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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Withdrawn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
Jeffrey Zwicker, MD
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, Sickle Cell-Beta0-Thalassemia, isoquercetin

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

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

    First Posted
    July 6, 2020
    Last Updated
    January 7, 2021
    Sponsor
    Jeffrey Zwicker, MD
    Collaborators
    Quercegen Pharmaceuticals
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    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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