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Safety Evaluation of Cellavita HD Administered Intravenously in Participants With Huntington's Disease (SAVE-DH)

Primary Purpose

Huntington Disease

Status
Active
Phase
Phase 1
Locations
Brazil
Study Type
Interventional
Intervention
Cellavita HD Lower Dose
Cellavita HD Higher dose
Sponsored by
Azidus Brasil
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Huntington Disease focused on measuring Huntington's Disease, Stem Cell, Dental Pulp Stem Cells

Eligibility Criteria

21 Years - 65 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Sign and date ICF;
  • Ability to follow instructions as well as ability to understand and fulfill the study requirements correctly;
  • Male participant aged ≥ 21 and ≤ 65;
  • Participants who submit medical report (PCR) attesting Huntington's disease with a number of CAG repeats on chromosome 4, greater than or equal to 40 and less than or equal to 50 (if the participant has not performed the examination and/or if he does not have the report available, a new exam should be done);
  • Score 5 points or more in motor assessment UHDRS scale (Unified Huntington's Disease Rating Scale) at the time of enrollment;
  • Score between 8 and 11 points in the functional capacity of the UHDRS scale at the time of enrollment.

Exclusion Criteria:

  • Participation within 12 months in any clinical trial;
  • Any medical observation data (clinical and physical) that medical research judge as a risk for subject if enrollment at the study;
  • Any laboratory exam data that medical research judge as a risk for subject if enrollment at the study;
  • Juvenile Huntington disease diagnosis;
  • History of epilepsy;
  • Diagnostic of major cognitive impairment;
  • Active decompensated psychiatric disease;
  • Current or prior history of neoplasia;
  • Current history of gastrointestinal, hepatic, renal, endocrine, pulmonary, hematologic, immune, metabolic pathology or severe and uncontrolled cardiovascular disease;
  • Diagnostic of any active infection, be it viral, bacterial, fungal, or caused by another pathogen;
  • Participants who have contraindication to undergo any of the tests performed in this study, for example, have pacemakers or surgical clip;
  • History of alcohol or illegal drugs abusers;
  • History of 1 or more episodes of suicide in the two years before Visit V-4;
  • Active smoker or have stopped smoking less than six months prior to enrollment;
  • Test positive in at least one of the serological tests: HIV 1 and 2 (Anti-HIV-1,2), HTLV I and II, HBV (HBsAg, anti-HBc), HCV (anti-HCV-Ab) and VDRL (Treponema pallidum);
  • History of drug allergy, including contrasts for imaging, or bovine products;
  • In use or expected use of immunosuppressive drugs or prohibited medicines for the first three months after the first administration of the investigational product;
  • Any clinical changes that is interpreted by the medical researcher as a risk to participant's enrollment.

Sites / Locations

  • Azidus Brasil Pesquisa Científica e Desenvolvimento Ltda.

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cellavita HD Lower Dose

Cellavita HD Higher dose

Arm Description

Participants assigned to this arm will receive 3 administrations, one every 30 days, of 1x10^6 cells/weight range per administration of Cellavita HD (n= 3) .

Participants assigned to this arm will receive 3 administrations, one every 30 days, of 2x10^6 cells/weight range per administration of Cellavita HD (n= 3).

Outcomes

Primary Outcome Measures

Safety of Cellavita HD by periodic monitoring changes at adverse events, vital signs, laboratory tests, ECG and incidence of benign and malignant neoplasms
The safety of the investigational product will be evaluated in detail from periodic evaluations contemplating monitoring changes of: Adverse events including type, frequency, intensity, seriousness, severity, and action taken related to the investigational product study; Vital signs (BP, HR, axillary temperature), physical and medical examination (BMI, weight, height, medical condition - cardiovascular, pulmonary, digestive, musculoskeletal and peripheral, with emphasis on the neurological assessment and others); Laboratory tests included hematologic, biochemical, urologic and serological analysis; Electrocardiogram (ECG) of 12 derivations; Incidence and classification of benign and malignant neoplasms in the following organs/systems: CNS, lung, liver, spleen, pancreas, prostate, testicle, urinary, hematological and skeletal system through the laboratory tests, magnetic resonance imaging, computerized tomography and ultrasonography.

Secondary Outcome Measures

Preliminary efficacy of Cellavita HD by UHDRS improvement and global clinical response (CIBIS)
Will be evaluated by statistical comparison of the results of each UHDRS scale component: motor, cognitive and behavior. The global clinical response will be assessed by statistical comparison between baseline score observed by the Investigator before and after Cellavita HD treatment.
Preliminary efficacy of Cellavita HD by comparison of the inflammatory markers
Will be evaluated by statistical comparison of the inflammatory markers included IL-4, IL-6, IL-10 (interleukin IL) and TNF-alpha (tumoral necrosis factor alpha).
Immunological Response of Cellavita HD
The immunological response induced by Cellavita HD will be evaluated by statistical comparison between baseline results of CD4+ and CD8+ proliferation and the other evaluated times.
Preliminary efficacy of Cellavita HD by comparison of the CNS assessment
Will be evaluated by statistical comparison of the CNS assessment through magnetic resonance image at cortical thickness measurements, volumes of different brain structures, especially the basal ganglia, with special attention to caudate and metabolic changes identified in proton spectroscopy.
Risk of suicidal ideation by Hamilton Depression Rating Scale (HDRS)
Will be evaluated by suicidal domain. The classificatory pontuation may correspond to mild depression (score: 8 to 13), moderate depression (score: 19 - 22) and severe depression (score: > 23).

Full Information

First Posted
March 11, 2016
Last Updated
November 1, 2022
Sponsor
Azidus Brasil
Collaborators
Cellavita Pesquisa Científica Ltda, Azidus Brasil Scientific Research and Development Ltda
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1. Study Identification

Unique Protocol Identification Number
NCT02728115
Brief Title
Safety Evaluation of Cellavita HD Administered Intravenously in Participants With Huntington's Disease
Acronym
SAVE-DH
Official Title
First in Human Study to Evaluate Safety of Cellavita HD Investigational Product After Intravenous Application in Participants With Huntington's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 16, 2017 (Actual)
Primary Completion Date
December 31, 2022 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Azidus Brasil
Collaborators
Cellavita Pesquisa Científica Ltda, Azidus Brasil Scientific Research and Development Ltda

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Cellavita HD is a stem-cell therapy for Huntington's Disease. This is a first-in-human, non-randomized, phase I study in which participants with Huntington's Disease will receive three intravenous injections and will be followed for 5 years to evaluate safety and tolearability of product and preliminary evidence of effectiveness.
Detailed Description
This is a first-in-human, non-randomized, phase I study in which participants with HD will receive three intravenous injections of one of two doses of the investigational product, one every month for three months. Safety evaluation data will be composed by the register of adverse events (including type, frequency, intensity, seriousness, severity, and action taken related to the investigational product), could be include changes in vital signs, physical and medical evaluations, laboratory or serology tests and electrocardiogram (ECG), and by the incidence of benign and malign neoplasms. Preliminary evidence of efficacy will be evaluated by global clinical improvement (CIBIS) and evolution of disease improvement (motor, cognitive and behavioral degradation) through Unified Huntington's Disease Rating Scale - UHDRS and inflammatory markers: IL-4, IL-6, IL-10 (interleukin IL) e TNF-alpha (tumoral necrosis factor alpha). CNS improvement will be assessed by magnetic resonance imaging (MRI). Fluctuation in suicide tendency grade will be evaluated by Hamilton Depression Rating Scale (HDRS).The immunological response of HD product over the administration period will be evaluated by CD4+ and CD8+ proliferation and inflammatory markers release. Participants who show evidence of loss of clinical benefit achieved over the course of treatment verified through worsening greater or equal to that expected for the natural course of the disease on motor, cognitive, behavioral and functional capacity symptoms assessed by the UHDRS scale, will receive additional doses of the product as long as there is clinical benefit at the Investigator's discretion and/or until the product is marketed. The same dose used by the subject during the treatment period will be administered throughout the period of additional doses.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Huntington Disease
Keywords
Huntington's Disease, Stem Cell, Dental Pulp Stem Cells

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cellavita HD Lower Dose
Arm Type
Experimental
Arm Description
Participants assigned to this arm will receive 3 administrations, one every 30 days, of 1x10^6 cells/weight range per administration of Cellavita HD (n= 3) .
Arm Title
Cellavita HD Higher dose
Arm Type
Experimental
Arm Description
Participants assigned to this arm will receive 3 administrations, one every 30 days, of 2x10^6 cells/weight range per administration of Cellavita HD (n= 3).
Intervention Type
Biological
Intervention Name(s)
Cellavita HD Lower Dose
Other Intervention Name(s)
cellular therapy, mesenchymal stem cells
Intervention Description
The first three participants enrolled in the study will be assigned to the lower dose arm with staggered treatment, with an interval of 30 days between the first administration of the first participant and the first administration of the second participant assigned to this arm. All participants will receive a total of 3 intravenous administration, one every 30 days.
Intervention Type
Biological
Intervention Name(s)
Cellavita HD Higher dose
Other Intervention Name(s)
cellular therapy, mesenchymal stem cells
Intervention Description
The last three participants enrolled in the study will be assigned to the higher dose arm with staggered treatment, with an interval of 30 days between the first administration of the first participant and the first administration of the second participant assigned to this arm. All participants will receive a total of 3 intravenous administration, one every 30 days.
Primary Outcome Measure Information:
Title
Safety of Cellavita HD by periodic monitoring changes at adverse events, vital signs, laboratory tests, ECG and incidence of benign and malignant neoplasms
Description
The safety of the investigational product will be evaluated in detail from periodic evaluations contemplating monitoring changes of: Adverse events including type, frequency, intensity, seriousness, severity, and action taken related to the investigational product study; Vital signs (BP, HR, axillary temperature), physical and medical examination (BMI, weight, height, medical condition - cardiovascular, pulmonary, digestive, musculoskeletal and peripheral, with emphasis on the neurological assessment and others); Laboratory tests included hematologic, biochemical, urologic and serological analysis; Electrocardiogram (ECG) of 12 derivations; Incidence and classification of benign and malignant neoplasms in the following organs/systems: CNS, lung, liver, spleen, pancreas, prostate, testicle, urinary, hematological and skeletal system through the laboratory tests, magnetic resonance imaging, computerized tomography and ultrasonography.
Time Frame
first year and in the following 4 years
Secondary Outcome Measure Information:
Title
Preliminary efficacy of Cellavita HD by UHDRS improvement and global clinical response (CIBIS)
Description
Will be evaluated by statistical comparison of the results of each UHDRS scale component: motor, cognitive and behavior. The global clinical response will be assessed by statistical comparison between baseline score observed by the Investigator before and after Cellavita HD treatment.
Time Frame
first year and in the following 4 years
Title
Preliminary efficacy of Cellavita HD by comparison of the inflammatory markers
Description
Will be evaluated by statistical comparison of the inflammatory markers included IL-4, IL-6, IL-10 (interleukin IL) and TNF-alpha (tumoral necrosis factor alpha).
Time Frame
first year
Title
Immunological Response of Cellavita HD
Description
The immunological response induced by Cellavita HD will be evaluated by statistical comparison between baseline results of CD4+ and CD8+ proliferation and the other evaluated times.
Time Frame
first year
Title
Preliminary efficacy of Cellavita HD by comparison of the CNS assessment
Description
Will be evaluated by statistical comparison of the CNS assessment through magnetic resonance image at cortical thickness measurements, volumes of different brain structures, especially the basal ganglia, with special attention to caudate and metabolic changes identified in proton spectroscopy.
Time Frame
first year
Title
Risk of suicidal ideation by Hamilton Depression Rating Scale (HDRS)
Description
Will be evaluated by suicidal domain. The classificatory pontuation may correspond to mild depression (score: 8 to 13), moderate depression (score: 19 - 22) and severe depression (score: > 23).
Time Frame
first year and in the following 4 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Sign and date ICF; Ability to follow instructions as well as ability to understand and fulfill the study requirements correctly; Male participant aged ≥ 21 and ≤ 65; Participants who submit medical report (PCR) attesting Huntington's disease with a number of CAG repeats on chromosome 4, greater than or equal to 40 and less than or equal to 50 (if the participant has not performed the examination and/or if he does not have the report available, a new exam should be done); Score 5 points or more in motor assessment UHDRS scale (Unified Huntington's Disease Rating Scale) at the time of enrollment; Score between 8 and 11 points in the functional capacity of the UHDRS scale at the time of enrollment. Exclusion Criteria: Participation within 12 months in any clinical trial; Any medical observation data (clinical and physical) that medical research judge as a risk for subject if enrollment at the study; Any laboratory exam data that medical research judge as a risk for subject if enrollment at the study; Juvenile Huntington disease diagnosis; History of epilepsy; Diagnostic of major cognitive impairment; Active decompensated psychiatric disease; Current or prior history of neoplasia; Current history of gastrointestinal, hepatic, renal, endocrine, pulmonary, hematologic, immune, metabolic pathology or severe and uncontrolled cardiovascular disease; Diagnostic of any active infection, be it viral, bacterial, fungal, or caused by another pathogen; Participants who have contraindication to undergo any of the tests performed in this study, for example, have pacemakers or surgical clip; History of alcohol or illegal drugs abusers; History of 1 or more episodes of suicide in the two years before Visit V-4; Active smoker or have stopped smoking less than six months prior to enrollment; Test positive in at least one of the serological tests: HIV 1 and 2 (Anti-HIV-1,2), HTLV I and II, HBV (HBsAg, anti-HBc), HCV (anti-HCV-Ab) and VDRL (Treponema pallidum); History of drug allergy, including contrasts for imaging, or bovine products; In use or expected use of immunosuppressive drugs or prohibited medicines for the first three months after the first administration of the investigational product; Any clinical changes that is interpreted by the medical researcher as a risk to participant's enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joyce Macedo da Silva, MD
Organizational Affiliation
Azidus Brasil Scientific Research and Development Ltda
Official's Role
Principal Investigator
Facility Information:
Facility Name
Azidus Brasil Pesquisa Científica e Desenvolvimento Ltda.
City
Valinhos
State/Province
São Paulo
ZIP/Postal Code
13271-130
Country
Brazil

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
It is believed that after the data analysis and presentation to the National Commission on Research Ethics, all data of the study will become public.
Citations:
PubMed Identifier
18394562
Citation
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Results Reference
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25097727
Citation
Aleynik A, Gernavage KM, Mourad YSh, Sherman LS, Liu K, Gubenko YA, Rameshwar P. Stem cell delivery of therapies for brain disorders. Clin Transl Med. 2014 Jul 19;3:24. doi: 10.1186/2001-1326-3-24. eCollection 2014.
Results Reference
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PubMed Identifier
21609310
Citation
de Almeida FM, Marques SA, Ramalho Bdos S, Rodrigues RF, Cadilhe DV, Furtado D, Kerkis I, Pereira LV, Rehen SK, Martinez AM. Human dental pulp cells: a new source of cell therapy in a mouse model of compressive spinal cord injury. J Neurotrauma. 2011 Sep;28(9):1939-49. doi: 10.1089/neu.2010.1317. Epub 2011 Aug 8.
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PubMed Identifier
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Citation
Bachoud-Levi AC, Gaura V, Brugieres P, Lefaucheur JP, Boisse MF, Maison P, Baudic S, Ribeiro MJ, Bourdet C, Remy P, Cesaro P, Hantraye P, Peschanski M. Effect of fetal neural transplants in patients with Huntington's disease 6 years after surgery: a long-term follow-up study. Lancet Neurol. 2006 Apr;5(4):303-9. doi: 10.1016/S1474-4422(06)70381-7.
Results Reference
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PubMed Identifier
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Citation
Bachoud-Levi AC, Remy P, Nguyen JP, Brugieres P, Lefaucheur JP, Bourdet C, Baudic S, Gaura V, Maison P, Haddad B, Boisse MF, Grandmougin T, Jeny R, Bartolomeo P, Dalla Barba G, Degos JD, Lisovoski F, Ergis AM, Pailhous E, Cesaro P, Hantraye P, Peschanski M. Motor and cognitive improvements in patients with Huntington's disease after neural transplantation. Lancet. 2000 Dec 9;356(9246):1975-9. doi: 10.1016/s0140-6736(00)03310-9.
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PubMed Identifier
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Citation
Ball LM, Bernardo ME, Roelofs H, van Tol MJ, Contoli B, Zwaginga JJ, Avanzini MA, Conforti A, Bertaina A, Giorgiani G, Jol-van der Zijde CM, Zecca M, Le Blanc K, Frassoni F, Egeler RM, Fibbe WE, Lankester AC, Locatelli F. Multiple infusions of mesenchymal stromal cells induce sustained remission in children with steroid-refractory, grade III-IV acute graft-versus-host disease. Br J Haematol. 2013 Nov;163(4):501-9. doi: 10.1111/bjh.12545. Epub 2013 Aug 31.
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Safety Evaluation of Cellavita HD Administered Intravenously in Participants With Huntington's Disease

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