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Allogeneic Mesenchymal Stem Cells in Osteoarthritis

Primary Purpose

Osteoarthritis of Knee

Status
Completed
Phase
Phase 2
Locations
India
Study Type
Interventional
Intervention
Ex- vivo cultured adult allogeneic MSCs
Plasmalyte-A
Sponsored by
Stempeutics Research Pvt Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis of Knee focused on measuring Osteoarthritis, Knee, Stem cells, Mesenchymal Stem Cells

Eligibility Criteria

40 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males or females in the age 40 - 70 years (both inclusive)
  2. Radiographic evidence of grade 2 to 3 osteoarthritis based on the Kellgren and Lawrence radiographic criteria.
  3. History of primary idiopathic osteoarthritis of the knee characterized by pain which requires intake of analgesics.
  4. Self-reported difficulty in at least one of the following activities attributed to knee pain: lifting and carrying groceries, walking 400 metres, getting in and out of a chair, or going up and down stairs.
  5. Patients who have been on stable medication which may be NSAIDs / Opioid or opiate analgesics, for the past three months.
  6. Female patients of childbearing age must be willing to use accepted methods of contraception during the course of the study
  7. Ability to provide written informed consent.

Exclusion Criteria:

  1. Prior or ongoing medical conditions (e.g., concomitant illness, psychiatric condition, alcoholism, drug abuse), medical history, physical findings, ECG findings, or laboratory abnormality that, in the investigator's opinion, could adversely affect the safety of the subject, makes it unlikely that the course of treatment or follow-up would be completed, or could impair the assessment of study results.
  2. History of surgery, or major trauma to the study joint
  3. Arthroscopy on the study joint in the previous 12 months
  4. Signs of active study joint inflammation including redness, warmth, and/or, if qualifying with osteoarthritis of the knee, a large, bulging effusion of the study knee joint with the loss of normal contour of the joint at the screening visit or at the baseline examination
  5. Patients who had received intraarticular steroids or hyaluronan within the last three months.
  6. Infections in or around the knee.
  7. Patients awaiting a replacement knee or hip joint
  8. Patients with other conditions that cause pain
  9. Patients with deformity of the knee joint.
  10. Significantly incapacitated or disabled and would be categorized as ACR Functional Class IV (largely or wholly incapacitated), or unable to walk without assistive devices
  11. Patients with other known rheumatic or inflammatory disease such as rheumatoid arthritis
  12. Other pathologic lesions on x-rays of knee
  13. Positive hepatitis B surface antigen, hepatitis C antibody test, Anti human immunodeficiency virus (HIV) antibody test, or RPR
  14. History of Bleeding disorders
  15. Known hypersensitivity to Hyaluronan products or animal sera
  16. For women of child-bearing potential: positive pregnancy test or lactating [Females who are planning pregnancy within next one year should be excluded]

Sites / Locations

  • Department of Orthopedics, M. S. Ramaiah Memorial Hospital
  • Department of Orthopedics, Kasturba Medical College
  • Seth G. S. Medical College and KEM Hospital
  • Jehangir Hospital
  • Department of Immunology Sanjay Gandhi Post Graduate Institute of Medical Sciences

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Ex- vivo cultured adult allogeneic MSCs

Plasmalyte-A

Arm Description

Single intraarticular dose of allogeneic MSCs suspended in 2-4ml Plasmalyte A followed by 2 ml of Hyaluronan

Single intraarticular dose of 2ml Plasmalyte

Outcomes

Primary Outcome Measures

Number and percentage of patients with adverse events as a measure of safety and tolerability
Safety evaluation will include assessment of physical examination, periodic monitoring of vital signs (heart rate, respiratory rate, blood pressure and temperature), clinical laboratory investigations (including haematology, serum chemistry, LFT, urine-analysis) and 12-lead ECG recording. Tolerability: Adverse events monitored using information volunteered by the patients and as observed by the PI will be summarized descriptively by total number of AE(s) and compared between the study arms.

Secondary Outcome Measures

Change from baseline in the WOMAC OA (Western Ontario and McMaster Universities Osteoarthritis) Index -pain subscale score
Change from baseline in WOMAC OA stiffness index
Change from baseline in WOMAC OA composite index
Change from baseline in ICOAP (Intermittent and Constant Osteoarthritis Pain)
Change from baseline in radiographic (X-ray) findings of knee
Change from baseline in the WORMS score (Whole-Organ Magnetic Resonance Imaging Score) of knee using MRI
Change from baseline in arthritis pain scores on the visual analogue scale
Reduction in the intake of analgesic tablets from baseline

Full Information

First Posted
October 13, 2011
Last Updated
May 11, 2016
Sponsor
Stempeutics Research Pvt Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT01453738
Brief Title
Allogeneic Mesenchymal Stem Cells in Osteoarthritis
Official Title
A Randomized, Double Blind, Multicentric, Placebo Controlled, Phase -II Study Assessing the Safety and Efficacy of Intraarticular Ex-vivo Cultured Adult Allogeneic Mesenchymal Stem Cells in Patients With Osteoarthritis of Knee
Study Type
Interventional

2. Study Status

Record Verification Date
May 2016
Overall Recruitment Status
Completed
Study Start Date
November 2011 (undefined)
Primary Completion Date
November 2014 (Actual)
Study Completion Date
November 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stempeutics Research Pvt Ltd

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This trial is planed to study if allogeneic mesenchymal stem cells would be safe and beneficial in osteoarthritis of knee joint. This is a double blind study. Different doses of stem cells will be used in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis of Knee
Keywords
Osteoarthritis, Knee, Stem cells, Mesenchymal Stem Cells

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ex- vivo cultured adult allogeneic MSCs
Arm Type
Experimental
Arm Description
Single intraarticular dose of allogeneic MSCs suspended in 2-4ml Plasmalyte A followed by 2 ml of Hyaluronan
Arm Title
Plasmalyte-A
Arm Type
Placebo Comparator
Arm Description
Single intraarticular dose of 2ml Plasmalyte
Intervention Type
Biological
Intervention Name(s)
Ex- vivo cultured adult allogeneic MSCs
Intervention Description
Single intraarticular dose of allogeneic MSCs suspended in 2ml Plasmalyte followed by 2ml of Hyaluronan
Intervention Type
Biological
Intervention Name(s)
Plasmalyte-A
Intervention Description
Single intraarticular dose of 2ml Plasmalyte followed by 2ml Hyaluronan
Primary Outcome Measure Information:
Title
Number and percentage of patients with adverse events as a measure of safety and tolerability
Description
Safety evaluation will include assessment of physical examination, periodic monitoring of vital signs (heart rate, respiratory rate, blood pressure and temperature), clinical laboratory investigations (including haematology, serum chemistry, LFT, urine-analysis) and 12-lead ECG recording. Tolerability: Adverse events monitored using information volunteered by the patients and as observed by the PI will be summarized descriptively by total number of AE(s) and compared between the study arms.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Change from baseline in the WOMAC OA (Western Ontario and McMaster Universities Osteoarthritis) Index -pain subscale score
Time Frame
2 years
Title
Change from baseline in WOMAC OA stiffness index
Time Frame
2 years
Title
Change from baseline in WOMAC OA composite index
Time Frame
2 years
Title
Change from baseline in ICOAP (Intermittent and Constant Osteoarthritis Pain)
Time Frame
2 years
Title
Change from baseline in radiographic (X-ray) findings of knee
Time Frame
2 years
Title
Change from baseline in the WORMS score (Whole-Organ Magnetic Resonance Imaging Score) of knee using MRI
Time Frame
2 years
Title
Change from baseline in arthritis pain scores on the visual analogue scale
Time Frame
2 years
Title
Reduction in the intake of analgesic tablets from baseline
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females in the age 40 - 70 years (both inclusive) Radiographic evidence of grade 2 to 3 osteoarthritis based on the Kellgren and Lawrence radiographic criteria. History of primary idiopathic osteoarthritis of the knee characterized by pain which requires intake of analgesics. Self-reported difficulty in at least one of the following activities attributed to knee pain: lifting and carrying groceries, walking 400 metres, getting in and out of a chair, or going up and down stairs. Patients who have been on stable medication which may be NSAIDs / Opioid or opiate analgesics, for the past three months. Female patients of childbearing age must be willing to use accepted methods of contraception during the course of the study Ability to provide written informed consent. Exclusion Criteria: Prior or ongoing medical conditions (e.g., concomitant illness, psychiatric condition, alcoholism, drug abuse), medical history, physical findings, ECG findings, or laboratory abnormality that, in the investigator's opinion, could adversely affect the safety of the subject, makes it unlikely that the course of treatment or follow-up would be completed, or could impair the assessment of study results. History of surgery, or major trauma to the study joint Arthroscopy on the study joint in the previous 12 months Signs of active study joint inflammation including redness, warmth, and/or, if qualifying with osteoarthritis of the knee, a large, bulging effusion of the study knee joint with the loss of normal contour of the joint at the screening visit or at the baseline examination Patients who had received intraarticular steroids or hyaluronan within the last three months. Infections in or around the knee. Patients awaiting a replacement knee or hip joint Patients with other conditions that cause pain Patients with deformity of the knee joint. Significantly incapacitated or disabled and would be categorized as ACR Functional Class IV (largely or wholly incapacitated), or unable to walk without assistive devices Patients with other known rheumatic or inflammatory disease such as rheumatoid arthritis Other pathologic lesions on x-rays of knee Positive hepatitis B surface antigen, hepatitis C antibody test, Anti human immunodeficiency virus (HIV) antibody test, or RPR History of Bleeding disorders Known hypersensitivity to Hyaluronan products or animal sera For women of child-bearing potential: positive pregnancy test or lactating [Females who are planning pregnancy within next one year should be excluded]
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vikas Agarwal, MD., DM
Organizational Affiliation
Department of Immunology Sanjay Gandhi Post Graduate Institute of Medical Sciences
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Vivek Pandey, MS
Organizational Affiliation
Department of Orthopedics, Kasturba Medical College
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Naresh Shetty, MS
Organizational Affiliation
Department of Orthopedics, M. S. Ramaiah Memorial Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Shrikant Wagh, MD
Organizational Affiliation
Jehangir Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Bhibas Dasgupta, MS
Organizational Affiliation
Seth G. S. Medical College and KEM Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Orthopedics, M. S. Ramaiah Memorial Hospital
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560054
Country
India
Facility Name
Department of Orthopedics, Kasturba Medical College
City
Manipal
State/Province
Karnataka
ZIP/Postal Code
576 104
Country
India
Facility Name
Seth G. S. Medical College and KEM Hospital
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400012
Country
India
Facility Name
Jehangir Hospital
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411001
Country
India
Facility Name
Department of Immunology Sanjay Gandhi Post Graduate Institute of Medical Sciences
City
Lucknow
State/Province
Uttar Pradesh
ZIP/Postal Code
226 014
Country
India

12. IPD Sharing Statement

Citations:
PubMed Identifier
27993154
Citation
Gupta PK, Chullikana A, Rengasamy M, Shetty N, Pandey V, Agarwal V, Wagh SY, Vellotare PK, Damodaran D, Viswanathan P, Thej C, Balasubramanian S, Majumdar AS. Efficacy and safety of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (Stempeucel(R)): preclinical and clinical trial in osteoarthritis of the knee joint. Arthritis Res Ther. 2016 Dec 20;18(1):301. doi: 10.1186/s13075-016-1195-7.
Results Reference
derived

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Allogeneic Mesenchymal Stem Cells in Osteoarthritis

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