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Safety and Preliminary Efficacy of FAB117-HC in Patients With Acute Traumatic Spinal Cord Injury (SPINE)

Primary Purpose

Acute Traumatic Spinal Cord Injury

Status
Unknown status
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
FAB117-HC
Control group
FAB117-HC
Sponsored by
Ferrer Internacional S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Traumatic Spinal Cord Injury focused on measuring Trauma Spinal Cord, Thoracic Acute Spinal Cord Injury, Neurosurgery, Cell Therapy, ATMP, HC016 adipose mesenchymal stem cell, SPINE

Eligibility Criteria

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

Inclusion Criteria:

Phase 1 (2 Cohorts)

  1. Male or female subjects ≥ 16 to ≤ 70 years.
  2. ASIA impairment grade A.
  3. Either a level of injury between D1-D12 both inclusive (cohorts 1 and 2).
  4. Single traumatic spinal cord injury as defined by MRI.
  5. Injury occurred between 72 and 120h before undergoing DSS and treatment.
  6. Clinically and haemodynamically stable, under medical criteria, enough to undergo DSS.
  7. Able to give informed consent either in writing or orally in the presence of a witness.

Phase 2 (2 Groups)

  1. Male or female subjects ≥ 16 to ≤ 70 years.
  2. ASIA impairment grade A or B.
  3. An injury between D1 and D12, both inclusive.
  4. Single traumatic spinal cord injury as defined by MRI.
  5. Injury occurring up to 96 h before undergoing DSS and treatment.
  6. Clinically and haemodynamically stable enough, under medical criteria, to undergo DSS.
  7. Able to give informed consent either in writing or orally in the presence of a witness.

Exclusion Criteria:

  1. Participated in a previous clinical study and received an investigational product within 28 days of SCI (within 5 years of SCI if the investigational product is a cell-based medicine).
  2. Radiological or MRI or DSS evidence of complete or partial spinal cord transection.
  3. Inability to unequivocally identify the injection sites.
  4. Multiple injuries to the neurological spinal cord at different levels.
  5. Patients with any of these additional conditions:

    1. Penetrating spinal cord injuries.
    2. Associated trauma or injury to the brachial and / or lumbosacral plexus.
  6. Active infection in the surgical area.
  7. Haemodynamic instability contraindicating DSS procedure in the time frame defined for inclusion in the trial.
  8. Multiple organ failure.
  9. Severe multiple trauma that hampers the stabilization procedure in the defined term for the inclusion in the trial.
  10. Significant head injury (Score on the Glasgow scale less than or equal to 13 and / or abnormal MRI/CT, meaning oedema, axonal lesion and/or haemorrhage) or other injury that in the investigator's opinion is sufficient to interfere with the assessment of spinal cord function or compromise the validity of patient data.
  11. Patients undergoing mechanical ventilation that does not allow a prior clinical examination.
  12. Inability to communicate with the neurological examiner so that the validity of patient data could be unreliable.
  13. Coma or significant impairment in the level of consciousness, including unconsciousness due to sedative-analgesic medications, that interferes with the performance or interpretation of assessments specific in the protocol.
  14. Preexisting or current significant diseases such as hepatitis C, HIV, epilepsy, neoplastic disease or other diseases that could cause neurological deficits including syphilis, myelopathy, and polyneuropathy.
  15. Background or acute episode of Guillain-Barre syndrome.
  16. History of meningitis or meningoencephalitis.
  17. Current autoimmune disease treated with immunosuppressant therapy.
  18. Patients with history of severe thrombophilia or under anticoagulant pharmacological therapy which long elimination half-live prevents a rapid transition to heparin (like dabigatran and rivaroxaban).
  19. Presence of any psychiatric illness, as defined by the DSM-IV-TR, or medically unstable illness that means a hindrance to the adherence to rehabilitation and/or to the informed consent signature.
  20. Pregnant women or women of childbearing age who are not using an appropriate method of contraception and, moreover, are not willing to continue to use it for the duration of the trial. If the patient is menopausal or sterile, it must be documented in the medical record.
  21. Women who are breastfeeding if unwilling to stop at the time of recruitment.
  22. History of allergy with anaphylactic shock.
  23. Patients with known hypersensitivity to any of the excipients of FAB117-HC.
  24. Patients with known hypersensitivity to penicillin, streptomycin, enzymes (trypsin or collagenase), bovine serum or DMSO.

Sites / Locations

  • Complexo Hospitalario Universitario A CoruñaRecruiting
  • Hospital Universitari Vall d'HebronRecruiting
  • Hospital Universitario Virgen de las NievesRecruiting
  • Hospital Universitario 12 de OctubreRecruiting
  • Hospital Universitario Virgen del RocíoRecruiting
  • Complejo Hospitalario de Toledo (HNP y VS)Recruiting
  • Hospital Universitari La FeRecruiting
  • Hospital Clínico Universitario Lozano BlesaRecruiting
  • Hospital Universitario Miguel ServetRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Other

Experimental

Arm Label

FAB117-HC (Ph 1)

Control group (Ph 2)

FAB117-HC (Ph 2)

Arm Description

Patients with acute traumatic spinal cord injury grading AIS A (8 patients)

Patients with acute traumatic spinal cord injury grading AIS A or B (up to 20 patients)

Patients with acute traumatic spinal cord injury grading AIS A or B (up to 20 patients)

Outcomes

Primary Outcome Measures

Number of adverse events as a measure of safety and tolerability of a single dose of FAB117-HC when administered by intramedullary injection into the injured spinal cord

Secondary Outcome Measures

Changes in neurological function using the International Standards for Neurological Classification of SCI (ISNCSCI) scale, examinations at 24h, 72h, 7d, 14d, 28d, 90d and 360 days after injection of FAB117-HC
Changes in the functional assessment of Spinal Cord Independence Measure (SCIM III)
Changes in Somatosensory-Evoked Potentials (SSEP) electrophysiological assessment test.
Changes in Motor-Evoked Potentials (MEP) electrophysiological assessment test

Full Information

First Posted
September 20, 2016
Last Updated
September 8, 2021
Sponsor
Ferrer Internacional S.A.
Collaborators
Histocell, S.L.
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1. Study Identification

Unique Protocol Identification Number
NCT02917291
Brief Title
Safety and Preliminary Efficacy of FAB117-HC in Patients With Acute Traumatic Spinal Cord Injury
Acronym
SPINE
Official Title
Clinical Trial of Phase 1/2 to Evaluate the Feasibility, Safety, Tolerability and Preliminary Efficacy of the Administration of FAB117-HC, a Drug Whose Active Ingredient is HC016, Allogeneic Adipose Derived Adult Mesenchymal Stem Cells Expanded and Pulsed With H2O2, in Acute Traumatic SCI Patients.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Unknown status
Study Start Date
December 2016 (undefined)
Primary Completion Date
July 2022 (Anticipated)
Study Completion Date
July 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ferrer Internacional S.A.
Collaborators
Histocell, S.L.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The main objective of the study is the evaluation of the safety and tolerability of FAB117-HC (a medicinal product containing human allogeneic adipose derived adult mesenchymal stem cells expanded and pulsed with H2O2, HC016 cells) administered at a single-time point to patients with acute thoracic traumatic spinal cord injury (SCI). The study will also include initial exploration of potential clinical efficacy. Dose levels of 20 million and 40 million cells will be administered.
Detailed Description
FAB117-HC is an investigational medicinal product whose active substance is HC016, allogeneic adipose-derived adult mesenchymal stem cells expanded and pulsed with H2O2. The main purpose of this study is to evaluate the safety and tolerability of a single administration of FAB117-HC using: a) two sequential escalating doses administered between 72 and 120 hours post-injury, to patients with acute traumatic SCI with ASIA Impairment Scale (AIS) grade A; and b) the determined maximum tolerated dose administered up to 96 h post-injury to patients with AIS grading of A or B. The study includes also initial exploration of efficacy. Treatment is administered by intramedullary injection into the injured spinal cord, during the decompression and stabilization surgery (DSS) of the fracture. DSS is routinely performed on almost all SCI patients. The study has been divided into two phases: Phase 1 (open label): 8 AIS A patients with lesion located between D1 and D12 will be included in 2 sequential cohorts. Phase 2 (randomized, controlled, double-blind): Up to 40 AIS A or B patients with lesion located between D1 and D12, will be randomly divided into two groups (control and treated) that will be balanced in AIS grade.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Traumatic Spinal Cord Injury
Keywords
Trauma Spinal Cord, Thoracic Acute Spinal Cord Injury, Neurosurgery, Cell Therapy, ATMP, HC016 adipose mesenchymal stem cell, SPINE

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
48 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
FAB117-HC (Ph 1)
Arm Type
Experimental
Arm Description
Patients with acute traumatic spinal cord injury grading AIS A (8 patients)
Arm Title
Control group (Ph 2)
Arm Type
Other
Arm Description
Patients with acute traumatic spinal cord injury grading AIS A or B (up to 20 patients)
Arm Title
FAB117-HC (Ph 2)
Arm Type
Experimental
Arm Description
Patients with acute traumatic spinal cord injury grading AIS A or B (up to 20 patients)
Intervention Type
Drug
Intervention Name(s)
FAB117-HC
Intervention Description
(Ph 1) Intramedullary administration. Open label dose escalation, 3 patients in cohort 1 (20 million cells) and 5 patients in cohort 2 (40 million cells)
Intervention Type
Other
Intervention Name(s)
Control group
Intervention Description
(Ph 2) No treatment will be administered
Intervention Type
Drug
Intervention Name(s)
FAB117-HC
Intervention Description
(Ph 2) Intramedullary administration of the maximum tolerated dose (20 or 40 million cells)
Primary Outcome Measure Information:
Title
Number of adverse events as a measure of safety and tolerability of a single dose of FAB117-HC when administered by intramedullary injection into the injured spinal cord
Time Frame
One year
Secondary Outcome Measure Information:
Title
Changes in neurological function using the International Standards for Neurological Classification of SCI (ISNCSCI) scale, examinations at 24h, 72h, 7d, 14d, 28d, 90d and 360 days after injection of FAB117-HC
Time Frame
One year
Title
Changes in the functional assessment of Spinal Cord Independence Measure (SCIM III)
Time Frame
Day 28 and Day 90
Title
Changes in Somatosensory-Evoked Potentials (SSEP) electrophysiological assessment test.
Time Frame
Day 28 and Day 90
Title
Changes in Motor-Evoked Potentials (MEP) electrophysiological assessment test
Time Frame
Day 28 and Day 90

10. Eligibility

Sex
All
Minimum Age & Unit of Time
16 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Phase 1 (2 Cohorts) Male or female subjects ≥ 16 to ≤ 70 years. ASIA impairment grade A. Either a level of injury between D1-D12 both inclusive (cohorts 1 and 2). Single traumatic spinal cord injury as defined by MRI. Injury occurred between 72 and 120h before undergoing DSS and treatment. Clinically and haemodynamically stable, under medical criteria, enough to undergo DSS. Able to give informed consent either in writing or orally in the presence of a witness. Phase 2 (2 Groups) Male or female subjects ≥ 16 to ≤ 70 years. ASIA impairment grade A or B. An injury between D1 and D12, both inclusive. Single traumatic spinal cord injury as defined by MRI. Injury occurring up to 96 h before undergoing DSS and treatment. Clinically and haemodynamically stable enough, under medical criteria, to undergo DSS. Able to give informed consent either in writing or orally in the presence of a witness. Exclusion Criteria: Participated in a previous clinical study and received an investigational product within 28 days of SCI (within 5 years of SCI if the investigational product is a cell-based medicine). Radiological or MRI or DSS evidence of complete or partial spinal cord transection. Inability to unequivocally identify the injection sites. Multiple injuries to the neurological spinal cord at different levels. Patients with any of these additional conditions: Penetrating spinal cord injuries. Associated trauma or injury to the brachial and / or lumbosacral plexus. Active infection in the surgical area. Haemodynamic instability contraindicating DSS procedure in the time frame defined for inclusion in the trial. Multiple organ failure. Severe multiple trauma that hampers the stabilization procedure in the defined term for the inclusion in the trial. Significant head injury (Score on the Glasgow scale less than or equal to 13 and / or abnormal MRI/CT, meaning oedema, axonal lesion and/or haemorrhage) or other injury that in the investigator's opinion is sufficient to interfere with the assessment of spinal cord function or compromise the validity of patient data. Patients undergoing mechanical ventilation that does not allow a prior clinical examination. Inability to communicate with the neurological examiner so that the validity of patient data could be unreliable. Coma or significant impairment in the level of consciousness, including unconsciousness due to sedative-analgesic medications, that interferes with the performance or interpretation of assessments specific in the protocol. Preexisting or current significant diseases such as hepatitis C, HIV, epilepsy, neoplastic disease or other diseases that could cause neurological deficits including syphilis, myelopathy, and polyneuropathy. Background or acute episode of Guillain-Barre syndrome. History of meningitis or meningoencephalitis. Current autoimmune disease treated with immunosuppressant therapy. Patients with history of severe thrombophilia or under anticoagulant pharmacological therapy which long elimination half-live prevents a rapid transition to heparin (like dabigatran and rivaroxaban). Presence of any psychiatric illness, as defined by the DSM-IV-TR, or medically unstable illness that means a hindrance to the adherence to rehabilitation and/or to the informed consent signature. Pregnant women or women of childbearing age who are not using an appropriate method of contraception and, moreover, are not willing to continue to use it for the duration of the trial. If the patient is menopausal or sterile, it must be documented in the medical record. Women who are breastfeeding if unwilling to stop at the time of recruitment. History of allergy with anaphylactic shock. Patients with known hypersensitivity to any of the excipients of FAB117-HC. Patients with known hypersensitivity to penicillin, streptomycin, enzymes (trypsin or collagenase), bovine serum or DMSO.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Andrés G Fernández, PhD
Email
ferreradvancedbiotherapeutics@ferrer.com
Facility Information:
Facility Name
Complexo Hospitalario Universitario A Coruña
City
A Coruña
ZIP/Postal Code
15006
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antonio Rodríguez Sotillo, MD, PhD
Facility Name
Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Miguel Ángel González Viejo, MD, PhD
Facility Name
Hospital Universitario Virgen de las Nieves
City
Granada
ZIP/Postal Code
18014
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Inmaculada García Montes, MD PhD
Facility Name
Hospital Universitario 12 de Octubre
City
Madrid
ZIP/Postal Code
28041
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Igor Paredes Sansinenea, MD, PhD
Facility Name
Hospital Universitario Virgen del Rocío
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Juana María Barrera Chacón, MD, PhD
Facility Name
Complejo Hospitalario de Toledo (HNP y VS)
City
Toledo
ZIP/Postal Code
45071
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ángel Gil Agudo, MD, PhD
Facility Name
Hospital Universitari La Fe
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Teresa Bas, MD, PhD
Facility Name
Hospital Clínico Universitario Lozano Blesa
City
Zaragoza
ZIP/Postal Code
50009
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Isabel Villarreal, MD PhD
Facility Name
Hospital Universitario Miguel Servet
City
Zaragoza
ZIP/Postal Code
50009
Country
Spain
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Begoña Hidalgo, MD PhD

12. IPD Sharing Statement

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Safety and Preliminary Efficacy of FAB117-HC in Patients With Acute Traumatic Spinal Cord Injury

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