search
Back to results

Efficacy of Allogeneic UCMSCs for Treating Large Defects Knee Injury

Primary Purpose

Osteoarthritis, Knee

Status
Unknown status
Phase
Phase 2
Locations
Malaysia
Study Type
Interventional
Intervention
Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs)
Marrow cellution
Sponsored by
Cytopeutics Sdn. Bhd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee

Eligibility Criteria

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

Inclusion Criteria:

  1. Men and women aged between 18 and 65 years.
  2. Patients diagnosed to have ICRS Grade 3 or 4 cartilage lesions based on the MRI scans of the affected knee.
  3. Presence of knee swelling, pain, stiffness, or knee mechanical symptoms resulting from cartilage lesions.
  4. All subjects must also satisfy at least 1 of the following inclusion criteria.

    • Isolated knee articular cartilage lesion (single lesion) estimated to be ≥1.0 cm2 as demonstrated on MRI scanning.
    • Multiple knee articular cartilage lesions (multiple lesions) with at least 1 lesion estimated to be ≥1.0 cm2 as demonstrated on MRI scanning.
    • Bipolar cartilage defects demonstrated on MRI scanning with at least 1 articular surface lesion to be ≥1.0 cm2.
    • One or more cartilage defects involving the patella-femoral joint as demonstrated on MRI scanning with at least 1 lesion ≥1.0 cm2.
    • One or more cartilage defects involving the tibio-femoral joint as demonstrated on MRI scanning with at least 1 lesion ≥1.0 cm2.
    • Previously failed cartilage repair procedures (i.e., microfracture, osteochondral autograft transplantation surgery (OATS), ACI) within 6 months.

Exclusion Criteria:

  1. Preoperative flexion deformity greater than 10 degrees.
  2. Significant cognitive impairment, non-ambulatory status or lower extremities amputation other than toes, serious illness or medication affecting operative risk or wound healing (e.g., steroid intake, anticoagulation).
  3. Patient with high co-morbidity
  4. Higher risk for postsurgical (e.g., bleeding disorder or taking anticoagulants except low-dose aspirin) or postsurgical infection (e.g., taking immune-suppressants, have a severe infection or a history of serious infection).
  5. Significant peripheral vascular disease of the lower limbs as indicated by absent or substantially reduced dorsalis pedis or posterior tibial pulses.
  6. Contraindications to sub-chondral drilling surgery.
  7. Women who are pregnant or who are not able to use contraceptives
  8. Known hypersensitivity (allergy) to hyaluronate or antibodies used for postsurgical prophylaxis.
  9. Infections or skin disease affecting the area of the injection site or joint.
  10. Intra-articular injections of hyaluronic acid in the target knee within the past 6 months before screening.
  11. Intra-articular injections of corticosteroids in the target knee within the past 3 months before screening.
  12. In the opinion of the investigators, the subjects have difficulty understanding or complying with the protocol procedures or requirements including follow up.
  13. In the opinion of the investigators, the subject has any medical, psychiatric, or other condition for which the study would pose particular safety risks and/or unfavorably affect the risk-benefit balance of participation.
  14. Presence of metallic implants, clips, or devices in the brain, eye, or spinal canal or implanted devices that are magnetically programmed that may affect the ability to perform MRI MOCART scoring.
  15. Significant knee malalignment, varus or valgus deformity with more than 10 degrees, or instability associated with ligamentous knee injury.

Sites / Locations

  • Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM-UKM)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs)

Marrow cellution (standard treatment)

Arm Description

Patients will receive 25 x 10^6 of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) with standard treatment.

Patients will undergo marrow cellution surgical procedure.

Outcomes

Primary Outcome Measures

Recording of Adverse Events and Serious Adverse Events
International Knee Documentation Committee (IKDC) score
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Visual Analog Score (VAS)
Magnetic resonance imaging (MRI)
Immunohistochemistry (IHC)
IHC staining for generated cartilage

Secondary Outcome Measures

Full Information

First Posted
November 15, 2020
Last Updated
August 15, 2021
Sponsor
Cytopeutics Sdn. Bhd.
Collaborators
Universiti Kebangsaan Malaysia Medical Centre
search

1. Study Identification

Unique Protocol Identification Number
NCT05016011
Brief Title
Efficacy of Allogeneic UCMSCs for Treating Large Defects Knee Injury
Official Title
Phase IIb Study Assessing the Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells for Knee Cartilage Injury
Study Type
Interventional

2. Study Status

Record Verification Date
August 2021
Overall Recruitment Status
Unknown status
Study Start Date
July 1, 2020 (Actual)
Primary Completion Date
June 1, 2022 (Anticipated)
Study Completion Date
June 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cytopeutics Sdn. Bhd.
Collaborators
Universiti Kebangsaan Malaysia Medical Centre

4. Oversight

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

5. Study Description

Brief Summary
In terms of the surgical treatment of the cartilage injury, various techniques and ways are created to repair or regenerate articular surface of synovial joint following traumatic damage or degeneration of the cartilage. The option for surgical treatments based on the size and depth of the cartilage knee injury may include knee debridement, radiofrequency, drilling, microfracture, mosaicplasty, allogenic osteochondral transplantation and autologous chondrocyte transplantation. The first two techniques mentioned have been used in treating the cartilage knee injury involving the partial defects meanwhile the latter techniques have been used for Grade III and IV cartilage defects based on ICRS. However, most of the surgical options up only provide more of Type I collagen rather than Type II collagen. The available treatments are more symptomatic rather than preventive or regenerative. Stem cell has big potential in this area where it has ability to differentiate to cartilage. As allogeneic umbilical cord blood MSCs are readily available and can be administered immediately, this study therefore aims to prove the efficacy of allogeneic umbilical cord-derived mesenchymal stem cells (UC-MSCs) for treating large defects knee injury. The study is a prospective, randomized controlled, open label, phase IIb clinical trial, involving 50 patients with large defects of cartilage injury for follow-up duration of 24 months. Patients will be assigned into 2 arms; Arm A - 25 subjects will receive Chondrocell-EX (UC-MSCs) and Arm B - 25 subject will receive marrow cellution. All patients will undergo debridement prior to receiving their assigned treatment. The patients will be assessed on KOOS, IKDC, VAS and MRI.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs)
Arm Type
Experimental
Arm Description
Patients will receive 25 x 10^6 of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) with standard treatment.
Arm Title
Marrow cellution (standard treatment)
Arm Type
Active Comparator
Arm Description
Patients will undergo marrow cellution surgical procedure.
Intervention Type
Biological
Intervention Name(s)
Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs)
Other Intervention Name(s)
Chondrocell-EX
Intervention Description
Human umbilical cord-derived mesenchymal stem cells
Intervention Type
Procedure
Intervention Name(s)
Marrow cellution
Intervention Description
Patients will undergo marrow cellution surgical procedure.
Primary Outcome Measure Information:
Title
Recording of Adverse Events and Serious Adverse Events
Time Frame
24 months
Title
International Knee Documentation Committee (IKDC) score
Time Frame
24 months
Title
Knee Injury and Osteoarthritis Outcome Score (KOOS)
Time Frame
24 months
Title
Visual Analog Score (VAS)
Time Frame
24 months
Title
Magnetic resonance imaging (MRI)
Time Frame
24 months
Title
Immunohistochemistry (IHC)
Description
IHC staining for generated cartilage
Time Frame
12 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: Men and women aged between 18 and 65 years. Patients diagnosed to have ICRS Grade 3 or 4 cartilage lesions based on the MRI scans of the affected knee. Presence of knee swelling, pain, stiffness, or knee mechanical symptoms resulting from cartilage lesions. All subjects must also satisfy at least 1 of the following inclusion criteria. Isolated knee articular cartilage lesion (single lesion) estimated to be ≥1.0 cm2 as demonstrated on MRI scanning. Multiple knee articular cartilage lesions (multiple lesions) with at least 1 lesion estimated to be ≥1.0 cm2 as demonstrated on MRI scanning. Bipolar cartilage defects demonstrated on MRI scanning with at least 1 articular surface lesion to be ≥1.0 cm2. One or more cartilage defects involving the patella-femoral joint as demonstrated on MRI scanning with at least 1 lesion ≥1.0 cm2. One or more cartilage defects involving the tibio-femoral joint as demonstrated on MRI scanning with at least 1 lesion ≥1.0 cm2. Previously failed cartilage repair procedures (i.e., microfracture, osteochondral autograft transplantation surgery (OATS), ACI) within 6 months. Exclusion Criteria: Preoperative flexion deformity greater than 10 degrees. Significant cognitive impairment, non-ambulatory status or lower extremities amputation other than toes, serious illness or medication affecting operative risk or wound healing (e.g., steroid intake, anticoagulation). Patient with high co-morbidity Higher risk for postsurgical (e.g., bleeding disorder or taking anticoagulants except low-dose aspirin) or postsurgical infection (e.g., taking immune-suppressants, have a severe infection or a history of serious infection). Significant peripheral vascular disease of the lower limbs as indicated by absent or substantially reduced dorsalis pedis or posterior tibial pulses. Contraindications to sub-chondral drilling surgery. Women who are pregnant or who are not able to use contraceptives Known hypersensitivity (allergy) to hyaluronate or antibodies used for postsurgical prophylaxis. Infections or skin disease affecting the area of the injection site or joint. Intra-articular injections of hyaluronic acid in the target knee within the past 6 months before screening. Intra-articular injections of corticosteroids in the target knee within the past 3 months before screening. In the opinion of the investigators, the subjects have difficulty understanding or complying with the protocol procedures or requirements including follow up. In the opinion of the investigators, the subject has any medical, psychiatric, or other condition for which the study would pose particular safety risks and/or unfavorably affect the risk-benefit balance of participation. Presence of metallic implants, clips, or devices in the brain, eye, or spinal canal or implanted devices that are magnetically programmed that may affect the ability to perform MRI MOCART scoring. Significant knee malalignment, varus or valgus deformity with more than 10 degrees, or instability associated with ligamentous knee injury.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sze Piaw Chin
Phone
+60386881098
Email
research@cytopeutics.com
First Name & Middle Initial & Last Name or Official Title & Degree
Siti Maizatul Syafinaz Mohd Shahadin
Phone
+60386881098
Email
sitimaizatul@cytopeutics.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Badrul Akmal Hisham Md Yusoff
Organizational Affiliation
Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM-UKM)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Canselor Tuanku Muhriz Universiti Kebangsaan Malaysia (HCTM-UKM)
City
Bandar Tun Razak
State/Province
Wilayah Persekutuan Kuala Lumpur
ZIP/Postal Code
56000
Country
Malaysia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mohd Saperi Zool Kipele
Email
saperi1567@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy of Allogeneic UCMSCs for Treating Large Defects Knee Injury

We'll reach out to this number within 24 hrs