HEMOGLOBIN SC DISEASE Clinical Trial
Official title:
The Effect of Oral Magnesium Pidolate on Incidence of Painful Crises in Patients With Hemoglobin SC Disease
Subjects have a form of sickle cell disease, called hemoglobin SC disease. This results in
abnormally shaped red blood cells that get 'stuck' in blood vessels and then results in
episodes of severe pain (pain crises). Patients with the more common form of sickle cell
disease, called hemoglobin SS disease, also suffer from pain crises. Treatment with the drug
hydroxyurea is available to help prevent the pain crises in hemoglobin SS disease, but there
is no good treatment to help prevent the pain crises in hemoglobin SC disease.
It has been shown that one of the reasons for the formation of the abnormally shaped red
blood cells in patients with SC disease is the fact that these cells do not contain enough
water; they are dehydrated. Drinking more water will not increase the amount of water in the
cells. Certain salts and minerals can however have an effect on the amount of water in the
red blood cells. One of the most important minerals influencing this is called magnesium.
Magnesium is present in food and also in certain medications used to treat heartburn.
Magnesium has been used successfully both in animals and people to increase the amount of
water in the red blood cells and is very well tolerated by most people.
Investigators are using a new form of magnesium known as magnesium pidolate because this
form of magnesium may help with the symptoms of disease without causing diarrhea (a common
side effect of magnesium products).
Purpose The purpose of this study is to find out whether treatment with magnesium pidolate
will increase the amount of water in the red blood cell and result in fewer painful crises
in patients with hemoglobin SC disease while not causing diarrhea.
The study will last for about 64 weeks (about 16 months).
This is a placebo-controlled study which means that the effectiveness of the magnesium
medication (the chemical form of which is known as Mg pidolate) will be compared to placebo.
A placebo looks like the drug that is being studied (in this case magnesium) but does not
contain any active drug of any kind. Comparing magnesium with placebo will help decide
whether magnesium is better than treatment with placebo.
The study lasts for 64 weeks (about 16 months) and is divided into 2 parts, each part
lasting for 32 weeks (8 months). During the first part study medication (magnesium or
placebo) will be taken twice daily for 24 weeks (about 6 months), followed by no study
medication for 8 weeks. These 8 weeks are called a washout period, during which time the
effects of the study medication are 'washed-out' of the body. After the washout 8 weeks,
patients will enter the second part of the study. During this second part, the study
medication (magnesium or placebo) will again be taken twice daily for 24 weeks. During the
second part of the study participants will receive whichever study medication that was not
taken during the first part of the study. Following the second 24 weeks, there will be an
observation period of 8 weeks (during which time no study medication is taken). The study is
completed at the end of the 8-week observation period. Participants will take magnesium for
24 weeks and placebo for 24 weeks. The decision whether participants will receive magnesium
or placebo first will be made randomly by a computer. This is a double-blind study which
means that neither the participant nor the study doctor will know which study medication is
taking during each part of the study. However, the study may be unblinded for safety issues
if necessary.
If the participant responds to the study medication, it can be continued after completion of
the 24 weeks.
The study medication is in the form of a liquid, taken two times a day (morning and evening)
with the actual amount taken depending on the participant's weight.
During this study the participant will be seen in clinic on a regular basis; initially every
2 weeks, later once a month. There will be a total of 21 clinic visits during the study.
Three of these are clinic visits that would normally take place in the routine management of
this disease. The other 18 visits are required for this study. At each visit participants
will have blood tests to measure the amount of magnesium in the blood, especially the red
blood cells, but also to look for any other changes that might occur. The total amount of
blood collected during the 16 month study is 120 ml (24 teaspoons), which is a safe amount.
Three ml (half teaspoon) will be drawn at 13 visits, 5ml (1 teaspoon) at 4 visits, and 15ml
(3 teaspoons) at a further 4 visits. At 4 of the clinic visits a urine test will be
performed.
During the study participants will be asked to keep a record of all episodes of pain, or any
other changes that are noticed, in the form of a diary.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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