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About
Treatment of patients with deep second degree burns of the skin with extracellular vesicles (EV) isolated from bone marrow derived mesenchymal stem cells.
Full description
This study is designed to examine the safety and efficacy, in 10 patients of administration of allogeneic MSC EV to deep second degree burn wounds. The dose level delivered will be approximately 1 X 107 EV particles for each cm2 treated area. Wounds eligible for treatment will not exceed 600 cm2 per wound or collection of wounds in a defined anatomical area (e.g., arm, leg, chest) treated. Patients with 20% or greater TBSA in total (3700 cm2 in a 70 kg, 175 cm subject) will be ineligible to participate in the study. The first treatment will be administered within 48 hours of the burn injury. Two additional administrations of EV will be given approximately one week (day 5-7 post-injury) and two weeks after the first treatment (unless the wound is fully closed, in which case the patient will continue to be monitored at weekly intervals through 5 weeks, then at 8, 12, 26, and 54 weeks). Safety will be assessed by collection of adverse event data. The potential for wound healing efficacy will be evaluated by recording the percent of burns re-epithelialized within 8 weeks as well as the time to complete closure. Wound closure will be defined as complete re-epithelialization that is not subject to re-injury during dressing changes or as a result of normal daily activities (e.g., wearing clothing, eating, sleeping). The potential for tissue regeneration and restoration of pigmentation, hair growth and skin texture will be evaluated by scoring healing and scar formation using POSAS. Assessment of the potential for prevention of conversion will be done using LDI. Deep second degree wounds presenting at screening that are assessed to be deeper by LDI at the 5-7 day reading than at the initial evaluation in the first 72 hours will be considered to have undergone conversion. Exploratory endpoints will include monitoring for the presence of an immunologic response in recipients.
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Inclusion criteria
Exclusion criteria
Solely first degree or solely third degree burns
Cumulative burn area ≥ 20% TBSA (20% TBSA corresponds to 3700 cm2 in a 70 kg, 175 cm subject)
Burns that occur over a previous scar
Chemical, radiation, or electrical burns
Subjects with superficial second degree burn who are expected to heal within 2 weeks with standard therapy
Evidence of active infection at the wound site
Evidence of significant wound healing prior to treatment
Burn wounds requiring surgery (other than debridement), or skin grafting
Wound exclusively located in the area of fingers, toes, face, or perineum
Wound that extends > 50% across one or more joints
Have any requirement for the use of systemic steroids or immunosuppressive medications
Subjects allergic to human albumin, streptomycin, or penicillin
Be a pregnant female or nursing mother
Subjects who are known or found to be HIV positive
History of alcohol or substance abuse requiring treatment within the past 12 months.
Severe medical conditions
WBC <3 or > 20 x109/L, Hgb < 9g/dL, platelet count 100x109/L or less, serum creatinine > 1.5 times the upper normal limit, AST or ALT > 2.4 times upper normal limit
Known history of coagulopathy
Subjects who have a reasonable likelihood of being a recipient of tissue or organ transplantation
History of poor compliance, unreliability
Primary purpose
Allocation
Interventional model
Masking
1 participants in 1 patient group
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Central trial contact
Willistine Lenon; Shelley Hartman
Data sourced from clinicaltrials.gov
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