ClinicalTrials.gg
RecruitingNCT04997811REPAIR-MDSUpdated Oct 3, 2023

Repurposed Drugs to Improve Haematological Responses in Myelodysplastic Syndromes

A Phase 2 interventional study of Sodium Valproate, Bezafibrate, Medroxyprogesterone and Danazol in Myelodysplastic Syndromes (MDS), sponsored by Prof. Janet Dunn. Recruiting at 19 sites in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-10-03.

Sponsored by Prof. Janet Dunn · Phase 2, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jan 2025, 1 year 9 months ago, but the record still lists the study as recruiting.
  • Started Dec 2021; still recruiting 4 years 10 months later.
Phase
Phase 2
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Over 7,000 people in the UK are living with Myelodysplastic Syndromes (MDS). Approximately 1,600 of these individuals (23%) die each year from their disease. MDS affects the production of blood cells by the bone marrow, causing chronic fatigue, bleeding, and recurrent infections. Many patients die because their disease transforms into acute myeloid leukaemia (AML) an even more aggressive blood cancer. The general outlook for AML is poor, but when AML arises from MDS it is worse.

REPAIR-MDS seeks to repurpose existing drugs in order to dramatically improve the outlook, health and quality of life of people with MDS. The trial treatments aim to improve the production of healthy functioning blood and immune cells that will fight against infections and boost the immune system's action against the MDS clone.

REPAIR-MDS design is a is a multicentre open label phase 2 randomised controlled trial which will compare VBaP (sodium valproate, bezafibrate, medroxyprogesterone) with danazol in patients who have received either Erythropoiesis Stimulating Agents (ESAs) and lost response, not responded to ESAs or are deemed unlikely to respond to ESAs.

02

Conditions studied

  • Myelodysplastic Syndromes (MDS)
03

In context

Myelodysplastic Syndromes

1,997 studies on the registry are indexed under Myelodysplastic Syndromes; 324 are open to participants now.

This study's planned enrollment of 120 is above the median of 40 across 1,611 interventional studies indexed under Myelodysplastic Syndromes.

Browse Myelodysplastic Syndromes studies →

Lead sponsor

This is the only study on the registry with Prof. Janet Dunn as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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

  1. Provision of written
  2. Age ≥ 18 years and able to give informed consent
  3. Diagnosis of Myelodysplastic Syndrome with an IPSS-R score of less than or equal to 3.51
  4. Haematological parameters:

    1. Mean \< 100 g/l over 16 weeks (pre transfusion) OR
    2. Mean \< 100 x 109/l over 16 weeks + evidence of bleeding (assessed using the ISTH Bleeding Assessment Tool) OR
    3. Mean neutrophils \< 1.0 x 109/l over 16 weeks + history of infection (the requirement for antimicrobial therapy and hospital admissions associated with infection)
  5. No response to Erythroid Stimulating Agents (ESAs) OR Have Ceased to respond to ESAs OR are predicated not to respond to ESAs by current UK guidelines2,3 (NB Patients with thrombocytopenia and/or neutropenia, without anaemia, are eligible as they are predicated not to respond to ESAs).
  6. performance status 0-3
  7. Expected survival > 12months

Exclusion criteria

Exclusion Criteria (For Randomisation):

Abnormal liver function (if patient has Gilbert's syndrome, then abnormal direct is an exclusion) 2. CrCl \< 20ml/min 3. Current systemic treatment for low risk MDS 4. History of Bone Marrow Transplant 5. History of having received ESAs and/or G-CSF in the past 16 weeks 6. Currently receiving statin medication for Secondary Prophylaxis of Cardiovascular Disease, Cerebrovascular Disease or Peripheral Vascular Disease (Please note patients receiving statin medication for Primary Prophylaxis of Cardiovascular Disease - i.e. the patient has no prior history of Ischaemic Heart Disease nor Cerebrovascular Disease - can still be entered, please see section 1.4 Statin use) 7. Currently receiving fibrate medications 8. Currently receiving sodium valproate, carbamazepine or phenytoin for treatment of epilepsy 9. Prior cytotoxic chemotherapy or hypomethylating agents for AML/MDS (eg Azacitidine) 10. Concurrent active requiring treatment 11. History of any Androgen Dependent Tumour (patients with Prostate Cancer are Excluded when a proven diagnosis of Prostate Cancer has been made OR their PSA is known to be elevated OR they are on active treatment for Prostate Cancer, including hormonal therapy).

  1. Currently receiving Vitamin K-Antagonist Anticoagulation (though patients receiving DOACs (direct oral anticoagulants) can be included) 13. History of Venous Thrombo-Embolism (VTE) 14. Cardiac Failure Class III or IV 15. Women of , pregnant or lactating 16. The physician or patient consider VBaP or danazol to be inappropriate for the patient 17. Known 18. Abnormally high CK level 19. Presence of isolated del 5q 20. Acute Porphyria 21. to any of the trial medications or known to any of the products (see Appendix C for contraindications) 22. Previous randomisation in the REPAIR-MDS trial 23. Participation in a clinical trial of an investigational medicinal product in the last 16 weeks
Terms in these criteria, in plain language(15)

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Allogeneic and autologous transplant

Stem cell (bone marrow) transplants. Allogeneic uses cells from a donor; autologous uses your own cells, collected earlier and given back.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
120 participants (estimated)

Study arms

  • Experimental
    VBaP

    Combination of sodium valproate, bezafibrate, medroxyprogesterone

    Drug: Sodium Valproate, Bezafibrate, Medroxyprogesterone

  • Experimental
    Danzol

    Single agent

    Drug: Danazol

Interventions

  • DrugSodium Valproate, Bezafibrate, Medroxyprogesterone

    Drug pages: Valproic Acid · Bezafibrate · Medroxyprogesterone

    Sodium valproate tablet 1 x 500mg bd, (starting 1 x 200mg bd) Bezafibrate standard release tablet 2 x 200mg tds, (starting 1 x 200mg tds) Medroxyprogesterone acetate tablet 1 x 400mg bd (starting 1 x 400mg od)

  • Danazol 1 x 200mg capsules tds, (starting 1 x 200mg od)

06

What researchers measure

Primary outcomes

  1. Haematological improvement (HI) in each arm and in the trial overall, with 25% or more of the participants having HI in each arm and overall.

    HI will be assessed in each participant by comparing post randomisation FBC parameters (Haemoglobin, platelet and neutrophil counts) and transfusion requirements, with their individual baseline as determined by the IWG 2018 haematology response criteria in patients with MDS.

    Time frame: 12 months

Secondary outcomes

  1. Reduced burden of red cell and/or platelet transfusion in each arm and in the trial overall, as per the IWG 2018 response criteria.

    Changes in transfusion requirements will be assessed in each participant by comparison with their individual 16-week lead-in baseline as determined by the IWG 2018 haematology response criteria in patients with MDS.

    Time frame: 12 months

  2. Duration of haematological response

    Clinically meaningful haematological responses that persist for 16 weeks or longer.

    Time frame: 12 months

  3. Reported improved Health Related Quality of Life scores in each arm and in the trial overall.

    The four Health Related Quality of Life questions measure 1) self-perceived health (excellent, very good, good, fair, or poor), (2) number of days out of the past 30 that physical health was not good, (3) number of days out of the past 30 that mental health was not good, and (4) number of days out of the past 30 that usual activities were limited by poor physical or mental health of life scores will be evaluated using established protocols.

    Time frame: 12 months

  4. Overall survival

    Overall survival at close of trial will be reported separately for each trial arm

    Time frame: Through study completion, an average of 1 year

07

Study locations

19 of 19 sites recruiting
  • Heartlands Hospital
    Birmingham, Bordesley Green East B9 5SS, United Kingdom
    Recruiting
    • Research and Development Manager · ContactR&D@uhb.nhs.uk;
    • Dr Manoj Raghavan · Principal investigator
  • Royal Cornwall Hospital NHS Trust
    Truro, Cornwall TR1 3LJ, United Kingdom
    Recruiting
  • University Hospitals Dorset NHS Foundation Trust
    Poole, Dorset BH15 2JB, United Kingdom
    Recruiting
    • Head of Research · Contactresearchoffice@uhd.nhs.uk
    • Dr Catherine Hockings · Principal investigator
    • Dr Mohamed Ifraz Hamid · Sub investigator
    • Dr Helen Mccarthy · Sub investigator
  • Russells Hall Hospital
    Dudley, England DY1 2HQ, United Kingdom
    Recruiting
    • Research and Development Department · Contactdgft.research.rhh@nhs.net
    • Dr Stephen Jenkins · Principal investigator
    • Dr Jeff Neilson · Sub investigator
    • Dr Shereef Elmoanly · Sub investigator
    • Dr Ovini Gamage · Sub investigator
  • University College London Hospitals NHS Foundation Trust
    London, England NW1 2PG, United Kingdom
    Recruiting
    • Contracts Manager · Contactuclh.rand@nhs.net
    • Dr Elspeth Payne · Principal investigator
  • King's College Hospital NHS Foundation Trust
    London, England SE5 9RS, United Kingdom
    Recruiting
    • Research & Innovation Governance Manager · Contactkch-tr.research@nhs.net
    • Dr Austin Kulasekararaj · Principal investigator
    • Dr Pramila Krishnamurthy · Sub investigator
    • Dr Victoria Potter · Sub investigator
  • Broomfield Hospital
    Chelmsford, Essex CM1 7ET, United Kingdom
    Recruiting
  • Colchester General Hospital
    Colchester, Essex CO4 5JL, United Kingdom
    Recruiting
    • Head of Research · ContactR&D@esneft.nhs.uk
    • Dr Mike Hamblin · Principal investigator
    • Dr Gavin Campbell · Sub investigator
    • Dr Mahalakshmi Mohan · Sub investigator
    • Dr Joseph Padayatty · Sub investigator
    • Dr Khalid Saja · Sub investigator
    • Dr Francis Anyanwu · Sub investigator
  • Basingstoke and North Hampshire Hospital,
    Basingstoke, Hampshire RG24 9NA, United Kingdom
    Recruiting
    • Research Department · Contactresearch.team@hhft.nhs.uk;
    • Dr Noel Ryman · Principal investigator
    • Dr Katherine Smith · Sub investigator
    • Dr Hussan Janan · Sub investigator
    • Dr Henna Wong · Sub investigator
    • Dr Kanchana De Abrew · Sub investigator
  • Royal Hampshire County Hospital, Hampshire Hospitals NHS Foundation Trust
    Winchester, Hampshire SO22 5DG, United Kingdom
    Recruiting
    • Research Department · Contactresearch.team@hhft.nhs.uk;
    • Dr Jennifer Arnold · Principal investigator
    • Dr Marianna Koperdanova · Sub investigator
    • Dr Katharine Lowndes · Sub investigator
  • East Kent Hospitals University Foundation Trust
    Canterbury, Kent CT1 3NG, United Kingdom
    Recruiting
    • R&I/CTU Manager · Contactekhuft.researchandinnovation@nhs.net
    • Dr Sreetharan Munisamy · Principal investigator
    • Dr Iresha Dharmasena · Sub investigator
    • Dr Caroline Grist · Sub investigator
    • Dr Jindriska Lindsay · Sub investigator
    • Dr Jayne Osborne · Sub investigator
    • Dr Sharath Dr Sharath · Sub investigator
    • Dr Samih Salih · Sub investigator
    • Dr Moya Young · Sub investigator
  • James Paget University Hospitals NHS Foundation Trust
    Gorleston-on-Sea, Norfolk NR31 6LA, United Kingdom
    Recruiting
  • Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Hucknall Road
    Nottingham, Nottinghamshire NG5 1PB, United Kingdom
    Recruiting
    • R&I Administrator · ContactR&I@NUH.nhs.uk
    • Dr Yadanar Lwin · Principal investigator
    • Dr Tom Taylor · Sub investigator
    • Dr Gerardo Errico · Sub investigator
    • Dr Malik Saeed · Sub investigator
    • Dr Jennifer Byrne · Sub investigator
  • Grampian Health Board
    Aberdeen, Scotland AB15 6RE, United Kingdom
    Recruiting
    • Research and Development · Contactgram.randdpermissions@nhs.scot;
    • Dr Dominic Culligan · Principal investigator
    • Mrs Mariella Lamacchia · Sub investigator
    • Dr Stephanie Bruce · Sub investigator
    • Dr Paraskevi Untiveros · Sub investigator
  • Good Hope Hospital
    Birmingham, Sutton Coldfield B75 7RR, United Kingdom
    Recruiting
    • Research Department · Contactclinicalhaem@trials.bham.ac.uk;
    • Dr Manoj Raghavan · Principal investigator
    • Dr Sophie Lee · Sub investigator
    • Dr Harshini Alwis · Sub investigator
  • Hull University Teaching Hospitals
    Hull, HU3 2JZ, United Kingdom
    Recruiting
  • Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust
    Leicester, LE1 5WW, United Kingdom
    Recruiting
  • James Cook University Hospital, South Tees Hospitals NHS Foundation Trust
    Middlesbrough, TS4 3BW, United Kingdom
    Recruiting
  • Royal Gwent Hospital, Aneurin Bevan University Health Board
    Newport, NP18 3XQ, United Kingdom
    Recruiting
08

References and documents

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Oct 3, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04997811
Lead sponsor
Prof. Janet Dunn
Collaborators
Blood Cancer UK, Dudley Group NHS Foundation Trust, University of Birmingham, University of Manchester, King's College Hospital NHS Trust
Responsible party
Prof. Janet Dunn (Professor of Clinical Trials, University of Warwick) — Sponsor-investigator
First posted
Aug 10, 2021
Start date
Dec 21, 2021
Primary completion
Jan 31, 2025 (estimated)
Completion
Jun 30, 2025 (estimated)
Last update
Oct 3, 2023

Study contacts

Bethany Foster, BSc
Contact
RepairMDS@warwick.ac.uk;
0044 24 76575675
Helen Higgins, MSc
Contact
h.higgins@warwick.ac.uk
0044 24 76151178

Oversight

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

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Studies of the drugs tested here: Valproic Acid · Bezafibrate · Medroxyprogesterone · Danazol

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