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Voxelotor Neurocognitive Function Study

Primary Purpose

Sickle Cell Disease

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Voxelotor Only Product in Oral Dose Form
Placebo
Sponsored by
Pfizer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sickle Cell Disease

Eligibility Criteria

8 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female participants with confirmed diagnosis of SCD (all genotypes). Documentation of SCD genotype is required and may be based on documented history of laboratory testing or confirmed by laboratory testing during Screening.
  2. Aged 8 to < 18 years.
  3. Screening Hb level 5.5 to 10.5 g/dL.
  4. Able to answer NIH Toolbox Module questions validated and normed based on age and maternal education on tablet.
  5. If participant is receiving HU they must have been on a stable dose for at least 90 days prior to signing the ICF/AF, with no dose modifications or initiation of HU planned or anticipated by the Investigator.
  6. If participant is receiving erythropoiesis-stimulating agents (ESAs) they must have been on a stable dose for at least 12 weeks before enrollment with no dose modifications planned or anticipated by the Investigator.
  7. Participants, who if female and of child-bearing potential, agree to use highly effective methods of contraception from study start to 30 days after the last dose of study drug and who if male, agree to use barrier methods of contraception and refrain from donating sperm from study start to 30 days after the last dose of study drug.
  8. Females of child-bearing potential must have a negative pregnancy test before the administration of study drug.
  9. Parental/guardian consent and participant assent (between ≥ 12 and < 18 years) per Institutional Review Board (IRB)/Independent ethics committee (IEC) policy and requirements, consistent with International Council for Harmonisation (ICH) guidelines.
  10. Capable of complying with the requirements and restrictions in the protocol, and willing to participate in the study.

Exclusion Criteria:

  1. Receiving chronic transfusion therapy.
  2. Red blood cell (RBC) transfusion within 3 months before initiation of study drug or receives scheduled RBC transfusion therapy (also termed chronic, prophylactic, or preventive transfusion).
  3. History of overt stroke including hemorrhagic stroke or transient ischemic attack (TIA) or spinal cord injury, magnetic resonance angiography (MRA)-defined vasculopathy, or magnetic resonance imaging (MRI)/transcranial doppler (TCD)-documented silent cerebral infarcts.
  4. Congenital brain malformation, previously diagnosed severe developmental disability (eg, autism and/or intelligence quotient [IQ] < 60, and/or severe attention deficit hyperactivity disorder [ADHD]), or impairment that would prevent the use of a computer tablet.
  5. Participant is taking or has received voxelotor (Oxbryta®) within 90 days prior to the Screening Visit.
  6. Surgery within 8 weeks before Day 1 or planned elective surgery during the study.
  7. Anemia due to bone marrow failure (eg, myelodysplasia).
  8. Absolute reticulocyte count (ARC) < 100 × 10^9/L.
  9. Screening alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 4× upper limit of normal (ULN).
  10. Severe renal dysfunction (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m^2) or is on chronic dialysis.
  11. Clinically significant bacterial, fungal, parasitic, or viral infection which requires therapy.

    1. Patients with acute bacterial infection requiring antibiotic use should delay screening /enrollment until the course of antibiotic therapy has been completed.
    2. Patients with known active hepatitis A, B, or C or who are known to be human immunodeficiency virus (HIV) positive.
  12. Symptomatic coronavirus disease of 2019 (COVID-19) infection.
  13. Females who are breast-feeding or pregnant.
  14. History of hematopoietic stem cell transplant or gene therapy.
  15. Participants taking concomitant medications such as sensitive cytochrome P450 (CYP)3A4 substrates with a narrow therapeutic range, or strong CYP3A4 inducers
  16. Participated in another clinical trial of an investigational product (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 product (or medical device).
  17. Medical, psychological, or behavioral condition that, in the opinion of the Investigator, would confound or interfere with evaluation of safety and/or efficacy of the study drug, prevent compliance with the study protocol; preclude informed consent; or, render the participant unable/unlikely to comply with the study procedures.

Sites / Locations

  • University of Maryland Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Active Drug

Placebo

Arm Description

Voxelotor 1500mg or equivalent daily as a tablet or powder for oral suspension

Matching Placebo

Outcomes

Primary Outcome Measures

Change in the executive abilities composite score
Change from baseline at Week 12 in the executive abilities composite score (using Dimensional Change Card Sort Test, Flanker Inhibitory Control and Attention Test, and List Sorting Test) as assessed by the NIH Toolbox Cognition Module.

Secondary Outcome Measures

Change in processing speed
Change from baseline at Week 12 in processing speed as measured by Pattern Comparison Test score as assessed by the NIH Toolbox Cognition Module.
Change in nonexecutive cognitive abilities
Change from baseline to Week 12 in nonexecutive cognitive abilities (Picture Vocabulary Test, Oral Reading Recognition Test, and Picture Sequence Memory Test) composite score as assessed by the NIH Toolbox Cognition Module.
Change in Hb level over time
Change from baseline in Hb level over time up to Week 12
Change in clinical measures of hemolysis
Change and percent change from Baseline over time up to Week 12 in clinical measures of hemolysis, including unconjugated bilirubin, absolute reticulocyte, % reticulocytes, and lactate dehydrogenase (LDH)

Full Information

First Posted
January 10, 2022
Last Updated
July 18, 2023
Sponsor
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT05228834
Brief Title
Voxelotor Neurocognitive Function Study
Official Title
A Phase 3b, Randomized, Double-blind, Placebo-controlled, Multicenter Study to Evaluate the Treatment Effect of Voxelotor on Neurocognitive Function in Pediatric Participants 8 to < 18 Years of Age With Sickle Cell Disease
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Terminated
Why Stopped
Data will not inform further development of Voxelotor
Study Start Date
December 2, 2021 (Actual)
Primary Completion Date
October 26, 2022 (Actual)
Study Completion Date
October 26, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pfizer

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
This is a Phase 3b, randomized, double-blind, placebo-controlled, multicenter study to assess the treatment effect of voxelotor on neurocognitive function as assessed by the National Institute of Health (NIH) Toolbox Cognition Module of executive abilities in pediatric participants (8 to < 18 years) with SCD.
Detailed Description
Eligible participants will receive daily treatment with 1500 mg voxelotor or matching placebo for 12 weeks. During screening and at the end of 12 weeks participants will undergo a series of tests to measure the change in neurocognitive functions.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Sickle Cell Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active Drug
Arm Type
Experimental
Arm Description
Voxelotor 1500mg or equivalent daily as a tablet or powder for oral suspension
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching Placebo
Intervention Type
Drug
Intervention Name(s)
Voxelotor Only Product in Oral Dose Form
Intervention Description
During the Randomized Treatment Period, participants will be randomized in a 1:1 ratio to receive 1500 mg of voxelotor (or the weight-adjusted equivalent dose for participants < 12 years old), once daily (administered orally as tablets/PFOS) or matching placebo for 12 weeks in addition to ongoing standard of care (SOC) treatment.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
During the Randomized Treatment Period, participants will be randomized in a 1:1 ratio to receive 1500 mg of voxelotor (or the weight-adjusted equivalent dose for participants < 12 years old), once daily (administered orally as tablets/PFOS) or matching placebo for 12 weeks in addition to ongoing standard of care (SOC) treatment.
Primary Outcome Measure Information:
Title
Change in the executive abilities composite score
Description
Change from baseline at Week 12 in the executive abilities composite score (using Dimensional Change Card Sort Test, Flanker Inhibitory Control and Attention Test, and List Sorting Test) as assessed by the NIH Toolbox Cognition Module.
Time Frame
Baseline to Week 12
Secondary Outcome Measure Information:
Title
Change in processing speed
Description
Change from baseline at Week 12 in processing speed as measured by Pattern Comparison Test score as assessed by the NIH Toolbox Cognition Module.
Time Frame
Baseline to Week 12
Title
Change in nonexecutive cognitive abilities
Description
Change from baseline to Week 12 in nonexecutive cognitive abilities (Picture Vocabulary Test, Oral Reading Recognition Test, and Picture Sequence Memory Test) composite score as assessed by the NIH Toolbox Cognition Module.
Time Frame
Baseline to Week 12
Title
Change in Hb level over time
Description
Change from baseline in Hb level over time up to Week 12
Time Frame
Baseline to Week 12
Title
Change in clinical measures of hemolysis
Description
Change and percent change from Baseline over time up to Week 12 in clinical measures of hemolysis, including unconjugated bilirubin, absolute reticulocyte, % reticulocytes, and lactate dehydrogenase (LDH)
Time Frame
Baseline to Week 12
Other Pre-specified Outcome Measures:
Title
Correlation between change from baseline in Hb level and change from baseline in executive abilities composite score.
Time Frame
Baseline to Week 12
Title
Health Related Quality of Life (HRQOL) Scores
Description
HRQOL scores using: - Patient Global Impression of Change (PGI-C)
Time Frame
Baseline to Week 12
Title
Health Related Quality of Life (HRQOL) Scores
Description
HRQOL scores using: - Pediatric quality of life in neurological disorders (Neuro-QOL) score
Time Frame
Baseline to Week 12
Title
Health Related Quality of Life (HRQOL) Scores
Description
HRQOL scores using: - Clinician Global Impression of Change (CGI-C)
Time Frame
Baseline to Week 12
Title
Incidence and severity of treatment emergent adverse events (AEs)
Time Frame
Baseline to Week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female participants with confirmed diagnosis of SCD (all genotypes). Documentation of SCD genotype is required and may be based on documented history of laboratory testing or confirmed by laboratory testing during Screening. Aged 8 to < 18 years. Screening Hb level 5.5 to 10.5 g/dL. Able to answer NIH Toolbox Module questions validated and normed based on age and maternal education on tablet. If participant is receiving HU they must have been on a stable dose for at least 90 days prior to signing the ICF/AF, with no dose modifications or initiation of HU planned or anticipated by the Investigator. If participant is receiving erythropoiesis-stimulating agents (ESAs) they must have been on a stable dose for at least 12 weeks before enrollment with no dose modifications planned or anticipated by the Investigator. Participants, who if female and of child-bearing potential, agree to use highly effective methods of contraception from study start to 30 days after the last dose of study drug and who if male, agree to use barrier methods of contraception and refrain from donating sperm from study start to 30 days after the last dose of study drug. Females of child-bearing potential must have a negative pregnancy test before the administration of study drug. Parental/guardian consent and participant assent (between ≥ 12 and < 18 years) per Institutional Review Board (IRB)/Independent ethics committee (IEC) policy and requirements, consistent with International Council for Harmonisation (ICH) guidelines. Capable of complying with the requirements and restrictions in the protocol, and willing to participate in the study. Exclusion Criteria: Receiving chronic transfusion therapy. Red blood cell (RBC) transfusion within 3 months before initiation of study drug or receives scheduled RBC transfusion therapy (also termed chronic, prophylactic, or preventive transfusion). History of overt stroke including hemorrhagic stroke or transient ischemic attack (TIA) or spinal cord injury, magnetic resonance angiography (MRA)-defined vasculopathy, or magnetic resonance imaging (MRI)/transcranial doppler (TCD)-documented silent cerebral infarcts. Congenital brain malformation, previously diagnosed severe developmental disability (eg, autism and/or intelligence quotient [IQ] < 60, and/or severe attention deficit hyperactivity disorder [ADHD]), or impairment that would prevent the use of a computer tablet. Participant is taking or has received voxelotor (Oxbryta®) within 90 days prior to the Screening Visit. Surgery within 8 weeks before Day 1 or planned elective surgery during the study. Anemia due to bone marrow failure (eg, myelodysplasia). Absolute reticulocyte count (ARC) < 100 × 10^9/L. Screening alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 4× upper limit of normal (ULN). Severe renal dysfunction (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m^2) or is on chronic dialysis. Clinically significant bacterial, fungal, parasitic, or viral infection which requires therapy. Patients with acute bacterial infection requiring antibiotic use should delay screening /enrollment until the course of antibiotic therapy has been completed. Patients with known active hepatitis A, B, or C or who are known to be human immunodeficiency virus (HIV) positive. Symptomatic coronavirus disease of 2019 (COVID-19) infection. Females who are breast-feeding or pregnant. History of hematopoietic stem cell transplant or gene therapy. Participants taking concomitant medications such as sensitive cytochrome P450 (CYP)3A4 substrates with a narrow therapeutic range, or strong CYP3A4 inducers Participated in another clinical trial of an investigational product (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 product (or medical device). Medical, psychological, or behavioral condition that, in the opinion of the Investigator, would confound or interfere with evaluation of safety and/or efficacy of the study drug, prevent compliance with the study protocol; preclude informed consent; or, render the participant unable/unlikely to comply with the study procedures.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pfizer CT.gov Call Center
Organizational Affiliation
Pfizer
Official's Role
Study Director
Facility Information:
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21201
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.
IPD Sharing URL
https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests
Links:
URL
https://pmiform.com/clinical-trial-info-request?StudyID=GBT440-044
Description
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Voxelotor Neurocognitive Function Study

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