This is a phase2, prospective, open label study designed to investigate the safety and efficacy of several infusions of HepaStem. This study will include 5 pediatric Urea Cycle Disorder (UCD) patients under 12 years old. Its assessment includes all safety parameters and an efficacy assessment based on 13C tracer tests, ammonia, medication and diet changes. HepaStem will be administered in addition to the conventional UCD treatments.
Patient eligibility will be assessed during the Screening visit. The investigator should ensure that the chronic metabolic treatment (i.e. balance between low protein diet, supplements in amino acid mix, nitrogen scavenger and supplements in arginine and/or citrulline) of the patient is optimized for his/her metabolic condition. During the baseline period, 3 study visits will take place at 6 weeks interval for assessing the metabolic condition and the chronic metabolic treatment of the patient. A calculated dose based on patient's body weight will be administered via Permanent mesenteric Portal Access and Catheter for four times or a Transient Percutaneous Transhepatic Catheter for three times. The follow-up period will start approximately 12 weeks after the first HepaStem infusion day. This period will last approximately 9 months. Study visits will take place every 1.5month, FU visit 1 to FU visit 7. Primary Objective: 1. To demonstrate the functional efficacy of HepaStem at 6 months after initiation of infusion in terms of ureagenesis improvement based on a functional test (13C tracer method) 2. To evaluate the safety of Hepastem up to one year after initiation the Hepastem infusion Secondary Objective: 1\. To evaluate the efficacy of Hepastem in terms of functional, clinical, and biochemical parameters up to one year after initiation of the infusion.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
HepaStem will be infused intravenously into the portal vein, either (1) via a permanent mesenteric PAC inserted surgically in an affluent of the portal vein; or (2) through a transient percutaneous transhepatic catheter inserted in to the portal vein under radio guidance.
Samsung Medical Center
Seoul, South Korea
Change of ureagenesis
Change of de novo ureagenesis at 6 months after the first infusion: absolute 13C blood urea AUC-120 min quantified with the 13C Tracer method at FU visit 3 compared with baseline evaluations.
Time frame: at 6 months after the first infusion
Hemodynamics (measurement of portal vein pressures)
Safety evaluation in terms of portal-vein hemodynamics
Time frame: up to 12 months after the first infusion
Number of subjects with anti-HLA antibody
Safety evaluation in terms of de novo detection of donor-specific circulating anti-HLA antibodies and/or other immune-related markers
Time frame: up to 12 months after the first infusion
Number of subjects with SAEs and AEs
Safety evaluations in terms of SAEs and clinically significant AEs related to study procedures
Time frame: up to 12 months after the first infusion
Change of ureagenesis
Change of de novo ureagenesis at 3, 9 and 12 months after the first infusion: absolute 13C blood urea AUC-120 min quantified with the 13C Tracer method at FU visit 1, 5 and 7 compared with baseline evaluations.
Time frame: at 3, 9 and 12 months after the first infusion
Change of chronic protein intake
Chronic protein intake (total and natural protein, reported in mg/kg/day and reported as compared to WHO safe level for age) considering diet evaluations at study visits during baseline period and at scheduled study visits during the follow-up period.
Time frame: Up to 12 months after the first infusion
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Change of chronic nitrogen scavenger dose
Chronic nitrogen scavenger dose (mg/kg/day) considering reported doses at scheduled study visits during baseline period and at scheduled study visits during the follow-up period.
Time frame: Up to 12 months after the first infusion
Change of the level of blood ammonia
Blood ammonia considering values measured at scheduled study visits during screening and baseline periods ant at scheduled study visits during the follow-up period.
Time frame: Up to 12 months after the first infusion
Change of relevant blood amino acids values
Relevant blood amino acids considering values measured at scheduled study visits during the screening and baseline periods and at scheduled study visits during the follow-up period.
Time frame: Up to 12 months after the first infusion
Number of subjects with Metabolic decompensations
Metabolic decompensations (hyperammonemia episodes with evocative symptomatology such as drowsiness, gastrointestinal symptoms and treated at hospital), considering all collected events during screening and baseline periods, during active treatment period, during follow-up period.
Time frame: Up to 12 months after the first infusion
Change of chronic single amino acid intake
Chronic single animo acid intake considering reported doses at study visits during baseline period and at study visits during the follow-up period.
Time frame: Up to 12 months after the first infusion
Evaluation of cognitive skill
Change of patient's cognitive skill score between the baseline period (at Baseline visit 1) and the follow-up period (at Follow up visit 7) will be evaluated by the Bayley Scales of Infant Development. (7 classes, from extremely low to very superior)
Time frame: Up to 12 months after the first infusion
Evaluation of Behavior indicator
Behavior indicator will be evaluated by the Child Behavior Checklist (CBCL) at Baseline visit 1, during follow-up period at 4.5 months, 7.5 months and 12 months post-first fusion (at Follow up visit 2, 4, 7)
Time frame: Up to 12 months after the first infusion
Evaluation of health-related Quality of Life (QoL) indicator
Health-related QoL indicator will be evaluated by the Pediatric Quality of Life Inventory at Baseline visit 1, during follow-up period at 4.5 months, 7.5 months and 12 months post-first fusion (at Follow up visit 2, 4, 7)
Time frame: Up to 12 months after the first infusion