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用于治疗阿尔茨海默病的 Lomecel-B 的 I 期临床试验结果和见解。

Results and insights from a phase I clinical trial of Lomecel-B for Alzheimer's disease.

机构信息

Brain Matters Research, Delray Beach, Florida, USA.

Miami Jewish Health, Miami, Florida, USA.

出版信息

Alzheimers Dement. 2023 Jan;19(1):261-273. doi: 10.1002/alz.12651. Epub 2022 Mar 31.

Abstract

HYPOTHESIS

We hypothesized that Lomecel-B, an allogeneic medicinal signaling cell (MSC) therapeutic candidate for Alzheimer's disease (AD), is safe and potentially disease-modifying via pleiotropic mechanisms of action.

KEY PREDICTIONS

We prospectively tested the predictions that Lomecel-B administration to mild AD patients is safe (primary endpoint) and would provide multiple exploratory indications of potential efficacy in clinical and biomarker domains (prespecified secondary/exploratory endpoints).

STRATEGY AND KEY RESULTS

Mild AD patient received a single infusion of low- or high-dose Lomecel-B, or placebo, in a double-blind, randomized, phase I trial. The primary safety endpoint was met. Fluid-based and imaging biomarkers indicated significant improvement in the Lomecel-B arms versus placebo. The low-dose Lomecel-B arm showed significant improvements versus placebo on neurocognitive and other assessments.

INTERPRETATION

Our results support the safety of Lomecel-B for AD, suggest clinical potential, and provide mechanistic insights. This early-stage study provides important exploratory information for larger efficacy-powered clinical trials.

摘要

假设

我们假设 Lomecel-B 是一种同种异体药物信号细胞 (MSC) 治疗阿尔茨海默病 (AD) 的候选药物,通过多种作用机制具有安全性和潜在的疾病修饰作用。

主要预测

我们前瞻性地测试了以下预测:向轻度 AD 患者给予 Lomecel-B 治疗是安全的(主要终点),并将在临床和生物标志物领域提供多个潜在疗效的探索性指标(预先指定的次要/探索性终点)。

策略和主要结果

轻度 AD 患者在一项双盲、随机、I 期临床试验中接受了低剂量或高剂量 Lomecel-B 或安慰剂的单次输注。主要安全性终点得到满足。基于液体的生物标志物和影像学生物标志物表明,与安慰剂相比,Lomecel-B 组有显著改善。与安慰剂相比,低剂量 Lomecel-B 组在神经认知和其他评估方面有显著改善。

解释

我们的结果支持 Lomecel-B 用于 AD 的安全性,表明其具有临床潜力,并提供了机制见解。这项早期研究为更大规模的疗效驱动临床试验提供了重要的探索性信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab16/10084163/f1a3661a3523/ALZ-19-261-g003.jpg

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