Intrathecal Autologous Mesenchymal Stem Cell Therapy in Multiple System Atrophy (MSA) - Effect of Dose and Natural History

Mayo Clinic2 sites in 1 country30 target enrollmentOctober 1, 2012

ConditionsMSA

InterventionsAutologous Mesenchymal Stem Cells

DrugsAutologous Mesenchymal Stem Cells

Overview

Phase: Phase 1
Intervention: Autologous Mesenchymal Stem Cells
Conditions: MSA
Sponsor: Mayo Clinic
Enrollment: 30
Locations: 2
Primary Endpoint: Adverse event frequency (by severity, type, attribution, and intervention dose).
Status: Active, Not Recruiting
Last Updated: 24 days ago

Overview Investigators Eligibility Criteria Arms & Interventions Outcomes Sites Similar Trials

Overview

Brief Summary

The purpose of this study is to determine whether mesenchymal stem cells (MSCs) can be safely delivered to the cerebrospinal fluid (CSF) of patients with multiple system atrophy (MSA). Funding Source - FDA OOPD.

Detailed Description

The primary aim is to evaluate the safety and tolerability of intrathecal injection of autologous MSCs in a dose escalation study in patients with MSA. Safety secondary goals include to monitor changes in peripheral blood and in components of CSF, and monitor for any changes of nervous system structures using MRI. Efficacy secondary goals include evaluating potential efficacy by providing a number of studies and instruments that will detect changes in the course of the disease in terms of autonomic and neurologic symptoms and deficits.

Registry

clinicaltrials.gov

Start Date

October 1, 2012

End Date

March 1, 2027

Last Updated

24 days ago

Study Type

Interventional

Study Design

Sequential

Sex

All

Investigators

Sponsor

Mayo Clinic

Responsible Party

Principal Investigator

Wolfgang Singer, MD

Associate Professor

Mayo Clinic

Eligibility Criteria

Inclusion Criteria

•Participants aged 30-80 years old with a diagnosis of MSA based on clinical criteria and standardized autonomic testing. This approach allows for identification of patients with MSA with very high specificity and is yet sensitive enough to allow for enrollment of patients at a disease stage at which an intervention on the natural disease course has a meaningful impact on patient outcome. Patients therefore have to fulfill Gilman Criteria (2000) for probable MSA of the parkinsonian subtype (MSA-P) or cerebellar subtype (MSA-C) and have findings on autonomic function testing suggestive of MSA (CASS ≥5 or a TST% ≥25%).
•Participants who are less than 4 years from the time of documented MSA diagnosis.
•Participants with an anticipated survival of at least 3 years in the opinion of the investigator.
•Participants who are willing and able to give informed consent.
•"Normal" cognition as assessed by Mini-Mental State Examination (MMSE). We will require a value \>24.

Exclusion Criteria

•Any of the following conditions will exclude the participant from entering the study:
•Women of childbearing potential who do not practice an acceptable method of birth control. Acceptable methods of birth control in this study are: surgical sterilization, intrauterine devices, partner's vasectomy, a double-protection method (condom or diaphragm with spermicide), hormonal contraceptive drug (i.e., oral contraceptive, contraceptive patch, long-acting injectable contraceptive) with a required second mode of contraception.
•Participants with a clinically significant or unstable medical or surgical condition that, in the opinion of the investigator, might preclude safe completion of the study or might affect the results of the study. These include conditions causing significant central nervous system (CNS) or autonomic dysfunction, including congestive heart failure, recent (\<6 months) myocardial infarct, cardiopulmonary disease, severe, uncontrolled hypertension, thrombocytopenia (\<50 x 10(9)/L), severe anemia (\<8g/dl), immunocompromised state, liver or kidney disease (creatinine \>2.3mg/dl), uncontrolled diabetes mellitus (HbA1c \>10g%), alcoholism, amyloidosis, uncontrolled hypothyroidism, sympathectomy, unstable peripheral neuropathies, concurrent infections, orthopedic problems that compromise mobility and activity of daily living, cerebrovascular accidents, neurotoxin or neuroactive drug exposure, parkinsonism due to drugs (including neuroleptics, alpha-methyldopa, reserpine, metoclopramide).
•Participants with malignant neoplasms.
•Participants who have taken any investigational products within 60 days prior to baseline.
•Medications that could affect autonomic function. If patients are taking those medications, those will be suspended prior to autonomic testing. Therapy with midodrine, anticholinergic, alpha and beta adrenergic antagonists or other medications that affect autonomic function will be withdrawn 48 hours prior to autonomic evaluations. Fludrocortisone doses up to 0.2 mg per day will be permitted.
•Diseases with features of Parkinsons Disease; e.g., diffuse Lewy body disease, progressive supranuclear palsy, essential tremor, hereditary olivopontocerebellar atrophy, or postencephalitic parkinsonism.
•Dementia (DSM-IV criteria - American Psychiatric Association 1994). The score on the Mini-Mental State Examination must be \>
•History of electroconvulsive therapy.
•History of brain surgery for Parkinsons disease.

Arms & Interventions

10 doses of 5 x 10(7) (±20%) MSCs

Group 4: Participants will receive up to 10 doses of 5 x 10(7) (±20%) mesenchymal stem cells (MSCs) approximately 6 months apart.