Mesenchymal Stem Cells for the Treatment of Rectovaginal Fistulas in Participants With Crohn's Disease (RVF)
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ClinicalTrials.gov Identifier: NCT04519697 |
Recruitment Status : Unknown
Verified April 2022 by Amy Lightner, The Cleveland Clinic.
Recruitment status was: Recruiting
First Posted : August 20, 2020
Last Update Posted : April 5, 2022
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Condition or disease | Intervention/treatment | Phase |
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Rectovaginal Fistula Crohn Disease Crohn Disease of Vulva Rectolabial; Fistula | Drug: Mesenchymal Stem Cells Other: Placebo | Phase 1 Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 40 participants |
Allocation: | Randomized |
Intervention Model: | Crossover Assignment |
Masking: | Single (Participant) |
Primary Purpose: | Treatment |
Official Title: | A Phase IB/IIA Study of Adult Allogeneic Bone Marrow Derived Mesenchymal Stem Cells for the Treatment of Rectovaginal Fistulas in the Setting of Crohn's Disease. |
Actual Study Start Date : | October 28, 2020 |
Estimated Primary Completion Date : | October 2022 |
Estimated Study Completion Date : | October 2022 |
Arm | Intervention/treatment |
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Experimental: Mesenchymal Stem Cells
Direct injection of adult allogeneic bone marrow derived mesenchymal stem cells at a dose of 75 million cells into rectovaginal fistula at baseline with a possible repeat injection at 3 months if not completely healed from the first injection.
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Drug: Mesenchymal Stem Cells
Adult allogeneic bone marrow derived mesenchymal stem cells for the treatment of rectovaginal fistulas in the setting of Crohn's disease. |
Placebo Comparator: Placebo
Direct injection of normal saline with a possible repeat injection at 3 months if not completely healed from the first injection. If not completely healed after 6 months, participants will then cross over to the treatment group to receive a direct injection of adult allogeneic bone marrow derived mesenchymal stem cells at a dose of 75 million cells into rectovaginal fistula.
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Other: Placebo
Normal Saline |
- Treatment related adverse events [ Time Frame: Month 6 ]Number of participants with treatment related adverse events post-injection of 75 million allogeneic bone marrow derived MSC's for the treatment of rectovaginal fistula in the setting of Crohn's disease as assessed by protocol CCF-Stem Cells IBD-003
- Complete clinical healing [ Time Frame: Month 6, Month 12 ]
Number of participants with complete clinical healing post-injection of 75 million allogeneic bone marrow derived MSC's for the treatment of rectovaginal fistula in the setting of Crohn's disease.
Complete healing is defined as:
Radiographic Healing: MRI with an absence of a fluid collection >2 cm in 3 of 3 dimensions, lack of edema, inflammation or sign of active inflammatory response. A remnant scar of a fistula tract may remain
Clinical Healing: 100% cessation of drainage on both clinical exam with deep palpation and per patient report and complete closure of the fistula tract upon assessment with an examination under anesthesia
- Partial healing [ Time Frame: Month 6, Month 12 ]
Number of participants with partial clinical healing post-injection of 75 million allogeneic bone marrow derived MSC's for the treatment of rectovaginal fistula in the setting of Crohn's disease
Partial healing is defined as:
Radiographic healing: MRI with an absence of a fluid collection >2 cm in 2 of 3 dimensions, lack of edema, inflammation or sign of active inflammatory response. A remnant scar of a fistula tract may remain
Clinical healing: Greater than or equal to 50% cessation of drainage on both clinical exam with deep palpation and per patient report and partial closure of the fistula tract upon assessment with an examination under anesthesia
- Lack of response [ Time Frame: Month 6, Month 12 ]
Number of participants with lack of response post-injection of 75 million allogeneic bone marrow derived MSC's for the treatment of rectovaginal fistula in the setting of Crohn's disease
Lack of Response is defined as: Radiographic and clinical healing which does not meet the threshold for Partial Healing
- Worsening disease [ Time Frame: Month 6, Month 12 ]
Number of participants with worsening disease post-injection of 75 million allogeneic bone marrow derived MSC's for the treatment of rectovaginal fistula in the setting of Crohn's disease
Worsening disease is defined as:
Radiographic: MRI with a fluid collection >2 cm in 2 of 3 dimensions, edema, inflammation or sign of active inflammatory response. An increased number of tracts may be seen, or increased branching from the primary tract,
Clinical: Increased drainage per patient report and on clinical exam
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Ages Eligible for Study: | 18 Years to 75 Years (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Gender Based Eligibility: | Yes |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Females 18-75 years of age with a diagnosis of Crohn's disease for at least six months duration.
- Single-tract, rectovaginal fistula in the setting of Crohn's disease.
- Have no contraindications to MR evaluations: e.g. pacemaker or magnetically active metal fragments, claustrophobia
- Ability to comply with protocol
- Competent and able to provide written informed consent, and ability to comply with protocol
- Concurrent Crohn's related therapies with stable doses (>2 months) corticosteroids, 5-ASA drugs, immunomodulators, anti-TNF therapy, anti-integrin and anti-interleukin are permitted
Exclusion Criteria:
- Inability to give informed consent.
- Clinically significant medical conditions within the six months before administration of MSCs: e.g. myocardial infarction, active angina, congestive heart failure or other conditions that would, in the opinion of the investigators, compromise the safety of the subject.
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Specific exclusions:
- Hepatitis B or C
- HIV
- Abnormal AST or ALT at screening(defined as >/= 2x ULN)
- History of cancer including melanoma (with the exception of localized skin cancers) within one year of screening.
- History of colorectal cancer within 5 years.
- Investigational drug within 30 days of treatment
- Pregnant or breast feeding or trying to become pregnant.
- Presence of a rectovaginal or perineal body fistula
- Change in Crohn's immunosuppressive regimen within the 2 months prior to enrollment
- Uncontrolled intestinal Crohn's disease which will require escalation for medical therapy or surgery within 2 months of enrollment
- Severe anal canal disease that is stenotic and requires dilation
- Inability to wean corticosteroids
- Unwilling to agree to use acceptable contraception methods during participation in study
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): NCT04519697
Contact: Allison Bayles, AA | 216-444-0887 | ibdstemcelltherapy@ccf.org | |
Contact: Alex VanDenBossche, BSN | 216-379-0307 | ibdstemcelltherapy@ccf.org |
United States, Ohio | |
Cleveland Clinic | Recruiting |
Cleveland, Ohio, United States, 44195 | |
Contact: Allison Bayles | |
Contact: Alex VanDenBossche |
Principal Investigator: | Amy Lightner, MD | The Cleveland Clinic |
Responsible Party: | Amy Lightner, Sponsor-investigator, The Cleveland Clinic |
ClinicalTrials.gov Identifier: | NCT04519697 |
Other Study ID Numbers: |
20-936 |
First Posted: | August 20, 2020 Key Record Dates |
Last Update Posted: | April 5, 2022 |
Last Verified: | April 2022 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Crohn's disease rectovaginal fistula mesenchymal stem cells mesenchymal stem cell |
Crohn Disease Rectovaginal Fistula Fistula Inflammatory Bowel Diseases Gastroenteritis Gastrointestinal Diseases Digestive System Diseases Intestinal Diseases Pathological Conditions, Anatomical Rectal Fistula |
Intestinal Fistula Digestive System Fistula Rectal Diseases Vaginal Fistula Vaginal Diseases Genital Diseases, Female Female Urogenital Diseases Female Urogenital Diseases and Pregnancy Complications Urogenital Diseases Genital Diseases |