Primary Biliary Cirrhosis Clinical Trial
Official title:
Phase 1/2 Study of UC-MSC Treatment for Evaluation the Efficacy and Safety in Patients With Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a slowly progressive disease that causes substantial loss of intrahepatic bile ducts, ultimately resulting in cholestasis, advanced fibrosis, cirrhosis, liver failure and even hepatocellular carcinoma. Histologically, the disease is characterized by chronic portal inflammation with infiltration, destruction and loss of the epithelial cells in the small-sized and medium-sized bile ducts. Currently, Ursodeoxycholic acid (UDCA) in a dose of 13-15mg/kg/day is recommended as therapeutic drugs for PBC by AASLD and is approved for this indication by the U.S. Food and Drug Administration (FDA). Treatment with UDCA may delay disease progression and prolong survival free of liver transplantation. However, one out of three patients does not adequately respond to UDCA therapy and many need additional medical therapy or liver transplantation, or both. UC-MSC has been application for the treatment of several severe autoimmune diseases, such as immune thrombocytopenia, systemic lupus erythematosus, and therapy-resistant rheumatoid arthritis. In this study, the safety and efficacy of UC-MSC transplantation for PBC patients will be evaluated.
Primary biliary cirrhosis (PBC) is a slowly progressive cholestatic disease associated with
the development of cirrhosis and liver failure that may justify liver transplantation.
Ursodeoxycholic acid (UDCA) is currently the only drug approved specifically for the
treatment of PBC. However, one out of three patients does not adequately respond to UDCA
therapy and many need additional medical therapy or liver transplantation, or both.
The potential for stem cells to differentiate into biliary epithelial cells was recently
confirmed. In particular, bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation
has been applicated in the clinic for treat several human disease such as GVHD, cardiac
injury and brain injury, and displayed good tolerance and efficiency. Recently, umbilical
cord-derived MSCs (UC-MSC) has also been used to treat severe autoimmune diseases, such as
therapy-resistant rheumatoid arthritis and multiple sclerosis.
The purpose of this study is to learn whether and how UC-MSC can improve the disease
condition in patients with primary biliary cirrhosis. This study will also look at how well
UC-MSC is tolerated and its safety in PBC patients
Participants in the study will be randomly assigned to one of two treatment arms:
Arm A: Participants will receive 12 weeks of UC-MSC treatment plus UDCA. Arm B: Participants
will receive 12 weeks of placebo plus UDCA. UC-MSC will be prepared according to standard
procedures and is collected in plastic bags containing anticoagulant. UC-MSCs are given via
i.v. under sonography monitoring. After cell therapy, patients are followed up at week
4,8,12,24,36 and 48. The evaluation of some clinical parameters such as the level of serum
alkaline phosphatase (ALP), alanine aminotransferase(ALT) aspartate aminotransferase (AST)
and total bilirubin (TB), prothrombin time(PT), albumin(ALB), prealbumin(PA), are detected
at these time points. Mayo risk score, portal hypertension, Liver histology, MELD score and
clinical symptoms were also observed simultaneously.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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