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Allogeneic Human Mesenchymal Stem Cells (hMSCs) Infusion in Patients With Treatment Resistant Depression (ANU)

Primary Purpose

Treatment Resistant Depression

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Allo-hMSCs
Placebo
Sponsored by
Joshua M Hare
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Treatment Resistant Depression focused on measuring Depression

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Provide written informed consent.
  2. Subjects age equal or greater than 18 and equal or less than 75 years at the time of signing the Informed Consent Form.
  3. Diagnosis of Treatment resistant depression (Failed at least two adequate trials of antidepressant monotherapy or antidepressant augmentation with an antipsychotic or lithium during the current episode)
  4. Patients who are receiving a third or more treatment will only be entered if they have not responded to the current treatment.
  5. Experiencing a current Major Depressive Episode (fulfilling Structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria per Structured Clinical Interview for DSM (SCID) for categorical diagnosis, and the Hamilton Depression Rating Scale for Depression (HAM-D))
  6. Hamilton Depression Rating Scale 21-item score greater than 18
  7. Adequacy of previous failed antidepressant trials will be defined using standard criteria by Massachusetts General Hospital (MGH) of patients with a score greater than or equal to 2.5
  8. Increased inflammation ([Serum CRP] greater than 3.0 mg/L)

Exclusion Criteria:

In order to participate in this study, a patient Must Not:

  1. Women who are pregnant, nursing, or of childbearing potential, while not practicing effective contraceptive methods. (Female subjects of childbearing potential must undergo a serum or urine pregnancy test at screening and within 36 hours prior to infusion.)
  2. Inability to perform any of the assessments required.
  3. Have clinically significant abnormal screening laboratory values, including but not limited to: hemoglobin <8 g/dl, white blood cell count <3000/mm3, platelets<80,000/mm3, INR > 1.5 not due to a reversible cause (i.e. Coumadin), aspartate transaminase, alanine transaminase, or alkaline phosphatase > 3 times upper limit of normal, total bilirubin > 1.8 mg/dl (unless due to a benign cause).
  4. Active medical condition that could cause or exacerbate depressive symptoms (e.g., hypothyroidism, anemia)
  5. Serious comorbid illness or any other condition (Such as bipolar, schizophrenia or schizoaffective disorder) that, in the opinion of the investigator, may compromise the safety or compliance of the subject or preclude successful completion of the study.
  6. Have acute suicidality
  7. Prior history of a suicide attempt, within the past year.
  8. Active psychotic disorder, eating disorder, or substance use disorder within 6 months of enrollment
  9. Treatment with any medication that, in the opinion of the Investigator, may compromise the safety of the subject or affect the validity of the data or the study endpoints.
  10. First major depressive episode after 50 years of age.
  11. Have known allergies to penicillin or streptomycin.
  12. Have hypersensitivity to dimethyl sulfoxide (DMSO).
  13. Have a clinical history of malignancy within 5 years (i.e., subjects with prior malignancy must be disease free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma.
  14. Have a non-pulmonary condition that limits lifespan to < 1 year.
  15. Have a history of drug or alcohol abuse within the past 24 months.
  16. Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C.

Sites / Locations

  • University of Miami Miller School of Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Experimental

Arm Label

Allogeneic hMSCs

Placebo

Pilot - Allogeneic hMSCs

Arm Description

Forty (40) subjects will be treated with a single administration of allogeneic Human Mesenchymal Stem Cell (hMSCs): 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.

Forty (40) subjects will be treated with a placebo administration consisting of 1% human albumin serum in Plasma-Lyte A delivered via a single peripheral intravenous infusion.

Eight (8) subjects will be treated with a single administration of allogeneic Human Mesenchymal Stem Cell (hMSCs): 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.

Outcomes

Primary Outcome Measures

Incidence of any treatment-emergent serious adverse events (TE-SAEs)
defined as a composite of acute suicidality, and hospitalization for suicide attempts.

Secondary Outcome Measures

Reduction of Inflammation
Reduction of Inflammation: Change in serum concentrations of high sensitivity C-Reactive Protein (hs-CRP)

Full Information

First Posted
February 1, 2016
Last Updated
March 28, 2019
Sponsor
Joshua M Hare
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1. Study Identification

Unique Protocol Identification Number
NCT02675556
Brief Title
Allogeneic Human Mesenchymal Stem Cells (hMSCs) Infusion in Patients With Treatment Resistant Depression
Acronym
ANU
Official Title
A Phase I, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Safety and Potential Efficacy of Allogeneic Human Mesenchymal Stem Cell Infusion Versus Placebo in Patients With Treatment Resistant Depression.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Terminated
Why Stopped
Difficulty in recruitment and funding.
Study Start Date
October 31, 2017 (Actual)
Primary Completion Date
March 26, 2019 (Actual)
Study Completion Date
March 26, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Joshua M Hare

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 intended to evaluate the safety and potential efficacy of Allogeneic Human Mesenchymal Stem Cell Infusion versus placebo in patients with Treatment Resistant Depression.
Detailed Description
This is a phase I study, with eight subjects in the pilot phase and eighty (80) subjects fulfilling all inclusion/exclusion criteria's will be randomly assigned to receive allogeneic Human Mesenchymal Stem Cell (hMSCs) or placebo in a 1:1 blinded fashion. The 8 subjects in the pilot phase will receive a single infusion of 100 million hMSCs. 40 patients will receive a single administration of allogeneic hMSCs and another 40 patients will receive a single administration of Placebo in a 1:1 blinded fashion. Following infusion, patients will be followed at 2, 4, 6, 8, 10 and 12 week's post-infusion to complete all safety and efficacy assessments. During these 12 weeks starting after the week 2 visit subjects will have a phone call in-between their visits. Patients will additionally be followed for up to 12 months post-infusion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Treatment Resistant Depression
Keywords
Depression

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Allogeneic hMSCs
Arm Type
Experimental
Arm Description
Forty (40) subjects will be treated with a single administration of allogeneic Human Mesenchymal Stem Cell (hMSCs): 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Forty (40) subjects will be treated with a placebo administration consisting of 1% human albumin serum in Plasma-Lyte A delivered via a single peripheral intravenous infusion.
Arm Title
Pilot - Allogeneic hMSCs
Arm Type
Experimental
Arm Description
Eight (8) subjects will be treated with a single administration of allogeneic Human Mesenchymal Stem Cell (hMSCs): 100 x 10^6 (100 million) allo-hMSCs of cells delivered via a single peripheral intravenous infusion.
Intervention Type
Drug
Intervention Name(s)
Allo-hMSCs
Other Intervention Name(s)
Allogeneic Human Mesenchymal Stem Cells, Stem Cells
Intervention Description
a single administration of allogeneic Human Mesenchymal Stem Cell (hMSCs): 100 x 10^6 (100 million) allo-hMSCs of cells
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
a placebo administration consisting of 1% human albumin serum in Plasma-Lyte A
Primary Outcome Measure Information:
Title
Incidence of any treatment-emergent serious adverse events (TE-SAEs)
Description
defined as a composite of acute suicidality, and hospitalization for suicide attempts.
Time Frame
One month post infusion
Secondary Outcome Measure Information:
Title
Reduction of Inflammation
Description
Reduction of Inflammation: Change in serum concentrations of high sensitivity C-Reactive Protein (hs-CRP)
Time Frame
Week 12
Other Pre-specified Outcome Measures:
Title
Reductions in serum concentrations
Description
Reductions in serum concentrations of other inflammatory markers;
Time Frame
Week 12
Title
Reduction in Depressive Symptoms
Description
Reduction in Depressive Symptoms due to change in Montgomery-Asberg Depression Rating Scale (MADRS)
Time Frame
Week 12
Title
Reduction in Anhedonia
Description
Reduction in Anhedonia due to change in the Snaith Hamilton Pleasure Scale
Time Frame
Week 12
Title
Improvements in Cognition
Description
Improvements in Cognition as a result of changes in Brief Assessment of Cognition for Affective Disorders (BAC-A), Performance Based Skills Assessment (UPSA-B), and Specific Level of Functioning (SLOF) scores
Time Frame
Week 12
Title
Improvements in Functional Capacity
Description
Improvements in Functional Capacity as a result of changes in Brief Assessment of Cognition for Affective Disorders (BAC-A), Performance Based Skills Assessment (UPSA-B), and Specific Level of Functioning (SLOF) scores
Time Frame
Week 12
Title
Improvements in everyday functioning
Description
Improvements in everyday functioning as a result of changes in Brief Assessment of Cognition for Affective Disorders (BAC-A), Performance Based Skills Assessment (UPSA-B), and Specific Level of Functioning (SLOF) scores
Time Frame
Week 12
Title
Mediating effects of child abuse and neglect.
Description
Mediating effects of child abuse and neglect.
Time Frame
week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent. Subjects age equal or greater than 18 and equal or less than 75 years at the time of signing the Informed Consent Form. Diagnosis of Treatment resistant depression (Failed at least two adequate trials of antidepressant monotherapy or antidepressant augmentation with an antipsychotic or lithium during the current episode) Patients who are receiving a third or more treatment will only be entered if they have not responded to the current treatment. Experiencing a current Major Depressive Episode (fulfilling Structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders (DSM V) criteria per Structured Clinical Interview for DSM (SCID) for categorical diagnosis, and the Hamilton Depression Rating Scale for Depression (HAM-D)) Hamilton Depression Rating Scale 21-item score greater than 18 Adequacy of previous failed antidepressant trials will be defined using standard criteria by Massachusetts General Hospital (MGH) of patients with a score greater than or equal to 2.5 Increased inflammation ([Serum CRP] greater than 3.0 mg/L) Exclusion Criteria: In order to participate in this study, a patient Must Not: Women who are pregnant, nursing, or of childbearing potential, while not practicing effective contraceptive methods. (Female subjects of childbearing potential must undergo a serum or urine pregnancy test at screening and within 36 hours prior to infusion.) Inability to perform any of the assessments required. Have clinically significant abnormal screening laboratory values, including but not limited to: hemoglobin <8 g/dl, white blood cell count <3000/mm3, platelets<80,000/mm3, INR > 1.5 not due to a reversible cause (i.e. Coumadin), aspartate transaminase, alanine transaminase, or alkaline phosphatase > 3 times upper limit of normal, total bilirubin > 1.8 mg/dl (unless due to a benign cause). Active medical condition that could cause or exacerbate depressive symptoms (e.g., hypothyroidism, anemia) Serious comorbid illness or any other condition (Such as bipolar, schizophrenia or schizoaffective disorder) that, in the opinion of the investigator, may compromise the safety or compliance of the subject or preclude successful completion of the study. Have acute suicidality Prior history of a suicide attempt, within the past year. Active psychotic disorder, eating disorder, or substance use disorder within 6 months of enrollment Treatment with any medication that, in the opinion of the Investigator, may compromise the safety of the subject or affect the validity of the data or the study endpoints. First major depressive episode after 50 years of age. Have known allergies to penicillin or streptomycin. Have hypersensitivity to dimethyl sulfoxide (DMSO). Have a clinical history of malignancy within 5 years (i.e., subjects with prior malignancy must be disease free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma. Have a non-pulmonary condition that limits lifespan to < 1 year. Have a history of drug or alcohol abuse within the past 24 months. Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joshua M Hare, MD
Organizational Affiliation
ISCI / University of Miami Miller School of Medicine
Official's Role
Study Director
Facility Information:
Facility Name
University of Miami Miller School of Medicine
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Allogeneic Human Mesenchymal Stem Cells (hMSCs) Infusion in Patients With Treatment Resistant Depression

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