This is a phase I/II, randomized, double-blind, placebo-controlled clinical trial that will evaluate the safety and potential efficacy of therapy with extracellular vesicles (EVs) obtained from mesenchymal stromal cells (MSCs), patients with moderate to severe acute respiratory distress syndrome due to COVID-19 or other etiology. Participants will be allocated to receive EVs obtained from MSCs or placebo (equal volume of Plasma-Lyte A). Blinding will cover the participants, the multidisciplinary intensive care team and the investigators.
The studied population will consist of 15 patients diagnosed with acute respiratory failure syndrome admitted to the intensive care unit of Hospital São Rafael. This research aims to assess the safety and potential effectiveness of intravenous therapy using extracellular vesicles derived from mesenchymal cells in patients with moderate to severe acute respiratory distress syndrome. The treatment group will receive intravenous administration of extracellular vesicles obtained from mesenchymal cells, while the control group will receive a placebo. EV group: will consist of 10 participants who will receive two infusions of 25 mL of the investigational product (Plasma-Lyte A solution containing EVs obtained from MSCs), intravenously, at intervals of 48 h. Placebo group: will consist of 5 participants who will receive an equal volume of Plasma-Lyte A, intravenously, following the same schedule as the IV group: two infusions with an interval of 48 hours.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
15
intravenous treatment with extracellular vesicles
intravenous treatment with placebo solution (without extracellular vesicles)
Hospital São Rafael
Salvador, Estado de Bahia, Brazil
Measure administration of extracellular vesicles (EVs) up to 28 days
Measure as reported adverse events up to 28 days after treatment or placebo administration to evaluate safety of treatment
Time frame: 28 days
All-cause mortality
at days 14 and 28 after randomization;
Time frame: Day 14 and day 28
Variation in the Ratio PaO2/FiO2
PaO2 (arterial partial pressure of oxygen)/FiO2 (fraction of inspired oxygen) on the day of randomization and at 24 hours, 48 hours and 7 days after the first infusion;
Time frame: Baseline, day 01, day 02 and day 07
Variation in the SOFA index
Variation in the SOFA index (Assessment of Sequential Organ Failure) at the time of randomization and during follow-up until discharge from the intensive care unit;
Time frame: day 01, day 02, day 07, day 09, day 14 and day 29
Exploratory laboratory analysis
variation in total and differential laboratory analysis.
Time frame: 30 days
Duration of the period of hospitalization
from hospital time in the intensive care unit (ICU)
Time frame: 30 days
Duration of the period of ICU ventilation
If applicable,will be measured the time of mechanical ventilation.
Time frame: 30 days
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