- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05962333
Effect and Safety MABs Administration m.3243A>G Mutation Carriers
Assess Effect and Safety of Intra-arterial Autologous Mesoangioblast Administration to the Upper Arm of m.3243A>G Mutation Carriers
The first primary objective is to assess the effect of three intra-arterial administrations of autologous mesoangioblasts (MABs) with respect to improving muscle strength and reduce fatigue of the treated biceps brachii (BB) compared to the untreated BB.
The second primary objective is safety of three intra-arterial administrations of autologous MABs, which the investigators will assess by monitoring (serious) adverse events ((S)AEs), blood flow in left arm pre- and post-intervention, and neurological vital signs during 8h post-intervention observation in the hospital.
Secondary objectives are to assess changes in muscle mass of the treated and untreated BB muscle, and microscopic changes and m.3243A>G mutation load at tissue level in treated biceps brachii (BB) muscle at baseline and after treatment.
Up to 20 adult m.3243A>G patients will undergo a ~30mg m. biceps brachii muscle biopsy at visit 1. The first six eligible patients will enroll the clinical study based on their m.3243A>G mutation load in skeletal muscle (50-90%) and mesoangioblasts (<10%), and on a decreased BB muscle strength and increased fatigue.
These 6 selected patients will visit the Maastricht University Medical Center for 8 additional times. From each patient, during visit 2 till 9:
- BB muscle biopsies of the left arm will be collected (1x ~130 mg at visit 2 and 1x ~30mg at visit 9)
- MRI of the BB muscles in both arms will be performed (visit 2 and 9).
- Autologous MABs will be injected into the left arm via axillary artery delivery. Angiography will be performed before and after infusion to assess vascular obstructions, and the participant will be monitored in the hospital for 8 hours (visit 4,6,8).
- Tc99m macroaggregated albumin (MAA) is infused to quantify blood flow to the BB muscle (visit 4).
- A bout of maximal eccentric exercise of BB muscles on both sides will be executed at visit 3, 5 and 7.
- BB muscle strength will be assessed using a Biodex dynamometer (visit 3-9)
- venous blood samples will be taken for assessing muscle damage and inflammation markers (visit 3-9), kidney functioning, coagulation and viral screening (visit 1 and 2).
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Florence van Tienen, PhD
- Phone Number: 00314331995
- Email: florence.vantienen@maastrichtuniversity.nl
Study Contact Backup
- Name: Bert Smeets, Prof. PhD
- Phone Number: 00314331995
- Email: bert.smeets@maastrichtuniversity.nl
Study Locations
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-
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Maastricht, Netherlands, 6229ER
- Recruiting
- Maastricht University Medical Center
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Contact:
- Florence van Tienen, PhD
- Phone Number: 0031433882918
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Written informed consent
- Age: 18-64
- Sex: male/female
- Patients with the m.3243A>G mutation load of 50%-90% determined in skeletal muscle or derived from age-corrected calculation of blood m.3243A>G mutation load
Exclusion Criteria:
A potential subject who meets any of the following criteria will be excluded from participation in this study:
- Use of dabigatran, apixaban, edoxaban or rivaroxaban (DOACs) as anti-coagulants
- Have a weekly alcohol intake of ≥ 35 units (men) or ≥ 24 units (women)
- Current history of drug abuse
- Deficient immune system or autoimmune disease
- Significant concurrent illness
- Ongoing participation in other clinical trials with intervention
- Pregnant or lactating women
- Psychiatric or other disorders likely to impact on informed consent
- Patients unable and/or unwilling to comply with treatment and study instructions
- A history of strokes with signs of extra-pyramidal or pyramidal syndrome
- Allergy for contrast fluid
- Peripheral signs of ischemia or vasculopathy
- Claustrophobia
- Metal implants
- Any other factor that in the opinion of the investigator excludes the patient from the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intra-arterial delivery of autologous MABs
Autologous MABs will be injected three times in left arm to treat biceps brachii muscle
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three times intra-arterial administration of autologous mesoangioblasts in biceps brachii of the left arm at 4-6 week interval
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess blood flow in left arm following i.a. arterial delivery of autologous MABs
Time Frame: before and directly after each administration in week 1,5 and 10
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Assess blood flow in left arm using digital subtraction angiography (DSA) before and directly after MABs administration in week 1, 5 and 10.
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before and directly after each administration in week 1,5 and 10
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Assess (serious) adverse events following 3 i.a. deliveries of autologous MABs
Time Frame: 15 weeks
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Assessment of (serious) adverse events
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15 weeks
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Assess temperature following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Temperature will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1,5 and 10.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess oxygen saturation following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Oxygen saturation will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1,5 and 10.
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0,1,2,3,4,6 and 8 hours after each administration.
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Muscle strength arm following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Using Medical Research Council (MRC) scale for muscle strength, muscle strength of left arm will be assessed 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
MRC scale ranges from 0 (no visible contraction) to 5 (normal)).
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess breathing frequency following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Breathing frequency will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess vital signs following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Heart rate will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess systolic and diastolic blood pressure following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Systolic and Diastolic blood pressure will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess Glasgow Coma scale (GCS) score following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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Glasgow Coma Scale (GCS) score will be determined 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
GCS score ranges from 3 to 15, 3 being the worst and 15 being the best score.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess if pupil size is symmetrical in both eyes following 3 i.a. deliveries of autologous MABs
Time Frame: 0, 1,2,3,4,6 and 8 hours after each administration.
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Pupil size of both eyes will be assessed 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.
If pupil size is not equal, this can indicate disease or trauma.
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0, 1,2,3,4,6 and 8 hours after each administration.
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Assess pupil reaction following 3 i.a. deliveries of autologous MABs
Time Frame: 0,1,2,3,4,6 and 8 hours after each administration.
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To assess brain functioning, reaction of pupils to light will be determined 0,1,2,3,4,6 and 8 hours after administration.
Upon light, both pupils should become smaller in week 1, 5 and 10.
No reaction or only reaction in one eye can indicate nerve damage.
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0,1,2,3,4,6 and 8 hours after each administration.
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Assess changes in muscle strength of biceps brachii muscle in both arms at baseline and 4-6 weeks after third i.a. delivery of autologous MABs in left arm, which is 12-16 weeks after baseline measurements.
Time Frame: baseline and 15 weeks after 1st administration
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Determine maximum muscle force generating capacity (peak torque N/m) of the biceps brachii muscle in both arms using Biodex dynamometer measurements.
Measurements will be performed in left (intervention) and right (no intervention) biceps brachii muscle using Biodex dynamometer measurements at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Assess changes in muscle fatigue of biceps brachii muscle in both arms at baseline and 4-6 weeks after third i.a. delivery of autologous MABs in left arm, which is 12-16 weeks after baseline measurements.
Time Frame: baseline and 15 weeks after 1st administration
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Asses changes in muscle fatigue by measuring percentage decrease in maximum muscle force generating capacity (peak torque N/m) between first and sixth repetition.
Measurements will be performed in left (intervention) and right (no intervention) biceps brachii muscle using Biodex dynamometer measurements at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess changes in muscle volume biceps brachii muscles of both arms following 3 i.a. deliveries of autologous MABs in left arm.
Time Frame: baseline and 15 weeks after 1st administration
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MRI T3 analysis to assess changes in muscle volume in both arms at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Assess formation of new muscle fibers following 3 i.a. deliveries of autologous MABs
Time Frame: baseline and 15 weeks after 1st administration
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Perform embryonic myosin heavy chain (MHC)+ immunostaining to assess percentage of new / regenerating muscle fibers in muscle biopsies collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Mitochondrial mutation load and functioning following 3 i.a. deliveries of autologous MABs
Time Frame: baseline and 15 weeks after 1st administration
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Assess changes in m.3243A>G mutation load in new/regenerating muscle fibers compared to existing muscle fibers isolated via laser microdissection from muscle biopsies left arm collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Mitochondrial functioning following 3 i.a. deliveries of autologous MABs in left arm.
Time Frame: baseline and 15 weeks after 1st administration
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Assess changes in mitochondrial functioning by performing Cytochrome C Oxidase / Succinate Dehydrogenase (COX/SDH) staining in muscle biopsies from left arm collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.
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baseline and 15 weeks after 1st administration
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess creatine kinase level in blood plasma as marker for muscle damage following 3 i.a. deliveries of autologous MABs
Time Frame: 0 and 8 hours after each administration.
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Assess creatine kinase (CK) in blood plasma following eccentric exercise prior and 8 hours after administration in week 1,5 and 10.
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0 and 8 hours after each administration.
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Janneke Hoeijmakers, MD, PhD, Maastricht University Medical Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
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
- NL82815.000.22
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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