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Status unknownNCT03296501ADIPOSTEMUpdated Apr 15, 2020

Intraspinal Transplantation of Autologous ADRC in ALS Patients

A Phase 1 interventional study of Cell-based therapy of autologous adipose derived regenerative cells transplanted intraspinally and intrathecally in ALS patients in Amyotrophic Lateral Sclerosis, sponsored by Mossakowski Medical Research Centre Polish Academy of Sciences. Status unknown at 1 site in Poland. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2020-04-15.

Sponsored by Mossakowski Medical Research Centre Polish Academy of Sciences · Phase 1, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Apr 2020), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Phase 1
Study type
Interventional
Enrollment
30
Allocation
Not applicable
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The goal of our nonrandomized, open label study is to investigate the safety and efficacy of autologous adipose derived mesenchymal regenerative cells (ADRC) transplantation into the individuals with diagnosed amyotrophic lateral sclerosis (ALS). All enrolled patients will have a documented at least 3-months clinical and electrophisiological observation of ALS disease course prior to study enrollment. Each patient will recive 3 injections of ADRC every 3 months: an intraspinal injection followed by 2 subsequent intrathecal infusions. Safety, adverse events and efficacy will be confirmed by clinical, elecrophisiological ( EMG, MUNIX), neuroimmaging and spirometry together with functional (ALSFRS-R) and objective motor assesment (MRC and dynamometer).

Read the detailed description

Amyotrophic Lateral Sclerosis (ALS) is an incurable disease of unknown etiology that in a short time leads to significant impairment of motor functions and death. The frequency of ALS is 4-8/100 000. Mostly it affects people between 40 and 70 years old, but it can occur at a younger age. Since the symptom onset is most frequently in the fifth or sixth decade, ALS is a huge economic burden for the society. There are many studies conducted to treat the disease and prevent it, but currently the medicine offers only one drug that can slow the appearance of disease symptoms but could not stop the progression. Yet, improvements in medical management, including nutrition and breathing, regularly increase patient survival - 50% of affected patients live at least 3 or more years after diagnosis; 20% live 5 years or more; and up to 10% will survive more than 10 years. The stem-cell-based therapies could be therefore a new waited strategy for ALS clinical treatment.

Since the clinical course of ALS may vary substantially between patients, we are planning to qualify them with a primarily established clinical course based on a detailed anamnesis and clinical assessment. The goal of our nonrandomized, open label study is to investigate the safety and efficacy of autologous adipose derived mesenchymal regenerative cells (ADRC) transplantation into the individuals with diagnosed amyotrophic lateral sclerosis. In order to select a group of 30 ALS patients for the ADRC treatment, approximately 50 ALS patients will be examined. All patients enrolled will have a documented at least 3-months clinical and electrophisiological observation of ALS disease course prior to study enrollment. Each patient will recive 3 injections of ADRC every 3 months: an intraspinal injection followed by 2 subsequent intrathecal infusions. Safety, adverse events and efficacy will be confirmed by clinical, elecrophisiological ( EMG, MUNIX), neuroimmaging and spirometry together with functional (ALSFRS-R) and objective motor assesment (MRC and dynamometer).

02

Conditions studied

  • Amyotrophic Lateral Sclerosis

Keywords

  • ALS
  • ADRC
  • adipose derived regenerative cells
  • intraspinal transplantation
  • mesenchymal cells
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • clinically definite or probable ALS according to El Escorial criteria
  • life expectancy of more than 1 year
  • INR ≤2 before liposuction
  • lack of treatment with immune-suppressants and/or corticosteroids within min. 20 days prior to recruitment
  • constant riluzole treatment (50 mg/bid) throughout the study period
  • compliance with treatment regimen e.g. will and possibility to attend check-up visits
  • Polish citizens

Exclusion criteria

Exclusion Criteria:

  • primary haematological disease, including hypercoagulable states
  • Presence of comorbidity that would stand in the way of neurosurgical treatment-
  • previous history of a spinal-cord surgery at the clinically affected level
  • previous/current history of neoplasm or comorbidity that could impact upon patient's survival
  • PEG
  • pregnancy /lactation
  • noninvasive/invasive mechanical ventilation at time of recruitment
  • alcohol abuse, cocaine amphetamine, etc.
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
30 participants (estimated)

Study arms

  • Experimental
    Autologous ADRC injection

    Biological: Cell-based therapy of autologous adipose derived regenerative cells transplanted intraspinally and intrathecally in ALS patients

Interventions

  • BiologicalCell-based therapy of autologous adipose derived regenerative cells transplanted intraspinally and intrathecally in ALS patients

    3 injections of ADRC: 1 intraspinal and 2 intrathecal

05

What researchers measure

Primary outcomes

  1. Functional progression rate

    Delta ALS Functional Rating Scale (ALSFRS-R)/month

    Time frame: 3 months

Secondary outcomes

  1. Electrophisiological progression rate

    electromyography (EMG)/ Motor unit number index (MUNIX)

    Time frame: 3 months

Other outcomes

  1. Respiratory insufficiency estimation

    Forced Vital Capacity (FVC)

    Time frame: 3 months

06

Study locations

1 site
  • Medical University of Warsaw
    Warsaw, 02-097, Poland
07

References and documents

Publications

  • Kuzma-Kozakiewicz M, Marchel A, Kaminska A, Gawel M, Sznajder J, Figiel-Dabrowska A, Nowak A, Maj E, Krzesniak NE, Noszczyk BH, Domanska-Janik K, Sarnowska A. Intraspinal Transplantation of the Adipose Tissue-Derived Regenerative Cells in Amyotrophic Lateral Sclerosis in Accordance with the Current Experts' Recommendations: Choosing Optimal Monitoring Tools. Stem Cells Int. 2018 Aug 12;2018:4392017. doi: 10.1155/2018/4392017. eCollection 2018. PubMed 30158984 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03296501
Lead sponsor
Mossakowski Medical Research Centre Polish Academy of Sciences
Collaborators
Medical University of Warsaw
Responsible party
Anna Sarnowska (M.D., Ph.D., Mossakowski Medical Research Centre Polish Academy of Sciences) — Principal investigator
First posted
Sep 28, 2017
Start date
Oct 13, 2015
Primary completion
Oct 31, 2020 (estimated)
Completion
Oct 31, 2022 (estimated)
Last update
Apr 15, 2020

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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