中央 cGMP 实验室生产的自体脂肪源性血管基质细胞治疗产品治疗膝骨关节炎的安全性和有效性临床评估。

Christopher J Rogers, Robert Harman, Mitchell B Sheinkop, Peter Hanson, Mary A Ambach, Tal David, Rahul Desai, Steven Sampson, Danielle Aufierro, Jay Bowen, Gerard Malanga
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引用次数: 0

摘要

膝关节骨关节炎(KOA)是一种以整个关节逐渐退化为特征的常见疾病,已成为全球范围内导致残疾的主要因素。这种疾病的性质及其对关节功能的影响极大地限制了患者的活动能力和日常活动,对患者的整体健康产生了重大影响。基质血管成分(SVF)是一种异源自体细胞产品,含有间充质干细胞,来源于患者的皮下脂肪组织,在治疗KOA患者方面具有安全性和有效性。我们在 Kellgren-Lawrence 严重程度 2-4 级的 KOA 患者中进行了一项经 FDA 批准的单臂、开放标签、多地点临床研究。细胞产品是在符合 FDA 标准的中心生产设施中,从患者特定的吸脂液中提取的。二十九(29)名受试者接受了经质量检测的单次 GMP SVF 关节内注射治疗。研究期间对不良事件、实验室值、生命体征和体检结果进行了监测。研究结果表明,受试者具有良好的耐受性,没有出现任何重大安全问题。通过膝关节损伤和骨关节炎结果评分(KOOS)对膝关节疼痛和功能进行评估,结果显示膝关节疼痛和功能明显改善。这些积极的益处持续了 12 个月,大多数参与者表示满意。每位患者的 SVF 都储存在液氮冷冻库中,以备将来临床治疗之用。这项自体细胞研究的独特之处在于将吸脂液从诊所运送到符合 FDA 标准的中央生产设施,在洁净室控制下进行生产。细胞产品表征数据表明,这种方法生产的产品在细胞数量和存活率方面与其他方法相当,而且在给患者用药前还能进行进一步的质量保证测试,包括无菌性、内毒素和流式细胞术测试。
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Clinical Evaluation of Safety and Efficacy of a Central Current Good Manufacturing Practices Laboratory Produced Autologous Adipose-Derived Stromal Vascular Fraction Cell Therapy Product for the Treatment of Knee Osteoarthritis.

Knee osteoarthritis (KOA) is a prevalent condition characterized by the progressive deterioration of the entire joint and has emerged as a prominent contributor to disability on a global scale. The nature of the disease and its impact on joint function significantly limit mobility and daily activities, highlighting its substantial influence on patients' overall well-being. Stromal vascular fraction (SVF) is a heterogenous, autologous cell product, containing mesenchymal stem cells, derived from the patient's subcutaneous adipose tissue with demonstrated safety and efficacy in the treatment of KOA patients. We conducted a single-arm, open-label, multisite, FDA approved clinical study in Kellgren-Lawrence severity grade 2-4 KOA patients. The cellular product was manufactured from patient-specific lipoaspirate in a centrally located FDA-compliant manufacturing facility. Twenty-nine subjects were treated with a quality tested single intra-articular injection of GMP manufactured SVF. Adverse events, laboratory values, vital signs, and physical examination findings were monitored during the study period. Robust tolerability, without any substantial safety issues, was demonstrated. Knee pain and function, assessed through the Knee Injury and Osteoarthritis Outcome Score (KOOS), demonstrated notable improvements. These positive benefits persisted for up to 12 months, and the majority of participants expressed satisfaction. SVF from each patient was stored in a liquid nitrogen freezer for future clinical treatments. Unique to this study of autologous cells is the shipment of lipoaspirate from the clinic to a central FDA-compliant manufacturing facility for cleanroom-controlled manufacturing. The cell product characterization data demonstrate that this method produces an equivalent product in terms of cell count and viability with the added benefit of further quality assurance testing, including sterility, endotoxin, and flow cytometry, before patient administration. Clinical Trial Registration Number: NCT04043819.

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