Mesenchymal Stem Cell Therapy for Liver Cirrhosis

Phase

1/2

Condition

Hyponatremia

Hepatic Fibrosis

Scar Tissue

Treatment

N/A

Clinical Study ID

NCT03626090

P-SM-L0001

Ages 21-69
All Genders

Study Summary

MSCs have been studied for the treatment of liver diseases as well as non-liver diseases. MSCs have been successful in treating conditions like acute steroid-resistant GVHD in hematopoietic stem cell transplanted patients and also have shown to improve the MELD score in end-stage liver disease. There were no severe side effects observed in using autologous MSCs as a treatment option. The outcome of the studies done so far have been positive and it is encouraged to study the use of MSCs as cell therapy for treating liver diseases.

The estimated rate of cirrhosis in HBV patients in Singapore is about 1.6% per year, rate of hepatocellular carcinoma is about 0.8% per year overall and 3.0% per year in cirrhotic patients. Knowing that there are not many options currently available for Liver Cirrhosis patients and that they have a poor prognosis with an average life expectancy of < 12 months, this study uses autologous MSCs to treat Liver Cirrhosis patients in Singapore. The objective of the study is to demonstrate that autologous bone marrow is safe to be used in patients with liver cirrhosis as well as demonstrate that bone marrow MSC may improve liver function and prolong patient survival.

Eligibility Criteria

Inclusion

Inclusion Criteria: Subjects must meet all the inclusive criteria to participate in the study:

with definite liver cirrhosis, irrespective of aetiology
must have Child's B or C stage
must have signed an informed consent form

Exclusion

Exclusion Criteria: Subjects with any of the following criteria are regarded as an exclusion from the study andwill not be permitted to participate:

age ≤21 years and >70 years old
with life expectancy of < 6 months
cancers and bone marrow malignancies
patients with an active infection or multiple infections
patients with uncontrolled hypertension and diabetes
immunosuppressed patients (IST must have stopped at least 4 weeks prior to trialenrolment)
patients who are HIV positive
patients who are pregnant or lactating

Study Design

August 18, 2018

October 22, 2021

Study Description

Liver cirrhosis refers to extreme scarring of the liver, resulting in suboptimal function of the liver. It can result from a variety of causes, ranging from hepatitis B and C infection, excessive alcohol consumption, autoimmune causes, fatty liver and others. Irrespective of the cause, once the liver becomes cirrhotic, it is a downhill course.

Liver cirrhosis is irreversible and most patients will progressively worsen over time. Once liver cirrhosis has reached the stage of decompensation, that is, development of jaundice, ascites, variceal bleeding, hepatic encephalopathy and coagulopathy the two-year survival drops to about 50%.

The definitive treatment of decompensated cirrhosis is liver transplantation. While a liver transplantation is potentially curative, the high costs, lack of a donor, treatment-related mortality and the immunosuppression complications make this option possible only for a limited number of patients. The vast majority do not have an effective option at all, thus the need to develop alternative therapies. Various types of Stem Cells had been investigated as a regenerative therapy for liver cirrhosis. These stem cells include bone marrow mesenchymal stem cells (MSC), bone marrow mononuclear cells (MNC) and peripheral CD34 positive cells. Some early studies have shown encouraging results in patients who had autologous bone marrow stem cell transplantation. There was improved liver function in these patients with cirrhotic livers.

The sponsor is proposing a study to look into the role of MSC therapy for patients with liver cirrhosis in Singapore. This will be a Phase I/II study with the main emphasis on the safety profile first. The trial will be conducted in compliance with the protocol, GCP and local regulatory requirement(s).

Connect with a study center

Asian American Liver Centre - Gleneagles Hospital (Annexe Block)
Singapore, 258500
Singapore
Active - Recruiting
Desmond Wai Liver & Gastrointestinal Disease Centre - Mount Elizabeth Novena Specialist Centre
Singapore, 329563
Singapore
Active - Recruiting
Parkway Cancer Centre - Gleneagles Hospital
Singapore, 258500
Singapore
Active - Recruiting

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.