Chronic Myocardial IschemiaPhase 2MESAMI2NCT02462330
Administration of Mesenchymal Stem Cells in Patients With Chronic Ischemic Cardiomyopathy (MESAMI2)
A Phase 2 study testing Autologous MSC from bone marrow in people with Chronic Myocardial Ischemia, run by University Hospital, Toulouse at 6 sites in France.
Trial summary
Stem cell therapy is an emerging treatment for cardiovascular disease but the best cell type and delivery method remain to be determined. Pre-clinical studies demonstrated improvement of cardiac function by Mesenchymal stem cells (MSC) therapy in particular by their paracrine and immunosuppressive properties. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Chronic Myocardial Ischemia
- What is being tested?
- Autologous MSC from bone marrow
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 39 participants
- Where
- 6 sitesFrance
- Study dates
- 19 Feb 2016to 19 Dec 2022
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient who signed the informed consent,
- Chronic stable ischemic cardiomyopathy for at least one month with a NYHA Class II-IV and/or -Angina pectoris CCS Class III or IV,
- Not a candidate for revascularization by coronary artery by-pass surgery or angioplasty,
- Left ventricular function ≤45%,
- Presence of ischemia or myocardial viability on the myocardial perfusion imaging,
- VO2 max≤ 20 ml/min/kg,
- Optimal medical therapy,
- Optimal interventional therapy (Implantable Cardiovertor Defibrillator, effort rehabilitation).
Who cannot join
- Pregnancy or breastfeeding,
- Acute coronary syndrome or myocardial infarction during the last 3 months,
- Revascularization (PCI or CABG), or cardiac resynchronization during the last 3 months,
- Further revascularization planned for the next 30 days,
- LVEF >45%,
- Left intraventricular Thrombus and / or ventricular aneurysm detected by transthoracic echocardiography,
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- Wall thickness in the target region <8 mm as determined by echocardiography,
- Critical Limb Ischemia stages 3 or 4,
- Inability to achieve a VO2 test,
- Not feasible peripheral arterial access for percutaneous procedure,
- Aortic stenosis (<1cm²) or aortic insufficiency (> 2 +),
- Patients with transplanted organ,
- Chronic renal failure with creatinemia ≥ 250 µmol/L,
- Severe hepatic dysfunction,
- Chronic atrial fibrillation,
- Decompensated heart failure,
- Uncontrolled Ventricular arrhythmias,
- Indication of cardiac resynchronization by multisite pacemaker or cardiac resynchronization during the last 3 months,
- Obesity preventing bone marrow aspiration or manual compression of the puncture area after bone marrow collection,
- Active uncontrolled infection
- Immuno-modulator treatment (ciclosporin, mycophenolate, mycophenolate mofetil, azathioprine, tacrolimus, anthracyclines, neupogen, hydrea, etanercept interferons, prednisolone, methylprednisolone, colchicine),
- History of cancer in the last 5 years,
- Hemopathy, hematopoietic disease,
- Haemorrhagic syndrome,
- Chronic or progressive disease that may alter the prognosis within 3 months,
- Positive serologies for Human immunodeficiency virus (HIV1-2), HTLV-1 (human T-cell lymphotrophic virus) and 2, HBV (hepatitis B virus) or HCV (hepatitis B virus).
- Allergic to xylocain.
Trial locations and contacts
6 sites in 1 country.
6 sites in 1 country
France6 sites
University hospital of Henri Mondor
Créteil, 94010
University hospital of Grenoble
Grenoble, 38043
University hospital of Lille
Lille, 59037
University hospital of Nantes
Nantes, 44093
University hospital of Pitié-Salpêtrière
Paris, 75651
Cardiology Department of Rangueil Hospital - Rangueil Hospital
Toulouse, 31059
About this study
Official title: Effect of Intramyocardial Mesenchymal Stem Cells Injection in Patients With Chronic Ischemic Cardiomyopathy and Left Ventricular Dysfunction Guide by NogaStar XP System Catheter.
Stem cell therapy is an emerging treatment for cardiovascular disease but the best cell type and delivery method remain to be determined. Pre-clinical studies demonstrated improvement of cardiac function by Mesenchymal stem cells (MSC) therapy in particular by their paracrine and immunosuppressive properties. Investigators initiated the MESAMI program by the bicentric pilot phase and highlighted the safety and feasibility of intramyocardial injections of MSCs from bone marrow in patients with chronic ischemic cardiomyopathy and left ventricular dysfunction, guide by the NOGA-XP system. The MESAMI program continues with the phase 2, multicenter, double-blind, randomized, placebo-controlled trial.The aim of this phase 2 study is to demonstrate a functional improvement, measuring peak VO2, at 3 months between the cell therapy group and the placebo group.
Read the detailed description
Ischemic cardiomyopathies are a leading cause of death in both men and women. During the last decade, treatments for heart failure have evolved, but their purpose is to improve symptoms and prevent aggravation of the disease. Current research is focusing on the development of cell-based therapies using different sources of stem cells which can provide trophic and paracrine support or even replace dying cells with new ones. A specific form of stem cells, called adult mesenchymal stem cells (MSCs), has shown promise for heart repair. These cells are known for their ability to secrete paracrine factors and their immunosuppressive properties. The MESAMI 2 study will evaluate the efficacy of MSCs injection directly into the heart to repair and restore heart function in people with chronic ischemic heart failure using NOGA-XP system.
This phase 2 study is a prospective, multicenter, double-blind, randomized, placebo-controlled trial. A total of 90 patients will be randomized in 2 arms to receive intramyocardial injection of MSCs or placebo. Patients will be followed up for 13 months. Bone marrow will be collected and immediately transported to the French Blood Establishment for MSC isolation and expansion. Patients will receive intramyocardial injection of MSCs or placebo during a left heart catheterization.
- Conditions
- Chronic Myocardial Ischemia
- Being tested
- Autologous MSC from bone marrow, Placebo comparator
- Keywords
- Mesenchymal stem cells, ischemic cardiomyopathy, NogaStar XP system catheter
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Autologous MSC from bone marrowDrug
Also called mesenchymal stem cells
After bone-marrow aspiration by an authorized person, MSCs were isolated and cultured during 17±2 days by the French Blood Establishment. Then, patients receive intramyocardial injections of MSCs using the electromechanical NOGA-XP system.
Placebo comparatorDrug
Also called Human Albumin
injections of human albumin
| Study group | Role | What they receive |
|---|---|---|
| Placebo comparator | Placebo comparator | injection of human albumin 4% Receives: Drug: Placebo comparator |
| Autologous MSC from bone marrow | Experimental | intramyocardial injection of 6.10e7 stem cells Receives: Drug: Autologous MSC from bone marrow |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in VO2max
Change in VO2max (or peak VO2) before injection and at 3 months post injection.
Measured: 3 months
Secondary outcomes (8)
Left ventricular viability
MRI
Measured: Before injection and at 3, 6 and 12 months
NYHA/CCS class
Change on class
Measured: Before injection and at 3, 6 and 12 months
Quality of life (Minnesota questionnaire)
Change on quality of life test score
Measured: Before injection and at 3, 6 and 12 months
VO2 max
Change in VO2max (or peak VO2) at 6 and 12 months post injection.
Measured: At 6 and 12 months
6'walking-test
Distance to walk test
Measured: Between 3 and 12 months
Echocardiography
Volume of myocardium and measurement of ejection fraction
Measured: Before injection and at 3, 6 and 12 months
Myocardial perfusion imaging
Efficacy of the cell therapy on LVEF
Measured: Before injection and at 3, 6 and 12 months
BNP blood test
Change of the BNP blood test at 3, 6 and 12 months
Measured: Before injection and at 3, 6 and 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2015 (estimated)
- Study start19 Feb 2016
- Primary completion19 Dec 2022
- Study completion19 Dec 2022
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Chronic Myocardial IschemiaStudies of the same condition, open and under way.
- More trials run by University Hospital, ToulouseThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 39 participants (actual)
Sponsor and investigators
- Lead sponsor
- University Hospital, Toulouse
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Jerôme Roncalli, MD, PhD, Principal investigator, University Hospital, Toulouse
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02462330
- Sponsor's protocol ID
- 10 142 01
- Acronym
- MESAMI2
- Status last verified
- Mar 2023
- First submitted
- 27 May 2015
- Last updated
- 30 Mar 2023
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 30 Mar 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Intramyocardial Mesenchymal Stem Cells Injection in Patients With Chronic Ischemic Cardiomyopathy and Left Ventricular Dysfunction Guide by NogaStar XP System Catheter.
- ClinicalTrials.gov ID
- NCT02462330
- Acronym / sponsor ID
- MESAMI2 / 10 142 01
- Conditions
- Chronic Myocardial Ischemia
- Keywords
- Mesenchymal stem cells, ischemic cardiomyopathy, NogaStar XP system catheter
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 39 participants (actual)
- Lead sponsor
- University Hospital, ToulouseUniversity, hospital or other
- Study start
- 19 Feb 2016 (actual)
- Primary completion
- 19 Dec 2022 (actual)
- Study completion
- 19 Dec 2022 (actual)
- First posted
- 4 Jun 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Stem cell therapy is an emerging treatment for cardiovascular disease but the best cell type and delivery method remain to be determined. Pre-clinical studies demonstrated improvement of cardiac function by Mesenchymal stem cells (MSC) therapy in particular by their paracrine and immunosuppressive properties. Investigators initiated the MESAMI program by the bicentric pilot phase and highlighted the safety and feasibility of intramyocardial injections of MSCs from bone marrow in patients with chronic ischemic cardiomyopathy and left ventricular dysfunction, guide by the NOGA-XP system. The MESAMI program continues with the phase 2, multicenter, double-blind, randomized, placebo-controlled trial.The aim of this phase 2 study is to demonstrate a functional improvement, measuring peak VO2, at 3 months between the cell therapy group and the placebo group.
Detailed description
Ischemic cardiomyopathies are a leading cause of death in both men and women. During the last decade, treatments for heart failure have evolved, but their purpose is to improve symptoms and prevent aggravation of the disease. Current research is focusing on the development of cell-based therapies using different sources of stem cells which can provide trophic and paracrine support or even replace dying cells with new ones. A specific form of stem cells, called adult mesenchymal stem cells (MSCs), has shown promise for heart repair. These cells are known for their ability to secrete paracrine factors and their immunosuppressive properties. The MESAMI 2 study will evaluate the efficacy of MSCs injection directly into the heart to repair and restore heart function in people with chronic ischemic heart failure using NOGA-XP system.
This phase 2 study is a prospective, multicenter, double-blind, randomized, placebo-controlled trial. A total of 90 patients will be randomized in 2 arms to receive intramyocardial injection of MSCs or placebo. Patients will be followed up for 13 months. Bone marrow will be collected and immediately transported to the French Blood Establishment for MSC isolation and expansion. Patients will receive intramyocardial injection of MSCs or placebo during a left heart catheterization.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Placebo comparator | Placebo comparator | Drug: Placebo comparatorinjection of human albumin 4% |
| Autologous MSC from bone marrow | Experimental | Drug: Autologous MSC from bone marrowintramyocardial injection of 6.10e7 stem cells |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Patient who signed the informed consent,
- Chronic stable ischemic cardiomyopathy for at least one month with a NYHA Class II-IV and/or -Angina pectoris CCS Class III or IV,
- Not a candidate for revascularization by coronary artery by-pass surgery or angioplasty,
- Left ventricular function ≤45%,
- Presence of ischemia or myocardial viability on the myocardial perfusion imaging,
Key exclusion criteria (27 listed)
- Pregnancy or breastfeeding,
- Acute coronary syndrome or myocardial infarction during the last 3 months,
- Revascularization (PCI or CABG), or cardiac resynchronization during the last 3 months,
- Further revascularization planned for the next 30 days,
- LVEF >45%,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Autologous MSC from bone marrowAlso: mesenchymal stem cellsAfter bone-marrow aspiration by an authorized person, MSCs were isolated and cultured during 17±2 days by the French Blood Establishment. Then, patients receive intramyocardial injections of MSCs using the electromechanical NOGA-XP system. | Drug | Autologous MSC from bone marrow |
| Placebo comparatorAlso: Human Albumininjections of human albumin | Drug | Placebo comparator |
Primary outcome
Change in VO2max
Time frame: 3 months
Change in VO2max (or peak VO2) before injection and at 3 months post injection.
8 secondary outcomes
Left ventricular viability
Time frame: Before injection and at 3, 6 and 12 months
NYHA/CCS class
Time frame: Before injection and at 3, 6 and 12 months
Quality of life (Minnesota questionnaire)
Time frame: Before injection and at 3, 6 and 12 months
VO2 max
Time frame: At 6 and 12 months
6'walking-test
Time frame: Between 3 and 12 months
Echocardiography
Time frame: Before injection and at 3, 6 and 12 months
Myocardial perfusion imaging
Time frame: Before injection and at 3, 6 and 12 months
BNP blood test
Time frame: Before injection and at 3, 6 and 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Mar 2023.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Jerôme Roncalli, MD, PhD principal investigator
University Hospital, Toulouse
6 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Autologous MSC from bone marrow in people with Chronic Myocardial Ischemia, run by University Hospital, Toulouse at 6 sites in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 27 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Mar 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 6 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in VO2max (time frame: 3 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Mar 2023.