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A Study of Allogeneic Low Oxygen Mesenchymal Bone Marrow Cells in Subjects With Myocardial Infarction

Primary Purpose

Myocardial Infarction

Status
Completed
Phase
Phase 3
Locations
Kazakhstan
Study Type
Interventional
Intervention
Stem cells
Placebo
Sponsored by
Altaco XXI, LLP
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction focused on measuring AMI, hBMMSCs, stem cells,

Eligibility Criteria

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

Inclusion Criteria:

  1. Males and females 18-85 years of age.
  2. First Acute Myocardial Infarction (STEMI, non STEMI) within 7 days of study enrollment. Myocardial infarction is defined as ECG, Lab and CMR evidences.
  3. Subject had successful revascularization within 12 hours of symptoms as evidenced by residual stenosis < 30% and TIMI antegrade flow II or III in the culprit vessel. Revascularization may include one of the following:

    • PCI angioplasty/stenting placement
    • Thrombolytic therapy
  4. Life expectancy greater than 12 months.
  5. Ability to understand and provide signed informed consent, or have a designated legal guardian or spouse legally able and willing to make such decisions on the subject's behalf.
  6. Reasonable expectation that subject will receive standard post myocardial infarction care, unless contraindicated, including medications: • Anticoagulation (e.g. aspirin, clopidogrel, ticlopidine, prasugrel, etc.), beta-blockers, ace inhibitors, and statin agents, as tolerated.
  7. Attend all scheduled safety follow-up visits.

Exclusion Criteria:

  1. Hemodynamic instability as demonstrated by any of the following:

    • Requirement of intra-aortic balloon pump of left ventricular assist device.
    • Need for inotropic support (e.g. dopamine and/or dobutamine) for more than 36 hours for the maintenance of mean arterial blood pressure ≥60 mmHg.
  2. History of cancer within the past 5 years, with the exception of localized basal or squamous cell carcinoma.
  3. Clinically-significant hematologic, hepatic, or renal impairment within 24 hours of study procedure as determined by screening clinical laboratory tests. Severe chronic anemia or hematocrit ≤24%. Liver function tests (total bilirubin at 3 times upper limit of normal, or creatinine level ≥3mg/dL).
  4. Presence of any other clinically-significant medical condition, psychiatric condition, or laboratory abnormality, that in the judgment of the Investigator or Sponsor for which participation in the study would pose a safety risk to the subject.
  5. Participation in another study with an investigational drug or device within 3 months prior to stem cell administration.
  6. History within the past year of drug or alcohol abuse.
  7. Females known to be pregnant, lactating or having a positive pregnancy test (will be tested during screening) or planning to become pregnant during the study.
  8. Inability to comply with the conditions of the protocol.
  9. Presence of a transplanted tissue or organ or left ventricular assist device (LVAD) (or the expectation of the same within the next 12 months).
  10. Planned Automatic Implantable Cardiac Defibrillator (AICD) or CRT within the next 12 months.
  11. Need for chronic intermittent inotropic therapy.
  12. Active myocarditis or early postpartum cardiomyopathy (within the first twelve months of delivery).
  13. Porphyria.
  14. Allergy to sodium citrate or any "caine" type of local anesthetic.
  15. Subject scheduled for hospice care.
  16. Clinically relevant abnormal findings in the clinical history, physical examination, ECG (e.g. life threatening arrhythmias, including QTc interval of ≥550 ms) or laboratory tests at the screening assessment that would interfere with the objectives of the study or that would, in the Investigator's opinion, preclude safe completion of the study.
  17. Abnormal findings could include: known HIV infection or other immunodeficiency state, chronic active viral infection (such as hepatitis B or C), acute systemic infections (defined as subjects undergoing treatment with antibiotics), gastrointestinal tract bleeding, or any severe or acute concomitant illness or injury.
  18. Any other medical, social, or geographical factor that would make it unlikely that the subject could comply with study procedures (e.g., alcohol abuse, lack of permanent residence, severe depression, disorientation, distant location, or a history of noncompliance).

Sites / Locations

  • National Research Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Stem Cells

Placebo

Arm Description

Experimental: Stem Cells ALLOGENEIC LOW OXYGEN MESENCHYMAL BONE MARROW CELLS Intervention: Biological: Stem cells

Lactated Ringer's Solution

Outcomes

Primary Outcome Measures

The safety and tolerability of aMBMC intravenous administration during the six month study period as determined by major adverse events MACE endpoint

Secondary Outcome Measures

The change from baseline on physical exam conducted at 1, 3 and 6 months post-administration
LV end diastolic volume
measured by MRI
LV end systolic volume
measured by MRI
Infarct size measured by MRI, with contrast
measured by MRI
Global Left Ventricular Ejection Fraction
measured by MRI

Full Information

First Posted
February 1, 2016
Last Updated
October 5, 2016
Sponsor
Altaco XXI, LLP
Collaborators
Duke University
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1. Study Identification

Unique Protocol Identification Number
NCT02672267
Brief Title
A Study of Allogeneic Low Oxygen Mesenchymal Bone Marrow Cells in Subjects With Myocardial Infarction
Official Title
A Phase III, Double-blinded, Single Center, Randomized, Placebo Controlled Study to Assess the Safety, Tolerability, and Preliminary Efficacy of Single Intravenous Dose of Allogeneic Ischemia Tolerant Human Mesenchymal Bone Marrow Cells to Subjects With Acute Myocardial Infarction
Study Type
Interventional

2. Study Status

Record Verification Date
April 2016
Overall Recruitment Status
Completed
Study Start Date
July 2014 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Altaco XXI, LLP
Collaborators
Duke University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety, tolerability and preliminary efficacy of human allogeneic ischemia tolerant mesenchymal bone marrow cells (aLoOxMBMC) administered intravenously to subjects with Acute Myocardial Infarction (STEMI, non STEMI).
Detailed Description
Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality despite continuing advances in various treatment options. In developed countries, ischemic heart disease causes more than 50% of all cardiovascular deaths. Stem cell transplantation has the potential to repair and improve cardiac function, thus helping to significantly decrease morbidity and mortality rates. Preclinical data from a variety of animal studies demonstrated the capacity for skeletal myoblasts to engraft, form myotubules, and enhance cardiac function after transplantation into infarcted myocardium. The underlying sequela of the post infarcted left ventricle often includes massive damage to the cardiomyocyte. The left ventricle remodeling (dilation) and dysfunction is thought to be irreversible. The development of treatments that will regenerate its musculature and vascular components is now considered a main therapeutic challenge. Preliminary human studies focusing on subjects with ischemic heart disease have demonstrated successful myoblast transplantation into the post infarction scar. Another study demonstrated the benefits of stem cell therapy on ventricular function and profusion. Allogeneic mesenchymal stem cells have been used in a number of clinical trials for different indications. These clinical trials showed excellent safety, reduction in arrhythmias, improvement in functional status and increased ejection fraction. The hMSCs are able to: Prevent reperfusion injury; Prevent excessive fibrosis; Reestablish function of hibernating cardiomyocytes in peripheral zone area. Reestablish angiogenesis/vasculogenesis; Preserve wall motion (prevent arrhythmia and functional contractile deterioration); Prevent post infarct ventricular remodeling and left ventricular dilation. It is well accepted that dilated cardiomyopathy mortality rates are 50% within 5 years of diagnosis; Limit infarct size. If we can preserve and restore cardiac function as measured by ejection fraction and LVESV preserving left ventricular integrity would increase subject quality of life as well as longevity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction
Keywords
AMI, hBMMSCs, stem cells,

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Care Provider
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Stem Cells
Arm Type
Experimental
Arm Description
Experimental: Stem Cells ALLOGENEIC LOW OXYGEN MESENCHYMAL BONE MARROW CELLS Intervention: Biological: Stem cells
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Lactated Ringer's Solution
Intervention Type
Biological
Intervention Name(s)
Stem cells
Other Intervention Name(s)
Allogeneic Low Oxygen mesenchymal stem cells
Intervention Description
human Allogeneic Low Oxygen mesenchymal stem cells; Ischemia tolerant
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Lactated Ringer's Solution
Primary Outcome Measure Information:
Title
The safety and tolerability of aMBMC intravenous administration during the six month study period as determined by major adverse events MACE endpoint
Time Frame
6 months
Secondary Outcome Measure Information:
Title
The change from baseline on physical exam conducted at 1, 3 and 6 months post-administration
Time Frame
6 months
Title
LV end diastolic volume
Description
measured by MRI
Time Frame
3 months
Title
LV end systolic volume
Description
measured by MRI
Time Frame
3 months
Title
Infarct size measured by MRI, with contrast
Description
measured by MRI
Time Frame
3 months
Title
Global Left Ventricular Ejection Fraction
Description
measured by MRI
Time Frame
3 months

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: Males and females 18-85 years of age. First Acute Myocardial Infarction (STEMI, non STEMI) within 7 days of study enrollment. Myocardial infarction is defined as ECG, Lab and CMR evidences. Subject had successful revascularization within 12 hours of symptoms as evidenced by residual stenosis < 30% and TIMI antegrade flow II or III in the culprit vessel. Revascularization may include one of the following: PCI angioplasty/stenting placement Thrombolytic therapy Life expectancy greater than 12 months. Ability to understand and provide signed informed consent, or have a designated legal guardian or spouse legally able and willing to make such decisions on the subject's behalf. Reasonable expectation that subject will receive standard post myocardial infarction care, unless contraindicated, including medications: • Anticoagulation (e.g. aspirin, clopidogrel, ticlopidine, prasugrel, etc.), beta-blockers, ace inhibitors, and statin agents, as tolerated. Attend all scheduled safety follow-up visits. Exclusion Criteria: Hemodynamic instability as demonstrated by any of the following: Requirement of intra-aortic balloon pump of left ventricular assist device. Need for inotropic support (e.g. dopamine and/or dobutamine) for more than 36 hours for the maintenance of mean arterial blood pressure ≥60 mmHg. History of cancer within the past 5 years, with the exception of localized basal or squamous cell carcinoma. Clinically-significant hematologic, hepatic, or renal impairment within 24 hours of study procedure as determined by screening clinical laboratory tests. Severe chronic anemia or hematocrit ≤24%. Liver function tests (total bilirubin at 3 times upper limit of normal, or creatinine level ≥3mg/dL). Presence of any other clinically-significant medical condition, psychiatric condition, or laboratory abnormality, that in the judgment of the Investigator or Sponsor for which participation in the study would pose a safety risk to the subject. Participation in another study with an investigational drug or device within 3 months prior to stem cell administration. History within the past year of drug or alcohol abuse. Females known to be pregnant, lactating or having a positive pregnancy test (will be tested during screening) or planning to become pregnant during the study. Inability to comply with the conditions of the protocol. Presence of a transplanted tissue or organ or left ventricular assist device (LVAD) (or the expectation of the same within the next 12 months). Planned Automatic Implantable Cardiac Defibrillator (AICD) or CRT within the next 12 months. Need for chronic intermittent inotropic therapy. Active myocarditis or early postpartum cardiomyopathy (within the first twelve months of delivery). Porphyria. Allergy to sodium citrate or any "caine" type of local anesthetic. Subject scheduled for hospice care. Clinically relevant abnormal findings in the clinical history, physical examination, ECG (e.g. life threatening arrhythmias, including QTc interval of ≥550 ms) or laboratory tests at the screening assessment that would interfere with the objectives of the study or that would, in the Investigator's opinion, preclude safe completion of the study. Abnormal findings could include: known HIV infection or other immunodeficiency state, chronic active viral infection (such as hepatitis B or C), acute systemic infections (defined as subjects undergoing treatment with antibiotics), gastrointestinal tract bleeding, or any severe or acute concomitant illness or injury. Any other medical, social, or geographical factor that would make it unlikely that the subject could comply with study procedures (e.g., alcohol abuse, lack of permanent residence, severe depression, disorientation, distant location, or a history of noncompliance).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Saule Abseitova, MD, Prof.
Organizational Affiliation
National Research Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Daniyar Jumaniyazov, MD, PhD
Organizational Affiliation
Altaco XXI, LLP
Official's Role
Study Director
Facility Information:
Facility Name
National Research Medical Center
City
Astana
ZIP/Postal Code
010000
Country
Kazakhstan

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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A Study of Allogeneic Low Oxygen Mesenchymal Bone Marrow Cells in Subjects With Myocardial Infarction

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