measured: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)

Secondary outcomes (25)
  1. Adverse Events

    Incidence of Adverse events during the course of the trial from screening to final follow up phone call at Week 64.

    Relatedness refers to 'at least possibly related to the IMP', with severity/toxicity assessed using the CTCAE Toxicity Grade and seriousness based on the standard definition for SAE in accordance with GCP. With the exception of SCA related events, requiring >7day hospitalisation, or extension of hospitalisation before being reported as an SAE due to their frequency within the disease population. All other non-SCA related SAEs were reportable.

    Measured: Screening Up to Week 64

  2. Absolute Neutrophil Count (ANC)

    Safety review for haematological toxicity (mild myelosuppression target: 1-3x10^9/L)

    Measured: Baseline and Week 60 (or final visit); max 15 months on treatment

  3. White Blood Cell Count (Leukocytes)

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Baseline to Week 60 or Final Visit; max 15 months on treatment

  4. Platelets

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Baseline to Week 60 (or Final Visit), max 15 months on treatment

  5. Mean Corpuscular Hemoglobin (MCH)

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Baseline to Week 60 (or Final Visit), max 15 months on treatment

  6. Hematocrit

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  7. Bilirubin

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  8. Elevation in Liver Function Tests (LFTs)

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry, including Liver Function Tests (LFTs): Alkaline Phosphatase (ALP), Gamma Glutamyl Transferase (GGT), Aspartate Amino Transferase (AST), Alanine Aminotransferase (ALT)

    Measured: Up to Week 60

  9. Hemoglobin

    Safety and efficacy of hydroxyurea therapy

    Measured: Baseline to Week 60 (or Final Visit); max 15 months on treatment

  10. Bacterial Infections

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  11. Viral Infections

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  12. Fungal Infections

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  13. Leg Ulcers

    Impact of Hydroxyurea on Safety, Hematology and Biochemistry

    Measured: Up to Week 60

  14. Fetal Hemoglobin

    Biomarker endpoints of Hydroxyurea efficacy

    Measured: Baseline to Week 60 (or Final Visit); max 15 months on treatment

  15. Mean Corpuscular Volume (MCV)

    Biomarker endpoints of Hydroxyurea efficacy

    Measured: Baseline to Week 60 (or Final Visit); max 15 months on treatment

  16. Cystatin C

    Biomarker Endpoints

    Measured: PK1 (day 1), week 20-32 (6 months) and Week 60 (Final Visit)

  17. Incidence of Acute Vaso-Occlusive Pain Crises (VOC)

    Hospitalization Incidence for 12 Months Prior to and After First Dose of IMP (Safety Population) for vaso-occlusive crisis (Mean [SD])

    Measured: 12 months prior to treatment and time-averaged 12 months post-treatment; maximum 15 months on IMP

  18. Number and Frequency of Blood Transfusions

    Clinical status endpoints, related to blood transfusions for treatment of SCA, this may be hospitalization, A\&E, or in-clinic treatment from safety population (n=32)

    Measured: Up to Week 60

  19. Acute Chest Syndrome (ACS)

    Hospitalization Incidence for 12 Months Prior to and After First Dose of IMP (Safety Population) for Acute Chest Syndrome (Mean [SD])

    Measured: 12 months prior to treatment and time averaged 12 months post-treatment; maximum 15 months on IMP

  20. Hospitalizations

    Clinical Status endpoints, all hospitalisations (not ER/Accident without hospitalization) (Mean [SD])

    Measured: 12 months prior to treatment and time-averaged 12 months post-treatment; maximum 15 months on IMP

  21. Dose Escalation i.e. Maximum Tolerated Dose (MTD)

    Summary of maximum tolerated dose achieved in mg/kg (Mean [SD])

    Measured: Screening Up to Final Visit (Week 60 or Withdrawal), maximum 15 months on IMP

  22. Other SCA-related Hospitalizations

    Clinical parameters (symptoms), secondary clinical status endpoints (not including ACS, VOC, Other Non-SCA related) (mean [SD])

    Measured: 12 months prior to treatment and time averaged 12 months post-treatment; maximum 15 months on IMP

  23. Parent/Caregiver Palatability and Acceptability Questionnaire

    Clinical status endpoints. Visual Analogue scale used to determine, taste, smell, aftertaste, acceptability and ease of dosing (1-100mm scale) with 1 being worst possible and 100 being best possible.

    Assessed for <6 years of age by parents/guardians. Assessed for >6 years of age, combination of parent/guardian and participant responses.

    Measured: Taken once at any point after 8 weeks on study medication (or at early Withdrawal)

  24. Vitamin D

    Biochemistry

    Measured: From Screening Up to Final Visit (Week 60 or WD)

  25. Other Non-SCA-related Hospitalizations

    Clinical parameters (symptoms), secondary clinical status endpoints (not including ACS, VOC, Other SCA-related)

    Measured: 12 months prior to treatment and 12 months post-treatment; maximum 15 months on IMP

Timeline

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

  1. First posted4 Dec 2018
  2. Study start3 Jan 2019
  3. Primary completion19 May 2021
  4. Study completion29 Dec 2021

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
Not applicable
Intervention model
Single group
Model description
Open label, observational, pharmacokinetic study of oral hydroxyurea solution administered to children from 6 months-17.99 years over a 12-15-month period
Masking
None (open label)
Enrolment
33 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03763656
Sponsor's protocol ID
INV543
Other IDs
2017-004568-37, 2017
Acronym
HUPK
Status last verified
Aug 2024
First submitted
3 Dec 2018
Last updated
28 Oct 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Oral Hydroxyurea (100 mg/mL) Solution in people with Sickle Cell Disease and Sickle-Cell; Hemoglobin Disease, Thalassemia, run by Nova Laboratories Limited at 6 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 4 inclusion and 13 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 28 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in United Kingdom, Jamaica. 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 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?

Yes. Results are posted in the registry (first posted 28 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Clearance (CL/F) (time frame: 0, 0.25, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 12 hours post-dose on Day 1 and Day 2 (Week 20-36)). The study lists 6 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 28 Oct 2024.

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