Treatment of Osteoarthritis by Intra-articular Injection of Bone Marrow Mesenchymal Stem Cells With Platelet Rich Plasma (CMM-PRGF/ART)
Phase I/II. Treatment of Osteoarthritis by Intra-articular Injection of Bone Marrow Mesenchymal Stem Cells With Platelet Rich Plasma(PRGF)
Purpose: To determine the safety, feasibility and effectiveness (clinical and radiological) of intra-articular administration of autologous mesenchymal stem cells (MSCs) with platelet richa plasma (PRGF) in patients with knee osteoarthritis.
Patients and methods
Clinical trial phase I- II, randomized , multicenter , with two treatment arms and 19 patients for each group. The investigators compare the intraarticular injection of against the administration of two different doses of mesenchymal stem cells with hialuronic acid according to the following scheme:
- Group A: 3 intra-articular injections of platelet rich plasma (PRGF®) separated by 7 days.
- Group B: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days and one with Mesenchimal stems cells. Intra-articular injection of 100 million autologous mesenchymal progenitor stem cells cultured ex - vivo (cell suspension sterile small volume (5-10 ml ) in a vehicle suitable for intraarticular injection ) followed by an intraarticular injection of platelet richa plasma (PRGF®). The treatment is completed with 2 more injection of platelet richa plasma (PRGF®) separeted by one week.
In addition the investigators assess the response to intra-articular infusion of CMM analyzing the following parameters:
- Clinical assessment of pain and function (Baseline, 1, 3, 6 and 12 months since treatment): VAS , WOMAC , KOOS , EuroQol, SF-16, Lequesne , WOMAC , KOOS.
- Radiographic (baseline and 12 months from treatment): Femorotibial space.
- Radiographic using MRI (baseline and 12 months from treatment): by assessing the number location of the lesions , cartilage thickness , signal intensity , subchondral bone alteration , volume and WORMS and dGEMRIC protocols.
調査の概要
状態
条件
詳細な説明
Purpose: To determine the safety, feasibility and effectiveness (clinical and radiological) of intra-articular administration of autologous mesenchymal stem cells (MSCs) with platelet richa plasma (PRGF®) in patients with knee osteoarthritis.
Patients and methods
Clinical trial phase I- II, randomized , multicenter , with two treatment arms and 19 patients for each group. The investigators compare the intraarticular injection of against the administration of two different doses of mesenchymal stem cells with hialuronic acid according to the following scheme:
- Group A: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days.
- Group B: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days and one with Mesenchimal stem cell. Intra-articular injection of 100 million autologous mesenchymal progenitor stem cells cultured ex - vivo (cell suspension sterile small volume (5-10 ml ) in a vehicle suitable for intraarticular injection ) followed by an intraarticular injection of platelet richa plasma (PRGF®). The treatment is completed with 2 more injection of platelet richa plasma (PRGF®) separeted by one week.
The autologous mesenchymal stem cells are obtained from the iliac crest under local anesthesia and sedation. They are cultured ex vivo The primary endpoint is safety and feasibility. The investigators registered the occurrence of complications and / or adverse effects during the study.
In addition the investigators assess the response to intra-articular infusion of CMM analyzing the following parameters:
- Clinical assessment of pain and function (Baseline, 1, 3, 6 and 12 months since treatment): VAS , WOMAC , KOOS , EuroQol, SF-16, Lequesne , WOMAC , KOOS.
- Radiographic (baseline, 6 and 12 months since treatment): Femorotibial space.
- Radiographic using MRI (baseline, 6 and 12 months since treatment): by assessing the number location of the lesions , cartilage thickness , signal intensity , subchondral bone alteration , volume and WORMS and dGEMRIC protocols.
All patients met the following inclusion and exclusion criteria:
研究の種類
入学 (予想される)
段階
- フェーズ2
- フェーズ 1
連絡先と場所
研究場所
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Castilla-León
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Salamanca、Castilla-León、スペイン、37007
- Hospital Universitario De Salamanca
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Navarra
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Pamplona、Navarra、スペイン、31008
- Departamento Cirugía Ortopédica y Traumatología. Clinica Universidad de Navarra
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Males and females between 40 and 80 year old
- Bad results with previous hyaluronic acid injection
- Diagnosis of knee OA according to the criteria of osteoarthritis of the ACR (American College of Rheumatology)
- Joint pain equal or greater than 2.5 points on the visual analogue scale (VAS)
- Radiological Classification: Kellgren-Lawrence scale greater or equal to 2
- Body mass index between 20 and 35 kg/m2
- Ability to follow during the study period
Exclusion Criteria:
- Bilateral Osteoarthritis of the Knee requiring treatment in both knees
- Previous diagnosis of polyarticular disease
- Severe mechanical deformation
- Arthroscopy during the previous 6 months
- Intraarticular infiltration of hyaluronic acid in the last 6 months
- Systemic autoimmune rheumatic disease
- Poorly controlled diabetes mellitus
- Blood dyscrasias
- Immunosuppressive or anticoagulant treatments
- Treatment with corticosteroids in the 3 months prior to inclusion in the study
- NSAID therapy within 15 days prior to inclusion in the study
- Patients with a history of allergy to penicillin or streptomycin
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:他の
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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アクティブコンパレータ:Platelet Rich Plasma (PRGF)
Platelet Rich plasma (PRGF) 3 intraarticular onjections sepataded by 7 days.
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3 injections of PRGF
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アクティブコンパレータ:BMMSC with Platelet Rich Plasma (PRGF)
Single intraarticular injection of 100 million Bone marrow mesenchimal stem cells and three intraarticular injections of plateler Rich Plasma (PRGF) separatede by 7 days.
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3 injections of PRGF
100 million Bone marrow mesenchimal stem cells with PRGF
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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3か月時のビジュアルアナログスケール(VAS)
時間枠:3ヶ月
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3か月時のビジュアルアナログスケール(VAS)
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3ヶ月
|
|
6か月時のビジュアルアナログスケール(VAS)
時間枠:6ヵ月
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6か月時のビジュアルアナログスケール(VAS)
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6ヵ月
|
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12か月時のビジュアルアナログスケール(VAS)
時間枠:12ヶ月
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12か月時のビジュアルアナログスケール(VAS)
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12ヶ月
|
|
1か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
時間枠:1ヶ月
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1か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
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1ヶ月
|
|
3か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
時間枠:3ヶ月
|
3か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
|
3ヶ月
|
|
6か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
時間枠:6ヵ月
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6か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
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6ヵ月
|
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12か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
時間枠:12ヶ月
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12か月後の膝損傷および変形性関節症アウトカムスコア(Koos)の値
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12ヶ月
|
|
Baseline Visual analogue scale (VAS) Baseline Visual analogue scale (VAS)
時間枠:Day 1
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Baseline Visual analogue scale (VAS) prior to the initial dose on day 1
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Day 1
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Baseline value of knee injury and osteoarthritis outcome score (Koos).
時間枠:Day 1
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Prior to the intervention on day 1 value of knee injury and osteoarthritis outcome score (Koos).
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Day 1
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Baseline Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC).
時間枠:Day 1
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Universities Osteoarthritis Index score (WOMAC).
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Day 1
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Baseline SF-36 value
時間枠:Day 1
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Baseline SF-36 value
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Day 1
|
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Baseline euroquol 5D value
時間枠:Day 1
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Pretreatment euroquol 5D value
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Day 1
|
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Baseline Lequesne index
時間枠:Day 1
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Prior to the intervention on day 1 Lequesne index
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Day 1
|
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Baseline femorotibial distance
時間枠:Day 1
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Prior to the intervention femoritibial distance on rosenberg x-ray view
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Day 1
|
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Number of Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events
時間枠:Follow up (up to 12 months)
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Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events During the follow up
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Follow up (up to 12 months)
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Visual analogue scale (VAS) at 1 month
時間枠:1 month
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Visual analogue scale (VAS) at on month
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1 month
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協力者と研究者
捜査官
- 主任研究者:José Lamo-Espinosa, MD、Clinica Universidad de Navarra
- スタディディレクター:Felipe Prosper, MD, PhD、Clinica Universidad de Navarra
- 主任研究者:Juan Blanco, MD; PhD、Complejo Universitario de Salamanca
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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