Combination Therapy of Umbilical Cord Blood and Erythropoietin for Stroke Paients

NCT ID: NCT04013646

Last Updated: 2020-11-05

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

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-05-02

Study Completion Date

2021-11-02

Brief Summary

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This clinical trial is a clinical trial for the evaluation of the safety and efficacy of umbilical cord blood (UCB) therapy, UCB and erythropoietin (EPO) combination therapy in adult stroke patients.

Detailed Description

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UCB is a high-quality source of mesenchymal stem cells, and studies are being actively developed for stroke patients. UCB therapy has a neuroprotective effect through anti-inflammatory effect and anti-apoptosis.

However, UCB alone has not been able to provide sufficient improvement and is being studied for combination therapies with growth factors that can exert its effects. Among the various growth factors, EPO is a powerful factor that can act as a neurotrophic factor in neurons, astrocytes, oligodendrocytes, microglia, endothelial cells, and neural stem/precursor cells.

In our previous study of subacute stroke animal models, investigators confirmed that the combined administration of UCB and EPO improved the behavioral assessment (mNSS, Cylinder test) compared to UCB only administration.

The aim of this study is to investigate the difference in therapeutic effects between UCB alone therapy and UCB and EPO combination therapy.

Conditions

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Stroke Umbilical Cord Blood Erythropoietin Safety Treatment Outcome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group 1: UCB infusion and EPO injection group Group 2: UCB infusion and placebo EPO injection group Group 3: Placebo UCB infusion and placebo EPO injection group
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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UCB infusion and EPO injection group

Take immunosuppressant agents for 1 week. Umbilical cord blood is administered in the treatment room. Afterward, the venous erythropoietin agent injects into the peripheral vein 5 times a total of 5 times a week.

Group Type EXPERIMENTAL

Placebo umbilical cord blood infusion

Intervention Type DRUG

Placebo umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Placebo erythropoietin injection

Intervention Type DRUG

Placebo erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Active rehabilitation

Intervention Type PROCEDURE

Physical therapy and occupational therapy are performed daily.

UCB infusion and placebo EPO injection group

Take immunosuppressant agents for 1 week. Umbilical cord blood is administered in the treatment room. Afterward, the venous erythropoietin placebo injects into the peripheral vein 5 times a total of 5 times a week.

Group Type EXPERIMENTAL

Umbilical cord blood infusion

Intervention Type DRUG

The umbilical cord blood is donated umbilical cord blood which is stored in the cord blood bank donated by Cha Hospital. The total number of nuclear cells should be at least 2 x 10 7 / kg, and at least three out of six of the six human leukocyte antigens (HLA-A, B, DR) should be selected. The cord blood that matches ABO and Rh blood type is preferentially used. Umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Placebo erythropoietin injection

Intervention Type DRUG

Placebo erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Active rehabilitation

Intervention Type PROCEDURE

Physical therapy and occupational therapy are performed daily.

Placebo UCB infusion and placebo EPO injection group

Take immunosuppressant placebo for 1 week with the same schedule as the experimental group. As in the experimental group, placebo umbilical cord blood is administered in the treatment room and stay in the treatment room for the same time. Afterward, the venous erythropoietin placebo injects into the peripheral vein 5 times a total of 5 times a week. Other inspection schedules proceed with other groups.

Group Type PLACEBO_COMPARATOR

Umbilical cord blood infusion

Intervention Type DRUG

The umbilical cord blood is donated umbilical cord blood which is stored in the cord blood bank donated by Cha Hospital. The total number of nuclear cells should be at least 2 x 10 7 / kg, and at least three out of six of the six human leukocyte antigens (HLA-A, B, DR) should be selected. The cord blood that matches ABO and Rh blood type is preferentially used. Umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Erythropoietin injection

Intervention Type DRUG

Recombinant human erythropoietin is used and is administered intravenously at a maximum of 5 times at a rate of 500 IU / kg 2 times/week after cord blood peripheral blood infusion, calculated as the dose per body weight. Or subcutaneous administration if intravenous administration is not possible. Store in a sealed container at 2-8 °C in the refrigerator before dosing. Erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Active rehabilitation

Intervention Type PROCEDURE

Physical therapy and occupational therapy are performed daily.

Interventions

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Umbilical cord blood infusion

The umbilical cord blood is donated umbilical cord blood which is stored in the cord blood bank donated by Cha Hospital. The total number of nuclear cells should be at least 2 x 10 7 / kg, and at least three out of six of the six human leukocyte antigens (HLA-A, B, DR) should be selected. The cord blood that matches ABO and Rh blood type is preferentially used. Umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Intervention Type DRUG

Erythropoietin injection

Recombinant human erythropoietin is used and is administered intravenously at a maximum of 5 times at a rate of 500 IU / kg 2 times/week after cord blood peripheral blood infusion, calculated as the dose per body weight. Or subcutaneous administration if intravenous administration is not possible. Store in a sealed container at 2-8 °C in the refrigerator before dosing. Erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Intervention Type DRUG

Placebo umbilical cord blood infusion

Placebo umbilical cord blood infusion is administered intravenously and is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Intervention Type DRUG

Placebo erythropoietin injection

Placebo erythropoietin injection is performed at the stem cell clinical trial center. The procedure is performed by the doctor who is enrolled in this study. Monitor pulse and oxygen saturation during the procedure.

Intervention Type DRUG

Active rehabilitation

Physical therapy and occupational therapy are performed daily.

Intervention Type PROCEDURE

Other Intervention Names

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UCB EPO pUCB pEPO Rehabilitation

Eligibility Criteria

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Inclusion Criteria

1. Adult patients over 20 years old
2. Patients with a stroke lasting from 30 days to less than 9 months
3. After hearing and fully understanding the details of this clinical trial, the person or legal representative has agreed to voluntary participation and has agreed in writing to comply with the notice

Exclusion Criteria

Patients with one or more of the following can not participate in the study.

1. Patients with uncontrolled hypertension
2. A person who has impaired ability of consent, who is not accompanied by a guardian
3. Women who are pregnant, lactating, have a pregnancy plan during the trial, or those who do not use an available contraceptive method (women of childbearing age must be negative in the pregnancy test on baseline visit (0 weeks) .)
4. Those who satisfy the following conditions

* A person whose ALT / AST is measured at 120 IU / L or more
* Serum creatinine greater than 1.8 mg / dL
* Total bilirubin\> 1.8 mg / dL
* Total WBC count less than 3000 / mm3
* Those with a Hb of 16 g / dL or more
* Platelet count less than 150,000 / uL or more than 675,000 / uL
5. Clinically significant infections during the screening period (pneumonia, pyelonephritis, sepsis, etc.)
6. Persons with severe medical conditions such as cardiovascular, digestive, respiratory, and endocrine conditions.
7. Any kind of confirmed congenital or acquired immune deficiency syndrome
8. Those who have been diagnosed with malignant carcinoma (excluding complete remission for more than 10 years)
9. If participants have side effects on your medication \[Regarding erythropoietin agent\]

* Patients with hypersensitivity to erythropoietin
* Patients sensitive to mammalian cell-derived drugs or human albumin
* epileptic patients
* Patients with a history of seizures
* Patients on a thrombolytic drug (meaning thrombolytic agent such as Tissue Plasminogen Activator, allowing anti-platelet agents such as aspirin and plavix) \[Related to tacrolimus\] Patients with hypersensitivity to tacrolimus or macrolide compounds
* Patients receiving cyclosporine or bosentan
* Patients receiving potassium-preserving diuretics
10. Other If the investigator determines that participation in this trial is not appropriate
Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Korea Evaluation Institute of Industrial Technology

OTHER

Sponsor Role collaborator

Bundang CHA Hospital

OTHER

Sponsor Role lead

Responsible Party

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MinYoung Kim, MD, PhD

Head of Rehabilitation Medicine Department, Professor, Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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MinYoung Kim, MD,PhD

Role: STUDY_DIRECTOR

CHA Bundang Medical Center

Locations

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Bundang CHA Medical Center

Seongnam-si, Gyeonggi-do, South Korea

Site Status RECRUITING

Countries

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South Korea

Central Contacts

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Jong Moon Kim, MD

Role: CONTACT

82-31-870-5456

Facility Contacts

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Jong Moon Kim, MD

Role: primary

+82-31-780-5456

Sun Hee Lee

Role: backup

+82-31-780-2954

Other Identifiers

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2018-12-030

Identifier Type: -

Identifier Source: org_study_id