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Mesenchymal Stromal Cells in Adults With Recessive Dystrophic Epidermolysis Bullosa (ADSTEM)

Primary Purpose

Recessive Dystrophic Epidermolysis Bullosa

Status
Unknown status
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Mesenchymal stromal cells
Sponsored by
King's College London
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Recessive Dystrophic Epidermolysis Bullosa

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Individuals with a diagnosis of RDEB confirmed by DNA analysis and skin immunofluorescence for partial or complete absence of type VII collagen.
  2. Individuals ≥ 18 years and ≤ 65 years of age, both male and female
  3. Individuals that have voluntarily signed and dated an informed consent form (ICF) prior to the first study intervention.

Exclusion Criteria:

  1. Subjects who have had other investigational medicinal products within 90 days prior to screening or during the treatment phase.
  2. Subjects who have received immunotherapy including oral corticosteroids for more than 1 week (intranasal and topical preparations are permitted).
  3. Subjects with a known allergy to any of the constituents of the investigational product.
  4. Subjects with a medical history or evidence of malignancy, including cutaneous squamous cell carcinoma.
  5. Subjects who are pregnant or of child-bearing potential who are not abstinent or practicing an acceptable means of contraception, as determined by the Investigator, for the duration of the treatment phase.

Sites / Locations

  • Guys and St Thomas' hospital NHS Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention arm

Arm Description

10 patients with RDEB will be selected to receive the intervention - mesenchymal stromal cells.

Outcomes

Primary Outcome Measures

Lack of serious and severe adverse events (SAEs) related to the administration of the investigational medicinal product.

Secondary Outcome Measures

Presence of new type VII collagen at the dermal-epidermal junction post treatment.
Change in general markers of inflammation
Changes in specific markers of inflammation
Change in the clinical changes in the skin assessed with clinical photographs
Differences in quality of life data
Change in BEBSS and EBDASI scores
Change in Pain scores
Change in pruritus score using the Leuven Itch Scale (LIS)
Quantification of total blister numbers over the entire body surface area
10. Increase in the skin strength measured by time to blister formation after negative pressure skin suction test
Qualitative analyses based on a series of interview questions
to reveal objective data on quality of sleep, skin healing time, amount of dressings used, improvement in oral diet, improvement in energy levels, mood, quality of family life/relationships.

Full Information

First Posted
December 18, 2014
Last Updated
March 1, 2017
Sponsor
King's College London
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1. Study Identification

Unique Protocol Identification Number
NCT02323789
Brief Title
Mesenchymal Stromal Cells in Adults With Recessive Dystrophic Epidermolysis Bullosa
Acronym
ADSTEM
Official Title
A Phase I/II Study Evaluating Allogeneic Mesenchymal Stromal Cells in Adults With Recessive Dystrophic Epidermolysis Bullosa
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Unknown status
Study Start Date
June 2015 (Actual)
Primary Completion Date
July 2017 (Anticipated)
Study Completion Date
July 2017 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
King's College London

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To assess whether intravenously administered third-party bone marrow-derived mesenchymal stromal cells (MSCs) are safe and have an impact on disease severity in RDEB
Detailed Description
This is a phase I/II clinical trial with a key objective of evaluating safety of third party bone MSCs intravenous infusions in 10 adults with the inherited severe skin fragility disorder, recessive dystrophic epidermolysis bullosa (RDEB). The main objectives of our study are to: (1) to assess the spectrum of clinical responses in adults with RDEB receiving intravenous MSCs; (2) to identify the best cohort of individuals to target for future trials and therapies; (3) to improve our understanding of in vivo and in vitro responsiveness to MSCs; (4) to identify candidate molecules germane to activating MSCs and making them clinically more potent, independently of the permissive conditions of the patient and (5) to assess its impact on reducing disease morbidity/severity in this population. This is a prospective, non-randomised, open label study. All study participants will receive two intravenous MSC infusions at baseline Day 0 and Day 14 and will be followed up for a 12 month period following the first infusion. Each subject will undergo an initial screening including physical examination, assessment of vital signs and disease severity assessment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recessive Dystrophic Epidermolysis Bullosa

7. Study Design

Primary Purpose
Other
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Intervention arm
Arm Type
Experimental
Arm Description
10 patients with RDEB will be selected to receive the intervention - mesenchymal stromal cells.
Intervention Type
Drug
Intervention Name(s)
Mesenchymal stromal cells
Other Intervention Name(s)
TC-MSC
Intervention Description
TC-MSC: a cell product containing mesenchymal stromal cells. Mesenchymal stromal cells are adherent non-haematopoietic multipotent cells that are expanded from bone marrow from healthy donors, using platelet lysate as source of growth factor.
Primary Outcome Measure Information:
Title
Lack of serious and severe adverse events (SAEs) related to the administration of the investigational medicinal product.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Presence of new type VII collagen at the dermal-epidermal junction post treatment.
Time Frame
Day 14, Day 28, Day 60, Day 100 and Month 6.
Title
Change in general markers of inflammation
Time Frame
Day 14, Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
Changes in specific markers of inflammation
Time Frame
Day 14, Day 28, Day 60 and Month 6 compared to baseline
Title
Change in the clinical changes in the skin assessed with clinical photographs
Time Frame
Day 14, Day 28, Day 60, Day 100, Month 6 and Month 12.
Title
Differences in quality of life data
Time Frame
Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
Change in BEBSS and EBDASI scores
Time Frame
at Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
Change in Pain scores
Time Frame
Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
Change in pruritus score using the Leuven Itch Scale (LIS)
Time Frame
Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline.
Title
Quantification of total blister numbers over the entire body surface area
Time Frame
Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
10. Increase in the skin strength measured by time to blister formation after negative pressure skin suction test
Time Frame
Day 28, Day 60, Day 100, Month 6 and Month 12 compared to baseline
Title
Qualitative analyses based on a series of interview questions
Description
to reveal objective data on quality of sleep, skin healing time, amount of dressings used, improvement in oral diet, improvement in energy levels, mood, quality of family life/relationships.
Time Frame
between screening and Day 0, between Day 28 and Day 60, and between Month 6 and Month 12.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals with a diagnosis of RDEB confirmed by DNA analysis and skin immunofluorescence for partial or complete absence of type VII collagen. Individuals ≥ 18 years and ≤ 65 years of age, both male and female Individuals that have voluntarily signed and dated an informed consent form (ICF) prior to the first study intervention. Exclusion Criteria: Subjects who have had other investigational medicinal products within 90 days prior to screening or during the treatment phase. Subjects who have received immunotherapy including oral corticosteroids for more than 1 week (intranasal and topical preparations are permitted). Subjects with a known allergy to any of the constituents of the investigational product. Subjects with a medical history or evidence of malignancy, including cutaneous squamous cell carcinoma. Subjects who are pregnant or of child-bearing potential who are not abstinent or practicing an acceptable means of contraception, as determined by the Investigator, for the duration of the treatment phase.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John McGrath, FRCP/FSci/MD
Organizational Affiliation
King's College London
Official's Role
Principal Investigator
Facility Information:
Facility Name
Guys and St Thomas' hospital NHS Trust
City
London
ZIP/Postal Code
SE1 9RT
Country
United Kingdom

12. IPD Sharing Statement

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Mesenchymal Stromal Cells in Adults With Recessive Dystrophic Epidermolysis Bullosa

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