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Clinical trial information and results are updated daily from ClinicalTrials.gov. The latest data update was conducted on 06/15/2021.

Mesenchymal Stem Cells Treatment for Decompensated Liver Cirrhosis

Clinicaltrials.gov identifier NCT03945487

Recruitment Status Recruiting

First Posted May 10, 2019

Last update posted May 10, 2019

Study Description

Brief summary:

Decompensated liver cirrhosis is a life-threatening chronic liver disease with high mortality. Liver transplantation is the only option that can improve the survival of these patients; however, this procedure is associated with several limitations, such as the severe shortage of donor livers, long waiting lists, multiple complications, and high cost. Our and other previous studies have demonstrated that marrow bone-derived mesenchymal stem cells (BM-MSC) or unbilical cord derived MSC (UC-MSC) infusion is clinically safe and could improve liver function in patients with decompensated liver cirrhosis. However, the long-term outcomes of MSC infusion have not been reported until now. This prospective and randomized controlled study examined the longer-term safety and efficacy of UC-MSC in patients with decompensated liver cirrhosis.

  • Condition or Disease:Decompensated Liver Cirrhosis
  • Intervention/Treatment: Biological: umbilical cord-derived mesenchymal stem cell
    Other: Comprehensive treatment
  • Phase: Phase 2
Detailed Description

Liver cirrhosis represents a late stage of progressive hepatic fibrosis characterized by the formation and accumulation of an extracellular matrix, which leads to the progressive distortion of the hepatic architecture. In China, the most important cause of liver cirrhosis is chronic hepatitis B virus (HBV) infection. Liver cirrhosis usually progresses irreversibly into advanced stage, such as a decompensated stage which is characterized by a series of clinical manifestations, including ascites, variceal hemorrhage, and hepatic encephalopathy with high mortality. Liver transplantation is the only option that can improve the survival of these decompensated liver cirrhosis patients; however, this procedure is associated with several limitations, such as the severe shortage of donor livers, long waiting lists, multiple complications, and high cost. Therefore, it is urgent to find a safe and effective therapeutic approach to decompensated liver cirrhosis. Animal models have shown that bone marrow-derived MSC (BM-MSC) can ameliorate liver fibrosis and reverse fulminant hepatic failure. In clinical, autologous BM-MSC have significantly improved liver function in patients with liver cirrhosis. A recent research also found that autologous BM-MSC therapy safely improved histological fibrosis and liver function in patients with alcoholic cirrhosis. Allogeneic MSC therapy, such as umbilical cord-derived MSC (UC-MSC), have shown to be safe and beneficial for the patients with liver cirrhosis caused by autoimmune diseases. Our previous studies showed that infusions of UC-MSC significantly improved liver function in decompensated liver cirrhosis and primary biliary cirrhosis (PBC) patients and increased the survival rate in acute-on-chronic liver failure (ACLF) patients. However, the single-center clinical study, the relative small size of the patient cohorts, absence of evaluation on long-term efficacy prevent firm conclusions being made with regard to the safety and efficacy of this treatment in liver diseases. The purpose of this study is to investigate whether and how UC-MSC can improve the liver function, and the incidence of serious complications in patients with decompensated liver cirrhosis through a multi-center clinical study.

Study Design
  • Study Type: Interventional
  • Estimated Enrollment: 200 participants
  • Allocation: Randomized
  • Intervention Model: Parallel Assignment
  • Masking: None (Open Label) ()
  • Primary Purpose: Treatment
  • Official Title: Safety and Efficacy of Human Unbilical Cord Derived-mesenchymal Stem Cells Treatment for Patients With Decompensated Liver Cirrhosis
  • Estimated Study Start Date: May 2019
  • Estimated Primary Completion Date: December 2021
  • Estimated Study Completion Date: December 2023
Arms and interventions
Arm Intervention/treatment
Experimental: Comprehensive treatment plus UC-MSC treatment
Biological: umbilical cord-derived mesenchymal stem cell
Taken a dose of 1.0*10E6 UC-MSC/kg body weight intravenously three times at 3-week intervals, in addition to comprehensive treatment.
Other: Comprehensive treatment
Other: Comprehensive treatment
All patients received anti-HBV treatment with NAs (entecavir (ETV), tenofovir disoproxil fumarate (TDF), or tenofovir alafenamide (TAF)). Strategies based on targeting abnormalities in gut-liver axis by antibiotic administration (i.e. rifaximin), improving the disturbed systemic circulatory function (i.e. longterm albumin administration), decreasing the inflammatory state (i.e. statins), and reducing portal hypertension (i.e. beta-blockers).
Outcome Measures
  • Primary Outcome Measures: 1. Liver function [ Time Frame: 96 weeks ]
    including the levels of albumin [ALB], prothrombin activity [PTA], total bilirubin [TBIL, and cholinesterase [CHE].
  • 2. The incidence of serious complications [ Time Frame: 96 weeks ]
    including infection, gastrointestinal bleeding, encephalopathy, and hepatorenal syndrome.
  • Secondary Outcome Measures: 1. The incidence of adverse events [ Time Frame: 96 weeks ]
    e.g. fever, allergy, rash, infection
  • 2. Disease-free survival time [ Time Frame: 96 weeks ]
    The length of survival time after first UC-MSC treatment for the patient during the follow-up period.
  • 3. Incidence of hepatocellular carcinoma (HCC) events [ Time Frame: 96 weeks ]
    HCC deveopled in the patient during the follow-up period.
Eligibility Criteria
  • Ages Eligible for Study: 18 to 69 Years (Adult, Older Adult)
  • Sexes Eligible for Study: All
  • Accepts Healthy Volunteers: No
Criteria

Inclusion Criteria:

1. Age 18-69 years;

2. Decompensated liver cirrhosis (manifestations including gastrointestinal bleeding,
hepatic encephalopathy, and ascites, based on previously stable cirrhosis);

3. Positive testing for serum hepatitis B surface antigen (HBsAg) for more than 6 months
(chronic hepatitis B patients);

4. Written consent.

Exclusion Criteria:

1. Hepatocellular carcinoma or other malignancies;

2. Liver cirrhosis caused by other reasons, such as autoimmune diseases, alcocal, drugs
and so on;

3. Pregnant women;

4. The presence of other vital organ severe dysfunction;

5. Participate in other studies;

6. Lack of a supportive family;

7. Refusal to sign the informed consent form.

Contacts and Locations
Contacts

Contact: Ming Shi 86-10-63879735 shiming302@sina.com

Locations

China
Beijing 302 Hospital
Beijing

Sponsors and Collaborators

Beijing 302 Hospital

Investigators

Study Chair: Fu-Sheng Wang Beijing 302 Hospital

More Information
  • Responsible Party: Beijing 302 Hospital
  • ClinicalTrials.gov Identifier: NCT03945487 History of Changes
  • Other Study ID Numbers: Beijing302-011
  • First Posted: May 10, 2019 Key Record Dates
  • Last Update Posted: May 10, 2019
  • Last Verified: May 2019
  • Individual Participant
    Data (IPD) Sharing
    Statement:
  • Plan to Share IPD: No
  • Studies a U.S. FDA-regulated Drug Product: No
  • Studies a U.S. FDA-regulated Device Product: No
  • Keywords provided by Beijing 302 Hospital: liver cirrhosis
    mesenchymal stem cells
    liver function
    safety
  • Additional relevant MeSH terms: Liver Cirrhosis Fibrosis