The Transendocardial Autologous Cells (hMSC) or (hMSC) and (hCSC) in Ischemic Heart Failure Trial.

NCT ID: NCT02503280

Last Updated: 2020-10-22

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

WITHDRAWN

Clinical Phase

PHASE1/PHASE2

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-01

Study Completion Date

2032-03-31

Brief Summary

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Before initiating the full randomized study, a Pilot Safety Phase will be performed. In this phase the composition of cells administered via the Biosense Webster MyoStar NOGA Injection Catheter System will be tested. The randomized portion of the study will be conducted after a full review of the safety data from the pilot Phase by the Data safety monitoring board.

Following the Pilot Phase of five (5) Fifty (50) patients scheduled to undergo cardiac catheterization and meeting all inclusion/exclusion criteria will be evaluated at baseline.

Patients will be randomized in a 2:2:1 ratio to one of three Treatment Strategies.

Detailed Description

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A Phase I/II, Randomized, Placebo-Controlled Study of the Safety and Efficacy of Transendocardial Injection of Autologous Human Cells (Mesenchymal or the combination of MSC and Cardiac Stem Cells) in Patients With Chronic Ischemic Left Ventricular Dysfunction and Heart Failure Secondary to Myocardial Infarction.

A total of 55 subjects participating, with 5 in the pilot phase and 50 in the randomized phase.

Patients with chronic ischemic left ventricular dysfunction and heart failure secondary to MI scheduled to undergo cardiac catheterization.

Conditions

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Chronic Ischemic Left Ventricular Dysfunction Myocardial Infarction

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group A - Autologous hMSCs

Autologous hMSCs: 40 million cells/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 2 x 10\^8 (200 million) hMSCs. The Biosense Webster MyoStar NOGA Injection Catheter System will be used in the delivery of the study drug.

Group Type EXPERIMENTAL

Autologous hMSCs

Intervention Type DRUG

Autologous hMSCs: 40 million cells/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 2 x 10\^8 (200 million) hMSCs.

Biosense Webster MyoStar NOGA Injection Catheter System

Intervention Type DEVICE

Biosense Webster MyoStar NOGA Injection Catheter System will be used to administer the study drug

Group B - Autologous Human C-Kit CSCs II

Autologous hMSCs PLUS autologous C-Kit hCSCs: Mixture of 39.8 million hMSCs and 0.2 million C-Kit hCSCs/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 1.99 x 10\^8 (199 million) hMSCs and 1 million C-Kit hCSCs.The Biosense Webster MyoStar NOGA Injection Catheter System will be used in the delivery of the study drug.

Group Type EXPERIMENTAL

Autologous Human C-Kit CSCs II

Intervention Type DRUG

Autologous hMSCs PLUS autologous C-Kit hCSCs: Mixture of 39.8 million hMSCs and 0.2 million C-Kit hCSCs/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 1.99 x 10\^8 (199 million) hMSCs and 1 million C-Kit hCSCs.

Biosense Webster MyoStar NOGA Injection Catheter System

Intervention Type DEVICE

Biosense Webster MyoStar NOGA Injection Catheter System will be used to administer the study drug

Placebo

Placebo (ten 0.5 ml injections of phosphate-buffered saline \[PBS\] and 1% human serum albumin \[HSA\]).The Biosense Webster MyoStar NOGA Injection Catheter System will be used in the delivery of the study drug.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo (ten 0.5 ml injections of phosphate-buffered saline \[PBS\] and 1% human serum albumin \[HSA\]).

Biosense Webster MyoStar NOGA Injection Catheter System

Intervention Type DEVICE

Biosense Webster MyoStar NOGA Injection Catheter System will be used to administer the study drug

Interventions

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Autologous hMSCs

Autologous hMSCs: 40 million cells/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 2 x 10\^8 (200 million) hMSCs.

Intervention Type DRUG

Autologous Human C-Kit CSCs II

Autologous hMSCs PLUS autologous C-Kit hCSCs: Mixture of 39.8 million hMSCs and 0.2 million C-Kit hCSCs/ml delivered in 0.5 ml injection volumes times 10 injections for a total of 1.99 x 10\^8 (199 million) hMSCs and 1 million C-Kit hCSCs.

Intervention Type DRUG

Placebo

Placebo (ten 0.5 ml injections of phosphate-buffered saline \[PBS\] and 1% human serum albumin \[HSA\]).

Intervention Type DRUG

Biosense Webster MyoStar NOGA Injection Catheter System

Biosense Webster MyoStar NOGA Injection Catheter System will be used to administer the study drug

Intervention Type DEVICE

Other Intervention Names

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Autologous Human Mesenchymal Stem Cells (hMSCs) Autologous Human C-Kit Cardiac Stem Cells (CSCs) II NOGA

Eligibility Criteria

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Inclusion Criteria

* In order to participate in this study, a patient MUST:

1. Be ≥ 21 and \< 90 years of age.
2. Provide written informed consent.
3. Have a diagnosis of chronic ischemic left ventricular dysfunction secondary to myocardial infarction (MI) as defined by the following: Screening MRI must show an area of akinesis, dyskinesis, or severe hypokinesis associated with evidence of myocardial scarring based on delayed hyperenhancement following gadolinium infusion.
4. Been treated with appropriate maximal medical therapy for heart failure or post-infarction left ventricular dysfunction. For beta-blockade, the patient must have been on a stable dose of a clinically appropriate beta-blocker for 3 months. For angiotensin-converting enzyme inhibition, the patient must have been on a stable dose of a clinically appropriate agent for 1 month.
5. Be a candidate for cardiac catheterization.
6. Have an ejection fraction ≤ 50% by gated blood pool scan, two-dimensional echocardiogram, cardiac MRI, or left ventriculogram within the prior six months and not in the setting of a recent ischemic event.

Exclusion Criteria

* In order to participate in this study, a patient MUST NOT:

1. Have a baseline glomerular filtration rate \< 50 ml/min1.73m2.
2. Have a known, serious radiographic contrast allergy.
3. Have a mechanical aortic valve or heart constrictive device.
4. Have a documented presence of aortic stenosis (aortic stenosis graded as ≥ +2 equivalent to an orifice area of 1.5cm2 or less).
5. Have a documented presence of moderate to severe aortic insufficiency (echocardiographic assessment of aortic insufficiency graded as ≥+2).
6. Require coronary artery revascularization. Patients who require or undergo revascularization procedures should undergo these procedures a minimum of 3 months in advance of treatment within this study. In addition, patients who develop a need for revascularization following enrollment will be submitted for this therapy without delay.
7. Evidence of a life-threatening arrhythmia (nonsustained ventricular tachycardia ≥ 20 consecutive beats or complete heart block) or QTc interval \> 550 ms on screening ECG.
8. AICD firing in the past 60 days prior to the procedure.
9. Have unstable angina within 2 weeks of the planned procedure.
10. Have a hematologic abnormality as evidenced by hematocrit \< 25%, white blood cell \< 2,500/ul or platelet values \< 100,000/ul without another explanation.
11. Have liver dysfunction, as evidenced by enzymes (AST and ALT) greater than three times the ULN.
12. Have a coagulopathy = (INR \> 1.3) not due to a reversible cause (i.e., Coumadin). Patients on Coumadin will be withdrawn 5 days before the procedure and confirmed to have an INR \< 1.3. Patients who cannot be withdrawn from Coumadin will be excluded from enrollment
13. Have known allergies to penicillin or streptomycin.
14. Have a contra-indication to performance of an MRI scan.
15. Be an organ transplant recipient.
16. Have a clinical history of malignancy within 5 years (i.e., patients with prior malignancy must be disease free for 5 years), except curatively-treated basal cell carcinoma, squamous cell carcinoma, or cervical carcinoma.
17. Have a non-cardiac condition that limits lifespan to \< 1 year.
18. Have a history of drug or alcohol abuse within the past 24 months.
19. Be on chronic therapy with immunosuppressant medication, such as corticosteroids or TNFα antagonists.
20. Be serum positive for HIV, hepatitis BsAg or hepatitis C.
21. Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial.
22. Be a female who is pregnant, nursing, or of childbearing potential while not practicing effective contraceptive methods. Female patients must undergo a blood or urine pregnancy test at screening and within 36 hours prior to injection.
Minimum Eligible Age

21 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Joshua M Hare

OTHER

Sponsor Role lead

Responsible Party

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Joshua M Hare

ISCI Director, Chief Science Officer, Senior Assoc. Dean, Louis Lemberg Professor of Medicine

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Joshua M Hare, MD

Role: PRINCIPAL_INVESTIGATOR

ISCI / University of Miami Miller School of Medicine

Locations

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ISCI / University of Miami

Miami, Florida, United States

Site Status

Countries

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United States

Related Links

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http://isci.med.miami.edu

Interdisciplinary Stem Cell Institute at the University of Miami Miller School of Medicine

Other Identifiers

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20120203

Identifier Type: -

Identifier Source: org_study_id

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