Mesenchymal Stem Cell Therapy in Multiple System Atrophy

NCT02315027 | Active Not Recruiting Phase 1 DMC FDA Drug

• 3 other identifiers: 12-005950R01FD004789R01NS092625
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine whether mesenchymal stem cells (MSCs) can be safely delivered to the cerebrospinal fluid (CSF) of patients with multiple system atrophy (MSA). Funding Source - FDA OOPD.

Conditions

MSA

Outcome Measures

Primary Outcomes (1)

• Adverse event frequency (by severity, type, attribution, and intervention dose).

  14 months

Secondary Outcomes (7)

• Rate of change of Unified Multiple System Atrophy Rating Scale (UMSARS) I score from baseline to 12 months (or last available date), compared with placebo limb of Rifampicin trial (historical control cohort).

  12 months

• Rate of change from baseline to 12 months (or last available date) in UMSARS II score.

  12 months

• Rate of change from baseline to 12 months (or last available date) in UMSARS total score.

  12 months

• Rate of change in COMPASS-select score from baseline to 12 months.

  12 months

• Change in CASS score and thermoregulatory sweat test (TST) % from baseline to 12 months.

  12 months

Study Arms (5)

1 dose of 1 × 10(7) MSCs

EXPERIMENTAL

Group 1: Participants will receive a single intrathecal dose of 1 × 10(7) mesenchymal stem cells (MSCs)

Biological: Autologous Mesenchymal Stem Cells

2 doses of 5 × 10(7) MSCs

EXPERIMENTAL

Group 2: Participants will receive one intrathecal dose of 5 × 10(7) mesenchymal stem cells (MSCs), followed by a second intrathecal dose of 5 × 10(7) MSCs approximately one month later

Biological: Autologous Mesenchymal Stem Cells

2 doses of 1 × 10(8) MSCs

EXPERIMENTAL

Group 3: Participants will receive one intrathecal dose of 1 × 10(8) mesenchymal stem cells (MSCs), followed by a second intrathecal dose of 1 × 10(8) MSCs approximately one month later

Biological: Autologous Mesenchymal Stem Cells

10 doses of 5 x 10(7) (±20%) MSCs

EXPERIMENTAL

Group 4: Participants will receive up to 10 doses of 5 x 10(7) (±20%) mesenchymal stem cells (MSCs) approximately 6 months apart.

Biological: Autologous Mesenchymal Stem Cells

10 doses of 2.5 x 10(7) (±20%) MSCs

EXPERIMENTAL

Group 5: Participants will receive up to 10 doses of 2.5 x 10(7) (±20%) mesenchymal stem cells (MSCs) approximately 6 months apart.

Biological: Autologous Mesenchymal Stem Cells

Interventions

Autologous Mesenchymal Stem Cells BIOLOGICAL

single dose of 1 × 10(7) cells intrathecally

1 dose of 1 × 10(7) MSCs

Eligibility Criteria

• Age: 30 Years - 80 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants aged 30-80 years old with a diagnosis of MSA based on clinical criteria and standardized autonomic testing. This approach allows for identification of patients with MSA with very high specificity and is yet sensitive enough to allow for enrollment of patients at a disease stage at which an intervention on the natural disease course has a meaningful impact on patient outcome. Patients therefore have to fulfill Gilman Criteria (2000) for probable MSA of the parkinsonian subtype (MSA-P) or cerebellar subtype (MSA-C) and have findings on autonomic function testing suggestive of MSA (CASS ≥5 or a TST% ≥25%).
• Participants who are less than 4 years from the time of documented MSA diagnosis.
• Participants with an anticipated survival of at least 3 years in the opinion of the investigator.
• Participants who are willing and able to give informed consent.
• "Normal" cognition as assessed by Mini-Mental State Examination (MMSE). We will require a value \>24.

You may not qualify if:

• Any of the following conditions will exclude the participant from entering the study:
• Women of childbearing potential who do not practice an acceptable method of birth control. Acceptable methods of birth control in this study are: surgical sterilization, intrauterine devices, partner's vasectomy, a double-protection method (condom or diaphragm with spermicide), hormonal contraceptive drug (i.e., oral contraceptive, contraceptive patch, long-acting injectable contraceptive) with a required second mode of contraception.
• Participants with a clinically significant or unstable medical or surgical condition that, in the opinion of the investigator, might preclude safe completion of the study or might affect the results of the study. These include conditions causing significant central nervous system (CNS) or autonomic dysfunction, including congestive heart failure, recent (\<6 months) myocardial infarct, cardiopulmonary disease, severe, uncontrolled hypertension, thrombocytopenia (\<50 x 10(9)/L), severe anemia (\<8g/dl), immunocompromised state, liver or kidney disease (creatinine \>2.3mg/dl), uncontrolled diabetes mellitus (HbA1c \>10g%), alcoholism, amyloidosis, uncontrolled hypothyroidism, sympathectomy, unstable peripheral neuropathies, concurrent infections, orthopedic problems that compromise mobility and activity of daily living, cerebrovascular accidents, neurotoxin or neuroactive drug exposure, parkinsonism due to drugs (including neuroleptics, alpha-methyldopa, reserpine, metoclopramide).
• Participants with malignant neoplasms.
• Participants who have taken any investigational products within 60 days prior to baseline.
• Medications that could affect autonomic function. If patients are taking those medications, those will be suspended prior to autonomic testing. Therapy with midodrine, anticholinergic, alpha and beta adrenergic antagonists or other medications that affect autonomic function will be withdrawn 48 hours prior to autonomic evaluations. Fludrocortisone doses up to 0.2 mg per day will be permitted.
• Diseases with features of Parkinsons Disease; e.g., diffuse Lewy body disease, progressive supranuclear palsy, essential tremor, hereditary olivopontocerebellar atrophy, or postencephalitic parkinsonism.
• Dementia (DSM-IV criteria - American Psychiatric Association 1994). The score on the Mini-Mental State Examination must be \>24.
• History of electroconvulsive therapy.
• History of brain surgery for Parkinsons disease.
• Patients with contraindication for MRI scanning, including those with MRI-incompatible pacemakers
• Patients with active systemic infection or local infection, which is close to the spinal injection site

Sponsors & Collaborators

• Mayo Clinic: lead
• Food and Drug Administration (FDA): collaborator
• National Institute of Neurological Disorders and Stroke (NINDS): collaborator

Study Sites (1)

Mayo Clinic in Rochester

Rochester, Minnesota, 55905, United States

Location

Related Publications (1)

• Camilleri ET, Gustafson MP, Dudakovic A, Riester SM, Garces CG, Paradise CR, Takai H, Karperien M, Cool S, Sampen HJ, Larson AN, Qu W, Smith J, Dietz AB, van Wijnen AJ. Identification and validation of multiple cell surface markers of clinical-grade adipose-derived mesenchymal stromal cells as novel release criteria for good manufacturing practice-compliant production. Stem Cell Res Ther. 2016 Aug 11;7(1):107. doi: 10.1186/s13287-016-0370-8.

  PMID: 27515308 DERIVED

Study Officials

• Wolfgang Singer, MD

  Mayo Clinic

  PRINCIPAL INVESTIGATOR

• Phillip Low, MD

  Mayo Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: October 31, 2014
• First Posted: December 11, 2014
• Study Start: October 1, 2012
• Primary Completion (Estimated): March 1, 2027
• Study Completion (Estimated): March 1, 2027
• Last Updated: April 8, 2026

Record last verified: 2026-04

Locations

US (1)