EXCELLENT (EXpanded CELL ENdocardiac Transplantation) (EXCELLENT)
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT02669810 |
Recruitment Status :
Completed
First Posted : February 1, 2016
Last Update Posted : April 26, 2024
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Condition or disease | Intervention/treatment | Phase |
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Acute Myocardial Infarction | Drug: PROTHERACYTES Drug: Standard Treatment for CHF post AMI | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 49 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | EXpanded CELL ENdocardiac Transplantation (EXCELLENT) |
Actual Study Start Date : | September 25, 2015 |
Actual Primary Completion Date : | March 15, 2024 |
Actual Study Completion Date : | March 15, 2024 |
Arm | Intervention/treatment |
---|---|
Experimental: PROTHERACYTES
The interventional investigators will perform the ProtheraCytes® cardiac injections using a catheter introduced via the femoral route up to the left ventricle cavity for intraventricular injections (Helix/Biocardia). Intracoronary injection will be possible with OTW catheter or microcatheter (UK only) if patient presents a contraindication to intramyocardial injection |
Drug: PROTHERACYTES
ProtheraCytes endocardiac injections performed with the HELIX and Morph catheters Drug: Standard Treatment for CHF post AMI |
Active Comparator: Standard of Care
Patients will be treated as standard treatment for CHF post - AMI.
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Drug: Standard Treatment for CHF post AMI |
- Major Adverse Cardiac Events (MACE) [ Time Frame: From randomization up to 6 months ]The primary endpoint is the incidence of Major Adverse Cardiac Events (MACE), which have been adjudicated and confirmed to be a MACE by an independent and blinded Clinical Events Committee (CEC) from randomization
- Left Ventricle End Systolic Volume index (LVESVi) [ Time Frame: From Baseline up to 6 months ]
Improvement of LVESVi will be assessed by comparing cMRI at baseline, 3 and 6 months. The left ventricular volumes will be indexed to body surface area. cMRI will also assess other parameters such as:
- Left ventricular end diastolic volume index (ml/m²)
- Left ventricular ejection fraction (%)
- Left ventricular mass (g)
- Viability improvement of the infarcted segment(s) [ Time Frame: From Baseline up to 6 months ]The viability assessment will be performed using cMRI and perfusion 99mTc SPECT (optional) respectively. A correlation assessment between LVESVi improvement and viability of the infarcted segment(s) will be statistically performed.
- Other secondary outcomes measures [ Time Frame: From Baseline up to 6 months ]Cardiac event free survival; Quality of life via SF36 scale
- Exploratory outcome measures [ Time Frame: From randomization up to 6 months ]Incidence of adverse events in patient treated via the intracoronary route
- Exploratory outcome measures [ Time Frame: From randomization up to 6 months ]Improvement of MACE, of LVESVi, viability of infarcted segments and other cMRI parameters in patient treated with intracoronary route
- Exploratory outcome measures [ Time Frame: From Baseline up to 6 months ]cMRI parameters related to microvascular obstruction (MVO) and myocardial perfusion in all patients
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Ages Eligible for Study: | 18 Years to 85 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion criteria
- LV main AMI with or without ST segment elevation and with a detection of rise of troponin with at least one value 70 times above the upper reference limit.
- MI within 1 week after first symptoms. D0 = day of last stent implantation or; D0 = day of hospital presentation when no stent implanted.
- Combination of LVEF < 50% and LV akinetic or dyskinetic segment(s) - by echography as per local practice
- Age must be ≥ 18 and ≤ 85 years
- Men and Non-pregnant non-lactating women who take efficacious contraceptive measures such as oral contraceptive medications or efficacious and permanent intra-uterine device (drug eluted or not) (IUD) or subcutaneous permanent contraceptive implants or menopaused women (at least 2 years confirmed menopause) or surgically sterilized women.
- Having previously signed a written informed consent prior to any study-specific procedure
- LVEF remaining < 50% assessed by cMRI at D8 (± 3)
- Identification of LV segment(s) both non-viable (transmural scar extend >50%) and akinetic (no cardiac wall thickening during systole) or dyskinetic (cardiac wall thickening in the wrong orientation during systole) by cMRI at D8 (± 3)
Non-inclusion criteria
- History of CABG surgery
- History of former significant mitral valve replacement surgery or heart transplantation.
- History of severe valve disease: mitral, aortic stenosis / insufficiency.
- History of non-ischemic dilated cardiomyopathy due to valvular dysfunction, mitral regurgitation, tachycardia, or myocarditis.
- Aortic stenosis as determined as valve area less than 1 cm2 that prohibits catheter access to LV.
- Presence of a prosthetic / mechanical aortic or mitral valve or heart constrictive device.
- Sepsis.
- Endocarditis.
- Infectious pericarditis;
- Pericardial tamponade.
- Left Ventricular Thrombus detected at Echo or MRI
- Severe peripheral vascular disease precluding femoral artery access as determined at the time of original catheterization.
- Any condition leading to contraindicated or unexploitable cMRI.
- History of metallic foreign body in their eye
- Former or current aortic dissection
- Previous G-CSF or other hematopoietic growth factor administration.
- Hepatic failure, history of liver cirrhosis or hepatic severe impairment.
- Constitutional or acquired coagulopathy
- Treated chronic renal failure, haemodialysis or renal severe impairment (creatinine clearance < 30 ml/min).
- Prior or concomitant malignancies except non-melanoma skin cancer or adequately treated in situ cervical cancer or previous cancer in complete response without any treatment in the last 5 years.
- History of prior mediastinal radiation exposure.
- Serious underlying medical condition at the investigator's discretion, which could impair the ability of the patient to participate in the trial (e.g. ongoing infection, active autoimmune disease, Amyotrophic Lateral Sclerosis, Systemic Lupus, Multiple Sclerosis).
- Chronic immunomodulatory or cytotoxic drug treatment intake.
- Active bleeding or major surgery within 1 month.
- History or current Human immunodeficiency HIV1-2, HTLV1, HTLV2 (according to 2006/17/EC).
- Current Active Hepatitis B (according to 2006/17/EC) based on the decision of the biologist or/and the PI.
- History or current Hepatitis C (according to 2006/17/EC).
- Syphilis (according to 2006/17/EC) based on the decision of the biologist or/and the P.
- Active participation in any other clinical trials.
- Current or recent treatment (within two months) with another investigational drug or procedure.
- Any other co-existing conditions that will preclude participation in the study or compromise ability to give informed consent.
- Impairment of cognitive function. If patient is 75-85 years old (included), score < 24 at Mini Mental State Examination (MMSE)
- History of Splenomegaly;
- History of Phenylketonuria;
- History of iron-Dextran allergy;
- History of murine protein allergy.
- Diagnosis of Takotsubo
Discontinuation criteria
- Inadequate bone marrow function: patient at risk to have Haemoglobin < 10 g/dL and Platelet count < 100 x 109 /L at the time of blood harvest
- Blood transfusion within the previous 3 days before the first G-CSF injection
- Cardiogenic shock: requirement of i.v. catecholamines or mechanical hemodynamic support (aortic balloon pump) initiated 24 hours before screening cMRI.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02669810
France | |
CHU BESANCON Hopital Jean Minjoz 3 Boulevard A.Fleming | |
Besançon, France, 25030 | |
CHU DIJON Hôpital François Mitterrand 14 rue Gaffarel | |
Dijon, France, 21079 | |
CHU de Grenoble | |
Grenoble, France | |
Institut Jacques Cartier | |
Massy, France | |
CHU Montpellier Arnaud-De-Villeneuve | |
Montpellier, France | |
GHRMSA | |
Mulhouse, France, 68100 | |
Hôpital Haut Levèque | |
Pessac, France | |
Hôpital de Rangueil | |
Toulouse, France | |
United Kingdom | |
Ninewells Hospital & Medical School | |
Dundee, United Kingdom, B15 2GW | |
BIRMINGHAM, Queen Elizabeth Hospital ,Mindelsohn Way, | |
Edgbaston, United Kingdom, B15 2GW | |
University of Edinburgh | |
Edinburgh, United Kingdom | |
Leeds University & Leeds Teaching Hospitals NHS Trust | |
Leeds, United Kingdom | |
Saint Bartholomew's Hospital W Smithfield, | |
London, United Kingdom, EC1A 7BE |
Responsible Party: | CellProthera |
ClinicalTrials.gov Identifier: | NCT02669810 |
Other Study ID Numbers: |
EudraCT 2014-001476-63 |
First Posted: | February 1, 2016 Key Record Dates |
Last Update Posted: | April 26, 2024 |
Last Verified: | April 2024 |
Myocardial Infarction Infarction Ischemia Pathologic Processes Necrosis |
Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |