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Mitochondrial MyopathiesPhase 2NCT05962333

Effect and Safety MABs Administration m.3243A>G Mutation Carriers

A Phase 2 study testing Intra-arterial delivery of autologous MABs in people with Mitochondrial Myopathies, run by Maastricht University at 1 site in Netherlands.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The first primary objective is to assess the effect of three intra-arterial administrations of autologous mesoangioblasts (MABs) with respect to improving muscle strength and reduce fatigue of the treated biceps brachii (BB) compared to the untreated BB. Read more about this study

Who is it for?
Ages 18 to 64 years
Conditions the study is for
Mitochondrial Myopathies
What is being tested?
Intra-arterial delivery of autologous MABs
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteNetherlands
Study dates
1 Aug 2023to 1 Feb 2025
Phase
Phase 2
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 18 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Written informed consent
  • Age: 18-64
  • Sex: male/female
  • Patients with the m.3243A>G mutation load of 50%-90% determined in skeletal muscle or derived from age-corrected calculation of blood m.3243A>G mutation load

Who cannot join

  • A potential subject who meets any of the following criteria will be excluded from participation in this study:
  • Use of dabigatran, apixaban, edoxaban or rivaroxaban (DOACs) as anti-coagulants
  • Have a weekly alcohol intake of ≥ 35 units (men) or ≥ 24 units (women)
  • Current history of drug abuse
  • Deficient immune system or autoimmune disease
  • Significant concurrent illness
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  • Ongoing participation in other clinical trials with intervention
  • Pregnant or lactating women
  • Psychiatric or other disorders likely to impact on informed consent
  • Patients unable and/or unwilling to comply with treatment and study instructions
  • A history of strokes with signs of extra-pyramidal or pyramidal syndrome
  • Allergy for contrast fluid
  • Peripheral signs of ischemia or vasculopathy
  • Claustrophobia
  • Metal implants
  • Any other factor that in the opinion of the investigator excludes the patient from the study

Trial locations and contacts

1 site in 1 country.

Netherlands1 site, 1 recruiting
  • Maastricht University Medical Center

    Maastricht, 6229ER

    Florence van Tienen, PhD, 0031433882918

    Recruiting

Other trials in Netherlands

About this study

Official title: Assess Effect and Safety of Intra-arterial Autologous Mesoangioblast Administration to the Upper Arm of m.3243A>G Mutation Carriers

The first primary objective is to assess the effect of three intra-arterial administrations of autologous mesoangioblasts (MABs) with respect to improving muscle strength and reduce fatigue of the treated biceps brachii (BB) compared to the untreated BB.

The second primary objective is safety of three intra-arterial administrations of autologous MABs, which the investigators will assess by monitoring (serious) adverse events ((S)AEs), blood flow in left arm pre- and post-intervention, and neurological vital signs during 8h post-intervention observation in the hospital.

Read more

Secondary objectives are to assess changes in muscle mass of the treated and untreated BB muscle, and microscopic changes and m.3243A>G mutation load at tissue level in treated biceps brachii (BB) muscle at baseline and after treatment.

Up to 20 adult m.3243A>G patients will undergo a ~30mg m. biceps brachii muscle biopsy at visit 1. The first six eligible patients will enroll the clinical study based on their m.3243A>G mutation load in skeletal muscle (50-90%) and mesoangioblasts (<10%), and on a decreased BB muscle strength and increased fatigue.

These 6 selected patients will visit the Maastricht University Medical Center for 8 additional times. From each patient, during visit 2 till 9:

  • BB muscle biopsies of the left arm will be collected (1x ~130 mg at visit 2 and 1x ~30mg at visit 9)
  • MRI of the BB muscles in both arms will be performed (visit 2 and 9).
  • Autologous MABs will be injected into the left arm via axillary artery delivery. Angiography will be performed before and after infusion to assess vascular obstructions, and the participant will be monitored in the hospital for 8 hours (visit 4,6,8).
  • Tc99m macroaggregated albumin (MAA) is infused to quantify blood flow to the BB muscle (visit 4).
  • A bout of maximal eccentric exercise of BB muscles on both sides will be executed at visit 3, 5 and 7.
  • BB muscle strength will be assessed using a Biodex dynamometer (visit 3-9)
  • venous blood samples will be taken for assessing muscle damage and inflammation markers (visit 3-9), kidney functioning, coagulation and viral screening (visit 1 and 2).
Being tested
Intra-arterial delivery of autologous MABs
Keywords
m.3243A>G, mesoangioblasts
Medical subject headings
Mitochondrial Myopathies

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intra-arterial delivery of autologous MABsBiological

    three times intra-arterial administration of autologous mesoangioblasts in biceps brachii of the left arm at 4-6 week interval

Study groups in NCT05962333
Study groupRoleWhat they receive
Intra-arterial delivery of autologous MABsExperimentalAutologous MABs will be injected three times in left arm to treat biceps brachii muscle
Receives: Biological: Intra-arterial delivery of autologous MABs

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Assess blood flow in left arm following i.a. arterial delivery of autologous MABs

    Assess blood flow in left arm using digital subtraction angiography (DSA) before and directly after MABs administration in week 1, 5 and 10.

    Measured: before and directly after each administration in week 1,5 and 10

  2. Assess (serious) adverse events following 3 i.a. deliveries of autologous MABs

    Assessment of (serious) adverse events

    Measured: 15 weeks

  3. Assess temperature following 3 i.a. deliveries of autologous MABs

    Temperature will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1,5 and 10.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  4. Assess oxygen saturation following 3 i.a. deliveries of autologous MABs

    Oxygen saturation will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1,5 and 10.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  5. Muscle strength arm following 3 i.a. deliveries of autologous MABs

    Using Medical Research Council (MRC) scale for muscle strength, muscle strength of left arm will be assessed 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10. MRC scale ranges from 0 (no visible contraction) to 5 (normal)).

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  6. Assess breathing frequency following 3 i.a. deliveries of autologous MABs

    Breathing frequency will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  7. Assess vital signs following 3 i.a. deliveries of autologous MABs

    Heart rate will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  8. Assess systolic and diastolic blood pressure following 3 i.a. deliveries of autologous MABs

    Systolic and Diastolic blood pressure will be checked 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  9. Assess Glasgow Coma scale (GCS) score following 3 i.a. deliveries of autologous MABs

    Glasgow Coma Scale (GCS) score will be determined 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10. GCS score ranges from 3 to 15, 3 being the worst and 15 being the best score.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  10. Assess if pupil size is symmetrical in both eyes following 3 i.a. deliveries of autologous MABs

    Pupil size of both eyes will be assessed 0,1,2,3,4,6 and 8 hours after administration in week 1, 5 and 10. If pupil size is not equal, this can indicate disease or trauma.

    Measured: 0, 1,2,3,4,6 and 8 hours after each administration.

  11. Assess pupil reaction following 3 i.a. deliveries of autologous MABs

    To assess brain functioning, reaction of pupils to light will be determined 0,1,2,3,4,6 and 8 hours after administration. Upon light, both pupils should become smaller in week 1, 5 and 10. No reaction or only reaction in one eye can indicate nerve damage.

    Measured: 0,1,2,3,4,6 and 8 hours after each administration.

  12. Assess changes in muscle strength of biceps brachii muscle in both arms at baseline and 4-6 weeks after third i.a. delivery of autologous MABs in left arm, which is 12-16 weeks after baseline measurements.

    Determine maximum muscle force generating capacity (peak torque N/m) of the biceps brachii muscle in both arms using Biodex dynamometer measurements. Measurements will be performed in left (intervention) and right (no intervention) biceps brachii muscle using Biodex dynamometer measurements at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

  13. Assess changes in muscle fatigue of biceps brachii muscle in both arms at baseline and 4-6 weeks after third i.a. delivery of autologous MABs in left arm, which is 12-16 weeks after baseline measurements.

    Asses changes in muscle fatigue by measuring percentage decrease in maximum muscle force generating capacity (peak torque N/m) between first and sixth repetition. Measurements will be performed in left (intervention) and right (no intervention) biceps brachii muscle using Biodex dynamometer measurements at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

Secondary outcomes (4)
  1. Assess changes in muscle volume biceps brachii muscles of both arms following 3 i.a. deliveries of autologous MABs in left arm.

    MRI T3 analysis to assess changes in muscle volume in both arms at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

  2. Assess formation of new muscle fibers following 3 i.a. deliveries of autologous MABs

    Perform embryonic myosin heavy chain (MHC)+ immunostaining to assess percentage of new / regenerating muscle fibers in muscle biopsies collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

  3. Mitochondrial mutation load and functioning following 3 i.a. deliveries of autologous MABs

    Assess changes in m.3243A>G mutation load in new/regenerating muscle fibers compared to existing muscle fibers isolated via laser microdissection from muscle biopsies left arm collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

  4. Mitochondrial functioning following 3 i.a. deliveries of autologous MABs in left arm.

    Assess changes in mitochondrial functioning by performing Cytochrome C Oxidase / Succinate Dehydrogenase (COX/SDH) staining in muscle biopsies from left arm collected at baseline and 5 weeks after the third autologous MABs administration, which is 15 weeks after baseline measurements.

    Measured: baseline and 15 weeks after 1st administration

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jul 2023
  2. Study start1 Aug 2023
  3. Primary completion1 Aug 2024 (estimated)
  4. Study completion1 Feb 2025 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Intra-subjected controlled clinical study. Treatment is performed in left arm of the subjects and right arm (no intervention), measurements are performed before the first and after the last administration.
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05962333
Sponsor's protocol ID
NL82815.000.22
Status last verified
Apr 2024
First submitted
23 May 2023
Last updated
15 Apr 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • van Tienen F, Zelissen R, Timmer E, van Gisbergen M, Lindsey P, Quattrocelli M, Sampaolesi M, Mulder-den Hartog E, de Coo I, Smeets H. Healthy, mtDNA-mutation free mesoangioblasts from mtDNA patients qualify for autologous therapy. Stem Cell Res Ther. 2019 Dec 21;10(1):405. doi: 10.1186/s13287-019-1510-8.

    PubMed 31864395

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Intra-arterial delivery of autologous MABs in people with Mitochondrial Myopathies, run by Maastricht University at 1 site in Netherlands.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 16 exclusion criteria. 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: status not confirmed, as of the sponsor's last update on 15 Apr 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 Netherlands. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Florence van Tienen, PhD (00314331995, florence.vantienen@maastrichtuniversity.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Assess blood flow in left arm following i.a. arterial delivery of autologous MABs (time frame: before and directly after each administration in week 1,5 and 10). The study lists 13 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 NCT05962333, 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 15 Apr 2024; AzTrials last refreshed its copy on 1 Nov 2026.

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