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Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With COVID-19 (UMSC01)

Primary Purpose

COVID-19 Infection

Status
Active
Phase
Phase 1
Locations
Taiwan
Study Type
Interventional
Intervention
Allogeneic umbilical cord mesenchymal stem cells
Controlled normal saline
Sponsored by
Ever Supreme Bio Technology Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COVID-19 Infection

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female aged 20 to 80 years old.
  2. Hospitalized severe and critical COVID-19 patients with laboratory confirmation by reverse-transcription polymerase chain reaction (RT-PCR) from nasopharyngeal/ oropharyngeal samples collected using standardized method.
  3. Pneumonia or interstitial lung damage that is confirmed by chest radiographs or computed tomography.
  4. Severe COVID-19 infection which meets any one of the following: 1) dyspnea (PR ≥ 30 times/min), 2) finger oxygen saturation ≤ 93% in the room air and resting state, 3) arterial oxygen partial pressure (PaO2)/oxygen absorption concentration (FiO2) ≤ 300 mmHg, 4) pulmonary imaging which shows that the focus progress > 50% within 24-48 hours, or
  5. Critically severe COVID-19 infection which meets any of the following: 1) respiratory failure treated by mechanical ventilation, 2) shock, 3) combined with other organ failure, 4) patients expected to need ICU monitoring and treatment.
  6. High sensitivity C-reactive protein (hs-CRP) serum level > 4.0 mg/dL.
  7. All female patients with child-bearing potential (between puberty and 2 years after menopause) should use appropriate contraception method(s) shown below, for at least 4 weeks after UMSC01 treatment and agree to maintain such contraceptive method(s) for another 4 weeks after UMSC01 treatment.

    1. Total abstinence (when this is in line with the preferred and usual lifestyle of the subject). Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception.
    2. Female sterilization (bilateral oophorectomy with or without hysterectomy) or tubal ligation at least 6 weeks before taking study treatment. In case of oophorectomy alone, the reproductive status of the woman should be confirmed by the hormone level assessment.
    3. Male sterilization (at least 6 months prior to screening). For female subjects in the study, the vasectomized male partner should be the sole partner for that subject.
    4. Combination of any two of the following listed methods: (d.1 + d.2 or d.1 + d.3, or d.2 + d.3):

    d.1 Use of oral, injected, or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate < 1%), such as hormone vaginal ring or transdermal hormone contraception.

    d.2 Placement of an intrauterine device (IUD) or intrauterine system (IUS). d.3 Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository.

Exclusion Criteria:

  1. Pregnancy, lactation, and those who are not pregnant but did not, or unwilling to, take effective contraceptives measures 4 weeks before and after the treatment.
  2. Patients with malignant tumors or other serious systemic diseases.
  3. Patients with hemoglobin < 10 g, alanine aminotransferase (ALT) ≥ 5 × ULN, aspartate aminotransferase (AST) ≥ 5 × ULN, alkaline phosphatase (ALP) ≥ 5 × ULN, total bilirubin (TBILI) ≥ 2 × ULN, serum creatinine > 2.5 mg/dl, platelet counts < 100,000/μL, WBC < 3,000 cells/μL, or neutrophil counts < 1,000/μL at screening.
  4. Presence of barotrauma or hemodynamic instability defined as hypotension with diastolic blood pressure < 90 mmHg or mean arterial pressure (MAP) < 70 mmHg despite fluid expansion, and vasoactive support or pneumothorax at screening.
  5. Uncontrolled hypertension with systolic blood pressure > 170 mmHg and diastolic blood pressure > 100 mmHg which, in the investigator's judgment, would not make participation appropriate.
  6. Recent history of (within 2 years) ischemic heart disease or cerebrovascular attack, such as myocardial infarction, unstable angina, or stroke.
  7. Recent history (within 2 years) of hypercoagulable disorder, antiphospholipid syndrome, pulmonary embolism, or deep venous thrombosis.
  8. Condition other than COVID-19 that is projected to limit lifespan to ≤ 1 year.
  9. History of drug or alcohol abuse within the past 24 months.
  10. Unwilling to commit to follow-up visits.
  11. Patients who are participating in other clinical trials with an investigational product.
  12. Co-infection of HIV, tuberculosis, influenza virus, adenovirus, and other respiratory infection virus.
  13. Patients with other conditions that are not suitable to participate in this clinical study as determined by the investigator.

Sites / Locations

  • China Medical University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

UMSC01

Placebo

Arm Description

UMSC01 cells mixed with normal saline will be administered to patients after COVID-19 infection.

Normal saline will be administered to patients after COVID-19 infection.

Outcomes

Primary Outcome Measures

Two Co-Primary Efficacy Endpoints
Proportion of patients alive with sustained improvement within the 21 days of the treatment period (Proportion Analysis), which indicates the capability of UMSC01 to save more lives
Two Co-Primary Efficacy Endpoints
Time (days) to reach sustained improvement within the 21 days of the treatment period (Time-to-Event Analysis), which indicates the capability of UMSC01 to enable patients to less suffer from the disease condition.

Secondary Outcome Measures

Secondary Efficacy Endpoints
Proportion of enrolled patients alive on Day 21
Secondary Efficacy Endpoints
Proportion of enrolled patients alive and free of respiratory failure on Day 21
Secondary Efficacy Endpoints
Improvement of COVID 19 pneumonia confirmed by chest radiographs or computed tomography on Day 21 or on the day of discharge compared with baseline
Secondary Efficacy Endpoints
Improvement of clinical symptoms including duration of fever in degrees C and respiratory failure on Day 21 or on the day of discharge compared with baseline
Secondary Efficacy Endpoints
Duration of ventilator usage or oxygen therapy on Day 21 or on the day of discharge compared with baseline
Secondary Efficacy Endpoints
Levels of tumor necrosis factor-alpha (TNF-α) in pg/ml, interleukin-6 (IL-6) in pg/ml and interleukin-10 (IL-10) in pg/ml, and C-reactive protein (hsCRP) in mg/dl on Day 21 or on the day of discharge compared to baseline
Secondary Efficacy Endpoints
Troponin I level as assessed via serum blood samples on Day 21 or on the day of discharge compared with baseline
Secondary Efficacy Endpoints
ICU admission rate on Day 21 or on the day of discharge with historical data
Secondary Efficacy Endpoints
Percentage of subjects recorded in each severity rating based on Clinical classification of the COVID-19 (NCOSS scores from 1 to 8;higher scores mean a worse outcome) on Day 14 compared with historical data
Secondary Efficacy Endpoints
Percentage of subjects recorded in each severity rating based on Clinical classification of the COVID-19 (NCOSS scores from 1 to 8;higher scores mean a worse outcome) on Day 21 compared with historical data
Secondary Efficacy Endpoints
Average time (days) for which the patients are alive and free of respiratory failure during the treatment period
Secondary Efficacy Endpoints
Proportion of patients who need ICU care on Day 21 based on the clinical indicative of admission to ICU
Secondary Efficacy Endpoints
Proportion of patients who has been discharged form hospital on Day 21
Secondary Safety Endpoints
Number of Participants with infusion-related and allergic reactions during the treatment period
Secondary Safety Endpoints
Secondary infection, treatment emergent adverse event (TEAE), serious adverse event (SAE), and suspected and unexpected serious adverse reaction (SUSAR) incidences over the study period. The toxicities will be assessed by CTCAE V5.0 during the whole study period (380 days)

Full Information

First Posted
August 10, 2022
Last Updated
August 11, 2022
Sponsor
Ever Supreme Bio Technology Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05501418
Brief Title
Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With COVID-19
Acronym
UMSC01
Official Title
A Seamless Phase I/IIa Clinical Study to Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With Severe and Critical COVID-19 Condition
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 5, 2020 (Actual)
Primary Completion Date
December 31, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ever Supreme Bio Technology Co., Ltd.

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
This study is to explore the safety and efficacy of using UCMSC01 in patients with COVID-19 infection via IV stem cell administration. The novelty of the current UMSC01 treatment is the single IV infusion of UMSC01 to the worldwide emergency outbreaks of COVID-19. We hypothesize that sufficient UMSC01 retention in lung may modulate the systemic inflammatory responses.
Detailed Description
The lead Phase I safety phase will further confirm the safety profile of UMSC01 in 5 COVID-19 patients each at two dose regimens and placebo. To start the Phase IIa study, data analysis will be performed as soon as the 21-day treatment period has been completed in the three groups. With considerations of the pandemic status and clinical practice, only one of the two active treatment groups will be selected to complete the Phase IIa study, which will recruit 60 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COVID-19 Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
75 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
UMSC01
Arm Type
Experimental
Arm Description
UMSC01 cells mixed with normal saline will be administered to patients after COVID-19 infection.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Normal saline will be administered to patients after COVID-19 infection.
Intervention Type
Biological
Intervention Name(s)
Allogeneic umbilical cord mesenchymal stem cells
Intervention Description
UMSC01 cells will be IV infusion with 12 months of follow up after treatment.
Intervention Type
Biological
Intervention Name(s)
Controlled normal saline
Intervention Description
Normal saline will be IV infusion with 12 months of follow up after treatment.
Primary Outcome Measure Information:
Title
Two Co-Primary Efficacy Endpoints
Description
Proportion of patients alive with sustained improvement within the 21 days of the treatment period (Proportion Analysis), which indicates the capability of UMSC01 to save more lives
Time Frame
21 days of the treatment period
Title
Two Co-Primary Efficacy Endpoints
Description
Time (days) to reach sustained improvement within the 21 days of the treatment period (Time-to-Event Analysis), which indicates the capability of UMSC01 to enable patients to less suffer from the disease condition.
Time Frame
21 days of the treatment period
Secondary Outcome Measure Information:
Title
Secondary Efficacy Endpoints
Description
Proportion of enrolled patients alive on Day 21
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Proportion of enrolled patients alive and free of respiratory failure on Day 21
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Improvement of COVID 19 pneumonia confirmed by chest radiographs or computed tomography on Day 21 or on the day of discharge compared with baseline
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Improvement of clinical symptoms including duration of fever in degrees C and respiratory failure on Day 21 or on the day of discharge compared with baseline
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Duration of ventilator usage or oxygen therapy on Day 21 or on the day of discharge compared with baseline
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Levels of tumor necrosis factor-alpha (TNF-α) in pg/ml, interleukin-6 (IL-6) in pg/ml and interleukin-10 (IL-10) in pg/ml, and C-reactive protein (hsCRP) in mg/dl on Day 21 or on the day of discharge compared to baseline
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Troponin I level as assessed via serum blood samples on Day 21 or on the day of discharge compared with baseline
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
ICU admission rate on Day 21 or on the day of discharge with historical data
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Percentage of subjects recorded in each severity rating based on Clinical classification of the COVID-19 (NCOSS scores from 1 to 8;higher scores mean a worse outcome) on Day 14 compared with historical data
Time Frame
14 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Percentage of subjects recorded in each severity rating based on Clinical classification of the COVID-19 (NCOSS scores from 1 to 8;higher scores mean a worse outcome) on Day 21 compared with historical data
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Average time (days) for which the patients are alive and free of respiratory failure during the treatment period
Time Frame
through study completion, an average of 1 year
Title
Secondary Efficacy Endpoints
Description
Proportion of patients who need ICU care on Day 21 based on the clinical indicative of admission to ICU
Time Frame
21 days of the treatment period
Title
Secondary Efficacy Endpoints
Description
Proportion of patients who has been discharged form hospital on Day 21
Time Frame
21 days of the treatment period
Title
Secondary Safety Endpoints
Description
Number of Participants with infusion-related and allergic reactions during the treatment period
Time Frame
21 days of the treatment period
Title
Secondary Safety Endpoints
Description
Secondary infection, treatment emergent adverse event (TEAE), serious adverse event (SAE), and suspected and unexpected serious adverse reaction (SUSAR) incidences over the study period. The toxicities will be assessed by CTCAE V5.0 during the whole study period (380 days)
Time Frame
through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged 20 to 80 years old. Hospitalized severe and critical COVID-19 patients with laboratory confirmation by reverse-transcription polymerase chain reaction (RT-PCR) from nasopharyngeal/ oropharyngeal samples collected using standardized method. Pneumonia or interstitial lung damage that is confirmed by chest radiographs or computed tomography. Severe COVID-19 infection which meets any one of the following: 1) dyspnea (PR ≥ 30 times/min), 2) finger oxygen saturation ≤ 93% in the room air and resting state, 3) arterial oxygen partial pressure (PaO2)/oxygen absorption concentration (FiO2) ≤ 300 mmHg, 4) pulmonary imaging which shows that the focus progress > 50% within 24-48 hours, or Critically severe COVID-19 infection which meets any of the following: 1) respiratory failure treated by mechanical ventilation, 2) shock, 3) combined with other organ failure, 4) patients expected to need ICU monitoring and treatment. High sensitivity C-reactive protein (hs-CRP) serum level > 4.0 mg/dL. All female patients with child-bearing potential (between puberty and 2 years after menopause) should use appropriate contraception method(s) shown below, for at least 4 weeks after UMSC01 treatment and agree to maintain such contraceptive method(s) for another 4 weeks after UMSC01 treatment. Total abstinence (when this is in line with the preferred and usual lifestyle of the subject). Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception. Female sterilization (bilateral oophorectomy with or without hysterectomy) or tubal ligation at least 6 weeks before taking study treatment. In case of oophorectomy alone, the reproductive status of the woman should be confirmed by the hormone level assessment. Male sterilization (at least 6 months prior to screening). For female subjects in the study, the vasectomized male partner should be the sole partner for that subject. Combination of any two of the following listed methods: (d.1 + d.2 or d.1 + d.3, or d.2 + d.3): d.1 Use of oral, injected, or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate < 1%), such as hormone vaginal ring or transdermal hormone contraception. d.2 Placement of an intrauterine device (IUD) or intrauterine system (IUS). d.3 Barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository. Exclusion Criteria: Pregnancy, lactation, and those who are not pregnant but did not, or unwilling to, take effective contraceptives measures 4 weeks before and after the treatment. Patients with malignant tumors or other serious systemic diseases. Patients with hemoglobin < 10 g, alanine aminotransferase (ALT) ≥ 5 × ULN, aspartate aminotransferase (AST) ≥ 5 × ULN, alkaline phosphatase (ALP) ≥ 5 × ULN, total bilirubin (TBILI) ≥ 2 × ULN, serum creatinine > 2.5 mg/dl, platelet counts < 100,000/μL, WBC < 3,000 cells/μL, or neutrophil counts < 1,000/μL at screening. Presence of barotrauma or hemodynamic instability defined as hypotension with diastolic blood pressure < 90 mmHg or mean arterial pressure (MAP) < 70 mmHg despite fluid expansion, and vasoactive support or pneumothorax at screening. Uncontrolled hypertension with systolic blood pressure > 170 mmHg and diastolic blood pressure > 100 mmHg which, in the investigator's judgment, would not make participation appropriate. Recent history of (within 2 years) ischemic heart disease or cerebrovascular attack, such as myocardial infarction, unstable angina, or stroke. Recent history (within 2 years) of hypercoagulable disorder, antiphospholipid syndrome, pulmonary embolism, or deep venous thrombosis. Condition other than COVID-19 that is projected to limit lifespan to ≤ 1 year. History of drug or alcohol abuse within the past 24 months. Unwilling to commit to follow-up visits. Patients who are participating in other clinical trials with an investigational product. Co-infection of HIV, tuberculosis, influenza virus, adenovirus, and other respiratory infection virus. Patients with other conditions that are not suitable to participate in this clinical study as determined by the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Woei C Shyu
Organizational Affiliation
Ever Supreme Bio Technology Co., Ltd.
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Long Bin Jeng
Organizational Affiliation
China Medical University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
China Medical University Hospital
City
Taichung
State/Province
Non-US
ZIP/Postal Code
404
Country
Taiwan

12. IPD Sharing Statement

Learn more about this trial

Evaluate the Safety and Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With COVID-19

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