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11 例膝骨关节炎患者关节内注射脂肪间充质干细胞 GXCPC1 的安全性和耐受性:无对照臂的非随机初步研究。

Safety and Tolerability of Intra-Articular Injection of Adipose-Derived Mesenchymal Stem Cells GXCPC1 in 11 Subjects With Knee Osteoarthritis: A Nonrandomized Pilot Study Without a Control Arm.

机构信息

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Department of Surgery, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.

出版信息

Cell Transplant. 2024 Jan-Dec;33:9636897231221882. doi: 10.1177/09636897231221882.

Abstract

The current study aimed to determine the safety profile of intra-articular-injected allogeneic adipose-derived mesenchymal stem cells (ADSCs) GXCPC1 in subjects with knee osteoarthritis (OA) and its preliminary efficacy outcome. The 3 + 3 phase I study was designed with two dose-escalation cohorts: low dose (6.7 × 10 GXCPC1, = 5) and high dose (4 × 10 GXCPC1, = 6). The primary endpoint was safety, which was evaluated by recording adverse events throughout the trial; the secondary endpoints included total, pain, stiffness, and function subscales of the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) for pain, and 12-Item Short Form (SF-12) health survey questionnaire. The GXCPC1 treatment was found to be safe after 1 year of follow-up with no treatment-related severe adverse events observed. When compared to baseline, subjects in both the low- and high-dose cohorts demonstrated improving trends in pain and knee function after receiving GXCPC1 treatment. Generally, the net change in pain (95% confidence interval (CI) = -7.773 to -2.561t at 12 weeks compared to baseline) and knee function (95% CI = -24.297 to -10.036t at 12 weeks compared to baseline) was better in subjects receiving high-dose GXCPC1. Although this study included a limited number of subjects without a placebo arm, it showed that the intra-articular injection of ADSCs was safe and well-tolerated in subjects with therapeutic alternatives to treat knee OA. However, a larger scale study with an appropriate control would be necessary for clinical efficacy in the following study.

摘要

本研究旨在评估关节内注射异体脂肪间充质干细胞(ADSCs)GXCPC1 治疗膝骨关节炎(OA)患者的安全性,并初步观察其疗效。本研究采用 3+3 剂量递增设计,分为低剂量(6.7×10 GXCPC1,n=5)和高剂量(4×10 GXCPC1,n=6)两个递增剂量组。主要终点为安全性,通过记录整个试验过程中的不良事件进行评估;次要终点包括 Western Ontario and McMaster Universities Arthritis Index(WOMAC)的总评分、疼痛评分、僵硬评分和功能评分、疼痛视觉模拟量表(VAS)评分和 12 项简明健康状况量表(SF-12)问卷。经过 1 年的随访,未观察到与治疗相关的严重不良事件,表明 GXCPC1 治疗是安全的。与基线相比,低剂量和高剂量组患者在接受 GXCPC1 治疗后疼痛和膝关节功能均有改善趋势。一般来说,与基线相比,高剂量组患者在 12 周时的疼痛(95%置信区间(CI)=-7.773 至-2.561t)和膝关节功能(95%CI=-24.297 至-10.036t)的净变化更好。虽然本研究纳入的患者数量有限,且无安慰剂对照,但结果表明关节内注射 ADSCs 治疗膝 OA 患者是安全且耐受良好的。然而,在下一阶段的研究中,还需要进行更大规模的研究并设置合适的对照来评估其临床疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/352f/10785714/950f39b52ca1/10.1177_09636897231221882-fig1.jpg

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