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Treatment of Myelodysplastic Syndromes Comparing Hydralazine/Ac. Valproic and Supportive Care in Patients Not Candidates, Refractory and/or Intolerant to Intensive Chemotherapy

Primary Purpose

Myelodysplastic Syndrome

Status
Unknown status
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
BSC
HIDRA/VPA
Sponsored by
Basque Health Service
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myelodysplastic Syndrome focused on measuring myelodysplastic syndrome, Transfusion, Hydralazine, valproic acid

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Ability to understand and voluntarily sign the consent form.
  2. Age ≥ 18 years at the time of signing the informed consent form.
  3. Ability and willingness to meet the schedule of study visits and other protocol requirements.
  4. Documented diagnosis of SMDs according to the criteria of disease risk IPSS intermediate-2, high risk or any risk with transfusion requirements.
  5. Transfusion-dependent anemia erythrocytes defined as the absence of a period of 56 consecutive days without transfusion of red blood cells for at least 112 days prior (16 weeks).
  6. Engage both women and men to use highly effective contraception.
  7. Patients are not candidates for treatment with azacitidine or chemotherapy

Exclusion Criteria:

  • Patients who have any of these exclusion criteria may not be included in the trial:

    1. Pregnant or breastfeeding.
    2. After hematopoietic stem cell transplantation.
    3. Patients with vitamin B12 deficiency, Folic Acid and Iron
    4. Any severe psychiatric illness or condition that prevents the patient sign the consent form for the patient or involves an unacceptable risk in case of participating in the study.
    5. Hypersensitivity to hydralazine and / or AC. Valproic

Sites / Locations

  • Txagorritxu Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

HIDRA/VPA

best supportive care (BSC)

Arm Description

In each cycle (30 days), Hydralazine 50mg tablets every 12 hours and Valproic 500mg tablets every 8 hours will be administrated orally to HYDRA / VPA group.Each patient will receive 6 cycles of hydralazine and valproic acid.

The support group will be receive transfusional BSC, erythropoietin and / or G-CSF as determined by the physician.

Outcomes

Primary Outcome Measures

change in hemoglobin from baseline in patients who express an erythroid response.
Independence RBC transfusion requirement for ≥ 8 weeks (56 days) followed by treatment at any time.

Secondary Outcome Measures

Erythroid response according to the criteria of the international working group of SMDs at 24 weeks
Number and type of administered blood transfusions, time between the last transfusion prior to inclusion in the study and the first transfusion after the 8 weeks of treatment.

Full Information

First Posted
May 18, 2011
Last Updated
May 19, 2011
Sponsor
Basque Health Service
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1. Study Identification

Unique Protocol Identification Number
NCT01356875
Brief Title
Treatment of Myelodysplastic Syndromes Comparing Hydralazine/Ac. Valproic and Supportive Care in Patients Not Candidates, Refractory and/or Intolerant to Intensive Chemotherapy
Official Title
Phase II Clinical Trial for Treatment of Myelodysplastic Syndromes Comparing Hydralazine / Ac.Valproico and Supportive Care in Patients Not Candidates, Refractory and / or Intolerant to Intensive Chemotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
April 2011
Overall Recruitment Status
Unknown status
Study Start Date
September 2011 (undefined)
Primary Completion Date
September 2014 (Anticipated)
Study Completion Date
January 2015 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Basque Health Service

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Transfusional dependence has been associated closely and independently with low survival in patients with myelodysplastic syndrome (MDS), especially in patients at low risk according to IPSS. Treatment of patients with hydralazine + valproic acid as an alternative to treatment with 5-azacytidine has lower cost and possibly as effective with fewer side effects. The objective of this phase II study is to determine the effectiveness of combination therapy with hydralazine + Ac. Valproic compared with best supportive care. The investigators will select 42 patients per group, and after 14 weeks of treatment the investigators will study in both groups the hematological response (transfusion-dependent, hemoglobin, cytogenetics and morphology) and treatment safety (adverse reactions and vital signs) to 1 year after starting treatment. The concentration of hemoglobin, the number of transfusions, platelets, neutrophils and other continuous variables in both groups will be compared by Student t or Mann-Whitney, as appropriate. For comparison of cytogenetic and morphological response and other categorical variables between groups Chi square will be used. And within each group the investigators will compare each of these variables before and after treatment by t-test for paired data or Wilcoxon test.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myelodysplastic Syndrome
Keywords
myelodysplastic syndrome, Transfusion, Hydralazine, valproic acid

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
HIDRA/VPA
Arm Type
Experimental
Arm Description
In each cycle (30 days), Hydralazine 50mg tablets every 12 hours and Valproic 500mg tablets every 8 hours will be administrated orally to HYDRA / VPA group.Each patient will receive 6 cycles of hydralazine and valproic acid.
Arm Title
best supportive care (BSC)
Arm Type
Active Comparator
Arm Description
The support group will be receive transfusional BSC, erythropoietin and / or G-CSF as determined by the physician.
Intervention Type
Drug
Intervention Name(s)
BSC
Intervention Description
The support group will be receive transfusional BSC, erythropoietin and / or G-CSF as determined by the physician.
Intervention Type
Drug
Intervention Name(s)
HIDRA/VPA
Intervention Description
In each cycle (30 days), Hydralazine 50mg tablets every 12 hours and Valproic 500mg tablets every 8 hours will be administrated orally to HYDRA / VPA group.Each patient will receive 6 cycle.
Primary Outcome Measure Information:
Title
change in hemoglobin from baseline in patients who express an erythroid response.
Description
Independence RBC transfusion requirement for ≥ 8 weeks (56 days) followed by treatment at any time.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Erythroid response according to the criteria of the international working group of SMDs at 24 weeks
Description
Number and type of administered blood transfusions, time between the last transfusion prior to inclusion in the study and the first transfusion after the 8 weeks of treatment.
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ability to understand and voluntarily sign the consent form. Age ≥ 18 years at the time of signing the informed consent form. Ability and willingness to meet the schedule of study visits and other protocol requirements. Documented diagnosis of SMDs according to the criteria of disease risk IPSS intermediate-2, high risk or any risk with transfusion requirements. Transfusion-dependent anemia erythrocytes defined as the absence of a period of 56 consecutive days without transfusion of red blood cells for at least 112 days prior (16 weeks). Engage both women and men to use highly effective contraception. Patients are not candidates for treatment with azacitidine or chemotherapy Exclusion Criteria: Patients who have any of these exclusion criteria may not be included in the trial: Pregnant or breastfeeding. After hematopoietic stem cell transplantation. Patients with vitamin B12 deficiency, Folic Acid and Iron Any severe psychiatric illness or condition that prevents the patient sign the consent form for the patient or involves an unacceptable risk in case of participating in the study. Hypersensitivity to hydralazine and / or AC. Valproic
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Breno Moreno de Gusmao, MD
Phone
+34-945 007000
Email
breno.morenodegusmao@osakidetza.net
Facility Information:
Facility Name
Txagorritxu Hospital
City
Vitoria-Gasteiz
State/Province
Alava
ZIP/Postal Code
01009
Country
Spain
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Breno Moreno de Gusmao, MD
Phone
+34 945 007000
Email
breno.morenodegusmao@osakidetza.net

12. IPD Sharing Statement

Learn more about this trial

Treatment of Myelodysplastic Syndromes Comparing Hydralazine/Ac. Valproic and Supportive Care in Patients Not Candidates, Refractory and/or Intolerant to Intensive Chemotherapy

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