Patient-Derived Stem Cell Therapy for Diabetic Kidney Disease

April 3, 2023 updated by: LaTonya J. Hickson, Mayo Clinic

Intra-arterially Delivered Autologous Mesenchymal Stem/Stromal Cell Therapy in Patients With Diabetic Kidney Disease: A Phase I Study

The Researchers will assess the safety, tolerability, dosing effect, and early signals of efficacy of intra-arterially delivered autologous (from self) adipose (fat) tissue-derived mesenchymal stem/stromal cells (MSC) in patients with progressive diabetic kidney disease (DKD).

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

This is a single center, open-label dose-escalating study assessing safety, tolerability, dosing effect, and early signals of efficacy of intra-arterially delivered autologous (from self) adipose tissue-derived mesenchymal stem/stromal cells (MSC) in 30 patients with progressive diabetic kidney disease (DKD). DKD will be defined as chronic kidney disease (CKD; estimated glomerular filtration rate; eGFR<60 mL/min/1.73m2) in the setting of diabetes mellitus (type 2; on anti-diabetes therapy) without overt etiologies of CKD beyond concomitant hypertension. Progressive DKD will be considered as eGFR 25-55 ml/min/1.73m2 with a) eGFR decline of 5 ml/min over 18 months or 10 ml/min over 3 years or b) an intermediate or high 5-year risk of progression to end-stage kidney failure (dialysis or transplant) based on the validated Tangri 4-variable (age, sex, eGFR, urinary albumin-creatinine ratio) kidney failure risk equation. Fifteen subjects will be placed in one of two cell dosage arms in a parallel design with single-kidney MSC administration at Day 0 and Month 3. Subjects will be followed a total of 15 months from time of initial cell administration.

Study Type

Interventional

Enrollment (Actual)

2

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Minnesota
      • Rochester, Minnesota, United States, 55905
        • Mayo Clinic in Rochester

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

45 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Diabetes mellitus (on anti-diabetes drug therapy)
  • Age 45-75 years
  • eGFR 25-55 ml/min/1.73m2 at time of consent with: a) eGFR decline of 5 ml/min over 18 months or 10 ml/min over 3 years or b) an intermediate or high 5-year risk of progression to end-stage kidney failure (dialysis or transplant) based on the validated Tangri 4-variable (age, sex, eGFR, urinary albumin-creatinine ratio) kidney failure risk equation https://kidneyfailurerisk.com/
  • Primary cause of kidney disease is diabetes without suspicion of concomitant kidney disease beyond hypertension
  • Spot urine albumin:creatinine ≥30 mg/g unless on RAAS inhibition
  • Ability to give informed consent

Exclusion Criteria:

  • Hemoglobin A1c≥11%
  • Pregnancy
  • Active malignancy
  • Active Immunosuppression therapy
  • Kidney transplantation history
  • Concomitant glomerulonephritis
  • Nephrotic syndrome
  • Solid organ transplantation history
  • Autosomal dominant or recessive polycystic kidney disease
  • Known renovascular disease
  • Kidney failure (hemodialysis, peritoneal dialysis, or kidney transplantation)
  • Active tobacco use
  • Body weight >150 kg or BMI>50
  • Uncontrolled hypertension: Systolic blood pressure (SBP) >180 mmHg despite antihypertensive therapy
  • Recent cardiovascular event (myocardial infarction, stroke, congestive heart failure within 6 months
  • Evidence of hepatitis B or C, or HIV infection, chronic
  • Anticoagulation therapy requiring heparin bridging for procedures.
  • History of methicillin-resistant staphylococcus aureus colonization
  • Recent plastic, chemical or surgical manipulation of adipose tissue for cosmetic purposes within 6 months
  • Inability to give informed consent
  • Potentially unreliable subjects and those judged by the investigator to be unsuitable for the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Lower Dose MSC
This arm will receive autologous adipose-derived Mesenchymal stem/stromal cells (MSC) Lower Dose.
Biological: Autologous adipose-derived mesenchymal stem/stromal cells (MSC) Lower Dose
Two MSC infusions of 2.5x10^5 cells/kg at time zero and three months; single kidney, intra-arterial delivery
Experimental: Higher Dose MSC
This arm will receive autologous adipose-derived Mesenchymal stem/stromal cells (MSC) Higher Dose
Biological: Autologous adipose-derived mesenchymal stem/stromal cells (MSC) Higher Dose
Two MSC infusions of 5.0x10^5 cells/kg at time zero and three months; single kidney, intra-arterial delivery

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Adverse Events
Time Frame: Baseline through Month 15
The number of Adverse Events associated with MSC intervention per treatment arm
Baseline through Month 15
Adverse Events
Time Frame: Baseline through Month 15
The percentage of Adverse Events associated with MSC intervention per treatment arm
Baseline through Month 15

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Kidney Function
Time Frame: baseline, month 6
Change in measured glomerular filtration rate (mGFR). Measured as mL/min/BSA
baseline, month 6
Kidney Function
Time Frame: pretreatment, month 12
Change in estimated glomerular filtration rate (eGFR) slope. Measured as mL/min/1.73m^2/month
pretreatment, month 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Mayo Clinic

Collaborators

Regenerative Medicine Minnesota

Investigators

  • Principal Investigator: LaTonya J Hickson, MD, Mayo Clinic

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

October 23, 2019

Primary Completion (Actual)

August 4, 2020

Study Completion (Actual)

August 4, 2020

Study Registration Dates

First Submitted

February 11, 2019

First Submitted That Met QC Criteria

February 11, 2019

First Posted (Actual)

February 15, 2019

Study Record Updates

Last Update Posted (Actual)

April 5, 2023

Last Update Submitted That Met QC Criteria

April 3, 2023

Last Verified

April 1, 2023

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 18-002423
  • RMM 091718 CT 001 (Other Grant/Funding Number: Regenerative Medicine Minnesota)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

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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