Willekens Barbara, Presas-Rodríguez Silvia, Mansilla M J, Derdelinckx Judith, Lee Wai-Ping, Nijs Griet, De Laere Maxime, Wens Inez, Cras Patrick, Parizel Paul, Van Hecke Wim, Ribbens Annemie, Billiet Thibo, Adams Geert, Couttenye Marie-Madeleine, Navarro-Barriuso Juan, Teniente-Serra Aina, Quirant-Sánchez Bibiana, Lopez-Diaz de Cerio Ascensión, Inogés Susana, Prosper Felipe, Kip Anke, Verheij Herman, Gross Catharina C, Wiendl Heinz, Van Ham Marieke Sm, Ten Brinke Anja, Barriocanal Ana Maria, Massuet-Vilamajó Anna, Hens Niel, Berneman Zwi, Martínez-Cáceres Eva, Cools Nathalie, Ramo-Tello Cristina
Department of Neurology, University Hospital Antwerp, Edegem, Belgium.
Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp Faculty of Medicine and Health Sciences, Wilrijk, Belgium.
BMJ Open. 2019 Sep 9;9(9):e030309. doi: 10.1136/bmjopen-2019-030309.
INTRODUCTION: Based on the advances in the treatment of multiple sclerosis (MS), currently available disease-modifying treatments (DMT) have positively influenced the disease course of MS. However, the efficacy of DMT is highly variable and increasing treatment efficacy comes with a more severe risk profile. Hence, the unmet need for safer and more selective treatments remains. Specifically restoring immune tolerance towards myelin antigens may provide an attractive alternative. In this respect, antigen-specific tolerisation with autologous tolerogenic dendritic cells (tolDC) is a promising approach. METHODS AND ANALYSIS: Here, we will evaluate the clinical use of tolDC in a well-defined population of MS patients in two phase I clinical trials. In doing so, we aim to compare two ways of tolDC administration, namely intradermal and intranodal. The cells will be injected at consecutive intervals in three cohorts receiving incremental doses of tolDC, according to a best-of-five design. The primary objective is to assess the safety and feasibility of tolDC administration. For safety, the number of adverse events including MRI and clinical outcomes will be assessed. For feasibility, successful production of tolDC will be determined. Secondary endpoints include clinical and MRI outcome measures. The patients' immune profile will be assessed to find presumptive evidence for a tolerogenic effect in vivo. ETHICS AND DISSEMINATION: Ethics approval was obtained for the two phase I clinical trials. The results of the trials will be disseminated in a peer-reviewed journal, at scientific conferences and to patient associations. TRIAL REGISTRATION NUMBERS: NCT02618902 and NCT02903537; EudraCT numbers: 2015-002975-16 and 2015-003541-26.
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