Bone Marrow Versus Adipose Autologous Mesenchymal Stem Cells for the Treatment of Knee Osteoarthritis

NCT ID: NCT04351932

Last Updated: 2020-04-17

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

PHASE3

Total Enrollment

54 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-07

Study Completion Date

2021-09-07

Brief Summary

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Mesenchymal stem cells (MSC) are stromal cells that have the ability to self-renew and also exhibit multilineage differentiation. MSCs can be isolated from a variety of tissues, such as umbilical cord, bone marrow, and adipose tissue. The multipotent properties of MSCs make them a promising option for the treatment of osteoarthritis (OA).

Bone marrow mesenchymal stem cells (BM-MSC) and adipose derived mesenchymal stem cells (AD-MSC) have been used separately to treat OA. The aim of the present study will be to compare in a randomized non blind controlled clinical trial 3 types of intra-articular injections containing MSC populations obtained from two clinically relevant sources: BM-MSC, AD-MSC and a combination of both BM-MSC and AD-MSC.

Detailed Description

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The aim of the present study will be to compare 3 types of intra-articular injections of MSC populations obtained from two clinically relevant sources: injections containing BM-MSC or AD-MSC or a combination of both BM-MSC,and AD-MSC in a randomized non blind clinical trial.

To assess the efficacy and safety of 3 kind of MSC injections in relation to pain, function and quality of life in patients with knee OA.

A total of 54 patients with the diagnosis of knee OA grade II and III will be recruited to receive a single intra-articular injection of MSC: Group 1 (n 18 patients) will receive BM-MSC, Group 3 (n 18 patients) will receive AD-MSC. Group 3 (18 patients) will receive a combination of BM-MSC and AD-MSC.

A randomized non blind clinical trial with active control. For this purpose, the random number generator is 54, found on the RANDOM.ORG ® website (available at https://www.random.org/integers/)

Conditions

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Osteo Arthritis Knee

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A total of 54 patients with the diagnosis of knee OA grade II and III will be recruited to receive a single intra-articular injection of MSC: Group 1 (n 18 patients) will receive BM-MSC, Group 2 (n 18 patients) will receive AD-MSC. Group 3 (18 patients) will receive a combination of BM-MSC and AD-MSC.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

A randomized non blind clinical trial with active control. For this purpose, the random number generator, found on the RANDOM.ORG ® website (available at https://www.random.org/integers/)

Study Groups

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bone marrow mesenchymal stem cell

Bone marrow mesenchymal stem cells 10 cc by intra articular injection once

Group Type ACTIVE_COMPARATOR

bone marrow mesenchymal stem cells

Intervention Type BIOLOGICAL

intrarticular bone marrow mesenchymal stem cells injection

adipose mesenchymal stem cells

Stromal vascular factor from adipose mesenchymal stem cells 10 cc by intra articular injection once

Group Type ACTIVE_COMPARATOR

Adipose Mesenchymal stem cells

Intervention Type BIOLOGICAL

intrarticular adipose mesenchymal stem cells injection

Bone marrow and Adipose mesenchymal stem cells

Bone marrow and Stromal vascular factor from adipose mesenchymal stem cells 5 cc each one, by intra articular injection once.

Group Type ACTIVE_COMPARATOR

bone marrow & adipose mesenchymal stem cells injection

Intervention Type BIOLOGICAL

intrarticular bone marrow and adipose stem cells injection.

Interventions

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bone marrow mesenchymal stem cells

intrarticular bone marrow mesenchymal stem cells injection

Intervention Type BIOLOGICAL

Adipose Mesenchymal stem cells

intrarticular adipose mesenchymal stem cells injection

Intervention Type BIOLOGICAL

bone marrow & adipose mesenchymal stem cells injection

intrarticular bone marrow and adipose stem cells injection.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Patients aged 18 to 70 years, with grade II and III knee OA, according to the Ahlbäck classification will be included.
* Minimal VAS pain score of 4.
* Chronic knee pain of mechanical origin.
* All patients who sign a specially prepared informed consent for this clinical trial.

Exclusion Criteria

* Varus or valgus knee mal alignment superior to 10°.
* OA grade IV according Ahlbäck classification.
* Bone marrow cancer like lymphoma.
* Severe anemia.
* Active infections.
* Pregnant patients.
* Inmune diseases such as Rheumatoid arthritis, gout or pseudogout arthritis, psoriasis.
* Bone diseases such as Kahler and Paget.
* Corticoesteroid and hyaluronic injections within the last 3 months.
* Knee surgery in the last 6 months.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Maastricht University Medical Center

OTHER

Sponsor Role collaborator

Universidad Catolica Santiago de Guayaquil

OTHER

Sponsor Role lead

Responsible Party

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Dr. Carlos Chiriboga Accini

Research Professor. Orthopaedic Staff. Omnihospital.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Carlos A Chiriboga, MD

Role: PRINCIPAL_INVESTIGATOR

Universidad Católica Santiago de Guayaquil

Locations

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Omnihospital

Guayaquil, Guayas, Ecuador

Site Status

Countries

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Ecuador

Central Contacts

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Carlos A Chiriboga, MD

Role: CONTACT

593 9 9995 4148

Peter A Chedraui, Phd

Role: CONTACT

593 9 9942 4629

Facility Contacts

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Carlos Chiriboga

Role: primary

593 9 99954148

References

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Wagner W, Wein F, Seckinger A, Frankhauser M, Wirkner U, Krause U, Blake J, Schwager C, Eckstein V, Ansorge W, Ho AD. Comparative characteristics of mesenchymal stem cells from human bone marrow, adipose tissue, and umbilical cord blood. Exp Hematol. 2005 Nov;33(11):1402-16. doi: 10.1016/j.exphem.2005.07.003.

Reference Type RESULT
PMID: 16263424 (View on PubMed)

Wakitani S, Imoto K, Yamamoto T, Saito M, Murata N, Yoneda M. Human autologous culture expanded bone marrow mesenchymal cell transplantation for repair of cartilage defects in osteoarthritic knees. Osteoarthritis Cartilage. 2002 Mar;10(3):199-206. doi: 10.1053/joca.2001.0504.

Reference Type RESULT
PMID: 11869080 (View on PubMed)

Xia P, Wang X, Lin Q, Li X. Efficacy of mesenchymal stem cells injection for the management of knee osteoarthritis: a systematic review and meta-analysis. Int Orthop. 2015 Dec;39(12):2363-72. doi: 10.1007/s00264-015-2785-8. Epub 2015 May 6.

Reference Type RESULT
PMID: 25944079 (View on PubMed)

Wakitani S, Okabe T, Horibe S, Mitsuoka T, Saito M, Koyama T, Nawata M, Tensho K, Kato H, Uematsu K, Kuroda R, Kurosaka M, Yoshiya S, Hattori K, Ohgushi H. Safety of autologous bone marrow-derived mesenchymal stem cell transplantation for cartilage repair in 41 patients with 45 joints followed for up to 11 years and 5 months. J Tissue Eng Regen Med. 2011 Feb;5(2):146-50. doi: 10.1002/term.299.

Reference Type RESULT
PMID: 20603892 (View on PubMed)

Jo CH, Lee YG, Shin WH, Kim H, Chai JW, Jeong EC, Kim JE, Shim H, Shin JS, Shin IS, Ra JC, Oh S, Yoon KS. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial. Stem Cells. 2014 May;32(5):1254-66. doi: 10.1002/stem.1634.

Reference Type RESULT
PMID: 24449146 (View on PubMed)

Peeters CM, Leijs MJ, Reijman M, van Osch GJ, Bos PK. Safety of intra-articular cell-therapy with culture-expanded stem cells in humans: a systematic literature review. Osteoarthritis Cartilage. 2013 Oct;21(10):1465-73. doi: 10.1016/j.joca.2013.06.025. Epub 2013 Jul 4.

Reference Type RESULT
PMID: 23831631 (View on PubMed)

Freitag J, Bates D, Boyd R, Shah K, Barnard A, Huguenin L, Tenen A. Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy - a review. BMC Musculoskelet Disord. 2016 May 26;17:230. doi: 10.1186/s12891-016-1085-9.

Reference Type RESULT
PMID: 27229856 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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UCSantiagodeGuayaquil001

Identifier Type: -

Identifier Source: org_study_id

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