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Allogeneic ABCB5-positive Stem Cells for Treatment of Epidermolysis Bullosa

Primary Purpose

Recessive Dystrophic Epidermolysis Bullosa

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
allo-APZ2-EB
Sponsored by
RHEACELL GmbH & Co. KG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recessive Dystrophic Epidermolysis Bullosa focused on measuring Epidermolysis Bullosa, Epidermolysis Bullosa Dystrophica, Skin Abnormalities, Congenital Abnormalities, Skin Diseases, Genetic, Somatic Cell Therapy, Mesenchymal Stem Cells, ABCB5, Allogeneic

Eligibility Criteria

0 Years - 55 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

1. Male or female patients aged between 0 and ≤55 years;

Staggered design for patient enrollment:

  1. at least 3 adult patients (safety assessment 2 weeks after last treatment of third patient),
  2. at least 3 patients ≥12 to <18 years (safety assessment 2 weeks after first treatment of third patient),
  3. at least 3 patients ≥5 to <12 years (safety assessment 2 weeks after first treatment of third patient), and
  4. at least 3 patients ≥12 months to <5 years;
  5. patients 0 to <12 months (only in the UK);

2. Diagnosed with RDEB (combined diagnosis by genotype assessment [mutation analysis] and correlating phenotype assessment [wound assessment]), patients must have a negative immunofluorescence test result on salt-split skin against proteins of the basement membrane at Visit 1 (existing test results will be accepted);

3. Patient is eligible to participate in this clinical trial based on general health condition at the investigator's discretion;

US only:

Patient is eligible to participate in this clinical trial based on general health condition assessed by specific lab values (Hematology: Absolute neutrophil count >1000/mm3 and platelet count >150,000/mcL; Coagulation: PT and PTT <2x the upper limit of normal for age; Hepatic: AST and ALT <2x the upper limit of normal for age; Renal: Creatinine <2x the upper limit of normal for age; Pulmonary: Oxygen saturation >92% on room air and without supplemental oxygen requirement);

4. Patient/legal representative understands the nature of the procedure and are providing written informed consent prior to any clinical trial procedure;

5. Women of childbearing potential must have a negative urine pregnancy test at Visit 1;

6. Women of childbearing potential and their partner must be willing to use highly effective contraceptive methods during the course of the clinical trial.

Exclusion Criteria:

  1. Tumor diseases or history of tumor disease;
  2. Known positive result for human immunodeficiency virus 1 and/or 2;
  3. Any known allergies to components of the IMP;
  4. Evidence of any other medical conditions (such as psychiatric illness or active infection) based on physical examination, or laboratory findings that may interfere with the planned treatment, affect the patient's compliance, or place the patient at high risk of complications related to the treatment; at investigators discretion;
  5. History of prior thrombosis or patients at risk for thrombosis;
  6. Clinically significant or unstable concurrent disease or other clinical contraindications (based upon investigator's judgment);
  7. Patient/legal representative anticipated to be unwilling or unable to comply with the requirements of the protocol;
  8. Pregnant or lactating women;
  9. Current or previous (within 30 days of enrollment) treatment with another IMP, or participation and/or under follow-up in another clinical trial;
  10. Previous participation in this clinical trial (except for screening failures due to an exclusion criterion);
  11. Known abuse of alcohol, drugs, or medicinal products;
  12. Employees of the sponsor, or employees or relatives of the investigator.

Sites / Locations

  • University of Minnesota, Masonic Cancer Center and Medical Center
  • EB-Haus Austria; Salzburger Landeskliniken (SALK); Paracelsus Medizinische Privatuniversität Salzburg (PMU)
  • Hôpital Saint-Louis; Département de dermatologie
  • Department of Dermatology, Medical Center-University of Freiburg
  • King's College London; St John's Institute of Dermatology;
  • Great Ormond Street Hospital; Dermatology Department

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

allo-APZ2-EB

Arm Description

intravenous infusion, three doses of allo-APZ2-EB (2 x 10^6 cells/kg)

Outcomes

Primary Outcome Measures

Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient's EBDASI score), score), or last available post-baseline measurement if the Week 12 measurement is missing
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Assessment of adverse event (AE) occurrence
All AEs occurring during the clinical trial will be registered, documented and evaluated.

Secondary Outcome Measures

Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient's EBDASI score)
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient's iscorEB), or last available post-baseline measurement if the Week 12 measurement is missing
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient's iscorEB)
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Overall improvement of EB symptoms at Day 17 (measured by percentage change of a patient's EBDASI score)
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Overall improvement of EB symptoms at Day 17 (measured by percentage change of a patient's iscorEB)
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Overall improvement of EB symptoms at Day 35 (measured by percentage change of a patient's EBDASI score)
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Overall improvement of EB symptoms at Day 35 (measured by percentage change of a patient's iscorEB)
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Inflammation (measured by panel of inflammation markers)
A panel of inflammation markers will be measured and evaluated.
Pain assessment as per NRS
Pain assessment as per numerical rating scale (NRS) will be evaluated.
Itch assessment as per NRS
Itch assessment as per numerical rating scale (NRS) will be evaluated.
Differences in patient's quality of life in EB
Assessment of quality of life data using an EB-specific quality of life questionnaire
Physical examination until Week 12;
A full physical examination will be performed and abnormal physical examination results will be evaluated and reported as AEs.
Vital signs: Body temperature until Week 12;
Body temperature will be evaluated at Screening, baseline, day 17, day 35 and week 12
Vital signs: Blood pressure until Week 12;
Blood pressure will be evaluated at Screening, baseline, day 17, day 35 and week 12
Vital signs: Heart rate until Week 12;
Heart rate will be evaluated at Screening, baseline, day 17, day 35 and week 12
Overall survival at month 24

Full Information

First Posted
April 24, 2018
Last Updated
October 6, 2022
Sponsor
RHEACELL GmbH & Co. KG
Collaborators
FGK Clinical Research GmbH, Granzer Regulatory Consulting & Services, Ticeba GmbH
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1. Study Identification

Unique Protocol Identification Number
NCT03529877
Brief Title
Allogeneic ABCB5-positive Stem Cells for Treatment of Epidermolysis Bullosa
Official Title
An Interventional, Multicenter, Single Arm, Phase I/IIa Clinical Trial to Investigate the Efficacy and Safety of Allo-APZ2-EB on Epidermolysis Bullosa (EB)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
February 16, 2019 (Actual)
Primary Completion Date
November 26, 2021 (Actual)
Study Completion Date
November 26, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RHEACELL GmbH & Co. KG
Collaborators
FGK Clinical Research GmbH, Granzer Regulatory Consulting & Services, Ticeba GmbH

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 aim of this clinical trial is to investigate the efficacy (by monitoring overall improvement of EB symptoms) and safety (by monitoring adverse events) of three doses of allo-APZ2-EB administered intravenously to patients with recessive dystrophic epidermolysis bullosa (RDEB).
Detailed Description
This is an interventional, single arm, non-randomized, open label, phase I/IIa clinical trial to investigate the efficacy and safety of the IMP allo-APZ2-EB in patients with RDEB. Patients will undergo treatment with the IMP (three repeated intravenous applications) and will be followed up for efficacy for 12 weeks. To assess long-term safety of allo-APZ2-EB one follow-up visit at Month 12 and one follow-up visit at Month 24 post IMP applications is included. Determination of the EB linked symptoms and quality of life will be assessed by using the EBDASI score, the iscorEB, the change in pain and itch perception, and patient's quality of life in EB. The wound healing process will be documented by photography.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recessive Dystrophic Epidermolysis Bullosa
Keywords
Epidermolysis Bullosa, Epidermolysis Bullosa Dystrophica, Skin Abnormalities, Congenital Abnormalities, Skin Diseases, Genetic, Somatic Cell Therapy, Mesenchymal Stem Cells, ABCB5, Allogeneic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
16 (Actual)

8. Arms, Groups, and Interventions

Arm Title
allo-APZ2-EB
Arm Type
Experimental
Arm Description
intravenous infusion, three doses of allo-APZ2-EB (2 x 10^6 cells/kg)
Intervention Type
Biological
Intervention Name(s)
allo-APZ2-EB
Other Intervention Name(s)
allogeneic ABCB5-positive mesenchymal stem cells
Intervention Description
intravenous infusion of allo-APZ2-EB
Primary Outcome Measure Information:
Title
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient's EBDASI score), score), or last available post-baseline measurement if the Week 12 measurement is missing
Description
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Time Frame
Week 12 post baseline, or last available post-baseline measurement if the Week 12 measurement is missing (last observation carried forward [LOCF])
Title
Assessment of adverse event (AE) occurrence
Description
All AEs occurring during the clinical trial will be registered, documented and evaluated.
Time Frame
Up to 24 months
Secondary Outcome Measure Information:
Title
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of a patient's EBDASI score)
Description
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Time Frame
between baseline and week 12 post baseline (without LOCF)
Title
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient's iscorEB), or last available post-baseline measurement if the Week 12 measurement is missing
Description
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Time Frame
Week 12 post baseline, or last available post-baseline measurement if the Week 12 measurement is missing (LOCF);
Title
Overall improvement of EB symptoms after 12 weeks (measured by percentage change of patient's iscorEB)
Description
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Time Frame
between baseline and week 12 post baseline (without LOCF)
Title
Overall improvement of EB symptoms at Day 17 (measured by percentage change of a patient's EBDASI score)
Description
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Time Frame
between baseline and day 17 post baseline
Title
Overall improvement of EB symptoms at Day 17 (measured by percentage change of a patient's iscorEB)
Description
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Time Frame
between baseline and day 17 post baseline
Title
Overall improvement of EB symptoms at Day 35 (measured by percentage change of a patient's EBDASI score)
Description
EBDASI: epidermolysis bullosa disease activity and scarring index; measured in percentage change to baseline score
Time Frame
between baseline and day 35 post baseline
Title
Overall improvement of EB symptoms at Day 35 (measured by percentage change of a patient's iscorEB)
Description
iscorEB: instrument for scoring clinical outcome of research for epidermolysis bullosa; measured in percentage change to baseline score
Time Frame
between baseline and day 35 post baseline
Title
Inflammation (measured by panel of inflammation markers)
Description
A panel of inflammation markers will be measured and evaluated.
Time Frame
between baseline and day 17, day 35 and week 12 post baseline
Title
Pain assessment as per NRS
Description
Pain assessment as per numerical rating scale (NRS) will be evaluated.
Time Frame
between baseline and day 17, day 35 and week 12 post baseline
Title
Itch assessment as per NRS
Description
Itch assessment as per numerical rating scale (NRS) will be evaluated.
Time Frame
between baseline and day 17, day 35 and week 12 post baseline
Title
Differences in patient's quality of life in EB
Description
Assessment of quality of life data using an EB-specific quality of life questionnaire
Time Frame
between baseline and day 17, day 35 and week 12 post baseline
Title
Physical examination until Week 12;
Description
A full physical examination will be performed and abnormal physical examination results will be evaluated and reported as AEs.
Time Frame
At Screening, baseline, day 17, day 35 and week 12
Title
Vital signs: Body temperature until Week 12;
Description
Body temperature will be evaluated at Screening, baseline, day 17, day 35 and week 12
Time Frame
At Screening, baseline, day 17, day 35 and week 12
Title
Vital signs: Blood pressure until Week 12;
Description
Blood pressure will be evaluated at Screening, baseline, day 17, day 35 and week 12
Time Frame
At Screening, baseline, day 17, day 35 and week 12
Title
Vital signs: Heart rate until Week 12;
Description
Heart rate will be evaluated at Screening, baseline, day 17, day 35 and week 12
Time Frame
At Screening, baseline, day 17, day 35 and week 12
Title
Overall survival at month 24
Time Frame
month 24 post baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
0 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 1. Male or female patients aged between 0 and ≤55 years; Staggered design for patient enrollment: at least 3 adult patients (safety assessment 2 weeks after last treatment of third patient), at least 3 patients ≥12 to <18 years (safety assessment 2 weeks after first treatment of third patient), at least 3 patients ≥5 to <12 years (safety assessment 2 weeks after first treatment of third patient), and at least 3 patients ≥12 months to <5 years; patients 0 to <12 months (only in the UK); 2. Diagnosed with RDEB (combined diagnosis by genotype assessment [mutation analysis] and correlating phenotype assessment [wound assessment]), patients must have a negative immunofluorescence test result on salt-split skin against proteins of the basement membrane at Visit 1 (existing test results will be accepted); 3. Patient is eligible to participate in this clinical trial based on general health condition at the investigator's discretion; US only: Patient is eligible to participate in this clinical trial based on general health condition assessed by specific lab values (Hematology: Absolute neutrophil count >1000/mm3 and platelet count >150,000/mcL; Coagulation: PT and PTT <2x the upper limit of normal for age; Hepatic: AST and ALT <2x the upper limit of normal for age; Renal: Creatinine <2x the upper limit of normal for age; Pulmonary: Oxygen saturation >92% on room air and without supplemental oxygen requirement); 4. Patient/legal representative understands the nature of the procedure and are providing written informed consent prior to any clinical trial procedure; 5. Women of childbearing potential must have a negative urine pregnancy test at Visit 1; 6. Women of childbearing potential and their partner must be willing to use highly effective contraceptive methods during the course of the clinical trial. Exclusion Criteria: Tumor diseases or history of tumor disease; Known positive result for human immunodeficiency virus 1 and/or 2; Any known allergies to components of the IMP; Evidence of any other medical conditions (such as psychiatric illness or active infection) based on physical examination, or laboratory findings that may interfere with the planned treatment, affect the patient's compliance, or place the patient at high risk of complications related to the treatment; at investigators discretion; History of prior thrombosis or patients at risk for thrombosis; Clinically significant or unstable concurrent disease or other clinical contraindications (based upon investigator's judgment); Patient/legal representative anticipated to be unwilling or unable to comply with the requirements of the protocol; Pregnant or lactating women; Current or previous (within 30 days of enrollment) treatment with another IMP, or participation and/or under follow-up in another clinical trial; Previous participation in this clinical trial (except for screening failures due to an exclusion criterion); Known abuse of alcohol, drugs, or medicinal products; Employees of the sponsor, or employees or relatives of the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jakub Tolar, MD, PhD
Organizational Affiliation
University of Minnesota, Masonic Cancer Center and Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Minnesota, Masonic Cancer Center and Medical Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
EB-Haus Austria; Salzburger Landeskliniken (SALK); Paracelsus Medizinische Privatuniversität Salzburg (PMU)
City
Salzburg
ZIP/Postal Code
5020
Country
Austria
Facility Name
Hôpital Saint-Louis; Département de dermatologie
City
Paris
ZIP/Postal Code
75010
Country
France
Facility Name
Department of Dermatology, Medical Center-University of Freiburg
City
Freiburg
ZIP/Postal Code
79104
Country
Germany
Facility Name
King's College London; St John's Institute of Dermatology;
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom
Facility Name
Great Ormond Street Hospital; Dermatology Department
City
London
ZIP/Postal Code
WC1N 3JH
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34665781
Citation
Kiritsi D, Dieter K, Niebergall-Roth E, Fluhr S, Daniele C, Esterlechner J, Sadeghi S, Ballikaya S, Erdinger L, Schauer F, Gewert S, Laimer M, Bauer JW, Hovnanian A, Zambruno G, El Hachem M, Bourrat E, Papanikolaou M, Petrof G, Kitzmuller S, Ebens CL, Frank MH, Frank NY, Ganss C, Martinez AE, McGrath JA, Tolar J, Kluth MA. Clinical trial of ABCB5+ mesenchymal stem cells for recessive dystrophic epidermolysis bullosa. JCI Insight. 2021 Nov 22;6(22):e151922. doi: 10.1172/jci.insight.151922.
Results Reference
derived
PubMed Identifier
33011075
Citation
Kerstan A, Niebergall-Roth E, Esterlechner J, Schroder HM, Gasser M, Waaga-Gasser AM, Goebeler M, Rak K, Schrufer P, Endres S, Hagenbusch P, Kraft K, Dieter K, Ballikaya S, Stemler N, Sadeghi S, Tappenbeck N, Murphy GF, Orgill DP, Frank NY, Ganss C, Scharffetter-Kochanek K, Frank MH, Kluth MA. Ex vivo-expanded highly pure ABCB5+ mesenchymal stromal cells as Good Manufacturing Practice-compliant autologous advanced therapy medicinal product for clinical use: process validation and first in-human data. Cytotherapy. 2021 Feb;23(2):165-175. doi: 10.1016/j.jcyt.2020.08.012. Epub 2020 Oct 1.
Results Reference
derived

Learn more about this trial

Allogeneic ABCB5-positive Stem Cells for Treatment of Epidermolysis Bullosa

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