Clinical Application of Stem Cell Educator Therapy in Alopecia Areata

Alopecia Areata Clinical Trial

Official title:

Clinical Treatment of Alopecia Areata With Stem Cell Educator Therapy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04011748
• Other study ID #: 2019-TH-001
• Status: Recruiting
• Phase: Phase 2
• Start date: September 20, 2022
• Est. completion date: July 30, 2023

Study information

• Verified date: January 2023
• Source: Throne Biotechnologies Inc.
• Contact: Yong Zhao, MD,PhD
• Phone: 2019880290
• Email: Yong.Zhao[@]ThroneBio.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Alopecia areata (AA) is a common autoimmune disease that results in loss of body hair in varying degrees. The condition is estimated to affect more than 6.8 million people in the United States alone (naaf.org), with a worldwide prevalence of 0.1% to 0.2% and calculated lifetime risk of 2%. AA is the most common form of the disease, in which areas of complete hair loss arise within normal hair-bearing skin. Other forms include alopecia totalis (AT), characterized by total loss of scalp hair, and alopecia universalis (AU), characterized by complete loss of body hair. AA and its variants can have devastating effects on patients' quality of life and social functioning. At present, curative therapy for AA does not exist. Therapeutic options are currently very limited, such as intralesional injections of glucocorticoids and induction of allergic contact dermatitis. These therapies are not effective for many patients and are generally impractical for patients with diffuse AA, AT or AU. Recently, Janus kinase (JAK) inhibitors were effective for the treatment of severe AA. However, for those patients who do respond, relapses are common after discontinuation of treatment, due to the existing of autoimmune memory T cells. Stem Cell Educator (SCE) therapy, which uses only autologous mononuclear cells that are externally exposed to cord blood stem cells, has previously been proven safe and effective in subjects for the improvement of type 1 diabetes (T1D), T2D and other autoimmune diseases such as alopecia areata. Minoxidil is the FDA approved drug for the treatment of androgenetic alopecia (AGA) in 1988. This trial will explore the therapeutic potential of Stem Cell Educator therapy for the treatment of AA by using topical minoxidil as control.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: July 30, 2023
• Est. primary completion date: July 30, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

1. Adult patients ( 18 years)

2. Must have a clinical diagnosis of AA, at least 50% hair loss involving the scalp

3. For cases in which there is 80% or more scalp hair loss, the duration of the severity of hair loss must be 10 years or less

4. Stable or worsening hair loss for at least 6 months without evidence of hair regrowth

5. Patients must not have received any treatments known to affect AA within 2 months of screening

6. Patients must agree that they are not permitted to use any other treatment besides topical minoxidil known to affect AA during a period of 6 months after undergoing SCE therapy

7. Adequate venous access for apheresis

8. Ability to provide informed consent

9. For female patients only, willingness to use FDA-recommended birth control (http://www.fda.gov/downloads/ForConsumers/ByAudience/ForWomen/FreePublications/UCM356 451.pdf) until 6 months post treatment.

10. Must agree to comply with all study requirements and be willing to complete all study visits

Exclusion Criteria:

1. AST or ALT 2 > x upper limit of normal.

2. Abnormal bilirubin (total bilirubin > 1.2 mg/dL, direct bilirubin > 0.4 mg/dL)

3. Creatinine > 2.0 mg/dl.

4. Known coronary artery disease or EKG suggestive of coronary artery disease unless cardiac clearance for apheresis is obtained from a cardiologist.

5. Known active infection such as Hepatitis B, Hepatitis C, or Human Immunodeficiency Virus (HIV)

6. Pregnancy assessed by a positive serum pregnancy test or breastfeeding mothers

7. Use of immunosuppressive medication within one month of enrollment including but not limited to prednisone, cyclosporine, tacrolimus, sirolimus, and chemotherapy.

8. Presence of any other autoimmune diseases (lupus, rheumatoid arthritis, scleroderma, etc.)

9. Anticoagulation other than ASA.

10. Hemoglobin < 10 g/dl or platelets < 100 k/ml

11. Is unable or unwilling to provide informed consent

12. Presence of any other physical or psychological medical condition that, in the opinion of the investigator, would preclude participation

13. Significant cardiovascular diseases that would make use of oral minoxidil inappropriate.

Related Conditions & MeSH terms

• Alopecia
• Alopecia Areata
• Alopecia Totalis
• Alopecia Universalis

Intervention

Combination Product:
• Stem Cell Educator therapy
AA subjects will be recruited and followed by the treatment with SCE therapy.

Locations

Country	Name	City	State
United States	Throne Biotechnologies	Paramus	New Jersey

Sponsors (1)

Lead Sponsor	Collaborator
Throne Biotechnologies Inc.

Country where clinical trial is conducted

United States, 

References & Publications (4)

Li Y, Yan B, Wang H, Li H, Li Q, Zhao D, Chen Y, Zhang Y, Li W, Zhang J, Wang S, Shen J, Li Y, Guindi E, Zhao Y. Hair regrowth in alopecia areata patients following Stem Cell Educator therapy. BMC Med. 2015 Apr 20;13:87. doi: 10.1186/s12916-015-0331-6. — View Citation

Zhao Y, Jiang Z, Zhao T, Ye M, Hu C, Yin Z, Li H, Zhang Y, Diao Y, Li Y, Chen Y, Sun X, Fisk MB, Skidgel R, Holterman M, Prabhakar B, Mazzone T. Reversal of type 1 diabetes via islet beta cell regeneration following immune modulation by cord blood-derived — View Citation

Zhao Y, Knight CM, Jiang Z, Delgado E, Van Hoven AM, Ghanny S, Zhou Z, Zhou H, Yu H, Hu W, Li H, Li X, Perez-Basterrechea M, Zhao L, Zhao Y, Giangola J, Weinberg R, Mazzone T. Stem Cell Educator therapy in type 1 diabetes: From the bench to clinical trials. Autoimmun Rev. 2022 May;21(5):103058. doi: 10.1016/j.autrev.2022.103058. Epub 2022 Jan 31. — View Citation

Zhao Y. Stem cell educator therapy and induction of immune balance. Curr Diab Rep. 2012 Oct;12(5):517-23. doi: 10.1007/s11892-012-0308-1. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The percentage change in scalp hair growth.	The primary endpoint was the percentage change in scalp hair growth, measured with the Severity of Alopecia Tool (SALT) score.	Hair regrowth will be evaluated at different time points post receiving Stem Cell Educator therapy in 1, 3, and 6 months.
Secondary	Feasibility of SCE therapy	The feasibility will be determined by the number of patients who were unable to complete SCE Therapy.	6 months
Secondary	Preliminary efficacy of SCE therapy	This will be determined by the duration of maintaining hair growth following SCE therapy.	6 months
Secondary	Efficacy of modulation of autoimmune-related memory T-cell markers	Measurements of immune markers' changes will be preformed by flow cytometry such as CD8+CD45RO+CCR7- effector memory T cells. Peripheral blood mononuclear cells (PBMC) will be collected at 1, 3, 6 month post the SCE therapy.	6 months

External Links

•   Throne Biotechnologies Inc