Sitagliptin for the Treatment of Grade 3-4 and Refractory Acute Graft-versus-host Disease
Status:
Recruiting
Trial end date:
2021-12-31
Target enrollment:
Participant gender:
Summary
The prognosis of severe (grade 3-4) and steroid refractory acute graft-versus-host disease
(GVHD) continues to be dismal. Sitagliptin given as GVHD-prophylaxis has recently been shown
to reduce the incidence of acute GVHD to less than 10% with an excellent safety profile.
In this single center and single arm phase 2 study we aim to explore the safety and efficacy
of sitagliptin in the treatment of severe and refractory acute GVHD.
Patient with new onset grade 3-4 acute GVHD will receive standard treatment consisting CNI
and methylprednisolone 1-2 mg/kg/day or an equivalent dose of prednisone. Patients with
refractory grade 2-4 acute GVHD will continue their current treatment; however
methylprednisolone dose will be reduced to ≤ 1 mg/kg/day or an equivalent dose of prednisone.
Oral sitagliptin will be commenced at a dose of 100 mg BID. The dose will be increased by 100
mg every three days up to a maximal dose of 300 mg BID. In the case of significant drug
related side effects or drug intolerance, the last tolerated dose will be resumed. Patients
responding well to lower doses of sitagliptin, will not be given higher doses of the drug.
Sitagliptin will be provided as long as deemed effective by the treating physician up to
three months.
The primary end point will be the proportion of patients achieving complete remission(CR),
very good partial response (VGPR) or partial response (PR) by day 28.