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Allogeneic Amniotic Mesenchymal Stem Cell Therapy for Lupus Nephritis

Primary Purpose

Lupus Nephritis, Mesenchymal Stem Cells

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
human amniotic mesenchymal stem cell
Sponsored by
Yan'an Affiliated Hospital of Kunming Medical University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lupus Nephritis focused on measuring Lupus Nephritis, Human Amniotic Mesenchymal Stem Cell, cell therapy, clinical trail

Eligibility Criteria

14 Years - 60 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Enrollment criteria:

  • Adult patients (age 14-60 years) who were diagnosed as lupus nephritis, regardless of gender, uncontrolled disease course;
  • Pathological examination of puncture biopsy resulting in diagnosis of type II, III, or IV lupus nephritis;
  • SLEDAI score >8;
  • proteinuria greater than 1 g/day and active urinary sediments;
  • Lupus nephritis treatment according to guidelines and norms before human amniotic mesenchymal stem cells therapy;
  • If there is a possibility of pregnancy in female, must be negative pregnancy test, not in lactation, and confirm that is receiving the method of contraception recognized by the researchers, and agree to maintain the method of contraception throughout the study. Sexually active male patients must agree to the use of an appropriate contraceptive method for birth control from the first administration of the study treatment until 24 weeks after the last administration.
  • The subjects should be fully informed, voluntarily sign the informed consent, and agree to participate in all visits, examinations, and treatments as required by the experimental protocol.

Exclusion criteria:

  • Patients with kidney biopsy diagnosis of type I, VI lupus nephritis or a diagnosis of another glomerular disease;
  • Patients with abnormal renal function (serum creatinine ≥ the upper limit of normal);
  • Patients with active liver disease or abnormal liver function test results (ALT or AST ≥2 times the upper limit of normal);
  • Patients with blood leukocyte count <2.5 × 109/L, hemoglobin <90 g/L, platelet count <100 × 109/L, or those who have other hematologic diseases (severe anemia, idiopathic thrombocytopenic purpura, splenomegaly, coagulation dysfunction, etc.);
  • Patients with serious and unstable cardiovascular or cerebrovascular diseases (unstable angina pectoris, coronary artery disease, cerebrovascular disease, transient ischemic attack, congestive heart failure, etc.), acute and difficult to control the disease, after treatment has not been effectively controlled severe hypertension (blood pressure >160/100 mm Hg), or organ transplantation;
  • Patients with uncontrolled infection;
  • Patients with tumors or abnormal tumor marker levels; 8. Patients with blood-borne diseases (i.e., HIV, syphilis, hepatitis B, and hepatitis C);
  • Pregnancy, the potential for pregnancy, or lactation;
  • Patients with a history of allergy, especially patients allergic to human blood albumin;
  • Patients with mental illness affecting their voluntarism, ability to make decisions, and ability to communicate;
  • A history of alcoholism or known drug addiction in the last 2 years;
  • Participation in another clinical trial within the last 3 months;
  • Patients judged inappropriate for this study by the physicians.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    No Intervention

    Arm Label

    human amniotic mesenchymal stem cell treatment group

    blank control group

    Arm Description

    Outcomes

    Primary Outcome Measures

    Incidence of Adverse Events
    The patient's discomfort and clinical symptoms during the study were recorded, as well as the related laboratory test indicators and physical examination abnormalities of the subjects during the study. Describe the association with Amniotic mesenchymal stem cell therapy and calculate the incidence of treatment-related acute and chronic adverse events.

    Secondary Outcome Measures

    Changes in 24h urine protein quantification before and after treatment;
    24-hour urinary protein quantification from baseline to 60 weeks of treatment.
    Changes in eGFR before and after treatment;
    changes in estimated glomerular filtration rate (eGFR) from baseline to 60 weeks of treatment.
    Changes in SLEDAI score before and after treatment;
    changes in SLEDAI score from baseline to 60 weeks of treatment. SLEDAI score: 0~4 points basically no activity;5-9 minutes light activity;10-14 minutes of moderate activity;≥15 minutes of severe activity.

    Full Information

    First Posted
    March 11, 2020
    Last Updated
    March 20, 2020
    Sponsor
    Yan'an Affiliated Hospital of Kunming Medical University
    Collaborators
    The First People's Hospital of Yunnan
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04318600
    Brief Title
    Allogeneic Amniotic Mesenchymal Stem Cell Therapy for Lupus Nephritis
    Official Title
    Allogeneic Amniotic Mesenchymal Stem Cell Therapy for Lupus Nephritis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    January 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    January 1, 2014 (Actual)
    Primary Completion Date
    March 1, 2017 (Actual)
    Study Completion Date
    January 1, 2019 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Yan'an Affiliated Hospital of Kunming Medical University
    Collaborators
    The First People's Hospital of Yunnan

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This study would further evaluate the safety and efficacy of human amniotic mesenchymal stem cell (hA-MSC) for the treatment of lupus nephritis (LN).
    Detailed Description
    Eleven patients with WHO class III, IV or V LN were given hA-MSC (Peripheral intravenous infusion, dose 1×106/kg cells, once every month for three times). At the same time, five patients with LN who were not given hA-MSC as the blank control group. All patients did not received intravenous corticosteroids pulse therapy, but the use of oral corticosteroids and intravenous cyclophosphamide, or oral mycophenolate mofetil, tacrolimus , leflunomide were allowed.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Lupus Nephritis, Mesenchymal Stem Cells
    Keywords
    Lupus Nephritis, Human Amniotic Mesenchymal Stem Cell, cell therapy, clinical trail

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Masking
    Participant
    Allocation
    Non-Randomized
    Enrollment
    16 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    human amniotic mesenchymal stem cell treatment group
    Arm Type
    Experimental
    Arm Title
    blank control group
    Arm Type
    No Intervention
    Intervention Type
    Drug
    Intervention Name(s)
    human amniotic mesenchymal stem cell
    Intervention Description
    human amniotic mesenchymal stem cell (hA-MSC) for the treatment of lupus nephritis patients with WHO class III, IV or V LN were given hA-MSC (Peripheral intravenous infusion, dose 1×106/kg cells, once every month for three times).
    Primary Outcome Measure Information:
    Title
    Incidence of Adverse Events
    Description
    The patient's discomfort and clinical symptoms during the study were recorded, as well as the related laboratory test indicators and physical examination abnormalities of the subjects during the study. Describe the association with Amniotic mesenchymal stem cell therapy and calculate the incidence of treatment-related acute and chronic adverse events.
    Time Frame
    60 weeks
    Secondary Outcome Measure Information:
    Title
    Changes in 24h urine protein quantification before and after treatment;
    Description
    24-hour urinary protein quantification from baseline to 60 weeks of treatment.
    Time Frame
    60 weeks
    Title
    Changes in eGFR before and after treatment;
    Description
    changes in estimated glomerular filtration rate (eGFR) from baseline to 60 weeks of treatment.
    Time Frame
    60 weeks
    Title
    Changes in SLEDAI score before and after treatment;
    Description
    changes in SLEDAI score from baseline to 60 weeks of treatment. SLEDAI score: 0~4 points basically no activity;5-9 minutes light activity;10-14 minutes of moderate activity;≥15 minutes of severe activity.
    Time Frame
    60 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    14 Years
    Maximum Age & Unit of Time
    60 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Enrollment criteria: Adult patients (age 14-60 years) who were diagnosed as lupus nephritis, regardless of gender, uncontrolled disease course; Pathological examination of puncture biopsy resulting in diagnosis of type II, III, or IV lupus nephritis; SLEDAI score >8; proteinuria greater than 1 g/day and active urinary sediments; Lupus nephritis treatment according to guidelines and norms before human amniotic mesenchymal stem cells therapy; If there is a possibility of pregnancy in female, must be negative pregnancy test, not in lactation, and confirm that is receiving the method of contraception recognized by the researchers, and agree to maintain the method of contraception throughout the study. Sexually active male patients must agree to the use of an appropriate contraceptive method for birth control from the first administration of the study treatment until 24 weeks after the last administration. The subjects should be fully informed, voluntarily sign the informed consent, and agree to participate in all visits, examinations, and treatments as required by the experimental protocol. Exclusion criteria: Patients with kidney biopsy diagnosis of type I, VI lupus nephritis or a diagnosis of another glomerular disease; Patients with abnormal renal function (serum creatinine ≥ the upper limit of normal); Patients with active liver disease or abnormal liver function test results (ALT or AST ≥2 times the upper limit of normal); Patients with blood leukocyte count <2.5 × 109/L, hemoglobin <90 g/L, platelet count <100 × 109/L, or those who have other hematologic diseases (severe anemia, idiopathic thrombocytopenic purpura, splenomegaly, coagulation dysfunction, etc.); Patients with serious and unstable cardiovascular or cerebrovascular diseases (unstable angina pectoris, coronary artery disease, cerebrovascular disease, transient ischemic attack, congestive heart failure, etc.), acute and difficult to control the disease, after treatment has not been effectively controlled severe hypertension (blood pressure >160/100 mm Hg), or organ transplantation; Patients with uncontrolled infection; Patients with tumors or abnormal tumor marker levels; 8. Patients with blood-borne diseases (i.e., HIV, syphilis, hepatitis B, and hepatitis C); Pregnancy, the potential for pregnancy, or lactation; Patients with a history of allergy, especially patients allergic to human blood albumin; Patients with mental illness affecting their voluntarism, ability to make decisions, and ability to communicate; A history of alcoholism or known drug addiction in the last 2 years; Participation in another clinical trial within the last 3 months; Patients judged inappropriate for this study by the physicians.

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    35412950
    Citation
    Naeem A, Gupta N, Naeem U, Khan MJ, Elrayess MA, Cui W, Albanese C. A comparison of isolation and culture protocols for human amniotic mesenchymal stem cells. Cell Cycle. 2022 Aug;21(15):1543-1556. doi: 10.1080/15384101.2022.2060641. Epub 2022 Apr 12.
    Results Reference
    derived

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    Allogeneic Amniotic Mesenchymal Stem Cell Therapy for Lupus Nephritis

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