- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03280056
Safety and Efficacy of Repeated Administrations of NurOwn® in ALS Patients
A Phase 3, Randomized Double-Blind, Placebo-Controlled Multicenter Study to Evaluate Efficacy and Safety of Repeated Administration of NurOwn® (Autologous Mesenchymal Stem Cells Secreting Neurotrophic Factors) in Participants With ALS
This study will evaluate the safety and efficacy of repeated administration of NurOwn® (MSC-NTF cells) therapy, which is based on transplantation of autologous bone marrow derived mesenchymal stromal cells (MSC), which are enriched from the patient's own bone marrow, propagated ex vivo and induced to secrete Neurotrophic factors (NTFs).
The autologous NurOwn® (MSC-NTF cells) are back-transplanted into the patient intrathecally by standard lumbar puncture where neurons and glial cells are expected to take up the neurotrophic factors secreted by the transplanted cells
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Neurotrophic factors (NTFs) are potent survival factors for embryonic, neonatal, and adult neurons and are considered potential therapeutic candidates for ALS. Delivery of multiple NTFs to the immediate environment of afflicted neurons in ALS patients is expected to improve their survival and thus slow down disease progression and alleviate symptoms. NTF-secreting mesenchymal stromal cells (MSC-NTF cells) are a novel cell-therapeutic approach aimed at effectively delivering NTFs directly to the site of damage in ALS patients.
Participants meeting the inclusion and exclusion criteria will be randomized and will undergo bone-marrow aspiration. MSC of the participants randomized to the treatment group will be induced into MSC-NTF cells. Participants will undergo a total of three intrathecal (IT) transplantations with NurOwn® (MSC-NTF cells) or matching placebo at three bi-monthly intervals
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
-
-
California
-
Irvine, California, United States, 92697
- University of California Irvine Alpha Stem Cell Clinic
-
Los Angeles, California, United States, 90048
- Cedars-Sinai Medical Center
-
San Francisco, California, United States, 94115
- California Pacific Medical Center
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Massachusetts General Hospital
-
Worcester, Massachusetts, United States, 01655
- University of Massachusetts Medical School
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- ALS diagnosed as possible, laboratory-supported probable, probable, or definite as defined by revised El Escorial criteria.
- Having onset of ALS disease symptoms, including limb weakness within 24 months at the Screening Visit.
- ALSFRS-R ≥ 25 at the screening Visit.
- Upright slow vital capacity (SVC) measure ≥ 65% of predicted for gender, height, and age at the screening Visit.
- Rapid progressors
- Participants taking a stable dose of Riluzole are permitted in the study
- Citizen or permanent resident of the United States or Canadian citizen able to travel to a US site for all follow-up study visits
Exclusion Criteria:
- Prior stem cell therapy of any kind
- History of autoimmune or other serious disease (including malignancy and immune deficiency) that may confound study results
- Current use of immunosuppressant medication or anticoagulants (per Investigator discretion)
- Exposure to any other experimental agent or participation in an ALS clinical trial within 30 days prior to Screening Visit
- Use of RADICAVA (edaravone injection) within 30 days of screening or intent to use edaravone at any time during the course of the study including the follow up period
- Use of non-invasive ventilation (BIPAP), diaphragm pacing system or invasive ventilation (tracheostomy)
- Feeding tube
- Pregnant women or women currently breastfeeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: NurOwn® (MSC-NTF cells)
Three Intrathecal administrations of NurOwn® (MSC-NTF cells) at bi-monthly intervals
|
Bone Marrow aspiration
NurOwn® (MSC-NTF): One course of treatment that includes three separate intrathecal injections of 100-125 x 10^6 cells every 8 weeks NurOwn® (MSC-NTF): Autologous, bone marrow-derived, mesenchymal stem cells secreting neurotrophic factors |
Placebo Comparator: Placebo
Three Intrathecal administrations of Placebo at bi-monthly intervals
|
Bone Marrow aspiration
One course of treatment that includes three separate intrathecal injections of Placebo every 8 weeks Placebo: liquid solution in syringe for injection |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
The Proportion of NurOwn® Treated Participants With a ≥1.25 Points/Month Improvement in Post-treatment Slope vs. Pre-treatment Slope in ALSFRS-R Score at 28 Weeks Following the First Treatment as Compared to Placebo
Time Frame: 28 weeks following the first intrathecal injection
|
The ALSFRS-R is a quickly administered (10 minutes) ordinal, validated rating scale (ratings 0-4) used to determine participants' assessment of their capability and independence in 12 functional activities.
All 12 activities are relevant in ALS.
Initial validity was established by documenting that in ALS patients, change in ALSFRS-R scores correlated with change in strength over time, as measured by quantitative neuromuscular strength testing, and with quality of life measures, and predicted survival.
The total score of ALSFRS-R ranges from 0-48, with higher score being better.
|
28 weeks following the first intrathecal injection
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants Whose Disease Progression is Halted or Improved as Measured by a 100% or Greater Improvement in Post-treatment Slope vs. Pre-treatment Slope in ALSFRS-R Score of NurOwn® Treatment vs. Placebo
Time Frame: 28 weeks following the first intrathecal injection
|
The ALSFRS-R is a quickly administered (10 minutes) ordinal, validated rating scale (ratings 0-4) used to determine participants' assessment of their capability and independence in 12 functional activities.
All 12 activities are relevant in ALS.
Initial validity was established by documenting that in ALS patients, change in ALSFRS-R scores correlated with change in strength over time, as measured by quantitative neuromuscular strength testing, and with quality of life measures, and predicted survival.
The total score of ALSFRS-R ranges from 0-48, with higher score being better.
|
28 weeks following the first intrathecal injection
|
Score of NurOwn® (MSC-NTF Cells) Treated Patients vs. Placebo Treated Patients as Measured by Change From Baseline in ALSFRS-R Score at Week 28
Time Frame: 28 weeks following the first intrathecal injection
|
The ALSFRS-R is a quickly administered (10 minutes) ordinal, validated rating scale (ratings 0-4) used to determine participants' assessment of their capability and independence in 12 functional activities.
All 12 activities are relevant in ALS.
Initial validity was established by documenting that in ALS patients, change in ALSFRS-R scores correlated with change in strength over time, as measured by quantitative neuromuscular strength testing, and with quality of life measures, and predicted survival.
The total score of ALSFRS-R ranges from 0-48, with higher score being better.
|
28 weeks following the first intrathecal injection
|
NurOwn® (MSC-NTF Cells) Treated Patients vs. Placebo Treated Patients as Measured by the Combined Assessment of Function and Survival at 28 Weeks
Time Frame: 28 weeks following the first intrathecal injection
|
The combined Assessment of Function and Survival (CAFS) is a composite endpoint based on (1) the change from baseline in ALS Functional Rating Scale-Revised (ALSFRS-R) score and (2) time to death. On the ALSFRS-R, 12 functions are rated on 5-point ordinal rating scales (from 0 to 4) with a total score range (minimum and maximum score) of 0-48 (sum of all 12 items). The higher the score the better functioning. For the survival endpoint, the longer time the better outcome. A patient's CAFS score represents a patient's rank in the study based on comparing the patient's outcome for both the change in ALSFRS-R and the time to death to all other patients in the study in a pairwise fashion. The ranked scores range from 001 to 189 (the number of subjects in the mITT population) with larger rank score numbers associated with a better outcome. The reported values are the mean rank scores in each group for the composite endpoint. |
28 weeks following the first intrathecal injection
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Merit E. Cudkowicz, MD, Massachusetts General Hospital
- Principal Investigator: Robert H. Brown, MD, PhD, UMass Medical School
- Principal Investigator: Namita A. Goyal, MD, UC Irvine
- Principal Investigator: Robert G. Miller, MD, California Pacific Medical Center (CPM) Research Institute
- Principal Investigator: Robert Baloh, MD, Ph.D., Cedars-Sinai Medical Center
- Principal Investigator: Anthony J. Windebank, MD, Mayo Clinic
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- BCT-002-US
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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