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Umbilical Cord Tissue-derived Mesenchymal Stem Cells for Rheumatoid Arthritis

Primary Purpose

Rheumatoid Arthritis

Status
Unknown status
Phase
Phase 1
Locations
Panama
Study Type
Interventional
Intervention
Umbilical cord mesenchymal stem cells
Sponsored by
Translational Biosciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis focused on measuring rheumatoid arthritis, umbilical cord, mesenchymal, stem cells

Eligibility Criteria

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

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

Sites / Locations

  • Stem Cell Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Umbilical cord mesenchymal stem cells

Arm Description

Outcomes

Primary Outcome Measures

Number of participants with adverse events

Secondary Outcome Measures

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

Full Information

First Posted
October 31, 2013
Last Updated
June 19, 2019
Sponsor
Translational Biosciences
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1. Study Identification

Unique Protocol Identification Number
NCT01985464
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
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Unknown status
Study Start Date
October 2013 (undefined)
Primary Completion Date
December 2019 (Anticipated)
Study Completion Date
June 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Translational Biosciences

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rheumatoid Arthritis
Keywords
rheumatoid arthritis, umbilical cord, mesenchymal, stem cells

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Umbilical cord mesenchymal stem cells
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Umbilical cord mesenchymal stem cells
Primary Outcome Measure Information:
Title
Number of participants with adverse events
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Number of participants with a change in disease activity index as measured by 28-DAS Score
Time Frame
12 months
Title
Number of participants with a change in current disease activity as measured by EULAR Response Criteria
Time Frame
12 months
Title
Change from baseline quality of life measure (based on Stanford HAQ)
Time Frame
12 months
Title
Change from baseline C-reactive protein
Time Frame
12 months
Title
Change from baseline erythrocyte sedimentation rate (ESR)
Time Frame
12 months
Title
Change from baseline anti-citrulline antibody measure
Time Frame
12 months
Title
Change from baseline rheumatoid factor (RF)
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerardo Castrellon, MD
Organizational Affiliation
Not Affiliated
Official's Role
Principal Investigator
Facility Information:
Facility Name
Stem Cell Institute
City
Panama City
Country
Panama

12. IPD Sharing Statement

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Umbilical Cord Tissue-derived Mesenchymal Stem Cells for Rheumatoid Arthritis

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