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Dose Escalation Study to Evaluate the Safety, Tolerability, PK and PD of Voxelotor in Patients With SCD

Primary Purpose

Sickle Cell Disease

Status
Terminated
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Voxelotor
Sponsored by
Global Blood Therapeutics
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, SCD

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female with SCD
  2. Documentation of SCD genotype HbSS or HbSB0
  3. Age 18 to < 60 years, inclusive
  4. Hemoglobin ≥ 5.5 and ≤ 10.5 g/dL during Screening, and considered stable and close to Baseline by the Investigator
  5. For participants taking HU, the dose in mg/kg must be stable for at least 90 days prior to signing the informed consent form (ICF) and with no anticipated need for dose adjustments during the study, in the opinion of the Investigator.
  6. Participants, who if female and of child-bearing potential, agree to use highly effective methods of contraception or practicing abstinence from study start to 30 days after the last dose of study drug, and who if male, agree to use barrier methods of contraception or practice abstinence from study start to 30 days after the last dose of study drug
  7. Participant has provided documented informed consent

Exclusion Criteria:

  1. More than 10 VOCs within 12 months of screening that required a hospital, emergency room, or clinic visit
  2. Female participant who is breast feeding or pregnant
  3. Receiving regularly scheduled blood (RBC) transfusion therapy (also termed chronic, prophylactic, or preventive transfusion) or have received an RBC transfusion for any reason within 60 days of signing the ICF or at any time during the Screening Period
  4. Hospitalized for sickle cell crisis or other vaso-occlusive event within 30 days prior to dosing (ie, a vaso-occlusive event cannot be within 30 days prior to dosing)
  5. Screening laboratory test of alanine aminotransferase (ALT) > 4 × upper level of normal (ULN)
  6. Clinically significant bacterial, fungal, parasitic, or viral infection which requires therapy, including acute bacterial infection requiring antibiotics
  7. Known to be COVID-19 positive from within 3 weeks of screening through Day 1
  8. Participants with active hepatitis A, B, or C or who are known to be human immunodeficiency virus (HIV) positive
  9. Severe renal dysfunction (estimated glomerular filtration rate < 30 mL/min/1.73 m2 at the Screening visit; calculated by the local laboratory to assess safety) or is on chronic dialysis
  10. History of malignancy within the past 2 years prior to treatment Day 1 requiring chemotherapy and/or radiation (with the exception of local therapy for non-melanoma skin malignancy)
  11. History of unstable or deteriorating cardiac or pulmonary disease within 6 months prior to consent including but not limited to the following:

    1. Unstable angina pectoris or myocardial infarction or elective coronary intervention
    2. Congestive heart failure requiring hospitalization
    3. Uncontrolled clinically significant arrhythmias
    4. Pulmonary hypertension
  12. Criteria related to ECG parameters:

    1. PR interval > 220 msec in any participant
    2. QRS interval > 120 msec or QT interval corrected using Fridericia's formula (QTcF) > 480 msec (both genders) in participants without bundle branch block
    3. QRS interval > 120 msec in participants with newly (within 3 months) emerged bundle branch block
    4. A participant with stable bundle branch block with or without stable cardiac disease may be enrolled; QRS interval > 120 msec and QTcF interval > 480 msec are acceptable in these participants.
  13. Any condition affecting drug absorption, such as major surgery involving the stomach or small intestine (prior cholecystectomy is acceptable)
  14. Participated in another clinical trial of an investigational agent or medical device within 30 days or 5 half-lives of date of informed consent, whichever is longer, or is currently participating in another trial of an investigational agent or medical device
  15. Inadequate venous access as determined by the Investigator/site staff
  16. Medical, psychological, or behavioral conditions, which, in the opinion of the Investigator, may preclude safe participation, confound study interpretation, interfere with compliance, or preclude informed consent
  17. Received erythropoietin or other hematopoietic growth factor treatment within 28 days of signing ICF or is anticipated to require such agents during the study
  18. Ongoing or recent (within 2 years) substance abuse
  19. Known allergy to voxelotor
  20. Use of herbal medications (eg, St. John's Wort), sensitive cytochrome P450 (CYP) 3A4 substrates with a narrow therapeutic index, strong CYP3A4 inhibitors, fluconazole, or moderate or strong CYP3A4 inducers

Sites / Locations

  • Guy's and St Thomas' NHS Foundation Trust
  • Guy's Hospital
  • Hammersmith Hospital
  • Homerton University
  • King's College Hospital
  • Royal London Hospital, Barts Health NHS Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cohort A open label

Arm Description

Participants will receive progressively higher doses of voxelotor administration starting from 1500 mg

Outcomes

Primary Outcome Measures

Treatment-emergent AEs
Treatment emergent AEs including SAEs

Secondary Outcome Measures

Change in Hb and clinical measures of hemolysis (unconjugated bilirubin, % reticulocyte, absolute reticulocyte, and lactate dehydrogenase [LDH]) from Baseline
Change in Hb
Proportion of participants with an Hb increase > 1 g/dL compared to Baseline
participants with an Hb increase > 1 g/dL compared to Baseline
Incidence rate of VOCs

Full Information

First Posted
January 21, 2020
Last Updated
August 29, 2022
Sponsor
Global Blood Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT04247594
Brief Title
Dose Escalation Study to Evaluate the Safety, Tolerability, PK and PD of Voxelotor in Patients With SCD
Official Title
A Phase 2, Open Label, Multiple Dose Escalation Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Voxelotor in Patients With Sickle Cell Disease
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Terminated
Why Stopped
Data will not inform further development of Voxelotor
Study Start Date
January 9, 2020 (Actual)
Primary Completion Date
June 8, 2021 (Actual)
Study Completion Date
June 8, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Global Blood Therapeutics

4. Oversight

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

5. Study Description

Brief Summary
Study participants will undergo up to four periods of voxelotor administered orally at progressively higher dose levels from 1500 mg until either a maximum tolerated dose (MTD) or 3000 mg/day dose is reached, whichever occurs first

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, SCD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort A open label
Arm Type
Experimental
Arm Description
Participants will receive progressively higher doses of voxelotor administration starting from 1500 mg
Intervention Type
Drug
Intervention Name(s)
Voxelotor
Intervention Description
synthetic small molecule supplied as 500 mg tablets
Primary Outcome Measure Information:
Title
Treatment-emergent AEs
Description
Treatment emergent AEs including SAEs
Time Frame
approximately 200 days
Secondary Outcome Measure Information:
Title
Change in Hb and clinical measures of hemolysis (unconjugated bilirubin, % reticulocyte, absolute reticulocyte, and lactate dehydrogenase [LDH]) from Baseline
Description
Change in Hb
Time Frame
approximately 200 days
Title
Proportion of participants with an Hb increase > 1 g/dL compared to Baseline
Description
participants with an Hb increase > 1 g/dL compared to Baseline
Time Frame
approximately 200 days
Title
Incidence rate of VOCs
Time Frame
approximately 200 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female with SCD Documentation of SCD genotype HbSS or HbSB0 Age 18 to < 60 years, inclusive Hemoglobin ≥ 5.5 and ≤ 10.5 g/dL during Screening, and considered stable and close to Baseline by the Investigator For participants taking HU, the dose in mg/kg must be stable for at least 90 days prior to signing the informed consent form (ICF) and with no anticipated need for dose adjustments during the study, in the opinion of the Investigator. Participants, who if female and of child-bearing potential, agree to use highly effective methods of contraception or practicing abstinence from study start to 30 days after the last dose of study drug, and who if male, agree to use barrier methods of contraception or practice abstinence from study start to 30 days after the last dose of study drug Participant has provided documented informed consent Exclusion Criteria: More than 10 VOCs within 12 months of screening that required a hospital, emergency room, or clinic visit Female participant who is breast feeding or pregnant Receiving regularly scheduled blood (RBC) transfusion therapy (also termed chronic, prophylactic, or preventive transfusion) or have received an RBC transfusion for any reason within 60 days of signing the ICF or at any time during the Screening Period Hospitalized for sickle cell crisis or other vaso-occlusive event within 30 days prior to dosing (ie, a vaso-occlusive event cannot be within 30 days prior to dosing) Screening laboratory test of alanine aminotransferase (ALT) > 4 × upper level of normal (ULN) Clinically significant bacterial, fungal, parasitic, or viral infection which requires therapy, including acute bacterial infection requiring antibiotics Known to be COVID-19 positive from within 3 weeks of screening through Day 1 Participants with active hepatitis A, B, or C or who are known to be human immunodeficiency virus (HIV) positive Severe renal dysfunction (estimated glomerular filtration rate < 30 mL/min/1.73 m2 at the Screening visit; calculated by the local laboratory to assess safety) or is on chronic dialysis History of malignancy within the past 2 years prior to treatment Day 1 requiring chemotherapy and/or radiation (with the exception of local therapy for non-melanoma skin malignancy) History of unstable or deteriorating cardiac or pulmonary disease within 6 months prior to consent including but not limited to the following: Unstable angina pectoris or myocardial infarction or elective coronary intervention Congestive heart failure requiring hospitalization Uncontrolled clinically significant arrhythmias Pulmonary hypertension Criteria related to ECG parameters: PR interval > 220 msec in any participant QRS interval > 120 msec or QT interval corrected using Fridericia's formula (QTcF) > 480 msec (both genders) in participants without bundle branch block QRS interval > 120 msec in participants with newly (within 3 months) emerged bundle branch block A participant with stable bundle branch block with or without stable cardiac disease may be enrolled; QRS interval > 120 msec and QTcF interval > 480 msec are acceptable in these participants. Any condition affecting drug absorption, such as major surgery involving the stomach or small intestine (prior cholecystectomy is acceptable) Participated in another clinical trial of an investigational agent or medical device within 30 days or 5 half-lives of date of informed consent, whichever is longer, or is currently participating in another trial of an investigational agent or medical device Inadequate venous access as determined by the Investigator/site staff Medical, psychological, or behavioral conditions, which, in the opinion of the Investigator, may preclude safe participation, confound study interpretation, interfere with compliance, or preclude informed consent Received erythropoietin or other hematopoietic growth factor treatment within 28 days of signing ICF or is anticipated to require such agents during the study Ongoing or recent (within 2 years) substance abuse Known allergy to voxelotor Use of herbal medications (eg, St. John's Wort), sensitive cytochrome P450 (CYP) 3A4 substrates with a narrow therapeutic index, strong CYP3A4 inhibitors, fluconazole, or moderate or strong CYP3A4 inducers
Facility Information:
Facility Name
Guy's and St Thomas' NHS Foundation Trust
City
London
Country
United Kingdom
Facility Name
Guy's Hospital
City
London
Country
United Kingdom
Facility Name
Hammersmith Hospital
City
London
Country
United Kingdom
Facility Name
Homerton University
City
London
Country
United Kingdom
Facility Name
King's College Hospital
City
London
Country
United Kingdom
Facility Name
Royal London Hospital, Barts Health NHS Trust
City
London
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Dose Escalation Study to Evaluate the Safety, Tolerability, PK and PD of Voxelotor in Patients With SCD

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