Phase II Combination Stem Cell Therapy for the Treatment of Severe Coronary Ischemia(CI)
Primary Purpose
Heart Disease, Blocked Arteries, Coronary Ischemia
Status
Suspended
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
MESENDO
placebo
Sponsored by
About this trial
This is an interventional treatment trial for Heart Disease
Eligibility Criteria
Inclusion Criteria:
- Age 18 to 80
- Male or female
- Angina pectoris: Canadian Cardiovascular Society Class III or IV or symptoms consistent with angina equivalent (dyspnea) CCS Class III or IV (Functional Class)
- Chronic coronary artery disease in at least one epicardial vessel with stenosis > 70% by coronary angiography within the last 6 months
- Stable medical therapy for at least one month
- Reversible perfusion defects by SPECT
- Not a candidate for coronary artery by-pass surgery due to poor targets or small vessels and not a candidate for percutaneous intervention due to small vessels or unreachable coronary lesions due to complicated anatomy
Exclusion Criteria:
- Inability to give written informed consent
- Previous angiogenic therapy or myocardial laser therapy
- Recent (< 4 weeks) acute ST-elevation myocardial infarction
- Patients with severe valvular heart disease
- Recent malignancy or radiation therapy (< 6 months) and not expected to survive 6 months
- Known sensitivity to gentamycin and/or amphotericin B
- Use or expected use of antineoplastic drugs
- Renal insufficiency with creatinine greater than 2.7 unless on dialysis
- WBC greater than 13,000 or lower than 3,000
- Hematocrit lower than 30 or higher than 50
- Platelet counts lower than 60,000 or higher than 500,000
- Child bearing potential without use of contraceptives
- Pregnant or planning to become pregnant
- Any illness which, in the investigator's judgment, will interfere with the patient's ability to comply with the protocol, compromise patient's safety, or interfere with the interpretation of the sturdy results
- Any illness which might affect patient's survival over the study follow-up period
- History of skeletal muscle disease, either primary (i.e. myopathy) or secondary (i.e. ischemic) or any underlying myopathy such as myasthenia gravis, muscular dystrophy, etc
- Patients with active infectious disease and/or who are known to have tested positive for HIV, HTLV, HBV-sAg, HCV, AST or ALT > 2 times ULRR
- Cardiogenic shock
- Any significant laboratory abnormality which will in the investigator's opinion interfere with the patient's ability to comply with the protocol, compromise the patient's safety, or interfere with the interpretation of the study result
Sites / Locations
- TCA Cellular Therapy
Arms of the Study
Arm 1
Arm 2
Arm Type
Placebo Comparator
Experimental
Arm Label
Placebo
MESENDO
Arm Description
20 individuals will receive placebo.
Active combination autologous stem cell therapy. 40 individuals will receive MESENDO in either the "high" or "low" dose treatment groups.
Outcomes
Primary Outcome Measures
Safety as measured by laboratory assessments, ecg and temperature.
Secondary Outcome Measures
Efficacy as measured by SPECT scan, MUGA scan and 2D Echogradiogram
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00790764
Brief Title
Phase II Combination Stem Cell Therapy for the Treatment of Severe Coronary Ischemia(CI)
Official Title
Phase II Study for the Transfer of Bone Marrow-Derived Mononuclear and Mesenchymal StemCells Into the Myocardium for the Treatment of Severe Coronary Ischemia
Study Type
Interventional
2. Study Status
Record Verification Date
April 2011
Overall Recruitment Status
Suspended
Why Stopped
Suspended due to lack of funding.
Study Start Date
November 2008 (undefined)
Primary Completion Date
May 2014 (Anticipated)
Study Completion Date
May 2014 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TCA Cellular Therapy
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The present investigation will be a Phase II, single center, placebo-controlled, randomized, dose escalation, infusion modality (intracoronary vs transendocardial injection using the Cordis Biosense NOGASTAR TM Mapping Catheter with the Biosense MYOSTAR TM left ventricular injection catheter) transplantation of an autologous (your own stem cells) combination of bone marrow-derived stem cells into myocardium for the treatment of severe coronary ischemia.
The purpose of this research study is to determine if the infusion of a combination of stem cells obtained from the bone marrow of the same patient will contribute to the formation of new blood vessels in patients with symptomatic severe coronary ischemia(CI).
In this trial we will determine whether the combination stem cell treatment is safe, feasible and results in the development of mature stable and/or collateral vessels and improvement of cardiac function.
Coronary Ischemia (CI) is intractable angina due to severe coronary artery disease which can seriously decrease blood flow to the heart.
CI needs a comprehensive treatment since the condition will not improve on its own. The overall goal of the treatment is to increase blood flow to the heart and improve symptoms of angina.
The study hypothesis is based on the concept that the process of formation of new blood vessels is complex and requires the participation of several types of stem cells and growth factors. The lack of any of these components will produce vessels which are immature and unable to provide appropriate blood supply to the heart.
Patients eligible to participate in this study are those suffering from severe blockages of the vessels of the heart and are not candidates for percutaneous revascularization or surgical procedures.
Detailed Description
Enrolled individuals (60) will be divided in 2 Treatment groups for the infusion of the cell /placebo product:
Treatment Group A (30 individuals, including patients and placebo controls) will receive the product by intracoronary infusion,
Treatment Group B (30 individuals, including patients and placebo controls) will receive the product by transendocardial injections.
In turn, each Treatment Group will consist of 2 subgroups of individuals that will receive the infusion of one of the two doses established of the cell product:
In treatment SubGroup 1, 10 individuals will receive the "low dose" of the cell product and 5 individuals will receive the placebo product.
In treatment SubGroup 2, 10 individuals will receive the "high dose" of the cell product and 5 individuals will receive the placebo product
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heart Disease, Blocked Arteries, Coronary Ischemia, Coronary Disease, Coronary Artery Disease, Coronary Atherosclerosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
60 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
20 individuals will receive placebo.
Arm Title
MESENDO
Arm Type
Experimental
Arm Description
Active combination autologous stem cell therapy. 40 individuals will receive MESENDO in either the "high" or "low" dose treatment groups.
Intervention Type
Biological
Intervention Name(s)
MESENDO
Intervention Description
For the cell product, proper aliquots of each cell type will be taken to fulfill the doses established for this protocol. The two aliquots will be mixed and resuspended to a final volume of 3 ml in the 'Final Suspension Medium' which consists of Dulbecco's Phosphate Buffered Saline (DPBS), containing 5% human serum albumin.
Intervention Type
Other
Intervention Name(s)
placebo
Intervention Description
For placebo, 3 ml of the 'Final Suspension Medium' which consists of Dulbecco's Phosphate Buffered Saline (DPBS), containing 5% human serum albumin will be transferred to a 5 ml syringe
Primary Outcome Measure Information:
Title
Safety as measured by laboratory assessments, ecg and temperature.
Time Frame
2 weeks
Secondary Outcome Measure Information:
Title
Efficacy as measured by SPECT scan, MUGA scan and 2D Echogradiogram
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 18 to 80
Male or female
Angina pectoris: Canadian Cardiovascular Society Class III or IV or symptoms consistent with angina equivalent (dyspnea) CCS Class III or IV (Functional Class)
Chronic coronary artery disease in at least one epicardial vessel with stenosis > 70% by coronary angiography within the last 6 months
Stable medical therapy for at least one month
Reversible perfusion defects by SPECT
Not a candidate for coronary artery by-pass surgery due to poor targets or small vessels and not a candidate for percutaneous intervention due to small vessels or unreachable coronary lesions due to complicated anatomy
Exclusion Criteria:
Inability to give written informed consent
Previous angiogenic therapy or myocardial laser therapy
Recent (< 4 weeks) acute ST-elevation myocardial infarction
Patients with severe valvular heart disease
Recent malignancy or radiation therapy (< 6 months) and not expected to survive 6 months
Known sensitivity to gentamycin and/or amphotericin B
Use or expected use of antineoplastic drugs
Renal insufficiency with creatinine greater than 2.7 unless on dialysis
WBC greater than 13,000 or lower than 3,000
Hematocrit lower than 30 or higher than 50
Platelet counts lower than 60,000 or higher than 500,000
Child bearing potential without use of contraceptives
Pregnant or planning to become pregnant
Any illness which, in the investigator's judgment, will interfere with the patient's ability to comply with the protocol, compromise patient's safety, or interfere with the interpretation of the sturdy results
Any illness which might affect patient's survival over the study follow-up period
History of skeletal muscle disease, either primary (i.e. myopathy) or secondary (i.e. ischemic) or any underlying myopathy such as myasthenia gravis, muscular dystrophy, etc
Patients with active infectious disease and/or who are known to have tested positive for HIV, HTLV, HBV-sAg, HCV, AST or ALT > 2 times ULRR
Cardiogenic shock
Any significant laboratory abnormality which will in the investigator's opinion interfere with the patient's ability to comply with the protocol, compromise the patient's safety, or interfere with the interpretation of the study result
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gabriel P. Lasala, MD
Organizational Affiliation
TCA Cellular Therapy
Official's Role
Principal Investigator
Facility Information:
Facility Name
TCA Cellular Therapy
City
Covington
State/Province
Louisiana
ZIP/Postal Code
70433
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Phase II Combination Stem Cell Therapy for the Treatment of Severe Coronary Ischemia(CI)
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