Cell Therapy for Chronic TBI
Interim Analysis of the Randomized Controlled STEMTRA Trial
Citation Manager Formats
Make Comment
See Comments

Abstract
Objective To determine whether chronic motor deficits secondary to traumatic brain injury (TBI) can be improved by implantation of allogeneic modified bone marrow–derived mesenchymal stromal/stem cells (SB623).
Methods This 6-month interim analysis of the 1-year double-blind, randomized, surgical sham–controlled, phase 2 Stem Cell Therapy for Traumatic Brain Injury (STEMTRA) trial (NCT02416492) evaluated safety and efficacy of the stereotactic intracranial implantation of SB623 in patients with stable chronic motor deficits secondary to TBI. Patients in this multicenter trial (n = 63) underwent randomization in a 1:1:1:1 ratio to 2.5 × 106, 5.0 × 106, or 10 × 106 SB623 cells or control. Safety was assessed in patients who underwent surgery (n = 61), and efficacy was assessed in the modified intent-to-treat population of randomized patients who underwent surgery (n = 61; SB623 = 46, control = 15).
Results The primary efficacy endpoint of significant improvement from baseline of Fugl-Meyer Motor Scale score at 6 months for SB623-treated patients was achieved. SB623-treated patients improved by (least square [LS] mean) 8.3 (standard error 1.4) vs 2.3 (standard error 2.5) for control at 6 months, the LS mean difference was 6.0 (95% confidence interval 0.3–11.8, p = 0.040). Secondary efficacy endpoints improved from baseline but were not statistically significant vs control at 6 months. There were no dose-limiting toxicities or deaths, and 100% of SB623-treated patients experienced treatment-emergent adverse events vs 93.3% of control patients (p = 0.25).
Conclusions SB623 cell implantation appeared to be safe and well tolerated, and patients implanted with SB623 experienced significant improvement from baseline motor status at 6 months compared to controls.
ClinicalTrials.gov Identifier: NCT02416492.
Classification of Evidence This study provides Class I evidence that implantation of SB623 was well tolerated and associated with improvement in motor status.
Glossary
- ARAT=
- Action Research Arm Test;
- BDNF=
- brain-derived neurotrophic factor;
- CI=
- confidence interval;
- DRS=
- Disability Rating Scale;
- FMMS=
- Fugl-Meyer Motor Scale;
- GOS-E=
- Glasgow Outcome Scale–Extended;
- GV=
- gait velocity;
- ITT=
- intent-to-treat;
- LS=
- least square;
- mITT=
- modified ITT;
- MMRM=
- mixed-model repeated measures;
- MSC=
- mesenchymal stromal/stem cell;
- SE=
- standard error;
- STEMTRA=
- Stem Cell Therapy for Traumatic Brain Injury;
- TBI=
- traumatic brain injury;
- TEAE=
- treatment-emergent adverse event;
- TESAE=
- treatment-emergent serious adverse event
Footnotes
Go to Neurology.org/Nhttps://n.neurology.org/lookup/doi/10.1212/WNL.0000000000011450 for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
The Article Processing Charge was funded by SanBio, Inc.
Editorial, page 357
Class of Evidence: NPub.org/coe
CME Course: NPub.org/cmelist
- Received February 9, 2020.
- Accepted in final form October 20, 2020.
- Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Disputes & Debates: Rapid online correspondence
NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.
- Stay timely. Submit only on articles published within the last 8 weeks.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- 200 words maximum.
- 5 references maximum. Reference 1 must be the article on which you are commenting.
- 5 authors maximum. Exception: replies can include all original authors of the article.
- Submitted comments are subject to editing and editor review prior to posting.