Hematologic Diseases Clinical Trial
Official title:
Pediatric Hydroxyurea Phase III Clinical Trial (BABY HUG)
The purpose of this study is to determine if hydroxyurea therapy is effective in the prevention of chronic end organ damage in pediatric patients with sickle cell anemia.
BACKGROUND:
In 1995, the Multicenter Study of Hydroxyurea (MSH) demonstrated that hydroxyurea is
effective in decreasing the frequency of painful crises, hospitalizations for crises, acute
chest syndrome, and blood transfusions by 50%. The recently completed phase II study of
hydroxyurea in children (PED HUG) demonstrated that children have a response to hydroxyurea
similar to that seen in adults in terms of increasing fetal hemoglobin levels and total
hemoglobin, and decreasing complications associated with sickle cell anemia. In addition,
this study demonstrated that the drug does not adversely affect growth and development
between the ages of 5 and 15. A recently completed pilot study of hydroxyurea given to
children between the ages of 6 months and 24 months demonstrated that the drug is tolerated
well by small infant, and that the fetal hemoglobin switch can be forced to remain in the "on
position" by hydroxyurea administration.
A Special Emphasis Panel (SEP) met on April 12, 1996 to review the results of the MSH trial
and the progress to date of the PED HUG study. The SEP recommended that NHLBI undertake the
BABY HUG trial.
DESIGN NARRATIVE:
BABY HUG is a randomized, double-blind, placebo-controlled study to determine if hydroxyurea
can prevent the onset of chronic end organ damage in young children with sickle cell anemia.
Approximately 200 children with sickle cell disease will be recruited to receive either
hydroxyurea or placebo. The children will be screened at study entry for signs of abnormal
brain, kidney, pulmonary, and splenic function, and developmental milestones. They will then
be randomly assigned to receive either hydroxyurea or placebo and followed yearly to assess
chronic end organ damage of the major organ systems. The primary endpoint will be a 50%
reduction in rates of damage to the major organs with surrogate markers of organ function
during follow-up in Phase II of the trial.
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