- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03487731
Allogeneic Human Mesenchymal Stem Cell Injection in PAtieNts With FaceTogenic Back Pain (VALIANT)
A Phase I/II, Randomized, Blinded and Placebo-controlled Trial to EValuate the Safety and Potential Efficacy of Allogeneic Human Mesenchymal Stem Cell Injection in PAtieNts With FaceTogenic Back Pain
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
There are 40 subjects that will be randomized into the trial into one of 4 groups. In the pilot phase 5 subjects will be enrolled into Group 1, and another 5 subjects will be enrolled into Group 2. Subjects in group 1 will receive placebo but will be eligible for a cross over phase where they will receive a injection of the study investigational product.
In the pilot phase, the first three (3) subjects in each treatment group will not be treated less than 10 days apart.
Following the pilot study, thirty (30) subjects will be scheduled to undergo CT guided facet injection of the lumbar facet joints using a posterior approach after meeting all inclusion/exclusion criteria and baseline evaluation.
Eligible participants will be randomized to either Group A or Group B.Group A will consist of 15 subjects that will receive 20 million Allogeneic hMSCs. Group B will receive placebo.
Study Type
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
Florida
-
Miami, Florida, United States, 33136
- ISCI / University of Miami Miller School of Medicine
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
In order to participate in this study, a subject must:
- Provide written informed consent.
- Subjects age >18 and <75 years at the time of signing the Informed Consent Form.
Facetogenic back pain diagnosed using the following diagnostic criteria:
- The facet joint may be affected by systemic disease, as rheumatoid arthritis and ankylosing spondylitis, or be site of micro traumatic fractures, osteoarthritis, meniscoid entrapment, synovial impingement, joint subluxation, synovial inflammation, loss of cartilage, and mechanical injury.
- Pain onset at dorsal extension and release at flexion is often considered suggestive for facet pain, even if non-specific, such as maximal tenderness upon deep palpation of posterior elements
- History of temporary improvement with a medial branch block anesthetic injection of the targeted joints
- Axial lumbar pain without radicular symptoms
- Pain on hyperextension, rotation, and lateral bending with physical exam
- Chronic facetogenic pain (≥ 6 months) in patients that have failed conservative management. (This includes but is not limited to a trial of oral medications, 6 weeks of physical therapy, intra-articular injection of the facet joints, and/or facet joint medial branch neurotomy.)
- Diagnosis of lumbar facet joint pain confirmed by analgesic injections.
- Have spinal level L3-4, L4-5 and L5-S1 bilaterally for bilateral pain and same side only for unilateral pain.
Exclusion Criteria:
In order to participate in this study, a subject must not:
- Previous surgical intervention for back pain
- Previous mesenchymal stem cell (MSC) injection(s) in to facet joints
- Use of anticoagulation or NSAIDs within 5 days of the injection
- MRI finding of severe high grade lumbar stenosis
- Leg pain exceeding back pain
- Pain worse with flexion maneuvers
- Fracture of lumbar vertebrae
- Be a female who is pregnant, nursing, or of childbearing potential while not practicing effective contraceptive methods. Female subjects must undergo a blood or urine pregnancy test at screening and within 36 hours prior to injection.
- Inability to perform any of the assessments required for endpoint analysis.
- Clinically abnormal screening laboratory values.
- Serious comorbid illness or any other condition that, in the opinion of the investigator, may compromise the safety or compliance of the subject or preclude successful completion of the study.
- Hypersensitivity to dimethyl sulfoxide (DMSO).
- Be an organ transplant recipient.
- Have a clinical history of malignancy within 5 years (i.e., subjects with prior malignancy must be disease free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, melanoma in situ or cervical carcinoma, if recurrence occurs.
- Have a non-pulmonary condition that limits lifespan to < 1 year.
- Have a history of drug or alcohol abuse within the past 24 months.
- Be serum positive for HIV, hepatitis BsAg or Viremic hepatitis C.
- Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
PLACEBO_COMPARATOR: Group 1 - Placebo
Group 1 - Five (5) subjects will be treated with a single administration of 1 cc of 1% lidocaine with 1 cc of 2% Ropivicaine and 0.5 cc of betamethasone soluspan (celestone) solution delivered via intra-facet injection.
These subjects will be part of the control (Standard care) group.
|
A single administration of 1 cc of 1% lidocaine with 1 cc of 2% Ropivicaine and 0.5 cc of betamethasone soluspan (celestone) solution delivered via intra-facet injection.
|
EXPERIMENTAL: Group 2 - Allogeneic Human Mesenchymal Stem Cells (hMSCs)
Group 2 - Five (5) subjects will be treated with a single administration of 20 million allogeneic mesenchymal stem cell delivered intra-facet via 6 injections of 1.5 mL per injection, total of 9 to 12ml.
These subjects will be part of the experimental group.
|
A single administration of 20 million allogeneic mesenchymal stem cell delivered intra-facet via 6 injections of 1.5 mL per injection, total of 9 to 12ml.
Other Names:
|
EXPERIMENTAL: Group A - Allogeneic Human Mesenchymal Stem Cells (hMSCs)
Group A will consist of 15 subjects that will receive 20 million Allogeneic hMSCs delivered via lumbar level injection based on pain originator.
|
A single administration of 20 million allogeneic mesenchymal stem cell delivered intra-facet via 6 injections of 1.5 mL per injection, total of 9 to 12ml.
Other Names:
|
PLACEBO_COMPARATOR: Group B - Placebo
Group B will consist of 15 subjects who will receive 2% Ropivicaine and 0.5 cc of betamethasone soluspan (celestone) solution via lumbar level injection based on pain originator.
|
A single administration of 1 cc of 1% lidocaine with 1 cc of 2% Ropivicaine and 0.5 cc of betamethasone soluspan (celestone) solution delivered via intra-facet injection.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of any treatment-emergent serious adverse events
Time Frame: at one-month post injection
|
Incidence (at one-month post injection) of any treatment-emergent serious adverse events.
|
at one-month post injection
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference in subject quality of life assessment - SF-12
Time Frame: Baseline, Month 3, and Month 6
|
Difference in subject quality of life assessment - SF-12 to assess if there is improvement in health via this health survey.
|
Baseline, Month 3, and Month 6
|
Difference in subject quality of life assessment - Oswestry Low Back Pain
Time Frame: Baseline, Month 3, and Month 6
|
Difference in subject quality of life assessment - Oswestry Low Back Pain where the scores are defined by percentage with 0 to 20% showing minimal disability and 81-100% showing severe disabling symptoms.
|
Baseline, Month 3, and Month 6
|
Death from any cause.
Time Frame: Baseline, Month 3, and Month 6
|
Death from any cause.
|
Baseline, Month 3, and Month 6
|
Change in pain using the Numeric rating scale
Time Frame: Baseline and Month 6
|
Change between baseline and 6 months in pain using the Numeric Rating Scale (NRS) scale.
This is assessed on a scale from 0 to 10 with 0 being no pain and 10 being the worst pain.
|
Baseline and Month 6
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Andrew Sherman, MD, University of Miami
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ANTICIPATED)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
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
- 20180018
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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