Anemia, Sickle Cell Clinical Trial
Official title:
Arginine Supplementation in Sickle Cell Anemia: Physiological and Prophylactic Effects
Sickle cell disease (SCD), also known as sickle cell anemia, is an inherited genetic disease that can cause intense pain episodes. This study will evaluate the effectiveness of the nutritional supplement arginine at improving blood cell function and disease symptoms in people with SCD.
SCD is an inherited blood disorder. Symptoms include anemia, infections, organ damage, and
intense episodes of pain that are called "sickle cell crises." SCD is caused by an abnormal
type of hemoglobin, which is a protein inside red blood cells that carries oxygen. In people
with SCD, the abnormal hemoglobin distorts the shape of the red blood cells. This causes the
red blood cells to clump together, decreasing blood flow and oxygen delivery to the body's
tissues. The reduced levels of oxygen can lead to sickle cell crises and tissue damage.
Hemolysis, the destruction of red blood cells, is also a hallmark of SCD. During hemolysis,
hemoglobin is released into the bloodstream, where it removes nitric oxide (NO), a natural
chemical in the body that expands blood vessels. Arginase, another protein released during
hemolysis, removes arginine from the bloodstream, which can also lead to decreased NO
levels. The lack of NO constricts blood vessels, further contributing to painful sickle cell
crises. Arginine supplementation may increase healthy hemoglobin and NO production and, in
turn, prevent or reduce sickle cell crises. The purpose of this study is to evaluate the
effectiveness of arginine at increasing NO levels, improving red blood cell function, and
reducing hospitalizations and pain medication use in people with SCD.
This study will enroll children and adults with SCD. Participants will be randomly assigned
to receive twice daily doses of either a low dose of arginine, a high dose of arginine, or
placebo for 12 weeks. Study visits will occur at baseline, three times during Month 1, and
Weeks 8, 12, 14, and 16. Each study visit will include an echocardiogram to measure heart
activity, blood collection, and a medical history review to identify adverse events, pain
medication usage, headaches, emergency department visits, and hospitalizations.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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