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Completed

NCT Number: NCT01597401

A Single Dose Study of the Safety, Blood Levels and Biological Effects of Aes-103 Compared to Placebo in Subjects With Stable Sickle Cell Disease

The purpose of this study is to assess the safety, tolerability, pharmacokinetic, and pharmacodynamic effects of Aes-103 (active ingredient 5-hydroxymethyl-2-furfural [5-HMF]) compared with placebo in subjects with stable sickle cell disease (SCD). Safety will be measured by monitoring adverse events (AEs), electrocardiograms (ECGs), vital signs, and laboratory values. Pharmacokinetics of Aes-103 will be measured over time in plasma, red blood cell hemolysate and binding of Aes-103 to hemoglobin. Pharmacodynamic effects will be assessed by measuring partial pressure of oxygen at which 50% of hemoglobin is saturated with oxygen (p50) while breathing normal air, blood oxygen levels (SpO2), ex-vivo antisickling effects in a hypoxic environment, and by imaging related changes in tissue blood flow and oxygen levels.

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

US National Institutes of Health - National Heart, Lung, and Blood Institute

Bethesda, Maryland, 20892, United States

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Be male or female, aged 18-65 years old, inclusive
  • Have sickle cell disease (SCD) (hemoglobin SS) without hospitalization for pain crises in the 30 days before screening or for any SCD complications on more than two occasions in the past 12 months; subjects are allowed concomitant usage of hydroxyurea (HU) if the dosage is stable for the 2 months before screening and is at a dosage that does not exceed the product's labeling.
  • Have normal laboratory values as defined below:
  • Direct bilirubin 0.1 to 1.0 mg/dL
  • Alanine transaminase (serum glutamic pyruvic transaminase) 6 to 41 IU/L
  • Creatinine for females 0.56 to 1.16 mg/dL and for males 0.77 to 1.19 mg/dL
  • If female, be non-pregnant and non-breastfeeding and be surgically sterile or using an acceptable method of contraception throughout the study and for 30 days after study completion
  • Have successfully completed an outpatient screening visit consisting of medical history, physical examination, 12-lead ECG, vital signs, hematology and chemistry tests, urinalysis, urine drug screen, pregnancy test (females), hemoglobin electrophoresis, hepatitis B and C screening, and HIV serology (Note: Subjects with abnormal screening values may be eligible if the results are not clinically significant, as judged by the investigator or medical monitor)
  • Be able to understand and have provided written informed consent including signature on an informed consent form approved by an institutional review board
  • Agree to abide by the study schedule and dietary restrictions and to return for the required assessments
  • Be willing to abstain from foods high in 5-HMF (e.g., coffee, malt, barley, balsamic vinegar, dried fruits, and caramel products) for at least 3 days before each dosing

Exclusion criteria

  • Have evidence of clinically significant cardiovascular, respiratory, renal, hepatic, pulmonary, gastrointestinal, hematological, neurological, psychiatric, or other disease that may interfere with the objectives of the study or the safety of the subject, as judged by the investigator in agreement with the sponsor or medical monitor, or have been hospitalized in the past 6 months as a result of these conditions
  • Have been hospitalized in the 14 days before enrollment, for any reason
  • Be currently on regularly scheduled transfusions
  • Have received a transfusion within 2 weeks of administration of study drug
  • Have taken herbal preparations in the 2 weeks before dosing (Note: subjects are allowed concomitant usage of HU and other scheduled prescription drugs if the dosage is stable for the 2 months before screening and is at a dosage that does not exceed the product's labeling. These scheduled prescription medications will be continued during the study [including during dosing]. All other medications, including over-the-counter medications used according to the product labeling, administered on an as-needed basis will be permitted except for the 24 hour period before dosing and the day of dosing. Medications for pain management will be allowed as needed [including during dosing.])
  • Have taken any other investigational drug within 30 days or 5 half-lives before the screening visit, whichever is longer
  • Consumed more than 14 alcoholic drinks per week or more than 3 drinks per day at any point in the past month
  • Have received disulfiram or 4-methylpyrazole within 30 days before dosing
  • Have taken any cough-cold product containing dextrorphan or dextromethorphan within 4 days before dosing
  • Have positive result for urine drug test (cocaine, marijuana, opiates, amphetamines, methamphetamines, benzodiazepines, ethanol) at screening visit. However, use of opiates, amphetamines, or benzodiazepines is allowed if prescribed by a physician.
  • Have engaged in strenuous exercise within 72 hours prior to dosing
  • Be considered not suitable for participation in this study for any reason, as judged by the investigator
  • Have pre-existing allergic or other adverse reactions to orange juice

Treatment and study plan

Aes-103

Drug

300 mg Aes-103 powder reconstituted in orange juice to a volume of 100 mL per single dose for oral administration.

Placebo

Drug

Orange juice vehicle, a solution that is highly similar in appearance to the Aes-103 orange juice solution.

Primary outcomes

  1. Safety, as assessed by frequency and severity of adverse events (AEs), and changes in vital signs, 12-lead electrocardiograms (ECGs), and laboratory assessments as compared to baseline.

    Time frame: 32 days

Secondary outcomes

  1. Plasma area under the curve (AUC) of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  2. Red blood cell (RBC) hemolysate AUC of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  3. Hemoglobin bound 5-hydroxymethyl-2-furfural (5-HMF) AUC

    Time frame: predose, .5 hrs, 1 hr, 4 hr, and 12 hr

  4. Renal elimination of Aes-103

    Time frame: predose, 0-4hrs, 4-8hrs, and 8-24hrs

  5. Percentage of hemoglobin bound to Aes-103

    Time frame: predose, 1 hr, 2 hr, 4 hr, and 12 hr

  6. Change from baseline in resting oxygen saturation (SpO2)

    Time frame: predose, .5 hrs, 1 hr, 4 hr, and 12 hr

  7. Change from baseline in partial pressure of oxygen required to achieve 50% hemoglobin saturation (p50) value

    Time frame: predose, 1 hr, 2 hr, 4 hr, and 12 hr

  8. Effects of food ingested prior to dosing on plasma AUC of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  9. Percentage of sickled cells under normal ex vivo conditions

    Time frame: predose, 1 hr, 2 hr, 4 hr, and 12 hr

  10. Change from baseline in blood flow distribution

    Time frame: predose and .5 to 2 hr

  11. Change from baseline in peripheral arterial tonometry

    Time frame: predose and .5 to 2 hr

  12. Change from baseline in pain as measured by the Numerical Pain Rating Scale (NPRS)

    Time frame: -1hr, -.5hrs, -5min, .1hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  13. Plasma maximum concentration (Cmax) of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  14. Plasma time to maximum concentration (Tmax) of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  15. Plasma half life (t1/2) of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  16. Plasma AUC of Aes-103's metabolite, 5-hydroxymethyl-2-furoic acid (HMFA)

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  17. Plasma maximum concentration (Cmax) of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  18. Plasma time to maximum concentration (Tmax) of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  19. Plasma half life (t1/2) of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  20. RBC hemolysate Cmax of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  21. RBC hemolysate Tmax of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  22. RBC hemolysate t1/2 of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  23. RBC hemolysate AUC of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  24. RBC hemolysate Cmax of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  25. RBC hemolysate Tmax of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  26. RBC hemolysate t1/2 of HMFA

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  27. Hemoglobin bound 5-HMF Cmax

    Time frame: predose, .5 hrs, 1 hr, 4 hr, and 12 hr

  28. Hemoglobin bound 5-HMF Tmax

    Time frame: predose, .5 hrs, 1 hr, 4 hr, and 12 hr

  29. Hemoglobin bound 5-HMF t1/2

    Time frame: predose, .5 hrs, 1 hr, 4 hr, and 12 hr

  30. Renal elimination of HMFA

    Time frame: predose, 0-4hrs, 4-8hrs, and 8-24hrs

  31. Effects of food ingested prior to dosing on plasma Cmax of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  32. Effects of food ingested prior to dosing on plasma Tmax of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  33. Effects of food ingested prior to dosing on plasma t1/2 of Aes-103

    Time frame: predose, .1 hrs, .25 hrs, .5 hrs, .75 hrs, 1 hr, 2 hr, 3 hr, 4 hr, 6 hr, 8 hr, 12 hr, and 24 hr

  34. Percentage of sickled cells under hypoxic ex vivo conditions

    Time frame: predose, 1 hr, 2 hr, 4 hr, and 12 hr

  35. Change from baseline in vasomotion

    Time frame: predose and .5 to 2 hr

Sponsors and collaborators

Lead sponsor

Baxalta now part of Shire

Industry

Collaborators

  • Cato Research
  • ClinPharm Consulting, LLC
  • Infrared Imaging and Thermometry Unit, Biomedical Engineering and Physical Science Shared Resource (NIBIB)
  • National Chung Cheng University
  • National Heart, Lung, and Blood Institute (NHLBI)
  • QS Pharma
  • Ricerca Biosciences LLC
  • SAIC-Frederick, Inc.
  • Therapeutics for Rare and Neglected Diseases (TRND)

Registry information

Official study title

A Phase 1, Placebo-Controlled, Randomized, Double-Blind Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Escalating, Single Oral Doses of Aes-103 in Subjects With Stable Sickle Cell Disease

Important dates

Study start
2012
Primary completion
2013
Study completion
2013
First posted
May 14, 2012
Registry last updated
May 5, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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