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ACT34-CMI -- Adult Autologous CD34+ Cells

8. januar 2021 opdateret af: Lisata Therapeutics, Inc.

A DB, Randomized, Placebo-controlled Study of the Tolerability, Efficacy, Safety, and Dose Range of Intramyocardial CLBS14 for Reduction of Angina Episodes in Patients With Refractory Chronic Myocardial Ischemia (ACT34-CMI)

The purpose of this study is to evaluate the efficacy and safety of intramyocardial injections of CLBS14 in patients with refractory chronic myocardial ischemia.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a double-blind, prospective, randomized, placebo-controlled trial to determine the tolerability, efficacy, safety and dose range of intramyocardial injections of adult autologous CD34+ cells mobilized with granulocyte colony stimulating factor (G-CSF) for the reduction of angina episodes in patients with refractory chronic myocardial ischemia.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

321

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35211
        • Cardiology PC
    • Arizona
      • Phoenix, Arizona, Forenede Stater, 85054
        • Mayo Clinic Hospital
      • Phoenix, Arizona, Forenede Stater, 85005
        • Arizona Heart Institute
    • California
      • La Jolla, California, Forenede Stater, 92037
        • Scripps Memorial Hospital
      • Stanford, California, Forenede Stater, 94305
        • Stanford University Hospital and Clinics
    • District of Columbia
      • Washington, District of Columbia, Forenede Stater, 20010
        • Washington Hospital Center
    • Florida
      • Fort Lauderdale, Florida, Forenede Stater, 33308
        • Holy Cross Hospital
      • Gainesville, Florida, Forenede Stater, 32610
        • University of Florida Health Science Center
      • Jacksonville, Florida, Forenede Stater, 32209
        • University of Florida Health Science Center
      • Orlando, Florida, Forenede Stater, 32803
        • Central Florida Cardiology Group
    • Georgia
      • Atlanta, Georgia, Forenede Stater, 30342
        • Saint Joseph's Research Institute
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60612
        • Rush University Medical Center
      • Chicago, Illinois, Forenede Stater, 60611
        • Northwestern University Medical Center, Bluhm Cardiovascluar Institute
    • Iowa
      • Iowa City, Iowa, Forenede Stater, 52242
        • University of Iowa Hospitals & Clinic
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
        • Massachusetts General Hospital
      • Boston, Massachusetts, Forenede Stater, 02135
        • Caritas Saint Elizabeth's Medical Center
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55407
        • Abbott Northwestern Hospital
    • New York
      • New York, New York, Forenede Stater, 10032
        • New York Presbyterian Hospital - Columbia University Medical Center
      • New York, New York, Forenede Stater, 10065
        • New York Presbyterian Hospital - Weill Cornell Medical College of Cornell University
    • Ohio
      • Cincinnati, Ohio, Forenede Stater, 45267
        • University of Cincinnati Medical Center
      • Cincinnati, Ohio, Forenede Stater, 45219
        • The Lindner Clinical Trial Center
      • Cleveland, Ohio, Forenede Stater, 44106
        • University Hospitals Case Medical Center
    • Pennsylvania
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • University of Pittsburgh Medical Center
    • Washington
      • Seattle, Washington, Forenede Stater, 98122
        • Swedish Heart & Vascular - Swedish Medical Center
    • Wisconsin
      • Madison, Wisconsin, Forenede Stater, 53792
        • University of Wisconsin Medical School
      • Milwaukee, Wisconsin, Forenede Stater, 53223
        • Comprehensive Cardiovascular Care Group

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

21 år til 80 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Canadian Cardiovascular Society (CCS) functional class III or IV chronic refractory angina
  • subjects without control of their angina symptoms, in spite of maximal tolerated doses of anti-anginal drugs, must be on optimal therapy for their angina and on a stable anti-anginal medication regimen for at least 1 month prior to entering the screening period of the study
  • identified as unsuitable for conventional revascularization
  • recent coronary angiogram (within the last 12 months) to document the coronary anatomy and to verify the revascularization procedures
  • subjects must have objective evidence of inducible ischemia or viable myocardium in the potential target injection zone
  • a left ventricular ejection fraction equal to or greater than 25% by ECHO or single photon emission computed tomography (SPECT) at screening
  • subjects must experience at minimum an average of 7 angina or anginal equivalent episodes per week
  • subjects must be able to complete a minimum of 3 minutes but nor more than 10 minutes on a treadmill following the Modified Bruce Protocol
  • subjects must experience angina or anginal equivalent episodes during the screening exercise treadmill test
  • female subjects must either be no longer capable of reproduction or using medically valid contraception to prevent pregnancy during the study
  • subjects must be willing and able to comply with specified follow-up evaluations

Exclusion Criteria:

  • predominant congestive heart failure
  • myocardial infarction within 60 days of treatment
  • successful or partially successful coronary revascularization procedures (any vessel) within 6 months of study enrollment
  • placement of a bi-ventricular pacemaker for cardiac resynchronization therapy (CRT) for heart failure in the past 90 days
  • documented stroke or transient ischemic attack (TIA) within 60 days of study enrollment
  • history of moderate to severe aortic stenosis or severe aortic insufficiency; severe mitral stenosis or severe mitral insufficiency
  • prosthetic aortic valve replacement
  • evidence of any life-threatening arrhythmia that requires intervention on the 24-hour Holter monitor. Life-threatening arrhythmia that is successfully treated with an implantable cardioverter defibrillator (ICD) is not exclusionary.
  • splenomegaly and/or severe co-morbidity associated with a reduction in life expectancy of less than 1 year, such as chronic medical illness (ie, severe chronic obstructive pulmonary disease, renal failure or cancer [exceptions: in-situ skin cancer or fully removed skin cancer other than melanoma, in-situ cervical cancer, or cancer free for 5 years with no history of a stem cell transplant])
  • sickle cell disease or sickle cell trait
  • platelet count greater than 10% above the upper limit of normal or a platelet count below 100,000 if on Clopidogrel or 50,000 without Clopidogrel
  • hematocrit <30%
  • serum creatinine >2.5 mg/dL
  • any clinically significant laboratory abnormality on screening laboratories
  • currently enrolled in another IDE or IND that has not completed the protocol required primary follow-up period (excludes 15 year follow up of gene therapy trials)
  • history of alcohol or drug abuse within 3 months of screening
  • joint or peripheral vascular disease or neurologic disease that severely limits treadmill walking
  • chronic obstructive pulmonary disease that severely limits walking or FEV1 <30% predicted
  • females who are pregnant or lactating
  • female subjects who are capable of reproduction and will not use medically valid contraception to prevent pregnancy during the study
  • subjects who test positive for HIV, hepatitis B or hepatitis C, or are on chronic immunosuppressive medications or have had a prior stem cell transplant
  • subjects with a known hypersensitivity to E. coli-derived proteins, or to any component of Neupogen (Filgrastim) or G-CSF
  • subjects who have a significant psychiatric disorder or mental disability that could interfere with the subject´s ability to provide informed consent and/or comply with protocol procedures

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: CLBS14: Low-Dose Group
10 intramyocardial injections of 0.2 mL each of auto-CD34+ cells at a dose of 1 x 10^5 (=100000) cells/kg bodyweight
Biologisk: CLBS14 (low-dose)
Eligible subjects will receive subcutaneous injections of 5 µg/kg/day G-CSF for 5 days to mobilize CD34+ cells from the bone marrow to the peripheral blood. Mononuclear cells (MNCs) will be collected via apheresis on day 5. On the day of the cell/placebo injection (day 6), the apheresis product will be enriched for CD34+ cells using the Isolex 300i Magnetic Cell Selection System (Baxter Healthcare). Autologous CD34+ cells will be delivered in 10 intramyocardial injections of 0.2 mL at a dose of 1 x 10^5 (=100000) cells/kg bodyweight each using the MyoStar injection catheter (Biosense Webster, Inc.) into the target areas of myocardial ischemia.
Andre navne:
  • G-CSF mobilized, autologous CD34+ cells
Eksperimentel: CLBS14: High-Dose Group
10 intramyocardial injections of 0.2 mL each of auto-CD34+ cells at a dose of 5 x 10^5 (=500000) cells/kg bodyweight
Biologisk: CLBS14 (high-dose)
Eligible subjects will receive subcutaneous injections of 5 µg/kg/day G-CSF for 5 days to mobilize CD34+cells from the bone marrow to the peripheral blood. Mononuclear cells (MNCs) will be collected via apheresis on day 5. On the day of the cell/placebo injection (day 6), the apheresis product will be enriched for CD34+ cells using the Isolex 300i Magnetic Cell Selection System (Baxter Healthcare). Autologous CD34+ cells will be delivered in 10 intramyocardial injections of 0.2 mL at a dose of 5 x 10^5 (=500000) cells/kg bodyweight each using the MyoStar injection catheter (Biosense Webster, Inc.) into the target areas of myocardial ischemia.
Andre navne:
  • G-CSF mobilized, autologous CD34+ cells
Placebo komparator: Placebo injection
10 intramyocardial injections of 0.2 mL each of 0.9% NaCl (saline) in 5% autologous plasma
Biologisk: placebo injection
Eligible subjects will receive subcutaneous injections of 5 µg/kg/day G-CSF for 5 days to mobilize CD34+ cells from the bone marrow to the peripheral blood. Mononuclear cells (MNCs) will be collected via apheresis on day 5. On the day of the cell/placebo injection (day 6), the apheresis product will be enriched for CD34+ cells using the Isolex 300i Magnetic Cell Selection System (Baxter Healthcare). Placebo will be delivered in 10 intramyocardial injections of 0.2 mL each of 0.9% NaCl (saline) in 5% autologous plasma into the target areas of myocardial ischemia.
Andre navne:
  • 0.9% NaCl (saline) in 5% autologous plasma

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Number of Angina Episodes Per Week at 6 and 12 Months
Tidsramme: 6 and 12 months
The number of angina episodes were collected via an electronic subject diary for four weeks at Baseline and at 6 and 12 months. The four-week angina episodes (per week mean) were used as the frequency for each visit. A lower number represents fewer angina episodes. A lower number is better.
6 and 12 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Exercise Treadmill Test According to Modified Bruce Protocol: Mean Change From Baseline in Duration of Exercise
Tidsramme: Change from Baseline to 6 months and change from baseline to 12 months after treatment
A modified Bruce Protocol Exercise Treadmill Test was used to evaluate duration of exercise in all subjects.
Change from Baseline to 6 months and change from baseline to 12 months after treatment
Number of Participants With Change in Canadian Cardiovascular Society Anginal Classification Levels
Tidsramme: Baseline and 12 months after treatment

The Canadian Cardiovascular Society (CCS) Functional Classification of Angina is as follows:

  • Class I - Angina only during strenuous or prolonged physical activity
  • Class II - Slight limitation, with angina only during vigorous physical activity
  • Class III - Symptoms with everyday living activities, i.e., moderate limitation
  • Class IV - Inability to perform any activity without angina or angina at rest, i.e., severe limitation
Baseline and 12 months after treatment
Changes From Baseline in Seattle Angina Questionnaire (SAQ) Scores at 6 Months
Tidsramme: Baseline to 6 months after treatment
Angina symptoms were evaluated based on the Seattle Angina Questionnaire (SAQ), which was used to analyze the following: physical limitations, angina stability, angina frequency, treatment satisfaction, and disease perception. The SAQ consisted of 11 questions with 5 or 6 possible responses. Responses were ordinal values (1-7, 10, 11, 97, depending on the type of question; no uniform ranges throughout); responses that corresponded to the lowest level of functioning (worse outcomes) were assigned values of 1, while responses that corresponded to higher functioning levels (better outcome) were assigned a higher ordinal value. If the response to any of these questions was 97 it was recoded as a missing value. Each scale can have a scored value ranging from 0 to 100. A larger number is better.
Baseline to 6 months after treatment
Changes From Baseline to 6 Months in Short Form 36 (SF-36) Parameters
Tidsramme: Baseline to 6 months after treatment
The Short Form 36 (SF-36) health survey form was used to analyze physical functioning, role limitations due to physical health, bodily pain, general health perceptions, vitality, social functioning, role limitations due to emotional problems, general mental health, and health transition. Responses were coded as ordinal numbers going from worst (=1) to best (=highest number). These ordinal scores were transformed into scales ranging from 0 to 100. Higher numbers are generally considered better.
Baseline to 6 months after treatment
Change in Anti-anginal Medication (ie, Nitroglycerin) Use
Tidsramme: Baseline to 6 months
The mean nitroglycerin use per week was analyzed at baseline and 6 months
Baseline to 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Lisata Therapeutics, Inc.

Efterforskere

  • Studieleder: Caladrius Study DIrector, Lisata Therapeutics, Inc.

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. april 2006

Primær færdiggørelse (Faktiske)

1. marts 2008

Studieafslutning (Faktiske)

1. marts 2009

Datoer for studieregistrering

Først indsendt

6. marts 2006

Først indsendt, der opfyldte QC-kriterier

6. marts 2006

Først opslået (Skøn)

8. marts 2006

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

26. januar 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. januar 2021

Sidst verificeret

1. januar 2021

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 24779

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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