Department of Neurology and Stroke Centre; Neurosciences Area, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.
Department of Neurology and Stroke Centre; Neurosciences Area, Hospital La Paz Institute for Health Research-IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain
BMJ Open. 2021 Aug 9;11(8):e051790. doi: 10.1136/bmjopen-2021-051790.
Stroke is a serious public health problem, given it is a major cause of disability worldwide despite the spread of recanalisation therapies. Enhancement of brain plasticity with stem cell administration is a promising innovative therapy to reduce sequelae in these patients.
We have developed a phase IIb, multicentre, randomised, double-blind, placebo-controlled clinical trial protocol to evaluate the safety and efficacy of intravenous administration of allogeneic adipose tissue-derived mesenchymal stem cells (AD-MSCs) in patients with acute ischaemic stroke, concurrently with conventional stroke treatment. Thirty patients will be randomised on a 1:1 basis to receive either intravenous placebo or allogeneic AD-MSCs as soon as possible within the first 4 days from stroke symptom onset. Patients will be followed up to 24 months after randomisation. The primary objective is the safety assessment of early intravenous administration of allogeneic AD-MSCs by reporting all adverse events and neurological or systemic complications in both treatment groups. Secondary objectives assess efficacy of early intravenous AD-MSC treatment in acute ischaemic stroke by evaluating changes in the modified Rankin Scale and the National Institutes of Health Stroke Scale throughout the follow-up period. In addition, brain repair biomarkers will be measured at various visits.
This clinical trial has been approved by the Clinical Research Ethics Committee of La Paz University Hospital (Madrid, Spain) and by the Spanish Agency of Medication and Health Products and has been registered in Eudra CT (2019-001724-35) and ClinicalTrials.gov (NCT04280003). Study results will be disseminated through peer-reviewed publications in Open Access format and at conference presentations.
尽管溶栓治疗已经普及,但脑卒中仍然是一个严重的全球公共卫生问题,因为它是导致全球残疾的主要原因之一。通过干细胞给药来增强大脑的可塑性是一种很有前途的创新疗法,可以减少这些患者的后遗症。
我们制定了一项 2b 期、多中心、随机、双盲、安慰剂对照的临床试验方案,以评估在急性缺血性脑卒中患者中,与常规脑卒中治疗同时,静脉内给予同种异体脂肪组织来源的间充质干细胞(AD-MSCs)的安全性和有效性。30 名患者将按照 1:1 的比例随机分为两组,分别接受静脉内安慰剂或同种异体 AD-MSCs 治疗,在脑卒中症状发作后 4 天内尽快接受治疗。患者将在随机分组后 24 个月进行随访。主要目的是通过报告两组治疗中所有不良事件和神经或全身并发症,评估早期静脉内给予同种异体 AD-MSCs 的安全性。次要目的评估早期静脉内 AD-MSC 治疗急性缺血性脑卒中的疗效,通过评估改良 Rankin 量表和国家卫生研究院脑卒中量表在整个随访期间的变化来评估。此外,还将在不同访视时测量脑修复生物标志物。
这项临床试验已经获得拉巴斯大学医院临床研究伦理委员会(马德里,西班牙)和西班牙药品和医疗产品管理局的批准,并在 EudraCT(2019-001724-35)和 ClinicalTrials.gov(NCT04280003)上注册。研究结果将通过同行评议的开放获取格式发表的文章和会议报告进行传播。