Acute Myocardial InfarctionPhase 1NCT04056819
Evaluate the Safety and Explore Efficacy of Umbilical Cord Mesenchymal Stem Cells in Acute Myocardial Infarction
A Phase 1 study testing Allogeneic umbilical cord mesenchymal stem cells in people with Acute Myocardial Infarction, run by Ever Supreme Bio Technology Co., Ltd. at 1 site in Taiwan.
Trial summary
This study is a first-in-human assessment of safety of using UCMSC in patients with AMI via a combination of IC and IV stem cell administration. The novelty of the current UMSC01 treatment study is the dual route of administration. Read more about this study
- Who is it for?
- Ages 20 to 75 years
- Conditions the study is for
- Acute Myocardial Infarction
- What is being tested?
- Allogeneic umbilical cord mesenchymal stem cells
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteTaiwan
- Study dates
- 27 May 2019to 17 Dec 2021
- Phase
- Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Donor-Inclusion Criteria:
- Pregnant women who are aged ≥ 20, <50 years old on date of consent.
- Pregnant women who are willing to and has given her signed written informed consent.
- Pregnant women whose gestation age ≥ 34 weeks and have intact placenta.
- Pregnant women who have not had any complication of pregnancy.
- Pregnant women who are willing to provide a personal and family medical history (as much available) of herself and the biologic father (as much available), prior to or following collection of the umbilical cord.
Donor-Exclusion Criteria:
- Pregnant women who have clinically severe and/or life-threatening disease(s) such as uncontrolled diabetes mellitus (fasting sugar level > 250 mg/dL) and malignant tumor.
- Pregnant women who have been tested positive for the following tests within 7 days before or after umbilical cord acquirement:
- Human immunodeficiency virus-1 (HIV-I): anti-HIV-I and nucleic acid test (NAT)
- HIV-II
- Hepatitis B virus (HBV): Hepatitis B surface antigen (HBsAg), anti- Hepatitis B core (HBc) and NAT
- Hepatitis C virus (HCV): anti-HCV and NAT
- Cytomegalovirus (CMV) (Note: If the pre-screened CMV result shows positive 8 weeks prior to umbilical cord acquirement will also be excluded.)
- Treponema pallidum
- Chlamydia trachomatis
- Neisseria gonorrhea
- Human T cell leukemia virus-I/II (HTLV-I/II)
- West Nile virus (WNV) NAT
- Pregnant women are with increased risk for Creutzfeldt-Jakob disease (CJD) if you have received a non-synthetic dura mater transplant, human pituitary-derived growth hormone, or have one or more blood relatives diagnosed with CJD.
- Pregnant women had spent three months or more cumulatively in the United Kingdom from the beginning of 1980 through the end of 1996; or had received any transfusion of blood or blood components in the U.K. or France between 1980 and the present; or lived 5 years or more cumulatively in Europe.
- Pregnant women or her sexual partners were born or lived in certain countries in Africa (Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, Gabon, Niger, or Nigeria) after 1977 (risk factor for HIV group O).
- Pregnant women who have medical diagnosis of Zika virus (ZIKV) infection or residence in, or travel to, an area with active ZIKV transmission (according to the list from Centers for Disease Control and Prevention. Zika Virus: Areas with Zika.) at any point during that pregnancy.
- Pregnant women who have sex at any point during that pregnancy with a male who is known to medical diagnosis of ZIKV infection or residence in, or travel to, an area with active ZIKV transmission.
- Pregnant women who have received blood infusion or stayed for more than 3 months in WNV potential countries.
- Pregnant women who have unexplained post-donation febrile illness with headache or other symptoms suggestive of WNV infection (i.e., flu-like symptoms that include fever with headache, eye pain, body aches, generalized weakness, new skin rash or swollen lymph nodes or other evidence of WNV infection) within two weeks.
- Pregnant women who have medical history of tuberculosis.
- Pregnant women who have medical history of malignant tumor.
- Fetuses that have found with genetic disease in prenatal checkups.
- Pregnant women who would like to store cord blood or umbilical cord cells, other than this study usage.
- Pregnant women who are not suitable to donate as judged by the Investigator(s).
Subject-Inclusion Criteria:
- Male or female patients are aged ≥20, <76 years old on date of consent.
- Patients who presented typical ischemic chest pain within 12 h after symptoms onset and are diagnosed first acute STEMI according to the 2013 American College of Cardiology (ACC) Foundation/American Heart Association (AHA) guideline for the Management of STEMI.
- Patients who have undergone standard-of-care for STEMI; the immediate reperfusion management should include primary percutaneous coronary intervention (PCI), aspiration thrombectomy and adjunctive antithrombotic therapy within 12 hours after the onset of symptoms.
- Patients who undergo successful acute reperfusion therapy (residual stenosis visually <50% and TIMI flow ≥2) with placement of an intracoronary stent have a patent infarct-related artery suitable for cell infusion to the target area of abnormal wall motion following myocardial infarction.
- Patients who have left ventricular ejection fraction (LVEF) ≥ 30% and < 50% diagnosed by echocardiogram.
- Patients are willing to sign informed consent or assent by the next of kin.
- Patients who have stable vital signs for at least 48 hours, defined as normal respiration, afebrile, systolic pressure ≥ 90 mmHg and < 180 mmHg, heart rate > 50/min and <110/min.
- Adequate pulmonary function test defined as a force expiratory volume 1s (FEV1) > 50% predicted and peripheral artery oxygen saturation ≥95% at room air.
- All male patients and female patients with child-bearing potential (between puberty and 2 years after menopause) should use appropriate contraception method(s) shown below, for at least 4 weeks after UMSC01 treatment.
- Total abstinence (when this is in line with the preferred and usual lifestyle of the subject. Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not acceptable methods of contraception).
- Female sterilization (have had surgical bilateral oophorectomy with or without hysterectomy) or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment.
- Male sterilization (at least 6 months prior to screening). For female subjects on the study, the vasectomized male partner should be the sole partner for that subject
- Combination of any two of the following listed methods: (d.1+d.2 or d.1+d.3, or d.2+d.3): d.1 Use of oral, injected or implanted hormonal methods of contraception or other forms of hormonal contraception that have comparable efficacy (failure rate <1%), for example hormone vaginal ring or transdermal hormone contraception. d.2 Placement of an intrauterine device (IUD) or intrauterine system (IUS). d.3 Barrier methods of contraception: Condom or Occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository.
Subject-Exclusion Criteria:
- Patients with cardiogenic shock (defined as systolic blood pressure < 80 mmHg requiring vasopressors, intra-aortic balloon pump (IABP) or extracorporeal membrane oxygenation (ECMO).
- Patients who have severe aortic stenosis or regurgitation according to the recommendation of the 2014 ACC/AHA guideline for the Management of Patients with Valvular Heart Disease.
- Patients who have severe mitral stenosis or regurgitation according to the recommendation of 2014 ACC/AHA guideline for the Management of Patients with Valvular Heart Disease.
- Patients who need to undergo staged coronary intervention therapy or coronary artery bypass grafting (CABG) surgery.
- Patients who have immuno-compromised condition, or is with known clinically significantly autoimmune conditions or is receiving immunosuppressive treatments.
- Patients who are unable to undergo cardiac magnetic resonance imaging (CMRI) scans for any reason.
- Patients with inadequate hepatic and renal function after onset of STEMI: Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ≥ 4 x upper limit of normal (ULN); estimated glomerular filtration rate (eGFR) < 30 mL/min.
- For patients with diabetes mellitus: patients with uncontrolled diabetes mellitus (fasting sugar level > 250 mg/dL).
- Patients who have medical history of malignant tumor or other clinically significant cardiovascular diseases that will confound the evaluation of this study.
- Patients who participated other clinical trial within last 3 months.
- Female patient who is pregnant, lactating or with child-bearing potential but not practicing effective contraceptive method(s).
- Patients not suitable to participate the trial as judged by the Investigator(s).
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Phase I, Open Label Study to Evaluate the Safety and to Explore Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With ST-elevation Acute Myocardial Infarction
This study is a first-in-human assessment of safety of using UCMSC in patients with AMI via a combination of IC and IV stem cell administration. The novelty of the current UMSC01 treatment study is the dual route of administration. Since dual administration of UCMSC via IC and IV had never been conducted in humans, there may be unknown risks to humans not predicted from the preclinical studies. However, the risk to patients in this trial will be minimized by rigorous adherence to the eligibility criteria, use of appropriate dose and concentration of stem cells, standardized techniques of stem cell infusion, and intensive patient monitoring during and after stem cell infusion.
Read the detailed description
Cardiovascular disease is the leading cause of death in the developed world, with global deaths due to coronary artery disease estimated to increase from 7.3 million in 2008 to 25 million by 2020 WHO, 2011.
The leading symptom that initiates the diagnostic and therapeutic cascade in patients with suspected acute coronary syndromes (ACS) is chest pain.
Most patients will ultimately develop an ST elevation myocardial infarction (STEMI). The mainstay of treatment in these patients is immediate reperfusion by primary angioplasty or fibrinolytic therapy. Basically, STEMI comprises approximately 25% to 40% of myocardial infarction (MI) presentations. Acute STEMI is a major cause of morbidity, mortality, and disability.
This product is a new cell therapy product for treating AMI and produced by Ever Supreme Bio Technology Co., Ltd in Taiwan. For animal studies, UMSC01 has been demonstrated its effectiveness for AMI and stroke. The rats with coronary artery ligation receiving intravenous injection of UMSC01 showed significantly improved cardiac function.
- Conditions
- Acute Myocardial Infarction
- Being tested
- Allogeneic umbilical cord mesenchymal stem cells
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Allogeneic umbilical cord mesenchymal stem cellsBiological
UMSC01 cells will be one single IC infusion followed by one single IV infusion with 12 months of follow up after treatment.
| Study group | Role | What they receive |
|---|---|---|
| UMSC01 | Experimental | UMSC01 cells mixed with normal saline will be administered to patients after the onset of heart attack. Receives: Biological: Allogeneic umbilical cord mesenchymal stem cells |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Treatment emergent adverse event (TEAE) as presented by MedDRA coding system
TEAE incidences over the study period
Measured: from visit 2 to 12-month follow-up period
Incidence of Serious adverse event (SAE) as presented by MedDRA coding system
SAE incidences over the study period
Measured: from visit 2 to 12-month follow-up period
Incidence of Suspected and unexpected serious adverse reaction (SUSAR) as presented by MedDRA coding system
SUSAR incidences over the study period
Measured: from visit 2 to 12-month follow-up period
Secondary outcomes (15)
New York Heart Association (NYHA) Classification
The NYHA classification is used to grade the severity of functional limitations in a patient with heart failure with Class I=no limitations to Class IV=unable to carry on any physical activity without discomfort.
Measured: 12 weeks
Incidence of major adverse cardiovascular events (MACE)
MACE are defined as death, recurrent MI, stroke, target vessel revascularization.
Measured: from screen visit to 12-month follow-up period
Serum level of amino-terminal pro-brain natriuretic peptide (NT pro-BNP)
Change of serum level of NT pro-BNP from baseline visit to subsequent visits will be summarized by descriptive statistics.
Measured: 52 weeks
Pulmonary function test
The FEV1 will be tested by Spirometry and recorded.
Measured: 52 weeks
Echocardiogram
Change of regional left ventricular wall motion score in total score from baseline visit to subsequent visits will be displayed by descriptive statistics
Measured: 52 weeks
Echocardiogram
Change of LVESV in mL from baseline visit to subsequent visits will be displayed by descriptive statistics
Measured: 52 weeks
Echocardiogram
Change of LVEDV in mL from baseline visit to subsequent visits will be displayed by descriptive statistics
Measured: 52 weeks
Echocardiogram
Change of LV fractional shortening in % from baseline visit to subsequent visits will be displayed by descriptive statistics
Measured: 52 weeks
Echocardiogram
Change of LVEF in % from baseline visit to subsequent visits will be displayed by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of LVEF in % from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of regional left ventricular wall motion score in total score from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of LVESV in mL from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of LVEDV in mL from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of scar volume in % from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Change of myocardial fibrosis quantification in % from baseline visit to subsequent visits will be summarized by descriptive statistics
Measured: 52 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2019
- Study start27 May 2019
- Primary completion2 Aug 2021
- Study completion17 Dec 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Acute Myocardial InfarctionStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 10 participants (actual)
Sponsor and investigators
- Lead sponsor
- Ever Supreme Bio Technology Co., Ltd.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Woei Shyu, Study director, Ever Supreme Bio Technology Co., Ltd.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04056819
- Sponsor's protocol ID
- ES-CMSC01-A1101
- Status last verified
- Mar 2022
- First submitted
- 31 Jul 2019
- Last updated
- 19 Sep 2024
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Hsiao LC, Lin YN, Shyu WC, Ho M, Lu CR, Chang SS, Wang YC, Chen JY, Lu SY, Wu MY, Li KY, Lin YK, Tseng WI, Su MY, Hsu CT, Tsai CK, Chiu LT, Chen CL, Lin CL, Hu KC, Cho DY, Tsai CH, Chang KC, Jeng LB. First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarction. Front Cardiovasc Med. 2022 Aug 9;9:961920. doi: 10.3389/fcvm.2022.961920. eCollection 2022.
PubMed 36017096
Study at a glance
From the registry record, last updated by the sponsor on 19 Sep 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase I, Open Label Study to Evaluate the Safety and to Explore Efficacy of Allogeneic Umbilical Cord Mesenchymal Stem Cells in Patients With ST-elevation Acute Myocardial Infarction
- ClinicalTrials.gov ID
- NCT04056819
- Acronym / sponsor ID
- ES-CMSC01-A1101
- Conditions
- Acute Myocardial Infarction
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 10 participants (actual)
- Lead sponsor
- Ever Supreme Bio Technology Co., Ltd.Industry (pharma, biotech, devices)
- Study start
- 27 May 2019 (actual)
- Primary completion
- 2 Aug 2021 (actual)
- Study completion
- 17 Dec 2021 (actual)
- First posted
- 14 Aug 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is a first-in-human assessment of safety of using UCMSC in patients with AMI via a combination of IC and IV stem cell administration. The novelty of the current UMSC01 treatment study is the dual route of administration. Since dual administration of UCMSC via IC and IV had never been conducted in humans, there may be unknown risks to humans not predicted from the preclinical studies. However, the risk to patients in this trial will be minimized by rigorous adherence to the eligibility criteria, use of appropriate dose and concentration of stem cells, standardized techniques of stem cell infusion, and intensive patient monitoring during and after stem cell infusion.
Detailed description
Cardiovascular disease is the leading cause of death in the developed world, with global deaths due to coronary artery disease estimated to increase from 7.3 million in 2008 to 25 million by 2020 WHO, 2011.
The leading symptom that initiates the diagnostic and therapeutic cascade in patients with suspected acute coronary syndromes (ACS) is chest pain.
Most patients will ultimately develop an ST elevation myocardial infarction (STEMI). The mainstay of treatment in these patients is immediate reperfusion by primary angioplasty or fibrinolytic therapy. Basically, STEMI comprises approximately 25% to 40% of myocardial infarction (MI) presentations. Acute STEMI is a major cause of morbidity, mortality, and disability.
This product is a new cell therapy product for treating AMI and produced by Ever Supreme Bio Technology Co., Ltd in Taiwan. For animal studies, UMSC01 has been demonstrated its effectiveness for AMI and stroke. The rats with coronary artery ligation receiving intravenous injection of UMSC01 showed significantly improved cardiac function.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| UMSC01 | Experimental | Biological: Allogeneic umbilical cord mesenchymal stem cellsUMSC01 cells mixed with normal saline will be administered to patients after the onset of heart attack. |
Who may qualify
- Ages
- 20 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Allogeneic umbilical cord mesenchymal stem cellsUMSC01 cells will be one single IC infusion followed by one single IV infusion with 12 months of follow up after treatment. | Biological | UMSC01 |
Primary outcome
Incidence of Treatment emergent adverse event (TEAE) as presented by MedDRA coding system
Time frame: from visit 2 to 12-month follow-up period
TEAE incidences over the study period
Incidence of Serious adverse event (SAE) as presented by MedDRA coding system
Time frame: from visit 2 to 12-month follow-up period
SAE incidences over the study period
Incidence of Suspected and unexpected serious adverse reaction (SUSAR) as presented by MedDRA coding system
Time frame: from visit 2 to 12-month follow-up period
SUSAR incidences over the study period
15 secondary outcomes
New York Heart Association (NYHA) Classification
Time frame: 12 weeks
Incidence of major adverse cardiovascular events (MACE)
Time frame: from screen visit to 12-month follow-up period
Serum level of amino-terminal pro-brain natriuretic peptide (NT pro-BNP)
Time frame: 52 weeks
Pulmonary function test
Time frame: 52 weeks
Echocardiogram
Time frame: 52 weeks
Echocardiogram
Time frame: 52 weeks
Echocardiogram
Time frame: 52 weeks
Echocardiogram
Time frame: 52 weeks
Echocardiogram
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Cardiac MRI (cMRI) for baseline and efficacy evaluation
Time frame: 52 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Sep 2024.
- Results publication: PubMed 36017096Hsiao LC, Lin YN, Shyu WC, Ho M, Lu CR, Chang SS, Wang YC, Chen JY, Lu SY, Wu MY, Li KY, Lin YK, Tseng WI, Su MY, Hsu CT, Tsai CK, Chiu LT, Chen CL, Lin CL, Hu KC, Cho DY, Tsai CH, Chang KC, Jeng LB. First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarction. Front Cardiovasc Med. 2022 Aug 9;9:961920. doi: 10.3389/fcvm.2022.961920. eCollection 2022.
- First-in-human pilot trial of combined intracoronary and intravenous mesenchymal stem cell therapy in acute myocardial infarctionLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Woei Shyu study director
Ever Supreme Bio Technology Co., Ltd.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Allogeneic umbilical cord mesenchymal stem cells in people with Acute Myocardial Infarction, run by Ever Supreme Bio Technology Co., Ltd. at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Treatment emergent adverse event (TEAE) as presented by MedDRA coding system (time frame: from visit 2 to 12-month follow-up period). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04056819, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Sep 2024.