Clinical Trial for Evaluation of Treatment With Multiple Infusions of Mononuclear Bone Marrow Cells in Patients With Chronic Liver Diseases

NCT ID: NCT02171949

Last Updated: 2017-11-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-04-30

Study Completion Date

2019-06-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to evaluate the safety and efficacy of multiple infusions of mononuclear bone marrow cells in patients with chronic liver diseases.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

This is a safety/efficacy phase II, open, randomized, controlled clinical trial, with two arms. The study population will consist of 30 patients with chronic decompensated liver disease (Child-Pugh B or C). The candidates included in the study will be asked to voluntarily participate and sign the written consent.

The patients will be allocated randomly into 2 groups: in group A, the patients will undergo the intervention; and in group B, the patients will be the controls. Patients of both groups will receive clinical follow-up. They will be maintained on drug therapy commonly used in patients with cirrhosis, which may include: spironolactone, furosemide, lactulose, metronidazole, neomycin, analogs of nucleoside / nucleotide in patients with hepatitis B, and vitamin complexes.

All patients included in Group A will undergo cell therapy according to the technique described as follows: on day 1 (D-1), patients will be hospitalized to undergo the bone marrow puncture through the iliac crest. 150 to 200 ml of bone marrow aspirate will be collected. The procedure will be done under local anesthesia and sedation. The fraction of mononuclear cells will be isolated from the aspirated marrow by the SEPAX (System of cell processing) - Biosafe, Switzerland.

The enriched fraction of collected mononuclear cells will be resuspended in saline. The obtained cell populations will be analyzed by flow cytometry for its characterization, and then diluted in 20 ml saline. The cells will be injected 3 times throughout the study, on days 1 (D-1), 30 (D-30) and 60 (D-60).

Patients will undergo a series of clinical and laboratory evaluations and will also be submitted to the following procedures:

* Cell blood count
* Biochemical analysis (measurement of electrolytes - sodium and potassium)
* Renal function tests (urea and creatinine)
* Liver profile tests (total proteins and fractions, bilirubin, prothrombin time, transaminases, alkaline phosphatase, gamma-GT)
* Metabolic profile (glucose, total cholesterol and fractions, triglycerides)
* Thyroid profile tests
* Serology required for blood transfusion and bone marrow transplant in Brazil
* Alpha-fetoprotein
* Beta-HCG (human chorionic gonadotropin), for women
* Handgrip dynamometer
* Treadmill test
* Six-minute walk test
* Abdomen doppler ultrasound
* Magnetic resonance imaging of the upper abdomen with elastography
* Measurement of serum factors
* Shear wave elastography

Also, the patients will respond to questions from the SF (Short Form) -36 questionnaire (for assessment of quality of life).

Clinical follow-up will be kept for patients who suspend their participation in the study for any adverse event and / or laboratory abnormality, or for the patient's own desire, following insurance protocols. In addition to the clinical and surgical follow-up, specific medical care will be offered to patients who experience adverse events, until stabilization of the patient, even if the target date for completion of the study has been exceeded.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Chronic Hepatitis Hepatic Cirrhosis

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Chronic hepatitis Hepatic cirrhosis

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Control group

Group Type NO_INTERVENTION

No interventions assigned to this group

Bone marrow mononuclear cell therapy

Group Type ACTIVE_COMPARATOR

Infusion of bone marrow mononuclear cells.

Intervention Type BIOLOGICAL

Patients on this group will receive therapy with mononuclear cells. The cells will be diluted on saline and then injected on the hepatic artery through femoral artery puncture.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Infusion of bone marrow mononuclear cells.

Patients on this group will receive therapy with mononuclear cells. The cells will be diluted on saline and then injected on the hepatic artery through femoral artery puncture.

Intervention Type BIOLOGICAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Diagnosis of liver cirrhosis of different etiologies, confirmed by clinical examination, laboratory tests, imaging studies and / or biopsy that shows process of evolution to cirrhosis or established cirrhosis (equivalent to Metavir score F3/F4);
* Non-participation on the waiting list for liver transplantation or, in case of participation, allocation after the fifth position in the list, for subjects with blood group A or O, and after the third position for subjects with other blood groups;
* Absence of clinical, laboratory and radiological evidence of hepatocellular carcinoma;
* Absence of pregnancy potential or negative pregnancy test for female patients, or impossibility to use a contraception method during the study;
* Permission for doing the puncture of iliac crest after evaluation of pre-anesthetic visit.

Exclusion Criteria

* Impossibility to obtain vascular access for percutaneous procedure;
* Sepsis;
* Hepatic encephalopathy detected at the screening tests;
* Budd-Chiari syndrome;
* Severe coagulopathy with INR \> 2,4 or platelet count \< 30.000;
* Presence of malignancies (excluding non-melanoma skin cancer);
* Decompensated heart failure;
* Primary hematologic diseases;
* Renal failure with creatinin \> 2,5mg/dl;
* Coinfection with HIV;
* Pregnancy;
* Dependence of organic medium such as circulatory or ventilatory;
* Any other comorbidity with an impact on the survival in 2 years;
* Participation in other clinical trial.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Ministry of Science and Technology, Brazil

OTHER

Sponsor Role collaborator

Ministry of Health, Brazil

OTHER_GOV

Sponsor Role collaborator

Hospital Sao Rafael

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ricardo Ribeiro dos Santos

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

André C Lyra, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital São Rafael

Bruno SF Souza, MD, Msc

Role: STUDY_CHAIR

Hospital São Rafael

Eduardo L Braga, PhD

Role: STUDY_CHAIR

Hospital São Rafael

Lourianne N Cavalcante, PhD

Role: STUDY_CHAIR

Hospital São Rafael

Milena BP Soares, PhD

Role: STUDY_CHAIR

Hospital São Rafael

Ricardo R dos Santos, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital São Rafael

Ticiana F Larocca, MD, Msc

Role: STUDY_CHAIR

Hospital São Rafael

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Hospital São Rafael

Salvador, Estado de Bahia, Brazil

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Brazil

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

André C Lyra, PhD

Role: CONTACT

Phone: 557132816455

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

André C Lyra, PhD

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

PCL 03/13

Identifier Type: -

Identifier Source: org_study_id