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A Phase II Dose-escalation Study to Assess the Feasibility and Safety of Transendocardial Delivery of Three Different Doses of Allogeneic Mesenchymal Precursor Cells (MPCs)in Subjects With Heart Failure

Primary Purpose

Heart Failure

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Mesenchymal Precursor Cells (MPCs)
Mesenchymal Precursor Cells (MPCs)
Mesenchymal Precursor Cells (MPCs)
standard-of-care treatment with mock mapping and injection procedures.
standard-of-care treatment with mock mapping and injection procedures.
standard-of-care treatment with mock mapping and injection procedures.
Sponsored by
Mesoblast, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heart Failure focused on measuring Heart Failure, Congestive Heart Failure

Eligibility Criteria

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

Inclusion Criteria:

  1. NYHA ≥ 2.
  2. Age >20 and <80.
  3. Cardiomyopathy of ischemic or idiopathic etiology.
  4. Subject is not a candidate for either percutaneous intervention or cardiac surgery as determined by both an interventional cardiologist and a cardiac surgeon.
  5. LVEF (Left ventricular ejection fraction) < 40% via 2-D Echocardiogram within 28 days of study procedure.
  6. On stable maximal, tolerable dosages of heart failure therapies including betablockers,ace inhibitors and/or diuretics with no interruption or change in medical therapy for at least 28 days prior to study enrollment.
  7. Left Ventricle wall thickness ≥ 8mm at target site by echo within 28 days of study procedure.
  8. If the subject or partner is of childbearing potential, he or she must be willing to use adequate contraception (hormonal or barrier method or abstinence) from the time of screening and for a period of at least 16 weeks after procedure.
  9. Female subjects of childbearing potential must have a negative serum pregnancy test at screening.
  10. Willing and able to understand, sign, and date the Informed Consent Form (ICF).
  11. Must be willing to return for required follow-up visits.
  12. Must be able to follow postoperative management program.

Exclusion Criteria:

  1. Acute Myocardial Infarction in past 30 days.
  2. Discharge of subject's ICD within 28 days of study procedure.
  3. Sustained Ventricular Tachycardia as demonstrated by QRS complexes wider than 120 msec, lasting >30 secs, and >100 bpm documented in screening ECG or 24 hour Holter monitoring.
  4. Unstable angina.
  5. LV thrombus by echocardiogram or angiogram with 28 days prior to and up to the time of cell injection.
  6. Aortic stenosis as determined by echocardiography as valve area less than 1 cm2 that prohibits NOGA catheter access to LV.
  7. Cardiogenic shock defined as the need for intravenous inotropic support, an intraaortic balloon pump, or mechanical circulatory support at the time of cell injections.
  8. Chronic AF or AF at the time of cell injections.
  9. Unprotected left main coronary artery disease >50%.
  10. Ischemic or hemorrhagic stroke as diagnosed by CT/MRI events within the last 3 months prior to enrollment.
  11. Bleeding diathesis disorder such as abnormal coagulation profile precluding performing of mapping/injection procedure.
  12. Serum glucose level > 400 mg/dl within 28 days of study procedure.
  13. Serum glucose level 300 to 400 mg/dl and presence of urine ketones within 28 days of study procedure.
  14. Creatinine level ≥ 2.5 mg/dL within 28 days of study procedure.
  15. Hematocrit ≤ 32% within 28 days of study procedure.
  16. White Blood Cell count > 12 x 106/mm3 within 28 days of study procedure.
  17. Platelet count ≤100 x106/mm3 within 28 days of study procedure.
  18. Total bilirubin >3 mg/dL, albumin <2.8 g/dL, aspartate aminotransferase (AST) ≥ 2.5x the upper limit of normal, gamma glutamyltranspeptidase (GGT) ≥ 1.5x the upper limit of normal within 28 days of study procedure.
  19. Presence of ≥ 20% anti-HLA antibody titers and/or having antibody specificities to donor HLA antigens.
  20. A known hypersensitivity to dimethyl sulfoxide (DMSO), murine and/or bovine products.
  21. History of cancer prior to screening (excluding basal cell carcinoma).
  22. Acute or chronic infectious disease, including but not limited to human immunodeficiency virus (HIV).
  23. Any concurrent disease or condition that, in the opinion of the investigator, would make the subject unsuitable for participation in the study.
  24. Treatment and/or an uncompleted follow-up treatment of any investigational. therapy within 6 months before procedure and intent to participate in any other investigational drug or cell therapy study during the 3-year follow-up period of this study.
  25. Active participation in other research therapy for cardiovascular repair/regeneration.
  26. Prior recipient of stem precursor cell therapy for cardiac repair.

Sites / Locations

  • Mercy Gilbert Medical Center
  • University of California, San Diego
  • Minneapolis Heart Institute 920 East 28th St, Suite 300
  • UPMC
  • Texas Heart Institue
  • Swedish Heart and Vascular Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Active Comparator

Sham Comparator

Active Comparator

Sham Comparator

Active Comparator

Sham Comparator

Arm Label

A1

A2

B1

B2

C1

C2

Arm Description

15 subjects randomized to receive 25 M allogeneic MPCs by transendocardial injection and mapping.

5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.

15 subjects randomized to receive 75 M allogeneic MPCs by transendocardial injection and mapping.

5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.

15 subjects randomized to receive 150 M allogeneic MPCs by transendocardial injection and mapping.

5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.

Outcomes

Primary Outcome Measures

The primary objective of this study is to evaluate the feasibility and safety of transendocardial injection using mapping Catheter with the Left Ventricular Injection Catheter of 25 M, 75 M, and 150 M allogeneic MPCs in subjects with heart failure.

Secondary Outcome Measures

The secondary objectives are to explore functional efficacy for subsequent study design.

Full Information

First Posted
July 21, 2008
Last Updated
March 9, 2020
Sponsor
Mesoblast, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT00721045
Brief Title
A Phase II Dose-escalation Study to Assess the Feasibility and Safety of Transendocardial Delivery of Three Different Doses of Allogeneic Mesenchymal Precursor Cells (MPCs)in Subjects With Heart Failure
Official Title
A Phase II Dose-escalation Study to Assess the Feasibility and Safety of Transendocardial Delivery of Three Different Doses of Allogeneic Mesenchymal Precursor Cells (MPCs)in Subjects With Heart Failure
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
June 2011 (Actual)
Study Completion Date
July 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mesoblast, Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a dose-ranging clinical study to evaluate the feasibility, safety, and tolerability of 3 different doses of immunoselected, culture expanded, nucleated, allogeneic MPCs in subjects who have cardiomyopathy of both ischemic and idiopathic etiology.
Detailed Description
Heart failure subjects recruited will include those who have advanced heart failure NYHA (New York Heart Association) class II to IV and a depressed ejection fraction (EF < 40%). Baseline eligibility testing assessments will be completed within 28 days prior to cell delivery. Efficacy will be explored at 3, 6, and 12 months. This will be a single-blinded, dose-escalation, cohort study in 60 subjects allocated sequentially to 1 of 3 cohorts A, B, or C. Forty-five subjects will be randomized to receive transendocardial delivery of MPC treatment, and 15 subjects will be randomized to receive standard-of-care treatment without MPC administration. The fifteen subjects randomized to receive standard of care without needle injection will serve as the study's control population and will undergo mock mapping and verbal injection scripts.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Failure
Keywords
Heart Failure, Congestive Heart Failure

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Factorial Assignment
Masking
Participant
Allocation
Randomized
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A1
Arm Type
Active Comparator
Arm Description
15 subjects randomized to receive 25 M allogeneic MPCs by transendocardial injection and mapping.
Arm Title
A2
Arm Type
Sham Comparator
Arm Description
5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.
Arm Title
B1
Arm Type
Active Comparator
Arm Description
15 subjects randomized to receive 75 M allogeneic MPCs by transendocardial injection and mapping.
Arm Title
B2
Arm Type
Sham Comparator
Arm Description
5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.
Arm Title
C1
Arm Type
Active Comparator
Arm Description
15 subjects randomized to receive 150 M allogeneic MPCs by transendocardial injection and mapping.
Arm Title
C2
Arm Type
Sham Comparator
Arm Description
5 subjects randomized to receive standard-of-care treatment with mock mapping and injection procedures.
Intervention Type
Biological
Intervention Name(s)
Mesenchymal Precursor Cells (MPCs)
Other Intervention Name(s)
Revascor
Intervention Description
25 M allogeneic MPCs by transendocardial injection and mapping.
Intervention Type
Biological
Intervention Name(s)
Mesenchymal Precursor Cells (MPCs)
Other Intervention Name(s)
Revascor
Intervention Description
75 M allogeneic MPCs by transendocardial injection and mapping.
Intervention Type
Biological
Intervention Name(s)
Mesenchymal Precursor Cells (MPCs)
Other Intervention Name(s)
Revascor
Intervention Description
150 M allogeneic MPCs by transendocardial injection
Intervention Type
Procedure
Intervention Name(s)
standard-of-care treatment with mock mapping and injection procedures.
Intervention Description
Mock
Intervention Type
Procedure
Intervention Name(s)
standard-of-care treatment with mock mapping and injection procedures.
Intervention Description
Mock
Intervention Type
Procedure
Intervention Name(s)
standard-of-care treatment with mock mapping and injection procedures.
Intervention Description
Mock
Primary Outcome Measure Information:
Title
The primary objective of this study is to evaluate the feasibility and safety of transendocardial injection using mapping Catheter with the Left Ventricular Injection Catheter of 25 M, 75 M, and 150 M allogeneic MPCs in subjects with heart failure.
Time Frame
3 years
Secondary Outcome Measure Information:
Title
The secondary objectives are to explore functional efficacy for subsequent study design.
Time Frame
3 years

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: NYHA ≥ 2. Age >20 and <80. Cardiomyopathy of ischemic or idiopathic etiology. Subject is not a candidate for either percutaneous intervention or cardiac surgery as determined by both an interventional cardiologist and a cardiac surgeon. LVEF (Left ventricular ejection fraction) < 40% via 2-D Echocardiogram within 28 days of study procedure. On stable maximal, tolerable dosages of heart failure therapies including betablockers,ace inhibitors and/or diuretics with no interruption or change in medical therapy for at least 28 days prior to study enrollment. Left Ventricle wall thickness ≥ 8mm at target site by echo within 28 days of study procedure. If the subject or partner is of childbearing potential, he or she must be willing to use adequate contraception (hormonal or barrier method or abstinence) from the time of screening and for a period of at least 16 weeks after procedure. Female subjects of childbearing potential must have a negative serum pregnancy test at screening. Willing and able to understand, sign, and date the Informed Consent Form (ICF). Must be willing to return for required follow-up visits. Must be able to follow postoperative management program. Exclusion Criteria: Acute Myocardial Infarction in past 30 days. Discharge of subject's ICD within 28 days of study procedure. Sustained Ventricular Tachycardia as demonstrated by QRS complexes wider than 120 msec, lasting >30 secs, and >100 bpm documented in screening ECG or 24 hour Holter monitoring. Unstable angina. LV thrombus by echocardiogram or angiogram with 28 days prior to and up to the time of cell injection. Aortic stenosis as determined by echocardiography as valve area less than 1 cm2 that prohibits NOGA catheter access to LV. Cardiogenic shock defined as the need for intravenous inotropic support, an intraaortic balloon pump, or mechanical circulatory support at the time of cell injections. Chronic AF or AF at the time of cell injections. Unprotected left main coronary artery disease >50%. Ischemic or hemorrhagic stroke as diagnosed by CT/MRI events within the last 3 months prior to enrollment. Bleeding diathesis disorder such as abnormal coagulation profile precluding performing of mapping/injection procedure. Serum glucose level > 400 mg/dl within 28 days of study procedure. Serum glucose level 300 to 400 mg/dl and presence of urine ketones within 28 days of study procedure. Creatinine level ≥ 2.5 mg/dL within 28 days of study procedure. Hematocrit ≤ 32% within 28 days of study procedure. White Blood Cell count > 12 x 106/mm3 within 28 days of study procedure. Platelet count ≤100 x106/mm3 within 28 days of study procedure. Total bilirubin >3 mg/dL, albumin <2.8 g/dL, aspartate aminotransferase (AST) ≥ 2.5x the upper limit of normal, gamma glutamyltranspeptidase (GGT) ≥ 1.5x the upper limit of normal within 28 days of study procedure. Presence of ≥ 20% anti-HLA antibody titers and/or having antibody specificities to donor HLA antigens. A known hypersensitivity to dimethyl sulfoxide (DMSO), murine and/or bovine products. History of cancer prior to screening (excluding basal cell carcinoma). Acute or chronic infectious disease, including but not limited to human immunodeficiency virus (HIV). Any concurrent disease or condition that, in the opinion of the investigator, would make the subject unsuitable for participation in the study. Treatment and/or an uncompleted follow-up treatment of any investigational. therapy within 6 months before procedure and intent to participate in any other investigational drug or cell therapy study during the 3-year follow-up period of this study. Active participation in other research therapy for cardiovascular repair/regeneration. Prior recipient of stem precursor cell therapy for cardiac repair.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Emerson Perin, MD
Organizational Affiliation
Texas Heart Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mercy Gilbert Medical Center
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85297
Country
United States
Facility Name
University of California, San Diego
City
La Jolla
State/Province
California
ZIP/Postal Code
92037-1300
Country
United States
Facility Name
Minneapolis Heart Institute 920 East 28th St, Suite 300
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407-1139
Country
United States
Facility Name
UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Texas Heart Institue
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Swedish Heart and Vascular Institute
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase II Dose-escalation Study to Assess the Feasibility and Safety of Transendocardial Delivery of Three Different Doses of Allogeneic Mesenchymal Precursor Cells (MPCs)in Subjects With Heart Failure

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