search
Back to results

Safety and Preliminary Efficacy Study of Mesenchymal Precursor Cells (MPCs) in Subjects With Lumbar Back Pain

Primary Purpose

Degenerative Disc Disease

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Single Dose MPCs Injection
Single injection of saline solution
Single injection of hyaluronic acid
Single Dose MPCs Injection
Sponsored by
Mesoblast, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Disc Disease focused on measuring Chronic Lumbar Back Pain, Low back pain, Back pain, Degenerative Disc Disease, Injection of Degenerated Lumbar Disc, Stem Cells, Adult Stem Cells, Allogeneic Mesenchymal Precursor cells (MPCs), Mesoblast

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or females at least 18 years of age.
  2. Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol.
  3. Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) privacy ruling in the US].
  4. Have chronic low back pain for at least 6 months.
  5. Have documented symptomatic diagnosis of DDD of one level from L1-S1 as determined by a change in disc hydration on MRI compared to normal disc with or without an annular fissure or a contained disc herniation.
  6. Have failed 3 months of non-operative low back pain management.
  7. Disc height loss of <30% compared to a normal adjacent disc based upon radiographic evaluation.
  8. Pre-treatment baseline low back pain of at least 40 mm on a 100 mm visual analog scale.
  9. Low back pain greater than leg pain.
  10. Pre-treatment baseline Oswestry Disability Index Questionnaire score of at least 30 on the 100-point questionnaire.

Exclusion Criteria:

  1. Female subjects who are pregnant or nursing, or women planning to become pregnant during the first year (12 months) following surgery.
  2. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening.
  3. Patients with compressive pathology due to stenosis or frankly herniated disc or sequestered discs are not candidates.
  4. Intact disc bulge/protrusion or focal herniation at the symptomatic level (s) > 3 mm or presence of disc extrusion or sequestration.
  5. Lumbar spondylitis or other undifferentiated spondyloarthropathy.
  6. Have undergone a previous surgery at the involved levels.
  7. Any lumbar intradiscal injection procedure (e.g., injection of corticosteroids, methylene blue, dextrose, or glucosamine and chondroitin sulfate). Discography may be performed, but must be done at least 2 weeks or more prior to the MPC injection procedure.
  8. Have an acute fracture of the spine at the time of enrollment in the study.
  9. Have a history of epidural steroid injections within 1 week prior to study treatment.
  10. Have a known history of hypersensitivity or anaphylactic reaction to murine or bovine products or dimethyl sulfoxide (DMSO).
  11. Have a positive screen for human immunodeficiency virus (HIV) antibodies.
  12. Have a known history of hypersensitivity or anaphylactic reaction to Hyaluronan.
  13. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening.
  14. Have been a recipient of prior stem cell/progenitor cell therapy or other biological intervention to repair the target intervertebral disc.
  15. Are transient or has been treated in the last 6 months before enrollment for alcohol and/or drug abuse in an inpatient substance abuse program.
  16. Currently incarcerated (prisoners).

Sites / Locations

  • Arizona Pain Specialists
  • UC Davis Spine Center
  • The Spine Institute
  • IPM Medical Group, Inc.
  • Denver Spine
  • Rocky Mountain Associates in Orthopedic Medicine, P.C.
  • Emory University School of Medicine
  • Carolina Neurosurgery and Spine Associates
  • Central Texas Spine Institute
  • Richmond Bone and Joint Clinic, Memorial Hermann Medical Group
  • Virginia Spine Research Institute, Inc.
  • Washington Center for Pain Management
  • The Center for Pain Relief, Inc.
  • Monash Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Sham Comparator

Placebo Comparator

Arm Label

High Dose MPCs

Low Dose MPCs

Saline injection

Hyaluronic acid injection

Arm Description

Injection of High Dose MPCs with Hyaluronic Acid

Injection of Low Dose MPCs with Hyaluronic Acid

Injection of saline solution.

Injection of hyaluronic acid solution

Outcomes

Primary Outcome Measures

To determine the overall safety of MPCs plus carrier using physical examinations, vital signs, treatment emergent adverse events (TEAEs), and the results of clinical lab tests (hematology, serum chemistry, inflammation, and immunology).

Secondary Outcome Measures

To evaluate the change of treated lumbar intervertebral discs using Magnetic Resonance Imaging (MRI) at 6 months post injection of MPCs.
To evaluate the effectiveness of MPCs in reducing chronic lumbar back pain using the visual analog scale (VAS).

Full Information

First Posted
February 3, 2011
Last Updated
June 25, 2020
Sponsor
Mesoblast, Ltd.
search

1. Study Identification

Unique Protocol Identification Number
NCT01290367
Brief Title
Safety and Preliminary Efficacy Study of Mesenchymal Precursor Cells (MPCs) in Subjects With Lumbar Back Pain
Official Title
A Prospective, Double Blind, Controlled Study Evaluating Safety and Preliminary Efficacy of a Single Injection of Adult Mesenchymal Precursor Cells (MPCs) Combined With Hyaluronan in Subjects With Chronic Discogenic Lumbar Back Pain
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
July 2013 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to compare two doses of immunoselected, culture-expanded, nucleated, allogeneic adult MPCs when combined with hyaluronic acid to two control intradiscal injections in subjects with chronic low back pain due to moderate Degenerative Disc Disease (DDD) at one lumbar level from L1 to S1. All investigational subjects in this study will undergo injection of either 6 million (M) or 18M cells in a hyaluronic acid carrier into the degenerated lumbar disc's nucleus pulposus. All control subjects will undergo an intradiscal control injection with either saline or hyaluronic acid only
Detailed Description
This is a prospective, multicenter, double blinded, controlled clinical study comparing two doses of immunoselected, culture-expanded, nucleated, allogeneic adult MPCs when combined with hyaluronic acid to two control intradiscal injections in subjects with chronic low back pain (> 6 months) due to moderate DDD at one lumbar level from L1 to S1 and unresponsive to conservative therapy for at least 3 months (including physical therapy). After the screening and injection visits, each subject will be evaluated clinically and radiographically at 30 days, and again at 3, 6, 12, 24 and 36 months after injection. Subjects will be evaluated at the same time points for safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Disc Disease
Keywords
Chronic Lumbar Back Pain, Low back pain, Back pain, Degenerative Disc Disease, Injection of Degenerated Lumbar Disc, Stem Cells, Adult Stem Cells, Allogeneic Mesenchymal Precursor cells (MPCs), Mesoblast

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
High Dose MPCs
Arm Type
Experimental
Arm Description
Injection of High Dose MPCs with Hyaluronic Acid
Arm Title
Low Dose MPCs
Arm Type
Experimental
Arm Description
Injection of Low Dose MPCs with Hyaluronic Acid
Arm Title
Saline injection
Arm Type
Sham Comparator
Arm Description
Injection of saline solution.
Arm Title
Hyaluronic acid injection
Arm Type
Placebo Comparator
Arm Description
Injection of hyaluronic acid solution
Intervention Type
Biological
Intervention Name(s)
Single Dose MPCs Injection
Other Intervention Name(s)
Direct MPCs Lumbar Disc Injection., Stem Cells
Intervention Description
Injection of Low Dose MPCs with Hyaluronic Acid into the degenerated lumbar disc's nucleus pulposus.
Intervention Type
Procedure
Intervention Name(s)
Single injection of saline solution
Other Intervention Name(s)
Saline injection, Sham control
Intervention Description
Intradiscal control injection with saline solution
Intervention Type
Procedure
Intervention Name(s)
Single injection of hyaluronic acid
Other Intervention Name(s)
Hyaluronic acid injection, Vehicle control
Intervention Description
Intradiscal control injection with hyaluronic acid
Intervention Type
Biological
Intervention Name(s)
Single Dose MPCs Injection
Other Intervention Name(s)
Stem Cells
Intervention Description
Injection of HighDose MPCs with Hyaluronic Acid into the degenerated lumbar disc's nucleus pulposus.
Primary Outcome Measure Information:
Title
To determine the overall safety of MPCs plus carrier using physical examinations, vital signs, treatment emergent adverse events (TEAEs), and the results of clinical lab tests (hematology, serum chemistry, inflammation, and immunology).
Time Frame
3 years
Secondary Outcome Measure Information:
Title
To evaluate the change of treated lumbar intervertebral discs using Magnetic Resonance Imaging (MRI) at 6 months post injection of MPCs.
Time Frame
6 - 36 Months
Title
To evaluate the effectiveness of MPCs in reducing chronic lumbar back pain using the visual analog scale (VAS).
Time Frame
1 - 36 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or females at least 18 years of age. Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol. Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) privacy ruling in the US]. Have chronic low back pain for at least 6 months. Have documented symptomatic diagnosis of DDD of one level from L1-S1 as determined by a change in disc hydration on MRI compared to normal disc with or without an annular fissure or a contained disc herniation. Have failed 3 months of non-operative low back pain management. Disc height loss of <30% compared to a normal adjacent disc based upon radiographic evaluation. Pre-treatment baseline low back pain of at least 40 mm on a 100 mm visual analog scale. Low back pain greater than leg pain. Pre-treatment baseline Oswestry Disability Index Questionnaire score of at least 30 on the 100-point questionnaire. Exclusion Criteria: Female subjects who are pregnant or nursing, or women planning to become pregnant during the first year (12 months) following surgery. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening. Patients with compressive pathology due to stenosis or frankly herniated disc or sequestered discs are not candidates. Intact disc bulge/protrusion or focal herniation at the symptomatic level (s) > 3 mm or presence of disc extrusion or sequestration. Lumbar spondylitis or other undifferentiated spondyloarthropathy. Have undergone a previous surgery at the involved levels. Any lumbar intradiscal injection procedure (e.g., injection of corticosteroids, methylene blue, dextrose, or glucosamine and chondroitin sulfate). Discography may be performed, but must be done at least 2 weeks or more prior to the MPC injection procedure. Have an acute fracture of the spine at the time of enrollment in the study. Have a history of epidural steroid injections within 1 week prior to study treatment. Have a known history of hypersensitivity or anaphylactic reaction to murine or bovine products or dimethyl sulfoxide (DMSO). Have a positive screen for human immunodeficiency virus (HIV) antibodies. Have a known history of hypersensitivity or anaphylactic reaction to Hyaluronan. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening. Have been a recipient of prior stem cell/progenitor cell therapy or other biological intervention to repair the target intervertebral disc. Are transient or has been treated in the last 6 months before enrollment for alcohol and/or drug abuse in an inpatient substance abuse program. Currently incarcerated (prisoners).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roger Brown
Organizational Affiliation
Mesoblast, Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Arizona Pain Specialists
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85258
Country
United States
Facility Name
UC Davis Spine Center
City
Sacramento
State/Province
California
ZIP/Postal Code
95816
Country
United States
Facility Name
The Spine Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States
Facility Name
IPM Medical Group, Inc.
City
Walnut Creek
State/Province
California
ZIP/Postal Code
94598
Country
United States
Facility Name
Denver Spine
City
Denver
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Rocky Mountain Associates in Orthopedic Medicine, P.C.
City
Loveland
State/Province
Colorado
ZIP/Postal Code
80538
Country
United States
Facility Name
Emory University School of Medicine
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Carolina Neurosurgery and Spine Associates
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28204
Country
United States
Facility Name
Central Texas Spine Institute
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States
Facility Name
Richmond Bone and Joint Clinic, Memorial Hermann Medical Group
City
Richmond
State/Province
Texas
ZIP/Postal Code
77469
Country
United States
Facility Name
Virginia Spine Research Institute, Inc.
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23235
Country
United States
Facility Name
Washington Center for Pain Management
City
Edmonds
State/Province
Washington
ZIP/Postal Code
98026
Country
United States
Facility Name
The Center for Pain Relief, Inc.
City
Charleston
State/Province
West Virginia
ZIP/Postal Code
25301
Country
United States
Facility Name
Monash Medical Center
City
Clayton
State/Province
Victoria
ZIP/Postal Code
3168
Country
Australia

12. IPD Sharing Statement

Learn more about this trial

Safety and Preliminary Efficacy Study of Mesenchymal Precursor Cells (MPCs) in Subjects With Lumbar Back Pain

We'll reach out to this number within 24 hrs