Study of PVS-10200 for the Treatment of Restenosis in Patients With Peripheral Artery Disease (TRIUMPH) (TRIUMPH)
Primary Purpose
Peripheral Artery Disease
Status
Completed
Phase
Phase 1
Locations
France
Study Type
Interventional
Intervention
PVS-10200
Sponsored by
About this trial
This is an interventional treatment trial for Peripheral Artery Disease focused on measuring peripheral artery disease, percutaneous transluminal angioplasty, stent, balloon/stent, superficial femoral artery
Eligibility Criteria
Inclusion Criteria:
- The subject has signed the informed consent document and patient information leaflet.
- Male and female subject ≥ 18 years of age at the time of consent.
- If female, the subject is (a) at least 1 year post-menopausal, or (b) surgically sterile, or (c) of child-bearing potential, with a negative serum pregnancy test result prior to study enrollment, who agrees to use adequate contraception for 6 months. Adequate contraception is defined as abstinence or a reliable method of birth control (e.g., a hormonal contraceptive, intra-uterine device, implantable or injectable contraceptives (Norplant® or Depo-Provera®), diaphragm, or condom with spermicide).
- Subject has symptomatic peripheral arterial disease involving the superficial femoral artery, defined as Fontaine Class IIb, III and IV.
Meets anatomic requirements based on biplane digital subtraction angiography performed at the time of intervention including:
- Stenosis of ≥ 50% or occlusion of the superficial femoral artery, and
- Target lesion length of ≤ 150 mm, and
- At least one patent (< 50 % stenosis) tibioperoneal runoff vessel
- Target lesion is 7-15 cm in length.
- Subject is expected to stay in the same geographic area for at least 48 weeks.
- In the opinion of the investigator, the subject is able to understand and is willing to complete the study requirements.
- Subject is receiving a therapeutic dose of statin therapy (starting minimum of 7 days prior to intervention) and continuing for a minimum of 4 weeks post-intervention.
Exclusion Criteria:
- Subject has acute limb ischemia.
- Subject has had prior revascularization of the target lesion.
- Subject has untreated inflow disease of the ipsilateral pelvic arteries (> 50% stenosis or occlusion).
- The target lesion is located within an aneurysm or associated with an aneurysm in the vessel segment either proximal or distal to the target lesion(s).
- Subject has an unresolved thrombus within the target vessel.
- Additional percutaneous interventional procedures (cardiac/peripheral) are planned ≤ 30 days following the study procedure.
- Subject has suffered a hemorrhagic stroke ≤ 6 mo prior to the study procedure.
- Subject has a history of bleeding diatheses or coagulopathy.
- Subject is diagnosed with septicemia at the time of the study procedure.
- Subject is known to be seropositive for HIV.
- Subject has some other medical illness that may cause the subject to be non-compliant with the protocol.
- Subject has a known allergy to bovine or porcine products (i.e., heparin).
- Subject has a known allergy to collagen/gelatin products.
- Subject has had a severe reaction to contrast media.
- Subject has a known allergy or intolerance to anti-platelet medication (e.g., acetylsalicylic acid or clopidogrel) or statin therapy.
- Subject has a history of IV drug use within 6 months prior to screening.
- Subject has a documented diagnosis of cancer within 2 years (24 months) prior to screening.
- Subject is a female who is pregnant, breast-feeding, or plans to become pregnant during the study.
- Subject is currently participating in another investigational drug, biologic or device trial, plans to participate in another investigational drug, biologic or device study during participation in this study, or has completed participation in another investigational drug, biologic or device trial within the last 30 days. Note: Subjects involved in extended follow-up trials for products that are currently commercially available and used as approved are not considered to be participating investigational trials.
- Subject is a staff member of any of the participating institutions or relative of a staff member.
Sites / Locations
- Centre Hospitalier Universitaire d'Amiens
- Hopital Europeen Georges Pompidou
- Hopital Bichat
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
PVS-10200
Arm Description
Each subject will receive one treatment of PVS-10200 delivered by ultrasound guided injection perivascular to the region of the target lesion within 24 hours of the completed angioplasty and stent placement.
Outcomes
Primary Outcome Measures
Incidence of Major Adverse Events (MAEs)
Major Adverse Events are: - Death - Major amputation - Procedural related serious adverse events - Investigational product related serious adverse events
Secondary Outcome Measures
Incidence of Major Adverse Events (MAEs)
Major Adverse Events are: - Death - Major amputation - Procedural related serious adverse events - Investigational product related serious adverse events
Incidence of Serious Adverse Events
Incidence of Adverse Events, Laboratory Abnormalities
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Rate of Binary In-stent Restenosis
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Rate of Binary In-stent Restenosis
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Rate of Binary In-stent Restenosis
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Number of Patients Requiring Reintervention of Target Lesion / Target Vessel
Survival analysis - outcome reported as patients requiring reintervention of the target lesion / vessel
Resting Ankle-brachial Index
ABI was calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm. This test is used to predict the severity of PAD.
Changes in Physical Exam
Changes in physical examination were compared to baseline: numbers of subjects presenting any new finding or worsening of abnormal findings compared to the screening examination are reported
The Fontaine Class of Peripheral Artery Disease
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
The Fontaine Class of Peripheral Artery Disease
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
The Fontaine Class of Peripheral Artery Disease
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01099215
Brief Title
Study of PVS-10200 for the Treatment of Restenosis in Patients With Peripheral Artery Disease (TRIUMPH)
Acronym
TRIUMPH
Official Title
An Open-Label Dose Escalation Safety Study of PVS-10200 for the Treatment of Restenosis in Patients Undergoing Minimally Invasive Peripheral Revascularization (TRIUMPH)
Study Type
Interventional
2. Study Status
Record Verification Date
June 2021
Overall Recruitment Status
Completed
Study Start Date
April 30, 2010 (Actual)
Primary Completion Date
June 30, 2012 (Actual)
Study Completion Date
October 31, 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shire
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety of two doses of PVS-10200, an allogeneic cellular therapy, delivered as a single injection following percutaneous transluminal ("balloon") angioplasty and stent placement for the treatment of peripheral artery disease (PAD).
Detailed Description
This is an open-label dose escalation safety study of PVS-10200 in 30 subjects with peripheral artery disease (PAD) requiring balloon angioplasty and stent placement in the superficial femoral artery (SFA). The study will be completed sequentially in two dose cohorts of 10 subjects (low dose group, Cohort A) and 20 subjects (high dose group, Cohort B). A Data Safety Monitoring Board (DSMB) will conduct regular safety reviews.
Each subject will receive one treatment of PVS-10200 delivered by ultrasound guided injection to the perivascular region (external to the vessel) of the stented target lesion. The treatment will be administered within 24 hours after balloon angioplasty/stent placement.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Artery Disease
Keywords
peripheral artery disease, percutaneous transluminal angioplasty, stent, balloon/stent, superficial femoral artery
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
21 (Actual)
8. Arms, Groups, and Interventions
Arm Title
PVS-10200
Arm Type
Other
Arm Description
Each subject will receive one treatment of PVS-10200 delivered by ultrasound guided injection perivascular to the region of the target lesion within 24 hours of the completed angioplasty and stent placement.
Intervention Type
Biological
Intervention Name(s)
PVS-10200
Intervention Description
PVS-10200 is composed of allogeneic human aortic endothelial cells cultured in a gelatin matrix.
Primary Outcome Measure Information:
Title
Incidence of Major Adverse Events (MAEs)
Description
Major Adverse Events are: - Death - Major amputation - Procedural related serious adverse events - Investigational product related serious adverse events
Time Frame
within 4 weeks after study procedure
Secondary Outcome Measure Information:
Title
Incidence of Major Adverse Events (MAEs)
Description
Major Adverse Events are: - Death - Major amputation - Procedural related serious adverse events - Investigational product related serious adverse events
Time Frame
within 24 and 48 weeks from study procedure
Title
Incidence of Serious Adverse Events
Time Frame
Up to 48 weeks from study procedure
Title
Incidence of Adverse Events, Laboratory Abnormalities
Time Frame
Up to 48 weeks from study procedure
Title
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Description
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 4 weeks from study procedure
Title
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Description
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 24 weeks from study procedure
Title
Maintenance of Primary Patency of Superficial Femoral Artery (SFA)
Description
Primary patency was defined as duplex ultrasound peak systolic velocity [PSV] ratio ≤2.4.Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 48 weeks from study procedure
Title
Rate of Binary In-stent Restenosis
Description
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 4 weeks from study procedure
Title
Rate of Binary In-stent Restenosis
Description
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 24 weeks from study procedure
Title
Rate of Binary In-stent Restenosis
Description
Binary restenosis relied on duplex ultrasound data with a Yes/No assessment with 0-49% being No (peak systolic velocity [PSV] ratio ≤2.4) and Yes being 50-99% (PSV ratio >2.4), with the PSV ratio calculated as PSV from stenosis divided by the PSV from a normal segment of artery proximal to the stenosis. Ultrasound data was obtained for each patient at each time point and had to be considered diagnostic and evaluable by the core lab; if it was not, then this analysis could not be done for that particular subject.
Time Frame
within 48 weeks from study procedure
Title
Number of Patients Requiring Reintervention of Target Lesion / Target Vessel
Description
Survival analysis - outcome reported as patients requiring reintervention of the target lesion / vessel
Time Frame
up to 48 Weeks from study procedure
Title
Resting Ankle-brachial Index
Description
ABI was calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm. This test is used to predict the severity of PAD.
Time Frame
within 4, 24 and 48 weeks from study procedure
Title
Changes in Physical Exam
Description
Changes in physical examination were compared to baseline: numbers of subjects presenting any new finding or worsening of abnormal findings compared to the screening examination are reported
Time Frame
within 4, 24 and 48 weeks from baseline
Title
The Fontaine Class of Peripheral Artery Disease
Description
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
Time Frame
change from baseline to 4 weeks
Title
The Fontaine Class of Peripheral Artery Disease
Description
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
Time Frame
change from baseline to 24 weeks
Title
The Fontaine Class of Peripheral Artery Disease
Description
CLASSIFICATION OF PERIPHERAL ATERIAL DISEASE ACCORDING TO FONTAINE Stage Clinical description I Asymptomatic IIA Mild claudication IIB Moderate -severe claudication III Ischemic rest pain IV Ulceration or gangrene
Time Frame
change from baseline to 48 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The subject has signed the informed consent document and patient information leaflet.
Male and female subject ≥ 18 years of age at the time of consent.
If female, the subject is (a) at least 1 year post-menopausal, or (b) surgically sterile, or (c) of child-bearing potential, with a negative serum pregnancy test result prior to study enrollment, who agrees to use adequate contraception for 6 months. Adequate contraception is defined as abstinence or a reliable method of birth control (e.g., a hormonal contraceptive, intra-uterine device, implantable or injectable contraceptives (Norplant® or Depo-Provera®), diaphragm, or condom with spermicide).
Subject has symptomatic peripheral arterial disease involving the superficial femoral artery, defined as Fontaine Class IIb, III and IV.
Meets anatomic requirements based on biplane digital subtraction angiography performed at the time of intervention including:
Stenosis of ≥ 50% or occlusion of the superficial femoral artery, and
Target lesion length of ≤ 150 mm, and
At least one patent (< 50 % stenosis) tibioperoneal runoff vessel
Target lesion is 7-15 cm in length.
Subject is expected to stay in the same geographic area for at least 48 weeks.
In the opinion of the investigator, the subject is able to understand and is willing to complete the study requirements.
Subject is receiving a therapeutic dose of statin therapy (starting minimum of 7 days prior to intervention) and continuing for a minimum of 4 weeks post-intervention.
Exclusion Criteria:
Subject has acute limb ischemia.
Subject has had prior revascularization of the target lesion.
Subject has untreated inflow disease of the ipsilateral pelvic arteries (> 50% stenosis or occlusion).
The target lesion is located within an aneurysm or associated with an aneurysm in the vessel segment either proximal or distal to the target lesion(s).
Subject has an unresolved thrombus within the target vessel.
Additional percutaneous interventional procedures (cardiac/peripheral) are planned ≤ 30 days following the study procedure.
Subject has suffered a hemorrhagic stroke ≤ 6 mo prior to the study procedure.
Subject has a history of bleeding diatheses or coagulopathy.
Subject is diagnosed with septicemia at the time of the study procedure.
Subject is known to be seropositive for HIV.
Subject has some other medical illness that may cause the subject to be non-compliant with the protocol.
Subject has a known allergy to bovine or porcine products (i.e., heparin).
Subject has a known allergy to collagen/gelatin products.
Subject has had a severe reaction to contrast media.
Subject has a known allergy or intolerance to anti-platelet medication (e.g., acetylsalicylic acid or clopidogrel) or statin therapy.
Subject has a history of IV drug use within 6 months prior to screening.
Subject has a documented diagnosis of cancer within 2 years (24 months) prior to screening.
Subject is a female who is pregnant, breast-feeding, or plans to become pregnant during the study.
Subject is currently participating in another investigational drug, biologic or device trial, plans to participate in another investigational drug, biologic or device study during participation in this study, or has completed participation in another investigational drug, biologic or device trial within the last 30 days. Note: Subjects involved in extended follow-up trials for products that are currently commercially available and used as approved are not considered to be participating investigational trials.
Subject is a staff member of any of the participating institutions or relative of a staff member.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
Centre Hospitalier Universitaire d'Amiens
City
Amiens
Country
France
Facility Name
Hopital Europeen Georges Pompidou
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Hopital Bichat
City
Paris
ZIP/Postal Code
75018
Country
France
12. IPD Sharing Statement
Citations:
PubMed Identifier
24613691
Citation
Sevestre MA, Larghero J, Castier Y, Nugent HM, Visonneau S, Alsac JM. Pilot safety study of perivascular injection of tissue-engineered allogeneic aortic endothelial cells in patients undergoing minimally invasive peripheral revascularization. J Vasc Surg. 2014 Jun;59(6):1597-606. doi: 10.1016/j.jvs.2014.01.014. Epub 2014 Mar 7.
Results Reference
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Study of PVS-10200 for the Treatment of Restenosis in Patients With Peripheral Artery Disease (TRIUMPH)
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