Combination Regimen With Sodium Valproate for Severe Hemophilia B: a Single-arm, Phase 1, Pilot Trial.
Study Details
Study Description
Brief Summary
The goal of this clinical trial is to determine the clinical efficacy and toxic effects of sodium valproate, sirolimus and calcitriol in the treatment of severe haemophilia B in participants with severe haemophilia B. The main questions it aims to answer are the possibility of adding a combination regimen to primary treatment for severe haemophilia B. Patients will receive oral sodium valproate extended-release tablets 0.5g/day, sirolimus tablets 1mg/day and osteopontin capsules 0.25μg/day.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 1/Phase 2 |
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Patients with severe haemophilia B confirmed as hemophilia B and FIX activity <1% |
Drug: Sodium valproate extended-release tablets
Sodium valproate extended-release tablets 0.5g/day; sirolimus tablets 1mg/day and calcitriol capsules 0.25μg/day.
Other Names:
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Outcome Measures
Primary Outcome Measures
- FIX Activity [through study completion, an average of 1 month]
FIX activity in peripheral blood
- FIX inhibitor concentration [through study completion, an average of 1 month]
FIX inhibitor concentration in peripheral blood
Secondary Outcome Measures
- frequency of joint bleeding [through study completion, an average of 1 month]
Record the number of joint bleeds each month
- Activated Partial Thromboplastin Time [through study completion, an average of 1 month]
activated partial thromboplastin time in peripheral blood
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients with clinically confirmed severe haemophilia B;
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Expected survival of ≥ 24 weeks with an ECOG score of 0-2;
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Not having participated in another clinical trial within four weeks;
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Informed consent signed by the patient or an immediate family member.
Exclusion Criteria:
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Those with other types of blood disorders diagnosed at the morphological or molecular level of the bone marrow;
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Significantly abnormal cardiopulmonary function;
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Hepatic or renal insufficiency;
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Pregnancy or lactation, or inability to use contraception during the trial and for three months before the test and one year after administration
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Persons who are allergic to the drugs likely to be used or where there is a contraindication to their use;
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Those with severe uncontrollable infectious diseases or uncontrolled hypertension, malignancy, etc.;
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Inability to cooperate with a regular follow-up due to psychological, social, family and other geographical circumstances;
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Any other condition that, in the investigator's opinion, makes participation in this trial inappropriate.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | PLA General Hospital | Beijing | China | 100853 |
Sponsors and Collaborators
- Xue-chun Lu
Investigators
- Principal Investigator: Xuechun Lu, M.D., Department of Hematology, the Second Medical Center of PLA General Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Den Uijl IE, Mauser Bunschoten EP, Roosendaal G, Schutgens RE, Biesma DH, Grobbee DE, Fischer K. Clinical severity of haemophilia A: does the classification of the 1950s still stand? Haemophilia. 2011 Nov;17(6):849-53. doi: 10.1111/j.1365-2516.2011.02539.x. Epub 2011 May 5.
- DiMichele D. Inhibitor development in haemophilia B: an orphan disease in need of attention. Br J Haematol. 2007 Aug;138(3):305-15. doi: 10.1111/j.1365-2141.2007.06657.x.
- Jankowska KI, McGill J, Pezeshkpoor B, Oldenburg J, Atreya CD, Sauna ZE. Clinical manifestation of hemophilia A in the absence of mutations in the F8 gene that encodes FVIII: role of microRNAs. Transfusion. 2020 Feb;60(2):401-413. doi: 10.1111/trf.15605. Epub 2019 Nov 29.
- Johannessen SI, Landmark CJ. Antiepileptic drug interactions - principles and clinical implications. Curr Neuropharmacol. 2010 Sep;8(3):254-67. doi: 10.2174/157015910792246254.
- Leissinger C. Another Victory for Patients with Hemophilia. N Engl J Med. 2023 Jan 26;388(4):372-373. doi: 10.1056/NEJMe2216176. No abstract available.
- Lu P, Yan M, He L, Li J, Ji Y, Ji J. Crosstalk between Epigenetic Modulations in Valproic Acid Deactivated Hepatic Stellate Cells: An Integrated Protein and miRNA Profiling Study. Int J Biol Sci. 2019 Jan 6;15(1):93-104. doi: 10.7150/ijbs.28642. eCollection 2019.
- Marchesini E, Morfini M, Valentino L. Recent Advances in the Treatment of Hemophilia: A Review. Biologics. 2021 Jun 15;15:221-235. doi: 10.2147/BTT.S252580. eCollection 2021.
- Mintzer S, Mattson RT. Should enzyme-inducing antiepileptic drugs be considered first-line agents? Epilepsia. 2009 Sep;50 Suppl 8:42-50. doi: 10.1111/j.1528-1167.2009.02235.x.
- Moghimi B, Sack BK, Nayak S, Markusic DM, Mah CS, Herzog RW. Induction of tolerance to factor VIII by transient co-administration with rapamycin. J Thromb Haemost. 2011 Aug;9(8):1524-33. doi: 10.1111/j.1538-7836.2011.04351.x.
- Verrotti A, Coppola G, Parisi P, Mohn A, Chiarelli F. Bone and calcium metabolism and antiepileptic drugs. Clin Neurol Neurosurg. 2010 Jan;112(1):1-10. doi: 10.1016/j.clineuro.2009.10.011. Epub 2009 Nov 12.
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