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| Name | Class |
|---|---|
| Daewoong Pharmaceutical Indonesia | UNKNOWN |
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Subjects will be provided a written informed consent to participate in the study and then undergo any screening. Subjects who meet all the inclusion criteria and none of the exclusion criteria based on the screening test results will be included into the study. At treatment day, the subjects will be administered 100 million cells of investigational product for 30 minutes for each package using a syringe pump. After 4 weeks (1 month) of Investigational product administration, the subjects will visit the study site to evaluate the safety and efficacy of investigational products. Follow up visits for potential efficacy will also be conducted after 12 weeks (3 months) and 24 weeks (6 months) of Investigational product administration. If necessary, additional examination and treatment may be performed according to the investigator's judgment
Frailty is defined as a clinically recognizable state of increased vulnerability resulting from aging-associated decline in reserve and function across multiple physiologic systems such that the ability to cope with every day or acute stressors is comprised. The prevalence of frailty varies between populations in different countries. A meta-analysis conducted from 240 studies across 62 countries, using the Frailty Index, showed that the prevalence of frailty and prefrailty among elderly people is 24% and 49%, respectively. In Indonesia, a meta-analysis showed that, using the frailty index, the prevalence of frailty and pre-frailty among elderly people is 26.8% and 55.5%, respectively. These data indicate that the prevalence of frailty and prefrailty in Indonesia is above the world average. This high prevalence of frailty in Indonesia will also become a serious problem, especially considering the various burdens that may arise as a result of frailty, such as geriatric syndromes, disability, mortality, and even cognitive impairment.
Stem cell therapy is proven to help reversing and slowing the progression of physical frailty through: improving the age-dependent senescence, restoring the frailty-related stem cell depletion, inhibit chronic inflammation, improving imbalance of immune homeostasis, restoring the reduction of multipotent stem cells. Mesenchymal Stem Cell (MSC) as one of the options for therapy of frailty becoming one of the future promising treatments. Umbilical Cord-derived Mesenchymal Stem Cell (UC-MSCs) become one of the popular types of Mesenchymal Stem Cell (MSC)'s origin, not only because of its promising immunomodulatory and anti-inflammatory properties, but also because of its safety and less ethical issues. Mesenchymal Stem Cell (MSC) proven too able to contribute in improving frailty condition through components, including neuroprotective effect, cardioprotective effect, muscle protective effect, and therapeutic effect on hormone. This study aimed to evaluate the safety and potential therapeutic effect of allogeneic human mesenchymal stem cell infusion in frailty patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 100 million cells of investigational product for 30 minutes per package using a syringe pump. | Experimental | 100 million cells of investigational product for 30 minutes per package using a syringe pump. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Daewoong Biologics Indonesia Umbilical Cord-derived Mesenchymal Stem Cell (DBI UC-MSC) | Biological | The investigational product will be in ready-to-use package in 50 ml syringes, containing 50 million cells in a saline solution with 5% dextrose and 3% human serum albumin. Each participant will receive two packages. The prepared suspension should be administered to the subjects via Intravenous (IV) infusion. The entire suspension should be infused over a 30-minute period per package using a syringe pump. |
| Measure | Description | Time Frame |
|---|---|---|
| Safety evaluation | Safety evaluation will be measured by the incidence of Serious Adverse Events (SAEs) | 1, 3, and 6 months |
| Safety evaluation | Safety will be assessed by evaluating thromboembolism risk as indicated by d-dimer level | 2 hours, 1 month, 3 months, and 6 months |
| Efficacy evaluation (Frailty state) | Frailty state condition will be evaluated using the Frail questionnaires | 1, 3, and 6 months |
| Efficacy evaluation (Patient quality of life) | Patient quality of life will be evaluated using Short-Form 12 Health Survey (SF-12) | 1, 3, and 6 months |
| Efficacy evaluation (Inflammatory biomarkers) | Inflammatory biomarkers will be evaluated using TNF-α (Tumor necrosis factor-alpha), IL-6 (Interleukin-6), IL-10 (Interleukin-10), and IL-11 (Interleukin 11), | 1, 3, and 6 months |
| Efficacy evaluation (Inflammatory biomarkers) | Inflammatory biomarkers will be evaluated using Leptin and D-dimer | 1, 3, and 6 months |
| Efficacy evaluation (Immune system biomarkers) | Immune system biomarkers will be evaluated including Cluster of Differentiation-4 (CD4) and Cluster of Differentiation-8 (CD8) | 1, 3, and 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| dr. Jonny Sp.PD-KEGH, MM, M.Kes, Post-doc | Central Army Hospital Gatot Soebroto | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Central Army Hospital Gatot Soebroto | Jakarta Pusat | Jakarta Special Capital Region | 10410 | Indonesia |
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| ID | Term |
|---|---|
| D000073496 | Frailty |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Efficacy evaluation (Immune system biomarkers) | Immune system biomarkers will be evaluated including Cell T Regulator | 1, 3, and 6 months |