safety and efficacy of repeated administration of nurown (msc-ntf cells) in participants with progressive ms

Conditions: Multiple Sclerosis, Chronic Progressive

Summary: a multidose open-label study with autologous mesenchymal stromal stem cells secreting neurotrophic factors (msc-ntf cells) involving 20 participants with progressive ms at multiple investigational study sites.

an open-label study with a single treatment arm involving 20 participants with progressive ms at multiple investigational study sites. after providing informed consent, participants meeting the inclusion and exclusion criteria will be randomized and approximately 4 weeks later will undergo a bone-marrow aspiration (bma). each participants will receive three intrathecal cell transplantations within 16 weeks and will be followed for 12 weeks for safety and efficacy.

Eligibility criteria:
inclusion criteria: 1. males and females ages 18 to 65 years old, inclusive, at the screening visit. 2. clinical diagnosis of progressive ms (primary and secondary) based on the 2017 revised macdonald criteria and confirmation by the investigator that the disease has entered the progressive stage for at least 6 months prior to enrollment. 3. no evidence of clinical ms relapse or high dose pulse corticosteroid treatment within 6 months prior to screening 4. disability status at screening with an expanded disability status scale (edss) 3.0-6.5, inclusive. 5. able to walk 25 feet in 60 seconds or less. 6. stable dose of non-excluded ms disease modifying therapy for at least 6 months prior to screening visit (visit 1). 7. women of childbearing potential shall either be surgically sterile, or must agree not to become pregnant for the duration of the study. women must be willing to undergo a serum pregnancy test at screening, and at the conclusion of the study. participants of childbearing potential must agree to use a medically approved form of birth control (abstinence, intrauterine device (iud), oral contraception, barrier and spermicide or hormonal implant) throughout the duration of the study and for at least 3 months following the last transplantation. for those women who are sexually active and using oral contraceptives, a second form of barrier contraception is required. men must be willing to consistently use two forms of contraceptive if their partners are of childbearing age. 8. capable of providing informed consent and willing and able to follow study procedures, including willingness to undergo multiple/repeated lumbar puncture. exclusion criteria: 1. prior stem cell therapy of any kind. 2. active participation in any other ms interventional study or use of unapproved ms investigational therapy within 90 days prior to the screening visit (visit 1). 3. inability to lie flat for the duration of intrathecal cell transplantation and/or bone marrow biopsy, or inability to tolerate study procedures for any other reason. 4. history of clinically significant autoimmune disease (excluding thyroid disease) that may confound study results, in the opinion of the investigator and the medical monitor, myelodysplastic or myeloproliferative disorder, leukemia or lymphoma, whole body irradiation, hip fracture, or severe scoliosis. 5. any unstable clinically significant medical condition other than multiple sclerosis (e.g., within six months of screening visit (visit 1), had myocardial infarction, angina pectoris, and/or congestive heart failure), treatment with anticoagulants that, in the opinion of the investigator, would compromise the safety of participants. 6. any history of malignancy within the previous 5 years, except for non-melanoma localized skin cancers (with no evidence of metastasis, significant invasion, or reoccurrence within three years of screening visit (visit 1)). 7. serum aspartate aminotransferase (ast) or alanine aminotransferase (alt) value \>3.0 times the upper normal limit. 8. serum creatinine value \>2.0 times the upper normal limit. 9. positive test for hepatitis b (hbv; surface antigen (hbsag) and antibodies to core antigen (igg and igm anti-hbc)), hepatitis c (hcv), or human immunodeficiency virus (hiv) 1 and 2. 10. current use of immunosuppressant medication or use of such medication within 6 months of study enrollment (aside from rituximab or other approved b-cell immunotherapy). alemtuzumab (lemtrada), cladribine (nda submitted), natalizumab (tysabri), s1p modulators (gilenya) are excluded for safety reasons due to the known risk of systemic autoimmune disease, malignancy, opportunistic infections, and cardiovascular toxicity associated with these therapies, as well as theoretical effects on msc-ntf cell homing and migration, that may be associated with natalizumab and/or s1p modulators (gilenya). 11. any history of acquired or inherited immune deficiency syndrome. 12. any history of either substance abuse within the past year, or unstable psychiatric disease according to the investigator's judgment. 13. pregnant women or women currently breastfeeding. 14. subjects for whom mri is contraindicated (i.e., have a pacemaker or other metallic implanted device, or are unable to remain in the machine for period of time needed to acquire a scan.