Isoquercetin in Sickle Cell Anemia
Primary Purpose
Sickle Cell Disease, Sickle Cell-Beta0-Thalassemia
Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Isoquercetin
Sponsored by
About this trial
This is an interventional treatment trial for Sickle Cell Disease focused on measuring Sickle Cell Disease, Sickle Cell-Beta0-Thalassemia, isoquercetin
Eligibility Criteria
Inclusion Criteria:
- Eligible subjects require an established diagnosis of sickle cell disease/homozygous hemoglobin S (SCD-SS) or sickle cell disease hemoglobin β0-thalassemia (SCD-Sβ0-thal).
- Patients on other therapy including hydroxyurea will be included.
- Age 18-50 years.
Participants must have preserved organ and marrow function as defined below:
- leukocytes ≥2,000/mcL
- platelets ≥75,000/mcL
- AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal
- Estimated creatinine clearance ≥45 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
- Subjects with no evidence of worsening over the last 4 weeks (e.g. any acute complication of SCD including but not limited to VOC, acute chest syndrome and stroke, that required unscheduled medical attention or intervention) as determined by the investigator will be included.
- Patients on anticoagulation therapy will be excluded.
- The effects of isoquercetin on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of isoquercetin administration.
- Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
- Please ensure exclusion criteria are clearly worded to describe participants who will not be eligible.
- Participants may not be concurrently receiving any other study agents.
- Subjects with no evidence of worsening over the last 1 month (e.g. any acute complication of SCD including but not limited to VOC, acute chest syndrome and stroke, that required unscheduled medical attention or intervention) as determined by the investigator will be included.
- Familial bleeding diathesis.
- Known diagnosis of disseminated intravascular coagulation.
- Currently receiving anticoagulant therapy.
- Currently using daily use of aspirin (>81mg daily), Clopidogrel (Plavix), cilostazol (Pletal), aspirin-dipyridamole (Aggrenox) (within 10 days)
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to isoquercetin.
- Uncontrolled intercurrent illness including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, or psychiatric illness/social situations that would limit study compliance.
- Pregnant women are excluded from this study because isoquercetin is a PDI inhibitor with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk of adverse events in nursing infants secondary to treatment of the mother with isoquercetin, breastfeeding should be discontinued if the mother is treated with isoquercetin. These potential risks may also apply to other agents used in this study.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
ISOQUERCETIN
Arm Description
The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits - ISOQUERCETIN: Oral Study Drug, 1 time per day, per predetermined dosed per 28 treatment cycle. This will continue for up to 337 days.
Outcomes
Primary Outcome Measures
Change in sP Selectin levels with isoquercetin
Comparisons between baseline and follow-up measurements (i.e. change in sP-Selectin), will be performed using a two-tailed, paired t-test analyses.
Secondary Outcome Measures
Platelet dependent thrombin generation (coagulation)
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
sE-selectin (adhesion)-Biomarker
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
C-reactive protein CRP
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
Number of Participants With Treatment-Related Adverse Events
Sickle cell events such as SCPC, uncomplicated pain crisis, hospitalizations, emergency room visits, transfusions, acute chest syndrome and transfusion support will be summarized as annualized numbers. Statistical comparisons will be made for each patient relative to the number from the previous year using a Wilcoxon rank-sum test.
Full Information
NCT ID
NCT04474626
First Posted
July 6, 2020
Last Updated
January 7, 2021
Sponsor
Jeffrey Zwicker, MD
Collaborators
Quercegen Pharmaceuticals
1. Study Identification
Unique Protocol Identification Number
NCT04474626
Brief Title
Isoquercetin in Sickle Cell Anemia
Official Title
Single-arm Phase 2 Study of Oral Isoquercetin in Sickle Cell Disease
Study Type
Interventional
2. Study Status
Record Verification Date
January 2021
Overall Recruitment Status
Withdrawn
Why Stopped
Trial did not activate
Study Start Date
December 2020 (Anticipated)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Jeffrey Zwicker, MD
Collaborators
Quercegen Pharmaceuticals
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
This research study is being done to assess the safety and effectiveness of isoquercetin to reduce levels of soluble P-Selectin in patients with sickle cell disease. Isoquercetin is a naturally occurring flavonoid-or vitamin. You will find quercetin and isoquercetin in fruits and vegetables.
The names of the study drug involved in this study are/is:
- Isoquercetin
Detailed Description
This is a single-arm phase 2 study in adults with Sickle Cell Disease (SCD) to assess the effect of oral isoquercetin on biomarkers of endothelial and platelet activation, inflammation and ongoing blood coagulation.
The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits.
The names of the study drug involved in this study are/is: Isoquercetin
Participants will receive study treatment for 1 year and will be followed for 30 days after the last dose.
This research study is a Phase II clinical trial. Phase II clinical trials test the safety and effectiveness of an investigational drug to learn whether the drug works in treating a specific disease. "Investigational" means that the drug is being studied.
The U.S. Food and Drug Administration (FDA) has not approved isoquercetin as a treatment for any disease.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sickle Cell Disease, Sickle Cell-Beta0-Thalassemia
Keywords
Sickle Cell Disease, Sickle Cell-Beta0-Thalassemia, isoquercetin
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ISOQUERCETIN
Arm Type
Experimental
Arm Description
The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits
- ISOQUERCETIN: Oral Study Drug, 1 time per day, per predetermined dosed per 28 treatment cycle.
This will continue for up to 337 days.
Intervention Type
Drug
Intervention Name(s)
Isoquercetin
Other Intervention Name(s)
IQC-950AN
Intervention Description
Oral, 1 time per day, per predetermined dosed per 28 treatment cycle.
Primary Outcome Measure Information:
Title
Change in sP Selectin levels with isoquercetin
Description
Comparisons between baseline and follow-up measurements (i.e. change in sP-Selectin), will be performed using a two-tailed, paired t-test analyses.
Time Frame
baseline to 28 Days
Secondary Outcome Measure Information:
Title
Platelet dependent thrombin generation (coagulation)
Description
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
Time Frame
baseline to 1 year
Title
sE-selectin (adhesion)-Biomarker
Description
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
Time Frame
baseline to 1 year
Title
C-reactive protein CRP
Description
Laboratory values at baseline and subsequent monthly follow-up time points will be modeled using linear mixed effects regression with an autoregressive covariance structure.
Time Frame
baseline to 1 year
Title
Number of Participants With Treatment-Related Adverse Events
Description
Sickle cell events such as SCPC, uncomplicated pain crisis, hospitalizations, emergency room visits, transfusions, acute chest syndrome and transfusion support will be summarized as annualized numbers. Statistical comparisons will be made for each patient relative to the number from the previous year using a Wilcoxon rank-sum test.
Time Frame
start of study treatment up to 13 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Eligible subjects require an established diagnosis of sickle cell disease/homozygous hemoglobin S (SCD-SS) or sickle cell disease hemoglobin β0-thalassemia (SCD-Sβ0-thal).
Patients on other therapy including hydroxyurea will be included.
Age 18-50 years.
Participants must have preserved organ and marrow function as defined below:
leukocytes ≥2,000/mcL
platelets ≥75,000/mcL
AST(SGOT)/ALT(SGPT) ≤2.5 × institutional upper limit of normal
Estimated creatinine clearance ≥45 mL/min/1.73 m2 for participants with creatinine levels above institutional normal.
Subjects with no evidence of worsening over the last 4 weeks (e.g. any acute complication of SCD including but not limited to VOC, acute chest syndrome and stroke, that required unscheduled medical attention or intervention) as determined by the investigator will be included.
Patients on anticoagulation therapy will be excluded.
The effects of isoquercetin on the developing human fetus are unknown. For this reason, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 4 months after completion of isoquercetin administration.
Ability to understand and the willingness to sign a written informed consent document
Exclusion Criteria:
Please ensure exclusion criteria are clearly worded to describe participants who will not be eligible.
Participants may not be concurrently receiving any other study agents.
Subjects with no evidence of worsening over the last 1 month (e.g. any acute complication of SCD including but not limited to VOC, acute chest syndrome and stroke, that required unscheduled medical attention or intervention) as determined by the investigator will be included.
Familial bleeding diathesis.
Known diagnosis of disseminated intravascular coagulation.
Currently receiving anticoagulant therapy.
Currently using daily use of aspirin (>81mg daily), Clopidogrel (Plavix), cilostazol (Pletal), aspirin-dipyridamole (Aggrenox) (within 10 days)
History of allergic reactions attributed to compounds of similar chemical or biologic composition to isoquercetin.
Uncontrolled intercurrent illness including but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina, cardiac arrhythmia, or psychiatric illness/social situations that would limit study compliance.
Pregnant women are excluded from this study because isoquercetin is a PDI inhibitor with the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk of adverse events in nursing infants secondary to treatment of the mother with isoquercetin, breastfeeding should be discontinued if the mother is treated with isoquercetin. These potential risks may also apply to other agents used in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jeffrey Zwicker, MD
Organizational Affiliation
Beth Israel Deaconess Medical Center
Official's Role
Principal Investigator
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to Sponsor Investigator or designee. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
IPD Sharing Time Frame
Data can be shared no earlier than 1 year following the date of publication
IPD Sharing Access Criteria
BIDMC - Contact the Beth Israel Deaconess Medical Center Technology Ventures Office at tvo@bidmc.harvard.edu
Learn more about this trial
Isoquercetin in Sickle Cell Anemia
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