A Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
Primary Purpose
Alzheimer Disease
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
AstroStem
Placebo-Control
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease
Eligibility Criteria
Inclusion Criteria:
- Male or female subjects aged 50 and above at the time of signing the Informed Consent form
- Subjects who can understand and provide written informed consent (assent)
- Subjects who have diagnosis of probable mild-to-moderate Alzheimer disease according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer's Disease and Related Disorders Association) criteria
- Subjects who have MMSE Score of 16 to 26 at screening
- Subjects who are taking FDA-approved AD medications (donepezil, galantamine, memantine, rivastigmine or their combinations) treatment on a stable dosage for at least 3 months prior to screening.
- Subjects who have one (or more) identified adult caregiver who is able to read, understand, and speak the designated language at the study site; either lives with the subject or sees the subject for ≥2 hours/day ≥4 days/week; and agrees to accompany the subject to each study visit
- Subjects who have a designated study partner who will accompany the subject to all clinic visits and participate in the subject's clinical assessments
Exclusion Criteria:
- Subjects who are females who are pregnant, nursing, or of childbearing potential while not practicing effective contraception
- Subjects who have signs of delirium
- Subjects who have had cortical stroke within the preceding 2 years
- Subjects who have a prolonged QTc interval; >450 msec in male or >470 msec in female at screening
- Subjects who have diagnosis of severe white matter hyperintensity (WMH), which is defined as ≥ 25mm of the deep white matter and ≥ 10mm of the periventricular capping/banding in lengths
- Subjects who have diagnosis of dementia or cause of cognitive impairment other than Alzheimer's disease
- Subjects who have a significant abnormal result in laboratory tests, in the opinion of the investigator
- Subjects who have participated in any investigational drug, stem cell therapy, or device trial within the previous 3 months at screening
- Subjects with any current psychiatric diagnosis other than AD if, in the judgment of the investigator, the psychiatric disorder or symptom is likely to confound interpretation of drug effect, affect cognitive assessments, or affect the subject´s ability to complete the study
- Subjects who are known to have autosomal dominant mutation-associated presenile AD
- Subjects who show signs of AIDS (Acquired Immunodeficiency Syndrome), HBV (Hepatitis B Virus), HCV (Hepatitis C), VDRL (Venereal Disease Research Laboratory)
- Subjects who have any conditions that would contraindicate an MRI, such as the presence metallic objects in the eyes, skin, or heart
- Subjects who have > 4 cerebral microhemorrhages (regardless of their anatomical location or diagnostic characterization as "possible" or "definite"), a single area of superficial siderosis, or evidence of a prior microhemorrhage as assessed by MRI
- Subjects who have history of malignant cancer within the last 5 years (The following is a partial list of conditions that are permissible for study entry: non-metastatic basal and/or squamous cell carcinoma of the skin, in situ cervical, or non-progressive prostate cancer)
- Subjects who have suspected active lung disease based on chest X-ray
- Subjects who are hypersensitive to fetal bovine serum or penicillin
- Subjects who are currently using immunosuppressants, cytotoxic drug, corticosteroids or similar steroidal anti-inflammatory medication (e.g., Prednisone) on a regular basis (exceptions allowed include; regular use of steroidal nasal sprays, topical steroids, and estrogen-replacement therapy)
- Subjects for whom the investigator judges the liposuction can cause any problems
- Subjects who have history of local anesthetic allergy
Sites / Locations
- ATP Clinical Research
- Syrentis Clinical Research
- Valden Medical
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
AstroStem
Placebo-Control
Arm Description
Outcomes
Primary Outcome Measures
Treatment Related Adverse Events
Number of subjects with treatment related adverse events as assessed by analysis of adverse events including symptoms, and abnormal findings on physical examination, vital signs, ECG, and standard laboratory examination results
ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive Subscale)
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from Baseline at Week 30 Score range: 0-70 A score of 70 represents the most severe impairment and 0 represents the least impairment
Secondary Outcome Measures
MMSE (Mini-mental Status Examination)
Change of MMSE from baseline at Week 30 Score range: 0-30 A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia.
CDR-SOB (Clinical Dementia Rating-Sum of Boxes)
Changes of CDR-SOB from baseline at Week 30 Score range: 0-18.0 0 = normal, 0.5-4.0 = questionable cognitive dementia, 4.5-9.0 = mild dementia, 9.5-15.5 = moderate dementia, and 16.0-18.0 = severe dementia
NPI (Neuropsychiatric Inventory)
Changes of NPI from baseline at Week 30 Score range: 0-144 higher score indicates higher disturbance.
GDS (Geriatric Depression Scale)
Changes of GDS from baseline at Week 30 Score range: 0-15 Scores of 0-4 are considered normal, depending on age, education, and complaints; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living)
Change of ADCS-ADL from baseline at Week 30 Score range: 0-78 Lower score indicates greater severity.
C-SSRS (Columbia Suicide Severity Rating Scale)
Changes of C-SSRS from baseline at Week 30 Score range: 0-25 Higher score indicates higher severity.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03117738
Brief Title
A Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
Official Title
A Phase 1/2, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of AstroStem, Autologous Adipose Tissue Derived Mesenchymal Stem Cells, in Patients With Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
May 9, 2017 (Actual)
Primary Completion Date
June 26, 2019 (Actual)
Study Completion Date
August 31, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nature Cell Co. Ltd.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a randomized, double-blind, placebo-controlled, parallel-group comparison study in subjects with Alzheimer's Disease. Following first screening period, subjects will be randomly assigned into one of the following arms: AstroStem and placebo control in a 1:1 ratio. AstroStem or placebo control will be administered via I.V. at Week 0. This procedure will be repeated 9 times at 2-week interval. Subjects will be scheduled for two follow-up visits at Weeks 30 and 52 to evaluate primary and secondary outcome endpoints.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
21 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AstroStem
Arm Type
Experimental
Arm Title
Placebo-Control
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
AstroStem
Intervention Description
Autologous adipose tissue derived mesenchymal stem cells (AdMSC)
Intervention Type
Other
Intervention Name(s)
Placebo-Control
Intervention Description
Saline with 30% auto-serum
Primary Outcome Measure Information:
Title
Treatment Related Adverse Events
Description
Number of subjects with treatment related adverse events as assessed by analysis of adverse events including symptoms, and abnormal findings on physical examination, vital signs, ECG, and standard laboratory examination results
Time Frame
30 Weeks
Title
ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive Subscale)
Description
Change of ADAS-Cog (Alzheimer's Disease Assessment Scale-cognitive subscale) from Baseline at Week 30 Score range: 0-70 A score of 70 represents the most severe impairment and 0 represents the least impairment
Time Frame
Baseline and 30 Weeks
Secondary Outcome Measure Information:
Title
MMSE (Mini-mental Status Examination)
Description
Change of MMSE from baseline at Week 30 Score range: 0-30 A score of 20 to 24 suggests mild dementia, 13 to 20 suggests moderate dementia, and less than 12 indicates severe dementia.
Time Frame
Baseline and 30 Weeks
Title
CDR-SOB (Clinical Dementia Rating-Sum of Boxes)
Description
Changes of CDR-SOB from baseline at Week 30 Score range: 0-18.0 0 = normal, 0.5-4.0 = questionable cognitive dementia, 4.5-9.0 = mild dementia, 9.5-15.5 = moderate dementia, and 16.0-18.0 = severe dementia
Time Frame
Baseline and 30 Weeks
Title
NPI (Neuropsychiatric Inventory)
Description
Changes of NPI from baseline at Week 30 Score range: 0-144 higher score indicates higher disturbance.
Time Frame
Baseline and 30 Weeks
Title
GDS (Geriatric Depression Scale)
Description
Changes of GDS from baseline at Week 30 Score range: 0-15 Scores of 0-4 are considered normal, depending on age, education, and complaints; 5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
Time Frame
Baseline and 30 Weeks
Title
ADCS-ADL (Alzheimer's Disease Cooperative Study Activities of Daily Living)
Description
Change of ADCS-ADL from baseline at Week 30 Score range: 0-78 Lower score indicates greater severity.
Time Frame
Baseline and 30 Weeks
Title
C-SSRS (Columbia Suicide Severity Rating Scale)
Description
Changes of C-SSRS from baseline at Week 30 Score range: 0-25 Higher score indicates higher severity.
Time Frame
Baseline and 30 Weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female subjects aged 50 and above at the time of signing the Informed Consent form
Subjects who can understand and provide written informed consent (assent)
Subjects who have diagnosis of probable mild-to-moderate Alzheimer disease according to NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke; Alzheimer's Disease and Related Disorders Association) criteria
Subjects who have MMSE Score of 16 to 26 at screening
Subjects who are taking FDA-approved AD medications (donepezil, galantamine, memantine, rivastigmine or their combinations) treatment on a stable dosage for at least 3 months prior to screening.
Subjects who have one (or more) identified adult caregiver who is able to read, understand, and speak the designated language at the study site; either lives with the subject or sees the subject for ≥2 hours/day ≥4 days/week; and agrees to accompany the subject to each study visit
Subjects who have a designated study partner who will accompany the subject to all clinic visits and participate in the subject's clinical assessments
Exclusion Criteria:
Subjects who are females who are pregnant, nursing, or of childbearing potential while not practicing effective contraception
Subjects who have signs of delirium
Subjects who have had cortical stroke within the preceding 2 years
Subjects who have a prolonged QTc interval; >450 msec in male or >470 msec in female at screening
Subjects who have diagnosis of severe white matter hyperintensity (WMH), which is defined as ≥ 25mm of the deep white matter and ≥ 10mm of the periventricular capping/banding in lengths
Subjects who have diagnosis of dementia or cause of cognitive impairment other than Alzheimer's disease
Subjects who have a significant abnormal result in laboratory tests, in the opinion of the investigator
Subjects who have participated in any investigational drug, stem cell therapy, or device trial within the previous 3 months at screening
Subjects with any current psychiatric diagnosis other than AD if, in the judgment of the investigator, the psychiatric disorder or symptom is likely to confound interpretation of drug effect, affect cognitive assessments, or affect the subject´s ability to complete the study
Subjects who are known to have autosomal dominant mutation-associated presenile AD
Subjects who show signs of AIDS (Acquired Immunodeficiency Syndrome), HBV (Hepatitis B Virus), HCV (Hepatitis C), VDRL (Venereal Disease Research Laboratory)
Subjects who have any conditions that would contraindicate an MRI, such as the presence metallic objects in the eyes, skin, or heart
Subjects who have > 4 cerebral microhemorrhages (regardless of their anatomical location or diagnostic characterization as "possible" or "definite"), a single area of superficial siderosis, or evidence of a prior microhemorrhage as assessed by MRI
Subjects who have history of malignant cancer within the last 5 years (The following is a partial list of conditions that are permissible for study entry: non-metastatic basal and/or squamous cell carcinoma of the skin, in situ cervical, or non-progressive prostate cancer)
Subjects who have suspected active lung disease based on chest X-ray
Subjects who are hypersensitive to fetal bovine serum or penicillin
Subjects who are currently using immunosuppressants, cytotoxic drug, corticosteroids or similar steroidal anti-inflammatory medication (e.g., Prednisone) on a regular basis (exceptions allowed include; regular use of steroidal nasal sprays, topical steroids, and estrogen-replacement therapy)
Subjects for whom the investigator judges the liposuction can cause any problems
Subjects who have history of local anesthetic allergy
Facility Information:
Facility Name
ATP Clinical Research
City
Costa Mesa
State/Province
California
ZIP/Postal Code
92626
Country
United States
Facility Name
Syrentis Clinical Research
City
Santa Ana
State/Province
California
ZIP/Postal Code
92705
Country
United States
Facility Name
Valden Medical
City
Honolulu
State/Province
Hawaii
ZIP/Postal Code
96817
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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A Study to Evaluate the Safety and Efficacy of AstroStem in Treatment of Alzheimer's Disease
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