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Safety Study of Human Spinal Cord-derived Neural Stem Cell Transplantation for the Treatment of Chronic SCI (SCI)

Primary Purpose

Spinal Cord Injury (SCI)

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Human spinal cord stem cells.
Sponsored by
Neuralstem Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Cord Injury (SCI) focused on measuring Paralysis, spinal cord injury, chronic spinal cord injury, cspine injury, neck injury

Eligibility Criteria

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

Inclusion Criteria:

  • Lives within 500 miles of study center (For Group B)

    1. Have the ability to understand the requirements of the study, provide written informed consent, understand and provide written authorization for the use and disclosure of Protected Health Information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) Privacy Ruling] and comply with the study procedures
    2. Men and women 18-65 years old
    3. Women must have a negative serum pregnancy test and practice an acceptable method of contraception or be of non-childbearing potential (post-menopausal for at least 2 years or who have undergone hysterectomy or oophorectomy or surgical sterilization)
    4. At least 1 year but no more than 2 years from time of injury at the time of surgery
    5. SCI injury classified as AIS-A complete as confirmed by the PI and a Physical Medicine and Rehabilitation doctor or other SCI Medicine board certified physician based on a complete ISNC SCI examination
    6. Neurologic level of injury:

      1. Group A: injury within cord segments T2-T12;
      2. Group B: injury within cord segments C5-C7
    7. Confirmation of bone fusion by CT scan
    8. Agrees to the visit schedule as outlined in the informed consent
    9. All required vaccinations current at the time of enrollment: tetanus/diptheria (TDAP), herpes zoster/shingles (Zostavax®: within last 10 years and must be prior to surgery), pneumonia (Pneumovax®), seasonal/H1N1 flu vaccines (as appropriate for season). Any missing vaccination will be provided at the screening if consented by the otherwise eligible patient who will then be scheduled for surgery no less than 30 days post vaccination.

Exclusion Criteria:

  1. SCI due to penetrating trauma such as gun shot or stabbing wound
  2. SCI injuries involving complete spinal cord transection
  3. Etiology of paraplegia or weakness related to other or additional neurologic process
  4. MRI evidence of syrinx, multiple cysts, or a cyst with greater than 2cm in length or injury site involving greater than 2cm of the cord
  5. Current or peak Panel Reactive Antibody (PRA) due to alloantibodies > 20% receiving their first allograft or presence of antibodies against HLA of the donor cells
  6. Receipt of any investigational drug or device within 30 days prior to surgery
  7. Receipt of any cell infusion other than blood transfusion
  8. Any concomitant medical disease or condition noted below:

    1. Coagulopathy with INR > 1.4 at the time of screening
    2. Active infection
    3. Active hypotension requiring vasopressor therapy
    4. Skin breakdown over the site of surgery
    5. History of Malignancy (except for non-melanoma skin cancer)
    6. Primary or secondary immune deficiency
    7. Persistent MRI artifact that would prevent imaging post-op h. Creatinine >1.5, liver function tests (SGOT/SGPT, Bilirubin, Alk Phos) > 2x upper limit of normal, hematocrit/hemoglobin < 30/10, total WBC < 3000, uncontrolled hypertension (systolic > 180 or diastolic > 100) or uncontrolled diabetes (defined as hemoglobin A1C >8), evidence of GI bleeding by hemoccult test, positive tuberculosis, hepatitis B or C, or human immunodeficiency virus (HIV)
  9. Presence of any of the following conditions:

    1. Current drug abuse or alcoholism
    2. Unstable medical conditions
    3. Unstable psychiatric illness including psychosis and untreated major depression
  10. Any condition that the Investigator or primary physician feels may interfere with participation in the study
  11. Any condition that the surgeon feels may pose complications for the surgery
  12. Known hypersensitivity to basiliximab, tacrolimus or mycophenolate mofetil
  13. Inability to provide informed consent as determined by screening protocol.
  14. Stage III or above decubitus wound, other open wound, or active colostomy;
  15. Autoimmune diseases, for which chronic corticosteroids or immunosuppression therapy may be needed;
  16. Implanted spine stimulator;
  17. Uncontrolled spasticity;
  18. Uncontrolled neuropathic pain

Sites / Locations

  • UCSD Medical Center, Division of NeurosurgeryRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Surgical implantation of human spinal cord stem cells

Arm Description

Surgical implantation of human spinal cord derived neural stem cells.

Outcomes

Primary Outcome Measures

Adverse events and clinically significant laboratory abnormalities

Secondary Outcome Measures

Graft survival in the transplant site as determined by MRI (for Group A) and via autopsy, if one is completed.
Effectiveness of immunosuppression as determined by absence of donor-specific HLA antibodies.

Full Information

First Posted
January 14, 2013
Last Updated
September 6, 2017
Sponsor
Neuralstem Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01772810
Brief Title
Safety Study of Human Spinal Cord-derived Neural Stem Cell Transplantation for the Treatment of Chronic SCI
Acronym
SCI
Official Title
A Phase 1, Open-label, Single-site, Safety Study of Human Spinal Cord-derived Neural Stem Cell Transplantation for the Treatment of Chronic SCI
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Unknown status
Study Start Date
August 2014 (Actual)
Primary Completion Date
July 2018 (Anticipated)
Study Completion Date
December 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Neuralstem Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a safety study of human spinal cord-derived neural stem cell (HSSC) transplantation for the treatment of chronic spinal cord injury.
Detailed Description
Phase I, open-label, single-site, safety study of HSSC transplantation for the treatment of chronic spinal cord injury (SCI). Group A enrolled 4 subjects with a cord injury at T2-T12; Group B will enroll 4 subjects with a C5-C7 cord injury. Study period will be 6 months post-operative. Post-study, subjects will be followed for an additional 54 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Cord Injury (SCI)
Keywords
Paralysis, spinal cord injury, chronic spinal cord injury, cspine injury, neck injury

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
8 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Surgical implantation of human spinal cord stem cells
Arm Type
Experimental
Arm Description
Surgical implantation of human spinal cord derived neural stem cells.
Intervention Type
Drug
Intervention Name(s)
Human spinal cord stem cells.
Other Intervention Name(s)
spinal cord injury (SCI)
Intervention Description
Human spinal cord stem cell implantation in paralysis patients due to a spinal cord injury.
Primary Outcome Measure Information:
Title
Adverse events and clinically significant laboratory abnormalities
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Graft survival in the transplant site as determined by MRI (for Group A) and via autopsy, if one is completed.
Description
Effectiveness of immunosuppression as determined by absence of donor-specific HLA antibodies.
Time Frame
Month 60
Other Pre-specified Outcome Measures:
Title
EMG, SCIM, ISNC SCI, and Bowel and bladder follow-up
Time Frame
60 months

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: Lives within 500 miles of study center (For Group B) Have the ability to understand the requirements of the study, provide written informed consent, understand and provide written authorization for the use and disclosure of Protected Health Information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) Privacy Ruling] and comply with the study procedures Men and women 18-65 years old Women must have a negative serum pregnancy test and practice an acceptable method of contraception or be of non-childbearing potential (post-menopausal for at least 2 years or who have undergone hysterectomy or oophorectomy or surgical sterilization) At least 1 year but no more than 2 years from time of injury at the time of surgery SCI injury classified as AIS-A complete as confirmed by the PI and a Physical Medicine and Rehabilitation doctor or other SCI Medicine board certified physician based on a complete ISNC SCI examination Neurologic level of injury: Group A: injury within cord segments T2-T12; Group B: injury within cord segments C5-C7 Confirmation of bone fusion by CT scan Agrees to the visit schedule as outlined in the informed consent All required vaccinations current at the time of enrollment: tetanus/diptheria (TDAP), herpes zoster/shingles (Zostavax®: within last 10 years and must be prior to surgery), pneumonia (Pneumovax®), seasonal/H1N1 flu vaccines (as appropriate for season). Any missing vaccination will be provided at the screening if consented by the otherwise eligible patient who will then be scheduled for surgery no less than 30 days post vaccination. Exclusion Criteria: SCI due to penetrating trauma such as gun shot or stabbing wound SCI injuries involving complete spinal cord transection Etiology of paraplegia or weakness related to other or additional neurologic process MRI evidence of syrinx, multiple cysts, or a cyst with greater than 2cm in length or injury site involving greater than 2cm of the cord Current or peak Panel Reactive Antibody (PRA) due to alloantibodies > 20% receiving their first allograft or presence of antibodies against HLA of the donor cells Receipt of any investigational drug or device within 30 days prior to surgery Receipt of any cell infusion other than blood transfusion Any concomitant medical disease or condition noted below: Coagulopathy with INR > 1.4 at the time of screening Active infection Active hypotension requiring vasopressor therapy Skin breakdown over the site of surgery History of Malignancy (except for non-melanoma skin cancer) Primary or secondary immune deficiency Persistent MRI artifact that would prevent imaging post-op h. Creatinine >1.5, liver function tests (SGOT/SGPT, Bilirubin, Alk Phos) > 2x upper limit of normal, hematocrit/hemoglobin < 30/10, total WBC < 3000, uncontrolled hypertension (systolic > 180 or diastolic > 100) or uncontrolled diabetes (defined as hemoglobin A1C >8), evidence of GI bleeding by hemoccult test, positive tuberculosis, hepatitis B or C, or human immunodeficiency virus (HIV) Presence of any of the following conditions: Current drug abuse or alcoholism Unstable medical conditions Unstable psychiatric illness including psychosis and untreated major depression Any condition that the Investigator or primary physician feels may interfere with participation in the study Any condition that the surgeon feels may pose complications for the surgery Known hypersensitivity to basiliximab, tacrolimus or mycophenolate mofetil Inability to provide informed consent as determined by screening protocol. Stage III or above decubitus wound, other open wound, or active colostomy; Autoimmune diseases, for which chronic corticosteroids or immunosuppression therapy may be needed; Implanted spine stimulator; Uncontrolled spasticity; Uncontrolled neuropathic pain
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Dr. Ciacci's Research Group
Phone
844-317-7836 (STEM)
Email
alphastemcellclinic@ucsd.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Ciacci, MD
Organizational Affiliation
UCSD Medical Center, Division of Neurosurgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCSD Medical Center, Division of Neurosurgery
City
San Diego
State/Province
California
ZIP/Postal Code
92103-8893
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr. Ciacci's Research Group
Phone
844-317-7836
Email
alphastemcellclinic@ucsd.edu
First Name & Middle Initial & Last Name & Degree
Joseph Ciacci, MD
First Name & Middle Initial & Last Name & Degree
Martin Marsala, MD

12. IPD Sharing Statement

Links:
URL
http://neuralstem.com
Description
Related Information

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Safety Study of Human Spinal Cord-derived Neural Stem Cell Transplantation for the Treatment of Chronic SCI

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