Mesenchymal Stromal Cells for Ischemic Stroke

Study Overview
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Brief Summary
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The purpose of this study is to determine if mesenchymal stem cells given by IV is feasible and safe in patients with recent ischemic stroke and to decide the maximum tolerated dose when given between 3-10 days after an ischemic stroke.

Detailed Description
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This is a randomized, double-blind, placebo controlled study. . Approximately 48 subjects will be enrolled in the trial, undergo a real or SHAM MSC IV infusion and will be follow out to 1 year. There will potentially be 4 Cohorts with the dose escalation at a 3:1 randomization schedule Objectives: The primary hypothesis' are that intravenous administration of allogeneic bone marrow derived mesenchymal stem cells is feasible and safe in patients with recent ischemic stroke and to determine the maximum tolerated dose (MTD) of IV MSCs when administered sub-acutely between 3-10 days following ischemic stroke. The secondary hypothesis is that allogeneic MSC transplantation will improve functional outcome after recent ischemic stroke. Safety and clinical efficacy points to be evaluated at Day 7 clinic visit, Day 30, Day 60, Day 90, and Day 180. Primary outcome or Primary endpoint of the study is to define the safety or harm of the MSCs

Official Title
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SAfety of Mesenchymal Stromal Cells for Ischemic Stroke

Conditions
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Ischemic Stroke

Intervention / Treatment
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* Biological: MSC Infusion
* Biological: Placebo Comparator


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: acute ischemic stroke age 18 to 83 years post stroke mRS > 3 NIHSS of 7-25 Deficits on the total NIHSS can be lower than 7 provided the patients have moderate aphasia or visual loss (2 on the Best Language or Visual loss NIHSS subcomponent) *Criteria for mRS not used for this category of subjects Last seen normal st within 3-9 days prior to stroke. Time of onset for wake-up stroke will be defined as the time the patient woke up with symptoms. stem cell transplantation procedure must be performed between 3-10 days after stroke symptom onset Exclusion Criteria: Ischemic stroke, primary hemorrhagic or traumatic lesion of the brain or myocardial infarction within past 30 days prior to current stroke. Mechanical heart valve Uncontrolled seizure disorder, defined as a seizure within the last 6 months Developmental delay Chronic kidney disease Hepatic disease or altered liver function Pulmonary disease Cancer within 5 years prior to study Prior immunosuppression, including chemotherapy within last 3 years Known HIV Uncorrected coagulopathy or severe anemia Pregnancy Unable to undergo MRI or CT scan Imaging shows clinically significant hemorrhage

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 83 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: MSC infusion<br>Allogeneic bone marrow derived mesenchymal stem cells given in one dose 3-10 days after stroke symptom onset | Biological: MSC Infusion<br>* Allogeneic bone marrow derived mesenchymal stem cells given in one dose 3-10 days after stroke symptom onset<br>|
| Placebo Comparator: SHAM infusion<br>Infusion of normal saline placebo | Biological: Placebo Comparator<br>* Normal saline<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| maximum tolerated dose (MTD) of IV MSCs |  | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improved functional outcome | as assessed by changes in mRS, NIHSS, Fugyl-Meyer and Barthel Index | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ischemic, Stroke, Stem Cells, MSC, Allogeneic, Bone Marrow