Mount Sinai School of Medicine, New York, NY 10029, USA.
Inflamm Bowel Dis. 2013 Mar-Apr;19(4):754-60. doi: 10.1097/MIB.0b013e31827f27df.
The clinical utility of cellular therapies is being investigated in a broad range of therapeutic areas. This phase 1 study represents the first exploration of PDA001, a preparation of cells cultured from human placental tissue, in subjects with Crohn's disease.
Twelve subjects with active, moderate-to-severe Crohn's disease unresponsive to previous therapy were given 2 intravenous infusions of PDA001 1 week apart, monitored weekly for 5 weeks, and assessed at 6 months, 1 year, and 2 years after infusion. Six subjects received 2 infusions of 2 × 10 cells (low dose), and 6 subjects received 2 infusions of 8 × 10 cells (high dose).
Mean baseline Crohn's Disease Activity Index in the low-dose and high-dose groups was 305 and 364, respectively, and mean C-reactive protein was 8 mg/L and 49 mg/L, respectively. All subjects in the low-dose group achieved a clinical response (a Crohn's Disease Activity Index decrease of ≥70 points versus baseline), and 3 achieved remission (a Crohn's Disease Activity Index decrease of ≥100 to <150 points). Two subjects in the high-dose group achieved response, and none met remission criteria. Most adverse events were mild to moderate in severity and included headache, nausea, fever, and infusion site reactions.
PDA001 infusions appear safe and well-tolerated in subjects with treatment-resistant Crohn's disease. A response was seen in all subjects in the low-dose group. The high-dose group, with a higher baseline disease activity, had only 2 responders, suggesting a more treatment-resistant population. A phase 2 study in this patient population is ongoing.
细胞疗法的临床应用正在广泛的治疗领域得到探索。这项 1 期研究代表了首次在克罗恩病患者中探索 PDA001,一种从人胎盘组织培养的细胞制剂。
12 名对既往治疗无反应的活动期中重度克罗恩病患者接受了 2 周间隔的 2 次 PDA001 静脉输注,输注后 5 周每周监测一次,并在输注后 6 个月、1 年和 2 年进行评估。6 名患者接受了 2 次 2×10 细胞(低剂量)输注,6 名患者接受了 2 次 8×10 细胞(高剂量)输注。
低剂量组和高剂量组的平均基线克罗恩病活动指数分别为 305 和 364,平均 C 反应蛋白分别为 8 mg/L 和 49 mg/L。低剂量组所有患者均获得临床应答(与基线相比,克罗恩病活动指数下降≥70 分),3 例达到缓解(克罗恩病活动指数下降≥100 至<150 分)。高剂量组有 2 例患者达到应答,均未达到缓解标准。大多数不良事件为轻度至中度,包括头痛、恶心、发热和输注部位反应。
PDA001 输注在治疗抵抗性克罗恩病患者中似乎安全且耐受良好。低剂量组所有患者均有应答。高剂量组基线疾病活动度较高,仅 2 例患者有应答,提示患者群体更具治疗抵抗性。一项针对该患者群体的 2 期研究正在进行中。