Pharmacokinetics and Safety of Endari (L-glutamine) in Sickle Cell Disease Patients

NCT ID: NCT04684381

Last Updated: 2022-08-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-04

Study Completion Date

2021-06-30

Brief Summary

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L-glutamine has been approved in the US to reduce the acute complications of sickle cell disease (SCD) in adult and pediatric patients 5 years of age and older. The purpose of this single-center, open-label, phase 4 study is to evaluate the pharmacokinetic characteristics and safety of L-glutamine in patients with SCD.

Detailed Description

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Sickle cell disease (SCD) is associated with a mutation in the β-hemoglobin gene that results in abnormal polymerization of hemoglobin. Polymerization of hemoglobin causes the red blood cell to sickle, leading to a cascade of events which cause acute complications for SCD patients.

L-glutamine has been approved in the US to reduce the acute complications of sickle cell disease (SCD) in adult and pediatric patients 5 years of age and older.

The purpose of this single-center, open-label, phase 4 study is to evaluate the pharmacokinetic characteristics and safety of L-glutamine in patients with SCD.

8 SCD patients and 4 healthy volunteers will receive weight-based dosing of L-glutamine for 3 weeks. Doses will be changed weekly: 0.1 g/kg administered twice daily during week 1, 0.3 g/kg administered twice daily during week 2, and 0.6 g/kg administered once daily during week 3.

The primary objective is to evaluate the pharmacokinetic characteristics of L-glutamine in SCD patients compared with healthy volunteers.

Conditions

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Sickle Cell Disease Pharmacokinetics

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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L-glutamine

Pharmacokinetic characteristics of L-glutamine

Group Type EXPERIMENTAL

L-glutamine

Intervention Type DRUG

Pharmacokinetic study

Interventions

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L-glutamine

Pharmacokinetic study

Intervention Type DRUG

Other Intervention Names

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Endari

Eligibility Criteria

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Inclusion Criteria

1. 5 years of age and older at Screening.
2. Has documented diagnosis of SCD with known genotype (HbSS, HbSβ0 and HbSC).
3. Written informed consent provided by patient or the patient's legally authorized representative.
4. Non-pregnant females of childbearing age must agree to avoid pregnancy during the study and to practice a recognized form of birth control during the course of the study (e.g., barrier, birth control pills, or abstinence).


1. No known hematologic illness.
2. No known renal impairment.
3. 18 Years of age or older at screening.
4. Written informed consent provided by patient or the patient's legally authorized representative.
5. African American and Hispanic participants preferred.

Exclusion Criteria

1. Recent significant medical condition that required hospitalization (other than sickle cell crisis) within 2 months prior to starting L-glutamine therapy.
2. History of chronic kidney disease Stage 4 (glomerular filtration rate \[GFR\]=15-29) or Stage 5 (GFR\<15 mL/min/1.73 m2).
3. History of chronic liver disease Child Pugh class C (10-15 points).
4. Received any blood products 3 months prior to starting L-glutamine therapy.
5. Currently pregnant or lactating or planning to conceive during the study period.
6. Currently taking or has taken any form of glutamine supplement within 30 days prior to starting L-glutamine therapy.
7. Has been treated with an investigational medication/treatment within 30 days prior to starting L-glutamine therapy.
8. Is currently enrolled in an investigational drug or device study and/or has participated in such a study within 30 days prior to starting L-glutamine therapy.
9. Factors that would, in the judgment of the investigator, make it difficult for the patient to comply with study requirements.
10. Patient is currently being treated with crizanlizumab or voxelotor.


1. Known allergies to L-glutamine.
2. Informed consent document was not completed and signed.
3. Currently pregnant or lactating or planning to conceive during the study period.
4. Known hematologic illness, renal or hepatic impairment.
5. Received any blood products within 3 months of starting L-glutamine therapy.
Minimum Eligible Age

5 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Emmaus Medical, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yutaka Niihara, MD

Role: STUDY_CHAIR

Emmaus Medical, Inc.

Locations

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Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Countries

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United States

References

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Sadaf A, Dong M, Pfeiffer A, Latham T, Kalfa T, Vinks AA, Ware RE, Quinn CT. A Population Pharmacokinetic Analysis of L-Glutamine Exposure in Patients with Sickle Cell Disease: Evaluation of Dose and Food Effects. Clin Pharmacokinet. 2024 Mar;63(3):357-365. doi: 10.1007/s40262-024-01349-4. Epub 2024 Feb 24.

Reference Type DERIVED
PMID: 38401036 (View on PubMed)

Other Identifiers

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EM-PK-01

Identifier Type: -

Identifier Source: org_study_id

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