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Study to Explore the Safety and Feasibility of Allogeneic Young Plasma Infusion in Older Adults

Primary Purpose

Frailty Syndrome, Heart Failure

Status
Withdrawn
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Allogeneic Young Plasma
Sponsored by
Wake Forest University Health Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Frailty Syndrome focused on measuring Frailty, Aging, Heart failure, Plasma, Infusion

Eligibility Criteria

65 Years - 80 Years (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • English speaking elderly males and females, aged 65-80 years, referred by the Gerontology Department and the Cardiology Clinic of the Wake Forest Baptist Health Sticht Center for Aging.
  • a score of 3 or greater (at least frail status) as demonstrated by the Fried Frailty criteria.

Exclusion Criteria:

  • Unable or unwilling to give informed consent in either study group
  • Current psychiatric disorder not currently under control or being adequately treated
  • Current consumption of more than 14 alcoholic drinks per week
  • Self-reported inability to walk across a small room
  • Residence in a nursing home
  • Previous MOCA score below 21
  • Difficulty in communication with study personnel due to speech or hearing problems
  • Other medical, psychiatric, or behavioral factors that in the judgment of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol
  • Elective surgery, planned prior to signing consent
  • Severe osteoarthritis
  • Rheumatoid arthritis
  • Severe B/L hip, knee, or hand pain (>7/10 on pain scale)
  • Cancer requiring treatment in the past three years, except for non-melanoma skin cancers or cancers that have clearly been cured or in the opinion of the investigator carry an excellent prognosis (e.g., Stage 1 cervical cancer)
  • Pulmonary disease including VQ mismatch/diffusion limitation, diminished inspired O2, hypoventilation, pulmonary fibrosis, or sarcoidosis
  • Current tobacco use (smoke/chew)
  • Currently prescribed corticosteroids
  • Patients taking nucleoside analogues (Zebularine, 5-azaC, Decitabine)
  • Patients on non-nucleoside analogues (Procaine, procainamide, hydralazine)
  • History of an inherited bleeding disorder or vitamin K deficiency
  • Cardiovascular disease (excluding HFpEF), clinically significant aortic stenosis, history of cardiac arrest, use of a cardiac defibrillator or uncontrolled angina.
  • Parkinson's disease or other serious neurological disorder
  • MMS score < 18
  • Renal disease (any stage, inappropriate for age; Cr Cl < 60)
  • Hypoalbuminemia, with serum albumin level < 3.5 g/dL
  • History of IgA deficiency
  • History of hypersensitivity to frozen plasma (PF24) or to plasma-derived products including any plasma protein
  • Active hepatitis or history of liver transplant
  • Anemia or polycythemia: Male - Hgb level below 12 or above 17.5 g/dL and/or HCT of 41%-53%. Female: Hgb level below 10.0 or above 16.0 g/dL and/or HCT 36%-46%
  • Current use of anti-coagulants
  • History of DMI or DMII
  • Peripheral vascular disease
  • Brain aneurysm or intracranial hemorrhage within the past 6 months
  • History of Hepatitis B, Hepatitis C, or HIV infection
  • Other illness of such severity that life expectancy is considered to be less than 12 months
  • Patients with initial VO2max that falls below expected value or that does not meet a minimum VO2max of 20 mL * kg * min (in order to demonstrate a more clinically meaningful increase)
  • Uncontrolled hypertension (systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 100 mmHg)
  • CVA, hip fracture, B/L hip or knee replacement, or spinal surgery in the past 6 months
  • Serious conduction disorder (e.g., 3rd degree heart block), uncontrolled arrhythmia, or new Q waves or ST-segment depressions (>3 mm) on ECG
  • Myocardial infarction, major heart surgery (i.e., valve replacement or bypass surgery), stroke, deep vein thrombosis or pulmonary embolism in the past 6 months
  • Undergoing physical therapy or cardiopulmonary rehabilitation
  • Currently enrolled in another randomized trial involving lifestyle or pharmaceutical interventions
  • Currently on an anaerobic/aerobic exercise plan
  • Inability or unwillingness to return for all transfusions/FU visits

Sites / Locations

  • Wake Forest University Health Sciences

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Geriatric participants with frailty

Geriatric participants with HFpEF

Arm Description

Geriatric participants aged 65-80 who have a diagnosis of frailty (Fried Frailty score of 3 or greater). Experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days).

Geriatric participants aged 65-80 who have a diagnosis of HFpEF. Experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days).

Outcomes

Primary Outcome Measures

Frequency of adverse events
The primary outcomes of this phase 0 study are built upon evaluating the outcome of safety with administering plasma (PF24) acquired from donors of a young chronological age intravenously to older adults at WFBMC, as evidenced by lack of any grade 4-5 adverse events and >/=50% grade 3-4 adverse events, as defined by NCI CTCAE v5.0. Grade 1-2 events will be recorded for statistical purposes.

Secondary Outcome Measures

Study participant retention
Secondary outcomes include indicators of feasibility as assessed by measuring study participant retention >/= 80%
Study participants ability to complete the Fried Frailty Assessment
Measurement of the Fried Frailty Score - The stages of frailty based on the Fried Frailty assessment criteria: a score of 0 means that a person is robust or not frail. Persons with a score of 1 or 2 are at intermediate risk for adverse outcomes or are considered to be pre-frail. A score of 3-5 indicates that someone is frail

Full Information

First Posted
January 13, 2020
Last Updated
May 21, 2020
Sponsor
Wake Forest University Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT04241159
Brief Title
Study to Explore the Safety and Feasibility of Allogeneic Young Plasma Infusion in Older Adults
Official Title
A Small-Scale Study to Explore the Safety and Feasibility of Allogeneic Young Plasma Infusion in Older Adults Experiencing Disability Across the Spectrum of Frailty Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Withdrawn
Why Stopped
Protocol required revisions and application was withdrawn from the IRB.
Study Start Date
May 2020 (Anticipated)
Primary Completion Date
August 2020 (Anticipated)
Study Completion Date
August 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Evaluate the feasibility of administering plasma (PF24) acquired from donors of a young chronological age intravenously to older adults at WFBMC while also exploring its effects on age-related functional decline
Detailed Description
A Small-Scale Study to Explore the Safety and Feasibility of Allogeneic Young Plasma Infusion in Older Adults Experiencing Disability Across the Spectrum of Frailty Syndrome Plasma (PF24) will be transfused into enrolled male and female geriatric patients aged 65-80 who have a diagnosis of frailty (Fried Frailty score of 3 or greater) or HFpEF. The experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days). Primary and secondary endpoints will measure safety and feasibility of infusing PF24 in this study population. Tertiary endpoints will include measurement of the Fried Frailty score, various cognitive testing, measurement of VO2max, and blood biomarkers associated with aging. We will measure change from baseline 1 week after the 8th infusion of PF24. Test of durability will occur 5 weeks after the 8th infusion of plasma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Frailty Syndrome, Heart Failure
Keywords
Frailty, Aging, Heart failure, Plasma, Infusion

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Early Phase 1
Interventional Study Model
Parallel Assignment
Model Description
All eligible study participants will undergo once weekly PF24 infusion for 8 weeks in the WFBH Clinical Research Unit (CRU), and return for cognitive, physical, and biomarker testing 1 week and 5 weeks after receiving the last dose of PF24.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Geriatric participants with frailty
Arm Type
Experimental
Arm Description
Geriatric participants aged 65-80 who have a diagnosis of frailty (Fried Frailty score of 3 or greater). Experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days).
Arm Title
Geriatric participants with HFpEF
Arm Type
Experimental
Arm Description
Geriatric participants aged 65-80 who have a diagnosis of HFpEF. Experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days).
Intervention Type
Biological
Intervention Name(s)
Allogeneic Young Plasma
Other Intervention Name(s)
PF24
Intervention Description
The experimental dosing will consist of once weekly administration of PF24 over a period of 8 consecutive weeks (8 total doses over 56 days). 250 mL single units of PF24 will be obtained from the South Texas Blood Bank and processed by the WFBH Blood Bank. 1 unit (250 mL) PF24, will be infused at 1 mL/kg/hr, once weekly for 8 consecutive weeks.
Primary Outcome Measure Information:
Title
Frequency of adverse events
Description
The primary outcomes of this phase 0 study are built upon evaluating the outcome of safety with administering plasma (PF24) acquired from donors of a young chronological age intravenously to older adults at WFBMC, as evidenced by lack of any grade 4-5 adverse events and >/=50% grade 3-4 adverse events, as defined by NCI CTCAE v5.0. Grade 1-2 events will be recorded for statistical purposes.
Time Frame
Post 5 weeks after the last infusion of plasma
Secondary Outcome Measure Information:
Title
Study participant retention
Description
Secondary outcomes include indicators of feasibility as assessed by measuring study participant retention >/= 80%
Time Frame
Post 5 weeks after the last infusion of plasma
Title
Study participants ability to complete the Fried Frailty Assessment
Description
Measurement of the Fried Frailty Score - The stages of frailty based on the Fried Frailty assessment criteria: a score of 0 means that a person is robust or not frail. Persons with a score of 1 or 2 are at intermediate risk for adverse outcomes or are considered to be pre-frail. A score of 3-5 indicates that someone is frail
Time Frame
Study endpoint weeks 11 and 15

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: English speaking elderly males and females, aged 65-80 years, referred by the Gerontology Department and the Cardiology Clinic of the Wake Forest Baptist Health Sticht Center for Aging. a score of 3 or greater (at least frail status) as demonstrated by the Fried Frailty criteria. Exclusion Criteria: Unable or unwilling to give informed consent in either study group Current psychiatric disorder not currently under control or being adequately treated Current consumption of more than 14 alcoholic drinks per week Self-reported inability to walk across a small room Residence in a nursing home Previous MOCA score below 21 Difficulty in communication with study personnel due to speech or hearing problems Other medical, psychiatric, or behavioral factors that in the judgment of the Principal Investigator may interfere with study participation or the ability to follow the intervention protocol Elective surgery, planned prior to signing consent Severe osteoarthritis Rheumatoid arthritis Severe B/L hip, knee, or hand pain (>7/10 on pain scale) Cancer requiring treatment in the past three years, except for non-melanoma skin cancers or cancers that have clearly been cured or in the opinion of the investigator carry an excellent prognosis (e.g., Stage 1 cervical cancer) Pulmonary disease including VQ mismatch/diffusion limitation, diminished inspired O2, hypoventilation, pulmonary fibrosis, or sarcoidosis Current tobacco use (smoke/chew) Currently prescribed corticosteroids Patients taking nucleoside analogues (Zebularine, 5-azaC, Decitabine) Patients on non-nucleoside analogues (Procaine, procainamide, hydralazine) History of an inherited bleeding disorder or vitamin K deficiency Cardiovascular disease (excluding HFpEF), clinically significant aortic stenosis, history of cardiac arrest, use of a cardiac defibrillator or uncontrolled angina. Parkinson's disease or other serious neurological disorder MMS score < 18 Renal disease (any stage, inappropriate for age; Cr Cl < 60) Hypoalbuminemia, with serum albumin level < 3.5 g/dL History of IgA deficiency History of hypersensitivity to frozen plasma (PF24) or to plasma-derived products including any plasma protein Active hepatitis or history of liver transplant Anemia or polycythemia: Male - Hgb level below 12 or above 17.5 g/dL and/or HCT of 41%-53%. Female: Hgb level below 10.0 or above 16.0 g/dL and/or HCT 36%-46% Current use of anti-coagulants History of DMI or DMII Peripheral vascular disease Brain aneurysm or intracranial hemorrhage within the past 6 months History of Hepatitis B, Hepatitis C, or HIV infection Other illness of such severity that life expectancy is considered to be less than 12 months Patients with initial VO2max that falls below expected value or that does not meet a minimum VO2max of 20 mL * kg * min (in order to demonstrate a more clinically meaningful increase) Uncontrolled hypertension (systolic blood pressure > 160 mmHg and/or diastolic blood pressure > 100 mmHg) CVA, hip fracture, B/L hip or knee replacement, or spinal surgery in the past 6 months Serious conduction disorder (e.g., 3rd degree heart block), uncontrolled arrhythmia, or new Q waves or ST-segment depressions (>3 mm) on ECG Myocardial infarction, major heart surgery (i.e., valve replacement or bypass surgery), stroke, deep vein thrombosis or pulmonary embolism in the past 6 months Undergoing physical therapy or cardiopulmonary rehabilitation Currently enrolled in another randomized trial involving lifestyle or pharmaceutical interventions Currently on an anaerobic/aerobic exercise plan Inability or unwillingness to return for all transfusions/FU visits
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shawn Johnson, D.O.., M.S.
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States

12. IPD Sharing Statement

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Study to Explore the Safety and Feasibility of Allogeneic Young Plasma Infusion in Older Adults

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