Trial Outcomes & Findings for Sparing Conversion to Abnormal TCD (Transcranial Doppler) Elevation (SCATE) (NCT NCT01531387)

NCT ID: NCT01531387

Last Updated: 2016-02-08

Results Overview

The primary endpoint of the SCATE trial is the cumulative incidence of conversion to abnormal maximum TAMV (time-averaged mean velocity) measured by transcranial doppler (TCD) ultrasonography. Subjects must have conditional velocities at baseline, defined as 170 - 199 cm/sec, which indicate moderate stroke risk. Abnormal velocities are defined as ≥ 200 cm/sec, which indicate high stroke risk. The number of conversions from conditional velocities to abnormal velocities in each treatment arm will be compared as the primary outcome.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

38 participants

Primary outcome timeframe

30 months

Results posted on

2016-02-08

Participant Flow

22 participants were randomized (e.g., a total of 38 participants enrolled, but only 22 participants were randomized to treatment)

Participant milestones

Participant milestones
Measure
Hydroxyurea
Half of the subjects will be randomized to hydroxyurea, taken as capsules (300 mg, 400 mg, or 500 mg), or as a liquid formulation (100 mg/mL). Hydroxyurea will be administered once daily by mouth. Subjects will be monitored monthly with clinical evaluations, laboratory tests, and TCD endpoint examinations. Hydroxyurea: Hydroxyurea will be administered once daily, in either capsule form (300mg, 400mg, or 500mg) or as a liquid formulation (100mg/ml). Dosing will commence at 20 mg/kg/day. Dose escalation will occur in 5 mg/kg/day increments, adjusting every 8 weeks unless hematological toxicity occurs.
Standard Therapy: Observation
Half of the subjects will be randomized to clinical observation only, which includes monthly visits with clinical evaluations, laboratory tests, and TCD endpoint examinations
Overall Study
STARTED
11
11
Overall Study
COMPLETED
0
0
Overall Study
NOT COMPLETED
11
11

Reasons for withdrawal

Reasons for withdrawal
Measure
Hydroxyurea
Half of the subjects will be randomized to hydroxyurea, taken as capsules (300 mg, 400 mg, or 500 mg), or as a liquid formulation (100 mg/mL). Hydroxyurea will be administered once daily by mouth. Subjects will be monitored monthly with clinical evaluations, laboratory tests, and TCD endpoint examinations. Hydroxyurea: Hydroxyurea will be administered once daily, in either capsule form (300mg, 400mg, or 500mg) or as a liquid formulation (100mg/ml). Dosing will commence at 20 mg/kg/day. Dose escalation will occur in 5 mg/kg/day increments, adjusting every 8 weeks unless hematological toxicity occurs.
Standard Therapy: Observation
Half of the subjects will be randomized to clinical observation only, which includes monthly visits with clinical evaluations, laboratory tests, and TCD endpoint examinations
Overall Study
Early termination of study
11
11

Baseline Characteristics

Sparing Conversion to Abnormal TCD (Transcranial Doppler) Elevation (SCATE)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Standard Therapy: Observation
n=11 Participants
Half of the subjects will be randomized to clinical observation only, which includes monthly visits with clinical evaluations, laboratory tests, and TCD endpoint examinations
Hydroxyurea
n=11 Participants
Half of the subjects will be randomized to hydroxyurea, taken as capsules (300 mg, 400 mg, or 500 mg), or as a liquid formulation (100 mg/mL). Hydroxyurea will be administered once daily by mouth. Subjects will be monitored monthly with clinical evaluations, laboratory tests, and TCD endpoint examinations. Hydroxyurea: Hydroxyurea will be administered once daily, in either capsule form (300mg, 400mg, or 500mg) or as a liquid formulation (100mg/ml). Dosing will commence at 20 mg/kg/day. Dose escalation will occur in 5 mg/kg/day increments, adjusting every 8 weeks unless hematological toxicity occurs.
Total
n=22 Participants
Total of all reporting groups
Age, Categorical
<=18 years
11 Participants
n=99 Participants
11 Participants
n=107 Participants
22 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
6.3 Years
STANDARD_DEVIATION 1.5 • n=99 Participants
6 Years
STANDARD_DEVIATION 2.4 • n=107 Participants
6.15 Years
STANDARD_DEVIATION 1.95 • n=206 Participants
Sex: Female, Male
Female
7 Participants
n=99 Participants
7 Participants
n=107 Participants
14 Participants
n=206 Participants
Sex: Female, Male
Male
4 Participants
n=99 Participants
4 Participants
n=107 Participants
8 Participants
n=206 Participants
Region of Enrollment
Jamaica
7 participants
n=99 Participants
6 participants
n=107 Participants
13 participants
n=206 Participants
Region of Enrollment
Brazil
2 participants
n=99 Participants
3 participants
n=107 Participants
5 participants
n=206 Participants
Region of Enrollment
United States
2 participants
n=99 Participants
2 participants
n=107 Participants
4 participants
n=206 Participants

PRIMARY outcome

Timeframe: 30 months

Population: No participants reached 30 months of treatment prior to study termination; therefore, the primary outcome measure was not analyzed.

The primary endpoint of the SCATE trial is the cumulative incidence of conversion to abnormal maximum TAMV (time-averaged mean velocity) measured by transcranial doppler (TCD) ultrasonography. Subjects must have conditional velocities at baseline, defined as 170 - 199 cm/sec, which indicate moderate stroke risk. Abnormal velocities are defined as ≥ 200 cm/sec, which indicate high stroke risk. The number of conversions from conditional velocities to abnormal velocities in each treatment arm will be compared as the primary outcome.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 30 months

Population: No participants reached 30 months of treatment prior to study termination; therefore, the secondary outcome measures were not analyzed.

This secondary outcome measure will be the highest TAMV obtained in specific arteries. Serial TCD velocities are measured throughout the SCATE trial and will be compared to the baseline value.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 30 months

Population: No participants reached 30 months of treatment prior to study termination; therefore, the secondary outcome measures were not analyzed.

The cumulative incidence of neurological events as a secondary endpoint, which include both stroke and non-stroke neurological events, will be determined over the treatment period for both standard and alternative arms.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 30 months

Population: No participants reached 30 months of treatment prior to study termination; therefore, the secondary outcome measures were not analyzed.

The cumulative incidence of non-neurological sickle cell-related events, including vaso-occlusion and splenic sequestration, will be estimated over the treatment period for both standard and alternative arms.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 30 months

Population: No participants reached 30 months of treatment prior to study termination; therefore, the secondary outcome measures were not analyzed.

Standard Quality of Life measure will be taken during specific time points, as well as one newly-developed Sickle Cell Disease Quality of Life measure.

Outcome measures

Outcome data not reported

Adverse Events

Hydroxyurea

Serious events: 6 serious events
Other events: 7 other events
Deaths: 0 deaths

Standard Therapy: Observation

Serious events: 11 serious events
Other events: 7 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Hydroxyurea
n=11 participants at risk
Half of the subjects will be randomized to hydroxyurea, taken as capsules (300 mg, 400 mg, or 500 mg), or as a liquid formulation (100 mg/mL). Hydroxyurea will be administered once daily by mouth. Subjects will be monitored monthly with clinical evaluations, laboratory tests, and TCD endpoint examinations. Hydroxyurea: Hydroxyurea will be administered once daily, in either capsule form (300mg, 400mg, or 500mg) or as a liquid formulation (100mg/ml). Dosing will commence at 20 mg/kg/day. Dose escalation will occur in 5 mg/kg/day increments, adjusting every 8 weeks unless hematological toxicity occurs.
Standard Therapy: Observation
n=11 participants at risk
Half of the subjects will be randomized to clinical observation only, which includes monthly visits with clinical evaluations, laboratory tests, and TCD endpoint examinations
Blood and lymphatic system disorders
Hemoglobin
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
27.3%
3/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Fever
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Hepatobiliary disorders
Hepatobiliary Disorder
18.2%
2/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Infections and Infestations
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Lung Infection
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Lymph gland infection
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Renal and urinary disorders
Hematuria
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Bronchospasm
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Acute Chest Syndrome
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Acute Splenic Sequestration
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Vaso-occlusive Event
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
AST
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Vascular disorders
Hypertension
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial

Other adverse events

Other adverse events
Measure
Hydroxyurea
n=11 participants at risk
Half of the subjects will be randomized to hydroxyurea, taken as capsules (300 mg, 400 mg, or 500 mg), or as a liquid formulation (100 mg/mL). Hydroxyurea will be administered once daily by mouth. Subjects will be monitored monthly with clinical evaluations, laboratory tests, and TCD endpoint examinations. Hydroxyurea: Hydroxyurea will be administered once daily, in either capsule form (300mg, 400mg, or 500mg) or as a liquid formulation (100mg/ml). Dosing will commence at 20 mg/kg/day. Dose escalation will occur in 5 mg/kg/day increments, adjusting every 8 weeks unless hematological toxicity occurs.
Standard Therapy: Observation
n=11 participants at risk
Half of the subjects will be randomized to clinical observation only, which includes monthly visits with clinical evaluations, laboratory tests, and TCD endpoint examinations
Gastrointestinal disorders
Abdominal pain
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Gastrointestinal disorders
Gastritis
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Gastrointestinal disorders
Vomiting
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Fever
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Flu Like Symptoms
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Non Cardiac Chest Pain
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
General disorders
Pain
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Hepatobiliary disorders
Hepatobiliary Disorders
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Infections and Infestations
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Lung infections
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Lymph Glad Infection
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Tooth Infection
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Infections and infestations
Upper Respiratory Infection
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Metabolism and nutrition disorders
Metabolism and Nutrition Disorders
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Nervous system disorders
Dizziness
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Nervous system disorders
Headache
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Renal and urinary disorders
Hematuria
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Renal and urinary disorders
Proteinuria
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Allergic Rhinitis
9.1%
1/11 • Number of events 3 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Bronchospasm
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Cough
9.1%
1/11 • Number of events 3 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Dysnea
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Respiratory, thoracic and mediastinal disorders
Wheezing
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
Acute Chest Syndrome
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
Acute Stlenic sequestration
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
Vaso-occlusive Event
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
27.3%
3/11 • Number of events 4 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
ANC
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
ARC
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
AST
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
Hemoglobin
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
18.2%
2/11 • Number of events 3 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Blood and lymphatic system disorders
Bilirubin
18.2%
2/11 • Number of events 2 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue dissorder other
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
Vascular disorders
hypertension
0.00%
0/11 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial
9.1%
1/11 • Number of events 1 • May 2012 - Jan 2014 = 20 months
AEs below grade 2 were not recorded for the SCATE trial

Additional Information

James M. Boyett, PhD

St. Jude Children's Research Hospital

Phone: 901-595-4986

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place