A phase 1/2 trial of HQK-1001, an oral fetal globin inducer, in sickle cell disease

Abdullah Kutlar, Kenneth Ataga, Marvin Reid, Elliott P. Vichinsky, Lynne Neumayr, Loray Blair-Britt, Richard Labotka, Jonathan Glass, Jeffrey R. Keefer, William A. Wargin, Ronald Berenson, Susan P. Perrine

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Therapeutics which reduce the pathology in sickle cell syndromes are needed, particularly noncytotoxic therapeutics. Fetal hemoglobin (HbF, α2γ2) is established as a major regulator of disease severity; increased HbF levels correlate with milder clinical courses and improved survival. Accordingly, sodium dimethylbutyrate (HQK-1001), an orally-bioavailable, promoter-targeted fetal globin gene-inducing agent, was evaluated in a randomized, blinded, dose-ranging Phase I/II trial in 24 adult patients with HbSS or S/β thalassemia, to determine safety and tolerability of three escalating dose levels. The study therapeutic was administered once daily for two 6-week cycles, with a two-week interim dose holiday. Twenty-one patients completed the study. Five patients received study drug at 10 or 20 mg/kg doses, seven patients received study drug at 30 mg/kg/dose, and 4 patients received placebo. HQK-1001 was well-tolerated with no unexpected drug-related adverse events; a dose-limiting toxicity was not identified. Plasma drug levels were sustained above targeted levels for 24 hr. Increases in HbF above baseline were observed particularly with 30 mg/kg/day doses; in five of seven treated patients, a mean absolute increase in HbF of 0.2 g/dl and a mean increase in total hemoglobin (Hgb) of 0.83 g/dl above baseline were observed, whereas no increases occurred in placebo-treated controls. These findings of favorable PK profiles, tolerability, early rises in HbF, and total Hgb indicate that trials of longer duration appear warranted to more definitively evaluate the therapeutic potential of HQK-1001 in sickle cell disease.

Original languageEnglish (US)
Pages (from-to)1017-1021
Number of pages5
JournalAmerican Journal of Hematology
Volume87
Issue number11
DOIs
StatePublished - Nov 2012

ASJC Scopus subject areas

  • Hematology

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    Kutlar, A., Ataga, K., Reid, M., Vichinsky, E. P., Neumayr, L., Blair-Britt, L., Labotka, R., Glass, J., Keefer, J. R., Wargin, W. A., Berenson, R., & Perrine, S. P. (2012). A phase 1/2 trial of HQK-1001, an oral fetal globin inducer, in sickle cell disease. American Journal of Hematology, 87(11), 1017-1021. https://doi.org/10.1002/ajh.23306