SanBio Announces Publication Comparing Outcome Measures for Persons With Chronic Traumatic Brain Injury in Expert Review of Neurotherapeutics
SanBio Group has published significant data in Expert Review of Neurotherapeutics, focusing on outcome measures for chronic motor deficits in traumatic brain injury (TBI). The study introduces minimally clinically important differences (MCIDs) for the Disability Rating Scale (DRS) and Fugl-Meyer Motor Scale (FMMS), essential for future clinical trials. With findings derived from the 61 patient STEMTRA trial, results showed that SB623 led to an average 8.3-point improvement in FMMS compared to 2.3 points in the control group. The company aims to file for regulatory approval for SB623 as a regenerative medicine.
- Study established MCIDs for DRS and FMMS, improving precision in assessing long-term outcomes in TBI.
- SB623 treatment resulted in an 8.3-point improvement in FMMS compared to 2.3 points for the control group (p=0.040).
- No new safety signals were identified during the trial, indicating a favorable safety profile.
- SanBio plans to apply for marketing approval for SB623 utilizing Japan’s regenerative medicine approval system.
- None.
“Success in clinical trials in chronic TBI is challenging to define and measure; therefore, this publication is an important advancement for the field of research as it relates to the assessment of persons with motor deficits resulting from a TBI,” said
While acute TBI is widely assessed using Extended Glasgow Outcome Scale (GOS-E), this scale is less well-defined for persons who have chronic, or long-term, motor deficits as a result of their injury. The publication, entitled, “Determining minimally clinically important differences (MCIDs) for outcome measures in patients with chronic motor deficits secondary to traumatic brain injury”, determined MCIDs for DRS and FMMS. MCID is defined as the smallest change on a measure that is reliably associated with a meaningful change in a patient's clinical status, function, or quality of life.
Establishing MCIDs for the DRS and FMMS in chronic TBI provides improved precision for assessing long-term functional outcomes and motor impairment, respectively, as compared to the widely used GOS-E Scale, which is most appropriate for use in acute TBI. The findings of this study support the use of DRS and Fugl-Meyer Scales in the evaluation of clinical outcomes, and define the amplitude of clinically meaningful improvement for future chronic TBI clinical trials.
“At SanBio, we are passionate about improving the lives of persons living with long-term motor deficits as a result of a TBI or stroke. This publication will help to overcome one of the most challenging areas of clinical research: determining the minimal improvement that would be clinically meaningful in patients with chronic motor deficit. We would like to extend our gratitude to the physicians and rehabilitation specialists who supported this important work,” added, Bijan Nejadnik, M.D., Corporate Officer, Chief Medical Officer and Head of Research.
This retrospective analysis is from SanBio’s 1-year, double-blind, randomized, surgical sham-controlled, Phase 2 ‘STEM cell therapy for TRAumatic brain injury’ (STEMTRA) trial (NCT02416492), in which persons with chronic motor deficits secondary to TBI (n=61) underwent intracerebral stereotactic implantation of SB623 or sham surgery. MCIDs for DRS and FMMS were triangulated with anchor-based, distribution-based, and Delphi panel estimates. The published Delphi panel results are available here. The MCIDs for DRS and FMMS were: 1) −1.5 points for the Disability Rating Scale; 2) 6.2 points for the Fugl-Meyer Upper Extremity Subscale; 3) 3.2 points for the Fugl-Meyer Lower Extremity Subscale; and 4) 8.4 points for the Fugl-Meyer Motor Scale in persons with chronic motor deficits secondary to TBI.
The full publication can be accessed here.
About the STEM cell therapy for TRAumatic brain injury (STEMTRA) Trial
STEMTRA was a 12-month, Phase 2, randomized, double-blind, surgical sham-controlled, global trial evaluating the efficacy and safety of SB623 compared to sham surgery in patients with stable chronic neurological motor deficits secondary to TBI (https://clinicaltrials.gov identifier: NCT02416492). In this study, SB623 cells were implanted directly around the site of brain injury. The primary endpoint was mean change from baseline in FMMS score at six months to measure changes in motor impairment.
To be eligible for this trial, patients (ages 18-75) must have been at least 12 months post-TBI and had a Glasgow Outcome Scale extended (GOS-E) score of 3-6 (e.g., moderate or severe disability). The STEMTRA trial treated 61 patients from 27 sites in the
In this study, SB623 met its primary endpoint, with patients treated with SB623 achieving an average 8.3-point improvement from baseline in the FMMS, versus 2.3-points in the control group, at 6 months (p=0.040). No new safety signals were identified, and the most commonly reported adverse event was headaches. The Group, based on the study results, aims to apply for manufacture and marketing approval for SB623 as a regenerative medicine product by utilizing Japan’s conditional and time-limited approval system for regenerative medicine products.
About Traumatic Brain Injury
Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide. The estimated global incidence of acute TBI during 2016 was 27 million cases, and the estimated global prevalence of chronic impairment secondary to TBI was 55.5 million cases. Overall, TBI and long-term motor deficits secondary to TBI significantly impair person’s self-care, employability, and quality of life, and are major burdens on healthcare systems worldwide. In
About SB623
SB623 is a proprietary, cell-based investigational product made from allogeneic modified and cultured adult bone marrow-derived mesenchymal stem cells (MSCs) that undergo temporary genetic modification. Implantation of SB623 cells into injured nerve tissue in the brain is expected to trigger the brain’s natural regenerative ability to recover lost motor functions. SanBio is preparing to file a Biologics License Application with the
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Sources:
Alves, et al, “Why Does Brain Trauma Research Fail?” World Neurosurg. (2019) 130:115-121.
Selassie AW, et al. “Incidence of long-term disability following traumatic brain injury hospitalization, U.S.”, 2003. J Head Trauma Rehabil 2008;23:123-31.
James SL, et al. “Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.” Lancet Neurol 2019;18:56-87.
Walker WC & Pickett TC. “Motor impairment after severe traumatic brain injury: a longitudinal multicenter study.” J Rehabil Res Dev 2007;44:975-82.
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