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Iron OverloadPhase 2/3NCT04292314

Hydroxy Urea, Omega 3, Nigella Sativa,Honey on Oxidative Stress and Iron Chelation in Pediatric Major Thalassemia

A Phase 2/3 study testing Omega 3, Nigella Sativa Oil and Hydroxyurea in people with Iron Overload and Oxidative Stress, run by Beni-Suef University at 4 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

The aim of the present study is evaluating the strength of combination therapy of hydroxy urea, omega 3, nigella sativa and honey on antioxidant-oxidant status (OXIDATIVE STRESS) in response to reactive oxygen species production (LIPID PEROXIDATION) and their effect on iron intoxication (IRON CHELATION) in pediatric… Read more about this study

Who is it for?
Ages 7 to 15 years
Conditions the study is for
Iron Overload, Oxidative Stress, Thalassemia Major
What is being tested?
Omega 3, Nigella Sativa Oil and Hydroxyurea
Could I receive a placebo?
No, everyone receives an active treatment
How many people
350 participants
Where
4 sitesin 2 countries
Study dates
1 Nov 2019to 20 Jan 2021
Phase
Phase 2/3
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 7 to 15 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Any case with full manifestation of β-THALASSEMIA major disease
  • #Aged from 7-15 years old
  • # accompanied with ineffective erythropoiesis
  • # with low hemoglobin level
  • # with iron overload

Who cannot join

  • The presence of any other chronic illness.
  • Patient age>15 years old or < 7 years old.
  • The presence of concomitant myocardial infarction, stroke, acute chest syndrome.
  • The patient suffers from any other type of anemia.

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

Egypt3 sites
  • Faculty of medicine, Beni-suef univeristy - Beni-Suef university hospital

    Banī Suwayf

  • Faculty of Pharmacy, Beni-Suef university

    Banī Suwayf

  • Health insurance hospital

    Banī Suwayf

Other trials in Egypt

Saudi Arabia1 site
  • Maternity and Children hospital

    Mecca

Other trials in Saudi Arabia

About this study

Official title: Impact of Combination Therapy Between Hydroxy Urea, Omega 3, Nigella Sativa and Honey on Antioxidant-oxidant Status and Reduction of Iron Overload in Pediatric Major Thalassemia

The aim of the present study is evaluating the strength of combination therapy of hydroxy urea, omega 3, nigella sativa and honey on antioxidant-oxidant status (OXIDATIVE STRESS) in response to reactive oxygen species production (LIPID PEROXIDATION) and their effect on iron intoxication (IRON CHELATION) in pediatric major thalassemia.

Read the detailed description

Beta thalassemia is a blood disorder that reduces the production of hemoglobin. Hemoglobin is the iron-containing protein in red blood cells that carries oxygen to cells throughout the body. In people with beta thalassemia, low levels of hemoglobin lead to a lack of oxygen in many parts of the body. Affected individuals also have a shortage of red blood cells (anemia), which can cause pale skin, weakness, fatigue, and more serious complications. People with beta thalassemia are at an increased risk of developing abnormal blood clots. Beta thalassemia is classified into two types depending on the severity of symptoms: thalassemia major (also known as Cooley's anemia) and thalassemia intermedia. Of the two types, thalassemia major is more severe.

Beta-thalassemia syndromes are a group of hereditary blood disorders. It is characterized by reduced beta globin chain synthesis, resulting in reduced Hb in red blood cells (RBC), decreased RBC production and anemia.

Homozygotes for beta-thalassemia may develop either thalassemia major or thalassemia intermedia. Individuals with thalassemia major usually come to medical attention within the first 2 years and require regular blood transfusion to survive.

Affected infants with thalassemia major fail to thrive and become progressively pale. Feeding problems, diarrhea, irritability, recurrent bouts of fever, and enlargement of the abdomen, caused by splenomegaly, may occur. If a regular transfusion program that maintains a minimum Hb concentration of 95-105 g/L is initiated, then growth and development are normal until the age of 10-11 years. After the age of 10-11 years, affected individuals are at risk of developing severe complications related to posttransfusional iron overload, depending on their compliance with chelation therapy.

Complications of iron overload include growth retardation and failure of sexual maturation and also those complications observed in adults with hemachromatosis -associated hereditary hemochromatosis (HH): involvement of the heart (dilated myocardiopathy and pericarditis), liver (chronic hepatitis, fibrosis, and cirrhosis), and endocrine glands (resulting in diabetes mellitus and insufficiency of the parathyroid, thyroid, pituitary, and, less commonly, adrenal glands).

The underlying basis of b-thalassemia pathology is the diminished b-globin synthesis leading to a-globin accumulation and premature apoptotic destruction of erythroblasts, causing oxidative stress-induced ineffective erythropoiesis.

Being tested
Omega 3, Nigella Sativa Oil, Hydroxyurea, Honey, Deferoxamine
Keywords
thymoquinone, omega3, hydroxyurea, pediatric Thalassemia Major, oxidative stress, iron chelation, iron overload, chelation activity of thymoquinone, antioxidant effect of omega3, anti-hemolysis effect of hydroxyurea
Medical subject headings
Iron Overload, beta-Thalassemia

What participants receive

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

  • Omega 3Drug

    Omega-3 supplementation (300-400mg EPA \& 200-300mg DHA) per day for 8 consecutive months up to 10 months

  • Nigella Sativa OilDrug

    Nigella sativa supplementation (1g black seed oil contain 1% thymoquinone) per day for 8 consecutive months up to 10 months

  • HydroxyureaDrug

    hydroxyurea medication (5 to 15mg/kg) per day for 8 consecutive months up to 10 months.

  • HoneyDrug

    Also called Natural honey formulation

    Natural honey(2.5 mg/kg dissolved in 250 ml water) per day for 8 consecutive months up to 10 months.

  • DeferoxamineDrug

    deferoxamine (SubQ infusion: 20 to 40 mg/kg/day over 8 to 12 hours, 6 to 7 nights per week, maximum daily dose: 40 mg/kg/day)for 8 consecutive months up to 10 months.

  • blood transfusion sessionProcedure or surgery

    Regular blood transfusion session based on patient hematological profile starts from one session every 2 weeks.

Study groups in NCT04292314
Study groupRoleWhat they receive
Omega-3 experimental groupExperimental50 patients from each participating hospital that will receive Omega-3 supplementation (300-400mg EPA \& 200-300mg DHA) per day for 8 consecutive months up to 10 months. in addition to experimental treatment this group will receive the traditional treatment of deferoxamine/deferasirox plus regular blood transfusion with dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Omega 3; Drug: Deferoxamine; Procedure: blood transfusion session
Nigella sativa experimental groupExperimental50 patients from each participating hospital that will receive Nigella sativa supplementation (1g black seed oil contain 1% thymoquinone) per day for 8 consecutive months up to 10 months. in addition to experimental treatment this group will receive the traditional treatment of deferoxamine/deferasirox plus regular blood transfusion with dose de-escalation methods till efficacy of experimental treatment proved.
Receives: Drug: Nigella Sativa Oil; Drug: Deferoxamine; Procedure: blood transfusion session
Hydroxyurea experimental groupExperimental50 patients from each participating hospital that will receive hydroxyurea medication (5 to 15mg/kg) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of deferoxamine/deferasirox plus regular blood transfusion with dose de-escalation methods until the efficacy of experimental treatment proved.
Receives: Drug: Hydroxyurea; Drug: Deferoxamine; Procedure: blood transfusion session
Natural honey experimental groupExperimental50 patients from each participating hospital that will receive natural honey(2.5 mg/kg dissolved in 250 ml water) per day for 8 consecutive months up to 10 months. in addition to the experimental treatment, this group will receive the traditional treatment of deferoxamine/deferasirox plus regular blood transfusion with dose de-escalation methods until the efficacy of experimental treatment proved.
Receives: Drug: Honey; Drug: Deferoxamine; Procedure: blood transfusion session
Ordinary hospital treatment groupActive comparator50 patients from each participating hospital that will receive the ordinary treatment of iron chelator agent of deferoxamine or deferasirox (SubQ infusion: 20 to 40 mg/kg/day over 8 to 12 hours, 6 to 7 nights per week, maximum daily dose: 40 mg/kg/day)for 8 consecutive months up to 10 months. in addition to iron chelator agent, this group receive regular blood transfusion session.
Receives: Drug: Deferoxamine; Procedure: blood transfusion session

What is being measured

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

  1. F 2 -isoprostanes pg/mL

    plasma F 2 -isoprostanes Picograms Per Millilitre measured by high pressure liquid chromatography assay

    Measured: 3 months

  2. Total cholesterol Mg/dl

    Total cholesterol milligrams per deciliter

    Measured: 10 months

  3. HDL cholesterol Mg/dl

    HDL cholesterol milligrams per deciliter

    Measured: 10 months

  4. LDL cholesterol Mg/dl

    LDL cholesterol milligrams per deciliter

    Measured: 10 months

  5. Triglycerides Mg/dl

    Triglycerides milligrams per deciliter

    Measured: 10 months

  6. Serum total iron mcg/dL

    Serum total iron micrograms per decilitre

    Measured: 10 months

  7. % transferrin saturation

    transferrin saturation percentage

    Measured: 10 months

  8. C-reactive protein mg/L

    C-reactive protein milligrams per deciliter

    Measured: 10 months

  9. Serum Ferritin ng/ml

    Serum Ferritin Nanograms per milliliter

    Measured: 10 months

  10. Total Iron Binding Capacity (TIBC) mcg/dL

    Total Iron Binding Capacity micrograms per decilitre

    Measured: 10 months

  11. hemoglobin (Hbg) g/dL

    hemoglobin (Hbg) gram/deciliter

    Measured: 10 months

  12. mean corpuscular hemoglobin (MCH) pg/ml

    mean corpuscular hemoglobin (MCH) Picograms Per Millilitre

    Measured: 10 months

  13. leukocytes count μl

    leukocytes in microliter

    Measured: 10 months

  14. % Chelation activity Fe+++ - thymoquinone complex

    Chelation activity of Ferric - thymoquinone complex in percentage measured by high pressure liquid chromatography coupled with gaschromatography - mass spectroscopy analysis

    Measured: 3 months

  15. % Chelation activity Fe++ - thymoquinone complex

    Chelation activity of Ferrous - thymoquinone complex in percentage measured by high pressure liquid chromatography coupled with gaschromatography- mass spectroscopy analysis

    Measured: 3 months

  16. Lactic acid dehydrogenase U/L

    Lactic acid dehydrogenase unit per litter

    Measured: 10 months

  17. Reticulocyte count %

    Reticulocyte count percentage

    Measured: 10 months

  18. Hb-F level g/dL

    hemoglobin- F level in gram per deciliter

    Measured: 10 months

  19. Reticulocyte absolute count

    Reticulocyte absolute count in a cubic milliliter of blood

    Measured: 10 months

  20. White blood cells count

    White blood cells count in a cubic milliliter of blood

    Measured: 10 months

Timeline

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

  1. First posted3 Mar 2020
  2. Study start1 Nov 2019
  3. Primary completion20 Dec 2020
  4. Study completion20 Jan 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 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Four experimental groups, one control group. Each experimental group receives different experimental treatments plus traditional treatment in the hospital and the control group receives only traditional treatment.
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
350 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04292314
Sponsor's protocol ID
TQ/Omega-3 on Thalassemia
Status last verified
Jan 2021
First submitted
28 Feb 2020
Last updated
27 Jan 2021
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Omega 3, Nigella Sativa Oil and Hydroxyurea in people with Iron Overload and Oxidative Stress, run by Beni-Suef University at 4 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 5 inclusion and 4 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 27 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Egypt, Saudi Arabia. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

F 2 -isoprostanes pg/mL (time frame: 3 months). The study lists 20 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 27 Jan 2021.

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