Study of the Selective GlyT1 Inhibitor Bitopertin for Steroid-Refractory Diamond-Blackfan Anemia (NCT05828108) | Clinical Trial Compass
CompletedPhase 1/2
Study of the Selective GlyT1 Inhibitor Bitopertin for Steroid-Refractory Diamond-Blackfan Anemia
United States15 participantsStarted 2023-07-25
Plain-language summary
Background:
Diamond-Blackfan anemia (DBA) is an inherited disease that affects the bone marrow. People with DBA have chronic anemia that can be severe. Many must have frequent transfusions of red blood cells. Current treatments for DBA all have risks of serious side effects. Better treatments are needed.
Objective:
To test a new drug (bitopertin) in people with DBA.
Eligibility:
People aged 18 or older with DBA.
Design:
Participants will be screened. They will have a physical exam; they will have blood tests and a test of their heart function. They will have a bone marrow biopsy: An area of their hip will be numbed, and a needle will be inserted to remove a sample of tissue from inside the bone.
Bitopertin is a pill taken by mouth. Participants will take the drug once a day every day for 8 months. They will start with a low dose of the drug; the dosage may increase gradually over time. They will keep a diary to record each dose.
Participants will have blood tests every 4 weeks. This may be done in the clinic. Participants may also have telehealth visits; they can have blood drawn at a local lab and sent to the researchers.
The bone marrow biopsy and other tests will be repeated after 8 months.
Participants who have a positive response to bitopertin will be invited to enter an extended phase of the trial. They may continue to take the drug for 3 more years.
Those who choose not to continue in the extended phase may have a follow-up visit 6 months after they stop taking the drug.
Who can participate
Age range18 Years – 100 Years
SexALL
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Inclusion criteria
✓. Diamond-Blackfan anemia defined as chronic anemia presenting on or before the third year of life, associated with reticulocytopenia and greatly reduced or absent bone marrow erythroid precursors, supported by, but not requiring either:
✓. familial history
✓. gene mutation testing demonstrating a known disease-causing mutation or a mutation of disease-associated gene in combination with clinical characteristics of DBA
✓. Clinically-significant anemia as defined as either:
✓. hemoglobin less than 9.0 g/dL
✓. red cell transfusion of at least 2 units PRBC for adults in the eight weeks prior to study enrollment
✓. Relapsed and/or steroid-refractory disease or patient intolerance of systemic corticosteroids
✓. Age \>= 18 years at the time of consent
Exclusion criteria
✕. Treatment with androgens (danazol or oxymetholone) or corticosteroids less than 4 weeks prior to initiating bitopertin.
What they're measuring
1
Rate of response
Timeframe: On a rolling basis (sliding window) from drug initiation until 8 months (32 weeks)
Trial details
NCT IDNCT05828108
SponsorNational Heart, Lung, and Blood Institute (NHLBI)
✕Stable physiologic dose steroid replacement for adrenal insufficiency or other similar conditions is not an exclusion criterium.
✕. Hypersensitivity to bitopertin or its components
✕. Patient Health Questionnaire-8 (PHQ-8) score greater than or equal to 10 or imminent suicidal risk identified by the Columbia-Suicide Severity Rating Scale (C-SSRS) as defined as suicidal ideation with intent (grade 4 or 5) within the last year or any suicidal behavior within the last five years
✕. Moribund status or concurrent hepatic, renal, cardiac, neurologic, pulmonary, infectious, or metabolic disease of such severity that it would preclude the patient s ability to tolerate protocol therapy
✕. Life expectancy of less than 3 months from any cause
✕. History or current diagnosis of cardiac disease indicating significant risk of safety for patients participating in the study such as uncontrolled or significant cardiac disease, including any of the following:
✕. Known active or uncontrolled infections not adequately responding to appropriate therapy.