Alzheimer's Disease Stem Cells Multiple Infusions
Primary Purpose
Alzheimer Disease
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Approximately 100 million cells allogeneic hMSC
Sponsored by
About this trial
This is an interventional treatment trial for Alzheimer Disease focused on measuring Dementia, Stem cells, Alzheimer's Disease
Eligibility Criteria
Inclusion Criteria:
All subjects enrolled in this trial must:
- Provide written informed consent
- Male or female subjects aged 50-85 years at time of signing Informed Consent
- Mini-Mental State Examination (MMSE) between 20-26
- Amyloid PET scan or CSF Aß1-42 positive for the presence of amyloid
- Meet criteria for either Alzheimer's Disease or probable Alzheimer's Disease (AD) according to National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINDCDS/ARDRA)
- Subjects, if taking cholinesterase inhibitor medications (donepezil, rivastigmine (oral or transdermal) or galantamine), are required to have been taking them on a stable dose for at least 3 months prior to Baseline Visit These medicines are not required
- Subjects already taking memantine will not have an effect in the inclusion/exclusion criteria.
- Have a study partner
- No clinically significant abnormal screening laboratory values, as determined by the investigator
- Women must be postmenopausal, surgically sterile, or having infertility. A postmenopausal woman is defined as either having an intact uterus with at least 12 months of spontaneous amenorrhea or a diagnosis of menopause, defined as an Follicular Stimulating Hormone (FSH) level of > 25 IU/L
Exclusion Criteria:
All subjects enrolled must not have:
- Dementia other than AD
- A negative Amyloid PET scan
- Other neurodegenerative disease
- Significant psychiatric illness (e.g., uncontrolled major depression, schizophrenia, bipolar affective disorder)
- History of seizures
- Contraindication for Magnetic Resonance Imaging (MRI)
History of malignancy, except:
- > 5 years in remission prior to screening
- Be excised or treated basal cell, squamous carcinoma or melanoma in situ
- Prostate cancer in situ
- Cervical carcinoma in situ
Uncontrolled medical conditions
- Hypertension
- Diabetes
- Unstable angina or history of Myocardial Infarction (MI) within 1 year prior to screening
- History of alcohol or drug use disorder (except tobacco use disorder) within 2 years before the screening visit
- Brain MRI at screening that shows evidence of findings incompatible with a diagnosis of Alzheimer's disease. Volumetric MRI scans done within 6 months prior to ICF signature will be accepted if completed locally.
- History of bleeding disorder
- History of or positive results for Human Immunodeficiency Virus (HIV)
- History of or positive results for Hepatitis C Virus (HCV) or Hepatitis B Virus (HBV)
- Hypersensitivity to dimethyl sulfoxide (DMSO)
- Inability to perform any of the assessments required for endpoint analysis
- Currently receiving (or received within four weeks of screening) experimental agents for the treatment of AD or enrolled in clinical trials in the prior 3 months
- Be a transplant recipient, or on active listing (or expected future listing) for transplant of any organ.
- Any other condition that, in the opinion of the investigator, may compromise the safety or compliance of the patient or preclude successful completion of the study.
Sites / Locations
- University of Miami
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
hMSC Treatment group
Arm Description
Participants in the hMSC treatment group will receive a total of 4 doses of the hMSC intervention. Each dose will be administered once about every 13 weeks within a year period.
Outcomes
Primary Outcome Measures
Number of Incidence of any Treatment-Emergent Serious Adverse Events (TE-SAEs)
All adverse events will be evaluated by the investigator for relationship with the study intervention. Treatment-Emergent Serious Adverse Events is defined as any untoward medical occurrence with a reasonable possibility that it is caused by the study intervention that:
Is life-threatening (e.g.; leads to stroke or non-fatal pulmonary embolism);
Requires inpatient hospitalization or prolongation of existing hospitalization;
Results in persistent or significant disability/incapacity
Results in other clinically significant sign(s) or symptom(s), (e.g.; clinically asymptomatic brain microhemorrhages); or
Results in death
Secondary Outcome Measures
Cognitive function over time as assessed by the Alzheimer's Disease Assessment Scale - Cognitive (ADAS-Cog 11)
The ADAS-Cog 11 is a 13-item version of ADAS-Cog comprising of the original 11-item ADAS-Cog as well as Delayed Recall and Digit Cancellation items. The total score ranges from 0-85 points, with a lower score indicating better performance.
Cognitive function over time as assessed by the Mini Mental State Examination (MMSE) of Folstein test
The MMSE assesses orientation to time and place, immediate and delayed recall of words, attention and calculation, language (naming, comprehension and repetition), and spatial ability (copying a figure). The total score ranges from 0-30, with a higher score indicating better cognitive performance.
Depressive symptoms over time as assessed by the Geriatric Depression Scale (GDS) Short Version
The GDS is a 15-item questionnaire with each item counting as one point. The total score ranges from 0 to 15 with a score greater than 5 indicating possible depression.
Participant quality of life over time assessed via Alzheimer's Disease Related Quality of Life (ADRQL-40) Questionnaire as completed by the caregiver
ADRQL-40 is a questionnaire completed by the caregiver assessing the quality of life of the participant with AD. The total score for the ADRQL is computed by summing the values assigned to the responses, dividing the sum by the maximum value for the scale and multiplying the results by 100 to obtain a percentage score of 0 to 100. A higher score reflects a higher quality of life.
Participant quality of life over time as assessed via the Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Questionnaire as completed by the caregiver
The ADCS-ADL is a 23 item questionnaire completed by the caregiver assessing the basic and instrumental activities of daily living by the AD participant. Total score range from 0-78 with the higher score indicating increased independence.
Neuropsychiatric Inventory-Q (NPI-Q) Scores over time
The NPI-Q is a questionnaire used to assess behavioral changes common in dementia patients. This questionnaire is completed by the caregiver. The questionnaire consists of 12 items with each item having a scoring range between 0-3. The higher score indicates a more severe neuropsychiatric symptomatology.
Caregiver's Quality of life over time as assessed by the Caregiver Self-Assessment Questionnaire scores
The Caregiver Self-Assessment questionnaire is completed by the caregiver. It is an 18-item questionnaire answered with a "yes" or "no". Evidence of distress is indicated for having over 10 "yes" answers.
Biomarker levels over time
Serum blood inflammatory and biomarker levels will be evaluated including Interleukin-6 (IL-6), Neurofilament light (NfL), Amyloid Beta 40 (Aβ40) and Amyloid Beta 42 (Aβ42) in pg/mL.
Serum ApoE level over time
Serum blood Apolipoprotein E (ApoE) will be evaluated in mg/dL.
Serum PRA level over time
Serum blood Plasma Renin Activity (PRA) will be evaluated in ng/mL per hour.
Serum Tau protein level over time
Serum blood Tau protein level will be evaluated in ng/L.
Cerebrospinal Fluid (CSF) Biomarker levels over time
CSF inflammatory and biomarker levels will be evaluated including Interleukin-6 (IL-6), Neurofilament light (NfL), Amyloid Beta 40 (Aβ40) and Amyloid Beta 42 (Aβ42) in pg/mL.
CSF ApoE level over time
CSF Apolipoprotein E (ApoE) levels will be evaluated in mg/dL.
CSF PRA level over time
CSF Plasma Renin Activity (PRA) levels will be evaluated in ng/mL per hour.
CSF Tau protein level over time
CSF Tau protein levels will be evaluated in ng/L.
Change in hippocampal volume
Change in hippocampal volume will be assessed via MRI Brain volumetric studies
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04040348
Brief Title
Alzheimer's Disease Stem Cells Multiple Infusions
Official Title
A Phase I, Prospective, Open-label Trial to Evaluate the Safety, Tolerability and Exploratory Outcomes of Multiple Allogeneic Human Mesenchymal Stem Cells (HMSC) Infusions in Patients With Mild to Moderate Alzheimer's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
October 8, 2019 (Actual)
Primary Completion Date
April 25, 2023 (Actual)
Study Completion Date
April 25, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Bernard (Barry) Baumel
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 research study is to test the safety, possible side effects, and possible effectiveness of mesenchymal stem cell infusions when given to people with a diagnosis of mild to moderate Alzheimer's disease.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer Disease
Keywords
Dementia, Stem cells, Alzheimer's Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
hMSC Treatment group
Arm Type
Experimental
Arm Description
Participants in the hMSC treatment group will receive a total of 4 doses of the hMSC intervention. Each dose will be administered once about every 13 weeks within a year period.
Intervention Type
Biological
Intervention Name(s)
Approximately 100 million cells allogeneic hMSC
Intervention Description
Umbilical cord-derived, allogeneic hMSC administered intravenously at a dose of approximately 100 million cells per infusion.
Primary Outcome Measure Information:
Title
Number of Incidence of any Treatment-Emergent Serious Adverse Events (TE-SAEs)
Description
All adverse events will be evaluated by the investigator for relationship with the study intervention. Treatment-Emergent Serious Adverse Events is defined as any untoward medical occurrence with a reasonable possibility that it is caused by the study intervention that:
Is life-threatening (e.g.; leads to stroke or non-fatal pulmonary embolism);
Requires inpatient hospitalization or prolongation of existing hospitalization;
Results in persistent or significant disability/incapacity
Results in other clinically significant sign(s) or symptom(s), (e.g.; clinically asymptomatic brain microhemorrhages); or
Results in death
Time Frame
One month post-infusion
Secondary Outcome Measure Information:
Title
Cognitive function over time as assessed by the Alzheimer's Disease Assessment Scale - Cognitive (ADAS-Cog 11)
Description
The ADAS-Cog 11 is a 13-item version of ADAS-Cog comprising of the original 11-item ADAS-Cog as well as Delayed Recall and Digit Cancellation items. The total score ranges from 0-85 points, with a lower score indicating better performance.
Time Frame
Up to Week 65
Title
Cognitive function over time as assessed by the Mini Mental State Examination (MMSE) of Folstein test
Description
The MMSE assesses orientation to time and place, immediate and delayed recall of words, attention and calculation, language (naming, comprehension and repetition), and spatial ability (copying a figure). The total score ranges from 0-30, with a higher score indicating better cognitive performance.
Time Frame
Up to Week 65
Title
Depressive symptoms over time as assessed by the Geriatric Depression Scale (GDS) Short Version
Description
The GDS is a 15-item questionnaire with each item counting as one point. The total score ranges from 0 to 15 with a score greater than 5 indicating possible depression.
Time Frame
Up to Week 65
Title
Participant quality of life over time assessed via Alzheimer's Disease Related Quality of Life (ADRQL-40) Questionnaire as completed by the caregiver
Description
ADRQL-40 is a questionnaire completed by the caregiver assessing the quality of life of the participant with AD. The total score for the ADRQL is computed by summing the values assigned to the responses, dividing the sum by the maximum value for the scale and multiplying the results by 100 to obtain a percentage score of 0 to 100. A higher score reflects a higher quality of life.
Time Frame
Up to Week 65
Title
Participant quality of life over time as assessed via the Alzheimer's Disease Cooperative Study Activities of Daily Living (ADCS-ADL) Questionnaire as completed by the caregiver
Description
The ADCS-ADL is a 23 item questionnaire completed by the caregiver assessing the basic and instrumental activities of daily living by the AD participant. Total score range from 0-78 with the higher score indicating increased independence.
Time Frame
Up to Week 65
Title
Neuropsychiatric Inventory-Q (NPI-Q) Scores over time
Description
The NPI-Q is a questionnaire used to assess behavioral changes common in dementia patients. This questionnaire is completed by the caregiver. The questionnaire consists of 12 items with each item having a scoring range between 0-3. The higher score indicates a more severe neuropsychiatric symptomatology.
Time Frame
Up to Week 52
Title
Caregiver's Quality of life over time as assessed by the Caregiver Self-Assessment Questionnaire scores
Description
The Caregiver Self-Assessment questionnaire is completed by the caregiver. It is an 18-item questionnaire answered with a "yes" or "no". Evidence of distress is indicated for having over 10 "yes" answers.
Time Frame
Up to Week 52
Title
Biomarker levels over time
Description
Serum blood inflammatory and biomarker levels will be evaluated including Interleukin-6 (IL-6), Neurofilament light (NfL), Amyloid Beta 40 (Aβ40) and Amyloid Beta 42 (Aβ42) in pg/mL.
Time Frame
Up to Week 65
Title
Serum ApoE level over time
Description
Serum blood Apolipoprotein E (ApoE) will be evaluated in mg/dL.
Time Frame
Up to Week 65
Title
Serum PRA level over time
Description
Serum blood Plasma Renin Activity (PRA) will be evaluated in ng/mL per hour.
Time Frame
Up to Week 65
Title
Serum Tau protein level over time
Description
Serum blood Tau protein level will be evaluated in ng/L.
Time Frame
Up to Week 65
Title
Cerebrospinal Fluid (CSF) Biomarker levels over time
Description
CSF inflammatory and biomarker levels will be evaluated including Interleukin-6 (IL-6), Neurofilament light (NfL), Amyloid Beta 40 (Aβ40) and Amyloid Beta 42 (Aβ42) in pg/mL.
Time Frame
Up to Week 52
Title
CSF ApoE level over time
Description
CSF Apolipoprotein E (ApoE) levels will be evaluated in mg/dL.
Time Frame
Up to Week 52
Title
CSF PRA level over time
Description
CSF Plasma Renin Activity (PRA) levels will be evaluated in ng/mL per hour.
Time Frame
Up to Week 52
Title
CSF Tau protein level over time
Description
CSF Tau protein levels will be evaluated in ng/L.
Time Frame
Up to Week 52
Title
Change in hippocampal volume
Description
Change in hippocampal volume will be assessed via MRI Brain volumetric studies
Time Frame
Baseline to Week 6, Baseline to Week 52
10. Eligibility
Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
All subjects enrolled in this trial must:
Provide written informed consent
Male or female subjects aged 50-85 years at time of signing Informed Consent
Mini-Mental State Examination (MMSE) between 20-26
Amyloid PET scan or CSF Aß1-42 positive for the presence of amyloid
Meet criteria for either Alzheimer's Disease or probable Alzheimer's Disease (AD) according to National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINDCDS/ARDRA)
Subjects, if taking cholinesterase inhibitor medications (donepezil, rivastigmine (oral or transdermal) or galantamine), are required to have been taking them on a stable dose for at least 3 months prior to Baseline Visit These medicines are not required
Subjects already taking memantine will not have an effect in the inclusion/exclusion criteria.
Have a study partner
No clinically significant abnormal screening laboratory values, as determined by the investigator
Women must be postmenopausal, surgically sterile, or having infertility. A postmenopausal woman is defined as either having an intact uterus with at least 12 months of spontaneous amenorrhea or a diagnosis of menopause, defined as an Follicular Stimulating Hormone (FSH) level of > 25 IU/L
Exclusion Criteria:
All subjects enrolled must not have:
Dementia other than AD
A negative Amyloid PET scan
Other neurodegenerative disease
Significant psychiatric illness (e.g., uncontrolled major depression, schizophrenia, bipolar affective disorder)
History of seizures
Contraindication for Magnetic Resonance Imaging (MRI)
History of malignancy, except:
> 5 years in remission prior to screening
Be excised or treated basal cell, squamous carcinoma or melanoma in situ
Prostate cancer in situ
Cervical carcinoma in situ
Uncontrolled medical conditions
Hypertension
Diabetes
Unstable angina or history of Myocardial Infarction (MI) within 1 year prior to screening
History of alcohol or drug use disorder (except tobacco use disorder) within 2 years before the screening visit
Brain MRI at screening that shows evidence of findings incompatible with a diagnosis of Alzheimer's disease. Volumetric MRI scans done within 6 months prior to ICF signature will be accepted if completed locally.
History of bleeding disorder
History of or positive results for Human Immunodeficiency Virus (HIV)
History of or positive results for Hepatitis C Virus (HCV) or Hepatitis B Virus (HBV)
Hypersensitivity to dimethyl sulfoxide (DMSO)
Inability to perform any of the assessments required for endpoint analysis
Currently receiving (or received within four weeks of screening) experimental agents for the treatment of AD or enrolled in clinical trials in the prior 3 months
Be a transplant recipient, or on active listing (or expected future listing) for transplant of any organ.
Any other condition that, in the opinion of the investigator, may compromise the safety or compliance of the patient or preclude successful completion of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bernard (Barry) Baumel, MD
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Alzheimer's Disease Stem Cells Multiple Infusions
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