HOPE-Duchenne (Halt cardiomyOPathy progrEssion in Duchenne) (HOPE)
Duchenne Muscular Dystrophy, Cardiomyopathy
About this trial
This is an interventional treatment trial for Duchenne Muscular Dystrophy focused on measuring Duchenne Muscular Dystrophy, Cardiomyopathy
Eligibility Criteria
Inclusion Criteria:
- Male subjects 18 years of age or older must be able to provide informed consent and follow up with protocol procedures. Male subjects at least 12 years of age but younger than 18 years of age must be able to provide assent with parent or guardian providing permission for study participation. Only male subjects will be randomized into this study.
- Documented diagnosis of Duchenne Muscular Dystrophy by genetic mutation analysis.
- Cardiomyopathy with left ventricular scar by LGE in at least 4 segments as assessed by contrast-enhanced MRI and EF >35% at the time of screening.
- Use of evidence based medical-therapy in accordance with the "DMD Care Considerations Working Group" guidelines for the management of DMD, for at least three months prior to signing the consent form (or, providing assent) or documented contraindication or intolerance or patient preference.
- Subjects must be taking systemic glucocorticoids for at least six months prior to screening.
- Subjects must be 12 years of age or older at time of screening
- Subjects must be appropriate candidates for cardiac catheterization and intracoronary infusion of CAP-1002, in the judgement of the site's interventional cardiologist.
Exclusion Criteria:
- Therapy with intravenous inotropic or vasoactive medications at the time of screening.
- Inability to undergo cardiac catheterization and/or MRI without general anesthesia.
- Immunologic incompatibility with all available Master Cell Banks (MCBs) by single-antigen bead (SAB) serum antibody profiling.
- Planned or likely major surgery in the next 12 months after planned randomization.
- Left Ventricular Assist Devices (LVAD) or those subjects actively in the process of acquiring a LVAD.
- Contraindication to cardiac MRI.
- Known hypersensitivity to contrast agents.
- Estimated glomerular filtration rate (GFR) <60 mL/min, as calculated by the CKD-EPI cystatin C equation (Inker, Schmid et al. 2012).
- Active infection not responsive to treatment.
- Active systemic allergic reaction(s), connective tissue disease or autoimmune disorder(s).
- History of cardiac tumor or cardiac tumor demonstrated on screening MRI.
- History of previous stem cell therapy.
- History of use of medications listed in Appendix 3 within 3 months prior to signing the ICF / Assent through completion of the study infusion.
- Known moderate-to-severe aortic stenosis/insufficiency or severe mitral stenosis/regurgitation.
- Current active alcohol or drug abuse.
- Known history of Human Immunodeficiency Virus (HIV) infection.
- Known history of chronic viral hepatitis.
- Abnormal liver function (ALT/AST >10 times the upper reference range) and/or abnormal hematology (hematocrit <25%, WBC <3000 μl, platelets <100,000 μl) studies without a reversible, identifiable cause.
- Known hypersensitivity to bovine products.
- Known hypersensitivity to dimethyl sulfoxide (DMSO).
- Uncontrolled diabetes (HbA1c >9.0).
- Inability to comply with protocol-related procedures, including required study visits.
- Any condition or other reason that, in the opinion of the Investigator or Medical Monitor, would render the subject unsuitable for the study.
Currently receiving investigational treatment on another clinical study or expanded access protocol, including any of the following:
- Received investigational intervention within 30 days prior to randomization
- Treatment and/or an incomplete follow-up to treatment with any investigational cell based therapy within 6 months prior to randomization
- Active participation in other research therapy for cardiovascular repair/regeneration
Sites / Locations
- Cedars-Sinai Medical Center
- University of Florida
- Cincinnati Children's Hospital Medical Center
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Allogeneic Cardiosphere-Derived Cells (CAP-1002)
Usual Care
CAP-1002 is an investigational product consisting of allogeneic cardiosphere-derived cells (CDCs). All subjects assigned to the active treatment arm will receive an intended total dose of 75 million (M) CAP-1002 cells infused as 25M cells into each of the three left ventricle cardiac territories (anterior, lateral, inferior/posterior). If any of the three coronary arteries are deemed by the infusing Investigator to supply less than 30% of the left ventricular myocardium, the infusing Investigator may choose to infuse only 12.5M cells into that coronary artery or arteries. Therefore the full dose of CAP-1002 delivered may range from 50M cells to 75M cells provided that all three arteries are infused.
Subjects randomized to receive usual care will continue to be cared for and treated in whatever manner the investigator deems most appropriate for the subject on an ongoing basis, and will receive no infusion.