Clinical trials on Cold agglutinin disease

Cold Agglutinin Disease

Cold agglutinin disease (CAD) is a rare type of autoimmune hemolytic anemia in which the body’s immune system attacks and destroys its own red blood cells. This condition is triggered by cold temperatures, causing antibodies called cold agglutinins to bind to red blood cells, leading to their destruction. The symptoms can vary in severity and may include fatigue, weakness, pallor, and jaundice. CAD can lead to various complications if left untreated.


  • Hemolytic anemia: Chronic destruction of red blood cells leading to severe fatigue, pallor, and shortness of breath.
  • Raynaud’s phenomenon: Reduced blood flow to extremities such as fingers and toes, causing them to turn white, blue, or red in response to cold or stress.
  • Acrocyanosis: Persistent blue or purple discoloration of the hands and feet due to prolonged cold exposure.
  • Peripheral necrosis: Severe cases can lead to tissue death in extremities.
  • Infections: Increased susceptibility to infections due to impaired immune function.
  • Thrombosis: Increased risk of blood clots, which can lead to deep vein thrombosis, pulmonary embolism, or stroke.
  • Organ damage: Chronic anemia can lead to enlargement of the liver and spleen and may affect heart function over time.

Treatment Methods

  • Avoidance of cold: Keeping warm to prevent the activation of cold agglutinins.
  • Blood transfusions: Providing healthy red blood cells to replace those destroyed by the disease.
  • Immunosuppressive therapy: Medications such as rituximab, which target and reduce the production of cold agglutinins.
  • Corticosteroids: Occasionally used to suppress the immune system, although less effective in CAD.
  • Plasma exchange (plasmapheresis): Removing plasma containing cold agglutinins and replacing it with donor plasma.
  • Monoclonal antibodies: Emerging treatments targeting specific components of the immune system involved in CAD.


The prognosis of cold agglutinin disease varies depending on the severity of the condition and the response to treatment. With appropriate management, many patients can lead relatively normal lives. Avoiding cold exposure and receiving appropriate medical treatments can significantly reduce symptoms and complications. Without treatment, the disease can lead to severe anemia, recurrent infections, and significant organ damage, which can adversely affect quality of life and overall health. Early diagnosis and intervention are crucial for managing the disease and improving outcomes.  
  • CT-EU-00119886

    Study of Povetacicept for treating autoimmune blood disorders

    This clinical study aims to evaluate the safety and potential benefits of a drug called povetacicept in adults with autoimmune cytopenias, specifically immune thrombocytopenia, autoimmune hemolytic anemia, and cold agglutinin disease. The study is open-label, meaning both the researchers and participants know what treatment is being administered. Participants will receive povetacicept through a subcutaneous injection approximately every four weeks for six months. There is also a possibility of extending the treatment for an additional six months. The primary goal is to monitor the type, incidence, severity, and seriousness of any adverse events from the first day of treatment through 30 days after the last dose. This study is designed to determine if povetacicept is safe and potentially beneficial in treating these autoimmune conditions.

    • povetacicept
  • Testing safety and effectiveness of pegcetacoplan for cold agglutinin disease

    This is a trial about a drug named pegcetacoplan for treating people with cold agglutinin disease (CAD). CAD is often identified by low levels of a substance in your blood called Hemoglobin (Hgb). Low Hgb can make you feel tired and exhausted. In this study, the researchers will give participants either pegcetacoplan or placebo without telling them which one they are receiving to impartially examine if pegcetacoplan can increase Hgb levels and avoid needs for blood transfusions.

    • Pegcetacoplan