- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00285454
Cell Repair in Heart Failure
A Phase I/II, Randomised, Double-blind, Placebo Controlled, Single-centre Study of Bone Marrow Mononuclear Cells by Percutaneous Retrograde Coronary Venous Delivery to Patients With Ischaemic Heart Failure and no Standard Revascularisation Options.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Study Objectives:
- Evaluate the safety of a single administration of bone marrow mononuclear cells by retrograde coronary venous delivery.
- Evaluate the bioactivity of bone marrow mononuclear cells in mediating increased perfusion in viable underperfused areas of myocardium.
- Evaluate the ability of bone marrow mononuclear cells to improve myocardial function specifically regional wall motion and cardiac synchronisation.
- Evaluate the use of potential bioactivity assays and clinical outcomes for assessing bone marrow mononuclear cell- induced myocardial changes.
Study Design:
A phase I/II, randomised, double-blind, placebo controlled, single-centre study of bone marrow mononuclear cells by percutaneous retrograde coronary venous delivery to patients with ischaemic heart failure and no standard revascularisation options.
Study Population:
Patients with symptomatic ischaemic heart failure, not amenable to conventional revascularisation strategies (PCI, CABG, LVAD) or transplantation.
Independent Eligibility:
The results of the screening procedures will be compiled and submitted to an independent interventional cardiologist and cardiac surgeon who are not associated with the study for consideration for enrolment. It will be the independent reviewer's responsibility to confirm eligibility prior to a patient participating in the study.
Product:
Autologous bone marrow mononuclear, the first 6 safety and feasibility patients (open-labelled) will receive a sub-population of Indium-111 labelled cells to assess feasibility of delivery. The remaining patients will either receive Active: Bone marrow mononuclear cells and 5 % HSA Placebo: 5% HSA
Route:
Retrograde coronary venous delivery The total dose of bone marrow mononuclear cells or placebo will be divided into two, each administered as a 10ml bolus into a selective coronary veins. There will be significant patient heterogeneity regarding size of ischaemic viable territory present and anatomy of venous system. We aim to treat two veins, individual SPECT and venogram results will be used to direct the venous anatomy to be targeted. An attempt will be made to cover as large an area as possible of a patient's ischaemic viable territory. The total dose of cells will remain constant between patients.
Safety:
The first 6 patients will receive cells as an adjunct to Cardiac resynchronization Therapy and ICD. An external Data Safety and Monitoring Board has also been appointed to oversee this study.
Tipo de estudio
Fase
- Fase 2
- Fase 1
Contactos y Ubicaciones
Ubicaciones de estudio
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Middlesex
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London, Middlesex, Reino Unido, SW3 6LR
- The Department of Gene Therapy, The National Heart and Lung Institute, Imperial College London and The Royal Brompton Hospital.
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Symptomatic ischaemic multi-vessel coronary artery disease (CAD) not suitable for standard revascularization procedures such as CABG, PCI, LVAD, or heart transplant.
- Area of reversible inducible ischaemia (>10% of LV on SPECT) performed not more than six months prior to study treatment.
- LVEF < 45% on optimal medical therapy.
- NYHA class II- IV patient stable on optimal medical therapy for at least 30 days.
- Written informed consent and agree to attend hospital appointments for 1 year.
- Male and females 18 to 80 years of age.
Exclusion Criteria:
- Left ventricular aneurysm or thrombus.
- Thoracic aortic aneurysm.
- Congenital Heart disease
- Acute unstable angina, idiopathic cardiomyopathy, life-threatening ventricular arrhythmias, recent (less than 6 weeks).
- Contraindication to MRI or any other study procedure.
- Presence or history of cancer (except low grade and fully resolved non-melanoma skin malignancy).
- Any co-morbidity likely to reduce short- term survival or which may interfere with functional testing.
- Recent myocardial infarction < 6mths.
- Cerebral vascular accident < 6mths.
- Active hepatitis, receiving immunosuppressive therapy, undergoing haemodialysis.
- Clinically significant abnormal haematology.
- Recent history of alcoholism, drug abuse, or severe emotional, behavioural, or psychiatric problems.
- Fertile women who are pregnant, nursing, or using no form of contraception.
- Receiving experimental medications or participating in another study within 12 weeks of enrolment into this study.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Doble
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
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Eficacia
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Safety: up to one year
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Co-primary endpoints at 180 Days
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Perfusion (MIBI SPECT)
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Function (CMR)
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Medidas de resultado secundarias
Medida de resultado |
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CDV
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Efficacy: at 180 days
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Perfusion (CMR)
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Function (ECHO, SPECT)
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Exercise (VO2 Max)
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Eric WF Alton, The Department of Gene Therapy, The NHLI Imperial College London
- Investigador principal: Jonathan R Clague, The Royal Brompton Hospital London
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Anticipado)
Finalización del estudio (Anticipado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- Amanda Heinl-Green
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