Intrathecal Administration of Autologous Mesenchymal Stem Cell-derived Neural Progenitors (MSC-NP) in Patients With Multiple Sclerosis
Primary Purpose
Multiple Sclerosis
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
intrathecal administration of autologous MSC-NP
Sponsored by

About this trial
This is an interventional treatment trial for Multiple Sclerosis focused on measuring mesenchymal stem cells, neural progenitors, autologous, bone marrow, multiple sclerosis
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of MS as defined by the McDonald criteria
- Diagnosis of primary progressive or secondary progressive MS
- Between the ages of 18-70 years
- Significant disability shown by an Expanded Disability Status Score (EDSS) of 3.0 or greater that was not acquired within the last 12 months
- Stable disease state as evidenced by a lack of gadolinium-enhancing lesions on an MRI and by a stable MRI disease burden (number of T2 lesions and size of lesions) in the last six months and no significant change in EDSS (1 point or more) in the last 12 months
- Must agree to undergo MRIs at the time of enrollment, 2 months after the first treatment, and 27 months after the last treatment
- Live in northern New Jersey, southern New York, or southwestern Connecticut during the study period, or patients must be able to arrange reliable travel accommodations to be present for every study visit if they live farther away.
Exclusion Criteria:
- Pregnant or nursing mothers or any woman intending to become pregnant in the next three years
- All patients will have pre-study liver function tests, PT/PPT, platelets, hematocrit, and renal function laboratory tests done. Only patients whose values are in the normal range as determined by the laboratory norms based on age and sex will be allowed to participate.
- Use of systemic chemotherapeutic or anti-mitotic medications within three months of study start date due to the possibility of interference with bone marrow procedure
- Any patients with a history of or with active malignancy
- Use of steroids within three months of the study start date, as this would suggest a highly active disease state
- History of cirrhosis due to increased risk of central nervous system (CNS) infection
- Poorly controlled hypertension because of increased risk for stroke or CNS hemorrhage. Specifically, any patient with a systolic blood pressure value of ≥ 145 mm/Hg or a diastolic blood pressure value of ≥ 95 mm/Hg will be excluded from study participation.
- History of thyroid disorders or other endocrine disorders because of hormone influence on cell growth
- History of central nervous system infection or immunodeficiency syndromes due to increased risk of CNS infection
- Preexisting blood disease (such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia) due to invasive nature of bone-marrow aspiration
- Previous or current history of a coagulation disorder
- Any metal in the body, which is contraindicated for MRI studies
- Allergy to any of the antibiotics used in this study, e.g. tobramycin, vancomycin, or gentamicin
- Patients with alcohol or other substance abuse problems
- Other major disease that, in the opinion of the Principal Investigator, would preclude participation in the study
- Patients with HBV, HCV, syphilis, HIV-1, or HIV-2.
- Any evidence of significant cognitive dysfunction based on a screening history and physical examination because it would preclude giving a truly informed consent
- Patients who are enrolled in another clinical trial for MS treatment or who have received any study drug/biologics within the last 6 months
Sites / Locations
- Tisch MS Research Center of New York
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
autologous MSC-NP
Arm Description
intrathecal administration of autologous MSC-NP in three doses at three month intervals
Outcomes
Primary Outcome Measures
Number of participants with adverse events
The primary objective of the study is to assess the safety and tolerability of intrathecal therapy with autologous MSCNPs in MS. Number of participants with adverse events will be documented 1 day, 1 week, 1 month and 2 months post treatment for three treatments (followup for third treatment is 3 months instead of 2 months).
Number of participants with adverse events .
The co-primary objective will be to observe long term safety of the treatment 6 months and 30 months following the last treatment.
Secondary Outcome Measures
Preliminary evaluation of efficacy
The secondary objective is to observe trends in efficacy over the course of the experimental treatment. Outcome measures include evoked potentials (baseline and 3 months post 3rd dose) ,quality of life questionnaire, EDSS, and MSFC (baseline, at the time of each dose, and 3 and 6 months after third dose), and MRI (baseline, 2 months after first dose, and 3 and 24 months after third dose).
Full Information
NCT ID
NCT01933802
First Posted
August 23, 2013
Last Updated
March 15, 2018
Sponsor
Tisch Multiple Sclerosis Research Center of New York
1. Study Identification
Unique Protocol Identification Number
NCT01933802
Brief Title
Intrathecal Administration of Autologous Mesenchymal Stem Cell-derived Neural Progenitors (MSC-NP) in Patients With Multiple Sclerosis
Official Title
Phase 1 Safety Study of Autologous Bone Marrow-derived Mesenchymal Stem Cell-derived Neural Progenitor Cells (MSC-NP), Expanded Ex Vivo, Administered Intrathecally in Patients With Multiple Sclerosis
Study Type
Interventional
2. Study Status
Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
April 2014 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
March 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tisch Multiple Sclerosis Research Center of New York
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The study is an open-label, phase I clinical trial designed to evaluate the safety and tolerability of intrathecal administration of autologous mesenchymal stem cell-derived neural progenitor cells (MSC-NP) in patients with progressive multiple sclerosis. Study participants will receive three intrathecal injections of culture-expanded autologous MSC-NPs at three month intervals.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis
Keywords
mesenchymal stem cells, neural progenitors, autologous, bone marrow, multiple sclerosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
autologous MSC-NP
Arm Type
Experimental
Arm Description
intrathecal administration of autologous MSC-NP in three doses at three month intervals
Intervention Type
Biological
Intervention Name(s)
intrathecal administration of autologous MSC-NP
Intervention Description
Autologous MSC-NPs administered intrathecally at a dose between 2 and 10 million cells, depending on ex vivo expansion characteristics. Three doses will be administered at 3 month intervals.
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Description
The primary objective of the study is to assess the safety and tolerability of intrathecal therapy with autologous MSCNPs in MS. Number of participants with adverse events will be documented 1 day, 1 week, 1 month and 2 months post treatment for three treatments (followup for third treatment is 3 months instead of 2 months).
Time Frame
9 months
Title
Number of participants with adverse events .
Description
The co-primary objective will be to observe long term safety of the treatment 6 months and 30 months following the last treatment.
Time Frame
30 months
Secondary Outcome Measure Information:
Title
Preliminary evaluation of efficacy
Description
The secondary objective is to observe trends in efficacy over the course of the experimental treatment. Outcome measures include evoked potentials (baseline and 3 months post 3rd dose) ,quality of life questionnaire, EDSS, and MSFC (baseline, at the time of each dose, and 3 and 6 months after third dose), and MRI (baseline, 2 months after first dose, and 3 and 24 months after third dose).
Time Frame
9 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of MS as defined by the McDonald criteria
Diagnosis of primary progressive or secondary progressive MS
Between the ages of 18-70 years
Significant disability shown by an Expanded Disability Status Score (EDSS) of 3.0 or greater that was not acquired within the last 12 months
Stable disease state as evidenced by a lack of gadolinium-enhancing lesions on an MRI and by a stable MRI disease burden (number of T2 lesions and size of lesions) in the last six months and no significant change in EDSS (1 point or more) in the last 12 months
Must agree to undergo MRIs at the time of enrollment, 2 months after the first treatment, and 27 months after the last treatment
Live in northern New Jersey, southern New York, or southwestern Connecticut during the study period, or patients must be able to arrange reliable travel accommodations to be present for every study visit if they live farther away.
Exclusion Criteria:
Pregnant or nursing mothers or any woman intending to become pregnant in the next three years
All patients will have pre-study liver function tests, PT/PPT, platelets, hematocrit, and renal function laboratory tests done. Only patients whose values are in the normal range as determined by the laboratory norms based on age and sex will be allowed to participate.
Use of systemic chemotherapeutic or anti-mitotic medications within three months of study start date due to the possibility of interference with bone marrow procedure
Any patients with a history of or with active malignancy
Use of steroids within three months of the study start date, as this would suggest a highly active disease state
History of cirrhosis due to increased risk of central nervous system (CNS) infection
Poorly controlled hypertension because of increased risk for stroke or CNS hemorrhage. Specifically, any patient with a systolic blood pressure value of ≥ 145 mm/Hg or a diastolic blood pressure value of ≥ 95 mm/Hg will be excluded from study participation.
History of thyroid disorders or other endocrine disorders because of hormone influence on cell growth
History of central nervous system infection or immunodeficiency syndromes due to increased risk of CNS infection
Preexisting blood disease (such as bone marrow hypoplasia, leukopenia, thrombocytopenia, or significant anemia) due to invasive nature of bone-marrow aspiration
Previous or current history of a coagulation disorder
Any metal in the body, which is contraindicated for MRI studies
Allergy to any of the antibiotics used in this study, e.g. tobramycin, vancomycin, or gentamicin
Patients with alcohol or other substance abuse problems
Other major disease that, in the opinion of the Principal Investigator, would preclude participation in the study
Patients with HBV, HCV, syphilis, HIV-1, or HIV-2.
Any evidence of significant cognitive dysfunction based on a screening history and physical examination because it would preclude giving a truly informed consent
Patients who are enrolled in another clinical trial for MS treatment or who have received any study drug/biologics within the last 6 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Saud A Sadiq, MD
Organizational Affiliation
Tisch MS Research Center of New York
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tisch MS Research Center of New York
City
New York
State/Province
New York
ZIP/Postal Code
10019
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
23197858
Citation
Harris VK, Faroqui R, Vyshkina T, Sadiq SA. Characterization of autologous mesenchymal stem cell-derived neural progenitors as a feasible source of stem cells for central nervous system applications in multiple sclerosis. Stem Cells Transl Med. 2012 Jul;1(7):536-47. doi: 10.5966/sctm.2012-0015. Epub 2012 Jun 28.
Results Reference
background
PubMed Identifier
21962795
Citation
Harris VK, Yan QJ, Vyshkina T, Sahabi S, Liu X, Sadiq SA. Clinical and pathological effects of intrathecal injection of mesenchymal stem cell-derived neural progenitors in an experimental model of multiple sclerosis. J Neurol Sci. 2012 Feb 15;313(1-2):167-77. doi: 10.1016/j.jns.2011.08.036. Epub 2011 Oct 1.
Results Reference
background
PubMed Identifier
29449193
Citation
Harris VK, Stark J, Vyshkina T, Blackshear L, Joo G, Stefanova V, Sara G, Sadiq SA. Phase I Trial of Intrathecal Mesenchymal Stem Cell-derived Neural Progenitors in Progressive Multiple Sclerosis. EBioMedicine. 2018 Mar;29:23-30. doi: 10.1016/j.ebiom.2018.02.002. Epub 2018 Feb 3.
Results Reference
result
PubMed Identifier
33277427
Citation
Harris VK, Stark JW, Yang S, Zanker S, Tuddenham J, Sadiq SA. Mesenchymal stem cell-derived neural progenitors in progressive MS: Two-year follow-up of a phase I study. Neurol Neuroimmunol Neuroinflamm. 2020 Dec 4;8(1):e928. doi: 10.1212/NXI.0000000000000928. Print 2021 Jan.
Results Reference
derived
Links:
URL
http://tischms.org
Description
Tisch MS Research Center of New York
Learn more about this trial
Intrathecal Administration of Autologous Mesenchymal Stem Cell-derived Neural Progenitors (MSC-NP) in Patients With Multiple Sclerosis
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