Sickle Cell Disease and CardiovAscular Risk - Red Cell Exchange Trial (SCD-CARRE)

ID#: NCT04084080

Age: 18 years - 66+

Gender: All

Healthy Subjects: No

Study Phase: Phase 3

Recruitment Status: Recruiting

Start Date: February 26, 2020

End Date: April 30, 2026

Contact Information:
Jude Jonassaint, RN
Nydia Chien, MSN
Summary: The SCD-CARRE trial is a Phase 3, prospective, randomized, multicenter, controlled, parallel two-arm study aimed to determine if automated exchange blood transfusion and standard of care administered to high mortality risk adult SCD patients reduces the total number of episodes of clinical worsening of SCD requiring acute health care encounters (non-elective infusion center/ER/hospital visits) or resulting in death over 12 months as compared with standard of care.

Inclusion Criteria:

- Age 18 years or older

- Diagnosis of SCD: homozygous sickle cell disease, hemoglobin-SC, Sβ-thalassemia, hemoglobin-SO or hemoglobin-SD.

- Patients not on a chronic exchange transfusion program for at least 2 months.

- If patients are on hydroxyurea, glutamin, or selectin inhibitors the doses must be stable for at least 2 months prior to randomization.

- Any one of the following vasculopathy biomarker clinical results (a, b, or c) measured in the 13 months before randomization that indicates a high-risk patient:

1. Both a TRV 2.5-2.9 m/sec and NT-proBNP plasma level ≥ 160 pg/mL

2. TRV ≥ 3.0 m/sec

3. Chronic kidney disease (CKD) due to SCD with macroalbuminuria (albumin creatinine ratio (ACR) >300 mg/g) on 2 occasions, or proteinuria (protein creatinine ratio >30 mg/mmol) on 2 occasions, or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 calculated on 2 occasions.

- Written informed consent obtained from patient to participate in the trial.

Exclusion Criteria:

- RBC alloimmunization resulting in inability of blood bank to obtain compatible components for chronic exchange transfusions

- Previous history of hyper-hemolysis syndrome

- Previous history of severe transfusion reaction resulting in renal failure or due to serious complications such as hypotension or respiratory distress

- More than 10 vaso-occlusive episodes in the past 12 months requiring admission to a hospital to receive treatment.

- Religious objection to receiving blood transfusion

- Diagnosis of ischemic stroke within the past 6 months

- Clinical evidence of liver failure or advanced cirrhosis or any co-existing medical condition that in the Investigator's judgement will substantially increase the risk associated with the patient's participation in the trial

- Women of childbearing potential who have a positive pregnancy test at baseline