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Treatment of Non-ischemic Cardiomyopathies by Intravenous Extracellular Vesicles of Cardiovascular Progenitor Cells (SECRET-HF)

Primary Purpose

Heart Failure With Reduced Ejection Fraction

Status
Recruiting
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
Extracellular vesicle-enriched secretome of cardiovascular progenitor cells differentiated from induced pluripotent stem cells
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Failure With Reduced Ejection Fraction

Eligibility Criteria

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

Inclusion Criteria: Aged between 18 to 80 years Signed written informed consent French Social Security affiliation; Dilated cardiomyopathy defined by a dilated LV with a reduced EF ≤40% on echocardiography and/or CMR imaging, unexplained by pressure or volume overload (severe arterial hypertension or significant valve disease), coronary artery disease (as assessed by coronary angiography) or a systemic disease; in case of chemotherapy-induced cardiomyopathy, patients should have a period of at least two years of clinical cancer-free state* and a low estimated likelihood of recurrence (≤30% at 5 years), as determined by an oncologist, based on tumor type, response to therapy, and negative metastatic work-up at the time of diagnosis (*exceptions to this are carcinoma in situ or fully resected basal and squamous cell cancer of the skin); NYHA Class III in spite of optimal heart failure maximally tolerated guideline-directed medical therapy, including cardiac resynchronization if needed, without other treatment options; Plasma level of B-type natriuretic peptide (BNP) > 150 pg/mL or, N-terminal pro-BNP (NT-proBNP) ≥ 400 pg/mL; For child-bearing aged women, efficient contraception such as combined (estrogen and progestogen containing) hormonal contraception or progestogen-only hormonal contraception associated with inhibition of ovulation and for men efficient contraception such as condom, during treatment and until the end of the relevant systemic exposure, i.e. until 3 months after the end of treatment. Exclusion Criteria: Implantation of a cardiac resynchronisation therapy device or an ICD unit during the preceding 3 months; End-stage heart failure with reduced EF (HFrEF) defined as patients with American College of Cardiology Foundation/American Heart Association (ACCF/AHA) stage D (candidates for specialized interventions, including heart transplantation and mechanical assistance) or terminal HF (advanced HF with poor response to all forms of treatment, frequent hospitalizations and life expectancy < 12 months) Patients treated with inotropic agents during the 1 month period prior to inclusion; Acute heart failure (regardless of the cause); Heart failure caused by cardiac valve disease, untreated hypertension or documented coronary artery disease with lesions which could explain the cardiomyopathy; Cardiomyopathy due to a reversible cause e.g. endocrine disease, alcohol or drug abuse, myocarditis, Tako-Tsubo, or arrhythmias; Cardiomyopathy due a syndromic/systemic disease (e.g. Duchenne's muscular dystrophy, immune/inflammatory/infiltrative disorders [amyloidosis, hemochromatosis]); If post-chemotherapy cardiomyopathy: a history of radiation therapy AND evidence of constrictive physiology; a baseline computerized tomography scan or CMR showing new tumor or suspicious lymphadenopathy raising concern of malignancy; a trastuzumab treatment within the last 3 months; Previous cardiac surgery; Recent stroke (within the last 3 months); Documented presence of a known LV thrombus, aortic dissection, or aortic aneurysm; Uncontrolled ventricular tachycardia defined by sustained ventricular tachycardia, including electrical storm and incessant ventricular tachycardia with no response to antiarrhythmic medication; Internal Cardioverter Defibrillator firing in the 30 days prior to the first infusion; History of drug-induced allergic reactions or allergy of any type having required treatment; Contraindication to corticosteroids or anti-histaminic agents; Contraindication to gadoterate meglumine if it will be used with CMR; Hematological disease: anaemia (haematocrit < 25%), leukopenia (leucocytes < 2,500/μL) or thrombocytopenia (thrombocytes < 100,000/μL); myeloproliferative disorders, myelodysplastic syndrome, acute or chronic leukaemia, and plasma cell dyscrasias (multiple myeloma); Coagulopathy not due to a reversible cause; Diminished functional capacity for other reasons such as: Chronic Obstructive Pulmonary Disease (COPD) with Forced Expiratory Volume (FEV) <1 L/min, moderate to severe claudication or morbid obesity; Diabetes with poorly controlled blood glucose levels and/or evidence of proliferative retinopathy; Dialysis-dependent renal insufficiency; Autoimmune disorders or current immunosuppressive therapy; History of organ transplant or cell-based treatment; Serum positivity for HIV, hepatitis BsAg, or viremic hepatitis C; Female patient who is pregnant, nursing, or of child-bearing potential and not using effective birth control; Active infection; Known allergy to aminoglycosides; Patient under legal protection (guardianship); Participation in another interventional trial; Life expectancy less than one year. Contraindication to 18FDG-PETscan

Sites / Locations

  • Hôpital européen Georges PompidouRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treated group

Arm Description

A maximum of 12 patients will be included in the study following a dose-escalating design: Cohort 1 (4 patients) will receive 20x10E9 particles/kg for each infusion, with a total of 3 infusions, for a cumulative dose of 60x10E9 particles/kg; Cohort 2: in the absence of safety issues in Cohort 1, 8 patients will receive 40x10E9 particles/kg for each infusion, with a total of 3 infusions, for a cumulative dose of 120x10E9 particles/kg.

Outcomes

Primary Outcome Measures

Serious Adverse Events
Number of any potentially Serious Adverse Events (SAEs)/Reactions attributed to the experimental treatment: death (cardiovascular or of any cause), hospitalization for worsening heart failure, acute coronary syndrome (including myocardial infarction), sustained atrial and ventricular arrhythmias, ischemic stroke, immune-allergic or infectious reactions to the intravenous infusions of the IMP, and any other potential adverse effects detected and corroborated by clinical presentation, laboratory investigations and image analysis.

Secondary Outcome Measures

Validation of the bioactivity of the EV-enriched secretome by proliferation of human vascular endothelial cells.
Bioactivity of the IMP (potency tests) assessed by proliferation of human vascular endothelial cells assessed by BrdU (>20% relative to the control).
Validation of the bioactivity of the EV-enriched secretome by activation of allogeneic peripheral blood mononuclear cells.
Bioactivity of the IMP (potency tests) assessed by activation of allogeneic peripheral blood mononuclear cells assessed by the secretion of IL-2 and IFNγ (lack of increased secretion compared with the control).
Validation of the bioactivity of the EV-enriched secretome
Bioactivity of the IMP (potency tests) assessed by degranulation of Natural Killer cells assessed by the expression of CD107 (compared with a negative control).
Assessment of the effects of the IMP on immune and inflammatory responses at 3 weeks after the onset of the treatment.
Detection of donor-specific antibodies before the second secretome infusion.
Assessment of the effects of the IMP on immune and inflammatory responses at 6 weeks after the onset of the treatment.
Detection of donor-specific antibodies before the third secretome infusion.
Assessment of the effects of the IMP on immune and inflammatory responses at 10 weeks after the onset of the treatment.
Detection of donor-specific antibodies at 28 days following the last secretome infusion.
Assessment of the effects of the IMP on immune and inflammatory responses at 6 months after the last secretome infusion.
Detection of donor-specific antibodies at 6 months following the last secretome infusion if DSA are detected at the 28 days post-treatment study point at MFI ≥ 5000.
Inflammatory response to IMP infusions
Assessment of blood levels of interleukins, C- Reactive Protein and immune cells.
Monitoring for Major Cardiovascular Adverse Events (MACE)
MACE including cardiac death, rehospitalization for heart failure, acute coronary syndromes, ischemic stroke and ventricular arrhythmias during the 1-year follow-up.
Changes in LV function assessed by NYHA at 28 days after the end of the treatment.
New York Heart Association (NYHA) functional class.
Changes in LV function assessed by NYHA at 6 months after the end of the treatment.
New York Heart Association (NYHA) functional class.
Changes in LV function assessed by NYHA at 12 months after the end of the treatment.
New York Heart Association (NYHA) functional class.
Changes in LV function assessed by Minnesota Living With Heart Failure questionnaire at 6 months after the end of the treatment.
Quality of life assessed by Minnesota Living With Heart Failure questionnaire.
Changes in LV function assessed by Minnesota Living With Heart Failure questionnaire at 12 months after the end of the treatment.
Quality of life assessed by Minnesota Living With Heart Failure questionnaire.
Changes in LV function assessed by LV ejection fraction at 28 days after the end of the treatment.
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Changes in LV function assessed by LV ejection fraction at 6 months after the end of the treatment.
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Changes in LV function assessed by LV ejection fraction at 12 months after the end of the treatment.
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Changes in LV function assessed by LV Volumes at 28 days after the end of the treatment.
LV Volumes ml/m2 by Doppler-echocardiography.
Changes in LV function assessed by LV Volumes at 6 months after the end of the treatment.
LV Volumes ml/m2 by Doppler-echocardiography.
Changes in LV function assessed by LV Volumes at 12 months after the end of the treatment.
LV Volumes ml/m2 by Doppler-echocardiography.
Changes in LV function assessed by LV global longitudinal strain at 28 days after the end of the treatment.
LV global longitudinal strain (%) by Doppler-echocardiography.
Changes in LV function assessed by LV global longitudinal strain at 6 months after the end of the treatment.
LV global longitudinal strain (%) by Doppler-echocardiography.
Changes in LV function assessed by LV global longitudinal strain at 12 months after the end of the treatment.
LV global longitudinal strain (%) by Doppler-echocardiography.
Changes in LV function assessed by LV ejection fraction (%) by Cardiac Magnetic Resonance at 6 months after the end of the treatment.
Measurements of LV ejection fraction (%) by Cardiac Magnetic Resonance.
Changes in LV function assessed by LV ejection fraction (%) by Cardiac Magnetic Resonance at 12 months after the end of the treatment.
Measurements of LV ejection fraction (%) by Cardiac Magnetic Resonance.
Changes in LV function assessed by LV volumes (ml/m2) by Cardiac Magnetic Resonance at 6 months after the end of the treatment.
LV volumes (ml/m2) by Cardiac Magnetic Resonance (CMR).
Changes in LV function Changes in LV function assessed by LV volumes (ml/m2) by Cardiac Magnetic Resonance at 12 months after the end of the treatment.
LV volumes (ml/m2) by Cardiac Magnetic Resonance (CMR).
Changes in LV function assessed by the presence/extent of myocardial late-enhancement at 6 months after the end of the treatment.
Presence/extent of myocardial late-enhancement after gadolinium administration, in the absence of contra-indication, by Cardiac Magnetic Resonance.
Changes in LV function assessed by the presence/extent of myocardial late-enhancement at 12 months after the end of the treatment.
Presence/extent of myocardial late-enhancement after gadolinium administration, in the absence of contra-indication, by Cardiac Magnetic Resonance.
Changes in LV function assessed by maximum oxygen consumption at 6 months after the end of the treatment.
Maximum oxygen consumption at exercise (mL/min/kg).
Changes in LV function assessed by maximum oxygen consumption at 12 months after the end of the treatment.
Maximum oxygen consumption at exercise (mL/min/kg).
Changes in LV function assessed by Natriuretic peptide plasma levels at 28 days after the end of the treatment.
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Changes in LV function assessed by Natriuretic peptide plasma levels at 6 months after the end of the treatment.
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Changes in LV function assessed by Natriuretic peptide plasma levels at 12 months after the end of the treatment.
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Serious Adverse Events
Number of any potentially Serious Adverse Events (T-SAEs)/Reactions attributed to the experimental treatment (primary endpoint) up to 12 months.

Full Information

First Posted
February 20, 2023
Last Updated
September 22, 2023
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Ministry of Health, France
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1. Study Identification

Unique Protocol Identification Number
NCT05774509
Brief Title
Treatment of Non-ischemic Cardiomyopathies by Intravenous Extracellular Vesicles of Cardiovascular Progenitor Cells
Acronym
SECRET-HF
Official Title
Treatment of Non-ischemic Dilated Cardiomyopathies by Intravenous Infusions of the Extracellular Vesicle-Enriched Secretome of Cardiovascular Progenitor Cells
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 31, 2023 (Actual)
Primary Completion Date
August 15, 2025 (Anticipated)
Study Completion Date
July 15, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Ministry of Health, France

4. Oversight

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

5. Study Description

Brief Summary
The goal of this clinical trial is to assess the safety and efficacy of three intravenous injections of the extracellulat vesicle-enriched secretome of cardiovascular progenitor cells in severely symptomatic patients with drug-refractory left ventricular (LV) dysfunction secondary to non-ischemic dilated cardiomyopathy. The main questions it aims to answer are: Are these repeated injections safe and well tolerated? Do they improve cardiac function and, if yes, to what extent?
Detailed Description
The overall objective of this study is to assess the safety and efficacy of repeated intravenous injections of the secretome of cardiovascular progenitor cells in severely symptomatic patients with drug-refractory left ventricular (LV) dysfunction secondary to non-ischemic dilated cardiomyopathy. The rationale and design of this trial are based on three main assumptions: The tissue-repair capacity of transplanted cells can be duplicated by the delivery of the extracellular vesicles (EV) that they secrete. The greatest therapeutic efficacy seems to be achieved by using secreting cells that are committed to the same lineage as those of the tissue to be repaired, hence, the use of cardiovascular progenitor cells as the source of the EV-enriched secretome. Leveraging the benefits of cells, or their secreted products, by repeated administrations requires a non-invasive approach, which highlights the potential interest of the intravenous approach.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure With Reduced Ejection Fraction

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treated group
Arm Type
Experimental
Arm Description
A maximum of 12 patients will be included in the study following a dose-escalating design: Cohort 1 (4 patients) will receive 20x10E9 particles/kg for each infusion, with a total of 3 infusions, for a cumulative dose of 60x10E9 particles/kg; Cohort 2: in the absence of safety issues in Cohort 1, 8 patients will receive 40x10E9 particles/kg for each infusion, with a total of 3 infusions, for a cumulative dose of 120x10E9 particles/kg.
Intervention Type
Biological
Intervention Name(s)
Extracellular vesicle-enriched secretome of cardiovascular progenitor cells differentiated from induced pluripotent stem cells
Intervention Description
Repeated (X3) intravenous infusions of the extracellular vesicle-enriched secretome of cardiovascular progenitor cells (differentiated from human induced pluripotent stem cells)
Primary Outcome Measure Information:
Title
Serious Adverse Events
Description
Number of any potentially Serious Adverse Events (SAEs)/Reactions attributed to the experimental treatment: death (cardiovascular or of any cause), hospitalization for worsening heart failure, acute coronary syndrome (including myocardial infarction), sustained atrial and ventricular arrhythmias, ischemic stroke, immune-allergic or infectious reactions to the intravenous infusions of the IMP, and any other potential adverse effects detected and corroborated by clinical presentation, laboratory investigations and image analysis.
Time Frame
10 weeks after the onset of treatment: 6 weeks of treatment and 4 weeks of follow-up after the last IMP infusion.
Secondary Outcome Measure Information:
Title
Validation of the bioactivity of the EV-enriched secretome by proliferation of human vascular endothelial cells.
Description
Bioactivity of the IMP (potency tests) assessed by proliferation of human vascular endothelial cells assessed by BrdU (>20% relative to the control).
Time Frame
12 months
Title
Validation of the bioactivity of the EV-enriched secretome by activation of allogeneic peripheral blood mononuclear cells.
Description
Bioactivity of the IMP (potency tests) assessed by activation of allogeneic peripheral blood mononuclear cells assessed by the secretion of IL-2 and IFNγ (lack of increased secretion compared with the control).
Time Frame
12 months
Title
Validation of the bioactivity of the EV-enriched secretome
Description
Bioactivity of the IMP (potency tests) assessed by degranulation of Natural Killer cells assessed by the expression of CD107 (compared with a negative control).
Time Frame
12 months
Title
Assessment of the effects of the IMP on immune and inflammatory responses at 3 weeks after the onset of the treatment.
Description
Detection of donor-specific antibodies before the second secretome infusion.
Time Frame
3 weeks after the onset of the treatment.
Title
Assessment of the effects of the IMP on immune and inflammatory responses at 6 weeks after the onset of the treatment.
Description
Detection of donor-specific antibodies before the third secretome infusion.
Time Frame
6 weeks after the onset of the treatment.
Title
Assessment of the effects of the IMP on immune and inflammatory responses at 10 weeks after the onset of the treatment.
Description
Detection of donor-specific antibodies at 28 days following the last secretome infusion.
Time Frame
10 weeks after the onset of the treatment.
Title
Assessment of the effects of the IMP on immune and inflammatory responses at 6 months after the last secretome infusion.
Description
Detection of donor-specific antibodies at 6 months following the last secretome infusion if DSA are detected at the 28 days post-treatment study point at MFI ≥ 5000.
Time Frame
6 months after the last secretome infusion.
Title
Inflammatory response to IMP infusions
Description
Assessment of blood levels of interleukins, C- Reactive Protein and immune cells.
Time Frame
28 days, 6 and 12 months following the third infusion
Title
Monitoring for Major Cardiovascular Adverse Events (MACE)
Description
MACE including cardiac death, rehospitalization for heart failure, acute coronary syndromes, ischemic stroke and ventricular arrhythmias during the 1-year follow-up.
Time Frame
28 days following the last IMP infusion and subsequently until 1 year after the end of treatment
Title
Changes in LV function assessed by NYHA at 28 days after the end of the treatment.
Description
New York Heart Association (NYHA) functional class.
Time Frame
28 days after the end of the treatment.
Title
Changes in LV function assessed by NYHA at 6 months after the end of the treatment.
Description
New York Heart Association (NYHA) functional class.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by NYHA at 12 months after the end of the treatment.
Description
New York Heart Association (NYHA) functional class.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by Minnesota Living With Heart Failure questionnaire at 6 months after the end of the treatment.
Description
Quality of life assessed by Minnesota Living With Heart Failure questionnaire.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by Minnesota Living With Heart Failure questionnaire at 12 months after the end of the treatment.
Description
Quality of life assessed by Minnesota Living With Heart Failure questionnaire.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by LV ejection fraction at 28 days after the end of the treatment.
Description
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Time Frame
28 days after the end of the treatment.
Title
Changes in LV function assessed by LV ejection fraction at 6 months after the end of the treatment.
Description
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by LV ejection fraction at 12 months after the end of the treatment.
Description
Measurements of LV ejection fraction (EF%) by Doppler-echocardiography.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by LV Volumes at 28 days after the end of the treatment.
Description
LV Volumes ml/m2 by Doppler-echocardiography.
Time Frame
28 days after the end of the treatment.
Title
Changes in LV function assessed by LV Volumes at 6 months after the end of the treatment.
Description
LV Volumes ml/m2 by Doppler-echocardiography.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by LV Volumes at 12 months after the end of the treatment.
Description
LV Volumes ml/m2 by Doppler-echocardiography.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by LV global longitudinal strain at 28 days after the end of the treatment.
Description
LV global longitudinal strain (%) by Doppler-echocardiography.
Time Frame
28 days after the end of the treatment.
Title
Changes in LV function assessed by LV global longitudinal strain at 6 months after the end of the treatment.
Description
LV global longitudinal strain (%) by Doppler-echocardiography.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by LV global longitudinal strain at 12 months after the end of the treatment.
Description
LV global longitudinal strain (%) by Doppler-echocardiography.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by LV ejection fraction (%) by Cardiac Magnetic Resonance at 6 months after the end of the treatment.
Description
Measurements of LV ejection fraction (%) by Cardiac Magnetic Resonance.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by LV ejection fraction (%) by Cardiac Magnetic Resonance at 12 months after the end of the treatment.
Description
Measurements of LV ejection fraction (%) by Cardiac Magnetic Resonance.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by LV volumes (ml/m2) by Cardiac Magnetic Resonance at 6 months after the end of the treatment.
Description
LV volumes (ml/m2) by Cardiac Magnetic Resonance (CMR).
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function Changes in LV function assessed by LV volumes (ml/m2) by Cardiac Magnetic Resonance at 12 months after the end of the treatment.
Description
LV volumes (ml/m2) by Cardiac Magnetic Resonance (CMR).
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by the presence/extent of myocardial late-enhancement at 6 months after the end of the treatment.
Description
Presence/extent of myocardial late-enhancement after gadolinium administration, in the absence of contra-indication, by Cardiac Magnetic Resonance.
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by the presence/extent of myocardial late-enhancement at 12 months after the end of the treatment.
Description
Presence/extent of myocardial late-enhancement after gadolinium administration, in the absence of contra-indication, by Cardiac Magnetic Resonance.
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by maximum oxygen consumption at 6 months after the end of the treatment.
Description
Maximum oxygen consumption at exercise (mL/min/kg).
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by maximum oxygen consumption at 12 months after the end of the treatment.
Description
Maximum oxygen consumption at exercise (mL/min/kg).
Time Frame
12 months after the end of the treatment.
Title
Changes in LV function assessed by Natriuretic peptide plasma levels at 28 days after the end of the treatment.
Description
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Time Frame
28 days after the end of the treatment.
Title
Changes in LV function assessed by Natriuretic peptide plasma levels at 6 months after the end of the treatment.
Description
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Time Frame
6 months after the end of the treatment.
Title
Changes in LV function assessed by Natriuretic peptide plasma levels at 12 months after the end of the treatment.
Description
Natriuretic peptide plasma levels (BNP or NT-ProBNP in pg/mL).
Time Frame
12 months after the end of the treatment.
Title
Serious Adverse Events
Description
Number of any potentially Serious Adverse Events (T-SAEs)/Reactions attributed to the experimental treatment (primary endpoint) up to 12 months.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Aged between 18 to 80 years Signed written informed consent French Social Security affiliation; Dilated cardiomyopathy defined by a dilated LV with a reduced EF ≤40% on echocardiography and/or CMR imaging, unexplained by pressure or volume overload (severe arterial hypertension or significant valve disease), coronary artery disease (as assessed by coronary angiography) or a systemic disease; in case of chemotherapy-induced cardiomyopathy, patients should have a period of at least two years of clinical cancer-free state* and a low estimated likelihood of recurrence (≤30% at 5 years), as determined by an oncologist, based on tumor type, response to therapy, and negative metastatic work-up at the time of diagnosis (*exceptions to this are carcinoma in situ or fully resected basal and squamous cell cancer of the skin); NYHA Class III in spite of optimal heart failure maximally tolerated guideline-directed medical therapy, including cardiac resynchronization if needed, without other treatment options; Plasma level of B-type natriuretic peptide (BNP) > 150 pg/mL or, N-terminal pro-BNP (NT-proBNP) ≥ 400 pg/mL; For child-bearing aged women, efficient contraception such as combined (estrogen and progestogen containing) hormonal contraception or progestogen-only hormonal contraception associated with inhibition of ovulation and for men efficient contraception such as condom, during treatment and until the end of the relevant systemic exposure, i.e. until 3 months after the end of treatment. Exclusion Criteria: Implantation of a cardiac resynchronisation therapy device or an ICD unit during the preceding 3 months; End-stage heart failure with reduced EF (HFrEF) defined as patients with American College of Cardiology Foundation/American Heart Association (ACCF/AHA) stage D (candidates for specialized interventions, including heart transplantation and mechanical assistance) or terminal HF (advanced HF with poor response to all forms of treatment, frequent hospitalizations and life expectancy < 12 months) Patients treated with inotropic agents during the 1 month period prior to inclusion; Acute heart failure (regardless of the cause); Heart failure caused by cardiac valve disease, untreated hypertension or documented coronary artery disease with lesions which could explain the cardiomyopathy; Cardiomyopathy due to a reversible cause e.g. endocrine disease, alcohol or drug abuse, myocarditis, Tako-Tsubo, or arrhythmias; Cardiomyopathy due a syndromic/systemic disease (e.g. Duchenne's muscular dystrophy, immune/inflammatory/infiltrative disorders [amyloidosis, hemochromatosis]); If post-chemotherapy cardiomyopathy: a history of radiation therapy AND evidence of constrictive physiology; a baseline computerized tomography scan or CMR showing new tumor or suspicious lymphadenopathy raising concern of malignancy; a trastuzumab treatment within the last 3 months; Previous cardiac surgery; Recent stroke (within the last 3 months); Documented presence of a known LV thrombus, aortic dissection, or aortic aneurysm; Uncontrolled ventricular tachycardia defined by sustained ventricular tachycardia, including electrical storm and incessant ventricular tachycardia with no response to antiarrhythmic medication; Internal Cardioverter Defibrillator firing in the 30 days prior to the first infusion; History of drug-induced allergic reactions or allergy of any type having required treatment; Contraindication to corticosteroids or anti-histaminic agents; Contraindication to gadoterate meglumine if it will be used with CMR; Hematological disease: anaemia (haematocrit < 25%), leukopenia (leucocytes < 2,500/μL) or thrombocytopenia (thrombocytes < 100,000/μL); myeloproliferative disorders, myelodysplastic syndrome, acute or chronic leukaemia, and plasma cell dyscrasias (multiple myeloma); Coagulopathy not due to a reversible cause; Diminished functional capacity for other reasons such as: Chronic Obstructive Pulmonary Disease (COPD) with Forced Expiratory Volume (FEV) <1 L/min, moderate to severe claudication or morbid obesity; Diabetes with poorly controlled blood glucose levels and/or evidence of proliferative retinopathy; Dialysis-dependent renal insufficiency; Autoimmune disorders or current immunosuppressive therapy; History of organ transplant or cell-based treatment; Serum positivity for HIV, hepatitis BsAg, or viremic hepatitis C; Female patient who is pregnant, nursing, or of child-bearing potential and not using effective birth control; Active infection; Known allergy to aminoglycosides; Patient under legal protection (guardianship); Participation in another interventional trial; Life expectancy less than one year. Contraindication to 18FDG-PETscan
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Touria EL AAMRI
Phone
+33140271848
Email
touria.el-aamri@aphp.fr
First Name & Middle Initial & Last Name or Official Title & Degree
Sabrina BOUDIF
Phone
+33156092920
Email
sabrina.boudif@aphp.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Philippe Menasché, MD, PhD
Organizational Affiliation
Assistance Publique - Hôpitaux de Paris
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital européen Georges Pompidou
City
Paris
ZIP/Postal Code
75015
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Philippe MENASCHE, MD, PhD
Email
philippe.menasche@aphp.fr

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Individual participant data (IPD) that underlie results in publication could be shared. IPD detailed in the protocol of a planned metaanalysis could be shared
IPD Sharing Time Frame
One year after the last publication
IPD Sharing Access Criteria
Data sharing must be accepted by the sponsor and the PI based on a scientific project and scientific involvement of the PI team. Collaboration will be fostered. Data sharing must respect agreements made with funders. Teams wishing obtain IPD must meet the sponsor and IP team to present scientifics (and commercial) purpose, IPD needed, format of data transmission, and timeframe. Technical feasibility and financial support will be discussed before mandatory contractualization. Processing of shared data must comply with European General Data Protection Regulation (GDPR)
Citations:
PubMed Identifier
27041495
Citation
Kervadec A, Bellamy V, El Harane N, Arakelian L, Vanneaux V, Cacciapuoti I, Nemetalla H, Perier MC, Toeg HD, Richart A, Lemitre M, Yin M, Loyer X, Larghero J, Hagege A, Ruel M, Boulanger CM, Silvestre JS, Menasche P, Renault NK. Cardiovascular progenitor-derived extracellular vesicles recapitulate the beneficial effects of their parent cells in the treatment of chronic heart failure. J Heart Lung Transplant. 2016 Jun;35(6):795-807. doi: 10.1016/j.healun.2016.01.013. Epub 2016 Jan 19.
Results Reference
background
PubMed Identifier
29420830
Citation
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Treatment of Non-ischemic Cardiomyopathies by Intravenous Extracellular Vesicles of Cardiovascular Progenitor Cells

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