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Angiographic Delivery of AD-MSC for Ulcerative Colitis

Primary Purpose

Ulcerative Colitis

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Adipose derived, autologous mesenchymal stem cells
Sponsored by
Mayo Clinic
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis

Eligibility Criteria

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

Inclusion Criteria:

  • Males and Females 18-65 years of age.
  • Moderate to Severe medically refractory inflammatory ulcerative colitis:

    • as defined by a an Adapted Mayo Score of 5to 9 points
    • including an endoscopic sub-score of 2 or 3
  • Concurrent therapies with corticosteroids, 5-ASA drugs, thiopurines, MTX, antibiotics, anti-TNF, and anti-integrin therapy are permitted.
  • To meet the definition of refractory UC, all patients must have failed at least 2 standard FDA approved medications for the treatment of UC

    • Current standard therapy includes 5-ASA products, thiopurines, anti-TNF therapy, ustekinemab, vedolizumab, and tofacitinib (i.e. all FDA approved therapies for UC).
    • Refractory and failure to response is defined as continued symptoms despite 12 weeks of therapy at FDA approved doses by product necessitating change in medical strategy or referral for colectomy.
  • All patients should have undergone a colonoscopy in last 12 months to rule out malignant or premalignant condition
  • Female subjects that are of child bearing potential must to agree to use effective contraception method(s) for the duration of the study
  • Hemoglobin must be greater than 8
  • INR must be less than 1.5
  • Ability to comply with protocol
  • Competent and able to provide written informed consent

Exclusion Criteria:

  • Inability to give informed consent.
  • Clinically significant medical conditions within the six months before administration of MSCs: e.g. myocardial infarction, active angina, congestive heart failure or other conditions that would, in the opinion of the investigators, compromise the safety of the patient.
  • Specific exclusions; Known history of hepatitis B, C, or HIV
  • Patients that have had a partial colectomy
  • Patients that have underlying vasculitis or have been diagnosed with an underlying condition that predisposes to developing blood clots.
  • History of cancer including melanoma (with the exception of localized skin cancers)
  • Investigational drug within thirty (30) days of baseline
  • History of clinically significant auto-immunity (other than UC) or any previous example of fat-directed autoimmunity. Note that auto-immmunity is defined as a systemic immune mediated disease for which the antigen is known or unknown. Autoimmune diseases other than UC are excluded. Extraintestinal manifestations of UC (specifically joint inflammation, eye inflammation, PSC, skin manifestations- i.e. pyoderma gangrenosum, erythema nodosum) will be allowable.
  • Allergic to local anesthetics
  • Pregnant patients or trying to become pregnant or breast feeding.
  • Neoplasia of the colon and preoperative biopsy
  • C. Difficile infection within 30 days of study injection
  • Diagnosis of indeterminate colitis or suspicion of CD
  • Subjects with fulminant colitis, toxic megacolon, with ostomy, or ileoanal pouch
  • History or demonstration of pathology related to adipose tissue
  • Any other indication determined by the PI to be counter indicated for participation on this trial.

Sites / Locations

  • Mayo Clinic in RochesterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Autologous mesenchymal stem cells

Arm Description

Adipose derived, autologous mesenchymal stem cells (AD-MSCs) at a dose of 15 million or 30 million cells will be administered via intra-arterial delivery with interventional radiology to the inferior mesenteric artery in subjects with medically refractory ulcerative colitis.

Outcomes

Primary Outcome Measures

Number of participants with treatment-related adverse events
Evaluate safety by assessment of adverse events defined as worsening (change in nature, severity, or frequency of bowel movements, bleeding per rectum, or tenesmus) of UC present at the time of the study, intercurrent illnesses, abnormal laboratory values (this includes clinically significant shifts from baseline within the range of normal that the investigator considers to be clinically significant) or clinically significant abnormalities in physical examination, vital signs, weight, frequency of bloody stools or change in stools.

Secondary Outcome Measures

Number of participants with mucosal healing
Mucosal appearance at endoscopy via Adapted Mayo Score (defined as score of 0 or 1)
Number of participants with clinical symptom response
To assess the clinical symptom response of luminal healing induced by the intra-arterial delivery of autologous AD-MSCs for the treatment of UC. Using the validated via Adapted Mayo Score (decrease from Baseline ≥ 2 points and ≥ 30%, including a decrease in rectal bleeding sub-score ≥ 1 or an absolute rectal bleeding sub-score ≤ 1)
Number of participants with improved healing on pathology
Histopathology: Improved healing on surgical pathology (colectomy specimen or post-intervention colonic biopsies) as compared to pre-operative endoscopic biopsies

Full Information

First Posted
March 14, 2020
Last Updated
October 2, 2023
Sponsor
Mayo Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT04312113
Brief Title
Angiographic Delivery of AD-MSC for Ulcerative Colitis
Official Title
A Phase I Single Site Open Label Study of Intra-arterial Delivery of Mesenchymal Stem Cells for Luminal Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 16, 2020 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Mayo Clinic

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
Researchers are trying to determine the safety and feasibility of using an adipose derived mesenchymal stem cell (MSC) to treat people with Ulcerative Colitis.
Detailed Description
Participants will undergo screening for study, if eligible, participants will be dosed with 15 million or 30 million cells will be administered via IA delivery with interventional radiology. Participant study visits after study intervention includes visits on: Day 1, Week 1, Week 2, Week 8, Week 24, Week 52, and Week 104.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Autologous mesenchymal stem cells
Arm Type
Experimental
Arm Description
Adipose derived, autologous mesenchymal stem cells (AD-MSCs) at a dose of 15 million or 30 million cells will be administered via intra-arterial delivery with interventional radiology to the inferior mesenteric artery in subjects with medically refractory ulcerative colitis.
Intervention Type
Drug
Intervention Name(s)
Adipose derived, autologous mesenchymal stem cells
Other Intervention Name(s)
AD-MSC
Intervention Description
Fat tissue will be enzymatically treated and cells will be cultured until a sufficient number are obtained for the treatment protocol.
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events
Description
Evaluate safety by assessment of adverse events defined as worsening (change in nature, severity, or frequency of bowel movements, bleeding per rectum, or tenesmus) of UC present at the time of the study, intercurrent illnesses, abnormal laboratory values (this includes clinically significant shifts from baseline within the range of normal that the investigator considers to be clinically significant) or clinically significant abnormalities in physical examination, vital signs, weight, frequency of bloody stools or change in stools.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Number of participants with mucosal healing
Description
Mucosal appearance at endoscopy via Adapted Mayo Score (defined as score of 0 or 1)
Time Frame
6 months
Title
Number of participants with clinical symptom response
Description
To assess the clinical symptom response of luminal healing induced by the intra-arterial delivery of autologous AD-MSCs for the treatment of UC. Using the validated via Adapted Mayo Score (decrease from Baseline ≥ 2 points and ≥ 30%, including a decrease in rectal bleeding sub-score ≥ 1 or an absolute rectal bleeding sub-score ≤ 1)
Time Frame
24 months
Title
Number of participants with improved healing on pathology
Description
Histopathology: Improved healing on surgical pathology (colectomy specimen or post-intervention colonic biopsies) as compared to pre-operative endoscopic biopsies
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and Females 18-65 years of age. Moderate to Severe medically refractory inflammatory ulcerative colitis: as defined by a an Adapted Mayo Score of 5to 9 points including an endoscopic sub-score of 2 or 3 Concurrent therapies with corticosteroids, 5-ASA drugs, thiopurines, MTX, antibiotics, anti-TNF, and anti-integrin therapy are permitted. To meet the definition of refractory UC, all patients must have failed at least 2 standard FDA approved medications for the treatment of UC Current standard therapy includes 5-ASA products, thiopurines, anti-TNF therapy, ustekinemab, vedolizumab, and tofacitinib (i.e. all FDA approved therapies for UC). Refractory and failure to response is defined as continued symptoms despite 12 weeks of therapy at FDA approved doses by product necessitating change in medical strategy or referral for colectomy. All patients should have undergone a colonoscopy in last 12 months to rule out malignant or premalignant condition Female subjects that are of child bearing potential must to agree to use effective contraception method(s) for the duration of the study Hemoglobin must be greater than 8 INR must be less than 1.5 Ability to comply with protocol Competent and able to provide written informed consent Exclusion Criteria: Inability to give informed consent. Clinically significant medical conditions within the six months before administration of MSCs: e.g. myocardial infarction, active angina, congestive heart failure or other conditions that would, in the opinion of the investigators, compromise the safety of the patient. Specific exclusions; Known history of hepatitis B, C, or HIV Patients that have had a partial colectomy Patients that have underlying vasculitis or have been diagnosed with an underlying condition that predisposes to developing blood clots. History of cancer including melanoma (with the exception of localized skin cancers) Investigational drug within thirty (30) days of baseline History of clinically significant auto-immunity (other than UC) or any previous example of fat-directed autoimmunity. Note that auto-immmunity is defined as a systemic immune mediated disease for which the antigen is known or unknown. Autoimmune diseases other than UC are excluded. Extraintestinal manifestations of UC (specifically joint inflammation, eye inflammation, PSC, skin manifestations- i.e. pyoderma gangrenosum, erythema nodosum) will be allowable. Allergic to local anesthetics Pregnant patients or trying to become pregnant or breast feeding. Neoplasia of the colon and preoperative biopsy C. Difficile infection within 30 days of study injection Diagnosis of indeterminate colitis or suspicion of CD Subjects with fulminant colitis, toxic megacolon, with ostomy, or ileoanal pouch History or demonstration of pathology related to adipose tissue Any other indication determined by the PI to be counter indicated for participation on this trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Erin Kammer
Phone
507-538-0678
Email
kammer.erin@mayo.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
William Faubion, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic in Rochester
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
https://www.mayo.edu/research/clinical-trials
Description
Mayo Clinic Clinical Trials

Learn more about this trial

Angiographic Delivery of AD-MSC for Ulcerative Colitis

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