Vitamin D for Sickle-cell Respiratory Complications

NCT ID: NCT01443728

Last Updated: 2024-08-09

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2
• Total Enrollment: 70 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2011-12-13
• Study Completion Date: 2015-02-15

Brief Summary

This study aims to answer the question whether oral vitamin D supplementation can decrease lung complications in children and adolescents with sickle cell disease. Lung complications are the leading causes of morbidity and of death in sickle cell disease. Infections and increased inflammation play important roles in the development of the lung problems in sickle cell disease. Emerging evidence shows that vitamin D helps the immune system to fight infection and to control inflammation and could potentially help prevent respiratory complications in patients with sickle cell disease. The investigators hypothesize that oral vitamin D3, 100,000 IU (2.5 mg), given once a month to a group of children and adolescents with sickle cell disease, will reduce the rate of respiratory events (infection, asthma exacerbation and acute chest syndrome) compared to the rate in a group given standard dose oral vitamin D3, 12,000 IU (0.3 mg) given once a month.

Funding Source - U.S. Food & Drug Administration, Office of Orphan Products Development

Detailed Description

This study will be a Phase 2 double-blind randomized clinical trial in 80 patients with sickle cell disease, ages 3 to 20 years-old, comparing a 2-year monthly oral dose of vitamin D3, 100,000 IU (equivalent to 3,300 IU/day) to a standard monthly dose, 12,000 IU (400 IU/day) in reducing the rate of respiratory events (defined as respiratory infections, acute asthma exacerbation, and the acute chest syndrome) in children and adolescents with sickle cell disease in comparison with the rates of respiratory events over a baseline period of one year.

Eligible participants (130 patients) will initially be screened to determine their blood vitamin D levels (serum 25-hydroxyvitamin D). Those with 25-hydroxyvitamin D levels between 5 and 60 ng/mL will be eligible for randomization. At study entry, blood and urine samples will be collected for routine and special blood tests including tests on immune function, inflammation, and bone function. Children above 5 years old will also have lung function and muscle strength tests. Participants will be followed once a month to administer the study medication (oral vitamin D3) and to monitor any side effects from the study medication by history, examination and blood and urine tests. After 12 and 24 months of therapy, the same study procedures at study entry will be repeated.

This study could help establish oral vitamin D3 as a simple, low cost treatment to reduce respiratory complications in children and adolescents with sickle cell disease.

Conditions

Sickle Cell Disease; Vitamin D Deficiency; Acute Chest Syndrome; Asthma; Respiratory Infections

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Vitamin D3 100,000 IU

Oral vitamin D3, 100,000 IU \[2.5 mg\] given once a month

Group Type: EXPERIMENTAL

Experimental: Vitamin D3 100,000 IU

Intervention Type: DRUG

Oral vitamin D3, 100,000 IU \[2.5 mg\] given once a month

Vitamin D3 12,000 IU

Standard dose oral vitamin D3 12,000 IU \[0.3 mg\] given once a month

Group Type: ACTIVE_COMPARATOR

Active Comparator: Vitamin D3 12,000 IU

Intervention Type: DRUG

Standard dose oral vitamin D3 12,000 IU \[0.3 mg\] given once a month

Interventions

Experimental: Vitamin D3 100,000 IU

Oral vitamin D3, 100,000 IU \[2.5 mg\] given once a month

Intervention Type: DRUG

Active Comparator: Vitamin D3 12,000 IU

Standard dose oral vitamin D3 12,000 IU \[0.3 mg\] given once a month

Intervention Type: DRUG

Other Intervention Names

Cholecalciferol; Cholecalciferol

Eligibility Criteria

Inclusion Criteria

• Diagnosis of sickle cell disease (HbSS, HbSC, HbS Beta-thalassemia)
• Age 3 to 20 years old

Exclusion Criteria

• Patient (or parent or guardian) unwilling or unable to provide written informed consent (and assent, if applicable)
• Patient unable or unwilling to comply with requirements of the clinical trial
• Participation in other therapeutic clinical trial
• Current diagnosis of rickets
• History of hypercalcemia or diagnosis of any medical condition associated with hypercalcemia, including primary hyperparathyroidism, malignancy, sarcoidosis, tuberculosis, granulomatous disease, familial hypocalciuric hypercalcemia
• Current use of corticosteroids, excluding inhaled steroids
• Current use of anticonvulsants (phenytoin, phenobarbital, carbamazepine)
• Therapy with thiazide diuretics or lithium carbonate
• Known liver or renal disease
• Patients taking medications for pulmonary complications of sickle cell disease not on a stable dose of medications, as defined by a change in medications or doses within the three months prior to study entry
• Patients on chronic red blood cell transfusion therapy
• Absence of baseline record of respiratory events (respiratory infections, asthma exacerbations, episodes of acute chest syndrome) for the preceding year
• Pregnancy

• Minimum Eligible Age: 3 Years
• Maximum Eligible Age: 20 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Gary M Brittenham, MD

OTHER

Sponsor Role: lead

Responsible Party

Gary M Brittenham, MD

James A. Wolff Professor of Pediatrics

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Gary Brittenham, MD

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Margaret T. Lee, MD

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Locations

Columbia University Irving Medical Center

New York, New York, United States

Countries

United States

References

Lee MT, Kattan M, Fennoy I, Arpadi SM, Miller RL, Cremers S, McMahon DJ, Nieves JW, Brittenham GM. Randomized phase 2 trial of monthly vitamin D to prevent respiratory complications in children with sickle cell disease. Blood Adv. 2018 May 8;2(9):969-978. doi: 10.1182/bloodadvances.2017013979.

Reference Type: DERIVED

PMID: 29712666 (View on PubMed)

Other Identifiers

R01FD003894

Identifier Type: FDA

Identifier Source: secondary_id

View Link

AAAE3244

Identifier Type: -

Identifier Source: org_study_id