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NCT06989567Not yet recruitingPhase 3

A Study of Intravenous L-Citrulline in Patients Aged 6-21 Years Old With Sickle Cell Disease Presenting to Emergency Departments in Acute Vaso-Occlusive Crisis

A Phase III, Multi-Center, Double-Blind, Placebo-Controlled, Randomized Study of Intravenous L-Citrulline in Sickle Cell Disease Presenting to Emergency Departments in Acute Vaso-Occlusive Crisis in Children, Adolescents and Young Adults (6 to 21 Years)

Source: ClinicalTrials.gov · Last updated 29 May 2025 · Not updated for over 12 months - ask the site whether it is still open

Brief summary (registry, in English)

This study is being done to learn more about a possible new treatment for pain episodes (called vaso-occlusive crises or VOCs) in children, teens, and young adults with sickle cell disease (SCD). The study will include about 120 participants between the ages of 6 and 21 who come to the emergency department (ED) with a VOC. A VOC is a painful episode that happens with no clear cause and no signs of infection or major problems with organs like the liver or kidneys. Before joining the study, patients and their families may be asked to learn about it and give permission (called consent or assent) while at a regular clinic visit. If that hasn't happened yet, the consent/assent process will happen at the emergency department when the patient comes in for care. If the patient meets all the study requirements, they can join the treatment part of the study. Participants will be randomly assigned (like flipping a coin) to receive either: L-citrulline, the study drug, or A placebo, which looks the same but has no active ingredients. Everyone has an equal chance of getting either one. The study drug is given through an IV. It starts with one larger dose, followed by a steady infusion for up to 12 hours. All patients in the study will still receive the usual pain treatment (called standard of care), which may include opioids. However, some patients may need fewer opioids if the study treatment helps with their pain. If any medicines are not allowed during the study, the doctor will explain this during the consent process. Patients can go home once: Their pain is controlled with oral (by mouth) pain medicine, They're eating and drinking well, and They've been given a personal pain management plan to use at home. After leaving the hospital, the study team will follow up with patients by phone about 2 days later (within a 12-hour window), again around Day 7, and again around Day 30 to check how they're doing.

Status (registry)
Not yet recruiting
Phase (registry)
Phase 3
Study type
Interventional
Enrollment
120 (estimated)
First submitted
8 May 2025
Start date
25 Jul 2025
Primary completion date
Jun 2027
Lead sponsor
Asklepion Pharmaceuticals, LLC
NCT number
NCT06989567

What you commit to

  • Study type: Interventional · Phase 3
  • Planned participants: 120
  • From 25 Jul 2025 to the primary completion date, Jun 2027
  • 6 sites in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • History of 9 hospital admissions in the prior year
  • Participation in a clinical trial of a new therapy for SCD within the last 1 month
  • Systemic steroid therapy within the last 24 hours
  • Use of inhaled NO or medications that are known to cause hypotension (e.g., nitrates, sildenafil, tadalafil, vardenafil, osildenafil, or arginine) within the last 30 days

Other illness

  • Presence of any other complication related to SCD such as splenic sequestration, hepatic sequestration, stroke, avascular necrosis of the hip/shoulder, acute priapism, acute renal dysfunction, acute chest syndrome and other major medical conditions or organ dysfunction
  • Presence of acute chest syndrome, sepsis, known bacterial infection, or hemodynamic instability
  • Acute stroke or clinical concern for stroke
  • History of allergic reaction to L-citrulline product or dextrose

Lab values

  • Severe anemia (hemoglobin \<6 g/dL)
  • Serum creatinine levels:
  • Age 6-13 years: \>0.9 mg/dL
  • Age 14-17 years: \>1.0 mg/dL
  • Age ≥18 years: \>1.5 mg/dL

Age

  • Patients with inability to have assent given (ages 6 to 17 years) or consent (ages 18 through 21 years).
    • Note: Parents or legal guardians can provide consent for patients who are unable to provide assent (e.g., sleepy or preoccupied by their pain).

Other

  • Current pain lasting \>3 days
  • Hypotension requiring clinical intervention; hemodynamic instability; septic shock
  • Report of fever (\>38°C) within the last 24 hours
  • Acute mental status or neurological changes
  • Unreliable venous access
  • The PI considers that the patient will be unable to comply with the study requirements
  • Patients pre-planned for admission on arrival in ED

Who the study is looking for

  • SCD (all genotypes)
  • Children, adolescents and young adults between ages 6 to 21 years
  • In a steady disease state and not in the midst of any acute complication other than VOC due to SCD at study entry
  • Baseline NRS score \>5 or Faces Pain Scale score ≥6
  • For females of childbearing potential, a negative urine pregnancy test and using an adequate method of contraception including abstinence
  • Patients or parents or legal guardian of the patient who are willing and able to sign and provide consent and assent (where appropriate for the age of the child)
  • Patients willing to begin study treatment within 120 minutes after providing informed consent/assent and soon after the first/initial dose, but before any subsequent doses of IV opioid or ketamine

Age in the registry: 6 years to 21 years · Sex: All · Does not accept healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (6)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Emory University
Coordinator of this site? Confirm its status
AtlantaUnited StatesUnknown status
Johns Hopkins Hospital
Coordinator of this site? Confirm its status
BaltimoreUnited StatesUnknown status
University of Miami
Coordinator of this site? Confirm its status
Coral GablesUnited StatesUnknown status
Children's Hospital of Michigan
Coordinator of this site? Confirm its status
DetroitUnited StatesUnknown status
East Carolina (University of North Carolina)
Coordinator of this site? Confirm its status
GreenvilleUnited StatesUnknown status
Children's National Hospital
Coordinator of this site? Confirm its status
Washington D.C.United StatesUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.