Sickle Cell Disease Clinical Trial
Official title:
A Pilot Study of N-acetylcysteine in Patients With Sickle Cell Disease
Part 1: A pilot study in patients with homozygous S (HbSS) or hemoglobin S with beta zero
thalassemia(HbS-βo thalassemia), with the aim of examining the effect of intravenous NAC
treatment on plasma VWF parameters and measures of redox and RBC function.
Part 2: A pilot study in patients with sickle cell disease admitted to the hospital in
vaso-occlusive crisis to determine the effects of NAC infusions on plasma VWF parameters and
measures of redox and RBC function, and on measures of pain and hospital length of stay.
Two primary processes dominate the complications associated with sickle cell disease (SCD):
vasoocclusion and hemolysis. The plasma and vessel wall adhesive protein von Willebrand
factor (VWF) is thought to be involved in both of these processes, so strategies aimed at
reducing its secretion or reactivity, which could decrease complications in patients with
SCD, are being tested.
Based on prior studies, N-acetylcysteine (NAC) treatment may decrease VWF activity in
patients with SCD and may be a useful adjunctive treatment in this disorder.
Part 1 enrolls stable outpatients with homozygous S (HbSS) or hemoglobin S with beta zero
thalassemia (HbS-βo thalassemia), with the aim of examining the effect of NAC treatment on
VWF parameters, measures of oxidation and RBC fragments. Patients receive IV NAC first at 150
mg/kg over 8 hours and if tolerated, at a later date at 300 mg/kg over 8 hours in the
University of Washington Clinical Research Center. Blood is collected for laboratory
assessment. Subjects are later offered enrollment in an oral phase.
Part 2, patients with a history of vaso-occlusive crisis (VOC) are approached in the
outpatient setting to discuss the study. When admitted for VOC, subjects receive NAC as an IV
infusion75 mg/kg every 6 hours for up to 5 days. Blood for laboratory assays are collected
each morning and pain assessment is performed prior to and following each NAC infusion.
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