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Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles Infusion Treatment for ARDS (EXIT-ARDS)

Primary Purpose

ARDS, Human

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles
Saline
Sponsored by
Direct Biologics, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for ARDS, Human focused on measuring ExoFlo, EXIT-ARDS, ARDS, Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles, Direct Biologics

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Provision of signed and dated informed consent form (either by the individual or by the individual's healthcare proxy).
  2. Stated willingness to comply with all study procedures and availability for the duration of the study
  3. Male or female aged 18-85.
  4. Moderate to severe ARDS as defined by modified Berlin definition (See Section 2.2.1), which includes timing within 1 week of known clinical insult or new or worsening respiratory symptoms; bilateral opacities not fully explained by effusions, or lung collapse; respiratory failure not fully explained by cardiac failure or fluid overload; PaO2/FiO2 ≤ 200 mm Hg.
  5. Hypoxia requiring noninvasive oxygen support such as Nasal Cannula (NC), Nonrebreather (NRB), Bilevel Positive Airway Pressure (BIPAP), Continuous Positive Airway Pressure (CPAP), high flow nasal cannula oxygen (HFNC O2) or mechanical ventilation (MV) despite initiating standard of care.
  6. If the candidate is either a male or female of reproductive potential, he or she must agree to use of double barrier method of highly effective birth control contraception such as condoms with oral contraceptive pill or choose to remain abstinent if already practicing abstinence during the screening period. The required duration of usage of double barrier method OR maintenance of abstinence must include the time from the beginning of the screening period until 90 days following the last dose of the study treatment.

Exclusion Criteria:

  1. Vulnerable populations such as pregnant patients, children, individuals with severe physical or mental disabilities who cannot provide meaningful consent.
  2. Active malignancy requiring treatment within the last five years.
  3. Major physical trauma in the last 2 days, including motor vehicle accidents, assaults, mechanical falls with sequelae of significant bleeding or craniofacial bruising, and surgeries, such that not one or more injury may be undiagnosed at time of screening.
  4. Diagnosis or suspected diagnosis of sepsis without basic microbiology cultures (urinalysis, urine culture, two sets of blood cultures, respiratory culture, at least a standard respiratory viral panel PCR) being collected prior to screening. (Note: Standard respiratory viral panel is defined by at least PCR testing for Adenovirus, Influenza A, Influenza B, Parainfluenza 1-3, Rhinovirus/Enterovirus, and RSV.)
  5. Duration of mechanical ventilation exceeds 5 days or 120 hours.
  6. Severe pre-existing organ dysfunction prior to admission, as evidenced by being currently listed on one or more organ transplant list, or intermittent Hemodialysis (HD) or Peritoneal Dialysis.
  7. Presence of severe hematologic disorder or coagulopathy, such as Disseminated Intravascular Coagulopathy, as evidenced by the activation of a Massive Transfusion Protocols (as defined by the rapid administration of packed Red Blood Cells, Fresh Frozen Plasma and Platelets in fixed ratios, including at least 6 packed Red Blood Cells, within a 24 hour period) within 72 hours or frequent thrombosis of catheters (as specified by replacing 2 catheters or more within a 72 hour period of new placement) within 72 hours.
  8. Severe anemia or myelodysplastic syndrome requiring more than 10 units of packed Red Blood Cells transfused within the last 12 months.
  9. Patient is currently connected to Extracorporal Membrane Oxygenation.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm Type

    Placebo Comparator

    Experimental

    Experimental

    Arm Label

    Placebo Saline

    10mL Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles

    15mL Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles

    Arm Description

    Saline

    ExoFlo (Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles)

    ExoFlo (Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles)

    Outcomes

    Primary Outcome Measures

    The incidence of serious adverse events.
    Number to patients with All-Cause Mortality at 28 days

    Secondary Outcome Measures

    Ventilator-free days at 28days
    Change in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio from pre-infusion baseline(Day 0)to Day 7.PaO2 may be calculated from arterial blood gas (ABG)or imputed from the SpO2daily.

    Full Information

    First Posted
    November 9, 2021
    Last Updated
    May 2, 2023
    Sponsor
    Direct Biologics, LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05127122
    Brief Title
    Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles Infusion Treatment for ARDS
    Acronym
    EXIT-ARDS
    Official Title
    Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles Infusion Treatment for Acute Respiratory Distress Syndrome: A Phase I/II Clinical Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    April 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 2024 (Anticipated)
    Primary Completion Date
    December 2024 (Anticipated)
    Study Completion Date
    December 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Direct Biologics, LLC

    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
    To evaluate the safety and efficacy of intravenous(IV) administration of bone marrow mesenchymal stem cell derived extracellular vesicles(EV), ExoFlo, as treatment for Acute Respiratory Distress Syndrome.
    Detailed Description
    To evaluate the safety and efficacy of intravenous(IV) administration of bone marrow mesenchymal stem cell-derived extracellular vesicles (EV), ExoFlo, as treatment for Acute Respiratory Distress Syndrome. ExoFlo is also referred to as Investigational Product (IP) throughout the protocol. The duration of the study is 60 days, and the endpoints are as follows: Primary Endpoint: The incidence of serious adverse events. All-Cause Mortality at 28 days. Secondary Endpoints: Ventilator-free days at 28days. Improvement in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio from pre-infusion baseline(Day 0)to Day 7. The study population will consist of 81 inpatient adult patients between 18 and 85 years of age with moderate to severe ARDS as defined by modified Berlin's criteria. Patients will be randomized via Interactive Response Technology to one of the following 3 treatment arms: PLACEBO: Normal saline 100 mL EXPERIMENTAL: IP 10 mL mixed with Normal Saline 90 mL EXPERIMENTAL: IP 15 mL mixed with Normal Saline 85 mL

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    ARDS, Human
    Keywords
    ExoFlo, EXIT-ARDS, ARDS, Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles, Direct Biologics

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1, Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    81 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Placebo Saline
    Arm Type
    Placebo Comparator
    Arm Description
    Saline
    Arm Title
    10mL Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles
    Arm Type
    Experimental
    Arm Description
    ExoFlo (Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles)
    Arm Title
    15mL Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles
    Arm Type
    Experimental
    Arm Description
    ExoFlo (Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles)
    Intervention Type
    Drug
    Intervention Name(s)
    Bone Marrow Mesenchymal Stem Cell Derived Extracellular Vesicles
    Other Intervention Name(s)
    ExoFlo
    Intervention Description
    Injectable
    Intervention Type
    Other
    Intervention Name(s)
    Saline
    Intervention Description
    Placebo Saline
    Primary Outcome Measure Information:
    Title
    The incidence of serious adverse events.
    Time Frame
    60 days
    Title
    Number to patients with All-Cause Mortality at 28 days
    Time Frame
    28 days
    Secondary Outcome Measure Information:
    Title
    Ventilator-free days at 28days
    Time Frame
    28 days
    Title
    Change in partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) ratio from pre-infusion baseline(Day 0)to Day 7.PaO2 may be calculated from arterial blood gas (ABG)or imputed from the SpO2daily.
    Time Frame
    7 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Provision of signed and dated informed consent form (either by the individual or by the individual's healthcare proxy). Stated willingness to comply with all study procedures and availability for the duration of the study Male or female aged 18-85. Moderate to severe ARDS as defined by modified Berlin definition (See Section 2.2.1), which includes timing within 1 week of known clinical insult or new or worsening respiratory symptoms; bilateral opacities not fully explained by effusions, or lung collapse; respiratory failure not fully explained by cardiac failure or fluid overload; PaO2/FiO2 ≤ 200 mm Hg. Hypoxia requiring noninvasive oxygen support such as Nasal Cannula (NC), Nonrebreather (NRB), Bilevel Positive Airway Pressure (BIPAP), Continuous Positive Airway Pressure (CPAP), high flow nasal cannula oxygen (HFNC O2) or mechanical ventilation (MV) despite initiating standard of care. If the candidate is either a male or female of reproductive potential, he or she must agree to use of double barrier method of highly effective birth control contraception such as condoms with oral contraceptive pill or choose to remain abstinent if already practicing abstinence during the screening period. The required duration of usage of double barrier method OR maintenance of abstinence must include the time from the beginning of the screening period until 90 days following the last dose of the study treatment. Exclusion Criteria: Vulnerable populations such as pregnant patients, children, individuals with severe physical or mental disabilities who cannot provide meaningful consent. Active malignancy requiring treatment within the last five years. Major physical trauma in the last 2 days, including motor vehicle accidents, assaults, mechanical falls with sequelae of significant bleeding or craniofacial bruising, and surgeries, such that not one or more injury may be undiagnosed at time of screening. Diagnosis or suspected diagnosis of sepsis without basic microbiology cultures (urinalysis, urine culture, two sets of blood cultures, respiratory culture, at least a standard respiratory viral panel PCR) being collected prior to screening. (Note: Standard respiratory viral panel is defined by at least PCR testing for Adenovirus, Influenza A, Influenza B, Parainfluenza 1-3, Rhinovirus/Enterovirus, and RSV.) Duration of mechanical ventilation exceeds 5 days or 120 hours. Severe pre-existing organ dysfunction prior to admission, as evidenced by being currently listed on one or more organ transplant list, or intermittent Hemodialysis (HD) or Peritoneal Dialysis. Presence of severe hematologic disorder or coagulopathy, such as Disseminated Intravascular Coagulopathy, as evidenced by the activation of a Massive Transfusion Protocols (as defined by the rapid administration of packed Red Blood Cells, Fresh Frozen Plasma and Platelets in fixed ratios, including at least 6 packed Red Blood Cells, within a 24 hour period) within 72 hours or frequent thrombosis of catheters (as specified by replacing 2 catheters or more within a 72 hour period of new placement) within 72 hours. Severe anemia or myelodysplastic syndrome requiring more than 10 units of packed Red Blood Cells transfused within the last 12 months. Patient is currently connected to Extracorporal Membrane Oxygenation.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Amy Lightner, MD
    Phone
    512-354-7124
    Email
    alightner@directbiologics.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Stephanie Cahill
    Email
    scahill@directbiologics.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Amy Lightner, MD
    Organizational Affiliation
    Direct Biologics, LLC
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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