Novel Cellular Therapy for the Treatment of Pain Associated With Chronic Pancreatitis

Last updated: February 6, 2025
Sponsor: VA Office of Research and Development
Overall Status: Active - Recruiting

Phase

1

Condition

Chronic Pain

Pancreatitis

Pain

Treatment

Placebo

Mesenchymal stem cells

Clinical Study ID

NCT05925036
NURP-003-22F
I01CX002516
  • Ages 18-75
  • All Genders

Study Summary

The goal of this clinical trial is to test whether adult stem cells, called mesenchymal stem cells (MSCs) collected from the patient's bone marrow can help reduce pain caused by chronic pancreatitis and improve pancreatic function.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age between 18 and 75 years old, male or female

  • Definite chronic pancreatitis (stage 1-3) by M-ANNHEIM criteria

One or more of the following are required:

  • Pancreatic calcifications

  • Moderate or marked ductal lesions

  • Marked and persistent exocrine insufficiency defined as pancreatic steatorrheamarkedly reduced by enzyme supplementation

  • Typical histology of an adequate histological specimen

  • Patients who are diagnosed with painful CP for more than 6 months may be constant ormay have been waxing and waning/remitting.

  • Baseline Izbicki pain score > 50

  • Stable dose of opioids for the past 30 days

Exclusion

Exclusion Criteria:

  • Acute pancreatitis per 2012 revised Atlanta criteria within the last 30 days

  • Score >7 on the Opioid Risk Tool

  • Chronic pain syndromes other than pancreatitis that require daily use of opioids inthe past 30 days.

  • Hemoglobin of <8.0g/dL, EGFR<60 ml/min, AST or ALT >2 times upper limit of normal,Bilirubin > 1.5 mg/dl unless the subject has confirmed Gilbert syndrome., Platelets <100,000/microliter, HbA1c >10%

  • Congestive Heart Failure NYHA class >1

  • History of Malignancy except for in situ malignancies that have been surgicallytreated and basal cell skin cancers

  • Evidence of active infection using current antibiotics or with Hepatitis B, C, orHIV

  • Known intravenous contrast allergy causing anaphylaxis

  • TWEAK score > 2 points at screening (24) (the questions below will be asked of thesubjects at screening)

  • Any subject who has received an investigational drug or device within 30 days beforerandomization or who is expected to receive an investigational drug or device duringthis study.

  • Patients with planned endoscopic or surgical intervention, surgical resection orneedle drainage of pancreatic structures in the next 6 months.

  • Subjects with infected pancreatic pseudocysts or pancreatic walled-off necroticareas at the time of consent

  • Females who are pregnant or women of childbearing potential (WOCBP) and males withfemale partners of childbearing potential who are not willing to use adequatecontraception during the study

  • Breastfeeding females

  • Subject unwilling to follow the protocol and assessments

Study Design

Total Participants: 40
Treatment Group(s): 2
Primary Treatment: Placebo
Phase: 1
Study Start date:
January 01, 2024
Estimated Completion Date:
December 31, 2027

Study Description

Chronic pain affects approximately 50 million U.S. adults and disproportionally impacts about 20 million veterans; 1 in 3 Veterans have been diagnosed with a condition related to chronic pain. There is also a significant interaction between chronic pain, post-traumatic stress disorder (PTSD), and persistent post-concussive syndromes common to the veteran population. The opioids that are prescribed to treat chronic pain are often ineffective and are associated with a significantly increased risk of misuse, addiction, diversion, overdose, and death. Unconventional treatment options that can effectively manage pain and avoid or reduce opioid addiction in Veterans are of significant clinical importance to VA healthcare. Given the high morbidity and mortality attributable to pain therapy, not to mention the staggering medical cost, it is vital to the VA healthcare mission to explore novel strategies to treat chronic pain effectively. Chronic pancreatitis (CP) is an inflammatory disease characterized by pancreatic inflammation, fibrosis, and abdominal pain. CP subjects often suffer extreme pain, which often leads to opioid addiction. In our animal models, the investigators show a linkage between inflammatory increases in neuropeptides and pain. In humans, the investigators have more specific pain measurements to explore the link between inflammation, neuropeptides, and neuropathic pain measurement as impacted by a novel therapeutic.

Mesenchymal stromal cells (MSCs) are adult stem cells that can be harvested and expanded for therapy. MSC therapy represents a promising new intervention as increasing evidence demonstrates that MSC therapy can effectively target several injury pathways in a variety of fibroinflammatory diseases and can reduce pain while suppressing inflammation, something that most pharmacological interventions cannot accomplish.

Rationale of the study: Because MSCs are a novel therapy that my improve chronic pancreatitis pain in animal models and improve chronic pain in other human disease states, these cells are worthy of study. Specifically, the investigators propose a pilot phase 1 crossover study design in which MSCs or placebo are prospectively given to CP subjects with pain outcomes measured. This phase 1 study will inform future study designs and may lead to MSCs as a standard of care if they are safe and effective.

Connect with a study center

  • Ralph H. Johnson VA Medical Center, Charleston, SC

    Charleston, South Carolina 29401-5703
    United States

    Active - Recruiting

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