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. 2017 Jan-Mar;39(1):20-27.
doi: 10.1016/j.bjhh.2016.08.004. Epub 2016 Oct 20.

A Phase Ib open label, randomized, safety study of SANGUINATE™ in patients with sickle cell anemia

Hemant Misra  1 , James Bainbridge  2 , John Berryman  2 , Abraham Abuchowski  2 , Kenneth Mauricio Galvez  3 , Luis Fernando Uribe  4 , Angel Luis Hernandez  5 , Nestor Rodolfo Sosa  6
Affiliations

A Phase Ib open label, randomized, safety study of SANGUINATE™ in patients with sickle cell anemia

Hemant Misra et al. Rev Bras Hematol Hemoter. 2017 Jan-Mar.

Abstract

Background: Treatment of sickle cell anemia is a challenging task and despite the well understood genetic and biochemical pathway of sickle hemoglobin, current therapy continues to be limited to the symptomatic treatment of pain, supplemental oxygen, antibiotics, red blood cell transfusions and hydroxyurea. SANGUINATE is a carbon monoxide releasing molecule and oxygen transfer agent under clinical development for the treatment of sickle cell anemia and comorbidities.

Methods: An open-label randomized Phase Ib study was performed in adult sickle cell anemia patients. Two dose levels of SANGUINATE were compared to hydroxyurea in 24 homozygotes for Hb SS. Twelve subjects received either a low dose (160mg/kg) of SANGUINATE or 15mg/kg hydroxyurea. Another 12 subjects received either a high dose (320mg/kg) of SANGUINATE or 15mg/kg hydroxyurea. The primary endpoint was the safety of SANGUINATE versus hydroxyurea in sickle cell anemia patients. Secondary endpoints included determination of the plasma pharmacokinetics and assessment of hematologic measurements.

Results: Musculoskeletal related adverse events were the most common. Transient troponin I levels increased in three patients, one of whom had an increase in tricuspid regurgitant velocity; however, no clinical signs were noted. Following an assessment of vital signs, tricuspid regurgitant velocity, electrocardiogram, serum biochemistry, hematology, urinalysis, and analysis of reported adverse events, SANGUINATE was found to be safe in stable sickle cell anemia patients.

Conclusions: The clinical trial met its primary objective of demonstrating an acceptable safety profile for SANGUINATE in patients with sickle cell anemia. This trial established the safety of SANGUINATE at both dose levels and permitted its advance to Phase II trials.

Keywords: Clinical trial; SANGUINATE; Safety; Sickle cell disease.

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Figures

Figure 1
Figure 1
Overall study design.
Figure 2
Figure 2
Mean plasma concentration of SANGUINATE (mg/mL) by dose.
Figure 3
Figure 3
Mean systolic blood pressure.
Figure 4
Figure 4
Diastolic blood pressure.
See this image and copyright information in PMC

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