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Safety Study of Allogeneic Mesenchymal Precursor Cells (MPCs) in Subjects With Recent Acute Myocardial Infarction

Primary Purpose

Myocardial Infarction

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Allogeneic Mesenchymal Precursor Cells (MPCs)
Standard-of-care treatment with NOGA® mapping and staged injections.
Allogeneic Mesenchymal Precursor Cells (MPCs)
Standard-of-care treatment with NOGA® mapping and staged injections.
Allogeneic Mesenchymal Precursor Cells (MPCs)
Standard-of-care treatment with NOGA® mapping and staged injections.
Sponsored by
Angioblast Systems
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction focused on measuring Myocardial Infarction, Myocardial infarct, Infarction

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 18 years or older.
  2. An ST-elevation MI (STEMI) within 2 to 10 days of study enrollment. The STEMI must be documented by ECG with ST-segment elevation >1 mm in at least 2 contiguous precordial leads or in at least 2 adjacent limb leads. If there is a history of a previous AMI prior to the qualifying MI, then there must be a documented EF ≥ 50% by 2D echocardiogram within 12 months of enrollment.
  3. Successful percutaneous revascularization with Thrombolysis in Myocardial Infarction (TIMI)-3 flow of the infarct-related artery.
  4. A baseline 2D echocardiogram with EF ≥ 30 and ≤ 50% following PCI.
  5. Creatinine level ≤ 1.5mg/dL within 24 hours of study procedure.
  6. Hematocrit ≥ 30% within 24 hours of study procedure.
  7. White Blood Cell count < 20k/mm3 within 24 hours of study procedure.
  8. Platelet count ≥ 100k/mm3 within 24 hours of study procedure.
  9. INR ≤ 1.7 within 24 hours of study procedure.
  10. Total bilirubin <3 mg/dL, albumin >2.8 g/dL, aspartate aminotransferase(AST) ≤ 2.5x the upper limit of normal, gamma glutamyltranspeptidase (GGT) ≤ 1.5 x the upper limit of normal.
  11. If the subject or partner is of childbearing potential, he or she must be willing to use adequate contraception (hormonal or barrier method or abstinence) from the time of screening and for a period of at least 16 weeks after surgery.
  12. Female subjects of childbearing potential must have a negative serum pregnancy test at screening (within 2 weeks of enrollment) and a negative serum or urine pregnancy test on the day of cell implantation.
  13. Willing and able to understand, sign, and date the Informed Consent Form (ICF).
  14. Must be willing to return for required follow-up visits.
  15. Must be able to follow postoperative management program.

Exclusion Criteria:

  1. Subject is hemodynamically unstable at Day 5 post-AMI as demonstrated by any of the following:

    1. Killip Class 4 indicative of cardiogenic shock.
    2. Requirement of intra-aortic balloon pump or IV inotropic support for the maintenance of mean arterial blood pressure ≥ 60 mmHg.
  2. Sustained ventricular tachycardia as demonstrated by QRS complexes wider than 120 msec, lasting >30 secs, and >100 bpm occurring >48 hours following PCI without any identifiable, reversible cause (ie, electrolyte imbalance).
  3. Further revascularization planned for the next 30 days.
  4. Chronic atrial fibrillation.
  5. A wall thickness in the target region <8 mm as determined by 2D echocardiography(the target region is defined at the time of NOGA® mapping).
  6. An LV thrombus.
  7. Severe peripheral vascular disease precluding femoral artery access as determined at time of original catheterization.
  8. Aortic stenosis as determined as valve area less than 1 cm2 that prohibits catheter access to the LV.
  9. Echocardiographic evidence of hypertrophic cardiomyopathy indicating heart muscle thickness >15 mm.
  10. Human immunodeficiency virus (HIV)
  11. Serum glucose level ≥ 400 mg/dl within 24 hours of study procedure
  12. Serum glucose level 300-400 mg/dl and presence of urine ketones within 24 hours of study procedure.
  13. Claustrophobic, or with medical conditions or contradictions that impede performing baseline MRI study.
  14. An active uncontrolled infection.
  15. A prosthetic aortic valve.
  16. Presence of ≥ 20% anti-HLA antibody titers and/or having antibody specificities to donor HLA antigens.
  17. A current or prior history within the last 3 years of neoplasm (excluding basal cell) and/or any active neoplasm within the last 24 months.
  18. A known hypersensitivity to dimethyl sulfoxide (DMSO), murine and/or bovine products.
  19. Pregnancy or breastfeeding.
  20. Imprisoned at the time of enrollment.
  21. A treatment and/or an uncompleted follow-up treatment of any investigational therapy within 6 months before implantation surgery and intent to participate in any other investigational drug or cell therapy study during the 3-year follow-up period of this study.
  22. Active participation in other research therapy for cardiovascular repair/regeneration.
  23. A prior recipient of stem precursor cell therapy for cardiac repair.
  24. Any medical condition that would affect the investigator's ability to evaluate the subject's condition or could compromise the subject's safety.
  25. Any condition that, in the judgment of the investigator, would prohibit the subject from participating in the study.

Sites / Locations

  • University of Minnesota/Minneapolis Heart InstituteRecruiting
  • Texas Heart Institute/St. Luke's HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Other

Experimental

Other

Experimental

Other

Arm Label

A1

A2

B1

B2

C1

C2

Arm Description

5 subjects randomized to receive 25 M allogeneic MPCs by transendocardial injection

5 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.

5 subjects randomized to receive 75 M allogeneic MPCs by transendocardial injection

3 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.

5 subjects randomized to receive 150 M allogeneic MPCs by transendocardial injection

2 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.

Outcomes

Primary Outcome Measures

Evaluate the safety and feasibility of transendocardial injection using the Cordis Biosense NogaStarTM Mapping Catheter with the Biosense MyostarTM Left Ventricular Injection Catheter of allogeneic mesenchymal precursor cells (MPCs) in subjects with AMI.

Secondary Outcome Measures

Explore efficacy for subsequent study design and dose related tolerance: •Effect related to cardiac function.•Change from baseline in SF-36, KCCQ, SAQ, and the NYHA Classification.•Follow-up safety through Day 360 • Dose selection for future stu

Full Information

First Posted
November 7, 2007
Last Updated
February 16, 2010
Sponsor
Angioblast Systems
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1. Study Identification

Unique Protocol Identification Number
NCT00555828
Brief Title
Safety Study of Allogeneic Mesenchymal Precursor Cells (MPCs) in Subjects With Recent Acute Myocardial Infarction
Official Title
A Phase 1b/2a Dose Escalation Study to Assess the Safety and Feasibility of Transendocardial Delivery of 3 Different Doses of Allogeneic Mesenchymal Precursor Cells (MPCs) in Subjects With Recent Acute Myocardial Infarction
Study Type
Interventional

2. Study Status

Record Verification Date
June 2009
Overall Recruitment Status
Unknown status
Study Start Date
March 2008 (undefined)
Primary Completion Date
December 2013 (Anticipated)
Study Completion Date
December 2013 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Angioblast Systems

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Primary Objective The primary objective of this study is to evaluate the safety and feasibility of transendocardial injection using the Cordis Biosense NogaStarTM Mapping Catheter with the Biosense MyostarTM Left Ventricular Injection Catheter of 25 M, 75 M, and 150 M allogeneic mesenchymal precursor cells (MPCs) in subjects with AMI. SecondaryObjective The secondary objectives are to explore functional efficacy for subsequent study design, as well as late-term dose related tolerance, by: Evaluating the effect of allogeneic MPCs on exploratory efficacy endpoints related to cardiac function on Days 90, 180, and 1 year Evaluating the change from baseline in the Medical Outcome Study Short Form (SF-36), Kansas City Cardiomyopathy Questionnaire, Seattle Angina Questionnaire, and the New York Heart Association Classification at 30 days, 3 and 6 months, and 1, 2, and 3 years Evaluating follow-up safety through Day 360 Providing preliminary data to support dose selection for future studies

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction
Keywords
Myocardial Infarction, Myocardial infarct, Infarction

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
25 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
A1
Arm Type
Experimental
Arm Description
5 subjects randomized to receive 25 M allogeneic MPCs by transendocardial injection
Arm Title
A2
Arm Type
Other
Arm Description
5 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.
Arm Title
B1
Arm Type
Experimental
Arm Description
5 subjects randomized to receive 75 M allogeneic MPCs by transendocardial injection
Arm Title
B2
Arm Type
Other
Arm Description
3 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.
Arm Title
C1
Arm Type
Experimental
Arm Description
5 subjects randomized to receive 150 M allogeneic MPCs by transendocardial injection
Arm Title
C2
Arm Type
Other
Arm Description
2 subjects randomized to receive standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Type
Genetic
Intervention Name(s)
Allogeneic Mesenchymal Precursor Cells (MPCs)
Intervention Description
25 M allogeneic MPCs by transendocardial injection
Intervention Type
Procedure
Intervention Name(s)
Standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Description
Standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Type
Genetic
Intervention Name(s)
Allogeneic Mesenchymal Precursor Cells (MPCs)
Intervention Description
75 M allogeneic MPCs by transendocardial injection
Intervention Type
Procedure
Intervention Name(s)
Standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Description
Standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Type
Genetic
Intervention Name(s)
Allogeneic Mesenchymal Precursor Cells (MPCs)
Intervention Description
150 M allogeneic MPCs by transendocardial injection
Intervention Type
Procedure
Intervention Name(s)
Standard-of-care treatment with NOGA® mapping and staged injections.
Intervention Description
Standard-of-care treatment with NOGA® mapping and staged injections.
Primary Outcome Measure Information:
Title
Evaluate the safety and feasibility of transendocardial injection using the Cordis Biosense NogaStarTM Mapping Catheter with the Biosense MyostarTM Left Ventricular Injection Catheter of allogeneic mesenchymal precursor cells (MPCs) in subjects with AMI.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Explore efficacy for subsequent study design and dose related tolerance: •Effect related to cardiac function.•Change from baseline in SF-36, KCCQ, SAQ, and the NYHA Classification.•Follow-up safety through Day 360 • Dose selection for future stu
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18 years or older. An ST-elevation MI (STEMI) within 2 to 10 days of study enrollment. The STEMI must be documented by ECG with ST-segment elevation >1 mm in at least 2 contiguous precordial leads or in at least 2 adjacent limb leads. If there is a history of a previous AMI prior to the qualifying MI, then there must be a documented EF ≥ 50% by 2D echocardiogram within 12 months of enrollment. Successful percutaneous revascularization with Thrombolysis in Myocardial Infarction (TIMI)-3 flow of the infarct-related artery. A baseline 2D echocardiogram with EF ≥ 30 and ≤ 50% following PCI. Creatinine level ≤ 1.5mg/dL within 24 hours of study procedure. Hematocrit ≥ 30% within 24 hours of study procedure. White Blood Cell count < 20k/mm3 within 24 hours of study procedure. Platelet count ≥ 100k/mm3 within 24 hours of study procedure. INR ≤ 1.7 within 24 hours of study procedure. Total bilirubin <3 mg/dL, albumin >2.8 g/dL, aspartate aminotransferase(AST) ≤ 2.5x the upper limit of normal, gamma glutamyltranspeptidase (GGT) ≤ 1.5 x the upper limit of normal. If the subject or partner is of childbearing potential, he or she must be willing to use adequate contraception (hormonal or barrier method or abstinence) from the time of screening and for a period of at least 16 weeks after surgery. Female subjects of childbearing potential must have a negative serum pregnancy test at screening (within 2 weeks of enrollment) and a negative serum or urine pregnancy test on the day of cell implantation. Willing and able to understand, sign, and date the Informed Consent Form (ICF). Must be willing to return for required follow-up visits. Must be able to follow postoperative management program. Exclusion Criteria: Subject is hemodynamically unstable at Day 5 post-AMI as demonstrated by any of the following: Killip Class 4 indicative of cardiogenic shock. Requirement of intra-aortic balloon pump or IV inotropic support for the maintenance of mean arterial blood pressure ≥ 60 mmHg. Sustained ventricular tachycardia as demonstrated by QRS complexes wider than 120 msec, lasting >30 secs, and >100 bpm occurring >48 hours following PCI without any identifiable, reversible cause (ie, electrolyte imbalance). Further revascularization planned for the next 30 days. Chronic atrial fibrillation. A wall thickness in the target region <8 mm as determined by 2D echocardiography(the target region is defined at the time of NOGA® mapping). An LV thrombus. Severe peripheral vascular disease precluding femoral artery access as determined at time of original catheterization. Aortic stenosis as determined as valve area less than 1 cm2 that prohibits catheter access to the LV. Echocardiographic evidence of hypertrophic cardiomyopathy indicating heart muscle thickness >15 mm. Human immunodeficiency virus (HIV) Serum glucose level ≥ 400 mg/dl within 24 hours of study procedure Serum glucose level 300-400 mg/dl and presence of urine ketones within 24 hours of study procedure. Claustrophobic, or with medical conditions or contradictions that impede performing baseline MRI study. An active uncontrolled infection. A prosthetic aortic valve. Presence of ≥ 20% anti-HLA antibody titers and/or having antibody specificities to donor HLA antigens. A current or prior history within the last 3 years of neoplasm (excluding basal cell) and/or any active neoplasm within the last 24 months. A known hypersensitivity to dimethyl sulfoxide (DMSO), murine and/or bovine products. Pregnancy or breastfeeding. Imprisoned at the time of enrollment. A treatment and/or an uncompleted follow-up treatment of any investigational therapy within 6 months before implantation surgery and intent to participate in any other investigational drug or cell therapy study during the 3-year follow-up period of this study. Active participation in other research therapy for cardiovascular repair/regeneration. A prior recipient of stem precursor cell therapy for cardiac repair. Any medical condition that would affect the investigator's ability to evaluate the subject's condition or could compromise the subject's safety. Any condition that, in the judgment of the investigator, would prohibit the subject from participating in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Donna Skerrett, MD
Phone
1-888-369-2123
Email
donna.skerrett@angioblast.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Emerson C. Perin, MD, PhD
Organizational Affiliation
Texas Heart Institute/St. Luke's Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Minnesota/Minneapolis Heart Institute
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407-1139
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Timothy D. Henry, MD
Facility Name
Texas Heart Institute/St. Luke's Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emerson C. Perin, MD, PhD

12. IPD Sharing Statement

Learn more about this trial

Safety Study of Allogeneic Mesenchymal Precursor Cells (MPCs) in Subjects With Recent Acute Myocardial Infarction

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