Primary Biliary Cirrhosis
Conditions
Keywords
biliary cirrhosis
Brief summary
The study is designed to evaluate the safety and efficacy of intravenous administration of bone marrow derived mesenchymal stem cells for patients with refractory primary biliary cirrhosis (PBC).
Detailed description
Primary biliary cirrhosis (PBC) is an organ-specific inflammatory disease and characterized by immune mediated destruction of intrahepatic bile ducts, then lead to liver cirrhosis and eventually failure.Currently, ursodeoxycholic acid (UDCA) is the only drug approved by the Food and Drug Administration (FDA). Novel treatment is urgently needed for patients who have an incomplete response to UDCA. Mesenchymal stem cells (MSC) represent a promising tool for cell-based therapies of autoimmune diseases. To explore the therapeutic effect of MSCs for PBC, the investigators plan to conduct an open-label, randomized clinical trial. Patients with PBC will be enrolled and randomly divided into two groups which will receive MSCs and UDCA respectively. The investigators will evaluate the efficacy and safety of MSCs for PBC by comparison of symptom improvement, survival rate and side effects in the two groups.
Interventions
BIOLOGICALBiological: mesenchymal stem cell
Mesenchymal stem cells,5-50 million/kg, Intravenous infusion, One dosage，whether to give another dosage depending on patients' condition
DRUGursodeoxycholic acid
13-15 mg/kg/day, to the end of the study
Sponsors
Peking Union Medical College Hospital
Robert Chunhua Zhao, MD, PhD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* There must be at least two of the following: a concentration in serum of AMAs at titres of 1:40 or higher; an unexplained rise in the amount of alkaline phosphatase of at least 1•5 times the upper limit of normal for more than 24 weeks; and compatible liver histological findings, specifically non-suppurative cholangitis and interlobular bile duct injury. * Incomplete response to UDCA at 13-15 mg/kg/day, Criteria for the group of complete responders is including: concentrations of alkaline phosphatase less than three times the upper limit of normal, aspartate aminotransferase less than twice the upper limit of normal, and bilirubin less than 17 μmol/L;and normalisation of abnormal concentrations of bilirubin, albumin, or both. * Liver pathological staging in 2 or3, Histological staging is based on Ludwig's and Scheuer's classifications
Exclusion criteria
* Patients are receiving any other investigational agents within 4 weeks of study entry * Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (defined as invasive fungal infection and progressive CMV viremia), symptomatic congestive heart failure (NYH class III and IV), unstable angina pectoris, or cardiac arrhythmia * In pregnancy or lactation * Psychiatric illness or mental deficiency making compliance with treatment or informed consent impossible * HCVpositive ，HBSAg positive or with other liver diseases * Combined with other autoimmune disease * Expected survival time is less than one year * Decompensation of liver function（Child B or C） * Have a history of allergy or Allergic constitution
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| serum level of alkaline phosphatase | 24 months after MSCs administration | Serum level of alkaline phosphatase will be measured at entry, 1 months，3 months, 6 months and 24 months after therapy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Serum levels of TNF-alpha | 6 months after therapy | serum levels of TNF-alpha will be assessed before entry into therapeutic trials and at 6 months after therapy |
| changes in fatigue | 6 months after theraphy | changes in fatigue will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by PBC-40 score. |
| histological changes in liver biopsies | 6 months after therapy | Liver biopsy of each patient will be taken before entry into therapeutic trials and at 6 months after therapy. |
| Serum levels of Interleukin | 6 months after therapy | serum levels of Interleukin will be assessed before entry into therapeutic trials and at 6 months after therapy |
| changes in pruritus severity | 6 months after therapy | changes in pruritus severity will be evaluated before test (baseline), 1 month,3 months and 6 months after theraphy by VAS score. |
| The occurrence of cirrhosis and its complications | 24 months after therapy | — |
Countries
China
Contacts
Primary ContactFengchun Zhang, MD
Backup ContactYunjiao Yang, MD
Outcome results
None listed