Clinical trial
Intermediate-size Expanded Access of Remestemcel-L, Human Mesenchymal Stromal Cells, for Multisystem Inflammatory Syndrome in Children (MIS-C) Associated With Coronavirus Disease (COVID-19)
Name
MSB-MSC-MISC001
Description
The objectives of this intermediate-size expanded access protocol are to assess the safety and efficacy of remestemcel-L in participants with MIS-C associated with COVID-19.
Trial arms
Treatment
Remestemcel-L
Participants may receive up to 2 infusions of 2 x 10\^6 remestemcel-L within a 5-day period.
Hydrocortisone
Participants who are not currently taking a corticosteroid will receive hydrocortisone, 0.5-1 milligram per kilogram (mg/kg), up to 50 mg IV, at least 30 minutes prior to the infusion of remestemcel-L.
Diphenhydramine
Participants will receive diphenhydramine, 0.5-1 mg/kg, up to 50 mg IV, at least 30 minutes prior to the infusion of remestemcel-L.
Other names:
Benadryl®
Size
-1
Eligibility criteria
Inclusion Criteria
1. 2 months to 17 years of age, inclusive
2. Positive for current or recent SARS-CoV-2 (COVID-19) infection by real-time reverse transcription polymerase chain reaction (RT-PCR), serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms AND no alternative plausible diagnoses
3. Presenting with:
* Fever (\>38.0°C or \>100.4°F for ≥24 hours) or reporting subjective fever lasting ≥24 hours
* Laboratory evidence of inflammation with high sensitivity C-reactive protein (hsCRP) ≥4.0 milligrams per deciliter (mg/dL) and associated abnormalities of at least one of the following:
* elevated erythrocyte sedimentation rate (ESR)
* elevated fibrinogen
* elevated procalcitonin
* elevated d-dimer
* elevated ferritin
* elevated lactic dehydrogenase (LDH)
* elevated interleukin 6 (IL-6)
* elevated neutrophils
* reduced lymphocytes
* low albumin
* Clinically severe multisystem illness requiring hospitalization with evidence for cardiac involvement plus at least one other organ involvement (renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological)
* Cardiac involvement is defined as reduced left ventricular ejection fraction (\<55%) in addition to at least one of the following:
* increased troponin I,
* increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) or BNP and/or
* echocardiographic and/or other imaging evidence of left anterior descending coronary artery (LAD) and/or right coronary artery (RCA) dilation associated with a z-score \> 2.5
4. If on mechanical ventilation or ECMO, ≤72 hours post initiation of the respiratory support device
Exclusion Criteria
1. Documented other microbial cause for MIS-C including bacterial sepsis, staphylococcal or streptococcal shock syndromes, or infections associated with myocarditis such as enterovirus. Of importance, waiting for results of these investigations should not delay initiation of remestemcel-L therapy.
2. Females who are pregnant or lactating
3. Body mass index (BMI) ≥40 kilograms per square meter (kg/m\^2)
4. Known hypersensitivity to dimethyl sulfoxide (DMSO) or to porcine or bovine proteins
5. Aspartate aminotransferase/alanine transaminase (AST/ALT) ≥5x upper limit of normal (ULN)
6. Creatinine clearance \<30 mL/min
7. Serum creatinine \>2 mg/dL
8. Any end-stage organ disease which in the opinion of the treating physician may possibly affect the safety of the remestemcel-L treatment.
Protocol
{'studyType': 'EXPANDED_ACCESS', 'nPtrsToThisExpAccNctId': 1, 'expandedAccessTypes': {'intermediate': True}}
Updated at
2023-05-06
1 organization
3 products
1 indication
Organization
Mesoblast International SarlProduct
HydrocortisoneProduct
DiphenhydramineProduct
Remestemcel-L