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In this clinical trial, researchers are exploring a novel approach to delivering therapy directly into the spinal fluid, which surrounds and nourishes the brain and spinal cord. The study focuses on patients with progressive multiple sclerosis (MS), a form of the disease that leads to worsening disability without the typical relapses seen in other MS subtypes.
This investigational therapy involves the use of stem cells derived from amniotic fluid-the protective liquid surrounding a developing baby in the womb. To the best of the researchers' knowledge, these specific stem cells have never been tested in MS patients before. Amniotic fluid is ethically sourced from routine medical procedures during pregnancy, and similar stem cells can also be obtained from placentas that are typically discarded after childbirth.
Participants in the trial will receive multiple injections of these stem cells into their spinal fluid over the course of a year. Researchers will closely monitor for the safety of this therapy, as well as monitor the participants' walking ability and other neurological functions to assess potential improvements.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Open label stem cell arm | Experimental | The first 5 participants will receive 4 intrathecal injections of c-Kit stem cells at a dose of 25 x 106 cells per injection. The next 5 patients will receive 4 intrathecal injections of c-Kit stem cells at a dose of 50 x 106cells per injection. The next 10 patients will receive 4 intrathecal injections of c-Kit stem cells at a dose of 80 x 106cells per injection. Only if a dose is deemed safe by the investigators after 1 month of its first injection, will we advance to the next dose. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Amniotic fluid or placental CD117 stem cells | Biological | CD117 (c-Kit) positive stem cells, extracted from ethical fetal sources such as amniotic fluid and placental tissue. |
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| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Treatment-Emergent Adverse Events (Safety and Tolerability) | The primary safety outcome will be the incidence of adverse events (AEs) and serious adverse events (SAEs) related to the treatment, including their severity and duration. Adverse events will be classified according to the NIH Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. | From enrollment to the end of treatment at 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| The Multiple Sclerosis Functional Composite (MSFC) score | The Multiple Sclerosis Functional Composite (MSFC) is a three-part quantitative objective measure of neurologic function, measuring leg (timed 25-foot walk [25FTW] measured in seconds), arm (nine-hole peg test [9HPT] measured in seconds), and cognitive (three-second paced auditory serial addition test [PASAT3] measured in z-score) functions. The MSFC is a continuous scale that is a composite of the scores of its three parts. A change of 20% or more of the total score (the MSFC composite) or any of its individual component parts (25FTW, 9HPT, PASAT3) is considered clinically significant. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mahmoud Abdelrazek, MD | Wake Forest University Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Atrium Health | Charlotte | North Carolina | 28204 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37287077 | Background | Rosner M, Horer S, Feichtinger M, Hengstschlager M. Multipotent fetal stem cells in reproductive biology research. Stem Cell Res Ther. 2023 Jun 7;14(1):157. doi: 10.1186/s13287-023-03379-4. | |
| 30687321 | Background | Lassmann H. Pathogenic Mechanisms Associated With Different Clinical Courses of Multiple Sclerosis. Front Immunol. 2019 Jan 10;9:3116. doi: 10.3389/fimmu.2018.03116. eCollection 2018. |
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| ID | Term |
|---|---|
| D020528 | Multiple Sclerosis, Chronic Progressive |
| ID | Term |
|---|---|
| D009103 | Multiple Sclerosis |
| D020278 | Demyelinating Autoimmune Diseases, CNS |
| D020274 | Autoimmune Diseases of the Nervous System |
| D009422 | Nervous System Diseases |
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| From enrollment to the end of treatment at 12 months |
| The Six-minute Walk Test | The maximum distance walked in 6 minutes is measured. If the patient cannot complete the 6-minute walk then the measurement becomes the total time walked. A 20% change in the distance walked in 6 minutes for those who complete the 6-minute walk, or a 20% change in the total time walked for those who cannot, will be considered clinically significant. | From enrollment to the end of treatment at 12 months |
| The Expanded Disability Status Scale (EDSS) | The Expanded Disability Status Scale (EDSS) score ranges from 0 to 10.0, with higher scores indicating a greater degree of disability.25 Participants will undergo EDSS assessments at baseline, 6 months, and 12 months. A reduction in EDSS score by 1 point for baseline scores ≤5.5 and by 0.5 points for baseline scores ≤6.0 will indicate a reduction in disability, and vice versa for disability progression. | From enrollment to the end of treatment at 12 months |
| The Multiple Sclerosis Quality of Life-54 (MSQoL-54) | The Multiple Sclerosis Quality of Life-54 (MSQoL-54) is a health-related quality of life (HRQoL) questionnaire specifically designed for people with multiple sclerosis (MS). The MSQoL-54 generates 12 subscales and 2 composite scores. Scoring:
Interpretation:
| From enrollment to the end of treatment at 12 months |
| D003711 | Demyelinating Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |