Umbilical Cord Tissue-derived Mesenchymal Stem Cells for Rheumatoid Arthritis

• ClinicalTrials.gov Identifier: NCT01985464
• Recruitment Status: Unknown
• First Posted: November 15, 2013
• Last Update Posted: June 20, 2019
• Sponsor: Translational Biosciences
• Information provided by (Responsible Party): Translational Biosciences

Tracking Information

• First Submitted Date: October 31, 2013
• First Posted Date: November 15, 2013
• Last Update Posted Date: June 20, 2019
• Study Start Date: October 2013
• Estimated Primary Completion Date: December 2019 (Final data collection date for primary outcome measure)
• Current Primary Outcome Measures (submitted: November 8, 2013): Number of participants with adverse events [ Time Frame: 12 months ]
• Original Primary Outcome Measures: Same as current

Current Secondary Outcome Measures (submitted: November 8, 2013)

• Number of participants with a change in disease activity index as measured by 28-DAS Score [ Time Frame: 12 months ]
• Number of participants with a change in current disease activity as measured by EULAR Response Criteria [ Time Frame: 12 months ]
• Change from baseline quality of life measure (based on Stanford HAQ) [ Time Frame: 12 months ]
• Change from baseline C-reactive protein [ Time Frame: 12 months ]
• Change from baseline erythrocyte sedimentation rate (ESR) [ Time Frame: 12 months ]
• Change from baseline anti-citrulline antibody measure [ Time Frame: 12 months ]
• Change from baseline rheumatoid factor (RF) [ Time Frame: 12 months ]

• Original Secondary Outcome Measures: Same as current
• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: Umbilical Cord Tissue-derived Mesenchymal Stem Cells for Rheumatoid Arthritis
• Official Title: Feasibility Study of Umbilical Cord Tissue Derived Mesenchymal Stem Cells (UC-MSC) in Disease Modifying Anti-Rheumatic Drugs (DMARD) Resistant Rheumatoid Arthritis
• Brief Summary: Allogeneic human umbilical cord tissue-derived stem cells will be injected intravenously once per day for 5 days is a safe and useful procedure in inducing remission of RA in patients resistant to standard DMARD therapy.

Detailed Description

The proposed study will assess primarily safety and secondary efficacy endpoints of allogeneic UC-MSC administered to 20 patients with disease modifying antirheumatic drug (DMARD)-resistant Rheumatoid Arthritis (RA) who have been non-responsive to at least one course of one DMARD selected from a group comprising of: gold salts, leflunomide, methotrexate, and hydroxychloroquine.

The primary objective of safety will be defined as freedom from treatment associated adverse events for the period of one year. The secondary objective of efficacy will include evaluation at baseline and at months 3 and 12 of efficacy endpoints of C reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-citrulline antibody, rheumatoid factor (RF), Quality of Life Questionnaire, 28-joint disease activity score (DAS28), European League against Rheumatism (EULAR) response criteria and immunological parameters.

• Study Type: Interventional
• Study Phase: Phase 1; Phase 2
• Study Design: Allocation: N/A; Intervention Model: Single Group Assignment; Masking: None (Open Label); Primary Purpose: Treatment
• Condition: Rheumatoid Arthritis
• Intervention: Biological: Umbilical cord mesenchymal stem cells

Study Arms

Experimental: Umbilical cord mesenchymal stem cells

Intervention: Biological: Umbilical cord mesenchymal stem cells

• Publications *: Not Provided

Recruitment Information

• Recruitment Status: Unknown status
• Estimated Enrollment (submitted: November 8, 2013): 20
• Original Estimated Enrollment: Same as current
• Estimated Study Completion Date: June 2020
• Estimated Primary Completion Date: December 2019 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• Signed inform consent by the subject.
• Age older than 18 years and ability to understand the planned treatment.
• Patients of either gender with RA with a duration of 6 months to 20 years defined as the presence of at least three of the following criteria: 3 or more painful, 2 or more swollen joints, morning stiffness for at least 45 minutes (on average during the week prior to entry), and an erythrocyte sedimentation rate (ESR) of at least 28 mm.
• Non-responsive to at least one course of one DMARD selected from the group comprising of: gold salts, leflunomide, methotrexate, and hydroxychloroquine.
• Second-line agents are discontinued at least 4 weeks prior to entry.
• Able to tolerate ALL study procedures
• Able to give informed Consent
• Negative for HcG with a serum pregnancy test
• Hematocrit ≥ 28.0%, White Blood Cell count ≤ 14,000, Platelet count ≥ 50,000,
• Life expectancy of 6 months or more in the opinion of the investigator
• Serum bilirubin, ALT, AST up to 2.5 time the upper level of normal.
• Controlled blood pressure (systolic blood pressure ≤140 and a diastolic blood pressure of ≤90 mmHG) and established anti-hypertensive therapy as necessary prior to entry into the study
• Patient has received stable, standard medical therapy for at least one month with no new medications to treat the disease introduced in the last month.
• Pre-existing condition (e.g. thromboembolic risk, diabetes, hypercholesterolemia) are adequately controlled in the opinion of the investigator
• Fertile patients (male and female) must agree to use an appropriate form of contraception while participating in the study.

Exclusion Criteria:

• Female who is pregnant or nursing, or of child-bearing potential and is not using a reliable birth control method, or who intend to become pregnant during the tenure of this study.
• History of prior radiation exposure for oncological treatment.
• History of Bone Marrow Disorder (especially NHL, MDS)
• History of abnormal bleeding or clotting.
• History of Liver Cirrhosis.
• End stage renal disease (Creatinine ≤ 3.0 mg / dl) and/or dialysis
• Active clinical infection being treated by antibiotics before one week enrollment
• Inability or unwillingness to comply with the treatment protocol, follow-up, research tests, or give consent.
• History of life-threatening arrhythmias, except if an automated implantable cardioverter defibrillator (AICD) is implanted
• Life expectancy <6 months due to concomitant illnesses
• Known cancer and undergoing treatment; chemotherapy and/or radiotherapy
• Patients receiving treatment with hematopoietic growth factors (e.g., EPO, G-CSF)
• Patients who can not stop anticoagulation therapy (warfarin) 72hrs prior to infusion
• Patients who can not stop anti-platelet therapy (clopidogrel) 7 days prior infusion
• Prior admission for substance abuse
• Body Mass Index (BMI) of 40 kg/m2 or greater
• Patient receiving experimental medication or participating in another clinical study within 30 days of signing the informed consent
• In the opinion of the investigator or the sponsor, the patient is unsuitable for cellular therapy

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: Panama

Administrative Information

• NCT Number: NCT01985464
• Other Study ID Numbers: TBS-UCMSCRA-001
• Has Data Monitoring Committee: Yes
• U.S. FDA-regulated Product: Not Provided
• IPD Sharing Statement: Not Provided
• Current Responsible Party: Translational Biosciences
• Original Responsible Party: Same as current
• Current Study Sponsor: Translational Biosciences
• Original Study Sponsor: Same as current
• Collaborators: Not Provided

Investigators

• Principal Investigator: Gerardo Castrellon, MD; Not Affiliated

• PRS Account: Translational Biosciences
• Verification Date: October 2018