Extracellular Vesicles From Mesenchymal Cells in the Treatment of Acute Respiratory Failure

NCT ID: NCT06002841

Last Updated: 2023-08-21

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

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-02-01

Study Completion Date

2025-06-01

Brief Summary

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This is a phase I/II, randomized, double-blind, placebo-controlled clinical trial that will evaluate the safety and potential efficacy of therapy with extracellular vesicles (EVs) obtained from mesenchymal stromal cells (MSCs), patients with moderate to severe acute respiratory distress syndrome due to COVID-19 or other etiology. Participants will be allocated to receive EVs obtained from MSCs or placebo (equal volume of Plasma-Lyte A). Blinding will cover the participants, the multidisciplinary intensive care team and the investigators.

Detailed Description

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The studied population will consist of 15 patients diagnosed with acute respiratory failure syndrome admitted to the intensive care unit of Hospital São Rafael. This research aims to assess the safety and potential effectiveness of intravenous therapy using extracellular vesicles derived from mesenchymal cells in patients with moderate to severe acute respiratory distress syndrome. The treatment group will receive intravenous administration of extracellular vesicles obtained from mesenchymal cells, while the control group will receive a placebo.

EV group: will consist of 10 participants who will receive two infusions of 25 mL of the investigational product (Plasma-Lyte A solution containing EVs obtained from MSCs), intravenously, at intervals of 48 h.

Placebo group: will consist of 5 participants who will receive an equal volume of Plasma-Lyte A, intravenously, following the same schedule as the IV group: two infusions with an interval of 48 hours.

Conditions

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Severe Acute Respiratory Syndrome (SARS) Acute Respiratory Distress Syndrome (ARDS) Pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel Assignment
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
The treatment and placebo solutions will be indistinguishable in terms of their appearance. Stringent protocols will be established to guarantee that the physicians responsible for assessing patient safety, evaluating efficacy outcomes, and conducting laboratory analyses will be blinded to the randomization codes.

Study Groups

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EV group

will consist of 10 participants who will receive two infusions of 25 mL of the investigational product (Plasma-Lyte A solution containing EVs obtained from MSCs), intravenously, at intervals of 48 h.

Group Type EXPERIMENTAL

intravenous treatment with EVs

Intervention Type BIOLOGICAL

intravenous treatment with extracellular vesicles

Placebo group

will consist of 5 participants who will receive an equal volume of Plasma-Lyte A, intravenously, following the same schedule as the IV group: two infusions with an interval of 48 hours.

Group Type PLACEBO_COMPARATOR

intravenous treatment with placebo solution

Intervention Type BIOLOGICAL

intravenous treatment with placebo solution (without extracellular vesicles)

Interventions

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intravenous treatment with EVs

intravenous treatment with extracellular vesicles

Intervention Type BIOLOGICAL

intravenous treatment with placebo solution

intravenous treatment with placebo solution (without extracellular vesicles)

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Age \>= 18 years old;
* Chest CT radiological image with ground-glass opacities or chest X-ray with - bilateral infiltrates characteristic of pulmonary edema;
* In invasive mechanical ventilation with PEEP 5 cm H2O and PaO2/FiO2\<250mmHg;
* Respiratory failure not explained by cardiac causes or fluid overload.

Exclusion Criteria

* Unable to provide informed consent;
* Pregnancy or breastfeeding;
* Patients with active malignancy who have received chemotherapy in the last 2 years;
* Life expectancy of less than 6 months or in exclusive palliative care;
* Severe liver failure, with a Child-Pugh score \> 12;
* Previous renal failure: patients already undergoing dialysis or patients with GFR \< 30ml/min/1.73 m2
* Clinical or radiological suspicion of tuberculosis;
* Chronic respiratory failure;
* Use of ECMO;
* Moribund (high probability of death within the next 48 hours).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Sao Rafael

OTHER

Sponsor Role collaborator

Rio de Janeiro State Research Supporting Foundation (FAPERJ)

OTHER_GOV

Sponsor Role collaborator

Oswaldo Cruz Foundation

OTHER

Sponsor Role collaborator

D'Or Institute for Research and Education

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Bruno Souza, M.D

Role: PRINCIPAL_INVESTIGATOR

Instituto D'Or de Pesquisa e Ensino (IDOR), Salvador, Brazil

Patrícia Rocco, M.D

Role: PRINCIPAL_INVESTIGATOR

Universidade Federal do Rio de Janeiro (UFRJ)

Locations

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Hospital São Rafael

Salvador, Estado de Bahia, Brazil

Site Status

Countries

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Brazil

Central Contacts

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Carolina Nonaka, phD

Role: CONTACT

+55 (71) 3281-6970

Ingrid Barbosa, B.Sc

Role: CONTACT

+551121098855

Facility Contacts

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Carolina Nonaka, phD

Role: primary

+55 (71) 3281-6970

Tânia Aravena, B.Sc

Role: backup

+55 (71) 98748-6532

References

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Other Identifiers

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EVs_2023

Identifier Type: -

Identifier Source: org_study_id

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