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Treatment of Lupus Nephritis With Allogeneic Mesenchymal Stem Cells

Phase 2
Recruiting
Conditions
Lupus Nephritis
Lupus Erythematosus
Interventions
Drug: Mesenchymal stem cells (MSC)
Drug: Placebo
Registration Number
NCT03673748
Lead Sponsor
Red de Terapia Celular
Brief Summary

The purpose of this study is to evaluate the safety and efficacy of mesenchymal stem cells (MSCs) obtained from bone marrow for the treatment of adults with active proliferative lupus nephritis. The objective of this study is to evaluate the efficacy of mesenchymal stem cells (MSCs) in achieving a full or partial response in the treatment of Lupus Nephritis (LN) during its induction period.

Detailed Description

A Phase 2b, double-blind (neither the participant nor the investigator will know if active drug or placebo is assigned), placebo-controlled, randomized (assigned by chance), in which subjects with Lupus Nephritis (LN), who do not respond -or respond partially- to induction treatment, shall receive either MSCs (2 million cells/Kg) or placebo by intravenous injection. The administration of cells will be done only once.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mesenchymal stem cells (MSC)Mesenchymal stem cells (MSC)Participants will receive a single Intravenous infusion of Mesenchymal Stem Cells (MSV) 2 million cells per kg wt suspended in 100 ml of physiological saline solution. All participants will receive the infusion at the Baseline (Day 0) visit. All participants will continue on their standard-of-care therapy during the trial. GMP-compliant MSV will be prepared by IBGM-University of Valladolid-Citospin.
PlaceboPlaceboParticipants will receive a placebo infusion (100 ml of physiological saline solution) that does not contain any mesenchymal stem cells.
Primary Outcome Measures
NameTimeMethod
Proportion of patients who have achieved complete response0-24 weeks

Complete renal response criteria: glomerular filtration rate ≥ 60ml/min/1.73m², or decrease to initial values or ± 15% of the baseline value in those with glomerular filtration rate \< 60ml/min/1.73m²; proteinuria ≤ 0.5 g/24h; inactive sediment: ≤ 5 red blood cells, ≤ 5 leukocytes, absence of red blood cell casts; and serum albumin \> 3 g/dl.

Proportion of patients who have achieved partial response0-24 weeks

Partial renal response criteria: if baseline proteinuria ≥ 3.5 g/24h, decrease in proteinuria \< 3.5 g/24h; if baseline proteinuria \< 3.5 g/24h, proteinuria reduced by \> 50% compared to baseline; in both situations stabilization (±25%) or improvement in glomerular filtration compared to baseline values.

Secondary Outcome Measures
NameTimeMethod
Proportion of patients at week 24 whose prednisone-equivalent corticosteroid dose has been reduced0-24 weeks

The corticosteroid reduction is defined as reduction by ≥ 25% in comparison with the selection visit and to a dose ≤ 7.5 mg/day and who have no exacerbation BILAG A or 2B. A BILAG A or 2B exacerbation is defined as at least one new BILAG A organic domain score or at least 2 new BILAG B organic domain scores compared to the selection visit.

Proportion of patients at each visit whose prednisone-equivalent corticosteroid dose has been reducedThroughout the study until its completion, an average of 1.5 years

The corticosteroid reduction is defined as reduction by ≥ 25% in comparison with the selection visit and at a dose ≤ 7.5 mg/day, and who do not have any BILAG A or 2B exacerbations of disease activity.

Proportion of patients who have reduced the dose of immunosuppressants0-24 weeks

Proportion of patients who, up to week 24, have reduced the dose of immunosuppressants without presenting any BILAG A or 2B exacerbation.

Change from baseline in SF-36 scoreThroughout the study until its completion, an average of 1.5 years

Quality of life questionnaire (SF-36)

Proportion of patients at week 24 with a specific reduction relative to the selection visit in the daily dose of prednisone-equivalent corticosteroids.0-24 weeks

Different levels of corticosteroid dose reduction: 0-\<25%, 25%-50%, \>50%.

Cumulative dose of corticosteroids0-24 weeks

Cumulative dose of corticosteroids equivalent to prednisone up to week 24

Change from baseline in LupusQoL scoreThroughout the study until its completion, an average of 1.5 years

Quality of life questionnaire specific for LES (LupusQoL)

Change in proteinuria levelsThroughout the study until its completion, an average of 1.5 years

Change from baseline in the levels of proteinuria, a sign of disease activity

Change in disease activity (SLEDAI-2K index)Throughout the study until its completion, an average of 1.5 years

Change in disease activity measured by change from baseline of Systemic Lupus Erythematosus Disease Activity (SLEDAI-2K) index, which computes the score of different parameters.

Trial Locations

Locations (1)

University Hospital Río Hortega

🇪🇸

Valladolid, Spain

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