- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03825341
Hydroxyurea Therapy: Optimizing Access in Pediatric Populations Everywhere
Primary Objective
- Define the pharmacokinetics of liquid-formulated HU in infants (9 months to <2 years)
- Assess the relative bioavailability of HU "sprinkles" compared to capsules in children and adolescents (≥2 to 18 years).
Secondary Objective:
Compare PK parameters in infants versus older children on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Exploratory Objectives:
Capture information regarding the taste of HU sprinkles using palatability questionnaire.
This trial is an open label, single center assessment of the pharmacokinetics of two formulations of hydroxyurea (HU) designed to (1) determine the pharmacokinetic profile of a liquid formulation in infants and to (2) determine the bioavailability of "sprinkles", a novel method of administration for older children. The study aims to generate data to facilitate FDA approval for HU in children and potentially validate a new mode of administration ("sprinkles") that will optimize access and adherence for children in the US and globally.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
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Tennessee
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Memphis, Tennessee, United States, 38105
- St. Jude Children's Research Hospital
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Participants will be eligible for this study if only if all of the following inclusion criteria apply:
- Laboratory (i.e. electrophoretic, chromatographic or DNA) confirmation of HbSS or HbSβ0thalassemia.
- Participants may or may not be currently receiving HU. If participants are taking HU, then their most recent dose must be ≥24 hours prior to the start of the study.
- Participant is in the "well" state (defined by ≥ 2 weeks since the last SCD-related complication).
- Clinical evidence of normal gastrointestinal function and structure.
- No clinical evidence of hepatic compromise, including transaminases < 3 times the upper limit of normal.
- Estimated glomerular filtration rate (Schwartz equation) > 70 ml/min/1.73m2.
- Body mass index (BMI) ≥5th and ≤95th percentile as per CDC growth charts.
In addition:
For the Pharmacokinetic Study (Arm 1):
- Age ≥ 9 months and < 2 years.
- Able to consume a minimum of 30 ml of water following ingestion of the study article.
For the Bioavailability Study (Arm 2):
- Age ≥ 2 years and ≤ 18 years.
- Weight of ≥ 10 kg
- Females of child-bearing potential must have a negative pregnancy test prior to dosing and be willing to practice appropriate contraceptive measures, including abstinence, from the time of the initial pregnancy testing through the remainder of the study (30 days after last administration of investigational agents).
- Males of child-bearing potential must be willing to practice appropriate contraceptive measures, including abstinence, during study participation (30 days after last administration of investigational agents).
- Able to ingest both sprinkles and capsule study articles and consume a minimum of 30 ml of water following ingestion of each agent.
Exclusion Criteria:
- Chronic transfusion therapy, or transfused within 3 months of study participation.
- Known renal impairment (creatinine >1.5x the upper limit of normal for age).
- Known hepatic impairment or Grade 2 or higher transaminases and bilirubin levels.
- Diagnoses other than sickle cell anemia or sickle beta-zero thalassemia (i.e., other sickle cell variants or sickle/ hereditary persistence of fetal hemoglobin).
- Blood count parameters as follows: hemoglobin <6.0 gm/dL, absolute reticulocyte count <80,000/mm3, absolute neutrophil count <1000/mm3, or platelet count <80,000/mm3.
- The participant has used opiates, H2 blockers, proton pump inhibitors, antacids, other GI motility agents or any other medication that, in the opinion of the investigator, will interfere with the study procedures or affect the interpretation of the results of the study for 3 days prior to the first dose of study.
- Participants taking antiretroviral drugs (including didanosine and stavudine) due to increased risk of toxicity with concomitant use.
- Participation in another clinical intervention trial utilizing an IND/IDE agent, but can participate in HUGKISS since same drug agent.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Arm 1 Liquid Hydroxyurea
In Arm 1 of this study, n=18 infants ages 9 months to 2 years will be administered an extemporaneous oral liquid formulation of HU on a single occasion followed by PK sampling.
The dose administered will be ~20 mg/kg/day or the infant's usual daily dose.
|
Drug: Hydroxyurea oral liquid dose administered will be 20mg/kg/day or infants's usual daily dose.
Other Names:
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ACTIVE_COMPARATOR: Arm 2 Hydroxyurea Oral Capsule
In Arm 2, n=30 children who range in age from 2 to 18 years will be administered oral capsule HU, both a sprinkle formulation and capsules (Droxia® 200 mg), on two separate occasions separated by at least 1 but no more than 30 days in a randomized, crossover fashion.
The doses of HU on each occasion will be rounded to the nearest 200 mg and will not exceed 35 mg/kg or 2000 mg
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Drug: Hydroxyurea both a sprinkle formulation and capsules (Droxia 200mg) administered on 2 separate occasions.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Maximum Concentration Observed After Dosing (Cmax) for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
The Time of Maximum Observed Concentration (Cmax) Relative to Time of Dosing for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
AUClast for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
The area under the concentration-time curve from time of dosing of the drug to the time of the last measurable concentration or when concentrations were Below the Limit of Quantitation (BLQ) were calculated using either the linear (concentration before Cmax) or log trapezoidal rule (concentrations after Cmax).
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
AUCinfinity for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
The AUC extrapolated from the last measured concentration (Clast) to time infinity using the formula AUClast + Clast / λz.
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Mean Residence Time as Generated by WinNonlin (AUMC/AUC) for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Apparent Clearance Calculated From Dose/ AUCINF for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Apparent Clearance Normalized for Body Weight (BW) for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Elimination Slope for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
The first-order linear slope associated with the terminal (log-linear) portion of the curve and estimated via linear regression of log concentrations vs. time.
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Terminal Elimination Half-life Obtained From: t½ = ln(2)/ λz for HU Liquid Formulation in Infants (9 Months to <2 Years)
Time Frame: 1 day
|
Summary statistics including mean, standard deviation (SD) will be reported.
|
1 day
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Maximum Concentration Observed After Dosing (Cmax) for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
The Time of Maximum Observed Concentration (Cmax) Relative to Time of Dosing for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
AUClast for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
The AUC extrapolated from the last measured concentration (Clast) to time infinity using the formula AUClast + Clast / λz.
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
AUCinfinity for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
The AUC extrapolated from the last measured concentration (Clast) to time infinity using the formula AUClast + Clast / λz.
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Mean Residence Time as Generated by WinNonlin (AUMC/AUC) for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Apparent Clearance Calculated From Dose/ AUCINF for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Apparent Clearance Normalized for Body Weight (BW) for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Elimination Slope for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
The first-order linear slope associated with the terminal (log-linear) portion of the curve and estimated via linear regression of log concentrations vs. time.
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Terminal Elimination Half-life Obtained From: t½ = ln(2)/ λz for HU "Sprinkles" Compared to Capsules in Children and Adolescents (≥2 to 18 Years)
Time Frame: 2 days
|
Summary statistics including mean and SD will be reported for "sprinkles" and capsules and will be compared using two-sample t-test or Wilcoxon rank sum test depending on the normality of the data at a significance level of 0.05 per study design above.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
The Maximum Concentration Observed After Dosing (Cmax) for Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
The Time of Maximum Observed Concentration (Cmax) Relative to Time of Dosing for Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
AUClast for Infants Versus Older Children
Time Frame: 2 days
|
The area under the concentration-time curve from time of dosing of the drug to the time of the last measurable concentration or when concentrations were Below the Limit of Quantitation (BLQ) were calculated using either the linear (concentration before Cmax) or log trapezoidal rule (concentrations after Cmax).
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
AUCinfinity for Infants Versus Older Children
Time Frame: 2 days
|
The AUC extrapolated from the last measured concentration (Clast) to time infinity using the formula AUClast + Clast / λz.
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Mean Residence Time as Generated by WinNonlin (AUMC/AUC) for Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Apparent Clearance Calculated From Dose/ AUCINF for In Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Apparent Clearance Normalized for Body Weight (BW) for Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Elimination Slope for In Infants Versus Older Children
Time Frame: 2 days
|
The first-order linear slope associated with the terminal (log-linear) portion of the curve and estimated via linear regression of log concentrations vs. time.
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Terminal Elimination Half-life Obtained From: t½ = ln(2)/ λz for Infants Versus Older Children
Time Frame: 2 days
|
The older children will include children on arm 2 on this study and those from our previous "Pharmacokinetics and Bioavailability of a Liquid Formulation of Hydroxyurea in Pediatric Patients with Sickle Cell Anemia" (NCT01506544) trial.
Summary statistics will be reported for the infants and older children and will be compared using two sample t-test or Wilcoxon rank sum test depending on the normality of the data.
Logarithmic transformation will be applied if data do not follow normal.
|
2 days
|
Collaborators and Investigators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Hematologic Diseases
- Genetic Diseases, Inborn
- Anemia
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Hemoglobinopathies
- Anemia, Sickle Cell
- Thalassemia
- Molecular Mechanisms of Pharmacological Action
- Nucleic Acid Synthesis Inhibitors
- Enzyme Inhibitors
- Antineoplastic Agents
- Antisickling Agents
- Hydroxyurea
Other Study ID Numbers
- HOPE18
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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