An Efficacy, Safety and Tolerability Study of Ixmyelocel-T Administered via Transendocardial Catheter-based Injections to Subjects with Heart Failure Due to Ischemic Dilated Cardiomyopathy (IDCM)

Overview

About this study

This study is designed to assess the efficacy, safety and tolerability of ixmyelocel-T compared to placebo (vehicle control) when administered via transendocardial catheter-based injections to patients with end stage heart failure due to IDCM, who have no reasonable revascularization options (either surgical or percutaneous interventional) likely to provide clinical benefit.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria

  • Males and non-pregnant, non-lactating females
  • Age 30 to 86 years of age
  • Diagnosis of ischemic dilated cardiomyopathy
  • LVEF ≤ 35% by echocardiogram
  • Symptomatic heart failure in NYHA functional class III or IV
  • Subject is not a candidate for reasonable revascularization procedures that will produce clinical improvement
  • Subject is receiving appropriate clinical standard of care heart failure therapy, as tolerated and as dictated by a subject's current medical condition, for at least 30 days prior to screening
  • Must have an automatic implantable cardioverter defibrillator (AICD)
  • Worsening heart failure hospitalization or equivalent within 6 months prior to screening
    • hospitalization equivalent defined as an unplanned outpatient/emergency department visit for treatment of acute decompensated heart failure
  • Have an N-terminal prohormone B-type natriuretic peptide (NT-proBNP) ≥2000 pg/mL or BNP ≥400 pg/mL within 30 days of screening (including screening)
  • Have a 6-minute walk test (6MWT) distance of ≤400 meters at screening
  • Life expectancy of at least 12 months in the opinion of the Investigator
  • LV wall thickness ≥ 7mm (by echocardiogram) at anticipated target injection area
  • Hemodynamic stability without IV vasopressors or support devices
  • Subject is an acceptable candidate for bone marrow aspiration and cardiac catheterization and transendocardial injection procedures in the opinion of the investigator given the medical history and concurrent medication
  • Willing and able to comply with scheduled visits and tolerate study procedures
  • Voluntarily provide a personally-signed and dated informed consent.

 

Exclusion Criteria

  • Severe primary valvular heart disease not limited to
    • aortic valve stenosis and insufficiency
    • VAD implantation
    • Heart transplantation
    • Cardiomyoplasty
    • Left ventricular reduction surgery
    • Cardiac shunt implantation
  • Planned heart failure-related device interventions e.g.,
    • VAD implantation
    •  Initial cardiac resynchronization therapy
  • Planned cardiac procedures e.g.,
    • Heart transplant
    • Cardiomyoplasty
    •  Valvular repair
  • Current arrhythmias that would prohibit accurate NOGA® electromechanical mapping and NOGA®-guided injections
  • LV thrombus (as documented on echocardiography or LV angiography)
  • Myocardial infarction, stroke or transient ischemic attack within 3 months prior to screening
  • Percutaneous coronary intervention, valvuloplasty, cardiac surgery, and other major cardiac procedure within 30 days prior to screening
  • In the opinion of the Investigator, the subject's left ventricular wall is unsuitable for transendocardial injections (due to thickness or other reasons)
  • Stroke or transient ischemic attack (TIA) within 3 months of screening
  • Hemoglobin A1c (HbA1c) ≥ 9% at screening
  • Diabetic subjects with uncontrolled or untreated proliferative retinopathy as determined by dilated eye exam administered by a qualified eye care professional as per American Diabetes Association guidelines
  • Blood clotting disorder not caused by medication (e.g., thrombophilia)
  • Active malignancy (non-basal cell) requiring surgery, chemotherapy, and/or radiation in the past 12 months
  • Drug or alcohol abuse that would interfere with the subject's compliance with study procedures
  • Allergies to any equine, porcine, or bovine products
  • Body mass index (BMI) ≥ 40 kg/m2 at screening
  • Established chronic kidney disease (CKD) requiring dialysis (Stage 5)
  • Estimated creatinine clearance < 15 mL/min at screening
  • Subject has allergy or is unable to tolerate cardiac imaging contrast agents
  • Inability to get a good quality echocardiogram image at screening (as determined by the imaging core lab
  • Abnormal laboratory values (performed at central lab) at screening
    • Platelets < 50,000 μL
    • Hemoglobin < 9.0 g/dL
    • Aspartate aminotransferase/alanine aminotransferase (AST/ALT) > 3 times the upper limit of normal (ULN)
    • Human immunodeficiency virus 1 (HIV 1), HIV 2, or syphilis positive (rapid plasma reagin [RPR])
    • Active hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV) antibodies
      • NOTE: Additional lab tests may be performed per local requirements including but not limited to
        • hepatitis B core antibody
        • human T lymphotropic virus I/II
  • Subjects receiving anti-angiogenic drugs (e.g., anti-vascular endothelial growth factor [VEGF])
  • Chronic exposure to cytotoxic therapy for oncologic or chronic non-oncologic reasons in the prior 3 months or expected requirement over the course of the study
  • Concurrent participation in another interventional clinical trial or receiving experimental intervention within 30 days of screening or having previously been exposed to Aastrom's ixmyelocel T product or previously received allogeneic cell therapy, autologous cell therapy cultured with animal proteins
  • In the opinion of the Investigator, the subject is unsuitable for cellular therapy or has a
    • Food/drug allergy
    • Surgical or medical condition
    • Clinically significant psychiatric disorders
    • Poor nutritional status
    • Lab abnormality requiring further medical evaluation that may
      • Interfere with the investigational product
      • Interfere with the study results' interpretation
      • Interfere with the subject's ability to complete the study 
      • Compromise the subject's safety.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Scottsdale/Phoenix, Ariz.

Mayo Clinic principal investigator

F Fortuin, M.D.

Closed for enrollment

More information

Publications

Publications are currently not available

Study Results Summary

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Supplemental Study Information

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Additional contact information

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