The goal of this clinical trial is to explore the safety, tolerability, and efficacy in study intervention, MatriPlax, in subjects with Acute Respiratory Distress Syndrome (ARDS). MatriPlax contains placenta choriodecidual membrane-derived Mesenchymal Stem Cells (pcMSCs). Participants will receive two doses of MatriPlax on Day 1 and Day 4 and conduct efficacy and safety evaluations until 12 months after treatment or withdrawal from the study.
This open-label, dose-escalation Phase I study plans to evaluate the safety, tolerability, and efficacy of MatriPlax. This is a conventional 3+3 dose-escalation study in which subjects with moderate or severe ARDS will receive intravenous MatriPlax infusion. Participants will be assigned to one of three dose cohorts (low, middle and high doses of MatriPlax), depending on the time of their enrollment. Each participant will receive two doses of MatriPlax on Day 1 and Day 4. Each dose cohort will have three to six subjects enrolled sequentially with at least 1 week in between. All participants will be followed until 12 months after receiving MatriPlax or withdrawal from the study. A Data Safety and Monitoring Board (DSMB) meeting will be held when all participants of each cohort complete their 28-day of treatment and evaluation period. The DSMB will determine if the study is safe to proceed to the next dose level or it requires to recruit more subjects to the concurrent dose level for safety evaluation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
MatriPlax contains pcMSCs (placenta choriodecidual membrane-derived mesenchymal stem cells) and will be given intravenously on Day 1 and Day 4
Taipei Medical University Hospital
Taipei, Taiwan
The incidence of treatment-emergent adverse events (TEAEs) up to 28 days after receiving MatriPlax
TEAEs are adverse events (AE) that occur after the study intervention administration
Time frame: Day 1 to Day 29
The incidence of serious adverse events (SAEs) up to 28 days after receiving MatriPlax
SAE is an AE that results in any of the following outcomes: Death; Life-threatening; Requires inpatient hospitalization or prolongation of existing hospitalization; Results in persistent or significant disability/incapacity; Congenital anomaly/birth defect; Based upon appropriate medical judgment, the event may jeopardize the subject and may require medical or surgical intervention to prevent one of the outcomes listed above
Time frame: Day 1 to Day 29
The incidence of suspected unexpected serious adverse reactions (SUSAR) up to 28 days after receiving MatriPlax
SUSAR is an SAE that is considered related to study intervention and unexpected judged by sponsor and investigator
Time frame: Day 1 to Day 29
Changes in PaO2/FiO2 ratio from baseline
The PaO2/FiO2 ratio is the ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2), which is an indicator of the severity of ARDS.
Time frame: Baseline, Day 4, 6, 8, 15, 29
Changes in Lung injury score (LIS) from baseline
The LIS is a standard measure of ARDS, which is composed of four components. Each component has 5 scores (0, 1, 2, 3 and 4-point) and the score of LIS is the average of the four components. A higher LIS indicates more severe lung injury.
Time frame: Baseline, Day 8, 29
Overall survival
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Overall survival is defined as the time from treatment to death.
Time frame: Baseline, Day 29, Month 3, 6, 9, 12
All-cause mortality rate
All-cause mortality rate is defined as the rate of deaths from any cause in all participants.
Time frame: Baseline, Day 29, Month 3, 6, 9, 12
Cumulative ventilator-free hours (VFH)
Only subjects who wean from the ventilator and have at least 48 consecutive weaning hours
Time frame: Day 1 to 29
Time to the first weaning from ventilator
Only subjects who wean from the ventilator and have at least 48 consecutive weaning hours
Time frame: Up to 12 months
Number of subjects weaned from ventilator
Only subjects who wean from the ventilator and have at least 48 consecutive weaning hours
Time frame: Day 29
Intensive Care Unit (ICU) free hours
Only subjects who are stable for discharge from ICU and have at least 48 consecutive hours of discharge
Time frame: Day 1 to 29
Time to the first ICU discharge
Only subjects who are stable for discharge from ICU and have at least 48 consecutive hours of discharge
Time frame: Up to 12 months
Number of subjects discharged from ICU
Only subjects who are stable for discharge from ICU and have at least 48 consecutive hours of discharge
Time frame: Day 29
ICU/Respiratory Care Center (RCC) free hours
Only subjects who are stable for discharge from ICU/RCC and have at least 48 consecutive hours of discharge
Time frame: Day 1 to 29
Changes in Sequential Organ Failure Assessment (SOFA) score from baseline
The SOFA is a simple and objective score to evaluate the status of organ dysfunction of six organ systems (respiratory, coagulatory, liver, cardiovascular, renal, and neurologic). A subject is defined as free of organ failure when the SOFA score is zero. The total score of SOFA is 24.
Time frame: Baseline, Day 4, 6, 8, 15, 29
Cumulative vasopressor free days
The cumulative vasopressor free days are the sum of the days without taking vasopressor up to Day 29 or death.
Time frame: Day 1 to 29
Cumulative oxygen support free hours
The cumulative oxygen support free hours are the sum of hours without oxgen support up to Day 29 or death
Time frame: Day 1 to 29
The net change in c-reactive protein (CRP) from baseline
C-reactive protein is an inflammatory marker
Time frame: Baseline, Day 4, 6, 8, 15, and 29
The net change in D-dimer from baseline
D-dimer is an inflammatory marker
Time frame: Baseline, Day 4, 6, 8, 15, and 29
The net change in Lactate Dehydrogenase (LDH) from baseline
LDH is an inflammatory marker
Time frame: Baseline, Day 4, 6, 8, 15, and 29
The domain scores and total score of 12-item Short Form Survey (SF-12) Quality of Life (QoL) health survey questionnaire
The SF-12 QoL is a self-evaluated measurement of health status. It consists of eight domains and the score of each domain is transformed to a scale from 0 to 100. Zero indicates the worst health status, while 100 indicates the best health status.
Time frame: Month 3, 6, 9, 12
Number of subjects who experienced Dose Limiting Toxicity (DLT)
A DLT is defined as any SAE OR any equal or greater than Grade 3 (CTCAE v5.0) AE judged as MatriPlax-related during Day 1 to 29. The CTCAE (Common Terminology Criteria for Adverse Events) is a classification system used to grade AE.
Time frame: Day 1 to 29
Incidence of TEAEs (treatment-emergent AEs) and SAEs
The number of TEAEs (treatment-emergent AEs) and SAEs that occur in the study
Time frame: 12 months
Number of participants with abnormalities in vital signs
The vital signs include blood pressure, respiratory rate, oxygen saturation, pulse rate, and body temperature
Time frame: Baseline, Day 1, 4, 6, 8, 15, 29, Month 3, 6, 9, 12
Number of participants with abnormalities in physical examination
A physical examination includes general appearance, skin, eyes, ears, nose, throat, head and neck (including thyroid), heart, chest and lungs, abdomen, extremities, lymph nodes, musculoskeletal, neurological system, and other body systems if applicable.
Time frame: Baseline, Day 1, 4, 6, 8, 15, 29, Month 3, 6, 9, 12
Number of participants with abnormalities in laboratory examination parameters
The laboratory examination parameters include hematology (hemoglobin, hematocrit, red blood cell (RBC), platelet, white blood cell (WBC), neutrophils, lymphocytes, monocytes, eosinophils, basophils) and biochemistry (blood urea nitrogen (BUN), creatinine, albumin, total protein, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, C-reactive protein (CRP), prothrombin time (PT), D-dimer, Lactate Dehydrogenase (LDH))
Time frame: Baseline, Day 1, 4, 6, 8, 15, 29
Number of participants with abnormalities in ECG parameters
The ECG parameters include ventricular rate, PR interval, QRS interval, and QT interval. Each parameters will be evaluated by the investigator as "Normal", "Abnormal, non-clinical significant (NCS)" or "Abnormal, clinical significant (CS)".
Time frame: Baseline, Day 29