A Sickle CEll Disease ComplicatioN Trial (ASCENT)
Primary Purpose
Sickle Cell Disease
Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
SC411
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Sickle Cell Disease focused on measuring hemoglobin SS, hemoglobin SC, hemoglobin S/β°-thalassemia
Eligibility Criteria
Inclusion Criteria:
Patients who meet all of the following criteria will be eligible to participate in the study:
- 1. Aged ≥ 5 years and ≤ 17 years at screening;
- Has been diagnosed with SCD (that includes the genotypes HbSS, HbSC, and HbS/β°-thalassemia, documented by hemoglobin HPLC or electrophoresis);
- Has had between ≥ 2 to ≤10 episodes of acute SCC (as defined above) within 12 months of the Screening Visit. At least one crisis must have been managed in a hospital, clinic, or emergency room. For at least 2 of the episodes, the site must obtain the documentation created in a medical record at the time of the event.
- Must not be receiving HU or L-Glutamine, or if receiving HU and/or L-Glutamine must be at a stable weight-based treatment regimen (mg/kg), for at least 3 months prior to the Screening Visit with the intent to continue at a weight-based dose level at the discretion of the treating physician for the duration of the study, other than for safety reasons. If taking HU and/or L-glutamine, subjects must have had at least one SCC event (as previously defined) while on HU and/or L-Glutamine.
- Has a parent or guardian who is able to give written informed consent, and the potential pediatric subject must be able to provide assent in a manner approved by the Institutional Review Board (IRB) and comply with the requirements of the study; and
- If post pubertal in the opinion of the Investigator, must agree to use a reliable method of birth control (e.g., barrier, birth control pills, abstinence) during the study and for 1 month following the last dose of study drug.
Exclusion Criteria
Patients who meet any of the following criteria will be excluded from participation in the study:
- A known allergy or hypersensitivity to fish or shellfish;
- A known allergy or hypersensitivity to soy;
- Inability to swallow capsules;
- History of treatment with SC411;
- Confirmed diagnosis of chronic pain or chronic opioid use: Defined as pain experienced ≥3 days per week over a 6-month period or daily opioid use for pain management;
- Active infection with Human Immunodeficiency Virus (HIV), Hepatitis B, or Hepatitis C;
- Prothrombin time > 1.5 x ULN at screening;
- Required regular anticoagulation or chronic aspirin therapy;
- Moderate thrombocytopenia, defined as platelets < 80,000/µL at screening;
- History of stroke or Moyamoya syndrome;
- Abnormal results on most recent transcranial Doppler (TCD) evaluation;
- Received blood transfusion or blood products in the 2 months prior to the Screening Visit or on chronic blood transfusion;
- Chronic renal insufficiency, defined as a eGFR < 30ml/min at screening as estimated by the Schwartz equation (Appendix H), or requiring peritoneal or hemodialysis;
- Abnormal liver function tests (ALT > 3.0 x ULN) at screening;
- Received any organ transplant;
- Has a recent acute illness or other concomitant chronic medical or psychiatric condition that in the opinion of the Investigator would compromise participation in the study, prevent adherence to the protocol or confound the evaluation of the study outcome;
- Is pregnant or lactating, or has the intention of becoming pregnant during the study (if a female of child-bearing potential or partner of a female of child-bearing potential and sexually active and not willing to use an effective means of birth control);
- Is currently taking or has been treated with any form of omega-3 fatty acid or fish oil supplement within 30 days of the Screening Visit, or intends to do so during the course of the study;
- Has been treated with any investigational product within 30 days of the Screening Visit or intends to receive an investigational product during the course of this study; and
- There are factors that, in the judgment of the Investigator, would make it difficult for the patient to comply with the requirements of the study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
SC411
Placebo
Arm Description
Omega-3 docosahexaenoic acid, soft gelatin capsule, administered once a day on a per weight basis.
Soybean oil, soft gelatin capsule, administered once a day on a per weight basis.
Outcomes
Primary Outcome Measures
Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
The primary objective of this study is to assess the efficacy of orally administered SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects compared to placebo. A SCC event will be defined as either an acute painful crisis or an acute chest syndrome.
Secondary Outcome Measures
Evaluation of the effect of SC411 compared to placebo by measuring the time until the patient's first sickle cell event.
Evaluation of days to the first event from randomization for each patient.
Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
Evaluation of the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
To evaluate the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
Evaluation of the effect of SC411 compared to placebo by measuring the number of crisis-free days.
To evaluate the effect of SC411 compared to placebo by measuring the number of crisis-free days. A crisis-free day is defined as any day with a zero entry on the eDiary pain intensity scale.
Full Information
NCT ID
NCT02604368
First Posted
November 11, 2015
Last Updated
January 30, 2019
Sponsor
Micelle BioPharma Inc
1. Study Identification
Unique Protocol Identification Number
NCT02604368
Brief Title
A Sickle CEll Disease ComplicatioN Trial
Acronym
ASCENT
Official Title
A Phase 3, Prospective, Randomized, Double-Blind, Placebo Controlled, Multi-center Study of SC411 for Sickle Cell Disease
Study Type
Interventional
2. Study Status
Record Verification Date
January 2019
Overall Recruitment Status
Unknown status
Study Start Date
March 2019 (Anticipated)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Micelle BioPharma Inc
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of this study is to assess the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects receiving SC411 compared to those subjects receiving placebo.
Detailed Description
This Phase 3, prospective, randomized, double-blinded, placebo-controlled, multi-center study will enroll approximately 210 subjects at up to 70 sites in the United States. Participation will consist of a Screening Period, followed by a minimum 12-month Treatment Period. SC411 is administered orally as a soft gel mini capsule.
This study will enroll subjects aged ≥5 to ≤17 years who have a diagnosis of SCD that includes the phenotypes hemoglobin SS homozygous (HbSS), hemoglobin SC (HbSC), and hemoglobin S/β°-thalassemia (HbS/ β°-thalassemia); and have had at least 2 but no more than 10 documented SCC events (as defined above) within 12 months prior to the Screening Visit.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sickle Cell Disease
Keywords
hemoglobin SS, hemoglobin SC, hemoglobin S/β°-thalassemia
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
210 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
SC411
Arm Type
Experimental
Arm Description
Omega-3 docosahexaenoic acid, soft gelatin capsule, administered once a day on a per weight basis.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Soybean oil, soft gelatin capsule, administered once a day on a per weight basis.
Intervention Type
Drug
Intervention Name(s)
SC411
Other Intervention Name(s)
Docosahexaenoic acid (DHA)
Intervention Description
Soft gelatin capsule
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Soybean Oil
Intervention Description
Soft gelatin capsule
Primary Outcome Measure Information:
Title
Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
Description
Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
The primary objective of this study is to assess the efficacy of orally administered SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects compared to placebo. A SCC event will be defined as either an acute painful crisis or an acute chest syndrome.
Time Frame
52 weeks
Secondary Outcome Measure Information:
Title
Evaluation of the effect of SC411 compared to placebo by measuring the time until the patient's first sickle cell event.
Description
Evaluation of days to the first event from randomization for each patient.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
Description
Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of crisis-free days.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of crisis-free days. A crisis-free day is defined as any day with a zero entry on the eDiary pain intensity scale.
Time Frame
52 weeks
Other Pre-specified Outcome Measures:
Title
Evaluation of the effect of SC411 compared to placebo by measuring the time to second SCC event among subjects who had experienced at least one crisis while enrolled in the study.
Description
To evaluate the effect of SC411 compared to placebo by measuring the time to second SCC event among subjects who had experienced at least one crisis while enrolled in the study.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of complications of SCD.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of complications of SCD.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the Parent/guardian eDiary-recorded school attendance.
Description
To evaluate the effect of SC411 compared to placebo by measuring the Parent/guardian eDiary-recorded school attendance.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the percent of days free of eDiary-recorded sickle cell pain out of total number of Treatment Period days.
Description
To evaluate the effect of SC411 compared to placebo by measuring the percent of days free of eDiary-recorded sickle cell pain out of total number of Treatment Period days.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score on the days that pain is recorded analyzed over time for intensity and diminution.
Description
To evaluate the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score (scale from 0-10) on the days that pain is recorded analyzed over time for intensity and diminution.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score on the days during a SCC event analyzed over time for intensity and diminution.
Description
To evaluate the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score (from 0-10) on the days during a SCC event analyzed over time for intensity and diminution.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of hospitalization days due to SCC events.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of hospitalization days due to SCC events.
-
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of hospitalizations due to SCC events.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of hospitalizations due to SCC events.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of acute painful crisis events.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of acute painful crisis events.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of acute chest syndrome events.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of acute chest syndrome events.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the number of simple and exchange blood transfusions.
Description
To evaluate the effect of SC411 compared to placebo by measuring the number of simple and exchange blood transfusions.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in hemoglobin.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in hemoglobin.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in hematocrit.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in hematocrit.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in hemoglobin phenotype.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in hemoglobin phenotype.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in white blood cells.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in white blood cells.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in blood platelets.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in blood platelets.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in the RBC membrane omega-3 fatty acids index.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in the RBC membrane omega-3 fatty acids index (arachidonic acid, docosahexaenoic acid, and eicosapentaenoic acid).
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in the reticulocyte count.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in the reticulocyte count.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in lactate dehydrogenase.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in lactate dehydrogenase.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in haptoglobin.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in haptoglobin.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in indirect bilirubin.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in indirect bilirubin.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in high sensitivity C-reactive protein.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in high sensitivity C-reactive protein.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in D-dimer.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in D-dimer.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in whole blood adhesion to vascular cell adhesion molecule-1.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in whole blood adhesion to vascular cell adhesion molecule-1.
Time Frame
52 weeks
Title
Evaluation of the effect of SC411 compared to placebo by measuring the changes in E-selectin.
Description
To evaluate the effect of SC411 compared to placebo by measuring the changes in E-selectin.
Time Frame
52 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
5 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients who meet all of the following criteria will be eligible to participate in the study:
1. Aged ≥ 5 years and ≤ 17 years at screening;
Has been diagnosed with SCD (that includes the genotypes HbSS, HbSC, and HbS/β°-thalassemia, documented by hemoglobin HPLC or electrophoresis);
Has had between ≥ 2 to ≤10 episodes of acute SCC (as defined above) within 12 months of the Screening Visit. At least one crisis must have been managed in a hospital, clinic, or emergency room. For at least 2 of the episodes, the site must obtain the documentation created in a medical record at the time of the event.
Must not be receiving HU or L-Glutamine, or if receiving HU and/or L-Glutamine must be at a stable weight-based treatment regimen (mg/kg), for at least 3 months prior to the Screening Visit with the intent to continue at a weight-based dose level at the discretion of the treating physician for the duration of the study, other than for safety reasons. If taking HU and/or L-glutamine, subjects must have had at least one SCC event (as previously defined) while on HU and/or L-Glutamine.
Has a parent or guardian who is able to give written informed consent, and the potential pediatric subject must be able to provide assent in a manner approved by the Institutional Review Board (IRB) and comply with the requirements of the study; and
If post pubertal in the opinion of the Investigator, must agree to use a reliable method of birth control (e.g., barrier, birth control pills, abstinence) during the study and for 1 month following the last dose of study drug.
Exclusion Criteria
Patients who meet any of the following criteria will be excluded from participation in the study:
A known allergy or hypersensitivity to fish or shellfish;
A known allergy or hypersensitivity to soy;
Inability to swallow capsules;
History of treatment with SC411;
Confirmed diagnosis of chronic pain or chronic opioid use: Defined as pain experienced ≥3 days per week over a 6-month period or daily opioid use for pain management;
Active infection with Human Immunodeficiency Virus (HIV), Hepatitis B, or Hepatitis C;
Prothrombin time > 1.5 x ULN at screening;
Required regular anticoagulation or chronic aspirin therapy;
Moderate thrombocytopenia, defined as platelets < 80,000/µL at screening;
History of stroke or Moyamoya syndrome;
Abnormal results on most recent transcranial Doppler (TCD) evaluation;
Received blood transfusion or blood products in the 2 months prior to the Screening Visit or on chronic blood transfusion;
Chronic renal insufficiency, defined as a eGFR < 30ml/min at screening as estimated by the Schwartz equation (Appendix H), or requiring peritoneal or hemodialysis;
Abnormal liver function tests (ALT > 3.0 x ULN) at screening;
Received any organ transplant;
Has a recent acute illness or other concomitant chronic medical or psychiatric condition that in the opinion of the Investigator would compromise participation in the study, prevent adherence to the protocol or confound the evaluation of the study outcome;
Is pregnant or lactating, or has the intention of becoming pregnant during the study (if a female of child-bearing potential or partner of a female of child-bearing potential and sexually active and not willing to use an effective means of birth control);
Is currently taking or has been treated with any form of omega-3 fatty acid or fish oil supplement within 30 days of the Screening Visit, or intends to do so during the course of the study;
Has been treated with any investigational product within 30 days of the Screening Visit or intends to receive an investigational product during the course of this study; and
There are factors that, in the judgment of the Investigator, would make it difficult for the patient to comply with the requirements of the study
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Uche Sampson, MD
Phone
615-678-2336
Email
usampson@micellebio.com
First Name & Middle Initial & Last Name or Official Title & Degree
George Steinfels, PhD
Phone
301-742-5656
Email
gsteinfels@micellebio.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carton Dampier, MD
Organizational Affiliation
Emory University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Matt Heeney, MD
Organizational Affiliation
Harvard University
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Beng Fuh, MD
Organizational Affiliation
East Carolina University
Official's Role
Study Chair
12. IPD Sharing Statement
Learn more about this trial
A Sickle CEll Disease ComplicatioN Trial
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