Cell Therapy for IBM by Muscle Injection of ADSVF

Phase

Condition

Polymyositis (Inflammatory Muscle Disease)

Dermatomyositis (Connective Tissue Disease)

Myositis

Treatment

N/A

Clinical Study ID

NCT05032131

APHP180593

2020-005876-36

Ages 45-80
All Genders

Study Summary

Inclusion Body Myositis is a slowly but disabling myopathy, the most frequent in patients over 50 years old. No treatments (in particular immunosuppressive) are known to be efficient.

Autologous uncultured adipose-derived stromal vascular fraction (ADSVF) is recognized as an easily accessible (by a standard liposuction to obtain adipose tissue, from which ADSVF are isolated by centrifugation), safe and well tolerated source of cells with angiogenic, anti-inflammatory, immunomodulatory and regenerative properties. The purpose of our ADSVF in IBM phase I trial is to evaluate, for the first time in human diseased muscle, first the tolerance of autologous ADSVF cells locally injected in affected forearm muscles and second their capability to repair those muscles. With always the goals of tolerance first and second muscle repair, we will recruit in parallel two groups of IBM patients: the first treated by sirolimus since at least 6 months (but still disabled) and the second currently (for at least 3 months) without specific treatment for inclusion myositis.

Eligibility Criteria

Inclusion

Inclusion Criteria:

With an age ≥ 45 and ≤ 80 yo.
Man or menopausal woman. - With IBM defined by the Lloyd criteria (Lloyd et al., 2014): muscle weakness of finger flexors or quadriceps, and endomysial inflammatoryinfiltrates on muscle biopsy, and presence of invaded fibers or rimmed vacuoles onmuscle biopsy.
Who gave their written informed consent
Affiliated to a social security regime (expected AME) And for: -group 1: treated bysirolimus since at least 6 months (but still disabled ) - group 2: currently (for atleast 3 months) without specific treatment for inclusion myositis.

Exclusion

Exclusion Criteria:

Impossibility to walk 10 meters
Grip evaluated by MRC5 MMT at 0 OR 1.
Body mass index < 18
Not able to stop any anticoagulant, or antiaggregant drugs within the week before andthe 48 hours before the liposuction
Severe respiratory insufficiency (FVC < 50% and/or FEV1 < 50%)
Severe chronic kidney disease (Estimated Glomerular Filtration Rate < 15 ml/min and/orproteinuria > 0.5 g/24h)
Cancer non in remission (necessitating specific treatment) during the past 12 months
Connective Tissue Disease non in remission (necessitating specific treatment) duringthe past 12 months - Bone marrow transplantation
Connective Tissue disease non in remission (necessitating specific treatment) duringthe past 12months - Immunosuppressive drugs except sirolimus, ongoing or stopped inless than 3 months
Polyvalent immunoglobulins (IV or sub-cut) ongoing or stopped in less than 3 months
Any biotherapies (mAbs) such as ant-CD20, CTLA4Ig, anti-TNF, anti-IL6R, anti-IL1 etc…ongoing or stopped in less than 6 months.
Seropositivity for HIV, HCV or HBV
Contraindication to muscle MRI
Contraindications to the liposuction: eg coagulation disorders, etc… -Contraindications to anaesthetics
Documented conventional antibiotics severe allergy such as ß-lactam (cephalosporin),cyclins, macrolides (for example metronidazole), quinolones
Participation in another trial (Jardé 1 or Jardé 2)
Legal protection (curatorship or tutorship) or safety measure

Study Design

February 01, 2023

April 30, 2024

Study Description

The main objective of this study is to evaluate the tolerance of escalating doses of ADSVF, one month after intramuscular injection in the finger flexors, in the non-dominant forearm. The second objective of this study is to evaluate the efficacy in term of muscle repair (regenerative properties of ADSVF) and in term of muscle inflammation control, during 6 months, by functional strength tests, quantitative MRI and PBMC monitoring. This research is a phase I trial evaluating first the tolerance and second the efficacy of 3 escalating doses of ADSVF intramuscularly injected in the non-dominant forearm. The volume of injection will be of 1 ml in each of the 5 sites of the finger flexoses, in line at 1 cm apart, for a total dose of 5 millions (low dose) or 10 millions (intermediate dose) or 20 millions (high dose) of viable nucleated cells.These doses are chosen because of the perfect tolerance of intra-muscle injection of (in average) one million ADSVF per millilitre, with a total dose of viable nucleated cells injected between 2.5 and 8.6 millions.The cell treatment will be prepared from autologous uncultured Adipose-Derived Stromal Vascular Fraction (ADSVF) isolated by centrifugation of adipose tissue obtain by liposuction. The study population will be adult patients suffering of an Inclusion Body Myositis (IBM) fulfilling the Lloyd criteria treated by sirolimus since at least 6 months (but still disabled) - who are part of group 1 or currently (for at least 3 months) without specific treatment for inclusion myositis - who are part of group 2. The main inclusion criteria are : Patients: with an age ≥ 45 and ≤ 80 years old, with IBM defined by the Lloyd criteria: muscle weakness of finger flexors or quadriceps, and endomysial inflammatory infiltrates on muscle biopsy, and presence of invaded fibers or rimmed vacuoles on muscle biopsy, who gave their written informed consent, affiliated to a social security regime (expected AME) ; and for: group 1: treated by sirolimus since at least 6 months (but still disabled ) - group 2: currently (for at least 3 months) without specific treatment for inclusion myositis - group 2. The duration of participation of the patients will be 7 months, included one month between maximum the inclusion visit and the injection visit, and 6 month of follow-up periof after ADSVF injection.

Connect with a study center

Olivier BENVENISTE
Paris, 75013
France
Active - Recruiting

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