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Clinical Safety Study of Human Embryonic Stem Cell Derived Mesenchymal Cells in the Treatment of Moderate and Severe Intrauterine Adhesions

Primary Purpose

Intrauterine Adhesion

Status
Unknown status
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Inject a solution of stem cell preparation
Inject stem cells
Sponsored by
Qi Zhou
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intrauterine Adhesion

Eligibility Criteria

18 Years - 38 Years (Adult)FemaleDoes not accept healthy volunteers

Criteria:

Inclusion Criteria:

  • 18 ≤ age ≤38, female;
  • According to the 1988 American Fertility Society (AFS) diagnostic criteria, patients with uterine adhesions diagnosed with full civil capacity and with a score of ≥5 were enrolled in the study;
  • The patient had one or more of the following clinical symptoms: reduced menstruation or amenorrhea, periodic abdominal pain, secondary infertility, recurrent abortion, premature delivery and other adverse pregnancy outcomes;
  • The uterus was smaller than 8 weeks gestation and the uterine cavity depth was less than 12 cm;
  • The second to fifth day of menstruation FSH <10mIU/mL, AMH >1.2ng/mL, AFC>6;
  • Understand and sign informed consent voluntarily.

Exclusion Criteria:

  • Patients with acute pelvic inflammation or endometriosis;
  • Having or having a history of malignancy;
  • Thrombus, lupus erythematosus and other hormone use contraindications; Allergic to albumin products;
  • Patients with uterine malformation, adenomyosis, submucosal uterine fibroids,and uterine fibroids of any site >5cm;
  • Patients who were using anticoagulants or who had not recovered normal platelet function 10 days after discontinuation of antiplatelet drugs;
  • Previous history of abnormal coagulation function or abnormality before cell transplantation;
  • Always has a history of abnormal bleeding (such as abnormal bleeding during tooth extraction), or their immediate family members have hemorrhagic disease,such as hemophilia, bleeding symptoms (e.g., hematemesis, black, serious or recurrent nasal bleeding, coughing up blood, obvious hematuria, gastrointestinal bleeding, or intracranial hemorrhage), or suspected of vascular malformation such as aneurysm by researchers determine influence cell implant operation;
  • Alcohol or drug addiction;
  • Participated in other interventional clinical trials within 90 days before the informed consent was signed or before the cell transplantation;
  • Had used glucocorticoids or immunosuppressive drugs within 12 weeks before signing the informed consent;
  • Had used antipsychotic drugs, such as antidepressants and anti-manic drugs, within 12 weeks before signing the informed consent;
  • Severe heart failure within 24 weeks before the informed consent;
  • Glomerular filtration rate (eGFR) <90ml/min;
  • ALT>3 times normal upper limit;
  • Concomitant with other serious systemic diseases, such as pulmonary heart disease, severe chronic obstructive pulmonary disease (COPD), etc;
  • Patients with severe clinical infection should receive antibiotics within 1 week before signing the informed consent;
  • Active infectious diseases, including but not limited to positive human immunodeficiency virus and syphilis antibody;
  • The researchers considered poor compliance;
  • Other conditions not suitable for participation in this clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Experimental

    Arm Label

    Stem cell preparation solution injection group

    Injected stem cell group

    Arm Description

    The solution of stem cells preparation will be injected.

    The stem cells will injected.

    Outcomes

    Primary Outcome Measures

    Incidence of different Adverse Events of transplantation of mesenchymal cells from human embryonic stem cells
    Adverse events (AE), severe adverse events (SAE), and treatment-related adverse events (TEAE) occurred within 48 weeks after surgery.

    Secondary Outcome Measures

    Normal recovery rate of endometrial thickness
    Normal recovery rate of endometrial thickness at 1 and 2 months after surgery will be measured (effective rate = endometrium > 6mm after surgery/all participants ×100%).
    recurrence rate of intrauterine adhesions
    Recurrence rate of intrauterine adhesions (defined as patients with recurrence of intrauterine adhesions reviewed by hysteroscopy at 1 month/total patients ×100%) will be measured.
    Intrauterine adhesions score
    Intrauterine adhesions score will be measured according to the American Fertility Society in 1988 diagnostic criteria for intrauterine adhesions.The scores range from 1 to 12. Higher scores mean a worse outcome.
    The endometrial biopsies for CD31
    Immunohistochemical results of CD31 during the two endometrial biopsies will be measured.
    Menstrual volume change
    Menstrual volume change will be assessed according to menstrual blood loss chart.
    Clinical pregnancy rate
    Clinical pregnancy rate, abortion rate, live birth rate, and sustained pregnancy rate (defined as live pregnancy over 12 weeks) will be assessed.
    The endometrial biopsies for estrogen
    Estrogen receptor levels during the two endometrial biopsies will be measured.
    The endometrial biopsies for Ki67
    Ki67 expression levels during the two endometrial biopsies will be measured.

    Full Information

    First Posted
    December 27, 2019
    Last Updated
    January 15, 2020
    Sponsor
    Qi Zhou
    Collaborators
    Tongji Hospital
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04232592
    Brief Title
    Clinical Safety Study of Human Embryonic Stem Cell Derived Mesenchymal Cells in the Treatment of Moderate and Severe Intrauterine Adhesions
    Official Title
    Clinical Safety Study of Human Embryonic Stem Cell Derived Mesenchymal Cells in the Treatment of Moderate and Severe Intrauterine Adhesions
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2019
    Overall Recruitment Status
    Unknown status
    Study Start Date
    January 2020 (Anticipated)
    Primary Completion Date
    January 2022 (Anticipated)
    Study Completion Date
    January 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Qi Zhou
    Collaborators
    Tongji Hospital

    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
    To observe the clinical safety of intrauterine injection of human embryonic stem cell derived mesenchymal cells in the treatment of moderate and severe intrauterine adhesion, and to preliminarily explore its clinical effectiveness in promoting endometrial regeneration and repair.
    Detailed Description
    In this study, a single-center, controlled, open-label design was used for a dose escalation study.To observe the clinical safety of intrauterine injection of human embryonic stem cell derived mesenchymal cells in the treatment of moderate and severe intrauterine adhesion, and to preliminarily explore its clinical effectiveness in promoting endometrial regeneration and repair.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Intrauterine Adhesion

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    32 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Stem cell preparation solution injection group
    Arm Type
    Experimental
    Arm Description
    The solution of stem cells preparation will be injected.
    Arm Title
    Injected stem cell group
    Arm Type
    Experimental
    Arm Description
    The stem cells will injected.
    Intervention Type
    Biological
    Intervention Name(s)
    Inject a solution of stem cell preparation
    Intervention Description
    The control group was injected with a solution of stem cell preparation
    Intervention Type
    Biological
    Intervention Name(s)
    Inject stem cells
    Intervention Description
    Three dose groups were designed: low dose group, medium dose group and high dose group.
    Primary Outcome Measure Information:
    Title
    Incidence of different Adverse Events of transplantation of mesenchymal cells from human embryonic stem cells
    Description
    Adverse events (AE), severe adverse events (SAE), and treatment-related adverse events (TEAE) occurred within 48 weeks after surgery.
    Time Frame
    Within 48 weeks after surgery
    Secondary Outcome Measure Information:
    Title
    Normal recovery rate of endometrial thickness
    Description
    Normal recovery rate of endometrial thickness at 1 and 2 months after surgery will be measured (effective rate = endometrium > 6mm after surgery/all participants ×100%).
    Time Frame
    12 months
    Title
    recurrence rate of intrauterine adhesions
    Description
    Recurrence rate of intrauterine adhesions (defined as patients with recurrence of intrauterine adhesions reviewed by hysteroscopy at 1 month/total patients ×100%) will be measured.
    Time Frame
    12 months
    Title
    Intrauterine adhesions score
    Description
    Intrauterine adhesions score will be measured according to the American Fertility Society in 1988 diagnostic criteria for intrauterine adhesions.The scores range from 1 to 12. Higher scores mean a worse outcome.
    Time Frame
    12 months
    Title
    The endometrial biopsies for CD31
    Description
    Immunohistochemical results of CD31 during the two endometrial biopsies will be measured.
    Time Frame
    12 months
    Title
    Menstrual volume change
    Description
    Menstrual volume change will be assessed according to menstrual blood loss chart.
    Time Frame
    12 months
    Title
    Clinical pregnancy rate
    Description
    Clinical pregnancy rate, abortion rate, live birth rate, and sustained pregnancy rate (defined as live pregnancy over 12 weeks) will be assessed.
    Time Frame
    12 months
    Title
    The endometrial biopsies for estrogen
    Description
    Estrogen receptor levels during the two endometrial biopsies will be measured.
    Time Frame
    12 months
    Title
    The endometrial biopsies for Ki67
    Description
    Ki67 expression levels during the two endometrial biopsies will be measured.
    Time Frame
    12 months

    10. Eligibility

    Sex
    Female
    Gender Based
    Yes
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    38 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Criteria: Inclusion Criteria: 18 ≤ age ≤38, female; According to the 1988 American Fertility Society (AFS) diagnostic criteria, patients with uterine adhesions diagnosed with full civil capacity and with a score of ≥5 were enrolled in the study; The patient had one or more of the following clinical symptoms: reduced menstruation or amenorrhea, periodic abdominal pain, secondary infertility, recurrent abortion, premature delivery and other adverse pregnancy outcomes; The uterus was smaller than 8 weeks gestation and the uterine cavity depth was less than 12 cm; The second to fifth day of menstruation FSH <10mIU/mL, AMH >1.2ng/mL, AFC>6; Understand and sign informed consent voluntarily. Exclusion Criteria: Patients with acute pelvic inflammation or endometriosis; Having or having a history of malignancy; Thrombus, lupus erythematosus and other hormone use contraindications; Allergic to albumin products; Patients with uterine malformation, adenomyosis, submucosal uterine fibroids,and uterine fibroids of any site >5cm; Patients who were using anticoagulants or who had not recovered normal platelet function 10 days after discontinuation of antiplatelet drugs; Previous history of abnormal coagulation function or abnormality before cell transplantation; Always has a history of abnormal bleeding (such as abnormal bleeding during tooth extraction), or their immediate family members have hemorrhagic disease,such as hemophilia, bleeding symptoms (e.g., hematemesis, black, serious or recurrent nasal bleeding, coughing up blood, obvious hematuria, gastrointestinal bleeding, or intracranial hemorrhage), or suspected of vascular malformation such as aneurysm by researchers determine influence cell implant operation; Alcohol or drug addiction; Participated in other interventional clinical trials within 90 days before the informed consent was signed or before the cell transplantation; Had used glucocorticoids or immunosuppressive drugs within 12 weeks before signing the informed consent; Had used antipsychotic drugs, such as antidepressants and anti-manic drugs, within 12 weeks before signing the informed consent; Severe heart failure within 24 weeks before the informed consent; Glomerular filtration rate (eGFR) <90ml/min; ALT>3 times normal upper limit; Concomitant with other serious systemic diseases, such as pulmonary heart disease, severe chronic obstructive pulmonary disease (COPD), etc; Patients with severe clinical infection should receive antibiotics within 1 week before signing the informed consent; Active infectious diseases, including but not limited to positive human immunodeficiency virus and syphilis antibody; The researchers considered poor compliance; Other conditions not suitable for participation in this clinical trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Liu Wang, Doctor
    Phone
    +86-01064807858
    Email
    wangliu@ioz.ac.cn
    First Name & Middle Initial & Last Name or Official Title & Degree
    Jie Hao, Doctor
    Phone
    +86-01062558737
    Email
    haojie@ioz.ac.cn
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Qi Zhou, Doctor
    Organizational Affiliation
    Institute of zoology, Chinese Academy of Sciences
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Clinical Safety Study of Human Embryonic Stem Cell Derived Mesenchymal Cells in the Treatment of Moderate and Severe Intrauterine Adhesions

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