Chullikana Anoop, Majumdar Anish Sen, Gottipamula Sanjay, Krishnamurthy Sagar, Kumar A Sreenivas, Prakash V S, Gupta Pawan Kumar
Stempeutics Research Pvt Ltd, Bangalore, India, and Stempeutics Research Manipal, India.
CARE Hospital Hyderabad, India.
Cytotherapy. 2015 Mar;17(3):250-61. doi: 10.1016/j.jcyt.2014.10.009. Epub 2014 Dec 4.
Cell therapy is promising as an exploratory cardiovascular therapy. We have recently developed an investigational new drug named Stempeucel (bone marrow-derived allogeneic mesenchymal stromal cells) for patients with acute myocardial infarction (AMI) with ST-segment elevation. A phase I/II randomized, double-blind, single-dose study was conducted to assess the safety and efficacy of intravenous administration of Stempeucel versus placebo (multiple electrolytes injection).
Twenty patients who had undergone percutaneous coronary intervention for AMI were randomly assigned (1:1) to receive intravenous Stempeucel or placebo and were followed for 2 years.
The number of treatment-emergent adverse events observed were 18 and 21 in the Stempeucel and placebo groups, respectively. None of the adverse events were related to Stempeucel according to the investigators and independent data safety monitoring board. There was no serious adverse event in the Stempeucel group and there were three serious adverse events in the placebo group, of which one had a fatal outcome. Ejection fraction determined by use of echocardiography showed improvement in both Stempeucel (43.06% to 47.80%) and placebo (43.44% to 45.33%) groups at 6 months (P = 0.26). Perfusion scores measured by use of single-photon emission tomography and infarct volume measured by use of magnetic resonance imaging showed no significant differences between the two groups at 6 months.
This study showed that Stempeucel was safe and well tolerated when administered intravenously in AMI patients 2 days after percutaneous coronary intervention. The optimal dose and route of administration needs further evaluation in larger clinical trials (http://clinicaltrials.gov/show/NCT00883727).
细胞治疗作为一种探索性的心血管治疗方法具有广阔前景。我们最近为ST段抬高型急性心肌梗死(AMI)患者研发了一种名为Stempeucel(骨髓来源的同种异体间充质基质细胞)的研究性新药。开展了一项I/II期随机、双盲、单剂量研究,以评估静脉注射Stempeucel与安慰剂(多种电解质注射液)相比的安全性和有效性。
20例因AMI接受经皮冠状动脉介入治疗的患者被随机(1:1)分配接受静脉注射Stempeucel或安慰剂,并随访2年。
Stempeucel组和安慰剂组观察到的治疗中出现的不良事件数量分别为18例和21例。根据研究者和独立数据安全监测委员会的评估,没有不良事件与Stempeucel相关。Stempeucel组未出现严重不良事件,安慰剂组出现3例严重不良事件,其中1例导致死亡。使用超声心动图测定的射血分数显示,Stempeucel组(从43.06%提高到47.80%)和安慰剂组(从43.44%提高到45.33%)在6个月时均有所改善(P = 0.26)。使用单光子发射断层扫描测量的灌注分数和使用磁共振成像测量的梗死体积在6个月时两组之间无显著差异。
本研究表明,在经皮冠状动脉介入治疗2天后对AMI患者静脉注射Stempeucel是安全的且耐受性良好。最佳剂量和给药途径需要在更大规模的临床试验中进一步评估(http://clinicaltrials.gov/show/NCT00883727)。