Purpose

The purpose of this study is to evaluate the safety and effectiveness of an experimental drug called human allogeneic mesenchymal stem cell therapy.

Condition

Eligibility

Eligible Ages
Between 18 Years and 80 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

In order to be eligible to participate in this study, an individual must meet all of the following criteria: 1. Men and women aged 18 to 80 years (inclusive) at the time of signing the informed consent form. 2. Diagnosis of NIDCM with left ventricular ejection fraction ≤45%. 3. Appropriate guideline-directed optimal medical therapy for non-ischemic cardiomyopathy. At a minimum, subjects must be on beta blockers and angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) or Angiotensin Receptor Neprilysin Inhibitors (ARNI) or have appropriate medical indication precluding use of one or both of these agents. Subjects must be on a stable regimen for at least 30 days prior to the procedure. Dose titration is allowed. 4. Be a candidate for cardiac catheterization* 5. Be willing to undergo DNA test.

Exclusion Criteria

An individual who meets any of the following criteria will be excluded from participation in this study: 1. Be eligible for or require standard-of-care surgical or percutaneous intervention for the treatment of non-ischemic dilated cardiomyopathy 2. Clinical manifestation of coronary artery disease (CAD) (e.g., chest pain and concomitant clinical findings such as electrocardiogram changes suggestive of coronary ischemia, myocardial infarction) or evidence of endocardial or transmural scar on cardiac MRI suggestive of undiagnosed CAD or history of percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). Be indicated for or require coronary artery revascularization 3. Documented presence of epicardial stenosis of 70% or greater in one or more major epicardial coronary arteries 4. Valvular heart disease including 1) aortic valve prosthesis, mechanical mitral valve, and mitral valve clip; 2) severe aortic valve insufficiency/regurgitation within 12 months of consent* 5. Aortic stenosis with valve area ≤ 1.5cm2* 6. Cardiomyopathy due to acute Post-partum (within 6 months), Non-compaction*, or Hypertrophic* cardiomyopathy 7. Cardiomyopathy due to known toxin (e.g amyloid) Note: anthracycline induced cardiomyopathy will be allowed 8. QTc interval > 550 ms on baseline electrocardiogram (ECG) (note: QTc interval is the interval between the start of the Q wave and the end of the T wave in the heart's electrical cycle) 9. Automated Implantable Cardioverter Defibrillator (AICD) appropriate firing or anti tachycardia pacing for ventricular tachycardia or ventricular fibrillation within 30 days prior to consent 10. Have an estimated baseline glomerular filtration rate below the clinical site's institutional cutoff 11. A hematologic abnormality during baseline testing as evidenced by hemoglobin < 9 g/dl; hematocrit < 30%; absolute neutrophil count < 2,000 or total WBC count more than 2 times upper limit of normal; or platelet values < 100,000/ul 12. Have liver dysfunction, as evidenced by enzymes Aspartate Transaminase Enzyme (AST) and Alanine Aminotransferase Enzyme (ALT) greater than three times the ULN 13. Have a bleeding diathesis or coagulopathy (International Normalised Ratio (INR) > 1.5), cannot be withdrawn from anticoagulation therapy, or will refuse blood transfusions 14. Be a solid organ transplant recipient. This does not include prior cell based therapy (>12 months prior to enrollment), bone, skin, ligament, tendon or corneal grafting. 15. Have a history of organ or cell transplant rejection 16. Have a clinical history of malignancy within the past 12 months (i.e., subjects with prior malignancy must be disease free for 12 months), except curatively treated basal cell or squamous cell carcinoma or cervical carcinoma 17. Drug and/or alcohol abuse or dependence within the past 9 months 18. Be serum positive for HIV, hepatitis B surface antigen, or viremic hepatitis C 19. Documented presence of a known Left Ventricular (LV) thrombus, aortic dissection, or aortic aneurysm. (Refer to "Guidance to the PI" section with regards to LV thrombus, below)* 20. Blood glucose levels (HbA1c) >10% 21. Severe radiographic contrast allergy 22. Known history of anaphylactic reaction to penicillin or streptomycin 23. Hypersensitivity to dimethyl sulfoxide (DMSO) 24. Non-cardiac condition with life expectancy < 1 year 25. Acute stroke or transient ischemic attack within 3 months of enrollment 26. Be pregnant, nursing, or of childbearing potential while not practicing effective contraceptive methods 27. Pacemaker-dependence with an Implantable Cardioverter Defibrillator (ICD) (Note: pacemaker-dependent candidates without an ICD are not excluded) 28. Presence of a pacemaker and/or ICD generator with any of the following limitations/conditions: - manufactured before the year 2000 - leads implanted < 6 weeks prior to consent - non-transvenous epicardial or abandoned leads - subcutaneous ICDs - leadless pacemakers 29. A cardiac resynchronization therapy (CRT) device implanted less than 3 months prior to consent 30. Other MRI contraindications (e.g. subject body habitus incompatible with MRI) 31. Need for advanced heart failure therapy (e.g. IV inotropes) 32. Be currently participating (or participated within the previous 30 days) in an investigational therapeutic or device trial 33. Any other condition that in the judgment of the Investigator would be a contraindication to enrollment or follow-up (*) Applies to subjects receiving product via transendocardial administration only

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)

Arm Groups

ArmDescriptionAssigned Intervention
Placebo Comparator
Genotype A administered with placebo Group
Participants whose blood genotyping resulted with Genotype A (absence of any variant/ presence of benign variant) and randomized to the placebo group will receive the placebo intervention.
  • Other: Placebo
    Placebo will be administered as injections of plasmalyte A supplemented with 1% of 25% human serum albumin (HSA). 0.5 ml/ injection x 10 injections or an intravenous placebo infusion of Cell-free PlasmaLyte-A medium supplemented with 1% of 25% human serum albumin (HSA)
Experimental
Genotype A administered with hMSC Group
Participants whose blood genotyping resulted with Genotype A (absence of any variant/ presence of benign variant) and randomized to the treatment group will receive the hMSC intervention.
  • Biological: allogeneic human mesenchymal stem cells (hMSCs)
    allo-hMSCs, 16-20 million cells/ml delivered at a dose of 0.5 ml/ injection x 10 injections for a total of 80-100 million allo-hMSCs or a single administration of intravenous allogeneic hMSCs (100 million).
Placebo Comparator
Genotype B administered with placebo Group
Participants whose blood genotyping resulted with Genotype B (variants of uncertain significance) and randomized to the placebo group will receive the placebo intervention.
  • Other: Placebo
    Placebo will be administered as injections of plasmalyte A supplemented with 1% of 25% human serum albumin (HSA). 0.5 ml/ injection x 10 injections or an intravenous placebo infusion of Cell-free PlasmaLyte-A medium supplemented with 1% of 25% human serum albumin (HSA)
Experimental
Genotype B administered with hMSC Group
Participants whose blood genotyping resulted with Genotype B (variants of uncertain significance) and randomized to the treatment group will receive the hMSC intervention.
  • Biological: allogeneic human mesenchymal stem cells (hMSCs)
    allo-hMSCs, 16-20 million cells/ml delivered at a dose of 0.5 ml/ injection x 10 injections for a total of 80-100 million allo-hMSCs or a single administration of intravenous allogeneic hMSCs (100 million).
Placebo Comparator
Genotype C administered with placebo Group
Participants whose blood genotyping resulted with Genotype C (pathogenic or likely pathogenic variants) and randomized to the placebo group will receive the placebo intervention.
  • Other: Placebo
    Placebo will be administered as injections of plasmalyte A supplemented with 1% of 25% human serum albumin (HSA). 0.5 ml/ injection x 10 injections or an intravenous placebo infusion of Cell-free PlasmaLyte-A medium supplemented with 1% of 25% human serum albumin (HSA)
Experimental
Genotype C administered with hMSC Group
Participants whose blood genotyping resulted with Genotype C (pathogenic or likely pathogenic variants) and randomized to the treatment group will receive the hMSC intervention.
  • Biological: allogeneic human mesenchymal stem cells (hMSCs)
    allo-hMSCs, 16-20 million cells/ml delivered at a dose of 0.5 ml/ injection x 10 injections for a total of 80-100 million allo-hMSCs or a single administration of intravenous allogeneic hMSCs (100 million).

Recruiting Locations

Stanford University
Stanford 5398563, California 5332921 94304
Contact:
Fouzia Khan, MBBS
650-736-1410
fouziak@stanford.edu

University of Miami Miller School of Medicine
Miami 4164138, Florida 4155751 33136
Contact:
Lina Caceres
305-243-5399
lvc25@med.miami.edu

University of Louisville
Louisville 4299276, Kentucky 6254925 40202
Contact:
Heidi Wilson
502-540-3721
heidi.wilson@louisville.edu

Texas Heart Institute
Houston 4699066, Texas 4736286 77030
Contact:
Nichole Piece
832-355-9173
npiece@texasheart.org

More Details

NCT ID
NCT04476901
Status
Recruiting
Sponsor
Joshua M Hare

Study Contact

Shelly L Sayre, MPH
713-500-9529
Shelly.L.Sayre@uth.tmc.edu

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.