Efficacy and Safety Study of Allogenic Mesenchymal Stem Cells for Patients With Refractory Primary Biliary Cirrhosis (MSCsTreatPBC)
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Purpose
The study is designed to evaluate the safety and efficacy of intravenous administration of bone marrow derived mesenchymal stem cells for patients with refractory primary biliary cirrhosis (PBC).
| Condition | Intervention | Phase |
|---|---|---|
|
Primary Biliary Cirrhosis |
Biological: Biological: mesenchymal stem cell Drug: ursodeoxycholic acid |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase I Clinical Trial, Randomized, Controlled, to Evaluate the Efficacy and Safety of Therapy With Allogenic Mesenchymal Stem Cells From Bone Marrow for Patients With Refractory Primary Biliary Cirrhosis |
- serum level of alkaline phosphatase [ Time Frame: 24 months after MSCs administration ] [ Designated as safety issue: Yes ]Serum level of alkaline phosphatase will be measured at entry, 1 months,3 months, 6 months and 24 months after therapy
- histological changes in liver biopsies [ Time Frame: 6 months after therapy ] [ Designated as safety issue: No ]Liver biopsy of each patient will be taken before entry into therapeutic trials and at 6 months after therapy.
- Serum levels of TNF-alpha [ Time Frame: 6 months after therapy ] [ Designated as safety issue: No ]serum levels of TNF-alpha will be assessed before entry into therapeutic trials and at 6 months after therapy
- changes in fatigue [ Time Frame: 6 months after theraphy ] [ Designated as safety issue: No ]changes in fatigue will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by PBC-40 score.
- The occurrence of cirrhosis and its complications [ Time Frame: 24 months after therapy ] [ Designated as safety issue: No ]
- Serum levels of Interleukin [ Time Frame: 6 months after therapy ] [ Designated as safety issue: No ]serum levels of Interleukin will be assessed before entry into therapeutic trials and at 6 months after therapy
- changes in pruritus severity [ Time Frame: 6 months after therapy ] [ Designated as safety issue: No ]changes in pruritus severity will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by VAS score.
| Estimated Enrollment: | 20 |
| Study Start Date: | November 2011 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | November 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: allogenic mesenchymal stem cells (MSCs)
Patients who have primary biliary cirrhosis.
|
Biological: Biological: mesenchymal stem cell
Mesenchymal stem cells,5-50 million/kg, Intravenous infusion, One dosage,whether to give another dosage depending on patients' condition
Other Name: regenerative medicine:MSCs
|
|
Active Comparator: ursodeoxycholic acid (UDCA)
Patients who have primary biliary cirrhosis.
|
Drug: ursodeoxycholic acid
13-15 mg/kg/day, to the end of the study
Other Name: UDCA
|
Detailed Description:
Primary biliary cirrhosis (PBC) is an organ-specific inflammatory disease and characterized by immune mediated destruction of intrahepatic bile ducts, then lead to liver cirrhosis and eventually failure.Currently, ursodeoxycholic acid (UDCA) is the only drug approved by the Food and Drug Administration (FDA). Novel treatment is urgently needed for patients who have an incomplete response to UDCA. Mesenchymal stem cells (MSC) represent a promising tool for cell-based therapies of autoimmune diseases. To explore the therapeutic effect of MSCs for PBC, the investigators plan to conduct an open-label, randomized clinical trial. Patients with PBC will be enrolled and randomly divided into two groups which will receive MSCs and UDCA respectively. The investigators will evaluate the efficacy and safety of MSCs for PBC by comparison of symptom improvement, survival rate and side effects in the two groups.
Eligibility| Ages Eligible for Study: | 18 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- There must be at least two of the following: a concentration in serum of AMAs at titres of 1:40 or higher; an unexplained rise in the amount of alkaline phosphatase of at least 1•5 times the upper limit of normal for more than 24 weeks; and compatible liver histological findings, specifically non-suppurative cholangitis and interlobular bile duct injury.
- Incomplete response to UDCA at 13-15 mg/kg/day, Criteria for the group of complete responders is including: concentrations of alkaline phosphatase less than three times the upper limit of normal, aspartate aminotransferase less than twice the upper limit of normal, and bilirubin less than 17 μmol/L;and normalisation of abnormal concentrations of bilirubin, albumin, or both.
- Liver pathological staging in 2 or3, Histological staging is based on Ludwig's and Scheuer's classifications
Exclusion Criteria:
- Patients are receiving any other investigational agents within 4 weeks of study entry
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (defined as invasive fungal infection and progressive CMV viremia), symptomatic congestive heart failure (NYH class III and IV), unstable angina pectoris, or cardiac arrhythmia
- In pregnancy or lactation
- Psychiatric illness or mental deficiency making compliance with treatment or informed consent impossible
- HCVpositive ,HBSAg positive or with other liver diseases
- Combined with other autoimmune disease
- Expected survival time is less than one year
- Decompensation of liver function(Child B or C)
- Have a history of allergy or Allergic constitution
Contacts and Locations| Contact: Fengchun Zhang, MD | 0086-10-65296891 | zhangfccra@yahoo.com.cn |
| Contact: Yunjiao Yang, MD | 0086-10-65295047 | yangyunjiao81@163.com |
| China | |
| Peking Union Medical College Hospital | Recruiting |
| Beijing, China | |
| Contact: Fengchun Zhang, MD zhangfccra@yahoo.com.cn | |
| Principal Investigator: | Fengchun Zhang, MD | Peking Union Medical College Hospital |
| Principal Investigator: | Robert Chunhua Zhao, MD,PhD | Chinese Academy of Medical Sciences |
More Information
Publications:
| Responsible Party: | Robert Chunhua Zhao, MD, PhD, MD, PhD,Professor of medicine, Chinese Academy of Medical Sciences |
| ClinicalTrials.gov Identifier: | NCT01440309 History of Changes |
| Other Study ID Numbers: | 2008BAI59B03/2011AA020119 |
| Study First Received: | September 20, 2011 |
| Last Updated: | August 1, 2012 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by Chinese Academy of Medical Sciences:
|
biliary cirrhosis |
Additional relevant MeSH terms:
|
Liver Cirrhosis, Biliary Liver Cirrhosis Fibrosis Cholestasis, Intrahepatic Cholestasis Bile Duct Diseases Biliary Tract Diseases Digestive System Diseases |
Liver Diseases Pathologic Processes Ursodeoxycholic Acid Cholagogues and Choleretics Gastrointestinal Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 19, 2013