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Prochymal® (Human Adult Stem Cells) Intravenous Infusion Following Acute Myocardial Infarction (AMI)

Phase 2
Completed
Conditions
Myocardial Infarction
Interventions
Drug: Placebo
Drug: Prochymal®
Registration Number
NCT00877903
Lead Sponsor
Mesoblast, Inc.
Brief Summary

The objective of the present study is to establish the safety and efficacy of Prochymal® following first acute myocardial infarction.

Detailed Description

The standard of care treatment for acute myocardial infarction (AMI) usually includes immediate perfusion, optimal pain relief, oxygen, aspirin or other anti-coagulants, Beta-Blockers, nitrates and Ace-inhibitors. However, because salvaging the viable myocardium is dependent on early reperfusion, only a minority of participants will reach the hospital within the time-window for myocardial rescue. Thus, even if the participant manages their tobacco use, hypertension, lipid levels, diabetes, weight and exercise, many participants will go on to develop Congestive Heart Failure (CHF). Though the medical management for CHF may improve symptoms and slow disease progression, such treatment cannot restore a functioning myocardium. A therapy that could improve the myocardial remodeling process and reduce the incidence or severity of CHF following acute MI would provide a significant benefit. The characteristics and biologic activity of Prochymal®, along with a good safety profile in human trials to date, suggest that Prochymal® may be a good candidate for addressing this unmet medical need.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
220
Inclusion Criteria
  • Male or female between 21 and 85 years old, inclusive
  • First heart attack within 7 days prior to randomization and drug infusion
  • Baseline left ventricular ejection fraction (LVEF) 20-45%
  • Hemodynamically stable within 24 hours prior to randomization
  • Adequate pulmonary function
Exclusion Criteria
  • Previous medical history of heart attack, heart failure, significant valvular heart disease, aortic dissection
  • Pacemaker or other device
  • Pregnant, breast-feeding, or intends to become pregnant during the study
  • Allergy to cow or pig derived products
  • Evidence of active malignancy or prior history of active malignancy
  • Major surgical procedure or major trauma within the past 14 days
  • Autoimmune disease (e.g., Lupus, Multiple Sclerosis)
  • Any medical condition, which in the opinion of the Investigator, renders participation unsuitable
  • Undergone pharmacologic cardioversion or external defibrillation within 24 hours of randomization.
  • Experienced cardiac arrest more than 36 hours after presentation to site or within 24 hours of randomization.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants will receive Prochymal® placebo-matching single IV infusion at a dose of of 200 x 10\^6 hMSC, reconstituted in 80 mL, delivered at a rate of 2 mL/min, with a maximum rate of 5.0 x 10\^6 hMSC/minute, and the participants will be followed for 24 months and remain in the study for up to 60 months.
Prochymal®Prochymal®Participants will receive Prochymal® single intravenous (IV) infusion at a dose of 200 x 10\^6 human mesenchymal stem cells (hMSC), reconstituted in 80 mL, delivered at a rate of 2 mL/min, with a maximum rate of 5.0 x 10\^6 hMSC/minute, and the participants will be followed for 24 months and remain in the study for up to 60 months.
Primary Outcome Measures
NameTimeMethod
Change from Baseline in Cardiac Magnetic Resonance (CMR) imaging-determined End Systolic Volume (ESV) at Month 3Baseline, Month 3
Secondary Outcome Measures
NameTimeMethod
Infarct Size3 and 6 months
Left Ventricular Ejection Fraction3 and 6 months
Left Ventricular End Diastolic Volume3 and 6 months
Left Ventricular End Systolic Volume6 months
Overall Survival60 months
New York Heart Association (NYHA) Congestive Heart Failure Classification Status6, 12, 24, and 60 months
Maximal Symptom-limited Exercise Test (Treadmill)6 and 12 months
Number of Participants with Ventricular Arrhythmias3 and 6 months
Duke Activity Status Index (DASI) Assessment6, 12, and 24 months

The Duke Activity Status Index (DASI) is a brief, self-administered questionnaire that provides a standardized assessment of functional status and quality-of-life that correlates well with an objective measure of maximal exercise capacity. The scale ranges from 0 (unable to perform any tasks) to 58.20 (able to perform all tasks). Higher scores indicate a greater ability to perform daily activities.

Number of Participants with Major Adverse Cardiac Events (MACE)6, 12, 24, and 60 months
Number of Participants with Adverse Events3,6,12,24,60 months

Trial Locations

Locations (33)

Mercy Gilbert Medical Center / Catholic Health Care West

🇺🇸

Gilbert, Arizona, United States

Drexel University College of Medicine

🇺🇸

Philadelphia, Pennsylvania, United States

University of Miami

🇺🇸

Miami, Florida, United States

University of Texas Health Science Center

🇺🇸

Houston, Texas, United States

University of California - San Diego (UCSD)

🇺🇸

San Diego, California, United States

Minneapolis Heart Institute

🇺🇸

Minneapolis, Minnesota, United States

Baystate Medical Center

🇺🇸

Springfield, Massachusetts, United States

McGill University Health Centre

🇨🇦

Montreal, Quebec, Canada

Fletcher Allen Health Care

🇺🇸

Burlington, Vermont, United States

Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

University of Arizona

🇺🇸

Tucson, Arizona, United States

Rush University Medical Center

🇺🇸

Chicago, Illinois, United States

The Care Group

🇺🇸

Indianapolis, Indiana, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

University at Buffalo - Buffalo General Hospital

🇺🇸

Buffalo, New York, United States

The Lindner Research Center

🇺🇸

Cincinnati, Ohio, United States

Cotton-O'Neil Clinical Research Center

🇺🇸

Topeka, Kansas, United States

UMDNJ - Robert Wood Johnson Medical School

🇺🇸

New Brunswick, New Jersey, United States

William Beaumont Hospital

🇺🇸

Royal Oak, Michigan, United States

Tufts Medical Center

🇺🇸

Boston, Massachusetts, United States

The Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

The Stern Cardiovascular Center

🇺🇸

Germantown, Tennessee, United States

Allegheny General Hospital

🇺🇸

Pittsburgh, Pennsylvania, United States

University of Wisconsin School of Medicine

🇺🇸

Madison, Wisconsin, United States

Stony Brook University Medical Center

🇺🇸

Stony Brook, New York, United States

Michigan Cardiovascular Institute

🇺🇸

Saginaw, Michigan, United States

Penn State University - Milton S. Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Austin Heart P.A.

🇺🇸

Austin, Texas, United States

UC Davis Medical Center

🇺🇸

Sacramento, California, United States

UMass Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

University of Maryland Hospital

🇺🇸

Baltimore, Maryland, United States

Wake Forest University School of Medicine

🇺🇸

Winston-Salem, North Carolina, United States

Oregon Health & Science University

🇺🇸

Portland, Oregon, United States

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