Status:

RECRUITING

A Study of Nicotinamide With Oral Tetrahydrouridine and Decitabine to Treat High Risk Sickle Cell Disease

Lead Sponsor:

EpiDestiny, Inc.

Collaborating Sponsors:

National Institutes of Health (NIH)

National Heart, Lung, and Blood Institute (NHLBI)

Conditions:

Sickle Cell Disease

Eligibility:

All Genders

18+ years

Phase:

PHASE1

Brief Summary

A randomized control trial in 20 subjects with sickle cell disease comparing oral THU-decitabine to nicotinamide and in combination (THU, decitabine and nicotinamide).

Detailed Description

A randomized control trial comparing oral THU-decitabine to nicotinamide (1:1 randomization), and then comparing the effects of the combination of nicotinamide with THU-decitabine vs either treatment ...

Eligibility Criteria

Inclusion

  • Age 18 years or older.
  • Written informed consent provided by the subject before study entry.
  • Confirmed sickle cell disease (SCD) as determined by hemoglobin electrophoresis or liquid chromatography.
  • Subject is in his/her steady state and not having any acute complication due to SCD (i.e., hospitalization, acute pain, or acute chest syndrome in the past 14 days).
  • Weight at least 40kg
  • Regular compliance with comprehensive care and previous therapy.
  • Symptomatic SCD is defined as having one of following, despite at least 6 months of hydroxyurea therapy, or refuse to take hydroxyurea for personal reasons: fetal hemoglobin \<0.5 g/dL, or 3 or more pain episodes per year requiring parenteral narcotics, or 1 or more acute chest syndrome episodes, or Hemoglobin \<9 g/dL and absolute reticulocyte count \<250,000/mm3.

Exclusion

  • Inability to give informed consent.
  • Experienced severe sepsis or septic shock within the previous 12 weeks.
  • Last HU dose was ingested within the previous 4 weeks.
  • Currently pregnant or breast-feeding.
  • Alanine Aminotransferase (ALT) ≥ 3 times the upper limit of normal or albumin \<2.0 mg/dL or direct (conjugated) bilirubin ≥ 1.5 mg/dl.
  • Serum creatinine \>2.9 mg/dL and calculated creatinine clearance \<30 mL/min.
  • Platelet count \>800 x 109/L.
  • Absolute neutrophil count \<1.5 x 109/L.
  • Female of active childbearing potential who is unwilling to use at least one of the two following forms of birth control: (i) not having heterosexual sexual contact beginning at the screening visit and continuing until 4 weeks after the last dose of decitabine OR (ii) intrauterine device (IUD).
  • Sexually active male who is unwilling to use a condom when engaging in any sexual contact with a female with child-bearing potential, beginning at the screening visit and continuing until 4 weeks after taking the last dose of THU and decitabine. This requirement applies also to males who have had a successful vasectomy.
  • Altered mental status or recurrent seizures requiring anti-seizure medications.
  • Moribund or any concurrent disease (e.g., hepatic, renal, cardiac, metabolic) of such severity that death within 24 weeks is likely.
  • Concurrent diagnosis of malignancy including known Myelodysplastic syndrome, leukemia, or an abnormal karyotype.
  • New York Heart Association (NYHA) class III/IV status.
  • Eastern Co-operative Oncology Group (ECOG) performance status ≥3.
  • Participant is on chronic transfusion therapy
  • Known history of illicit drug or alcohol abuse within the past 12 months.
  • Other experimental or investigational drug therapy in the past 28 days.
  • Taking l-glutamine within the last 28 days
  • Being positive for HIV infection

Key Trial Info

Start Date :

January 24 2020

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

April 30 2027

Estimated Enrollment :

20 Patients enrolled

Trial Details

Trial ID

NCT04055818

Start Date

January 24 2020

End Date

April 30 2027

Last Update

May 25 2025

Active Locations (1)

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1

University of Illinois at Chicago College of Medicine

Chicago, Illinois, United States, 60612