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Efficacy and Safety Study of Allogenic Mesenchymal Stem Cells for Patients With Refractory Primary Biliary Cirrhosis (MSCsTreatPBC)

Primary Purpose

Primary Biliary Cirrhosis

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Biological: mesenchymal stem cell
ursodeoxycholic acid
Sponsored by
Robert Chunhua Zhao, MD, PhD
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Biliary Cirrhosis focused on measuring biliary cirrhosis

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • There must be at least two of the following: a concentration in serum of AMAs at titres of 1:40 or higher; an unexplained rise in the amount of alkaline phosphatase of at least 1•5 times the upper limit of normal for more than 24 weeks; and compatible liver histological findings, specifically non-suppurative cholangitis and interlobular bile duct injury.
  • Incomplete response to UDCA at 13-15 mg/kg/day, Criteria for the group of complete responders is including: concentrations of alkaline phosphatase less than three times the upper limit of normal, aspartate aminotransferase less than twice the upper limit of normal, and bilirubin less than 17 μmol/L;and normalisation of abnormal concentrations of bilirubin, albumin, or both.
  • Liver pathological staging in 2 or3, Histological staging is based on Ludwig's and Scheuer's classifications

Exclusion Criteria:

  • Patients are receiving any other investigational agents within 4 weeks of study entry
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (defined as invasive fungal infection and progressive CMV viremia), symptomatic congestive heart failure (NYH class III and IV), unstable angina pectoris, or cardiac arrhythmia
  • In pregnancy or lactation
  • Psychiatric illness or mental deficiency making compliance with treatment or informed consent impossible
  • HCVpositive ,HBSAg positive or with other liver diseases
  • Combined with other autoimmune disease
  • Expected survival time is less than one year
  • Decompensation of liver function(Child B or C)
  • Have a history of allergy or Allergic constitution

Sites / Locations

  • Peking Union Medical College HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

allogenic mesenchymal stem cells (MSCs)

ursodeoxycholic acid (UDCA)

Arm Description

Patients who have primary biliary cirrhosis.

Patients who have primary biliary cirrhosis.

Outcomes

Primary Outcome Measures

serum level of alkaline phosphatase
Serum level of alkaline phosphatase will be measured at entry, 1 months,3 months, 6 months and 24 months after therapy

Secondary Outcome Measures

histological changes in liver biopsies
Liver biopsy of each patient will be taken before entry into therapeutic trials and at 6 months after therapy.
Serum levels of TNF-alpha
serum levels of TNF-alpha will be assessed before entry into therapeutic trials and at 6 months after therapy
changes in fatigue
changes in fatigue will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by PBC-40 score.
The occurrence of cirrhosis and its complications
Serum levels of Interleukin
serum levels of Interleukin will be assessed before entry into therapeutic trials and at 6 months after therapy
changes in pruritus severity
changes in pruritus severity will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by VAS score.

Full Information

First Posted
September 20, 2011
Last Updated
August 1, 2012
Sponsor
Robert Chunhua Zhao, MD, PhD
Collaborators
Peking Union Medical College Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT01440309
Brief Title
Efficacy and Safety Study of Allogenic Mesenchymal Stem Cells for Patients With Refractory Primary Biliary Cirrhosis
Acronym
MSCsTreatPBC
Official Title
Phase I Clinical Trial, Randomized, Controlled, to Evaluate the Efficacy and Safety of Therapy With Allogenic Mesenchymal Stem Cells From Bone Marrow for Patients With Refractory Primary Biliary Cirrhosis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2011
Overall Recruitment Status
Unknown status
Study Start Date
November 2011 (undefined)
Primary Completion Date
November 2013 (Anticipated)
Study Completion Date
December 2013 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Robert Chunhua Zhao, MD, PhD
Collaborators
Peking Union Medical College Hospital

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The study is designed to evaluate the safety and efficacy of intravenous administration of bone marrow derived mesenchymal stem cells for patients with refractory primary biliary cirrhosis (PBC).
Detailed Description
Primary biliary cirrhosis (PBC) is an organ-specific inflammatory disease and characterized by immune mediated destruction of intrahepatic bile ducts, then lead to liver cirrhosis and eventually failure.Currently, ursodeoxycholic acid (UDCA) is the only drug approved by the Food and Drug Administration (FDA). Novel treatment is urgently needed for patients who have an incomplete response to UDCA. Mesenchymal stem cells (MSC) represent a promising tool for cell-based therapies of autoimmune diseases. To explore the therapeutic effect of MSCs for PBC, the investigators plan to conduct an open-label, randomized clinical trial. Patients with PBC will be enrolled and randomly divided into two groups which will receive MSCs and UDCA respectively. The investigators will evaluate the efficacy and safety of MSCs for PBC by comparison of symptom improvement, survival rate and side effects in the two groups.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Biliary Cirrhosis
Keywords
biliary cirrhosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
allogenic mesenchymal stem cells (MSCs)
Arm Type
Experimental
Arm Description
Patients who have primary biliary cirrhosis.
Arm Title
ursodeoxycholic acid (UDCA)
Arm Type
Active Comparator
Arm Description
Patients who have primary biliary cirrhosis.
Intervention Type
Biological
Intervention Name(s)
Biological: mesenchymal stem cell
Other Intervention Name(s)
regenerative medicine:MSCs
Intervention Description
Mesenchymal stem cells,5-50 million/kg, Intravenous infusion, One dosage,whether to give another dosage depending on patients' condition
Intervention Type
Drug
Intervention Name(s)
ursodeoxycholic acid
Other Intervention Name(s)
UDCA
Intervention Description
13-15 mg/kg/day, to the end of the study
Primary Outcome Measure Information:
Title
serum level of alkaline phosphatase
Description
Serum level of alkaline phosphatase will be measured at entry, 1 months,3 months, 6 months and 24 months after therapy
Time Frame
24 months after MSCs administration
Secondary Outcome Measure Information:
Title
histological changes in liver biopsies
Description
Liver biopsy of each patient will be taken before entry into therapeutic trials and at 6 months after therapy.
Time Frame
6 months after therapy
Title
Serum levels of TNF-alpha
Description
serum levels of TNF-alpha will be assessed before entry into therapeutic trials and at 6 months after therapy
Time Frame
6 months after therapy
Title
changes in fatigue
Description
changes in fatigue will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by PBC-40 score.
Time Frame
6 months after theraphy
Title
The occurrence of cirrhosis and its complications
Time Frame
24 months after therapy
Title
Serum levels of Interleukin
Description
serum levels of Interleukin will be assessed before entry into therapeutic trials and at 6 months after therapy
Time Frame
6 months after therapy
Title
changes in pruritus severity
Description
changes in pruritus severity will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by VAS score.
Time Frame
6 months after therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: There must be at least two of the following: a concentration in serum of AMAs at titres of 1:40 or higher; an unexplained rise in the amount of alkaline phosphatase of at least 1•5 times the upper limit of normal for more than 24 weeks; and compatible liver histological findings, specifically non-suppurative cholangitis and interlobular bile duct injury. Incomplete response to UDCA at 13-15 mg/kg/day, Criteria for the group of complete responders is including: concentrations of alkaline phosphatase less than three times the upper limit of normal, aspartate aminotransferase less than twice the upper limit of normal, and bilirubin less than 17 μmol/L;and normalisation of abnormal concentrations of bilirubin, albumin, or both. Liver pathological staging in 2 or3, Histological staging is based on Ludwig's and Scheuer's classifications Exclusion Criteria: Patients are receiving any other investigational agents within 4 weeks of study entry Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (defined as invasive fungal infection and progressive CMV viremia), symptomatic congestive heart failure (NYH class III and IV), unstable angina pectoris, or cardiac arrhythmia In pregnancy or lactation Psychiatric illness or mental deficiency making compliance with treatment or informed consent impossible HCVpositive ,HBSAg positive or with other liver diseases Combined with other autoimmune disease Expected survival time is less than one year Decompensation of liver function(Child B or C) Have a history of allergy or Allergic constitution
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Fengchun Zhang, MD
Phone
0086-10-65296891
Email
zhangfccra@yahoo.com.cn
First Name & Middle Initial & Last Name or Official Title & Degree
Yunjiao Yang, MD
Phone
0086-10-65295047
Email
yangyunjiao81@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fengchun Zhang, MD
Organizational Affiliation
Peking Union Medical College Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert Chunhua Zhao, MD,PhD
Organizational Affiliation
Chinese Academy of Medical Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fengchun Zhang, MD
Email
zhangfccra@yahoo.com.cn

12. IPD Sharing Statement

Citations:
PubMed Identifier
21235326
Citation
Sun Z, Han Q, Zhu Y, Li Z, Chen B, Liao L, Bian C, Li J, Shao C, Zhao RC. NANOG has a role in mesenchymal stem cells' immunomodulatory effect. Stem Cells Dev. 2011 Sep;20(9):1521-8. doi: 10.1089/scd.2010.0366. Epub 2011 Feb 26.
Results Reference
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PubMed Identifier
21078360
Citation
Shi D, Liao L, Zhang B, Liu R, Dou X, Li J, Zhu X, Yu L, Chen D, Zhao RC. Human adipose tissue-derived mesenchymal stem cells facilitate the immunosuppressive effect of cyclosporin A on T lymphocytes through Jagged-1-mediated inhibition of NF-kappaB signaling. Exp Hematol. 2011 Feb;39(2):214-224.e1. doi: 10.1016/j.exphem.2010.10.009. Epub 2010 Nov 13.
Results Reference
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PubMed Identifier
18832657
Citation
Zhang B, Liu R, Shi D, Liu X, Chen Y, Dou X, Zhu X, Lu C, Liang W, Liao L, Zenke M, Zhao RC. Mesenchymal stem cells induce mature dendritic cells into a novel Jagged-2-dependent regulatory dendritic cell population. Blood. 2009 Jan 1;113(1):46-57. doi: 10.1182/blood-2008-04-154138. Epub 2008 Oct 2.
Results Reference
background
PubMed Identifier
18673001
Citation
Liao L, Zhao RC. An overview of stem cell-based clinical trials in China. Stem Cells Dev. 2008 Aug;17(4):613-8. doi: 10.1089/scd.2008.0183.
Results Reference
background
PubMed Identifier
15257043
Citation
Fang B, Shi M, Liao L, Yang S, Liu Y, Zhao RC. Systemic infusion of FLK1(+) mesenchymal stem cells ameliorate carbon tetrachloride-induced liver fibrosis in mice. Transplantation. 2004 Jul 15;78(1):83-8. doi: 10.1097/01.tp.0000128326.95294.14.
Results Reference
background
PubMed Identifier
19788697
Citation
Wang J, Bian C, Liao L, Zhu Y, Li J, Zeng L, Zhao RC. Inhibition of hepatic stellate cells proliferation by mesenchymal stem cells and the possible mechanisms. Hepatol Res. 2009 Dec;39(12):1219-28. doi: 10.1111/j.1872-034X.2009.00564.x. Epub 2009 Sep 25.
Results Reference
background
PubMed Identifier
17999594
Citation
Chen L, Zhang W, Yue H, Han Q, Chen B, Shi M, Li J, Li B, You S, Shi Y, Zhao RC. Effects of human mesenchymal stem cells on the differentiation of dendritic cells from CD34+ cells. Stem Cells Dev. 2007 Oct;16(5):719-31. doi: 10.1089/scd.2007.0065.
Results Reference
background
PubMed Identifier
16008514
Citation
Deng W, Han Q, Liao L, You S, Deng H, Zhao RC. Effects of allogeneic bone marrow-derived mesenchymal stem cells on T and B lymphocytes from BXSB mice. DNA Cell Biol. 2005 Jul;24(7):458-63. doi: 10.1089/dna.2005.24.458.
Results Reference
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PubMed Identifier
15345288
Citation
Deng W, Han Q, Liao L, Li C, Ge W, Zhao Z, You S, Deng H, Zhao RC. Allogeneic bone marrow-derived flk-1+Sca-1- mesenchymal stem cells leads to stable mixed chimerism and donor-specific tolerance. Exp Hematol. 2004 Sep;32(9):861-7. doi: 10.1016/j.exphem.2004.06.009.
Results Reference
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PubMed Identifier
15186722
Citation
Zhang W, Ge W, Li C, You S, Liao L, Han Q, Deng W, Zhao RC. Effects of mesenchymal stem cells on differentiation, maturation, and function of human monocyte-derived dendritic cells. Stem Cells Dev. 2004 Jun;13(3):263-71. doi: 10.1089/154732804323099190.
Results Reference
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Efficacy and Safety Study of Allogenic Mesenchymal Stem Cells for Patients With Refractory Primary Biliary Cirrhosis

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