Skip to content

Hydroxy Urea, Omega 3, Nigella Sativa,Honey on Oxidative Stress and Iron Chelation in Pediatric Major Thalassemia

Impact of Combination Therapy Between Hydroxy Urea, Omega 3, Nigella Sativa and Honey on Antioxidant-oxidant Status and Reduction of Iron Overload in Pediatric Major Thalassemia

Status
Completed
Phases
Phase 2Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04292314
Enrollment
350
Registered
2020-03-03
Start date
2019-11-01
Completion date
2021-01-20
Last updated
2021-01-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Iron Overload, Oxidative Stress, Thalassemia Major

Keywords

thymoquinone, omega3, hydroxyurea, pediatric Thalassemia Major, oxidative stress, iron chelation, iron overload, chelation activity of thymoquinone, antioxidant effect of omega3, anti-hemolysis effect of hydroxyurea

Brief summary

The aim of the present study is evaluating the strength of combination therapy of hydroxy urea, omega 3, nigella sativa and honey on antioxidant-oxidant status (OXIDATIVE STRESS) in response to reactive oxygen species production (LIPID PEROXIDATION) and their effect on iron intoxication (IRON CHELATION) in pediatric major thalassemia.

Detailed description

Beta thalassemia is a blood disorder that reduces the production of hemoglobin. Hemoglobin is the iron-containing protein in red blood cells that carries oxygen to cells throughout the body. In people with beta thalassemia, low levels of hemoglobin lead to a lack of oxygen in many parts of the body. Affected individuals also have a shortage of red blood cells (anemia), which can cause pale skin, weakness, fatigue, and more serious complications. People with beta thalassemia are at an increased risk of developing abnormal blood clots. Beta thalassemia is classified into two types depending on the severity of symptoms: thalassemia major (also known as Cooley's anemia) and thalassemia intermedia. Of the two types, thalassemia major is more severe. Beta-thalassemia syndromes are a group of hereditary blood disorders. It is characterized by reduced beta globin chain synthesis, resulting in reduced Hb in red blood cells (RBC), decreased RBC production and anemia. Homozygotes for beta-thalassemia may develop either thalassemia major or thalassemia intermedia. Individuals with thalassemia major usually come to medical attention within the first 2 years and require regular blood transfusion to survive. Affected infants with thalassemia major fail to thrive and become progressively pale. Feeding problems, diarrhea, irritability, recurrent bouts of fever, and enlargement of the abdomen, caused by splenomegaly, may occur. If a regular transfusion program that maintains a minimum Hb concentration of 95-105 g/L is initiated, then growth and development are normal until the age of 10-11 years. After the age of 10-11 years, affected individuals are at risk of developing severe complications related to posttransfusional iron overload, depending on their compliance with chelation therapy. Complications of iron overload include growth retardation and failure of sexual maturation and also those complications observed in adults with hemachromatosis -associated hereditary hemochromatosis (HH): involvement of the heart (dilated myocardiopathy and pericarditis), liver (chronic hepatitis, fibrosis, and cirrhosis), and endocrine glands (resulting in diabetes mellitus and insufficiency of the parathyroid, thyroid, pituitary, and, less commonly, adrenal glands). The underlying basis of b-thalassemia pathology is the diminished b-globin synthesis leading to a-globin accumulation and premature apoptotic destruction of erythroblasts, causing oxidative stress-induced ineffective erythropoiesis.

Interventions

Nigella sativa supplementation (1g black seed oil contain 1% thymoquinone) per day for 8 consecutive months up to 10 months

DRUGHydroxyurea

hydroxyurea medication (5 to 15mg/kg) per day for 8 consecutive months up to 10 months.

DRUGOmega 3

Omega-3 supplementation (300-400mg EPA & 200-300mg DHA) per day for 8 consecutive months up to 10 months

DRUGHoney

Natural honey(2.5 mg/kg dissolved in 250 ml water) per day for 8 consecutive months up to 10 months.

DRUGDeferoxamine

deferoxamine (SubQ infusion: 20 to 40 mg/kg/day over 8 to 12 hours, 6 to 7 nights per week, maximum daily dose: 40 mg/kg/day)for 8 consecutive months up to 10 months.

Regular blood transfusion session based on patient hematological profile starts from one session every 2 weeks.

Sponsors

Maternity and Children Hospital, Makkah
CollaboratorOTHER
Beni-Suef Health insurance hospital
CollaboratorUNKNOWN
University of Arizona
CollaboratorOTHER
Beni-Suef University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)

Intervention model description

Four experimental groups, one control group. Each experimental group receives different experimental treatments plus traditional treatment in the hospital and the control group receives only traditional treatment.

Eligibility

Sex/Gender
ALL
Age
7 Years to 15 Years
Healthy volunteers
No

Inclusion criteria

1. Any case with full manifestation of β-THALASSEMIA major disease 2. #Aged from 7-15 years old 3. \# accompanied with ineffective erythropoiesis 4. \# with low hemoglobin level 5. \# with iron overload

Exclusion criteria

1. The presence of any other chronic illness. 2. Patient age\>15 years old or \< 7 years old. 3. The presence of concomitant myocardial infarction, stroke, acute chest syndrome. 4. The patient suffers from any other type of anemia.

Design outcomes

Primary

MeasureTime frameDescription
F 2 -isoprostanes pg/mL3 monthsplasma F 2 -isoprostanes Picograms Per Millilitre measured by high pressure liquid chromatography assay
Total cholesterol Mg/dl10 monthsTotal cholesterol milligrams per deciliter
HDL cholesterol Mg/dl10 monthsHDL cholesterol milligrams per deciliter
LDL cholesterol Mg/dl10 monthsLDL cholesterol milligrams per deciliter
Triglycerides Mg/dl10 monthsTriglycerides milligrams per deciliter
Serum total iron mcg/dL10 monthsSerum total iron micrograms per decilitre
% transferrin saturation10 monthstransferrin saturation percentage
C-reactive protein mg/L10 monthsC-reactive protein milligrams per deciliter
Serum Ferritin ng/ml10 monthsSerum Ferritin Nanograms per milliliter
Total Iron Binding Capacity (TIBC) mcg/dL10 monthsTotal Iron Binding Capacity micrograms per decilitre
hemoglobin (Hbg) g/dL10 monthshemoglobin (Hbg) gram/deciliter
mean corpuscular hemoglobin (MCH) pg/ml10 monthsmean corpuscular hemoglobin (MCH) Picograms Per Millilitre
leukocytes count μl10 monthsleukocytes in microliter
% Chelation activity Fe+++ - thymoquinone complex3 monthsChelation activity of Ferric - thymoquinone complex in percentage measured by high pressure liquid chromatography coupled with gaschromatography - mass spectroscopy analysis
% Chelation activity Fe++ - thymoquinone complex3 monthsChelation activity of Ferrous - thymoquinone complex in percentage measured by high pressure liquid chromatography coupled with gaschromatography- mass spectroscopy analysis
Lactic acid dehydrogenase U/L10 monthsLactic acid dehydrogenase unit per litter
Reticulocyte count %10 monthsReticulocyte count percentage
Hb-F level g/dL10 monthshemoglobin- F level in gram per deciliter
Reticulocyte absolute count10 monthsReticulocyte absolute count in a cubic milliliter of blood
White blood cells count10 monthsWhite blood cells count in a cubic milliliter of blood

Countries

Egypt, Saudi Arabia

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026