Osteoarthritis of Knee Clinical Trial
Official title:
Human Autologous Mesenchymal Stromal Cells for the Treatment of Mid to Late Stage Knee Osteoarthritis
Osteoarthritis (OA) is one of the most common forms of arthritis. It is a lasting condition
in which the material that cushions the joints, called cartilage, breaks down. This causes
the bones to rub against each other, causing inflammation, stiffness, pain and loss of joint
movement. Currently, there are few effective treatments available for patients suffering from
OA.
Mesenchymal stem cells (MSCs) are cells that have the ability to self-regenerate, which means
they have the ability to make copies of themselves and to turn into other kinds of cells
(e.g. cartilage cells). Stem cell science shows much promise for the future treatment of
osteoarthritis, but much of the research is still in the early stages. In this study,
researchers want to determine the safety of MSCs that a patient can tolerate without causing
side effects. This will be done by starting at a low dose of MSCs and moving on to the next
higher dose level provided there are no safety concerns. Researchers will also be looking at
the function of the knee over time, which may give them some insight on the usefulness of
MSCs as a treatment option.
The trial is a non-randomized, open-label, dose escalation phase I/II clinical trial. A total
of 12 participants will be enrolled - patients will be treated in cohorts of 3 to determine
the safety and preliminary efficacy of autologous, ex-vivo expanded bone-marrow derived MSC
injected into the knee joint in patients with moderate to advanced knee osteoarthritis.
A minimum of three evaluable patients will be entered at each dose level until the maximum
tolerated dose (MTD) is reached. Toxicity will be evaluated and graded according to the
Common Terminology Criteria (CTC) for Adverse Events, as Grade 3-4. If a patient is
discontinued due to a grade 3 or 4 adverse event (i.e. dose-limiting toxicity, DLT), an
additional patient will be enrolled at the same dose level to ensure that a minimum of 3
patients are evaluated. If 0/3 patients experience dose-limiting (DLT) at a given dose level,
then the dose will be escalated for next cohort of 3 patients. If 1/3 patients experience DLT
at a given dose level, then an additional 3 patients will be treated at that dose level. If
no other patient experiences a DLT, dose escalation will continue. If DLT occurs in 2/3 or
2/6 patients, dose escalation will stop and the prior dose level will be declared the MTD for
the MSC cell infusions in this study.
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