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PB2304 CRIZANLIZUMAB DOSE CONFIRMATION IN PEDIATRIC PATIENTS WITH SICKLE CELL DISEASE: SOLACE‐KIDS TRIAL DESIGN

2019· article· en· W2949508612 on OpenAlexaff
Matthew M. Heeney, David C. Rees, M. de Montalembert, Isaac Odame, R. Merino, Brittney Elliott, Shankaranand Bodla, Julie Kanter

Bibliographic record

VenueHemaSphere · 2019
Typearticle
Languageen
FieldMedicine
TopicHemoglobinopathies and Related Disorders
Canadian institutionsSickKids Foundation
Fundersnot available
KeywordsMedicineAcute chest syndromeDosingPlaceboSickle cell anemiaInflammationDiseaseAdverse effectInternal medicineImmunologyGastroenterologyPathology

Abstract

fetched live from OpenAlex

Background: Sickle cell disease (SCD) is the most common serious single‐gene disorder in the world and can lead to complications, including acute pain and acute/chronic organ damage. Episodes of vaso‐occlusion are a hallmark of SCD. P‐selectin, an adhesion molecule expressed primarily on endothelial cells and platelets, plays a key role in the initiation of leukocyte rolling along the blood vessel wall (leading to inflammation propagation) and contributes to multicellular adhesion and microvascular occlusion in SCD. Although children and adults with SCD have similar P‐selectin expression, SCD worsens with advancing age as repeated vascular occlusion results in cumulative endothelial damage. Crizanlizumab, a humanized monoclonal antibody that binds P‐selectin and blocks interaction with its ligands (including leukocyte PSGL‐1), significantly decreased vaso‐occlusive crises (VOCs) leading to healthcare visit vs placebo and was well tolerated in SUSTAIN, a phase 2 study in adults with SCD. Aims: To report the design of the first crizanlizumab study in pediatric patients with SCD. Methods: Primary objectives of this phase 2, multicenter, open‐label study are to confirm appropriate dosing and safety of crizanlizumab therapy in patients >6mo – <18yrs, using sequential, descending age groups of pediatric SCD patients. Secondary objectives include assessing number of VOCs and number/duration of hospitalizations and emergency room visits. Planned enrollment is ≥100 patients with confirmed SCD diagnosis (all genotypes), who experienced ≥1 VOC within the preceding 12mo, in 3 sequential descending age groups: Group 1 (≥26 patients; 12yr‐<18yr), Group 2 (≥26 patients; 6yr – <12yr), and Group 3 (≥8 patients; 2yr – <6yr) and (≥6 patients; 6mo – <2yr). First, the dose will be confirmed (Part A) by ≥8 patients in Group 1. If not confirmed, the dose will be adjusted based on observed pharmacokinetics/pharmacodynamics, and ≥8 additional patients will be enrolled in Group 1 (Part A) to confirm the new dose. Once the dose is confirmed, Group 1 will be expanded (Part B), and ≥8 patients will be enrolled to Group 2 for dose confirmation. This schema will continue until dose confirmed in Group 3, which will then be expanded for enrollment of an exploratory group of ≥6 patients ages 6mo‐<24mo. Patients being treated with hydroxyurea/hydroxycarbamide must have been taking it for ≥6mo prior to study entry with no planned dose adjustments other than accounting for weight changes. Crizanlizumab (5.0 mg/kg intravenously) will be administered on week 1, week 3, and every 4 weeks thereafter for 2 years. Results: Trial ongoing (ClinicalTrials.gov: NCT03474965). Summary/Conclusion: This study aims to address the unmet treatment need in pediatric patients with SCD by establishing pharmacokinetics/pharmacodynamics and confirming appropriate dose in different age groups. Safety will be assessed as a primary objective. Additionally, the number of VOCs and number/duration of hospitalizations and emergency room visits will be assessed as a secondary objective. Sponsored by Novartis.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.421
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.007
GPT teacher head0.211
Teacher spread0.204 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2019
Admission routes1
Has abstractyes

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