This trial is a single-center, single-arm exploratory clinical study aimed at assessing the safety, tolerability, and preliminary efficacy of a single intra-articular injection of hiSCs for the treatment of rheumatoid arthritis.
This trial is a single-center, single-arm exploratory clinical study aimed at assessing the safety, tolerability, and preliminary efficacy of a single intra-articular injection of hiSCs for the treatment of rheumatoid arthritis. In this trial, participants who have given informed consent will be screened to determine their eligibility according to the inclusion and exclusion criteria. The study intervention consists of a single injection of hiSCs, and the primary endpoint will be assessed during the 24-week follow-up visit after the cell injection.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
15
hiSCs are derived from human induced pluripotent stem cells and exhibit immunomodulatory properties.
Shanghai ChangZheng hospital
Shanghai, China
RECRUITINGTEAEs and SAEs
The incidence of TEAEs and SAEs related to the study intervention
Time frame: Within 12 weeks after the injection of hiSCs
WOMAC
The change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (range: 0-240 cm; including pain, stiffness, and physical function subscales) for the target knee, as assessed by the subject, with higher scores indicating greater symptom severity and worse physical function
Time frame: At 12 weeks after the injection of hiSCs
GSUS
The change from baseline in Gray-scale ultrasound (GSUS) (range: 0-12; including suprapatellar, medial, lateral, and posterior planes) for the target knee, as assessed by musculoskeletal ultrasound, with higher scores indicating more severe synovitis
Time frame: At 12 weeks after the injection of hiSCs
PDUS
The change from baseline in Power Doppler Ultrasound Synovitis (PDUS) score (range: 0-15; including suprapatellar, infrapatellar, medial, lateral, and posterior compartments) for the target knee, as assessed by power Doppler ultrasound, with higher scores indicating more severe synovitis
Time frame: At 12 weeks after the injection of hiSCs
ACR20, ACR50, ACR70
The proportion of subjects who achieved ACR20, ACR50, and ACR70(American College of Rheumatology 20%/50%/70% improvement)
Time frame: At Weeks 2, 4, 8, 12, and 24
TJC
Change from baseline in 68-joint tender joint count (TJC; American College of Rheumatology \[ACR\] Core Set measure; range 0-68, higher scores indicate worse disease activity)
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Time frame: At Weeks 2, 4, 8, 12, and 24
SJC
Change from baseline in 66-joint swollen joint count (SJC; ACR Core Set measure; range 0-66, higher scores indicate worse disease activity)
Time frame: At Weeks 2, 4, 8, 12, and 24
HAQ-DI
Change from baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI; ACR Core Set measure; range 0-3, higher scores indicate worse functional status)
Time frame: At Weeks 2, 4, 8, 12, and 24
Patient-reported pain intensity (VAS)
Change from baseline in patient-reported pain intensity (Visual Analog Scale \[VAS\]; ACR Core Set measure; 0-100 mm, higher scores indicate severe pain)
Time frame: At Weeks 2, 4, 8, 12, and 24
Patient-reported global disease activity (VAS)
Change from baseline in patient-reported global disease activity (VAS; ACR Core Set measure; 0-100 mm, higher scores indicate worse status)
Time frame: At Weeks 2, 4, 8, 12, and 24
Physician-evaluated global disease activity (VAS)
Change from baseline in physician-evaluated global disease activity (VAS; ACR Core Set measure; 0-100 mm, higher scores indicate worse status)
Time frame: At Weeks 2, 4, 8, 12, and 24
Acute-phase reactant
Change from baseline in acute-phase reactant (C-reactive protein \[CRP; high-sensitivity assay; 0-10 mg/L\] or erythrocyte sedimentation rate \[ESR; 0-15 mm/h\]; ACR Core Set measure; higher values indicate worse inflammation)
Time frame: At Weeks 2, 4, 8, 12, and 24
DAS28 (CRP or ESR) score of <2.6 and <3.2
The proportion of subjects achieving a DAS28 (CRP or ESR) score of \<2.6 and \<3.2
Time frame: At Weeks 2, 4, 8, 12, and 24
DAS28 (CRP or ESR)
The change from baseline in Disease Activity Score 28 (DAS28) using C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), with higher scores indicating greater disease activity
Time frame: At Weeks 2, 4, 8, 12, and 24
SDAI score of ≤3.3
The proportion of subjects achieving Simplified Disease Activity Index (SDAI) remission (score ≤3.3; total score range: 0-86), with lower scores indicating better disease control
Time frame: At Weeks 2, 4, 8, 12, and 24
SDAI
The change from baseline in Simplified Disease Activity Index (SDAI)score(total score range: 0-86), with lower scores indicating better disease control
Time frame: At Weeks 2, 4, 8, 12, and 24
CDAI score of ≤2.8
The proportion of subjects achieving Clinical Disease Activity Index (CDAI) remission (score ≤ 2.8; total score range: 0-76), with lower scores indicating better disease control
Time frame: At Weeks 2, 4, 8, 12, and 24
CDAI
The change from baseline in Clinical Disease Activity Index (CDAI)score (total score range: 0-76), with lower scores indicating better disease control
Time frame: At Weeks 2, 4, 8, 12, and 24
VAS
The change from baseline in Visual Analog Scale (VAS) pain score (range: 0-100 mm) for the target knee, as assessed by the subject, with higher scores indicating greater symptom severity and worse physical function
Time frame: At Weeks 2, 4, 8, 12, and 24
WOMAC
The change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score (range: 0-240 cm; including pain, stiffness, and physical function subscales) for the target knee, as assessed by the subject, with higher scores indicating greater symptom severity and worse physical function
Time frame: At Weeks 2, 4, 8, and 24
KOOS
The change from baseline in Knee Injury and Osteoarthritis Outcome Score (KOOS) (range: 0-100; including Pain, Symptoms, Activities of Daily Living, Sport/Recreation, and Quality of Life subscales), as assessed by the subject, with higher scores indicating better function and fewer symptoms
Time frame: At Weeks 2, 4, 8, 12, and 24
WORMS
The change from baseline in Whole-Organ Magnetic Resonance Imaging Score (WORMS) (assessing :cartilage morphology \[0-6 per subregion\], bone marrow lesions \[0-3 per subregion\], meniscal pathology \[0-4 per meniscus\], subchondral cysts \[0-3 per subregion\], osteophytes \[0-7 per subregion\], bone attrition \[0-3 per subregion\], synovitis/effusion \[0-3\], ligament abnormalities \[0-1 per ligament\], periarticular cysts \[0-3\], and loose bodies \[0-3\]), as assessed by MRI, with higher scores indicating more severe structural damage
Time frame: At 12 weeks after the injection of hiSCs
MOAKS
The change from baseline in the MRI Osteoarthritis Knee Score (MOAKS) (assessing: cartilage damage \[0-3 per subregion\], bone marrow lesions \[0-3 per subregion\], osteophytes \[0-3 per subregion\], meniscal pathology \[0-3 per region, location;0-1 per region, morphology\], synovitis/effusion \[0-3\], ligament/tendon abnormalities \[0-1 per ligament/tendon\], and periarticular features \[0-1\]), as assessed by MRI, with higher scores indicating more severe structural damage
Time frame: At 12 weeks after the injection of hiSCs
BLOKS
The change from baseline in the Boston-Leeds Osteoarthritis Knee Score (BLOKS) (assessing: cartilage morphology \[0-3 per region\], bone marrow lesions \[0-3 per region\], osteophytes \[0-3 per region\], meniscal pathology \[0-3 per region, location;0-1 per region, morphology\], synovitis/effusion \[0-3\], ligament abnormalities \[0-1 per ligament\], and periarticular features \[0-1\]), as assessed by MRI, with higher scores indicating more severe structural damage
Time frame: At 12 weeks after the injection of hiSCs
Synovial thickness
The change from baseline in synovial thickness (mm), as assessed by MRI, with increased values indicating greater synovial inflammation
Time frame: At 12 weeks after the injection of hiSCs
Synovial blood flow
The change from baseline in synovial blood flow (measured in mL/min/100g tissue), as assessed by MRI, with increased values indicating greater vascularity
Time frame: At 12 weeks after the injection of hiSCs
Joint effusion volume
The change from baseline in joint effusion volume(mL), as assessed by MRI, with increased values indicating greater effusion severity
Time frame: At 12 weeks after the injection of hiSCs
GSUS
The change from baseline in Gray-scale ultrasound (GSUS) (range: 0-12; including suprapatellar, medial, lateral, and posterior planes) for the target knee, as assessed by musculoskeletal ultrasound, with higher scores indicating more severe synovitis
Time frame: At Weeks 2, 4, 8, and 24
PDUS
The change from baseline in Power Doppler Ultrasound Synovitis (PDUS) score (range: 0-15; including suprapatellar, infrapatellar, medial, lateral, and posterior compartments) for the target knee, as assessed by power Doppler ultrasound, with higher scores indicating more severe synovitis
Time frame: At Weeks 2, 4, 8, and 24
ROM
The change from baseline in the range of motion (ROM) for the target knee, as assessed by a goniometer, with greater improvement indicating better physical function
Time frame: At Weeks 2, 4, 8, 12, and 24