Moderate and Severe Plaque Psoriasis
Conditions
Keywords
psoriasis, UC-MSCs
Brief summary
This is a study in patients with moderate to severe chronic plaque psoriasis.All the participants will be randomized into three groups, high-dose UC-MSCs, low-dose UC-MSCs, or methotrexate group.This study is designed to prove that UC-MSCs is safe and effective.
Detailed description
Psoriasis is a chronic, incurable, immune-mediated dermatological disease, and it is considered that immune system dysregulation is the important cause of the disease.Umbilical cord derived mesenchymal stem cells (UC-MSCs) have be proven safe and effective for the treatment of various intractable autoimmune and inflammatory disorders because of their distinct immunomodulatory properties. Patients will be randomized into three groups.In one group patients will be treated with 1x10\^6 cells/kg in 0,1,2,3,5,7 week, in the second group patients will be treated with 3x10\^6 cells/kg in 0,1,2,3,5,7 week,in the third group patients will be treated with 5-25mg Methotrexate from 0 to 15 week In this study, researchers will determine the safety of UC-MSCs that a patient can tolerate without causing side effects. Moreover researchers will also be assess the efficacy and sustainability of UC-MSCs in 52 weeks.
Interventions
Participants will receive 6 times UC-MSCs infusions (each time 1×10\^6/kg). The first time to fourth time will be given once a week for successive 4 weeks(week 0,1,2,3), then the last two times will be given once every two weeks(week 5,7).
Participants will receive 6 times UC-MSCs infusions (each time 3×10\^6/kg). The first time to fourth time will be given once a week for successive 4 weeks(week 0,1,2,3), then the last two times will be given once every two weeks(week 5,7).
Participants will be administered Methotrexate (each time 5-25mg) orally once a week for successive 16 weeks(week 0-15).
Sponsors
Study design
Eligibility
Inclusion criteria
* Male or female patients ≥18 years old with moderate-to-severe psoriasis. * Diagnosis of plaque psoriasis at least 6 months before entering the study. * Moderate-to-severe plaque psoriasis(PASI≥10,or BSA≥10% and DLQI score≥10). * Failure after conventional therapy. * No other treatment for psoriasis during the period of the trial. * Willing and able to comply with all study requirements and provide informed consent.
Exclusion criteria
* Other types of psoriasis,such as pustular, erythrodermic and guttate psoriasis). * Drug-induced psoriasis (i.e., new onset or current exacerbation from beta-blockers, calcium channel inhibitors or lithium). * Ongoing use of other psoriasis treatments. * Ever use of any biologic drug directly targeting IL-17,IL-23,TNFa etc. * Active systemic infections during the last two weeks (exception: common cold) prior to initiation of the trial and any infections that reoccur on a regular basis. * History of malignancy . * Evidence of infection with HIV, hepatitis B or hepatitis C. * Pregnant or lactating females, or willing to have a baby during the trial. * Can not be traced on time.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of subjects who achieve a score of 0 or 1 on a 5-point Physician's global assessment(PGA0/1) at week 20 | Week 20 | The proportion of subjects who achieve a score of 0(clear)or 1(almost clear)on a 5-point Physician's global assessment(PGA0/1) at week 20 |
| Proportion of subjects who have 75% or more reduction in [Psoriasis area-and-severity index score (PASI)] (PASI75) at week 20 | Week 20 | The proportion of subjects who have a reduction of 75% or more from baseline in the psoriasis area-and-severity index score (PASI 75) at week 20 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of subjects who have 75% or more reduction in [Psoriasis area-and-severity index score (PASI)] (PASI75) at week 12,16,36,52 | Week 12,16,36,52 | The proportion of subjects who have a reduction of 75% or more from baseline in the psoriasis area-and-severity index score (PASI 75) at week 12,16,36,52 |
| Frequency of Adverse Events and Serious Adverse Events | Week 0 through week 52 | Frequency of all Adverse Events (AEs) and Serious Adverse Events (SAEs) that occur during the whole trial including the observational period (AEs and SAEs include but not limited to headaches, allergies, fever and so on |
| Proportion of subjects who experience psoriasis relapse | Week 8 though week 52 | The proportion of subjects who experience a psoriasis relapse at any time until week 52. Psoriasis relapse is defined as loss of \> 50% of the initial PASI improvement measured at week 7 |
| Proportion of subjects who achieve a score of 0 or 1 on a 5-point Physician's global assessment(PGA0/1) at week 12,16,36,52 | Week 12,16,36,52 | The proportion of subjects who achieve a score of 0(clear)or 1(almost clear)on a 5-point Physician's global assessment(PGA0/1) at week 12,16,36,52 |
| Proportion of subjects who have 90% or more reduction in [Psoriasis area-and-severity index score (PASI)] (PASI90) at week 20 | Week 20 | The proportion of subjects who have a reduction of 90% or more from baseline in the psoriasis area-and-severity index score (PASI 90) at week 20 |
Other
| Measure | Time frame | Description |
|---|---|---|
| Change from Baseline in Dermatology Life Quality Index (DLQI) score though 52 weeks | Week 0,1,2,3,5,7,12,16,20,36,52 | DLQI score will be assessed at week 0,1,2,3,5,7,12,16,20,36,52 |
| Exploring the theoretical basis of stem cell therapy for psoriasis | 0,1,2,3,5,7 12,16,20,36,52 week | Analysis the serum cytokine content, immunological subgroup and pathological section to explore the theoretical basis of stem cell therapy for psoriasis |
Countries
China