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Study of Autologous Mesenchymal Stem Cells to Treat Idiopathic Pulmonary Fibrosis (CMM/FPI)

Primary Purpose

Idiopathic Pulmonary Fibrosis

Status
Completed
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
Endobronchial infusion of adult mesenchymal stem cells
Autologous mesenchymal stem cells derived from bone marrow
Sponsored by
Clinica Universidad de Navarra, Universidad de Navarra
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Pulmonary Fibrosis focused on measuring Idiopathic pulmonary fibrosis, Stem cells, Mesenchymal stem cells

Eligibility Criteria

30 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

INCLUSION CRITERIA:

  1. Capacity for signing informing consent and express the willing to fulfill all the requirements of the study protocol during the study.
  2. The patients should be, in the researcher opinion, capable to fulfill all the requirements of the trial.
  3. Male or female patients, 30 to 80 years old, inclusive.
  4. Diagnosis of idiopathic pulmonary fibrosis according to the following criteria, based on the ATS/ERS Guidelines:

    1. Definite or probable usual interstitial pneumonia confirmed by surgical lung biopsy.
    2. In the absence of surgical lung biopsy, all the following:

    i. High resolution CT (HRCT) showing definite findings for idiopathic pulmonary fibrosis (FPI): bibasal reticular opacities with minimal ground glass opacities.

    ii. Absence of other known causes of FPI including toxicity from drugs, environmental exposure or connective tissue diseases.

    iii. Pulmonary function tests showing ventilatory restrictive pattern and/or impaired gas exchange (FVC and/or DLCO <90% of predicted)

  5. FVC ≥ 50% of predicted value with ratio of FEV1 to FVC ≥ 0.70.
  6. DLco (corrected for hemoglobin) ≥ 35% predicted value.
  7. Capability of performing a 6 minutes walk test at the time of inclusion.

EXCLUSION CRITERIA:

Any of the following:

  1. Current pregnancy or lactation.
  2. Findings that are diagnostic of an interstitial pneumonia or restrictive respiratory disease condition other than UIP.
  3. Obstructive pulmonary disease defined by FEV1/FVC < 0,7 or significant emphysema on HRCT.
  4. Evidence of sustained improvement in FPI defined by improvement of respiratory function tests before inclusion, observed in >=2 test over the year prior to inclusion.
  5. Active or recent respiratory infection (less than 60 days before inclusion) or history of frequent exacerbations of IPF from an infectious cause (more than 2/year over the last 2 years)
  6. Hospitalization in the 60 days prior to inclusion due to acute exacerbation of IPF.
  7. Chronic cardiac failure (functional class NYHA III/IV) or left ventricular ejection fraction < 25%.
  8. Chronically receiving corticosteroid more than 10 mg of prednisone or equivalent, immunosuppressors or antifibrotic agents, including pirfenidone, D-penicillamine, colchicine, ciclosporin A, TNF-alpha antagonists, imatinib, IFN-gamma, azathioprine, cyclophosphamide, within the 30 days prior to inclusion.
  9. The patient requires hemodialysis, peritoneal dialysis or hemofiltration.
  10. History of malignancy, with the exception of skin squamous or basocellular carcinoma or cervix in situ carcinoma treated successfully.
  11. History of ethanol abuse within the year prior to inclusion
  12. The patient is participating in a clinical trial which includes other drugs or research products within the 28 days prior to baseline assessment.
  13. Comorbidities limiting life expectancy to less than 12 months from the baseline assessment.
  14. Medical or psychiatric condition serious or active which might interfere with the treatment of study, assessment or protocol fulfillment.
  15. Positive test for HBsAg, HCV antibody, syphilis screening essays, or HIV antibody at screening.

Sites / Locations

  • Servicio de Neumología, Clínica Universidad de Navarra
  • Servicio de Neumología. Hospital Universitario de Salamanaca

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MSC endobronchial infusion

Arm Description

Outcomes

Primary Outcome Measures

Number of participants with adverse side effects.
Number of participants with adverse side effects, and according to the level of severity: Low level: Increase in cough, fever or skin reactions Medium level: Infections not requiring hospital admission, mild alterations of renal or liver function High level: Death or major side effects requiring hospitalization: Worsening dyspnea with >=10% reduction in forced vital capacity, reduction in arterial pressure oxygen >= 10 mmHg and radiology progression between 3 months separated visits. Need for hospitalization due to respiratory failure requiring mechanical ventilation, worsening in gases exchange or lung infection. Carcinogenesis at 12 months after the endobronchial infusion of mesenchymal stem cells.

Secondary Outcome Measures

Efficacy of the infusion of mesenchymal stem cells in stopping the fall in pulmonary function in patients with mild to moderate IPF
Measures of efficacy: Fall in forced vital capacity as a continuous variable Progression of the disease defined by: Death, need for transplantation or deterioration in pulmonary function defined by fall in forced vital capacity (FVC) > 10% or in lung diffusion capacity (DLCO) > 15%.

Full Information

First Posted
August 1, 2013
Last Updated
May 2, 2018
Sponsor
Clinica Universidad de Navarra, Universidad de Navarra
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1. Study Identification

Unique Protocol Identification Number
NCT01919827
Brief Title
Study of Autologous Mesenchymal Stem Cells to Treat Idiopathic Pulmonary Fibrosis
Acronym
CMM/FPI
Official Title
Treatment of Idiopathic Pulmonary Fibrosis With Bone Marrow Derived Mesenchymal Stem Cells
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
May 1, 2018 (Actual)
Study Completion Date
May 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Clinica Universidad de Navarra, Universidad de Navarra

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Clinical Trial Phase I, open, multicentric, non randomized, study with escalating doses, to evaluate the safety and feasibility of treatment with mesenchymal stem cells in patients with diagnosis of idiopathic pulmonary fibrosis. Primary endpoint: The aim is to evaluate the safety and feasibility of the endobronchial administration of mesenchymal autolog stem cells derived from bone marrow (BM-MSC)in patients with mild-to-moderate idiopathic pulmonary fibrosis. Secondary endpoint:Assess the possible effect of the infusion of BM-MSC in stopping the fall of pulmonary function in patients with mild-to-moderate idiopathic pulmonary fibrosis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Idiopathic Pulmonary Fibrosis
Keywords
Idiopathic pulmonary fibrosis, Stem cells, Mesenchymal stem cells

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MSC endobronchial infusion
Arm Type
Experimental
Intervention Type
Biological
Intervention Name(s)
Endobronchial infusion of adult mesenchymal stem cells
Intervention Type
Biological
Intervention Name(s)
Autologous mesenchymal stem cells derived from bone marrow
Primary Outcome Measure Information:
Title
Number of participants with adverse side effects.
Description
Number of participants with adverse side effects, and according to the level of severity: Low level: Increase in cough, fever or skin reactions Medium level: Infections not requiring hospital admission, mild alterations of renal or liver function High level: Death or major side effects requiring hospitalization: Worsening dyspnea with >=10% reduction in forced vital capacity, reduction in arterial pressure oxygen >= 10 mmHg and radiology progression between 3 months separated visits. Need for hospitalization due to respiratory failure requiring mechanical ventilation, worsening in gases exchange or lung infection. Carcinogenesis at 12 months after the endobronchial infusion of mesenchymal stem cells.
Time Frame
Up to 12 months
Secondary Outcome Measure Information:
Title
Efficacy of the infusion of mesenchymal stem cells in stopping the fall in pulmonary function in patients with mild to moderate IPF
Description
Measures of efficacy: Fall in forced vital capacity as a continuous variable Progression of the disease defined by: Death, need for transplantation or deterioration in pulmonary function defined by fall in forced vital capacity (FVC) > 10% or in lung diffusion capacity (DLCO) > 15%.
Time Frame
Up to 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Capacity for signing informing consent and express the willing to fulfill all the requirements of the study protocol during the study. The patients should be, in the researcher opinion, capable to fulfill all the requirements of the trial. Male or female patients, 30 to 80 years old, inclusive. Diagnosis of idiopathic pulmonary fibrosis according to the following criteria, based on the ATS/ERS Guidelines: Definite or probable usual interstitial pneumonia confirmed by surgical lung biopsy. In the absence of surgical lung biopsy, all the following: i. High resolution CT (HRCT) showing definite findings for idiopathic pulmonary fibrosis (FPI): bibasal reticular opacities with minimal ground glass opacities. ii. Absence of other known causes of FPI including toxicity from drugs, environmental exposure or connective tissue diseases. iii. Pulmonary function tests showing ventilatory restrictive pattern and/or impaired gas exchange (FVC and/or DLCO <90% of predicted) FVC ≥ 50% of predicted value with ratio of FEV1 to FVC ≥ 0.70. DLco (corrected for hemoglobin) ≥ 35% predicted value. Capability of performing a 6 minutes walk test at the time of inclusion. EXCLUSION CRITERIA: Any of the following: Current pregnancy or lactation. Findings that are diagnostic of an interstitial pneumonia or restrictive respiratory disease condition other than UIP. Obstructive pulmonary disease defined by FEV1/FVC < 0,7 or significant emphysema on HRCT. Evidence of sustained improvement in FPI defined by improvement of respiratory function tests before inclusion, observed in >=2 test over the year prior to inclusion. Active or recent respiratory infection (less than 60 days before inclusion) or history of frequent exacerbations of IPF from an infectious cause (more than 2/year over the last 2 years) Hospitalization in the 60 days prior to inclusion due to acute exacerbation of IPF. Chronic cardiac failure (functional class NYHA III/IV) or left ventricular ejection fraction < 25%. Chronically receiving corticosteroid more than 10 mg of prednisone or equivalent, immunosuppressors or antifibrotic agents, including pirfenidone, D-penicillamine, colchicine, ciclosporin A, TNF-alpha antagonists, imatinib, IFN-gamma, azathioprine, cyclophosphamide, within the 30 days prior to inclusion. The patient requires hemodialysis, peritoneal dialysis or hemofiltration. History of malignancy, with the exception of skin squamous or basocellular carcinoma or cervix in situ carcinoma treated successfully. History of ethanol abuse within the year prior to inclusion The patient is participating in a clinical trial which includes other drugs or research products within the 28 days prior to baseline assessment. Comorbidities limiting life expectancy to less than 12 months from the baseline assessment. Medical or psychiatric condition serious or active which might interfere with the treatment of study, assessment or protocol fulfillment. Positive test for HBsAg, HCV antibody, syphilis screening essays, or HIV antibody at screening.
Facility Information:
Facility Name
Servicio de Neumología, Clínica Universidad de Navarra
City
Pamplona
State/Province
Navarra
ZIP/Postal Code
31008 Pamplona
Country
Spain
Facility Name
Servicio de Neumología. Hospital Universitario de Salamanaca
City
Salamanca
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
34195252
Citation
Campo A, Gonzalez-Ruiz JM, Andreu E, Alcaide AB, Ocon MM, De-Torres J, Pueyo J, Cordovilla R, Villaron E, Sanchez-Guijo F, Barrueco M, Nunez-Cordoba J, Prosper F, Zulueta JJ. Endobronchial autologous bone marrow-mesenchymal stromal cells in idiopathic pulmonary fibrosis: a phase I trial. ERJ Open Res. 2021 Jun 28;7(2):00773-2020. doi: 10.1183/23120541.00773-2020. eCollection 2021 Apr.
Results Reference
derived

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Study of Autologous Mesenchymal Stem Cells to Treat Idiopathic Pulmonary Fibrosis

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