The primary objective of the study is to investigate neuroregenerative efficacy (proof of concept) of intrathecal treatment with autologous MSCs as measured by neurophysiological parameters in patients with progressive MS. Secondary objectives are to assess neuroregenerative efficacy as measured by other neurophysiological parameters as well as clinical, opthalmological and MRI modalities, and to assess safety of the treatment procedure.
Prospective, interventional, randomized, placebo-controlled, cross-over study. Patients are randomized to either treatment arm A or B. Patients in both treatment arms receive intrathecal autologous MSCs, arm A at baseline and arm B at six months. All patients undergo bone marrow (BM) aspiration prior to baseline. Patients in treatment arm A receive intrathecal autologous MSCs whereas patients in treatment arm B receive placebo. The treatment is blinded for the patients. The BM aspirate from patients in treatment arm B is processed, cryopreserved and stored in a biobank. At six months, all patients undergo a second BM aspiration. Patients in treatment arm A now receive placebo. The BM aspirate from patients in treatment arm A is processed, cryopreserved and stored in a biobank. Patients in treatment arm B receive intrathecal autologous MSCs. The treatment is blinded for the patients. Primary outcome is assessed at six months and secondary outcomes are assessed at six, twelve and eighteen months post baseline. Investigator assessing outcomes are blinded to patient treatment allocation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
18
Akershus university hospital
Lørenskog, Akershus, Norway
University hospital of North Norway
Tromsø, Troms Og Finnmark, Norway
St.Olav university hospital
Trondheim, Trøndelag, Norway
Haukeland University Hospital
Bergen, Vestland, Norway
Neurophysiological parameters - Combined evoked potentials
Somatosensoric evoked potentials (SEP) + visual evoked potentials (VEP) + motor evoked potentials (MEP), latency (ms) and amplitude (mV)
Time frame: 6 months
Neurophysiological parameters - Somatosensoric evoked potantials
SEP, latency (ms) and amplitude (mV)
Time frame: 6 and 12 months
Neurophysiological parameters - Motor evoked potentials
MEP, latency (ms) and amplitude (mV)
Time frame: 6 and 12 months
Neurophysiological parameters - Visual evoked potentials
VEP, latency (ms) and amplitude (mV)
Time frame: 6 and 12 months
MRI-Lesion volumes
T1- and T2-weighted hyperintense lesion volume
Time frame: 6 and 12 months
MR- Brain volumes
Brain volumes
Time frame: 6 and 12 months
Expanded disability status scale
EDSS
Time frame: 6, 12 and 18 months
Patient reported outcomes (PROs)
Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), European Quality of Life 5 dimensions (EQ-5D-5L), Multiple Sclerosis Impact Scale (MSIS) and Fatigue severity scale (FSS)
Time frame: 6, 12 and 18 months
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Nine-Hole-Peg Test (9-HPT)
Nine-Hole-Peg Test (9-HPT)
Time frame: 6, 12 and 18 months
Timed 25 Foot Walk (T25FW)
Timed 25 Foot Walk (T25FW)
Time frame: 6, 12 and 18 months
Visual function
Visual acuity, visual field, color vision and contrast sensitivity
Time frame: 6, 12 and 18 months
Optical coherence tomography (OCT)
Retinal thickness
Time frame: 6, 12 and 18 months
Rate and nature of adverse- and serious adverse events
Adverse events
Time frame: 6, 12 and 18 months