Clinical Experience of Thalidomide in Thalassemic Patients

NCT ID: NCT05132270

Last Updated: 2021-11-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 135 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2020-01-01
• Study Completion Date: 2021-01-31

Brief Summary

Objectives

Primary objective:

• To determine the efficacy and safety of the combination therapy of Hydroxyurea and thalidomide in beta-thalassemia patients.

Secondary objective:

• To determine the change in liver and spleen size of beta-thalassemia patients on the combination therapy

A single-arm non-randomized trial to evaluate the efficacy and safety of combination therapy of hydroxyurea and thalidomide in beta-thalassemia patients. It was a twelve months study. Participants were monitored for six months on Hydroxyurea alone and then the combination therapy of hydroxyurea and thalidomide for another six months. Findings of physical examination, vital signs, laboratory, and ultrasound findings were recorded at baseline, during and end of the study.

Sample Size and Population This study included 135 Beta-thalassemia patients.

Detailed Description

The purpose of the study was to evaluate the efficacy and safety of the combination therapy of hydroxyurea and thalidomide in beta-thalassemia patients. The participants were evaluated on the basis of eligibility criteria, consent was obtained and baseline investigations were performed on the screening visit. Participants were continued on Hydroxyurea (10-20mg/kg/day) for the first six months and then for the next six months thalidomide (2-5 mg/kg/day) was added to the intervention. Aspirin was also added (2-4mg/kg/day).

Efficacy:

Maintenance or rise in Hemoglobin (Hb) levels and changes in transfusion frequency before and after the use of combination therapy was used to evaluate the efficacy of the combination therapy. Good responders were the patients who were on transfusion and went off-transfusion after the combination therapy or individuals who were already off transfusion and after combination therapy demonstrated an increase in Hb of at least 1gm/dl. Responders were those who remained on transfusion on combination therapy but displayed a 50% reduction in blood requirements. Whereas, non-responders, were individuals who were off-transfusion before combination therapy and had improvement in Hb of <1gm/dl, or those who remained on transfusion during combination therapy and did not experience transfusion reduction of at least 50%.

Safety:

Safety of the drug was evaluated on the basis of the following parameters and intervention was discontinued or put on hold if:

• Creatinine >1.1mg/dl, Urea >43mg/dl),
• Liver function (SGPT >35mg/L)
• Absolute Neutrophil counts<2*109/L
• Platelets < 100*109/L

Conditions

Thalassemia, Beta

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Combination of hydroxyurea and thalidomide

Hydroxyurea was continued at a dose of 10-20 mg/kg/day for 6 months and then thalidomide was added orally at a dose of 2-5mg/kg/day for 6 months.

Group Type: EXPERIMENTAL

hydroxyurea and thalidomide

Intervention Type: DRUG

Evaluation of hydroxyurea and thalidomide combination use in beta-thalassemia patients

Interventions

hydroxyurea and thalidomide

Evaluation of hydroxyurea and thalidomide combination use in beta-thalassemia patients

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

1. Patients with clinical and genetic diagnosis of β-thalassemia major and intermedia

2. Patients who showed partial response or a decline in response to hydroxyurea

3. Patients who are not the candidates for the bone marrow transplant procedure.

Exclusion Criteria

1. Married Patients

2. Patients with comorbidities such as liver, cerebrovascular, cardiovascular, or kidney diseases

3. Patients allergic to the drug ingredients

4. Patients with mental disorders

5. Patients who are enrolled in other clinical trials

6. Patients with a history of venous or arterial thrombosis

• Minimum Eligible Age: 2 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Children's Hospital Karachi

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Children's Hospital Karachi

Karachi, Sindh, Pakistan

Countries

Pakistan

References

Ansari SH, Ansari I, Wasim M, Sattar A, Khawaja S, Zohaib M, Hussain Z, Adil SO, Ansari AH, Ansari UH, Farooq F, Masqati NU. Evaluation of the combination therapy of hydroxyurea and thalidomide in beta-thalassemia. Blood Adv. 2022 Dec 27;6(24):6162-6168. doi: 10.1182/bloodadvances.2022007031.

Reference Type: DERIVED

PMID: 35477175 (View on PubMed)

Other Identifiers

CH-0420

Identifier Type: -

Identifier Source: org_study_id