Pediatric MSC-AFP Sub-study for Crohn's Fistula

Crohn Disease Clinical Trial

Official title:

A Phase I Study of Autologous Mesenchymal Stromal Cell Coated Fistula Plug in Patients With Fistulizing Crohn's Disease: Pediatric Sub-study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03449069
• Other study ID #: 17-010539
• Status: Completed
• Phase: Phase 1
• Start date: July 23, 2018
• Est. completion date: December 31, 2023

Study information

• Verified date: March 2024
• Source: Mayo Clinic
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the safety of using an autologous mesenchymal stromal cell (MSC) coated fistula plug in people with fistulizing Crohn's disease. Autologous means these cells to coat the plug come from the patient.

Description:

The investigators propose to study the safety of autologous mesenchymal stromal cell transfer using a biomatrix (the Gore Bio-A Fistula Plug) in a Phase I study using a single dose of 20 million cells. 5 patients (age 12 to 17 years) with Crohn's perianal fistulas will be enrolled.

Subjects will undergo standard adjuvant therapy including drainage of infection and placement of a draining seton. Six weeks post placement of the draining seton, the seton will be replaced with the MSC loaded Gore fistula plug as per current clinical practice. The subjects will be subsequently followed for fistula response and closure for 24 months. This is an autologous product derived from the patient and used only for the same patient.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1
• Est. completion date: December 31, 2023
• Est. primary completion date: December 31, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 12 Years to 17 Years

Eligibility

Inclusion Criteria

1. Males and females 12-17 years of age.

2. Residents of the United States.

3. Crohn's disease with single or multiple draining complex perianal fistulae (definition as below) for at least three months despite standard therapy (definition below).

4. Concurrent therapies with corticosteroids, 5-aminosalicylate (5-ASA) drugs, thiopurines, methotrexate (MTX), antibiotics, and anti-tumor necrosis factor (TNF) therapy are permitted.

5. All patients should have undergone a colonoscopy in last 12 months to rule out malignant or premalignant condition

6. Have no contraindications to MR evaluations: e.g. pacemaker or magnetically active metal fragments, claustrophobia

7. Ability to comply with protocol

8. Competent and able to provide written informed consent (and assent where appropriate).

9. Must have failed standard medical therapy including anti-TNF agents

Exclusion Criteria

1. Inability to obtain informed consent (and assent where appropriate).

2. Clinically significant medical conditions within the six months before administration of MSCs: e.g. sepsis, pneumonia active serious infection or other conditions that would, in the opinion of the investigators, compromise the safety of the patient.

3. Specific exclusions;

a. Evidence of hepatitis B, C, or HIV

4. History of cancer including melanoma (with the exception of localized skin cancers)

5. Investigational drug within thirty (30) days of baseline

6. A resident outside the United States

7. Pregnant or trying to become pregnant, or breast feeding.

8. History of clinically significant auto-immunity (other than Crohn's disease) or any previous example of fat-directed autoimmunity

9. Previous allergic reaction to a perianal fistula plug.

10. If adipose tissue is not technically feasible

11. Weight less than 35 kg

12. Allergic to local anesthetics

13. Non-enterocutaneous tracts (i.e. recto-vaginal, entero-vesicular)

Related Conditions & MeSH terms

• Crohn Disease
• Fistula
• Fistula in Ano

Intervention

Drug:
• MSC-AFP
Patients will have a mesenchymal stromal cell coated anal fistula plug placed in their Crohn's perianal fistula tract.

Locations

Country	Name	City	State
United States	Mayo Clinic in Rochester	Rochester	Minnesota

Sponsors (1)

Lead Sponsor	Collaborator
Mayo Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of participants with treatment-related adverse events (safety and toxicity)	Participants will have a health assessment and blood work done at each study visit to monitor for adverse events.	2 months to approximately at 24 months
Secondary	Number of participants with response to the treatment regarding cessation of drainage from the treated fistula.	Participants will have a clinical assessment of fistula drainage at each study visit.	2 months to approximately at 24 months
Secondary	Number of participants with radiographic response to the treatment regarding the treated fistula.	Participants will have an assessment of healing radiographically by magnetic resonance imaging (MRI) at Week 2 visit, Week 8, and Week 24.	Week 2, Week 8, and Week 24