Treating Congestive HF With hiPSC-CMs Through Endocardial Injection
Primary Purpose
Cardiovascular Diseases, Congestive Heart Failure, Dilated Cardiomyopathy
Status
Recruiting
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
hiPSC-CM therapy
Sponsored by
About this trial
This is an interventional treatment trial for Cardiovascular Diseases focused on measuring induced pluripotent stem cell, Congestive heart failure, Regenerative medicine, dilated cardiomyopathy
Eligibility Criteria
Inclusion Criteria:
- Patients aged 18-75 years (including 18 and 75).
- Signed the informed consent.
- Patients with congestive heart failure who have received regular treatment for heart failure.
- New York Heart Association (NYHA) Class III or IV despite optimal standard of care
- Left Ventricular Ejection Fraction (LVEF)<40% as assessed by echocardiography ( measure in the 3 months of recruit is included, excluding the measured values within 1 month of myocardial infarction )
- The thickness of left ventricular ≥8mm
- Female patient who is not pregnant or nursing during the clinical trial
Exclusion Criteria:
- PRA ≥ 20% or DSA positive.
- Patients received treatments such as pacemakers, ICD or CRT device.
- Patient with severe valvular disease or presence of a mechanical valve replacement, such as PCI implantation, or patients requiring simultaneous radiofrequency ablation of atrial fibrillation.
- Patient with any therapeutic traumatic heart surgery within 30 days.
- Hemodynamic instability or cardiogenic shock.
- Right heart failure.
- Restrictive cardiomyopathy such as amyloidosis, sarcoidosis or hematochromia, constrictive pericarditis.
- Myocardial infarction occurred within 30 days or stroke occurred within 60 days before enrollment.
- Thickness at left ventricular free wall infarction < 6 mm.
- Severe ventricular arrhythmias (persistent ventricular tachycardia or other conditions that the investigator considers necessary to exclude).
- Baseline glomerular filtration rate < 30 ml/min / 1.73 m2.
- Abnormal liver function: ALT or AST 3 times higher than the normal value.
- Have a hematologic abnormality as evidenced by hematocrit < 25%, white blood cells count <2,500/ul or platelet count <100000 / ul.
- Known allergies to penicillin, streptomycin or radiocontrast agent.
- Abnormal coagulation function, INR > 1.3, which cannot be corrected.
- Contra-indication to performance of a magnetic resonance imaging scan and PET/ECT examinations.
- Organ transplant recipient
- Patients with other malignant disease within 5 years prior to enrollment.
- Non-cardiac condition that limits lifespan to < 1 year
- On chronic therapy with immunosuppressant medication such as glucocorticoid or TNFα antagonist
- Contra-indication to take immunosuppressant medication.
- Serum positive for infectious diseases (HIV, HBV, HCV, TP).
- Participated in other clinical trials within the previous 3 months .
- Female patient who is pregnant or nursing.
- Other condition that the investigator considers inappropriate for participation in the study.
Sites / Locations
- Help TherapeuticsRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
hiPSC-CM therapy low dosage
hiPSC-CM therapy high dosage
Arm Description
Outcomes
Primary Outcome Measures
Incidence of major serious adverse events (SAEs)
Incidence of SAEs is defined as the composite of: death, fatal myocardial infarction, stroke, tamponade, cardiac perforation, ventricular arrhythmias affecting hemodynamics (> 15s), and tumorigenicity related to the hiPSC-CM .
Secondary Outcome Measures
Incidence of severe arrhythmia
Clinically significant arrhythmias will be recorded by 24-hour ambulatory electrocardiogram
Incidence of newly formed tumors
by comparing chest, abdominal and pelvic CT scan and PET-CT scan
Changes in penal reactive antibodies (PRA)
Changes in penal reactive antibodies (PRA) as assessed via blooddraw
Changes in donor specific antibodies (DSA)
Changes in donor specific antibodies (DSA) as assessed via blooddraw
Overall Left Ventricular systolic performance as assessed by MRI
Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDV), left ventricular end-systolic dimension (LVESV), evaluated and compared to baseline values.
Overall Left Ventricular systolic performance as assessed by PET/ECT Scan
Myocardial contraction and relaxation and myocardial perfusion, evaluated and compared to baseline values.
Functional status by 6 minute walk test
valuate Functional Capacity via the Six Minute Walk Test
Functional status by New York Heart Association (NYHA) Classification
Evaluate Functional Capacity via New York Heart Association (NYHA) Class Determination
Minnesota Living With Heart Failure Questionnaire (MLHFQ)
Evaluate Quality Of Life Changes via Minnesota Living with Heart Failure (MLHF). The Maximum possible scores being 105 and the minimum 0. Higher scores indicate a worse or worsening quality of life, while lower scores or decreasing scores indicate a better quality of life.
Full Information
NCT ID
NCT04982081
First Posted
July 1, 2021
Last Updated
September 22, 2022
Sponsor
Help Therapeutics
Collaborators
Xijing Hospital
1. Study Identification
Unique Protocol Identification Number
NCT04982081
Brief Title
Treating Congestive HF With hiPSC-CMs Through Endocardial Injection
Official Title
Treating Congestive Heart Failure Patients With Human iPSC-derived Cardiomyocytes Through Catheter-based Endocardial Injection
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 21, 2021 (Actual)
Primary Completion Date
December 30, 2022 (Anticipated)
Study Completion Date
July 31, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Help Therapeutics
Collaborators
Xijing Hospital
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
Heart failure is the primary cause of morbidity and mortality worldwide. Currently drug treatments for heart failure manage the symptoms, but not restore the loss cardiomyocytes due to the very limited regenerative capability in the adult heart. Novel reparative therapies that replace the cardiomyocytes loss are highly demanded to restore the cardiac function. The main purposes of this explanatory study is to investigate the safety and efficacy of the catheter-based endocardial delivery of human iPSC-derived cardiomyocytes in patients with congestive heart failure.
Detailed Description
Patients with severe congestive heart failure will be treated with allogeneic human iPSC-derived cardiomyocytes (HiCM-188) through the catheter-based injections. HiCM188, produced by Help therapeutics with cGMP condition, will be transplanted into the myocardium through a transcatheter endocardial injection system with two dosage (100 million cells or 400 million cells). The safety and efficacy assessments will be conducted at1, 3, 6 and 12 months after the cell transplantation.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cardiovascular Diseases, Congestive Heart Failure, Dilated Cardiomyopathy
Keywords
induced pluripotent stem cell, Congestive heart failure, Regenerative medicine, dilated cardiomyopathy
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
hiPSC-CM therapy low dosage
Arm Type
Experimental
Arm Title
hiPSC-CM therapy high dosage
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
hiPSC-CM therapy
Intervention Description
20 patients with congestive heart failure who met the inclusion and exclusion criteria will be recruited. After being fully informed and signed the informed consent, the patients will be randomly divided into two dosage groups: 100 million cells (10 patients) and 400 million cells (10 patients). Human iPSC-derived cardiomyocytes will be injected into the myocardium through a transcatheter endocardial injection system.
Primary Outcome Measure Information:
Title
Incidence of major serious adverse events (SAEs)
Description
Incidence of SAEs is defined as the composite of: death, fatal myocardial infarction, stroke, tamponade, cardiac perforation, ventricular arrhythmias affecting hemodynamics (> 15s), and tumorigenicity related to the hiPSC-CM .
Time Frame
First month post-catheterization
Secondary Outcome Measure Information:
Title
Incidence of severe arrhythmia
Description
Clinically significant arrhythmias will be recorded by 24-hour ambulatory electrocardiogram
Time Frame
1-6 months post-catheterization
Title
Incidence of newly formed tumors
Description
by comparing chest, abdominal and pelvic CT scan and PET-CT scan
Time Frame
Baseline, 1,3,6 and 12 months post-catheterization
Title
Changes in penal reactive antibodies (PRA)
Description
Changes in penal reactive antibodies (PRA) as assessed via blooddraw
Time Frame
Baseline, 1, 3 and 6 months post-catheterization
Title
Changes in donor specific antibodies (DSA)
Description
Changes in donor specific antibodies (DSA) as assessed via blooddraw
Time Frame
Baseline, 1, 3 and 6 months post-catheterization
Title
Overall Left Ventricular systolic performance as assessed by MRI
Description
Left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDV), left ventricular end-systolic dimension (LVESV), evaluated and compared to baseline values.
Time Frame
Baseline, 1, 3, 6 and 12 months post-catheterization
Title
Overall Left Ventricular systolic performance as assessed by PET/ECT Scan
Description
Myocardial contraction and relaxation and myocardial perfusion, evaluated and compared to baseline values.
Time Frame
Baseline, 6 and 12 months post-catheterization
Title
Functional status by 6 minute walk test
Description
valuate Functional Capacity via the Six Minute Walk Test
Time Frame
Baseline, 1,3,6 and 12 months post-catheterization
Title
Functional status by New York Heart Association (NYHA) Classification
Description
Evaluate Functional Capacity via New York Heart Association (NYHA) Class Determination
Time Frame
Baseline, 1,3,6 and 12 months post-catheterization
Title
Minnesota Living With Heart Failure Questionnaire (MLHFQ)
Description
Evaluate Quality Of Life Changes via Minnesota Living with Heart Failure (MLHF). The Maximum possible scores being 105 and the minimum 0. Higher scores indicate a worse or worsening quality of life, while lower scores or decreasing scores indicate a better quality of life.
Time Frame
Baseline, 1,3,6 and 12 months post-catheterization
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients aged 18-75 years (including 18 and 75).
Signed the informed consent.
Patients with congestive heart failure who have received regular treatment for heart failure.
New York Heart Association (NYHA) Class III or IV despite optimal standard of care
Left Ventricular Ejection Fraction (LVEF)<40% as assessed by echocardiography ( measure in the 3 months of recruit is included, excluding the measured values within 1 month of myocardial infarction )
The thickness of left ventricular ≥8mm
Female patient who is not pregnant or nursing during the clinical trial
Exclusion Criteria:
PRA ≥ 20% or DSA positive.
Patients received treatments such as pacemakers, ICD or CRT device.
Patient with severe valvular disease or presence of a mechanical valve replacement, such as PCI implantation, or patients requiring simultaneous radiofrequency ablation of atrial fibrillation.
Patient with any therapeutic traumatic heart surgery within 30 days.
Hemodynamic instability or cardiogenic shock.
Right heart failure.
Restrictive cardiomyopathy such as amyloidosis, sarcoidosis or hematochromia, constrictive pericarditis.
Myocardial infarction occurred within 30 days or stroke occurred within 60 days before enrollment.
Thickness at left ventricular free wall infarction < 6 mm.
Severe ventricular arrhythmias (persistent ventricular tachycardia or other conditions that the investigator considers necessary to exclude).
Baseline glomerular filtration rate < 30 ml/min / 1.73 m2.
Abnormal liver function: ALT or AST 3 times higher than the normal value.
Have a hematologic abnormality as evidenced by hematocrit < 25%, white blood cells count <2,500/ul or platelet count <100000 / ul.
Known allergies to penicillin, streptomycin or radiocontrast agent.
Abnormal coagulation function, INR > 1.3, which cannot be corrected.
Contra-indication to performance of a magnetic resonance imaging scan and PET/ECT examinations.
Organ transplant recipient
Patients with other malignant disease within 5 years prior to enrollment.
Non-cardiac condition that limits lifespan to < 1 year
On chronic therapy with immunosuppressant medication such as glucocorticoid or TNFα antagonist
Contra-indication to take immunosuppressant medication.
Serum positive for infectious diseases (HIV, HBV, HCV, TP).
Participated in other clinical trials within the previous 3 months .
Female patient who is pregnant or nursing.
Other condition that the investigator considers inappropriate for participation in the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jiaxian Wang, MD, PhD
Phone
+86-18565616060
Email
wangjx@helptx.com.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ling Tao, MD, PhD
Organizational Affiliation
Xijing Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Help Therapeutics
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210000
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jiaxian Wang, MD,PhD
Phone
+8618565616060
Email
wangjx@helpsci.com.cn
First Name & Middle Initial & Last Name & Degree
Ling Tao, MD
12. IPD Sharing Statement
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Treating Congestive HF With hiPSC-CMs Through Endocardial Injection
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