Omega 3 fatty acid for prevention of sickle cell crisis

ISRCTN ISRCTN80844630
DOI https://doi.org/10.1186/ISRCTN80844630
Secondary identifying numbers N/A
Submission date
15/12/2011
Registration date
23/01/2012
Last edited
16/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Haematological Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Sickle cell anaemia is an inherited blood disease that affects millions of people worldwide. It is most common in Sub-Sahara Africa and among people whose ancestors come from this region. The disease causes blockage of blood flow and serious damage to the kidneys, lungs, brain and other vital organs of the body. Sickle cell patients at a high risk of organ damage are treated with regular blood transfusions and hydroxyurea. These treatments pose new risks for patients. Moreover, they are not readily available in Sub-Sahara Africa. Hence, there is a need for effective, affordable and safe treatment. The aim of the study is to investigate if omega 3 fatty acids, nutrients obtained from oil fish, prevent blockage of blood flow.

Who can participate?
140 male and female patients between 2 and 50 years old with sickle cell anaemia were recruited from the Sickle Cell Referral Clinic, Khartoum Teaching Hospital, Khartoum (Sudan).

What does the study involve?
The patients were given capsules (pills) with or without omega 3 fatty acids.

What are the possible benefits and risks of participating?
If omega 3 fatty acids are shown to prevent blockage of blood flow, it will be beneficial to the participants and others who have the disease. Omega 3 fatty acids are nutrients widely present in fish and other marine food and do not present any risk.

Where is the study run from?
All the patients were recruited from the Sickle Cell Referral Clinic, Ibn-Aoaf Paediatric Hospital (the lead centre) and Khartoum Teaching Hospital, Khartoum, Sudan.

When is the study starting and how long is it expected to run for?
The study started in June 2008 and completed in May 2010.

Who is funding the study?
1. Marie Curie Transfer of Knowledge (European Union)
2. University of Khartoum (Sudan)
3. Efamol Limited (UK)
4. The Kitchener School of Medicine Trust Fund (UK)

Who is the main contact?
Professor Kebreab Ghebremeskel
k.ghebremeskel@londonmet.ac.uk

Study website

Contact information

Prof Kebreab Ghebremeskel
Scientific

Lipidomics and Nutrition Research Centre
Faculty of Life Sciences and Computing
London Metropolitan University
166 - 220 Holloway Road
London
N7 8DB
United Kingdom

Email k.ghebremeskel@londonmet.ac.uk

Study information

Study designRandomised double-blind placebo-controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typePrevention
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleOmega 3 Fatty Acids for prevention of vaso-occlusive and haemolytic crises in patients with homozygous Sickle Cell Disease (FASCD): a randomised, double-blind, placebo-controlled trial
Study acronymFASCD
Study hypothesis1. Supplementation with the long-chain polyunsaturated omega-3 fatty acids, docosahexaenoic (DHA) and eicospentaenoic (EPA), will prevent vaso-occlusive and clinical vaso-occluive episodes in patients with homozygous sickle cell disease (HbSS)
2. DHA and EPA supplement will reduce haemolytic crisis, blood transfusion rate and number of school days lost due to illness related to the disease and heamoglobin concentration

Protocol can be found at: http://www.londonmet.ac.uk/faculties/faculty-of-life-sciences-and-computing/research/lipidomics-and-nutrition-research-centre/research-projects/current/sickle-cell-disease---alternative-dietary-lipid-therapy/
Ethics approval(s)1. Ethics Committee of the Faculty of Medicine, University of Khartoum, Sudan, 19/04/2009
2. Research Ethics Committee of Southampton & South West Hampshire, UK, 18/05/2005, ref: 05/Q1702/48
ConditionSickle cell anaemia (HbSS)
InterventionThe subjects, after stratification by age and gender, will be randomly assigned to receive coded and indistinguishable omega 3 (n=70) or placebo (n=70) capsules.

Subsequent to randomisation, the patients will be given, daily for one year, one (2-4 year old), two (5-10), three (11-16) or four (≥ 17) omega 3 containing 277.8 mg DHA and 39.0 mg EPA or high oleic acid (41%) oil blend placebo capsules. The antioxidant vitamin E, 1.5mg/capsule, was added to the omega 3 and placebo to prevent peroxidation.

Enrolment identification number, gender, residence, ethnicity, weight, height, history of blood transfusion and stroke, number of sickle cell-related hospital admission during the previous years and sickle cell complication data will be collected using a validated structured questionnaire at baseline. Monthly self-assessment health diary will be given to each patient to daily record, pain frequency and intensity, pain medication taken and hospitalisation. Name and telephone number of the medical doctor in charge will be given to the patients and their guardians in case they require advice or care outside normal working hours.

During each monthly follow-up, the self-recorded health diaries will be reviewed, patients examined thoroughly and the data obtained entered into the database by the same physician. Whole blood, about 10 ml, will be obtained from the patients at recruitment and after one year of intervention for haematological and biochemical analyses.
Intervention typeSupplement
Primary outcome measure1. Annualised rates of clinical vaso-occlusive crisis is defined as painful events that lead to hospitalisation.
1.1. Vaso-occlusive crisis is defined as a painful event characterised by musculoskeletal and/or visceral pain which is usually associated with mild pyrexia and the passage of dark or red urine.
Secondary outcome measures1. Haemolytic crisis
2. Rate of blood transfusion
3. School attendance
4. Hb level and mean cell volume (MCV)
Overall study start date12/06/2008
Overall study end date30/05/2010

Eligibility

Participant type(s)Patient
Age groupMixed
SexBoth
Target number of participants140
Participant inclusion criteria1. HbSS phenotype
2. Male and female participants
3. Steady state
4. Aged 2 to 50 years old
Participant exclusion criteria1. Other phenotypes
2. Patients in crisis
3. Patients on hydroxyurea treatment
4. Presence of other chronic diseases
5. Blood transfusion in the previous four months
6. Pregnancy
7. Previous history of overt stroke
Recruitment start date12/06/2008
Recruitment end date30/05/2010

Locations

Countries of recruitment

  • England
  • Sudan
  • United Kingdom

Study participating centres

Lipidomics and Nutrition Research Centre,
Faculty of Life Sciences and Computing
London Metropolitan University
London
N7 8DB
United Kingdom
Faculty of Medicine,
University of Khartum
Khartum
-
Sudan
Sickle Cell Disease Clinic Abnaof Paediatric Hospital,
Khartum
-
Sudan

Sponsor information

Mother and Child Foundation (UK)
Charity

36 Regents Park Road
London
NW1 7SX
United Kingdom

Website http://www.mother-and-child.org/
ROR logo "ROR" https://ror.org/030ybgp98

Funders

Funder type

Research organisation

Marie Curie Transfer of Knowledge (EU) (ref: MTKD-CT-2005-029914)

No information available

University of Khartoum (Sudan)

No information available

Efamol Limited (UK)

No information available

The Kitchener School of Medicine Trust Fund (UK)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/01/2013 Yes No
Results article results 01/10/2013 Yes No
Results article results 01/12/2013 Yes No
Results article results 01/06/2015 Yes No
Results article results 01/10/2018 Yes No

Editorial Notes

16/04/2019: Publication reference added.