HEMolyse and Organ Damage imPROvement in Sickle Cell Disease by VoxElotor. An Open-label One Stage Phase II Design

Who is this study for? Patients with Sickle Cell Disease
What treatments are being studied? Voxelotor
Status: Unknown
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

Intro: Sickle cell disease is a genetic disorder caused by a mutation of the β hemoglobin called HbS, which causes red blood cell (RBC) abnormalities responsible for hemolysis, mainly intravascular, leading to chronic anemia. Intravascular hemolysis is responsible for severe inflammation and endothelial dysfunction. Maintaining hemoglobin in its oxygenated R-conformation is one of the strategies for inhibiting the polymerization of HbS. Previous experimental therapeutic approaches having this effect have been discontinued due to poor pharmaceutical properties or toxicity. Nevertheless, they proved the validity of the concept by demonstrating an increase in oxyhemoglobin and a decrease in biomarkers of hemolysis. Voxelotor binds to the α chain of globin and maintains Hb in its R conformation, thereby inhibiting the polymerization of HbS while increasing the affinity of Hb for oxygen. Because of its mechanism of action affecting anemia and hemolysis, Voxelotor is a promising treatment for the prevention and treatment of renal and cerebral arterial disease. Hypothesis/Objective : Investigator hypothesis is that the treatment by Voxelotor (GBT440) will improve intra vascular hemolysis and will increase the total mass of hemoglobin with beneficial effects on organ function. The primary objective of the study is to evaluate the biological activity of Voxelotor on the reduction of intra vascular hemolysis measured by plasma hemoglobin. The secondary objectives of the study will aim at characterizing the effects of GBT 440 Voxelotor on: * Intra vascular hemolysis measured by plasma Heme * Total hemoglobin mass (MHb) * RBCs lifespan * Blood volumes (plasma volume (PV), red blood cell mass (RBCM), total blood volume (BV)) * Blood viscosity * Cerebral perfusion * Cerebrovascular vaso-reactivity * Cognitive function (MoCA) * Six minute walk test * Renal perfusion and iron deposits in renal cortex * Measurement of Glomerular filtration rate Estimation of glomerular filtration rate (CKD/EPI equation) * Urine albumin/creatinine ratio * Ability to decrease or stop erythropoietin in patients under EPO treatment * Safety (VOC, ACS, Priapism) and tolerability of voxelotor * RBC properties Method: This is an open-label, single-arm, single-stage phase II trial in patients treated with Voxelotor 1500 mg daily for 48 weeks. Assessments will be done during the study at week 0, week 6, week 12, week 24, week 36 and week 48.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• SS or S-β0 major sickle cell syndrome

• Hemoglobin level \< 9 g/dL

• Aged 18 years or older

• Stable dose for at least 3 months if treated with HU, EPO, angiotensin-converting enzyme (ACE) or inhibitor/angiotensin receptor blocker (ARB) therapy; at least after 6 months after initiating HU treatment

• Patient with social security

• Female patient must have a negative serum pregnancy test (betaHCGat inclusion W0-V1D1) or evidence of post-menopausal status

• Effective methods of birth control (e.g., condom, spermicidal gel, oral contraceptive, indwelling intrauterine device, hormonal implant/patch, injections, approved cervical ring) or abstinence from screening through 4 weeks after last Voxelotor dose.

Locations
Other Locations
France
Hospital Henri Mondor
RECRUITING
Créteil
Contact Information
Primary
Gonzalo De Luna, MD
gonzalo.deluna@aphp.fr
0149812443
Backup
Pablo Bartolucci, PUPH
pablo.bartolucci@aphp.fr
0149817406
Time Frame
Start Date: 2023-03-22
Completion Date: 2025-03-22
Participants
Target number of participants: 30
Treatments
Experimental: Voxelotor 1500 mg oral per day (GBT440) for 48 weeks
Voxelotor 1500 mg oral per day (GBT440) for 48 weeks, in case of discontinuation due to patient's wishes and/or adverse event above grade 2 : 1000mg during 14 days then complete discontinuation if no resolution. In case of sudden discontinuation a therapeutic phlebotomy will be authorized.
Sponsors
Collaborators: Pfizer
Leads: Assistance Publique - Hôpitaux de Paris

This content was sourced from clinicaltrials.gov

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