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Allogeneic Human Mesenchymal Stem Cell Infusion vs Placebo in Alcohol Use Disorder and Major Depression. (Alaunus)

Primary Purpose

Major Depressive Disorder, Alcohol Use Disorder

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
allogeneic human mesenchymal stem cells (allo-hMSCs)
Placebo
Sponsored by
Ihsan M Salloum, MD, MPH
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring stem cells

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Provide written informed consent.
  2. Subjects age >18 and <75 years at the time of signing the Informed Consent Form.
  3. Diagnostic and Statistical Manual of Mental Disorder-5 criteria for Alcohol Urge Questionnaire (moderate or severe defined as meeting 4 or more of the 11 criteria) AND a concurrent Diagnostic and Statistical Manual of Mental Disorder-5 recurrent unipolar major depression with HRSD-25 score of 18 or above.
  4. A history of a depressive episode occurring or persisting during a period of one-month abstinence.
  5. Participants should express the desire to reduce or stop alcohol consumption, report 28 or more standard drinks (SD) per week for males or 21 for females over four weeks during the 90 days preceding study enrollment.
  6. Increased inflammation ([serum C-reactive protein] ≥3.0 mg/L.
  7. Agree to taper and discontinue antidepressant medications during the 12-week trial.
  8. Able to provide informed consent and comply with study procedures.
  9. Able to read English and understand study instruments.
  10. Entry criteria for depression and alcohol use disorder (moderate or severe) will be established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) for categorical diagnosis.
  11. Have a score of ≥18 on the Hamilton Depression Rating Scale for Depression (HAM-D).

Exclusion Criteria:

  1. Acute suicidality.
  2. Any lifetime history of bipolar disorder, schizophrenia, or schizoaffective disorder.
  3. Active psychotic disorder, eating disorder, or substance use disorder except for alcohol and tobacco or "mild" cannabis use disorder within 6 months of enrollment.
  4. Any lifetime history of autoimmune or immunodeficiency syndrome.
  5. Treatment with any psychotropic (including hypnotic), steroidal, or anti-inflammatory medication (including NSAIDs) within 2 weeks of treatment randomization (6 weeks for fluoxetine).
  6. Any current use of medication that affect alcohol consumption such as acamprosate, disulfiram, naltrexone (po or IM), topiramate, or sedative-hypnotics including benzodiazepines or any psychostimulant.
  7. Being enrolled in an alcohol treatment program (self-help groups participation such as Alcoholics Anonymous or Dual Diagnosis self-help are allowed).
  8. Active medical condition that could cause or exacerbate depressive symptoms (e.g., hypothyroidism, anemia).
  9. Currently pregnant or breast-feeding.
  10. Lack of use of a reliable means of contraception methods. (Female subjects of childbearing potential must undergo a serum or urine pregnancy test at screening and within 36 hours prior to infusion.)
  11. First major depressive episode after 50 years of age.
  12. Any evidence of current infection including serum positive for HIV, hepatitis BsAg or Viremic hepatitis.
  13. Medical conditions with known autoimmune or inflammatory mechanisms including any chronic allergic condition.
  14. Positive urine screens for any drug of abuse other than cannabis at baseline.
  15. Inability to read or understand study forms or informed consent or the presence of any other conditions or factors, which in the opinion of the investigator would make the patient unsuitable for study participation.
  16. Prior history of a suicide attempt, within the past year.
  17. Have hypersensitivity to dimethyl sulfoxide (DMSO).
  18. Have a clinical history of malignancy within 3 years (i.e., subjects with prior malignancy must be disease free for 3 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma.
  19. Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C.
  20. Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial.

Sites / Locations

  • University of Texas Rio Grande Valley School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

allogeneic human mesenchymal stem cells (allo-hMSCs)

Placebo

Arm Description

Participants will be treated with a single administration of allogeneic hMSCs: 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.

Participants will be treated with a placebo administration consisting of 1% human albumin serum in Plasma-Lyte A delivered via a single peripheral intravenous infusion.

Outcomes

Primary Outcome Measures

Incident of treatment emergent-serious adverse events
Incidence of any treatment-emergent serious adverse events, defined as a composite of acute suicidality and hospitalization for suicide attempts.

Secondary Outcome Measures

Change in serum concentrations of high sensitivity C-reactive protein.
Change in serum concentrations of high sensitivity C-reactive protein. A serum sample will be collected to assess the change.
Change in serum concentrations of inflammatory biomarkers
Change in serum concentrations of inflammatory biomarkers, such as in TNF alpha and interleukin-6. A serum sample will be collected to assess the change.
Change in depressive symptoms as assessed by MADRS
Montgomery and Asberg Depression Rating Scale (MADRS) is a ten item questionnaire with a total score ranging from 0-60 with a higher score indicating higher depressive symptoms.
Change in Depressive symptoms as assessed by CGI
Clinical Global Improvement (CGI) is rated on a 7 point scale ranging from 1 (very much improved) to 7 (very much worse).
Change in quantity of alcohol use as assessed by TLFB
30-day self report Timeline Follow Back (TLFB) questionnaire will be used to assess daily alcohol use.
Change in frequency of alcohol use as assessed by TLFB
30-day self report Timeline Follow Back (TLFB) questionnaire will be used to assess frequency of daily alcohol use.
Change in Anhedonia as measured by SHAPS
Snaith Hamilton Pleasure Scale (SHAPS) is a 14 item questionnaire with a total score ranging from 0-56 with a higher score indicating increased anhedonic symptoms.
Change in cravings as assessed by AUQ
Alcohol Urge Questionnaire (AUQ) is an 8 item questionnaire with total score ranging from 8-56 with a high score indicating increased cravings .
Change in cravings as assessed by OCDS
Obsessive-Compulsive Drinking Scale (OCDS) is a 14 item questionnaire ranging from 0-56 with a higher score indicating increase cravings.
Change in cognition as assessed by BAC-A
Brief Assessment of Cognition for Affective Disorders (BAC-A) includes brief assessments of executive functions, verbal fluency, attention, verbal memory, working memory and motor speed. Z-scores are calculated from composite scores. Higher z-scores are indicative of better cognitive performance, lower z-scores are indicative of lower cognitive performance. Range of z-scores anticipated to be between -3 and 3.
Change in functioning as assessed by UPSA-B
University of California of San Diego (UCSD) Performance Based Skills Assessment (UPSA-B) questionnaire has a total score from 0-100 with a higher score indication better functioning.
Change in functioning as assessed by GAF
Global Assessment of Functioning (GAF) questionnaire has a total score ranging from 1-100 with a higher score indicating of daily activities.
Change in quality of life as assessed by QOLI
Quality of Life Index (QOLI) questionnaire has a total score ranging from 10-100 with a higher score indicating higher quality of life.

Full Information

First Posted
August 16, 2017
Last Updated
November 14, 2022
Sponsor
Ihsan M Salloum, MD, MPH
Collaborators
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
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1. Study Identification

Unique Protocol Identification Number
NCT03265808
Brief Title
Allogeneic Human Mesenchymal Stem Cell Infusion vs Placebo in Alcohol Use Disorder and Major Depression.
Acronym
Alaunus
Official Title
A Phase I/II, Prospective, Randomized, Double-Blind, PlAcebo-ControLled Trial to EvAluate the Efficacy of Allogeneic HUman Mesenchymal Stem Cell InfusioN Versus Placebo in Subjects With Alcohol Use Disorder and Major DepreSsion.(ALAUNUS)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 18, 2018 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
April 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Ihsan M Salloum, MD, MPH
Collaborators
National Institute on Alcohol Abuse and Alcoholism (NIAAA)

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to look at the safety of a study treatment with stem cells in Alcohol Use Disorder And Major Depression (AUD-MD) subjects.
Detailed Description
This is a randomized, double-blind placebo-controlled study of allogeneic human mesenchymal stem cell in subjects with comorbid Alcohol Use Disorder And Major Depression (AUD-MD). 80 subjects will be randomized (1:1) to active treatment vs. placebo an followed weekly for 12 weeks and then every 3 months for 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder, Alcohol Use Disorder
Keywords
stem cells

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
allogeneic human mesenchymal stem cells (allo-hMSCs)
Arm Type
Experimental
Arm Description
Participants will be treated with a single administration of allogeneic hMSCs: 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants will be treated with a placebo administration consisting of 1% human albumin serum in Plasma-Lyte A delivered via a single peripheral intravenous infusion.
Intervention Type
Drug
Intervention Name(s)
allogeneic human mesenchymal stem cells (allo-hMSCs)
Intervention Description
Single administration of allogeneic hMSCs: 100 x 106 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo administration consisting of 1% human albumin serum in Plasma-Lyte A delivered via a single peripheral intravenous infusion.
Primary Outcome Measure Information:
Title
Incident of treatment emergent-serious adverse events
Description
Incidence of any treatment-emergent serious adverse events, defined as a composite of acute suicidality and hospitalization for suicide attempts.
Time Frame
One month post-infusion
Secondary Outcome Measure Information:
Title
Change in serum concentrations of high sensitivity C-reactive protein.
Description
Change in serum concentrations of high sensitivity C-reactive protein. A serum sample will be collected to assess the change.
Time Frame
Baseline, 12 weeks
Title
Change in serum concentrations of inflammatory biomarkers
Description
Change in serum concentrations of inflammatory biomarkers, such as in TNF alpha and interleukin-6. A serum sample will be collected to assess the change.
Time Frame
Baseline, 12 weeks
Title
Change in depressive symptoms as assessed by MADRS
Description
Montgomery and Asberg Depression Rating Scale (MADRS) is a ten item questionnaire with a total score ranging from 0-60 with a higher score indicating higher depressive symptoms.
Time Frame
Baseline, 12 weeks
Title
Change in Depressive symptoms as assessed by CGI
Description
Clinical Global Improvement (CGI) is rated on a 7 point scale ranging from 1 (very much improved) to 7 (very much worse).
Time Frame
Baseline, 12 weeks
Title
Change in quantity of alcohol use as assessed by TLFB
Description
30-day self report Timeline Follow Back (TLFB) questionnaire will be used to assess daily alcohol use.
Time Frame
Baseline, 12 weeks
Title
Change in frequency of alcohol use as assessed by TLFB
Description
30-day self report Timeline Follow Back (TLFB) questionnaire will be used to assess frequency of daily alcohol use.
Time Frame
Baseline, 12 weeks
Title
Change in Anhedonia as measured by SHAPS
Description
Snaith Hamilton Pleasure Scale (SHAPS) is a 14 item questionnaire with a total score ranging from 0-56 with a higher score indicating increased anhedonic symptoms.
Time Frame
Baseline, 12 weeks
Title
Change in cravings as assessed by AUQ
Description
Alcohol Urge Questionnaire (AUQ) is an 8 item questionnaire with total score ranging from 8-56 with a high score indicating increased cravings .
Time Frame
Baseline, 12 weeks
Title
Change in cravings as assessed by OCDS
Description
Obsessive-Compulsive Drinking Scale (OCDS) is a 14 item questionnaire ranging from 0-56 with a higher score indicating increase cravings.
Time Frame
Baseline, 12 weeks
Title
Change in cognition as assessed by BAC-A
Description
Brief Assessment of Cognition for Affective Disorders (BAC-A) includes brief assessments of executive functions, verbal fluency, attention, verbal memory, working memory and motor speed. Z-scores are calculated from composite scores. Higher z-scores are indicative of better cognitive performance, lower z-scores are indicative of lower cognitive performance. Range of z-scores anticipated to be between -3 and 3.
Time Frame
Baseline, 12 weeks
Title
Change in functioning as assessed by UPSA-B
Description
University of California of San Diego (UCSD) Performance Based Skills Assessment (UPSA-B) questionnaire has a total score from 0-100 with a higher score indication better functioning.
Time Frame
Baseline, 12 weeks
Title
Change in functioning as assessed by GAF
Description
Global Assessment of Functioning (GAF) questionnaire has a total score ranging from 1-100 with a higher score indicating of daily activities.
Time Frame
Baseline, 12 weeks
Title
Change in quality of life as assessed by QOLI
Description
Quality of Life Index (QOLI) questionnaire has a total score ranging from 10-100 with a higher score indicating higher quality of life.
Time Frame
Baseline, 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent. Subjects age >18 and <75 years at the time of signing the Informed Consent Form. Diagnostic and Statistical Manual of Mental Disorder-5 criteria for Alcohol Urge Questionnaire (moderate or severe defined as meeting 4 or more of the 11 criteria) AND a concurrent Diagnostic and Statistical Manual of Mental Disorder-5 recurrent unipolar major depression with HRSD-25 score of 18 or above. A history of a depressive episode occurring or persisting during a period of one-month abstinence. Participants should express the desire to reduce or stop alcohol consumption, report 28 or more standard drinks (SD) per week for males or 21 for females over four weeks during the 90 days preceding study enrollment. Increased inflammation ([serum C-reactive protein] ≥3.0 mg/L. Agree to taper and discontinue antidepressant medications during the 12-week trial. Able to provide informed consent and comply with study procedures. Able to read English and understand study instruments. Entry criteria for depression and alcohol use disorder (moderate or severe) will be established using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID) for categorical diagnosis. Have a score of ≥18 on the Hamilton Depression Rating Scale for Depression (HAM-D). Exclusion Criteria: Acute suicidality. Any lifetime history of bipolar disorder, schizophrenia, or schizoaffective disorder. Active psychotic disorder, eating disorder, or substance use disorder except for alcohol and tobacco or "mild" cannabis use disorder within 6 months of enrollment. Any lifetime history of autoimmune or immunodeficiency syndrome. Treatment with any psychotropic (including hypnotic), steroidal, or anti-inflammatory medication (including NSAIDs) within 2 weeks of treatment randomization (6 weeks for fluoxetine). Any current use of medication that affect alcohol consumption such as acamprosate, disulfiram, naltrexone (po or IM), topiramate, or sedative-hypnotics including benzodiazepines or any psychostimulant. Being enrolled in an alcohol treatment program (self-help groups participation such as Alcoholics Anonymous or Dual Diagnosis self-help are allowed). Active medical condition that could cause or exacerbate depressive symptoms (e.g., hypothyroidism, anemia). Currently pregnant or breast-feeding. Lack of use of a reliable means of contraception methods. (Female subjects of childbearing potential must undergo a serum or urine pregnancy test at screening and within 36 hours prior to infusion.) First major depressive episode after 50 years of age. Any evidence of current infection including serum positive for HIV, hepatitis BsAg or Viremic hepatitis. Medical conditions with known autoimmune or inflammatory mechanisms including any chronic allergic condition. Positive urine screens for any drug of abuse other than cannabis at baseline. Inability to read or understand study forms or informed consent or the presence of any other conditions or factors, which in the opinion of the investigator would make the patient unsuitable for study participation. Prior history of a suicide attempt, within the past year. Have hypersensitivity to dimethyl sulfoxide (DMSO). Have a clinical history of malignancy within 3 years (i.e., subjects with prior malignancy must be disease free for 3 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma. Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C. Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ihsan Salloum, MD
Organizational Affiliation
University of Texas Rio Grande Valley School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Texas Rio Grande Valley School of Medicine
City
Harlingen
State/Province
Texas
ZIP/Postal Code
78550
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Allogeneic Human Mesenchymal Stem Cell Infusion vs Placebo in Alcohol Use Disorder and Major Depression.

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