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Safety and Exploratory Efficacy Study of NEUROSTEM® Versus Placebo in Patients With Alzheimer's Disease

Primary Purpose

Alzheimer's Disease

Status
Completed
Phase
Phase 1
Locations
Korea, Republic of
Study Type
Interventional
Intervention
human umbilical cord blood derived mesenchymal stem cells
Normal saline 2mL
Sponsored by
Medipost Co Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease focused on measuring human umbilical cord blood derived mesenchymal stem cells, stem cells, alzheimer's disease, cognitive ability, mesenchymal stem cells, cord blood

Eligibility Criteria

50 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

1 stage Inclusion Criteria:

  1. Korean male or female at 50 -85 years of age
  2. Diagnosis of Probable Alzheimer type according to NINCDS-ADRDA criteria at Visit 1 (Screening)
  3. Korea Mini-Mental State Examination (KMMSE) score of 18 - 26 at Visit 1 (Screening)
  4. Positive for Amyloid on PIB-PET or Florbetaben PET
  5. A subject who is informed of the clinical trial and signs a consent form (if unable to sign, a consent from a legally acceptable representative is required)

2 stage Inclusion Criteria:

  1. Korean male or female at 50 -85 years of age
  2. Diagnosis of Probable Alzheimer type or mild cognitive impairment due to Alzheimer's disease (stage A) according to NIA-AA criteria at Visit 1(Screening)
  3. Korea Mini-Mental State Examination (KMMSE) score of over 18 at Visit 1 (Screening)
  4. Positive for Amyloid on Florbetaben PET
  5. A subject with neurodegeneration (mild atrophy of the brain) as confirmed by MRI
  6. A subject who is informed of the clinical trial and signs a consent form (if unable to sign, a consent from a legally acceptable representative is required)

Exclusion Criteria:

  1. Concurrent mental disorder (such as schizophrenia, depression, bi-polar diseases or others) aside from dementia
  2. Concurrent dementia as a result of other neurodegenerative disorders (due to infectious disease of the central nervous system such as HIV, syphilis), head injury, Creutzfeld-Jacob disease, Pick's disease, Huntington's disease, or Parkinson's disease
  3. Diagnosis of severe white matter hyperintensitivity (WMH) according to CREDOS (Clinical REsearch Center for Dementia of South Korea), which is defined as ≥ 25mm of the deep white matter and ≥ 10mm of the periventricular capping/banding in lengths
  4. History of stroke within 3 months prior to study enrollment
  5. Severe liver disorder (equivalent to double the normal values of ALT and AST) at Visit 1
  6. Severe kidney disorder (serum creatinine ≥1.5mg/dL) at Visit 1
  7. Pregnant or lactating females
  8. Abnormal Laboratory findings at Visit 1

    • Hemoglobin < 9.5 g/dL for male and <9.0 g/dL for female
    • Total WBC Count < 3000/mm3
    • Total Bilirubin >= 3 mg/dL
  9. Suspected active lung disease based on chest X-ray at Visit 1
  10. Woman of childbearing age who refuses to practice medically acceptable contraceptive method (post menopausal patient with no menstruation for at least 12 months is considered as infertile)
  11. History of screening failure for the clinical trial of NEUROSTEM® in the past 6 months
  12. Participation in another clinical trial in the past 3 months prior to the beginning (Week 0) of this clinical trial
  13. Bleeding disorder (abnormal blood coagulation test result (i.e. platelet count of < 150,000/mm3, PT ≥ 1.5 INR, or aPTT ≥ 1.5 x control anti-coagulant or anti-platelet, without anticoagulant or anti-platelet therapy)
  14. Diagnosis of cancer (of any body system, including brain tumor)
  15. Substance/alcohol abuse
  16. Contraindicated for any of the tests performed during the clinical trial period (for example, MRI, CT, PET)
  17. A subject in whom Ommaya reservoir insertion is considered difficult
  18. Whom the principal investigator considers inappropriate for participation in the study due to any reasons other than those listed above

Sites / Locations

  • Samsung Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

NEUROSTEM (hUCB-MSCs)- low dose

NEUROSTEM (hUCB-MSCs) - high dose

Placebo

Arm Description

human umbilical cord blood derived mesenchymal stem cells Low dose: 1 x 10^7cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals

human umbilical cord blood derived mesenchymal stem cells High dose: 3 x 10^7 cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals

normal saline 2mL, doses separated by 4 weeks for a total of 3 doses

Outcomes

Primary Outcome Measures

Number of subjects with adverse events
Number of subjects with adverse event, number of subjects with normal range of vital signs, mixed lymphocyte reaction result, and laboratory examination result

Secondary Outcome Measures

Change from the baseline in ADAS-Cog
Alzheimer's Disease assessment Scale-Cognitive Subscale
Change from the baseline in S-IADL
Seoul Instrumental Activities of Daily Living
Change from the baseline in K-MMSE
Mini Mental State Exmination Korean version
Change from the baseline in CGA-NPI
Caregiver-administered Neuropsychiatric Inventory
ADAS-Cog Response Rate
ADAS-cog response is defined as no worsening (no change or improvement on ADAS-cog score) of the ADAS-cog score at 24 weeks after the first administration compared to the baseline
Change in CDR-SOB
Clinical Dementia Rating-Sum of Box
Change in Florbetaben-PET
Florbetaben - Pittsburgh Compound B-positron emission tomography
Change in FDG-PET (CMRglc: regional cerebral metabolic rate for glucose)
fluorodeoxyglucose positron emission tomography
Change in CIBIC-plus
The Clinician's Interview Based Impression of Change-plus
Change from baseline in MRI (DTI mapping)
MRI Analysis
Change from the baseline in CSF biomarkers
biomakrer analysis

Full Information

First Posted
January 29, 2014
Last Updated
August 26, 2020
Sponsor
Medipost Co Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02054208
Brief Title
Safety and Exploratory Efficacy Study of NEUROSTEM® Versus Placebo in Patients With Alzheimer's Disease
Official Title
A Double-blind, Single-center, Phase 1/2a Clinical Trial to Evaluate the Safety and Exploratory Efficacy of Intraventricular Administrations of NEUROSTEM® Versus Placebo Via an Ommaya Reservoir in Patients With Alzheimer's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
August 2018
Overall Recruitment Status
Completed
Study Start Date
March 2014 (Actual)
Primary Completion Date
December 2019 (Actual)
Study Completion Date
December 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medipost Co Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This combined phase 1/2a clinical trial is to investigate the safety, dose limiting toxicity (DLT), and exploratory efficacy of three repeated intraventricular administrations of NEUROSTEM® (human umbilical cord blood-derived mesenchymal stem cells) versus placebo via an Ommaya reservoir at 4 week intervals in patients with Alzheimer's disease.
Detailed Description
The study is divided into the 2 stages: dose-escalation in stage 1 and randomized and multiple-dose cohort parallel design in stage 2.The target population for enrollment in this study is patients with mild to moderate Alzheimer's disease.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease
Keywords
human umbilical cord blood derived mesenchymal stem cells, stem cells, alzheimer's disease, cognitive ability, mesenchymal stem cells, cord blood

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Stage 1: 9 subjects (3 subjects for low dose and 6 subjects for high dose) Stage 2: 36 subjects ( 24 subjects for high dose and 12 subjects for placebo) A total of 45 subjects to be enrolled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
46 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NEUROSTEM (hUCB-MSCs)- low dose
Arm Type
Experimental
Arm Description
human umbilical cord blood derived mesenchymal stem cells Low dose: 1 x 10^7cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals
Arm Title
NEUROSTEM (hUCB-MSCs) - high dose
Arm Type
Experimental
Arm Description
human umbilical cord blood derived mesenchymal stem cells High dose: 3 x 10^7 cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
normal saline 2mL, doses separated by 4 weeks for a total of 3 doses
Intervention Type
Biological
Intervention Name(s)
human umbilical cord blood derived mesenchymal stem cells
Other Intervention Name(s)
NEUROSTEM
Intervention Description
Low dose: 1 x 10^7cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals High dose: 3 x 10^7cells/2mL 3 repeated intraventricular administrations via an Ommaya Reservoir at 4 week intervals
Intervention Type
Other
Intervention Name(s)
Normal saline 2mL
Intervention Description
Intraventricular administrations of 2mL Normal Saline at 4 week intervals via an Ommaya Reservoir, for a total of 3 administrations
Primary Outcome Measure Information:
Title
Number of subjects with adverse events
Description
Number of subjects with adverse event, number of subjects with normal range of vital signs, mixed lymphocyte reaction result, and laboratory examination result
Time Frame
24 weeks after the first dose
Secondary Outcome Measure Information:
Title
Change from the baseline in ADAS-Cog
Description
Alzheimer's Disease assessment Scale-Cognitive Subscale
Time Frame
24 weeks after the first dose
Title
Change from the baseline in S-IADL
Description
Seoul Instrumental Activities of Daily Living
Time Frame
24 weeks after the first dose
Title
Change from the baseline in K-MMSE
Description
Mini Mental State Exmination Korean version
Time Frame
24 weeks after the first dose
Title
Change from the baseline in CGA-NPI
Description
Caregiver-administered Neuropsychiatric Inventory
Time Frame
24 weeks from the first dose
Title
ADAS-Cog Response Rate
Description
ADAS-cog response is defined as no worsening (no change or improvement on ADAS-cog score) of the ADAS-cog score at 24 weeks after the first administration compared to the baseline
Time Frame
24 weeks after the first dose
Title
Change in CDR-SOB
Description
Clinical Dementia Rating-Sum of Box
Time Frame
24 weeks after the first dose
Title
Change in Florbetaben-PET
Description
Florbetaben - Pittsburgh Compound B-positron emission tomography
Time Frame
24 weeks after the first dose
Title
Change in FDG-PET (CMRglc: regional cerebral metabolic rate for glucose)
Description
fluorodeoxyglucose positron emission tomography
Time Frame
24 weeks after the first dose
Title
Change in CIBIC-plus
Description
The Clinician's Interview Based Impression of Change-plus
Time Frame
24 weeks after the first dose
Title
Change from baseline in MRI (DTI mapping)
Description
MRI Analysis
Time Frame
24 weeks after the first dose
Title
Change from the baseline in CSF biomarkers
Description
biomakrer analysis
Time Frame
24 weeks after the first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
1 stage Inclusion Criteria: Korean male or female at 50 -85 years of age Diagnosis of Probable Alzheimer type according to NINCDS-ADRDA criteria at Visit 1 (Screening) Korea Mini-Mental State Examination (KMMSE) score of 18 - 26 at Visit 1 (Screening) Positive for Amyloid on PIB-PET or Florbetaben PET A subject who is informed of the clinical trial and signs a consent form (if unable to sign, a consent from a legally acceptable representative is required) 2 stage Inclusion Criteria: Korean male or female at 50 -85 years of age Diagnosis of Probable Alzheimer type or mild cognitive impairment due to Alzheimer's disease (stage A) according to NIA-AA criteria at Visit 1(Screening) Korea Mini-Mental State Examination (KMMSE) score of over 18 at Visit 1 (Screening) Positive for Amyloid on Florbetaben PET A subject with neurodegeneration (mild atrophy of the brain) as confirmed by MRI A subject who is informed of the clinical trial and signs a consent form (if unable to sign, a consent from a legally acceptable representative is required) Exclusion Criteria: Concurrent mental disorder (such as schizophrenia, depression, bi-polar diseases or others) aside from dementia Concurrent dementia as a result of other neurodegenerative disorders (due to infectious disease of the central nervous system such as HIV, syphilis), head injury, Creutzfeld-Jacob disease, Pick's disease, Huntington's disease, or Parkinson's disease Diagnosis of severe white matter hyperintensitivity (WMH) according to CREDOS (Clinical REsearch Center for Dementia of South Korea), which is defined as ≥ 25mm of the deep white matter and ≥ 10mm of the periventricular capping/banding in lengths History of stroke within 3 months prior to study enrollment Severe liver disorder (equivalent to double the normal values of ALT and AST) at Visit 1 Severe kidney disorder (serum creatinine ≥1.5mg/dL) at Visit 1 Pregnant or lactating females Abnormal Laboratory findings at Visit 1 Hemoglobin < 9.5 g/dL for male and <9.0 g/dL for female Total WBC Count < 3000/mm3 Total Bilirubin >= 3 mg/dL Suspected active lung disease based on chest X-ray at Visit 1 Woman of childbearing age who refuses to practice medically acceptable contraceptive method (post menopausal patient with no menstruation for at least 12 months is considered as infertile) History of screening failure for the clinical trial of NEUROSTEM® in the past 6 months Participation in another clinical trial in the past 3 months prior to the beginning (Week 0) of this clinical trial Bleeding disorder (abnormal blood coagulation test result (i.e. platelet count of < 150,000/mm3, PT ≥ 1.5 INR, or aPTT ≥ 1.5 x control anti-coagulant or anti-platelet, without anticoagulant or anti-platelet therapy) Diagnosis of cancer (of any body system, including brain tumor) Substance/alcohol abuse Contraindicated for any of the tests performed during the clinical trial period (for example, MRI, CT, PET) A subject in whom Ommaya reservoir insertion is considered difficult Whom the principal investigator considers inappropriate for participation in the study due to any reasons other than those listed above
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Wonil Oh, MD, PhD
Organizational Affiliation
Medipost Co Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Samsung Medical Center
City
Seoul
Country
Korea, Republic of

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34521461
Citation
Kim HJ, Cho KR, Jang H, Lee NK, Jung YH, Kim JP, Lee JI, Chang JW, Park S, Kim ST, Moon SW, Seo SW, Choi SJ, Na DL. Intracerebroventricular injection of human umbilical cord blood mesenchymal stem cells in patients with Alzheimer's disease dementia: a phase I clinical trial. Alzheimers Res Ther. 2021 Sep 14;13(1):154. doi: 10.1186/s13195-021-00897-2.
Results Reference
derived
Links:
URL
http://www.clinicaltrials.gov/ct2/show/NCT01297218?term=neurostem&rank=2
Description
first-in-man study of NEUROSTEM

Learn more about this trial

Safety and Exploratory Efficacy Study of NEUROSTEM® Versus Placebo in Patients With Alzheimer's Disease

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