This study will evaluate the safety of AlloRx Stem Cells® in subjects with Pitt Hopkins syndrome ages 2-45 with a molecularly confirmed pathogenic mutation in TCF4 or 18q deletion including TCF4. Participants will receive mesenchymal stem cells infusions every 3 months for a year with completion of outcome measures to assess the efficacy of the product.
This is a phase 1/2, randomized placebo controlled double blinded standard dose study to evaluate the safety and tolerability of AlloRx® stem cells in pediatric patients with a confirmed diagnosis of a TCF4 mutation consistent with haploinsufficiency causing PTHS. Approximately 26 patients (male and female) ages ≥ 2 and≤ 45 years of age with a genetically confirmed diagnosis of Pitt-Hopkins syndrome caused by molecular findings consistent with a pathogenic mutation in the gene TCF4. Written informed consent will be obtained from the patient's parent or legal guardian/ authorized representative (LAR) prior to participation in the study. The study includes screening, baseline, treatment and safety follow up periods. The procedure for intravenous administration is performed under the supervision of clinician with experience caring for patients with PTHS. Each patient will remain inpatient for at least 24 hours after the initial dose of AlloRx, for frequent vital sign monitoring, electrocardiogram (ECG), blood and urine safety tests, and neurologic assessments. Investigators will work closely with the parent/legal guardian to ensure that any signs of discomfort/distress are immediately communicated to study staff. For the administration of the initial dose of study drug in each study cohort, patients will be dosed in a sequential fashion with no more than one patient receiving their first dose of study drug on the same day. An independent data DSMB will review all safety and laboratory data throughout the study on a periodic basis and ad hoc should an SAE occur. The DSMB will also review all available safety data when all patients have received 2 doses of AlloRx and have had at least two weeks of follow-up in order to determine if it is safe to dose the next patient.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
26
Umbilical cord-derived allogeneic mesenchymal stem cells
Placebo infusion without mesenchymal stem cells
Safety: Incidence of adverse events improvement) in one or more areas of ailments related to PTHS
Collection of all adverse events (AEs)
Time frame: Change from baseline to day 456 (end of study)
Safety: Incidence of serious adverse events
Collection of all serious adverse events
Time frame: Change from baseline to day 456 (end of study)
Change in motor function in individuals with PTHS
Ambulation measures by video and wearable device
Time frame: Change from baseline to day 456 (end of study)
Change in communication abilities in individuals with PTHS.
Observer-Reported Communication Ability Measure (ORCA)
Time frame: Change from baseline to day 456 (end of study)
Change in sleep habits
Sleep diary
Time frame: Change from baseline to day 456 (end of study)
Change in gastrointestinal health
Gastrointestinal Health Questionnaire
Time frame: Change from baseline to day 456 (end of study)
Change in breath holding spells
Diary of breath holding spells
Time frame: Change from baseline to day 456 (end of study)
Change in cognition
Bayley Scales of Infant Development (BSID-4)
Time frame: Change from baseline to day 456 (end of study)
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Change in adaptive function
Vineland Adaptive Behavioral Scale-3
Time frame: Change from baseline to day 456 (end of study)
Change in autistic features
Childhood Autism Rating Scale (CARS)
Time frame: Change from baseline to day 456 (end of study)
Change in parent assessment of quality of life
Pediatric Quality of Life Questionnaire
Time frame: Change from baseline to day 456 (end of study)
Change in global clinical status
PTHS-specific Clinical Global Impression Scale
Time frame: Change from baseline to day 456 (end of study)