Clinical Trial: Umbilical Cord Mesenchymal Stem Cells for Patients With Primary Biliary Cirrhosis

Study Status: Active, not recruiting
Recruit Status: Unknown status
Study Type: Interventional

Official Title: Phase 1/2 Study of UC-MSC Treatment for Evaluation the Efficacy and Safety in Patients With Primary Biliary Cirrhosis

Brief Summary: Primary biliary cirrhosis (PBC) is a slowly progressive disease that causes substantial loss of intrahepatic bile ducts, ultimately resulting in cholestasis, advanced fibrosis, cirrhosis, liver failure and even hepatocellular carcinoma. Histologically, the disease is characterized by chronic portal inflammation with infiltration, destruction and loss of the epithelial cells in the small-sized and medium-sized bile ducts. Currently, Ursodeoxycholic acid (UDCA) in a dose of 13-15mg/kg/day is recommended as therapeutic drugs for PBC by AASLD and is approved for this indication by the U.S. Food and Drug Administration (FDA). Treatment with UDCA may delay disease progression and prolong survival free of liver transplantation. However, one out of three patients does not adequately respond to UDCA therapy and many need additional medical therapy or liver transplantation, or both. UC-MSC has been application for the treatment of several severe autoimmune diseases, such as immune thrombocytopenia, systemic lupus erythematosus, and therapy-resistant rheumatoid arthritis. In this study, the safety and efficacy of UC-MSC transplantation for PBC patients will be evaluated.

Detailed Summary:

Primary biliary cirrhosis (PBC) is a slowly progressive cholestatic disease associated with the development of cirrhosis and liver failure that may justify liver transplantation. Ursodeoxycholic acid (UDCA) is currently the only drug approved specifically for the treatment of PBC. However, one out of three patients does not adequately respond to UDCA therapy and many need additional medical therapy or liver transplantation, or both.

The potential for stem cells to differentiate into biliary epithelial cells was recently confirmed. In particular, bone marrow-derived mesenchymal stem cell (BM-MSC) transplantation has been applicated in the clinic for treat several human disease such as GVHD, cardiac injury and brain injury, and displayed good tolerance and efficiency. Recently, umbilical cord-derived MSCs (UC-MSC) has also been used to treat severe autoimmune diseases, such as therapy-resistant rheumatoid arthritis and multiple sclerosis.

The purpose of this study is to learn whether and how UC-MSC can improve the disease condition in patients with primary biliary cirrhosis. This study will also look at how well UC-MSC is tolerated and its safety in PBC patients

Participants in the study will be randomly assigned to one of two treatment arms:

Arm A: Participants will receive 12 weeks of UC-MSC treatment plus UDCA. Arm B: Participants will receive 12 weeks of placebo plus UDCA. UC-MSC will be prepared according to standard procedures and is collected in plastic bags containing anticoagulant. UC-MSCs are given via i.v. under sonography monitoring. After cell therapy, patients are followed up at week 4,8,12,24,36 and 48. The evaluation of some clinical parameters such as the level of serum alkaline phosphatase (ALP), alanine amin
Sponsor: Beijing 302 Hospital

Current Primary Outcome: Serum alkaline phosphatase (ALP) [ Time Frame: 0, 4, 8,12, 24, 36,48 weeks after treatment ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • Histological changes in liver biopsies [ Time Frame: baseline and 48 weeks ]
  • Serum Bilirubin [ Time Frame: At base line and at week 4,8,12,24,36 and 48 ]
  • Serum AST [ Time Frame: At base line and at week 4,8,12,24,36 and 48 ]
  • Mayo risk score [ Time Frame: At base line and at week 4,8,12,24,36 and 48 ]
  • Number of patients with Portal Hypertension after 12 weeks treatment [ Time Frame: At base line and at week 12,24,36 and 48 ]
  • MELD score [ Time Frame: At base line and at week 4,8,12,24,36 and 48 ]
  • Number of participants with improvement of clinical symptoms [ Time Frame: At base line and at week 4,8,12,24,36 and 48 ]
    clinical symptoms including fatigue (Fatigue Impact Score, FIS) and pruritus ( Visual Analog Scale ,VAS)


Original Secondary Outcome: Same as current

Information By: Beijing 302 Hospital

Dates:
Date Received: August 5, 2012
Date Started: October 2011
Date Completion: October 2013
Last Updated: May 30, 2013
Last Verified: May 2013