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A Study of Etavopivat in Adults and Adolescents With Sickle Cell Disease (HIBISCUS)

Phase 3
Active, not recruiting
Conditions
Sickle Cell Disease
Interventions
Registration Number
NCT04624659
Lead Sponsor
Forma Therapeutics, Inc.
Brief Summary

This clinical trial is a Phase 2/3 study that will evaluate the efficacy and safety of etavopivat and test how well etavopivat works compared to placebo to improve the amount of hemoglobin in the blood and to reduce the number of vaso-occlusive crises (times when the blood vessels become blocked and cause pain).

Detailed Description

Etavopivat is designed to activate PKR and thereby modulate RBC metabolism by impacting two critical pathways in RBCs. The etavopivat clinical development program will investigate whether decreasing 2,3-DPG may help oxygen bind to hemoglobin (i.e. increasing oxygen affinity), and thereby increase ATP and impact RBC function. This study is a randomized, placebo-controlled, double-blind, multicenter Phase 2/3 study of patients age 12 to 65 years (inclusive), with sickle cell disease. There is one planned interim analyses in this study design. Initially, patients will be randomized at 1:1:1 to one of two dose levels of etavopivat or placebo. At the first interim analysis, one of the two etavopivat dose levels will be selected for the Phase 3 portion of the study, in which patients will be randomized at 1:1 to the selected etavopivat dose or placebo. Efficacy on hemoglobin will be evaluated at conclusion of the double-blind treatment period. Following completion of 52 weeks of double-blind treatment, patients may enter a 112-week etavopivat open-label extension period.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
450
Inclusion Criteria
  • Provision of consent
  • Patient has a confirmed diagnosis of sickle cell disease
  • At least 2 episodes of vaso-occlusive crises in the past 12 months
  • Hemoglobin ≥ 5.5 and ≤ 10.5 g/dL (≥ 55 and ≤ 105 g/L) during screening
  • Patients taking hydroxyurea, must demonstrate a stable dose for at least 90 days prior to start of study treatment
  • Patients on crizanlizumab or L-glutamine treatment at the time of consent must be on a stable dose for ≥ 12 months and must be ≥ 80% compliant with the planned regimen at the time of consent and meet the VOC eligibility criteria
  • Female patients of childbearing potential must use highly effective methods of contraception, male patients are willing to use barrier methods of contraception

Key

Exclusion Criteria
  • More than 15 vaso-occlusive crises within the past 12 months

  • Female who is breastfeeding or pregnant

  • Hepatic dysfunction characterized by:

    • Alanine aminotransferase (ALT) > 4.0 × upper limit of normal (ULN)
    • Direct bilirubin > 3.0 × ULN
  • Known HIV positivity

  • Active hepatitis B or hepatitis C infection

  • Severe renal dysfunction or on chronic dialysis

  • History of unstable or deteriorating cardiac or pulmonary disease within 6 months prior to consent including but not limited to the following:

    • Unstable angina pectoris or myocardial infarction or elective coronary intervention
    • Congestive heart failure requiring hospitalization
    • Uncontrolled clinically significant arrhythmias
    • Symptomatic pulmonary hypertension
  • History of overt clinical stroke within previous 2 years or any history of an intracranial hemorrhage

  • History of deep venous thrombosis requiring systemic anti-coagulation therapy for ≥ 6 weeks, occurring within 6 months prior to Day 1 of study treatment.

Prior/Concomitant Therapy

  • Patients receiving regularly scheduled blood (RBC) transfusion therapy (also termed chronic, prophylactic, or preventive transfusion)
  • Receiving or use of concomitant medications that are strong inducers of CYP3A4/5 within 2 weeks of starting study treatment or anticipated need for such agents during the study
  • Use of voxelotor within 28 days prior to starting study treatment or anticipated need for this agent during the study
  • Use of an experimental selectin antagonist (eg, monoclonal antibody or small molecule) within 28 days of starting study treatment or anticipated need for such agents during the study
  • Use of erythropoietin or other hematopoietic growth factor treatment within 28 days of starting study treatment or anticipated need for such agents during the study
  • Receipt of prior cellular-based therapy (eg, hematopoietic cell transplant, gene modification therapy)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Double blind etavopivat Low DoseEtavopivat Tablets Low doseDouble blind etavopivat Low Dose
Double blind etavopivat High DoseEtavopivat Tablets High doseDouble blind etavopivat High Dose
Double blind placeboPlacebo TabletsDouble blind placebo
Open label etavopivatEtavopivat TabletsOpen label etavopivat
Primary Outcome Measures
NameTimeMethod
Hemoglobin response rate24 Weeks

Hemoglobin response rate at Week 24 (increase of \> 1 g/dL \[\> 10 g/L\] from baseline) during the blinded treatment period

Annualized vaso-occlusive crisis52 Weeks

Annualized vaso-occlusive crisis rate during the 52-week blinded treatment period based on adjudicated vaso-occlusive crisis review

Secondary Outcome Measures
NameTimeMethod
Hemoglobin52 Weeks

Change from baseline in hemoglobin at Week 52 during the blinded treatment period

Absolute reticulocyte count24 Weeks

Change in absolute reticulocyte count from baseline at Week 24 during the blinded treatment period

Indirect bilirubin24 Weeks

Change in unconjugated bilirubin from baseline at Week 24 during the blinded treatment period

Lactate dehydrogenase24 Weeks

Change in lactate dehydrogenase from baseline at Week 24 during the blinded treatment period

Vaso-occlusive crisis52 Weeks

Time to first vaso-occlusive crisis during the blinded treatment period

Fatigue52 Weeks

Change in Patient-Reported Outcome Measurement Information System (PROMIS) Fatigue Scale from baseline in adult patients at Week 52 during the blinded treatment period

Trial Locations

Locations (215)

Hospices Civils de Lyon-Hopital Edouard Herriot

🇫🇷

Lyon, France

Univertatsklinikum Frankfurt

🇩🇪

Frankfurt, Germany

Hospital Clínico San Carlos

🇪🇸

Madrid, Spain

[Legal] Baylor College of Medicine

🇺🇸

Houston, Texas, United States

Univ of Alabama Birmingham

🇺🇸

Birmingham, Alabama, United States

University of Alabama at Birmingham (UAB)

🇺🇸

Birmingham, Alabama, United States

Phoenix Children's Hospital

🇺🇸

Phoenix, Arizona, United States

Phoenix Children's Hsptl

🇺🇸

Phoenix, Arizona, United States

[Legal] Woodland International Research Group, LLC

🇺🇸

Little Rock, Arkansas, United States

Woodland International Research Group

🇺🇸

Little Rock, Arkansas, United States

University of California, Irvine

🇺🇸

Irvine, California, United States

[Legal] Collaborative Neuroscience Network, LLC

🇺🇸

Long Beach, California, United States

Collaborative Neuroscience Research, LLC.

🇺🇸

Long Beach, California, United States

Pacific Research Partners, LLC

🇺🇸

Oakland, California, United States

Pacific Research Partners

🇺🇸

Oakland, California, United States

UCSF Benioff Children's Hospital Oakland

🇺🇸

Oakland, California, United States

UCSF Oakland Benioff ChildHosp

🇺🇸

Oakland, California, United States

University Of California Irvine

🇺🇸

Orange, California, United States

UC Davis Medical Center - UC Davis Comprehensive Cancer Center - Hemotology/Oncology Clinic

🇺🇸

Sacramento, California, United States

UC Davis Medical Center

🇺🇸

Sacramento, California, United States

University of Connecticut (UCONN) Health

🇺🇸

Farmington, Connecticut, United States

University of Connecticut

🇺🇸

Farmington, Connecticut, United States

Yale University

🇺🇸

New Haven, Connecticut, United States

Children's National Health Center

🇺🇸

Washington, District of Columbia, United States

Howard University

🇺🇸

Washington, District of Columbia, United States

Cornerstone Research Institute

🇺🇸

Altamonte Springs, Florida, United States

University of Florida Hematology

🇺🇸

Gainesville, Florida, United States

University of Florida

🇺🇸

Gainesville, Florida, United States

Office of Gershwin T. Blyden, MD

🇺🇸

Hollywood, Florida, United States

Foundation for Sickle Cell Disease Research

🇺🇸

Hollywood, Florida, United States

University of Miami - Miller School of Medicine

🇺🇸

Miami, Florida, United States

University Of Miami

🇺🇸

Miami, Florida, United States

Advanced Pharma CR LLC.

🇺🇸

Miami, Florida, United States

Advanced Pharma CR

🇺🇸

Miami, Florida, United States

Arnold Palmer Children's Hospital

🇺🇸

Orlando, Florida, United States

Arnold Palmer Hospital for Children - Haley Center for Children's Cancer and Blood Disorders

🇺🇸

Orlando, Florida, United States

Emory University School of Medicine

🇺🇸

Atlanta, Georgia, United States

Sonar Clinical Research

🇺🇸

Atlanta, Georgia, United States

Children's Healthcare of Atlanta - Pediatric Research Center

🇺🇸

Atlanta, Georgia, United States

Children's Healthcare of Atlanta Investigational Medication Pharmacy

🇺🇸

Atlanta, Georgia, United States

Augusta University Center for Blood Disorders.

🇺🇸

Augusta, Georgia, United States

Center for Blood Disorders Augusta University

🇺🇸

Augusta, Georgia, United States

iResearch Atlanta, LLC

🇺🇸

Decatur, Georgia, United States

University of Illinois at Chicago Sickle Cell Center

🇺🇸

Chicago, Illinois, United States

University of Illinois at Chicago

🇺🇸

Chicago, Illinois, United States

Children's Hosp-New Orleans

🇺🇸

New Orleans, Louisiana, United States

Children's Hospital New Orleans

🇺🇸

New Orleans, Louisiana, United States

University of Maryland School of Medicine

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital_Boston

🇺🇸

Boston, Massachusetts, United States

Boston Medical Center

🇺🇸

Boston, Massachusetts, United States

Barbara Ann Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Detroit Medical Center (DMC) - Children's Hospital of Michigan (CHM)

🇺🇸

Detroit, Michigan, United States

Karmanos Cancer Institute

🇺🇸

Detroit, Michigan, United States

Washington University School of Medicine Barnes - Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

Washington University School of Medicine_St. Louis

🇺🇸

Saint Louis, Missouri, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Children's National Health Hospital

🇺🇸

Washington, New Jersey, United States

Jacobi Medical Center

🇺🇸

Bronx, New York, United States

Children's Hospital at Montefiore

🇺🇸

Bronx, New York, United States

Montefiore Medical Center

🇺🇸

Bronx, New York, United States

Kings County Hospital

🇺🇸

Brooklyn, New York, United States

NYC Health+Hospitals

🇺🇸

Brooklyn, New York, United States

Queens Hospital Center

🇺🇸

Jamaica, New York, United States

North Shore Long Island Jewish Medical Center

🇺🇸

New Hyde Park, New York, United States

Long Island Jewish Medical Center

🇺🇸

New Hyde Park, New York, United States

Columbia University Medical Center_New York

🇺🇸

New York, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Weill Cornell Med Coll-NYPH

🇺🇸

New York, New York, United States

[Legal] The University of North Carolina at Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

UNC School of Medicine

🇺🇸

Chapel Hill, North Carolina, United States

Levine Cancer Institute

🇺🇸

Charlotte, North Carolina, United States

Duke University - Sickle Cell Center

🇺🇸

Durham, North Carolina, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

East Carolina University (ECU) Physicians

🇺🇸

Greenville, North Carolina, United States

East Carolina University

🇺🇸

Greenville, North Carolina, United States

Wake Forest Baptist Health

🇺🇸

Winston-Salem, North Carolina, United States

Wake Forest Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

University of Cincinnati Cancer Center

🇺🇸

Cincinnati, Ohio, United States

University of Cincinnati

🇺🇸

Cincinnati, Ohio, United States

[Legal] Children's Hospital Medical Center dba Cincinnati Children's

🇺🇸

Cincinnati, Ohio, United States

Cincinnati Childrens Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

The Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

Neuro-Behavioral Clinical Research

🇺🇸

North Canton, Ohio, United States

Jimmy Everest Cancer Hematology & Oncology

🇺🇸

Oklahoma City, Oklahoma, United States

Lynn Institute of Tulsa

🇺🇸

Tulsa, Oklahoma, United States

Children's Hosptl Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

The Children's Hospital of Philadelphia (CHOP)

🇺🇸

Philadelphia, Pennsylvania, United States

Thomas Jefferson University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

University of Pittsburgh Medical Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

Medical University of South Carolina (MUSC)

🇺🇸

Charleston, South Carolina, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Prisma Health-Upstate

🇺🇸

Greenville, South Carolina, United States

Prisma Health

🇺🇸

Greenville, South Carolina, United States

Methodist University Hospital

🇺🇸

Nashville, Tennessee, United States

[Legal] St. Jude Children's Research Hospital

🇺🇸

Memphis, Tennessee, United States

St. Jude Children's Research Hospital (SJCRH)

🇺🇸

Memphis, Tennessee, United States

Baylor College of Medicine

🇺🇸

Houston, Texas, United States

The University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

UT Health University of Texas

🇺🇸

Houston, Texas, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

Mary Bridge Children's Health Center

🇺🇸

Tacoma, Washington, United States

Mary Bridge Children's Health

🇺🇸

Tacoma, Washington, United States

Blood Center of Wisconsin (BCW)

🇺🇸

Milwaukee, Wisconsin, United States

Versiti Blood Center of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Providence Hematolgy

🇨🇦

Vancouver, British Columbia, Canada

The Hospital for Sick Children

🇨🇦

Toronto, Canada

University Health Network - Toronto General Hospital

🇨🇦

Toronto, Ontario, Canada

CHU Sainte-Justine Mother and Child University Hospital

🇨🇦

Montreal, Quebec, Canada

Universite de Montreal - Centre Hospitalier Universitaire (CHU) Sainte-Justine

🇨🇦

Montréal, Canada

University Health Network Toronto General Hospital

🇨🇦

Toronto, Canada

Providence Hematology

🇨🇦

Vancouver, Canada

[Legal] Alexandria Clinical Research LLC

🇪🇬

Alexandria, Egypt

Alexandria Clinical Research Center

🇪🇬

Alexandria, Egypt

Alexandria Faculty of Medicine - Clinical Research Center

🇪🇬

Alexandria, Egypt

Ain Shams University Hospital

🇪🇬

Cairo, Egypt

Cairo University

🇪🇬

Cairo, Egypt

Al Kasr AL Aini Hospital

🇪🇬

Cairo, Egypt

Sydnawy University Hospital

🇪🇬

Zagazig, Egypt

CHU Montpellier, Hôpital Saint-Eloi

🇫🇷

Montpellier, Montpellier Cedex 5, France

Ap-Hp-Hopital Henri Mondor

🇫🇷

Creteil, France

Hôpital Henri Mondor

🇫🇷

Créteil, France

Hôpital Edouard HERRIOT

🇫🇷

Lyon, France

Centre Hospitalier Universitaire de Montpellier-Hopital Saint-Eloi

🇫🇷

Montpellier Cedex 5, France

GHR Mulhouse Sud-Alsace

🇫🇷

Mulhouse, France

Hôpital Emile Muller

🇫🇷

Mulhouse, France

Ap-Hp-Hopital Robert Debre

🇫🇷

Paris, France

CHU Paris - Hôpital Robert Debré

🇫🇷

Paris, France

Saint-Denis Hospital Center

🇫🇷

Saint-Denis, France

Charité - Campus Virchow-Klinikum - Klinik für Pädiatrie mit Schwerpunkt Onkologie und Hämatologie

🇩🇪

Berlin, Germany

Charite Berlin - University Medicine

🇩🇪

Berlin, Germany

Universitätsklinikum Frankfurt

🇩🇪

Frankfurt am Main, Germany

Universitätsklinikum Freiburg-Zentrum für Kinder- und Jugendmedizin

🇩🇪

Freiburg, Germany

Universitätsklinikum Freiburg

🇩🇪

Freiburg, Germany

University Medical Center Hamburg-Eppendorf

🇩🇪

Hamburg, Germany

UKE Hamburg

🇩🇪

Hamburg, Germany

Uniklinik Heidelberg - Klinik für Pädiatrische Onkologie, Hämatologie, Immunologie und Pneumologie

🇩🇪

Heidelberg, Germany

University Hospital of Heidelberg

🇩🇪

Heidelberg, Germany

Universitätsklinikum Regensburg

🇩🇪

Regensburg, Germany

Universitatsklinikum Regensburg

🇩🇪

Regensburg, Germany

Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital (KBTH)

🇬🇭

AccrA, Ghana

Kintampo Health Research Centre (KHRC), Kintampo, Ghana

🇬🇭

Kintampo, Ghana

General University Hospital of Patras

🇬🇷

Rio, Patras, Greece

Gen Hosp Athens Ippokrateio,B' Uni Clinic Internal Medicine

🇬🇷

Athens, Greece

Hippocratio General Hospital

🇬🇷

Athens, Greece

General Hospital Of Larissa Koutlibaneio And Triantafylleio

🇬🇷

Larissa, Greece

General University Hospital of Larissa

🇬🇷

Larissa, Greece

'Ippokrateio' General Hospital of Thessaloniki

🇬🇷

Thessaloniki, Greece

General Hospital of Thessaloniki "Hippokration"

🇬🇷

Thessaloniki, Greece

K.J Somaiya Hospital and Research Centre

🇮🇳

Mumbai, Maharashtra, India

Victoria Hospital, Bangalore

🇮🇳

Bangalore, India

Srirama Chandra Bhanj Medical College & Hospital (S.C.B Medical College)

🇮🇳

Cutack, India

Yashoda Hospital

🇮🇳

Hyderabad, India

All India Institute of Medical Sciences (AIIMS)

🇮🇳

New Delhi, India

Centro per lo Studio e la Cura delle Amiloidosi Sistemiche Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, PV, Italy

Azienda Ospedaliero Universitaria Policlinico "G. Rodolico - San Marco"

🇮🇹

Catania, Italy

Azienda Ospedaliero Universitaria Policlinico G. Rodolico - San Marco

🇮🇹

Catania, Italy

Azienda Ospedaliera Universitaria San Luigi Gonzaga

🇮🇹

Orbassano, Italy

Azienda Ospedale Universita Padova

🇮🇹

Padova, Italy

Azienda Ospedale Università Padova

🇮🇹

Padova, Italy

ARNAS Ospedali Civico Di Cristina Benfratelli

🇮🇹

Palermo, Italy

Fondazione IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

Ospedale Pediatrico Bambino Ges

🇮🇹

Roma, Italy

IRCCS Ospedale Pediatrico Bambino Gesu

🇮🇹

Rome, Italy

Kombewa Clinical Research Centre

🇰🇪

Kisumu, Kenya

KEMRI Kondele Children Hospital, Kisumu

🇰🇪

Kisumu, Kenya

KEMRI Siaya Clinical Research Annex Siaya County Referral Hospital, Siaya

🇰🇪

Kisumu, Kenya

Gertrude's Children's Hospital, Nairobi

🇰🇪

Nairobi, Kenya

American University of Beirut Medical center

🇱🇧

Beirut, Lebanon

American University of Beirut Medical Center

🇱🇧

Beirut, Lebanon

Hospital Nini

🇱🇧

Tripoli, Lebanon

Nini Hospital

🇱🇧

Tripoli, Lebanon

University of Abuja Teaching Hospital, Gwagwalada, Abuja

🇳🇬

Abuja, Nigeria

Barau Dikko Teaching Hospital, Kaduna

🇳🇬

Kaduna, Nigeria

Aminu Kano Teaching Hospital (AKTH)

🇳🇬

Kano, Nigeria

Lagos University Teaching Hospital, Lagos

🇳🇬

Lagos, Nigeria

University of Nigeria Teaching Hospital, Enugu

🇳🇬

Lagos, Nigeria

Sultan Qaboos University Hospital

🇴🇲

Muscat, Oman

King Fahad Specialist Hospital-Dammam

🇸🇦

Damman, Saudi Arabia

Prince Mohammad Bin Naser Hospital

🇸🇦

Jazan, Saudi Arabia

King Khaled University Hospital,King Saud Univ. Med. City

🇸🇦

Riyadh, Saudi Arabia

Hospital Germans Trias i Pujol

🇪🇸

Badalona, Spain

Hospital Universitario de Cruces

🇪🇸

Baracaldo, Spain

Hospital De Cruces

🇪🇸

Barakaldo, Spain

Hospital Universitari Vall d'Hebron de Barcelona

🇪🇸

Barcelona, Spain

Hospital Vall d'Hebron

🇪🇸

Barcelona, Spain

Hospital Sant Joan de Déu

🇪🇸

Barcelona, Spain

Complejo Hospitalario Universitario A Coruña

🇪🇸

La Coruna, Spain

Hospital Gregorio Marañón

🇪🇸

Madrid, Spain

Hospital Ramón y Cajal

🇪🇸

Madrid, Spain

Hospital Clinico San Carlos

🇪🇸

Madrid, Spain

Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Universidad Autonoma de Madrid (UAM) - Hospital Universitario La Paz

🇪🇸

Madrid, Spain

Hospital Universitario Virgen del Rocio

🇪🇸

Sevilla, Spain

Hospital Universitario Virgen del Rocío

🇪🇸

Sevilla, Spain

Cukurova Universitesi

🇹🇷

Adana, Turkey

Baskent Universitesi Adana

🇹🇷

Adana, Turkey

Adana City Training and Research Hospital

🇹🇷

Adana, Turkey

Hacettepe Universitesi

🇹🇷

Ankara, Turkey

Ege University Medical Faculty

🇹🇷

Izmir, Turkey

Mersin University Medical Faculty Hospital, Hematology

🇹🇷

Mersin, Turkey

VM Medical Park Mersin Hospital

🇹🇷

Mersin, Turkey

Leicester Royal Infirmary

🇬🇧

Leicester, United Kingdom

University Hospital Lewisham, Lewisham and Greenwich NHS Trust

🇬🇧

London, United Kingdom

Guy's and St Thomas' NHS Foundation Trust

🇬🇧

London, United Kingdom

Guys and St Thomas NHS Foundation Trust / Evelina Childrens Hospital

🇬🇧

London, United Kingdom

King's College Hospital

🇬🇧

London, United Kingdom

Kings College Hospital

🇬🇧

London, United Kingdom

Hammersmith Hospital - Imperial College Healthcare NHS Trust

🇬🇧

London, United Kingdom

Imperial College Healthcare NHS Trust - Hammersmith Hospital

🇬🇧

London, United Kingdom

Imperial College Healthcare NHS Trust - St Mary's Hospital

🇬🇧

London, United Kingdom

Churchill Hospital

🇬🇧

Oxford, United Kingdom

Oxford University Hospitals NHS Trust - Churchill Hospital - Cancer and Haematology Centre

🇬🇧

Oxford, United Kingdom

The Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust

🇬🇧

Sheffield, United Kingdom

Royal Hallamshire Hospital

🇬🇧

Sheffield, United Kingdom

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