Lomecel-B on Vaccine-Specific Antibody- Response in Subjects With Aging Frailty

Phase 1

Completed

• Conditions: Aging Frailty
• Interventions: Biological: Longeveron Mesenchymal Stem Cells (LMSCs); Biological: Fluzone High Dose Vaccine

• Registration Number: NCT02982915
• Lead Sponsor: Longeveron Inc.

Brief Summary

This is a phase I/II, randomized, blinded and placebo-controlled study to test the safety and efficacy of Lomecel-B for improving vaccine immune response.

Detailed Description

A pilot phase will consist of a 3 subject safety run-in, followed by 20 subject randomized phase to evaluate influenza vaccine response at 1 week and 4 weeks post infusion of Lomecel-B (Formerly LMSCs). This will be followed by a double-blinded, randomized, placebo-controlled phase.

Study Timeline

• Study Start: 2016-11
• Study First Submitted: 2016-11-17
• Study First Submitted QC: 2016-12-01
• Study First Posted: 2016-12-06
• Primary Completion: 2021-09
• Study Completion: 2022-09
• Status Verified: 2022-11
• Last Update Submitted: 2022-11-03
• Last Update Posted: 2022-11-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 62

Inclusion Criteria

• be willing and able to provide written informed consent and comply with all procedures required by the protocol.
• be 65 - 90 years of age at the time of signing the Informed Consent Form.
• have a diagnosis of Aging Frailty, with a score of 4 to 7 using the Canadian Frailty Scale.
• have a six-minute walk test (6MWT) distance of 200m - 400m for each of 2 trials, and the 2 trials must be within 15% of each other.
• have total bilirubin between 0.3 - 1.9 mg/dL.

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Exclusion Criteria

• be unwilling or unable to perform any of the assessments required by the Protocol.

• score ≤24 on the Mini Mental State Examination (MMSE).

• have previously received current year's flu-vaccine.

• have any contraindication to receiving a vaccine.

• have a Hemoglobin A1c (HbA1c) level >9.0%.

• be diagnosed with malignancy (subjects without a recurrence in the last 2.5 years will be allowed) except curatively-treated basal cell carcinoma, melanoma in situ, or cervical carcinoma.

• have a condition that projected to limit the life-expectancy to ≤1 year.

• have autoimmune disease (e.g., rheumatoid arthritis).

• be using medication(s) known to alter immune response, e.g., high-dose corticosteroids.

• have HIV, AIDS, or other immunodeficiency.

• test positive for hepatitis B virus

  • If the subject tests positive for anti-HBc or anti-HBs, they must be receiving treatment for Hepatitis B virus prior to infusion and remain on treatment throughout the study.

• test positive for viremic hepatitis C, HIV1, HIV2, or syphilis.

• have a resting blood oxygen saturation of <93% (measured by pulse oximetry).

• be a female who is pregnant, nursing, or of childbearing potential while not practicing effective contraception.

• have documented current substance and/or alcohol abuse.

• have known allergies to latex or eggs.

• have a known hypersensitivity to dimethyl sulfoxide (DMSO).

• be an organ transplant recipient (other than corneal, bone, skin, ligament, or tendon transplant).

• be actively listed (or expected to be listed) for transplant of any organ (other than corneal, bone, skin, ligament, or tendon transplant).

• have any clinically important abnormal screening laboratory values, including but not limited to:

  • hemoglobin <10.0 g/dL.
  • white blood cell count < 2500/mm3.
  • platelets < 100,000/mm3.
  • prothrombin time/international normalized ratio (PT/INR) ˃ 1.5 not due to a reversible cause (i.e. Coumadin).

• aspartate transaminase, alanine transaminase, or alkaline phosphatase ˃ 2 times upper limit of normal.

• have a sitting or resting systolic blood pressure >180 mm Hg or diastolic blood pressure >110 mm Hg at Screening.

• have any serious illness or any other condition that, in the opinion of the investigator, may compromise the safety or compliance of the subject or preclude successful completion of the study, or that may compromise the validity of the study.

• be currently participating in an investigational therapeutic or device trial, or have participated in an investigational therapeutic or device trial within the previous 30 days, or participate in any other clinical trial for the duration of the time that the subject actively participates in this trial.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Pilot Phase Cohort B & C	Longeveron Mesenchymal Stem Cells (LMSCs)	Single dose of 100 million Longeveron Mesenchymal Stem Cells (LMSCs) followed by vaccination with Fluzone High-Dose at either 1 week (Cohort B) or 4 weeks (Cohort C) post infusion.
Pilot Phase Cohort B & C	Fluzone High Dose Vaccine	Single dose of 100 million Longeveron Mesenchymal Stem Cells (LMSCs) followed by vaccination with Fluzone High-Dose at either 1 week (Cohort B) or 4 weeks (Cohort C) post infusion.
Double-Blind,Randomized,Placebo Phase	Longeveron Mesenchymal Stem Cells (LMSCs)	2 cohorts to receive a single infusion of 100 million Longeveron Mesenchymal Stem Cells (LMSCs) (Cohort A: 30 subjects) or placebo (Cohort B:30 subjects) followed by vaccination with Fluzone High-Dose.
Double-Blind,Randomized,Placebo Phase	Fluzone High Dose Vaccine	2 cohorts to receive a single infusion of 100 million Longeveron Mesenchymal Stem Cells (LMSCs) (Cohort A: 30 subjects) or placebo (Cohort B:30 subjects) followed by vaccination with Fluzone High-Dose.
Pilot Phase- Cohort A	Fluzone High Dose Vaccine	Single dose of 20 million Longeveron Mesenchymal Stem Cells (LMSCs) will be delivered followed by vaccination with Fluzone High-Dose at 1 week post-infusion.
Pilot Phase- Cohort A	Longeveron Mesenchymal Stem Cells (LMSCs)	Single dose of 20 million Longeveron Mesenchymal Stem Cells (LMSCs) will be delivered followed by vaccination with Fluzone High-Dose at 1 week post-infusion.

Primary Outcome Measures

Name	Time	Method
The incidence of any treatment-emergent serious adverse event (TE-SAE), defined as one or more of the following untoward medical occurrences within 30 days after infusion as assessed by the following:	30 days after infusion	* Is life-threatening (e.g., stroke or non-fatal pulmonary embolism).; * Requires inpatient hospitalization or prolongation of existing hospitalization.; * Results in persistent or significant disability/incapacity.; * Results in death; * Results in other clinically significant untoward laboratory test result(s) or medical condition(s), determined per Investigator's judgment.
The ability of Lomecel-B (LMSC) treatment to improve inactivation of influenza virus as assessed by validated hemagglutination inhibition (HAI) assays.	Baseline Visit, Vaccination Visits, Weeks 1, 2, 4, Month 6 and Month 12 Follow-Up Visits.	Measurements of validated hemagglutination inhibition (HAI) assays at follow up visits.

Secondary Outcome Measures

Name	Time	Method
Rate of decline in Aging Frailty status as assessed by the 6 minute walk test	Baseline, month 6 and month 12 after infusion	Distance in meters walked in 6 minutes
Rate of decline in Aging Frailty status as assessed by the Short Physical Performance Battery (SPPB)	Baseline, month 6 and month 12 after infusion	Short Physical Performance Battery Assessment
Rate of decline in Aging Frailty status as assessed by the Tinetti POMA Test	Baseline, month 6 and month 12 after infusion	TInetti POMA assessment
Rate of decline in Aging Frailty status as assessed by the Weight Loss	Baseline, month 6 and month 12 after infusion	Weigh measurements at visits
Rate of decline in Aging Frailty status as assessed by the Handgrip Test	Baseline, month 6 and month 12 after infusion	Handgrip strength via dynamometer.
Changes from baseline between the LMSC and placebo cohorts as assessed by B & T cell levels:	Baseline, month 6 and month 12 after infusion	Plasma levels of B \& T Cells.
Changes from baseline between the LMSC and placebo cohorts as assessed by plasma cytokine levels:	Baseline, month 6 and month 12 after infusion	Plasma levels of interleukins measured in pg/mL.
Differences in rate of decline from Aging Frailty	Baseline, month 6 and month 12 after infusion	Change in Clinical Frailty rating
Assessed by the Falls Efficacy Scale-International and Performance Oriented Mobility Assessment	Baseline, month 6 and month 12 after infusion	Change in risk of falling
PROMIS Short Form 20a questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
PROMIS Mobility questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
PROMIS Upper Extremity questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
Short Form 36 questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
IIEF questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
SQOL-F questionnaire	Baseline, month 6 and month 12 after infusion	Change in subject quality of life as assessed by participant-reported outcomes.
Death from any cause	Within 12 months after infusion	Number of participants that die from any cause while enrolled on the trial and after being treated with LMSCs.
Falls Efficacy Scale-International (FES-I)	Baseline, month 6 and month 12 after infusion	Change by participant-reported outcomes. Minimum 16 (no concern about falling) to maximum 64 (severe concern about falling)

Trial Locations

Locations (6)

Optimal Research LLC; 🇺🇸 Rockville, Maryland, United States

Johns Hopkins University; 🇺🇸 Baltimore, Maryland, United States

Clinical Physiology Associates; 🇺🇸 Fort Myers, Florida, United States

University of Miami; 🇺🇸 Miami, Florida, United States

Vista Health Research; 🇺🇸 Miami, Florida, United States

Clinical Research of South Florida; 🇺🇸 Coral Gables, Florida, United States