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A Sickle CEll Disease ComplicatioN Trial (ASCENT)

Primary Purpose

Sickle Cell Disease

Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
SC411
Placebo
Sponsored by
Micelle BioPharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Sickle Cell Disease focused on measuring hemoglobin SS, hemoglobin SC, hemoglobin S/β°-thalassemia

Eligibility Criteria

5 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Patients who meet all of the following criteria will be eligible to participate in the study:

  1. 1. Aged ≥ 5 years and ≤ 17 years at screening;
  2. Has been diagnosed with SCD (that includes the genotypes HbSS, HbSC, and HbS/β°-thalassemia, documented by hemoglobin HPLC or electrophoresis);
  3. Has had between ≥ 2 to ≤10 episodes of acute SCC (as defined above) within 12 months of the Screening Visit. At least one crisis must have been managed in a hospital, clinic, or emergency room. For at least 2 of the episodes, the site must obtain the documentation created in a medical record at the time of the event.
  4. Must not be receiving HU or L-Glutamine, or if receiving HU and/or L-Glutamine must be at a stable weight-based treatment regimen (mg/kg), for at least 3 months prior to the Screening Visit with the intent to continue at a weight-based dose level at the discretion of the treating physician for the duration of the study, other than for safety reasons. If taking HU and/or L-glutamine, subjects must have had at least one SCC event (as previously defined) while on HU and/or L-Glutamine.
  5. Has a parent or guardian who is able to give written informed consent, and the potential pediatric subject must be able to provide assent in a manner approved by the Institutional Review Board (IRB) and comply with the requirements of the study; and
  6. If post pubertal in the opinion of the Investigator, must agree to use a reliable method of birth control (e.g., barrier, birth control pills, abstinence) during the study and for 1 month following the last dose of study drug.

Exclusion Criteria

Patients who meet any of the following criteria will be excluded from participation in the study:

  1. A known allergy or hypersensitivity to fish or shellfish;
  2. A known allergy or hypersensitivity to soy;
  3. Inability to swallow capsules;
  4. History of treatment with SC411;
  5. Confirmed diagnosis of chronic pain or chronic opioid use: Defined as pain experienced ≥3 days per week over a 6-month period or daily opioid use for pain management;
  6. Active infection with Human Immunodeficiency Virus (HIV), Hepatitis B, or Hepatitis C;
  7. Prothrombin time > 1.5 x ULN at screening;
  8. Required regular anticoagulation or chronic aspirin therapy;
  9. Moderate thrombocytopenia, defined as platelets < 80,000/µL at screening;
  10. History of stroke or Moyamoya syndrome;
  11. Abnormal results on most recent transcranial Doppler (TCD) evaluation;
  12. Received blood transfusion or blood products in the 2 months prior to the Screening Visit or on chronic blood transfusion;
  13. Chronic renal insufficiency, defined as a eGFR < 30ml/min at screening as estimated by the Schwartz equation (Appendix H), or requiring peritoneal or hemodialysis;
  14. Abnormal liver function tests (ALT > 3.0 x ULN) at screening;
  15. Received any organ transplant;
  16. Has a recent acute illness or other concomitant chronic medical or psychiatric condition that in the opinion of the Investigator would compromise participation in the study, prevent adherence to the protocol or confound the evaluation of the study outcome;
  17. Is pregnant or lactating, or has the intention of becoming pregnant during the study (if a female of child-bearing potential or partner of a female of child-bearing potential and sexually active and not willing to use an effective means of birth control);
  18. Is currently taking or has been treated with any form of omega-3 fatty acid or fish oil supplement within 30 days of the Screening Visit, or intends to do so during the course of the study;
  19. Has been treated with any investigational product within 30 days of the Screening Visit or intends to receive an investigational product during the course of this study; and
  20. There are factors that, in the judgment of the Investigator, would make it difficult for the patient to comply with the requirements of the study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    SC411

    Placebo

    Arm Description

    Omega-3 docosahexaenoic acid, soft gelatin capsule, administered once a day on a per weight basis.

    Soybean oil, soft gelatin capsule, administered once a day on a per weight basis.

    Outcomes

    Primary Outcome Measures

    Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
    Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization. The primary objective of this study is to assess the efficacy of orally administered SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects compared to placebo. A SCC event will be defined as either an acute painful crisis or an acute chest syndrome.

    Secondary Outcome Measures

    Evaluation of the effect of SC411 compared to placebo by measuring the time until the patient's first sickle cell event.
    Evaluation of days to the first event from randomization for each patient.
    Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
    Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
    Evaluation of the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
    To evaluate the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
    Evaluation of the effect of SC411 compared to placebo by measuring the number of crisis-free days.
    To evaluate the effect of SC411 compared to placebo by measuring the number of crisis-free days. A crisis-free day is defined as any day with a zero entry on the eDiary pain intensity scale.

    Full Information

    First Posted
    November 11, 2015
    Last Updated
    January 30, 2019
    Sponsor
    Micelle BioPharma Inc
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02604368
    Brief Title
    A Sickle CEll Disease ComplicatioN Trial
    Acronym
    ASCENT
    Official Title
    A Phase 3, Prospective, Randomized, Double-Blind, Placebo Controlled, Multi-center Study of SC411 for Sickle Cell Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2019
    Overall Recruitment Status
    Unknown status
    Study Start Date
    March 2019 (Anticipated)
    Primary Completion Date
    December 2020 (Anticipated)
    Study Completion Date
    December 2020 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Micelle BioPharma Inc

    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
    The objective of this study is to assess the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects receiving SC411 compared to those subjects receiving placebo.
    Detailed Description
    This Phase 3, prospective, randomized, double-blinded, placebo-controlled, multi-center study will enroll approximately 210 subjects at up to 70 sites in the United States. Participation will consist of a Screening Period, followed by a minimum 12-month Treatment Period. SC411 is administered orally as a soft gel mini capsule. This study will enroll subjects aged ≥5 to ≤17 years who have a diagnosis of SCD that includes the phenotypes hemoglobin SS homozygous (HbSS), hemoglobin SC (HbSC), and hemoglobin S/β°-thalassemia (HbS/ β°-thalassemia); and have had at least 2 but no more than 10 documented SCC events (as defined above) within 12 months prior to the Screening Visit.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Sickle Cell Disease
    Keywords
    hemoglobin SS, hemoglobin SC, hemoglobin S/β°-thalassemia

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    210 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    SC411
    Arm Type
    Experimental
    Arm Description
    Omega-3 docosahexaenoic acid, soft gelatin capsule, administered once a day on a per weight basis.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Soybean oil, soft gelatin capsule, administered once a day on a per weight basis.
    Intervention Type
    Drug
    Intervention Name(s)
    SC411
    Other Intervention Name(s)
    Docosahexaenoic acid (DHA)
    Intervention Description
    Soft gelatin capsule
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Other Intervention Name(s)
    Soybean Oil
    Intervention Description
    Soft gelatin capsule
    Primary Outcome Measure Information:
    Title
    Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization.
    Description
    Assessment of the efficacy of SC411 in reducing the number of sickle cell crisis (SCC) events in subjects compared to placebo will be measured by counting the number of sickle cell crises that occur after randomization. The primary objective of this study is to assess the efficacy of orally administered SC411 in reducing the number of sickle cell crisis (SCC) events in sickle cell disease (SCD) subjects compared to placebo. A SCC event will be defined as either an acute painful crisis or an acute chest syndrome.
    Time Frame
    52 weeks
    Secondary Outcome Measure Information:
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the time until the patient's first sickle cell event.
    Description
    Evaluation of days to the first event from randomization for each patient.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
    Description
    Evaluation of the effect of SC411 compared to placebo by measuring the the number of visits to a medical facility (hospital, clinic, or emergency room) for SCC event or complications of SCD.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of days with electronic diary (eDiary)-recorded opioid or non opioid analgesic use at home to manage sickle cell pain.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of crisis-free days.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of crisis-free days. A crisis-free day is defined as any day with a zero entry on the eDiary pain intensity scale.
    Time Frame
    52 weeks
    Other Pre-specified Outcome Measures:
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the time to second SCC event among subjects who had experienced at least one crisis while enrolled in the study.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the time to second SCC event among subjects who had experienced at least one crisis while enrolled in the study.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of complications of SCD.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of complications of SCD.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the Parent/guardian eDiary-recorded school attendance.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the Parent/guardian eDiary-recorded school attendance.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the percent of days free of eDiary-recorded sickle cell pain out of total number of Treatment Period days.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the percent of days free of eDiary-recorded sickle cell pain out of total number of Treatment Period days.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score on the days that pain is recorded analyzed over time for intensity and diminution.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score (scale from 0-10) on the days that pain is recorded analyzed over time for intensity and diminution.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score on the days during a SCC event analyzed over time for intensity and diminution.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the subjects eDiary-recorded sickle cell pain score (from 0-10) on the days during a SCC event analyzed over time for intensity and diminution.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of hospitalization days due to SCC events.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of hospitalization days due to SCC events. -
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of hospitalizations due to SCC events.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of hospitalizations due to SCC events.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of acute painful crisis events.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of acute painful crisis events.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of acute chest syndrome events.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of acute chest syndrome events.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the number of simple and exchange blood transfusions.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the number of simple and exchange blood transfusions.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in hemoglobin.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in hemoglobin.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in hematocrit.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in hematocrit.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in hemoglobin phenotype.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in hemoglobin phenotype.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in white blood cells.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in white blood cells.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in blood platelets.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in blood platelets.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in the RBC membrane omega-3 fatty acids index.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in the RBC membrane omega-3 fatty acids index (arachidonic acid, docosahexaenoic acid, and eicosapentaenoic acid).
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in the reticulocyte count.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in the reticulocyte count.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in lactate dehydrogenase.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in lactate dehydrogenase.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in haptoglobin.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in haptoglobin.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in indirect bilirubin.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in indirect bilirubin.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in high sensitivity C-reactive protein.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in high sensitivity C-reactive protein.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in D-dimer.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in D-dimer.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in whole blood adhesion to vascular cell adhesion molecule-1.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in whole blood adhesion to vascular cell adhesion molecule-1.
    Time Frame
    52 weeks
    Title
    Evaluation of the effect of SC411 compared to placebo by measuring the changes in E-selectin.
    Description
    To evaluate the effect of SC411 compared to placebo by measuring the changes in E-selectin.
    Time Frame
    52 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    5 Years
    Maximum Age & Unit of Time
    17 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patients who meet all of the following criteria will be eligible to participate in the study: 1. Aged ≥ 5 years and ≤ 17 years at screening; Has been diagnosed with SCD (that includes the genotypes HbSS, HbSC, and HbS/β°-thalassemia, documented by hemoglobin HPLC or electrophoresis); Has had between ≥ 2 to ≤10 episodes of acute SCC (as defined above) within 12 months of the Screening Visit. At least one crisis must have been managed in a hospital, clinic, or emergency room. For at least 2 of the episodes, the site must obtain the documentation created in a medical record at the time of the event. Must not be receiving HU or L-Glutamine, or if receiving HU and/or L-Glutamine must be at a stable weight-based treatment regimen (mg/kg), for at least 3 months prior to the Screening Visit with the intent to continue at a weight-based dose level at the discretion of the treating physician for the duration of the study, other than for safety reasons. If taking HU and/or L-glutamine, subjects must have had at least one SCC event (as previously defined) while on HU and/or L-Glutamine. Has a parent or guardian who is able to give written informed consent, and the potential pediatric subject must be able to provide assent in a manner approved by the Institutional Review Board (IRB) and comply with the requirements of the study; and If post pubertal in the opinion of the Investigator, must agree to use a reliable method of birth control (e.g., barrier, birth control pills, abstinence) during the study and for 1 month following the last dose of study drug. Exclusion Criteria Patients who meet any of the following criteria will be excluded from participation in the study: A known allergy or hypersensitivity to fish or shellfish; A known allergy or hypersensitivity to soy; Inability to swallow capsules; History of treatment with SC411; Confirmed diagnosis of chronic pain or chronic opioid use: Defined as pain experienced ≥3 days per week over a 6-month period or daily opioid use for pain management; Active infection with Human Immunodeficiency Virus (HIV), Hepatitis B, or Hepatitis C; Prothrombin time > 1.5 x ULN at screening; Required regular anticoagulation or chronic aspirin therapy; Moderate thrombocytopenia, defined as platelets < 80,000/µL at screening; History of stroke or Moyamoya syndrome; Abnormal results on most recent transcranial Doppler (TCD) evaluation; Received blood transfusion or blood products in the 2 months prior to the Screening Visit or on chronic blood transfusion; Chronic renal insufficiency, defined as a eGFR < 30ml/min at screening as estimated by the Schwartz equation (Appendix H), or requiring peritoneal or hemodialysis; Abnormal liver function tests (ALT > 3.0 x ULN) at screening; Received any organ transplant; Has a recent acute illness or other concomitant chronic medical or psychiatric condition that in the opinion of the Investigator would compromise participation in the study, prevent adherence to the protocol or confound the evaluation of the study outcome; Is pregnant or lactating, or has the intention of becoming pregnant during the study (if a female of child-bearing potential or partner of a female of child-bearing potential and sexually active and not willing to use an effective means of birth control); Is currently taking or has been treated with any form of omega-3 fatty acid or fish oil supplement within 30 days of the Screening Visit, or intends to do so during the course of the study; Has been treated with any investigational product within 30 days of the Screening Visit or intends to receive an investigational product during the course of this study; and There are factors that, in the judgment of the Investigator, would make it difficult for the patient to comply with the requirements of the study
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Uche Sampson, MD
    Phone
    615-678-2336
    Email
    usampson@micellebio.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    George Steinfels, PhD
    Phone
    301-742-5656
    Email
    gsteinfels@micellebio.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Carton Dampier, MD
    Organizational Affiliation
    Emory University
    Official's Role
    Study Chair
    First Name & Middle Initial & Last Name & Degree
    Matt Heeney, MD
    Organizational Affiliation
    Harvard University
    Official's Role
    Study Chair
    First Name & Middle Initial & Last Name & Degree
    Beng Fuh, MD
    Organizational Affiliation
    East Carolina University
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Learn more about this trial

    A Sickle CEll Disease ComplicatioN Trial

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