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Omega-3 Fatty Acids in Sickle Cell Disease

Primary Purpose

Sickle Cell Disease

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
SCD-Omegatex™
Sponsored by
Robin E. Miller
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sickle Cell Disease focused on measuring Sickle Cell Disease, omega-3 fatty acids, Docosahexaenoic Acid (DHA), Eicosapentaenoic Acid (EPA)

Eligibility Criteria

8 Years - 25 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects who meet all of the following criteria are eligible for enrollment into the study:

  • Participant has signed the informed consent/assent with parent signing informed consent as age appropriate.
  • Established diagnosis of HbSS, HbSC or HbSβo Thalassemia
  • History of ≥1 vasoocclusive events (managed at home and/or in hospital) in preceding 12 months.
  • Regular compliance with comprehensive care.
  • Aged 8 years or greater and less than 26 years.
  • At enrollment, subject should be in his/her baseline steady state and not in the midst of any acute complication due to SCD. Must be at least 2 weeks from infection or vasoocclusive crisis at time of screening labs

Exclusion Criteria:

  • Baseline hemoglobin levels <5.5 gm/dL.
  • Inability to swallow capsules
  • Poor compliance with previous treatment regimens.
  • Hepatic dysfunction
  • Renal dysfunction
  • PT and/or PTT ≥ 20% outside of normal
  • Allergy to fish, shell fish or soy
  • Triglyceride levels <80mg/dL.
  • Pregnancy.
  • Chronic Transfusion Therapy.
  • Transfusion within the last 30 days.
  • Treatment with any investigational drug or regular fish oil supplementations in last 60 days.
  • Currently receiving another investigational agent, or on such an agent with the last 60 days.
  • Dosage changes in preceding 3 months if on hydroxyurea
  • Diagnosed bleeding disorder or patient on concomitant anti-coagulation.
  • Conditional or abnormal result on most recent transcranial doppler or history of stroke.
  • Other active chronic illness that could adversely affect subjects performance
  • Children in Care
  • Platelet count less than 100,000

Sites / Locations

  • Nemours/Alfred I duPont Hospital for Children

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SCD-Omegatex™

Arm Description

single arm

Outcomes

Primary Outcome Measures

Clinical Safety, in a Dose Escalation Trial of SCD-Omegatex™ as Evidenced by an Absence of Adverse Events.
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Determine Whether 6 Months of Supplementation With SCD-Omegatex™ Will Reduce Thermal Sensitivity by Quantitative Sensory Testing to Below Pre-treatment Levels
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.

Secondary Outcome Measures

Health-associated Quality of Life
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Number of Days With Pain Measured by iPad Daily Report Pain Calendar
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Changes in Individual Thermal Sensitivity Thresholds by QST
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.

Full Information

First Posted
October 18, 2016
Last Updated
September 22, 2020
Sponsor
Robin E. Miller
Collaborators
National Institute of General Medical Sciences (NIGMS), Thomas Jefferson University, Solutex GC S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT02947100
Brief Title
Omega-3 Fatty Acids in Sickle Cell Disease
Official Title
Phase I/II Safety and Dose Escalation Trial of the Omega-3 Fatty Acids Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA) in Children and Young Adults With Sickle Cell Disease (SCD)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Terminated
Why Stopped
manufacturing problem with study drug
Study Start Date
January 25, 2018 (Actual)
Primary Completion Date
October 5, 2018 (Actual)
Study Completion Date
October 15, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Robin E. Miller
Collaborators
National Institute of General Medical Sciences (NIGMS), Thomas Jefferson University, Solutex GC S.L.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the safety of a new formulation of the omega-3 fatty acids Docosahexaenoic Acid (DHA) and Eicosapentaenoic Acid (EPA) and to assess whether it decreases inflammation and inflammatory pain in children and young adults with Sickle Cell Disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sickle Cell Disease
Keywords
Sickle Cell Disease, omega-3 fatty acids, Docosahexaenoic Acid (DHA), Eicosapentaenoic Acid (EPA)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SCD-Omegatex™
Arm Type
Experimental
Arm Description
single arm
Intervention Type
Drug
Intervention Name(s)
SCD-Omegatex™
Other Intervention Name(s)
Enteric Fish Oil 250 DHA/27 EPA Soft Gelatin Capsule
Intervention Description
Subjects will receive SCD-Omegatex™ (Enteric Fish Oil 250 DHA/27 EPA Soft Gelatin Capsule, 450 mg) at one of two daily doses, orally, once a day for 6 months. The trial will follow a "3+3" design using two dose levels. In the phase I portion, subjects will be treated with a dose of 25 mg/kg/day DHA and EPA. If this is tolerated without dose limiting toxicity (DLT), a subsequent cohort of patients will be treated at a dose of 37.5 mg/kg/day with a maximum total daily dose of 4 grams. Once a maximum tolerated dose (MTD) is determined, subjects on the phase II portion of the study will be treated at that dose.
Primary Outcome Measure Information:
Title
Clinical Safety, in a Dose Escalation Trial of SCD-Omegatex™ as Evidenced by an Absence of Adverse Events.
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months with continuous monitoring
Title
Determine Whether 6 Months of Supplementation With SCD-Omegatex™ Will Reduce Thermal Sensitivity by Quantitative Sensory Testing to Below Pre-treatment Levels
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Health-associated Quality of Life
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Number of Days With Pain Measured by iPad Daily Report Pain Calendar
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
8 months
Title
Changes in Individual Thermal Sensitivity Thresholds by QST
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
8 months
Other Pre-specified Outcome Measures:
Title
Thrombin Generation as Assessed by Calibrated Automated Thrombogram
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
High Sensitivity C-reactive Protein (mg/L)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Lipidomic Analysis
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Urine Resolvin D1 (pg/mg Creatinine)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Levels of Lactate Dehydrogenase (IU/L)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Fetal Hemoglobin (%)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Analysis of Pro and Anti-inflammatory Cytokines in Plasma Including Interleukin (IL)1-beta, IL-4, IL-6, IL-8, IL-10 and Tumor Necrosis Factor (TNF) Alpha ( pg/ml)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Endothelin-1(pg/ml)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Levels Soluble Vascular Adhesion Molecule -1 (VCAM-1) (ng/ml)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Levels of Soluble P-selectin (ng/ml)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Plasma Levels of Soluble L-selectin (ng/ml)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months
Title
Hemostatic Markers in Plasma Including D-dimers and Prothrombin Fragment 1.2 (Nmol/L)
Description
No results are available from any outcome measures as study was stopped early due to manufacturing issues with study drug and will not be reopened.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
25 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who meet all of the following criteria are eligible for enrollment into the study: Participant has signed the informed consent/assent with parent signing informed consent as age appropriate. Established diagnosis of HbSS, HbSC or HbSβo Thalassemia History of ≥1 vasoocclusive events (managed at home and/or in hospital) in preceding 12 months. Regular compliance with comprehensive care. Aged 8 years or greater and less than 26 years. At enrollment, subject should be in his/her baseline steady state and not in the midst of any acute complication due to SCD. Must be at least 2 weeks from infection or vasoocclusive crisis at time of screening labs Exclusion Criteria: Baseline hemoglobin levels <5.5 gm/dL. Inability to swallow capsules Poor compliance with previous treatment regimens. Hepatic dysfunction Renal dysfunction PT and/or PTT ≥ 20% outside of normal Allergy to fish, shell fish or soy Triglyceride levels <80mg/dL. Pregnancy. Chronic Transfusion Therapy. Transfusion within the last 30 days. Treatment with any investigational drug or regular fish oil supplementations in last 60 days. Currently receiving another investigational agent, or on such an agent with the last 60 days. Dosage changes in preceding 3 months if on hydroxyurea Diagnosed bleeding disorder or patient on concomitant anti-coagulation. Conditional or abnormal result on most recent transcranial doppler or history of stroke. Other active chronic illness that could adversely affect subjects performance Children in Care Platelet count less than 100,000
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robin E Miller, MD
Organizational Affiliation
Nemours Children's Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nemours/Alfred I duPont Hospital for Children
City
Wilmington
State/Province
Delaware
ZIP/Postal Code
19899
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
23193009
Citation
Daak AA, Ghebremeskel K, Hassan Z, Attallah B, Azan HH, Elbashir MI, Crawford M. Effect of omega-3 (n-3) fatty acid supplementation in patients with sickle cell anemia: randomized, double-blind, placebo-controlled trial. Am J Clin Nutr. 2013 Jan;97(1):37-44. doi: 10.3945/ajcn.112.036319. Epub 2012 Nov 28.
Results Reference
background
PubMed Identifier
17090225
Citation
Serhan CN. Resolution phase of inflammation: novel endogenous anti-inflammatory and proresolving lipid mediators and pathways. Annu Rev Immunol. 2007;25:101-37. doi: 10.1146/annurev.immunol.25.022106.141647.
Results Reference
background
PubMed Identifier
25149823
Citation
Calder PC. Marine omega-3 fatty acids and inflammatory processes: Effects, mechanisms and clinical relevance. Biochim Biophys Acta. 2015 Apr;1851(4):469-84. doi: 10.1016/j.bbalip.2014.08.010. Epub 2014 Aug 20.
Results Reference
background
PubMed Identifier
11434703
Citation
Tomer A, Kasey S, Connor WE, Clark S, Harker LA, Eckman JR. Reduction of pain episodes and prothrombotic activity in sickle cell disease by dietary n-3 fatty acids. Thromb Haemost. 2001 Jun;85(6):966-74.
Results Reference
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Omega-3 Fatty Acids in Sickle Cell Disease

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