Safety and Feasibility of Bilateral Striatal Transplantation of DopaCell in Parkinson's Disease
Evaluation of the Safety and Feasibility of a Single Transplantation of 10 Million Human Embryonic Stem Cell-Derived Dopaminergic Progenitor Cells Into the Bilateral Striatum of Patients With Moderately Severe Parkinson's Disease: a Multicenter, Open-label, Single-arm Phase I Clinical Trial
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Fase
Fase
- Fase 1
Contacten en locaties
Studiecontact
Studiecontact
- Naam: Sarvenaz Salahi, MD
- Telefoonnummer: 021-23562000
- E-mail: salahi13639@gmail.com
Studie Locaties
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Shiraz, Iran
- Werving
- Shiraz University of Medical Sciences
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Contact:
- Sarvenaz Salahi, MD
- Telefoonnummer: 021-2356200
- E-mail: salahi13639@gmail.com
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Tehran, Iran
- Werving
- Royan Institute
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Contact:
- Sarvenaz Salahi, MD
- Telefoonnummer: 021-2356200
- E-mail: salahi13639@gmail.com
-
Tehran, Iran
- Werving
- Iran University of Medical Sciences
-
Contact:
- Sarvenaz Salahi, MD
- Telefoonnummer: 021-2356200
- E-mail: salahi13639@gmail.com
-
-
Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- Age: 30-70 years
- Diagnosis of PD: MDS clinical Diagnostic Criteria for Parkinson's disease
- The disease duration more than 5 years
- Moderate Parkinson's disease, defined as a Hoehn and Yahr stage of 2 or 3 during the OFF period.
- The patient is receiving oral pharmacological therapy, and in the opinion of the Principal Investigator, the patient's symptoms remain inadequately controlled despite optimal medical management, or the patient is experiencing adverse effects related to their current treatment
- No history or only mild levodopa-induced dyskinesia, defined as a score of 2 or less on the UDysRS scale in any body region during the ON state.
- The patient demonstrates a clinically meaningful response to a therapeutic dose of levodopa, as determined by the Principal Clinical Investigator or a trained specialist under the supervision of the Principal Investigator.
The performance of different organs based on laboratory evaluations:
- Number of neutrophils ≥2000 / microliter
- Platelet count ≥100,000 / microliter
- AST / ALT: less than or equal to three times the maximum normal value at the intervention site
- Total bilirubin less than or equal to 1.5 times the maximum normal amount at the intervention site
- eGFR * rate: greater than or equal to 60 ml / min / 1.73 m2 * eGFR (mL / min / 1.73 m2) = 194 X Cr ^ -1.094 X age ^ -0.287 (X 0.739 for females)
- Informed consent
Exclusion Criteria:
- The abnormal function of immune system
- The symptomatic brain injuries (brain atrophy, cerebral Infarct, trauma, vascular malformation) confirmed by brain MRI
- Markedly reduced or normal signal in the ventral striatum on TRO-DaT SPECT imaging.
- Any abnormal findings on brain MRI.
- Positive GBA mutation test.
- Diagnosis of dementia based on a MoCA score < 24.
- The abnormality of thrombotic system or high risk of bleeding
- Positive for any of the following viral markers or active infections: HBsAg, HBsAb, HBcAb, anti-HIV antibodies, anti-HTLV-1&2 antibodies, active hepatitis C infection, syphilis, or active CMV, VZV, EBV, or COVID-19 infection.
- Impossibility of MRI imaging for patients with metal in the body, pacemaker in the body, claustrophobia, with artificial heart valves that are incompatible with MRI or body weight is not within the tolerable range for MRI.
- Patients with contraindications to the study drug: Tacrolimus, Prednisolone, Basiliximab, Cotrimoxazole, MRI contrast agent.
- Patients undergoing other cell transplants, including embryonic stem cell-derived dopaminergic progenitor cells.
- Patients with a history of PD at the same time and concurrent: Malignant neoplasm, epilepsy, cerebral hemorrhage or a positive history
- Psychiatric disorders confirmed by a psychiatrist, including major depression, bipolar disorder, or schizophrenia, that are uncontrolled or treatment resistant.
- Patients with intellectual disability who, in the judgment of a psychiatrist, are unable to fully comprehend the study requirements.
- History of pallidotomy, thalamotomy, or deep brain stimulation (DBS).
- Patients considered high-risk candidates for surgery, particularly neurosurgery or DBS implantation, due to significant cardiovascular, pulmonary, or other systemic comorbidities identified during preoperative evaluation.
- Patients who have a history of taking the following in the three months prior to enrollment: Immunosuppressant, antipsychotic drug, anticonvulsant drugs or anticoagulant therapy (if discontinuation or perioperative adjustment is not feasible), botulinum toxin (within 6 months), phenol injections, or other treatments for dystonia or muscle spasm
- History of Apomorphine use
- History of chronic alcohol use or illicit drug abuse.
- Patients who are pregnant, lactating, or people who did not avoid pregnancy during the study.
- Patients who, according to the researchers' opinions, are not suitable for safe study.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: NVT
- Interventioneel model: Opdracht voor een enkele groep
- Masker: Geen (open label)
Aantal wapens
Wapens en interventies
Deelnemersgroep / ArmDeelnemersgroep / Arm |
Interventie / BehandelingInterventie / Behandeling |
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Experimenteel: Transplantation
Experimental: DopaCell Biological: DopaCell, 5 million cells per putamen Immunosuppressive Regimen: Basiliximab, Tacrolimus, Prednisolone Device: Customized microinjection device
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DopaCells are dopamine-producing progenitor cells generated from human embryonic stem cells through differentiation under GMP-compliant conditions.
Basiliximab, Tacrolimus, Prednisolone
For intraputaminal delivery of DopaCell
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Safety
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Incidence and severity of treatment-emergent adverse events (TEAEs)
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Baseline to 12 Months Post-Transplant
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Safety
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Evidence of any post-transplantation anatomical changes at the transplant site suggestive of tumor formation, as assessed by MRI imaging.
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Baseline to 12 Months Post-Transplant
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Feasibility
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Successful completion of a single-session intraputaminal transplantation with of the intended cell dose
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Baseline to 12 Months Post-Transplant
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Efficacy
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Changes in the duration of OFF and ON periods following intracerebral DopaCells transplantation as assessed by the Hauser diary
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Baseline to 12 Months Post-Transplant
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Efficacy
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Changes in the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III score from baseline following intracerebral DopaCells transplantation during ON and OFF periods ( MDS-UPDRS Part III ranges from 0 to 132, where higher scores indicate worse motor impairment.)
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Baseline to 12 Months Post-Transplant
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Efficacy
Tijdsspanne: Baseline to 12 Months Post-Transplant
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Graft survival following intracerebral DopaCells transplantation based on TRODAT SPECT imaging findings.
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Baseline to 12 Months Post-Transplant
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Continuous Safety
Tijdsspanne: Baseline to 60 Months Post-Transplant
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Continuous Safety: The number and severity of treatment-emergent adverse events
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Baseline to 60 Months Post-Transplant
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Medewerkers en onderzoekers
Sponsor
Sponsor
Medewerkers
Medewerkers
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
Andere studie-ID-nummers
- 402000063
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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