| CTRI Number |
CTRI/2024/08/072780 [Registered on: 20/08/2024] Trial Registered Prospectively |
| Last Modified On: |
06/04/2026 |
| Post Graduate Thesis |
No |
| Type of Trial |
Interventional |
|
Type of Study
|
Drug |
| Study Design |
Randomized, Parallel Group, Placebo Controlled Trial |
|
Public Title of Study
|
Improving maternal and foetal outcomes among pregnant women suffering from sickle cell disease in Gujarat, India |
|
Scientific Title of Study
|
Effectiveness of Hydroxyurea along with standard of care compared to only standard of care on adverse maternal and foetal outcomes: A randomised controlled trial among pregnant women suffering from sickle cell disease in Gujarat, India |
| Trial Acronym |
NIL |
|
Secondary IDs if Any
|
| Secondary ID |
Identifier |
| NIL |
NIL |
|
|
Details of Principal Investigator or overall Trial Coordinator (multi-center study)
|
| Name |
Gayatri Desai |
| Designation |
Gynecologist |
| Affiliation |
SEWA Rural |
| Address |
SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India Bharuch GUJARAT 393110 India |
| Phone |
|
| Fax |
|
| Email |
gayatri.desai@sevarural.org |
|
Details of Contact Person Scientific Query
|
| Name |
Shrey Desai |
| Designation |
Research Director |
| Affiliation |
SEWA Rural |
| Address |
SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India Bharuch GUJARAT 393110 India |
| Phone |
9429109050 |
| Fax |
|
| Email |
shrey.desai@sevarural.org |
|
Details of Contact Person Public Query
|
| Name |
Shrey Desai |
| Designation |
Research Director |
| Affiliation |
SEWA Rural |
| Address |
SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India SEWA Rural
Department of Community Health and Research, Tower road, Jhagadia,
Bharuch
GUJARAT
393110
India
GUJARAT 393110 India |
| Phone |
9429109050 |
| Fax |
|
| Email |
shrey.desai@sevarural.org |
|
|
Source of Monetary or Material Support
|
| Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110
|
|
|
Primary Sponsor
|
| Name |
SEWA Rural |
| Address |
Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110 |
| Type of Sponsor |
Research institution and hospital |
|
|
Details of Secondary Sponsor
|
|
|
Countries of Recruitment
|
India |
|
Sites of Study
|
| No of Sites = 1 |
| Name of Principal
Investigator |
Name of Site |
Site Address |
Phone/Fax/Email |
| Dr Shrey Desai |
Kasturba Hospital |
Kasturba Maternity Hospital, SEWA Rural, Tower road, Jhagadia, District: Bharuch, Gujarat PIN 393110
Bharuch GUJARAT |
9429109050
shrey.desai@sevarural.org |
|
|
Details of Ethics Committee
|
| No of Ethics Committees= 1 |
| Name of Committee |
Approval Status |
| SEWA Rural IEC |
Approved |
|
|
Regulatory Clearance Status from DCGI
|
|
|
Health Condition / Problems Studied
|
| Health Type |
Condition |
| Patients |
(1) ICD-10 Condition: D759||Disease of blood and blood-formingorgans, unspecified, |
|
|
Intervention / Comparator Agent
|
| Type |
Name |
Details |
| Intervention |
Hydroxyurea medicine and standard treatment |
The intervention group will receive the current standard treatment and hydroxyurea medicine. Hydroxyurea will be started as per the national guidelines at 10-15 mg/kg/day orally. Hydroxyurea will be started as early as possible during the second trimester. Hydroxyurea will be continued up to delivery unless the patient experiences its side effects.
The standard antenatal care will be provided as per the clinical protocol of the hospital. This will include administration of the aspirin (150 mg daily), folic acid supplementation, iron supplementation, vitamin-D supplementation, calcium supplementation, regular sonographies, education of the patient and family members, and care in case of complications during the antenatal period. Top-up blood transfusion will be given for acute anaemia or sudden large reduction in hemoglobin level. Women will undergo induction of labour at 37 weeks of gestation in most cases, and will be closely monitored, especially during the first 12 hours postpartum. Standard inpatient care will be provided as per the clinical protocol of the hospital in case a patient is admitted for any obstetric, medical or sickle cell related complications with emphasis on volume management and prophylaxis for venous thromboembolic events. |
| Comparator Agent |
standard treatment |
The standard antenatal care will be provided as per the clinical protocol of the hospital. This will include administration of the aspirin (150 mg daily), folic acid supplementation, iron supplementation, vitamin-D supplementation, calcium supplementation, regular sonographies, education of the patient and family members, and care in case of complications during the antenatal period. Top-up blood transfusion will be given for acute anaemia or sudden large reduction in hemoglobin level. Women will undergo induction of labour at 37 weeks of gestation in most cases, and will be closely monitored, especially during the first 12 hours postpartum. Standard inpatient care will be provided as per the clinical protocol of the hospital in case a patient is admitted for any obstetric, medical or sickle cell related complications with emphasis on volume management and prophylaxis for venous thromboembolic events. |
|
|
Inclusion Criteria
|
| Age From |
18.00 Year(s) |
| Age To |
45.00 Year(s) |
| Gender |
Female |
| Details |
All consenting pregnant women with sickle cell disease seeking outpatient or inpatient care at Kasturba Maternity Hospital or its satellite center during the second trimester of pregnancy will be eligible for enrolment. Sickle cell disease status will be confirmed by a gold standard laboratory test- HPLC. |
|
| ExclusionCriteria |
| Details |
Dont, provide consent, out of study area, already on hydroxyurea treatment, not intended to get services at SEWA Rural, and those who have already the presence of contra indication to hydroxyurea medicine at baseline which includes neutropenia, thrombocytopenia, abnormal increase in serum creatinine, or hepatitis. |
|
|
Method of Generating Random Sequence
|
Computer generated randomization |
|
Method of Concealment
|
On-site computer system |
|
Blinding/Masking
|
Double Blind Double Dummy |
|
Primary Outcome
|
| Outcome |
TimePoints |
1. Adverse maternal outcome event score per person month will be primary outcome.
2. Time to first time occurrence of severe maternal adverse event since last menstruation period. |
The outcome will be assessed at interim midline (at one year) and endline (at two years). |
|
|
Secondary Outcome
|
| Outcome |
TimePoints |
| Secondary outcomes will be event rates per 100 person months for each of adverse maternal outcomes & foetal outcomes. |
The outcome will be assessed at interim midline (at one year) & at endline (at two years). |
|
|
Target Sample Size
|
Total Sample Size="98" Sample Size from India="98"
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" |
|
Phase of Trial
|
Phase 2 |
|
Date of First Enrollment (India)
|
02/09/2024 |
| Date of Study Completion (India) |
Applicable only for Completed/Terminated trials |
| Date of First Enrollment (Global) |
Date Missing |
| Date of Study Completion (Global) |
Applicable only for Completed/Terminated trials |
|
Estimated Duration of Trial
|
Years="1" Months="6" Days="30" |
Recruitment Status of Trial (Global)
Modification(s)
|
Not Yet Recruiting |
| Recruitment Status of Trial (India) |
Open to Recruitment |
|
Publication Details
|
N/A |
|
Individual Participant Data (IPD) Sharing Statement
|
Will individual participant data (IPD) be shared publicly (including data dictionaries)?
Response - YES
- What data in particular will be shared?
Response - All of the individual participant data collected during the trial, after de-identiļ¬cation.
- What additional supporting information will be shared?
Response - Study Protocol Response - Statistical Analysis Plan Response - Informed Consent Form
- Who will be able to view these files?
Response - Anyone
- For what types of analyses will this data be available?
Response - Any purpose.
- By what mechanism will data be made available?
Response - To gain access, data requestors will need to sign a data access agreement. Data are available for 5 years at a third party website (Database not finalised now, will update later).
- For how long will this data be available start date provided 01-09-2024 and end date provided 31-08-2029?
Response - Beginning 9 months and ending 36 months following article publication.
- Any URL or additional information regarding plan/policy for sharing IPD?
Additional Information - NIL
|
|
Brief Summary
|
Sickle cell disease is an
inherited blood disorder characterized by the tendency of red blood cells to
become sickle-shaped and block capillaries, leading to vaso-occlusion and
anaemia.
Pregnant
women who have Sickle cell disease (SCD) have an increased risk for adverse
maternal, fetal and neonatal outcomes. Despite providing the standard of care,
maternal and fetal outcomes have been unfavourable in a variety of clinical
settings, even in high-income countries. We propose doing a randomized control academic trial with consenting
patients in one arm to receive Hydroxyurea medicine after the first trimester
of pregnancy along with standard care and the control arm to receive standard care
only. This study will be conducted at Kasturba Maternity Hospital managed by a
voluntary organization SEWA-Rural situated in the Jhagadia block of the Bharuch
district in Gujarat, India. Jhagadia block has a population of 155,000. Almost
70% of the population is tribal/indigenous. This will be a parallel-group design,
double-blind, stratified, randomized controlled trial. The Hydroxyurea
medicine will be started as early as possible during the second trimester, and
it will be continued up to delivery unless the patient experiences its side
effects. The standard antenatal care will be provided as per the clinical
protocol of the hospital. Hydroxyurea will be started as per the national
guidelines at 10-15 mg/kg/day orally. The primary outcome of interest is
1. Adverse maternal outcome event score per person per month in the
intervention group in compared to the control group. 2. Time to first-time
occurrence of severe maternal adverse event. The required sample size based on sample size calculations as per primary outcomes was
39. After calculating loss to follow-up (15%) and MTP/abortion 10% we will need a total of 49 women in a group. We will do a mixed effect regression model and
survival analysis to find differences between the groups for primary outcome
indicators respectively. |