ClinicalTrials.gg
CompletedNCT03632876Updated Aug 16, 2018

Nutritional Outcomes After Vitamin A Supplementation in Subjects With SCD

An interventional study of retinyl palmitate in Sickle Cell Anemia in Children and Vitamin A Deficiency in Children, sponsored by Children's Hospital of Philadelphia. Completed at 1 site in United States. Open to participants aged 9 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2018-08-16.

Sponsored by Children's Hospital of Philadelphia · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 2 years 9 months after the study started (first participant enrolled Oct 2015, registered Aug 2018).
Phase
Not applicable
Study type
Interventional
Enrollment
42
Allocation
Randomized
Ages
9 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 733 studies in Anemia, Sickle Cell with a site in United States — 134 open to participants now, 185 under way, 16 of them phase 3. Anemia, Sickle Cell · United States.

Enrollment
231st of 559
42 · median 31
Started
2015
with 37 others
No phase
165 of 733
36 open now
Registered
421st of 733
by date

Among the 733 studies in Anemia, Sickle Cell with a site in United States, this one is the 231st largest by enrollment of the 559 interventional ones that give a count, is one of 38 that started in 2015, is one of 165 with no phase, and was the 421st registered.

Anemia, Sickle Cell

1,134 studies on the registry are indexed under Anemia, Sickle Cell; 238 are open to participants now.

Browse Anemia, Sickle Cell studies →

Open to participants now

134 of the 733 studies in Anemia, Sickle Cell with a site in United States are open now. Recruiting first, the newest first:

129 more — sign in →

All 134 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 177 Anemia, Sickle Cell studies recruiting now, 64 (36%) set no upper age limit and 97 (55%) stop at 75 or younger; 127 take children under 18; 29 take healthy volunteers.

This study: 9 Years and older · all sexes · healthy volunteers too.

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02

Study summary

This study establishes the safety and efficacy of vit A supplementation doses (3000 and 6000 IU/d) over 8 weeks in children with SCD-SS, ages 9 and older and test the impact of vit A supplementation on key functional and clinical outcomes. Additionally, vitamin A status is assessed in healthy children ages 9 and older to compare to subjects with SCD-SS.

Read the detailed description

Suboptimal vitamin A (vit A) status is prevalent in children with type SS sickle cell disease (SCD-SS) and associated with hospitalizations and poor growth and hematological status. Preliminary data in children with SCD-SS show that vit A supplementation at the dose recommended for healthy children failed to improve vit A status, resulting in no change in hospitalizations, growth or dark adaptation. This indicates an increased vit A requirement most likely due to chronic inflammation, low vit A intake and possible stool or urine loss. The dose of vit A needed to optimize vit A status in subjects with SCD-SS is unknown.

03

Conditions studied

  • Sickle Cell Anemia in Children
  • Vitamin A Deficiency in Children

Keywords

  • Retinol
  • Stable isotope dilution
  • DXA
  • retinyl palmitate
04

Who can participate

Ages eligible
9 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Sickle cell disease, SS genotype (subjects with sickle cell disease only)
  • Usual state of good health (no hospitalizations, emergency room visits, or unscheduled acute illness clinic visits for two weeks prior to screening)
  • Commitment to a 119-day study (subjects with sickle cell disease only), or a 4-day study (healthy volunteers only)

Exclusion criteria

Exclusion Criteria:

  • Hydroxyurea initiated within the previous 6 weeks (subjects with sickle cell disease only)
  • History of stroke (subjects with sickle cell disease only)
  • Other chronic conditions that may affect growth, dietary intake or nutritional status
  • Retinoic acid (topical or oral), weight loss medication and/or lipid lowering medications
  • Subjects with a greater than 98th percentile for age and sex
  • Pregnant or lactating females (subjects who become pregnant during the course of the study will not continue participation)
  • Liver function tests >4 x upper limit of reference range
  • Participation in another study with impact on vitamin A status (subjects with sickle cell disease only)
  • Use of multi-vitamin or commercial nutritional supplements containing vitamin A (those who are willing to discontinue these supplements, with the approval of the medical care team, will be eligible for the study after a 1 month . Subjects taking nutritional products without vitamin A will be eligible)
  • Inability to swallow pills (subjects with sickle cell disease only)
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
42 participants (actual)

Study arms

  • Active comparator
    Lower Dose Vitamin A

    Subjects with SCD-SS in the lower dose Vitamin A arm receive 3000IU of retinyl palmitate daily for 8 weeks.

    Dietary Supplement: retinyl palmitate

  • Active comparator
    Higher Dose Vitamin A

    Subjects with SCD-SS in the higher dose Vitamin A arm receive 6000IU of retinyl palmitate daily for 8 weeks.

    Dietary Supplement: retinyl palmitate

  • No intervention
    Healthy Comparison Arm

    Healthy subjects receive no intervention and undergo comparisons to the two vitamin A supplementation arms at baseline.

Interventions

06

What researchers measure

Primary outcomes

  1. Serum Vitamin A status

    Serum vitamin A as measured by retinol

    Time frame: Change from baseline after supplementation for 8 weeks

Secondary outcomes

  1. Vitamin A toxicity

    Retinyl palmitate

    Time frame: Change from baseline after supplementation for 8 weeks

  2. Height Z-score

    Measured on a stadiometer, compared to Center for Disease Control (CDC) reference standard to create a z-score

    Time frame: Change from baseline after supplementation for 8 weeks

  3. Weight Z-score

    Measured on a standing scale, compared to CDC reference standard to create a z-score

    Time frame: Change from baseline after supplementation for 8 weeks

  4. BMI Z-score

    Calculated using kg/m\^2 and compared to CDC reference standards

    Time frame: Change from baseline after supplementation for 8 weeks

  5. Fat-free Mass

    Calculated from dual-energy x-ray absorptiometry (DEXA) scan

    Time frame: Change from baseline after supplementation for 8 weeks

  6. Fat-free Mass

    Calculated from DEXA scan

    Time frame: Change from baseline after supplementation for 8 weeks

  7. Fat Mass

    Calculated from DEXA scan

    Time frame: Change from baseline after supplementation for 8 weeks

  8. Upper arm muscle area

    Calculated from mid-upper arm circumference

    Time frame: Change from baseline after supplementation for 8 weeks

  9. Upper arm fat area

    Calculated from mid-upper arm circumference and triceps skinfold thickness

    Time frame: Change from baseline after supplementation for 8 weeks

  10. Muscle strength

    Directly measured with Biodex Multi-Joint System 3 Pro

    Time frame: Change from baseline after supplementation for 8 weeks

  11. Jump strength

    Directly measured with Force Plate

    Time frame: Change from baseline after supplementation for 8 weeks

  12. Upper limb strength

    Directly measured with hand-grip strength dynamometer

    Time frame: Change from baseline after supplementation for 8 weeks

  13. Muscle function

    Directly measured with Bruininks-Oseretsky Test of Motor Proficiency

    Time frame: Change from baseline after supplementation for 8 weeks

  14. Dietary Intake

    Analysis of a three-day food record

    Time frame: Change from baseline after supplementation for 8 weeks

  15. Coefficient of fat absorption

    Calculated from 72-hour stool collection and dietary fat intake

    Time frame: Change from baseline after supplementation for 8 weeks

  16. Hemoglobin

    Direct measurement through spectral absorption

    Time frame: Change from baseline after supplementation for 8 weeks

  17. Hematocrit

    Direct measurement through spectral absorption

    Time frame: Change from baseline after supplementation for 8 weeks

  18. Fetal hemoglobin

    Direct measurement through quantitative flow cytometry

    Time frame: Change from baseline after supplementation for 8 weeks

  19. Mean corpuscular volume

    Direct measurement through quantitative flow cytometry

    Time frame: Change from baseline after supplementation for 8 weeks

  20. Mean corpuscular hemoglobin

    Calculated from hemoglobin mass and erythrocyte count

    Time frame: Change from baseline after supplementation for 8 weeks

  21. Mean corpuscular hemoglobin concentration

    Calculated from hemoglobin divided by hematocrit

    Time frame: Change from baseline after supplementation for 8 weeks

  22. Reticulocyte count

    Direct measurement through quantitative flow cytometry

    Time frame: Change from baseline after supplementation for 8 weeks

  23. Retinol binding protein, serum

    Direct measurement through quantitative nephelometry

    Time frame: Change from baseline after supplementation for 8 weeks

  24. Retinol binding protein, urine

    Direct measurement through quantitative nephelometry

    Time frame: Change from baseline after supplementation for 8 weeks

  25. Urine creatinine

    Direct measurement through quantitative spectrophotometry

    Time frame: Change from baseline after supplementation for 8 weeks

  26. Serum creatinine

    Direct measurement through quantitative spectrophotometry

    Time frame: Change from baseline after supplementation for 8 weeks

  27. Serum alanine aminotransferase

    Direct measurement through quantitative enzymatic assay

    Time frame: Change from baseline after supplementation for 8 weeks

  28. Serum aspartate aminotransferase

    Direct measurement through quantitative enzymatic assay

    Time frame: Change from baseline after supplementation for 8 weeks

  29. Serum gamma glutamyltransferase

    Direct measurement through quantitative enzymatic assay

    Time frame: Change from baseline after supplementation for 8 weeks

  30. Serum alkaline phosphatase

    Direct measurement through quantitative enzymatic assay

    Time frame: Change from baseline after supplementation for 8 weeks

  31. Serum bilirubin

    Direct measurement through quantitative quantitative spectrophotometry

    Time frame: Change from baseline after supplementation for 8 weeks

  32. High-sensitivity c-reactive protein

    Direct measurement through quantitative quantitative immunoturbidimetry

    Time frame: Change from baseline after supplementation for 8 weeks

  33. Tumor necrosis factor alpha

    Direct measurement through quantitative quantitative multiplex bead assay

    Time frame: Change from baseline after supplementation for 8 weeks

  34. White blood cell count

    Direct measurement through automated cell count

    Time frame: Change from baseline after supplementation for 8 weeks

  35. White blood cell differential

    Direct measurement through automated cell count

    Time frame: Change from baseline after supplementation for 8 weeks

  36. Lymphocyte subtypes

    Direct measurement through quantitative flow cytometry

    Time frame: Change from baseline after supplementation for 8 weeks

Other outcomes

  1. Total body vitamin A status via Stable Isotope Dilution

    compartmental modeling of \[13C10\]-retinyl acetate, measured by high performance liquid chromatography/mass spectroscopy

    Time frame: Change from baseline after supplementation for 8 weeks

07

Study locations

1 site
  • Children's Hospital of Philadelphia
    Philadelphia, Pennsylvania 19146, United States
08

References and documents

Publications

  • Ribaya-Mercado JD, Maramag CC, Tengco LW, Dolnikowski GG, Blumberg JB, Solon FS. Carotene-rich plant foods ingested with minimal dietary fat enhance the total-body vitamin A pool size in Filipino schoolchildren as assessed by stable-isotope-dilution methodology. Am J Clin Nutr. 2007 Apr;85(4):1041-9. doi: 10.1093/ajcn/85.4.1041. PubMed 17413103 ↗
  • Solomons NW. Vitamin A. In: B.Bowman, R.Russell, editors. Present Knowledge in Nutrition, Volume I. 9 ed. Washington DC: International Life Science Institute Press; 2006:157-183
  • Ross CA. Vitamin A and carotenoids. In: M.E.Shils, M.Shike, C.A.Ross, B.Caballero, R.J.Cousins, editors. Modern Nutrition in Health and Disease. 10 ed. Philadelphia: Lippincott, Williams and Wilkins; 2006:351-375
  • Schall JI, Zemel BS, Kawchak DA, Ohene-Frempong K, Stallings VA. Vitamin A status, hospitalizations, and other outcomes in young children with sickle cell disease. J Pediatr. 2004 Jul;145(1):99-106. doi: 10.1016/j.jpeds.2004.03.051. PubMed 15238915 ↗
  • Trumbo P, Yates AA, Schlicker S, Poos M. Dietary reference intakes: vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. J Am Diet Assoc. 2001 Mar;101(3):294-301. doi: 10.1016/S0002-8223(01)00078-5. No abstract available. PubMed 11269606 ↗
  • Dougherty KA, Schall JI, Kawchak DA, Green MH, Ohene-Frempong K, Zemel BS, Stallings VA. No improvement in suboptimal vitamin A status with a randomized, double-blind, placebo-controlled trial of vitamin A supplementation in children with sickle cell disease. Am J Clin Nutr. 2012 Oct;96(4):932-40. doi: 10.3945/ajcn.112.035725. Epub 2012 Sep 5. PubMed 22952182 ↗
  • Haskell MJ, Handelman GJ, Peerson JM, Jones AD, Rabbi MA, Awal MA, Wahed MA, Mahalanabis D, Brown KH. Assessment of vitamin A status by the deuterated-retinol-dilution technique and comparison with hepatic vitamin A concentration in Bangladeshi surgical patients. Am J Clin Nutr. 1997 Jul;66(1):67-74. doi: 10.1093/ajcn/66.1.67. Erratum In: Am J Clin Nutr 1999 Mar;69(3):576. PubMed 9209171 ↗
  • Ribaya-Mercado JD, Solon FS, Solon MA, Cabal-Barza MA, Perfecto CS, Tang G, Solon JA, Fjeld CR, Russell RM. Bioconversion of plant carotenoids to vitamin A in Filipino school-aged children varies inversely with vitamin A status. Am J Clin Nutr. 2000 Aug;72(2):455-65. doi: 10.1093/ajcn/72.2.455. PubMed 10919941 ↗
  • Olson JA. Serum levels of vitamin A and carotenoids as reflectors of nutritional status. J Natl Cancer Inst. 1984 Dec;73(6):1439-44. PubMed 6439934 ↗
  • Kawchak DA, Schall JI, Zemel BS, Ohene-Frempong K, Stallings VA. Adequacy of dietary intake declines with age in children with sickle cell disease. J Am Diet Assoc. 2007 May;107(5):843-8. doi: 10.1016/j.jada.2007.02.015. PubMed 17467383 ↗
  • Garcia OP. Effect of vitamin A deficiency on the immune response in obesity. Proc Nutr Soc. 2012 May;71(2):290-7. doi: 10.1017/S0029665112000079. Epub 2012 Feb 28. PubMed 22369848 ↗
  • Cantorna MT, Nashold FE, Hayes CE. In vitamin A deficiency multiple mechanisms establish a regulatory T helper cell imbalance with excess Th1 and insufficient Th2 function. J Immunol. 1994 Feb 15;152(4):1515-22. PubMed 8120366 ↗
  • Esteban-Pretel G, Marin MP, Cabezuelo F, Moreno V, Renau-Piqueras J, Timoneda J, Barber T. Vitamin A deficiency increases protein catabolism and induces urea cycle enzymes in rats. J Nutr. 2010 Apr;140(4):792-8. doi: 10.3945/jn.109.119388. Epub 2010 Feb 24. PubMed 20181784 ↗
  • Kennedy KA, Porter T, Mehta V, Ryan SD, Price F, Peshdary V, Karamboulas C, Savage J, Drysdale TA, Li SC, Bennett SA, Skerjanc IS. Retinoic acid enhances skeletal muscle progenitor formation and bypasses inhibition by bone morphogenetic protein 4 but not dominant negative beta-catenin. BMC Biol. 2009 Oct 8;7:67. doi: 10.1186/1741-7007-7-67. PubMed 19814781 ↗
  • Dougherty KA, Schall JI, Rovner AJ, Stallings VA, Zemel BS. Attenuated maximal muscle strength and peak power in children with sickle cell disease. J Pediatr Hematol Oncol. 2011 Mar;33(2):93-7. doi: 10.1097/MPH.0b013e318200ef49. PubMed 21228717 ↗
  • Zemel BS, Kawchak DA, Ohene-Frempong K, Schall JI, Stallings VA. Effects of delayed pubertal development, nutritional status, and disease severity on longitudinal patterns of growth failure in children with sickle cell disease. Pediatr Res. 2007 May;61(5 Pt 1):607-13. doi: 10.1203/pdr.0b013e318045bdca. PubMed 17413865 ↗
  • Allen LH, Haskell M. Estimating the potential for vitamin A toxicity in women and young children. J Nutr. 2002 Sep;132(9 Suppl):2907S-2919S. doi: 10.1093/jn/132.9.2907S. PubMed 12221269 ↗

Individual participant data

Plan to share: Yes — Individual participant data that underlie the results reported will be shared upon request, after deidentification.

Supporting information: Study protocol, Informed consent form

Time frame: The data will be available immediately upon publication.

Access criteria: Contact brownellj@email.chop.edu. Requestors will need to sign a data access agreement.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Oct 2015 to primary completion in Sep 2016, 11 months.

Of 165 non-industry interventional studies with no phase under Anemia, Sickle Cell, half reached primary completion within 28 months of starting (the median), counting those still running; a quarter within 17 and three quarters within 54. This study's 11 months is below that.

Counting every sponsor, half of 173 studies reached it within 28 months; a quarter within 15 and three quarters within 49.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 1, 2018
First posted
Aug 16, 2018
StartActual
Oct 2, 2015
Primary completionActual
Sep 30, 2016
CompletionActual
Sep 30, 2016
Last update
Aug 16, 2018
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 16, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03632876
Collaborators
Penn State University, Newcastle University
Responsible party
Sponsor
First posted
Aug 16, 2018
Start date
Oct 2, 2015
Primary completion
Sep 30, 2016
Completion
Sep 30, 2016
Last update
Aug 16, 2018

Study contacts

Virginia Stallings, MD
principal investigator · Children's Hospital of Philadelphia

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2018. You cannot join it, but the record below documents what was studied.

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Discussion

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Studies of the drug tested here: Retinol palmitate

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