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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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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:
Studietype
Inschrijving (Verwacht)
Fase
- Fase 2
- Fase 1
Contacten en locaties
Studie Locaties
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Castilla-León
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Salamanca, Castilla-León, Spanje, 37007
- Hospital Universitario De Salamanca
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Navarra
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Pamplona, Navarra, Spanje, 31008
- Departamento Cirugía Ortopédica y Traumatología. Clinica Universidad de Navarra
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ander
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Geen (open label)
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Platelet Rich Plasma (PRGF)
Platelet Rich plasma (PRGF) 3 intraarticular onjections sepataded by 7 days.
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3 injections of PRGF
|
|
Actieve vergelijker: 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.
|
3 injections of PRGF
100 million Bone marrow mesenchimal stem cells with PRGF
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Visuele analoge schaal (VAS) na 3 maanden
Tijdsspanne: 3 maanden
|
Visuele analoge schaal (VAS) na 3 maanden
|
3 maanden
|
|
Visuele analoge schaal (VAS) na 6 maanden
Tijdsspanne: 6 maanden
|
Visuele analoge schaal (VAS) na 6 maanden
|
6 maanden
|
|
Visuele analoge schaal (VAS) na 12 maanden
Tijdsspanne: 12 maanden
|
Visuele analoge schaal (VAS) na 12 maanden
|
12 maanden
|
|
Waarde van knieblessure en uitkomstscore artrose (Koos) na 1 maand
Tijdsspanne: 1 maand
|
Waarde van knieblessure en uitkomstscore artrose (Koos) na 1 maand
|
1 maand
|
|
Waarde van knieblessure en osteoartritis uitkomstscore (Koos) na 3 maanden
Tijdsspanne: 3 maanden
|
Waarde van knieblessure en osteoartritis uitkomstscore (Koos) na 3 maanden
|
3 maanden
|
|
Waarde van knieblessure en uitkomstscore voor artrose (Koos) na 6 maanden
Tijdsspanne: 6 maanden
|
Waarde van knieblessure en uitkomstscore voor artrose (Koos) na 6 maanden
|
6 maanden
|
|
Waarde van knieblessure en uitkomstscore artrose (Koos) na 12 maanden
Tijdsspanne: 12 maanden
|
Waarde van knieblessure en uitkomstscore artrose (Koos) na 12 maanden
|
12 maanden
|
|
Baseline Visual analogue scale (VAS) Baseline Visual analogue scale (VAS)
Tijdsspanne: Day 1
|
Baseline Visual analogue scale (VAS) prior to the initial dose on day 1
|
Day 1
|
|
Baseline value of knee injury and osteoarthritis outcome score (Koos).
Tijdsspanne: Day 1
|
Prior to the intervention on day 1 value of knee injury and osteoarthritis outcome score (Koos).
|
Day 1
|
|
Baseline Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC).
Tijdsspanne: Day 1
|
Universities Osteoarthritis Index score (WOMAC).
|
Day 1
|
|
Baseline SF-36 value
Tijdsspanne: Day 1
|
Baseline SF-36 value
|
Day 1
|
|
Baseline euroquol 5D value
Tijdsspanne: Day 1
|
Pretreatment euroquol 5D value
|
Day 1
|
|
Baseline Lequesne index
Tijdsspanne: Day 1
|
Prior to the intervention on day 1 Lequesne index
|
Day 1
|
|
Baseline femorotibial distance
Tijdsspanne: Day 1
|
Prior to the intervention femoritibial distance on rosenberg x-ray view
|
Day 1
|
|
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
Tijdsspanne: Follow up (up to 12 months)
|
Participants with Serious and Non-Serious Adverse Events Number of Participants with Serious and Non-Serious Adverse Events During the follow up
|
Follow up (up to 12 months)
|
|
Visual analogue scale (VAS) at 1 month
Tijdsspanne: 1 month
|
Visual analogue scale (VAS) at on month
|
1 month
|
Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: José Lamo-Espinosa, MD, Clinica Universidad de Navarra
- Studie directeur: Felipe Prosper, MD, PhD, Clinica Universidad de Navarra
- Hoofdonderzoeker: Juan Blanco, MD; PhD, Complejo Universitario de Salamanca
Publicaties en nuttige links
Nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Verwacht)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- CMM-PRGF/ART
- 2011-006036-23 (EudraCT-nummer)
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