The purpose of this study is to evaluate the efficacy and safety of mesenchymal stem cells (MSCs) obtained from umbilical cords for the treatment of adults with systemic lupus erythematosus (SLE). The goal of this study is to determine if patients receiving an MSC infusion plus standard of care respond better than patients receiving placebo infusion plus standard of care.
A phase 2 multicenter (several medical research centers participating), placebo controlled, randomized (assigned by chance), double blind (neither the participant nor the investigator will know if active drug or placebo is assigned) trial to evaluate the safety and efficacy of mesenchymal stem cells (MSCs) for the treatment of systemic lupus erythematosus (SLE) in adults. The MSCs will be obtained from healthy donor umbilical cords and two doses of MSCs will be tested. The cells will be produced at the Medical University of South Carolina (MUSC) and will be shipped to other participating centers for patients with SLE. Participants will receive either active drug or placebo through a single IV infusion. All participants will receive standard of care and their safety will be monitored throughout the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
81
Participants will receive a single IV infusion of Mesenchymal Stem Cells (MSCs) 1 x 10\^6 cells/kg in Plasma-Lyte A solution. All participants will receive the infusion at the Baseline (Day 0) visit. All participants will continue on their standard-of-care therapy during the trial.
Participants will receive a single IV infusion of Mesenchymal Stem Cells MSCs 5 x 10\^6 cells/kg in Plasma-Lyte A solution.
Participants will receive a placebo infusion that does not contain any mesenchymal stem cells.The placebo infusion will consist of Plasma-Lyte A, which is the same vehicle used to deliver the MSCs in the experimental groups.
Cedars-Sinai Medical Center
Los Angeles, California, United States
University of California - San Diego
San Diego, California, United States
Emory University
Atlanta, Georgia, United States
Clinical response at Week 24 as defined by the SLE Responder Index (SRI):
Systemic Lupus Erythematosus Responder Index (SRI) is defined as a greater than or equal to (≥) 4 point reduction in the Systemic Lupus Erythematosus Disease Activity Index score (SLEDAI), no new British Isles Lupus Assessment Group (BILAG) A or no more than 1 new BILAG B domain score, and no deterioration from Baseline in the Physician's Global Assessment (PGA) by greater than or equal to (≥) 0.3 points. Additionally, to be a "responder", corticosteroid dose must be less than of equal to (≤)10 mg/day of prednisone or equivalent by the Week 20 visit and be maintained at less than or equal to 10 mg/day through Week 24.
Time frame: Week 24
Change in SLEDAI score between groups
Changes in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) between the experimental and placebo group.
Time frame: Baseline to Weeks 12, 24, and 52
Renal and non-renal organ system flares
Frequency of renal and non-renal organ system flares at or before Weeks 12, 24, and 52, defined by the BILAG criteria.
Time frame: At or before Weeks 12, 24, and 52
Changes in SLICC-DI
• Change in SLICC-DI from Baseline to Week 52 to assess for accumulation of new damage (SLE-related or treatment-related)
Time frame: Baseline to Week 52
Changes in HR-QOL
Changes in HR-QOL (measured by SF36 v2) from Baseline to Weeks 12, 24, and 52
Time frame: Baseline to Week 52
Changes in Fatigue
Changes in fatigue (measured by PROMIS Fatigue Short Form (SF)) from Baseline to Weeks 12, 24, and 52
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Northwestern University
Chicago, Illinois, United States
The Feinstein Institute for Medical Research
Manhasset, New York, United States
University of Rochester Medical Center
Rochester, New York, United States
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Oklahoma Medical Research Foundation
Oklahoma City, Oklahoma, United States
Medical University of South Carolina
Charleston, South Carolina, United States
Time frame: Baseline to Week 52
Changes in Pain
Changes in pain (measured by PROMIS Pain SF) from Baseline to Weeks 12, 24, and 52
Time frame: Baseline to Week 52
Changes in Depression
Changes in depression (measured by PROMIS Depression SF) from Baseline to Weeks 12, 24, and 52
Time frame: Baseline to Week 52
Changes in patient-reported lupus-specific disease status
Changes in patient-reported lupus-specific disease status (measured by the LupusPro and LIT) from Baseline to Weeks 12, 24, and 52
Time frame: Baseline to Week 52
Steroid-sparing effect
Steroid-sparing effect (measured by discontinuation of corticosteroids and time to discontinuation among those taking corticosteroids)
Time frame: Baseline to Week 52
Cumulative systemic steroid dose
Cumulative systemic steroid dose (PO, IV, IM) at Week 52
Time frame: Week 52
Changes in the presence of serum and urine biomarkers of SLE activity:
Changes in the presence of serum and urine biomarkers of SLE activity: SLE-related cytopenias, low serum complement levels, anti-dsDNA levels or urine protein measures from Baseline to Weeks 12, 24, and 52.
Time frame: Baseline to Week 52