Sickle Cell Anemia Clinical Trial
Official title:
Sparing Conversion to Abnormal TCD Elevation (SCATE) - a Phase III Clinical Trial to Compare Standard Care (Observation) With Alternative Therapy (Hydroxyurea) for Reducing the Risk of Converting to an Abnormal TCD Velocity in Children With Sickle Cell Anemia and Conditional Pre-treatment TCD Velocities.
The primary goal of the Phase III SCATE trial is to compare 30 months of alternative therapy (hydroxyurea) to standard care (observation) in children with sickle cell anemia and conditional (170 - 199cm/sec) Transcranial Doppler (TCD) velocities. For the alternative regimen (hydroxyurea) to be declared superior to the standard treatment regimen (observation), the hydroxyurea-treated group must have a three-fold reduction in the incidence of conversion to abnormal TCD velocities (≥ 200 cm/sec), compared to the standard treatment arm.
Results from previous studies confirm an increased risk of stroke among children with
conditional TCD velocities. In addition, studies suggest that patients who were on
observation alone, converted from conditional TCD (moderate risk category) to an abnormal
TCD (with a much higher risk for primary stroke) within 30 months of initial identification
of the conditional TCD velocity; this conversion led to initiation of chronic and indefinite
transfusions in all cases. Preliminary data suggests that the risk of conversion to abnormal
TCD velocities will be lower for subjects with conditional TCD velocities on hydroxyurea by
at least three-fold. This important difference in conversion risk rate suggests that an
alternative treatment could have a substantial and beneficial impact on patients with
elevated TCD velocities.
An alternative treatment could protect the brain of patients with SCA and conditional TCD
velocities who are at increased risk for stroke. The avoidance of chronic blood transfusions
would be a great benefit for all children with sickle cell disease, especially those in
developing countries where the blood supply may be less safe (in comparison with that in the
US) or unavailable, and very costly.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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