- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05675436
Investigating the Mechanistic Effects of Mitapivat in Subjects With Sickle Cell Disease
Observational Study Investigating the Mechanistic Effects of Mitapivat in Subjects With Sickle Cell Disease
Background:
Sickle cell disease (SCD) is an inherited blood disorder. The disease affects the ability of red blood cells to carry oxygen; this in turn can injure organs including the heart, lungs, and kidneys. SCD can lead to serious illness and death. Treatments such as bone marrow transplants and gene therapies can cure SCD, but they are not widely available. Current drug treatments for SCD are not always effective. This natural history study will examine how a study drug (mitapivat) affects red blood cells in people with SCD.
Objective:
To learn how mitapivat affects red blood cells in people with SCD.
Eligibility:
People with SCD who are enrolled in the parent study, NIH protocol IRB001565-H.
Design:
Procedures for this study will be done during visits already scheduled for the parent study.
Participants will have additional blood drawn during study visits. The additional amount will be about 3.5 teaspoons.
Participants will undergo a test called near infrared spectroscopy (NIRS) up to 9 times. Probes will be placed on their skin. A blood pressure cuff will be placed on their arm. The cuff will be filled with air for up to 5 minutes and then released. Participants may be asked to breathe at a certain rate or to hold their breath during these measurements. NIRS measures oxygen levels, blood flow, and the makeup of skin and muscle.
Researchers will draw additional information for this study from participants medical records.
Study Overview
Status
Detailed Description
Study Description:
Subjects actively enrolled protocol AG348-C-020 (NIH protocol IRB001565-H), an industry-sponsored phase 2/3 study investigating the efficacy of mitapivat in treating sickle cell disease (SCD), will be invited to participate in this protocol simultaneously to further investigate the mechanistic effects of mitapivat. Subjects will be asked for a blood sample at specified time points before and after starting on mitapivat and to undergo near infrared spectroscopy (NIRS) testing to investigate the mechanisms of action of mitapivat in subjects with SCD.
Objectives:
To evaluate the mechanisms of action of mitapivat in subjects with SCD.
Endpoints:
PRIMARY ENDPOINT:
The percentage change in the oxygen affinity measure p50 (defined as the partial pressure of oxygen at which Hb is 50% saturated with oxygen) between baseline and the average value at 12, 24 and 52 weeks. This change will be compared between the placebo and mitapivat arms.
SECONDARY ENDPOINTS:
- The p50 changes will also be assessed at the individual time points of 12, 24, and 52 weeks and compared between arms.
- Percentage of sickled cells and time to 50% sickling (t50) under normal and hypoxic ex vivo conditions at regular time intervals on mitapivat and percentage change from baseline to the individual time points at 12, 24, and 52 weeks . This change will be compared between the placebo and mitapivat arms.
- Percentage change in intracellular reactive oxidative species (ROS) in red blood cells (RBCs) using a ROS sensitive fluorescent probe and mass spectrometry- based proteomics of RBC lysates between baseline and the individual time points at 12, 24, and 52 weeks. This change will be compared between the placebo and mitapivat arms.
The percentage change in phosphatidylserine (PS) externalization using annexin V labeling (marker of red cell survival) by flow cytometry between baseline and the individual time points at 12, 24, and 52 weeks. This change will be compared between the placebo and mitapivat arms.
- Percentage change in muscle physiology, tissue oxygenation and blood flow using NIRS methodologies between baseline the individual time points at 12, 24, 52, and 59 weeks. This change will be compared between the placebo and mitapivat arms.
TERTIARY/EXPLORATORY ENDPOINTS:
- Evaluate effect of mitapivat on RBC metabolomics and proteomics between baseline and various follow-up periods. This change will be compared between the placebo and mitapivat arms.
- Measurement of glycated Hb S level as a surrogate measure for red cell half-life between baseline and various follow-up periods. This change will be compared between the placebo and mitapivat arms.
- Evaluate effect of mitapivat on RBC band 3 tyrosine phosphorylation between baseline and various follow-up periods. This change will be compared between the placebo and mitapivat arms.
- Correlation between potential exploratory biomarkers and clinical laboratory parameters.
- Evaluate change in cerebral hemodynamic measurements through magnetic resonance imaging (MRI) for cerebral blood flow, oxygen extraction fraction, and cerebral metabolic rate of oxygen consumption from baseline, at 12 weeks, 52, and 59 weeks. This change will be compared between the placebo and mitapivat arms.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Locations
-
-
Maryland
-
Bethesda, Maryland, United States, 20892
- National Institutes of Health Clinical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
- INCLUSION CRITERIA:
All subjects enrolled at NIH meeting eligibility for the parent study (AG348-C-020) are eligible for this study.
EXCLUSION CRITERIA:
Subjects that did not meet eligibility criteria to the parent protocol (AG348-C-020) will not be eligible to enroll for this study.
Subjects will be screened for implanted metal objects or devices that may be incompatible with MRI (i.e. cerebral aneurysm clip, cochlear implant, pacemaker, etc.) These subjects will be eligible to proceed with study enrollment, but will not undergo the optional MRI study.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
---|
1
i. Phase 3: Mitapivat 50 mg BID
|
2
ii. Phase 3: Mitapivat 100 mg BID
|
3
iii.
Phase 3: Mitapivat Open-Label Extension Period
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The percentage change in the oxygen affinity measure p50 (defined as the partial pressure of oxygen at which Hb is 50% saturated with oxygen) between baseline.
Time Frame: 12, 24 and 52 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24 and 52 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage change in intracellular reactive oxidative species (ROS) in red blood cells (RBCs) using a ROS sensitive fluorescent probe and mass spectrometry- based proteomics of RBC lysates between baseline and the individual time points
Time Frame: 12, 24, and 52 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24, and 52 weeks
|
Percentage of sickled cells and time to 50% sickling (t50) under normal and hypoxic ex vivo conditions at regular time intervals on mitapivat and percentage change from baseline to the individual time points
Time Frame: 12, 24, and 52 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24, and 52 weeks
|
The p50 changes will also be assessed at the individual time points
Time Frame: 12, 24, and 52 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24, and 52 weeks
|
The percentage change in phosphatidylserine (PS) externalization using annexin V labeling (marker of red cell survival) by flow cytometry between baseline and the individual time points
Time Frame: 12, 24, and 52 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24, and 52 weeks
|
Percentage change in muscle physiology, tissue oxygenation and blood flow using NIRS methodologies between baseline the individual time points
Time Frame: 12, 24, 52, and 59 weeks
|
This change will be compared between the placebo and mitapivat arms.
|
12, 24, 52, and 59 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Swee Lay Thein, M.D., National Heart, Lung, and Blood Institute (NHLBI)
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 10001061
- 001061-H
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
Clinical Trials on Sickle Cell Anemia
-
Klein Buendel, Inc.National Institute on Minority Health and Health Disparities (NIMHD); Hilton...CompletedSickle Cell Disease | Sickle Cell Anemia in Children | Sickle Cell Thalassemia | Sickle Cell SC DiseaseUnited States
-
Brown UniversityNational Heart, Lung, and Blood Institute (NHLBI); NovartisRecruitingSickle Cell Disease | Sickle Cell Anemia in ChildrenAngola
-
SangartCompletedSickle Cell Disease | Anemia, Sickle Cell | Sickle Cell Anemia | Hemoglobin SC Disease | Sickle Cell Disorders | Sickle Cell Hemoglobin C DiseaseUnited Kingdom, France, Jamaica, Lebanon
-
University of British ColumbiaCompletedSickle Cell Disease | Beta-Thalassemia | Sickle Cell Trait | Sickle Cell-Beta Thalassemia | Sickle Cell-SS DiseaseCanada, Nepal
-
SangartWithdrawnSickle Cell Disease | Anemia, Sickle Cell | Sickle Cell Anemia | Hemoglobin SC Disease | Sickle Cell Disorders | Sickle Cell Hemoglobin C DiseaseFrance, United Kingdom, Netherlands, Turkey, Bahrain, Belgium, Brazil, Lebanon, Qatar
-
National Institute of Diabetes and Digestive and...RecruitingSickle Cell Disease | Sickle Cell Anemia | Sickle Cell TraitUnited States
-
Beni-Suef UniversityUniversity of Arizona; Maternity and Children Hospital, Makkah; Benisuef university...CompletedSickle Cell Disease | Vaso-occlusive Crisis | Sickle Cell Anemia in ChildrenEgypt, Saudi Arabia
-
Sidney Kimmel Cancer Center at Thomas Jefferson...National Heart, Lung, and Blood Institute (NHLBI)TerminatedSickle Cell Anemia | Sickle Cell-hemoglobin C Disease | Sickle Cell-β0-thalassemiaUnited States
-
Newark Beth Israel Medical CenterCompletedDoes IV Acetaminophen Reduce Opioid Requirement in Pediatric Patients With Acute Sickle Cell Crises?Sickle Cell Anemia CrisisUnited States
-
Amy TangPfizerRecruitingSickle Cell Anemia in ChildrenUnited States