Treatment of Osteoarthritis by Intra-articular Injection of Bone Marrow Mesenchymal Stem Cells With Platelet Rich Plasma

NCT ID: NCT02365142

Last Updated: 2017-10-24

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

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE1/PHASE2

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-06-30

Study Completion Date

2018-06-30

Brief Summary

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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:

1. Group A: 3 intra-articular injections of platelet rich plasma (PRGF®) separated by 7 days.
2. 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.

Detailed Description

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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:

1. Group A: 3 intra-articular injections of platelet richa plasma (PRGF®) separated by 7 days.
2. 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:

Conditions

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Knee Osteoarthritis

Keywords

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Knee Osteoarthritis Mesenchimal stem cell Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Platelet Rich Plasma (PRGF)

Platelet Rich plasma (PRGF) 3 intraarticular onjections sepataded by 7 days.

Group Type ACTIVE_COMPARATOR

Platelet Rich plasma (PRGF)

Intervention Type BIOLOGICAL

3 injections of PRGF

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.

Group Type ACTIVE_COMPARATOR

100 million Bone marrow mesenchimal stem cells

Intervention Type BIOLOGICAL

100 million Bone marrow mesenchimal stem cells with PRGF

Platelet Rich plasma (PRGF)

Intervention Type BIOLOGICAL

3 injections of PRGF

Interventions

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100 million Bone marrow mesenchimal stem cells

100 million Bone marrow mesenchimal stem cells with PRGF

Intervention Type BIOLOGICAL

Platelet Rich plasma (PRGF)

3 injections of PRGF

Intervention Type BIOLOGICAL

Eligibility Criteria

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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
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Clinica Universidad de Navarra, Universidad de Navarra

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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José Lamo-Espinosa, MD

Role: PRINCIPAL_INVESTIGATOR

Clinica Universidad de Navarra

Felipe Prosper, MD, PhD

Role: STUDY_DIRECTOR

Clínica Universidad de Navarra

Juan Blanco, MD; PhD

Role: PRINCIPAL_INVESTIGATOR

Complejo Universitario de Salamanca

Locations

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Hospital Universitario de Salamanca

Salamanca, Castille and León, Spain

Site Status

Departamento Cirugía Ortopédica y Traumatología. Clinica Universidad de Navarra

Pamplona, Navarre, Spain

Site Status

Countries

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Spain

References

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Lamo-Espinosa JM, Blanco JF, Sanchez M, Moreno V, Granero-Molto F, Sanchez-Guijo F, Crespo-Cullel I, Mora G, San Vicente DD, Pompei-Fernandez O, Aquerreta JD, Nunez-Cordoba JM, Vitoria Sola M, Valenti-Azcarate A, Andreu EJ, Del Consuelo Del Canizo M, Valenti-Nin JR, Prosper F. Phase II multicenter randomized controlled clinical trial on the efficacy of intra-articular injection of autologous bone marrow mesenchymal stem cells with platelet rich plasma for the treatment of knee osteoarthritis. J Transl Med. 2020 Sep 18;18(1):356. doi: 10.1186/s12967-020-02530-6.

Reference Type DERIVED
PMID: 32948200 (View on PubMed)

Related Links

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Other Identifiers

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2011-006036-23

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

CMM-PRGF/ART

Identifier Type: -

Identifier Source: org_study_id