An exploratory, open label, multiple dose, multicentre phase I/II trial evaluating safety and efficacy of postnatal or prenatal and postnatal administration of allogeneic expanded fetal mesenchymal stem cells for the treatment of severe Osteogenesis Imperfecta compared with a combination of historical and untreated prospective controls.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Four doses of expanded human 1st trimester fetal liver-derived mesenchymal stem cells.
Karolinska University Hospital
Stockholm, Stockholm County, Sweden
Safety and tolerability measured as seriousness, severity and frequency of treatment related adverse events.
The primary endpoint is safety and tolerability measured as seriousness, severity and frequency of treatment related adverse events (AEs), with specific focus on the following: 1. Vital signs in conjunction with the MSC administration 2. Transfusion reactions (administration toxicity, allergy, embolism) 3. Immune reaction with or without symptoms of inflammation, potentially resulting in rejection of the cells or development of donor-specific antibodies: * Allergy or Hypersensitivity responses to antibiotics or antimycotics * Development of Fetal Bovine Serum-specific antibodies * Hypersensitivity responses to Human Serum Albumin * Hypersensitivity to impurities in the IMP 4. Prenatal complications (miscarriage/intrauterine fetal death, premature birth, infection in utero or persistent \[\>1 min\] fetal bradycardia) in the prenatal group 5. Adverse effects of feto-maternal transmission of donor cells in the prenatal group 6. Tumourigenicity 7. Mortality/morbidity
Time frame: From baseline to the long-time follow-up (10 years after the first dose).
Number of fractures.
Number of fractures.
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and therafter assessed annually to the end of the long-time follow-up (10 years after the first dose).
Time (days) to first fracture after each stem cell administration.
Time (days) to first fracture after each stem cell administration.
Time frame: From each dose of stem cells to the time point of the first fracture. Assessed up to 10 years after the first stem cell dose.
Numbers of fractures at birth.
Numbers of fractures at birth.
Time frame: Evaluated at birth.
Change in bone-marrow density (g/cm2).
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Change in bone-marrow density (g/cm2).
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and thereafter assessed annually to the end of the long-time follow-up (10 years after the first dose).
Growth (cm).
Growth (cm) as assessed by clinician.
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and thereafter assessed annually to the end of the long-time follow-up (10 years after the first dose).
Growth (kg).
Growth (kg) as assessed by clinician.
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and thereafter assessed annually to the end of the long-time follow-up (10 years after the first dose).
Change in clinical status of OI.
Change in clinical status of OI based on parameters defined under efficacy assessments described in protocol, as assessed by OI clinician.
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and thereafter assessed annually to the end of the long-time follow-up (10 years after the first dose).
Assessment of biochemical bone turnover by analysis of the markers P-Calcium, P-Phosphate, P-Albumin, S-ALP, fP-PTH, S-25-OH Vitamin D, Bone specific S-ALP, S-CTx, S-Osteocalcin and U-DPD/Krea and U-NTx/Krea in blood and urine samples.
Assessment of biochemical bone turnover.
Time frame: From baseline to the primary follow-up (6 and 12 months after the last dose) and thereafter assessed annually to the end of the long-time follow-up (10 years after the first dose).