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Safety and Efficacy Study Using Gene Therapy for Critical Limb Ischemia (NL003CLI-II)

Primary Purpose

Arterial Occlusive Disease, Ulcers, Ischemia

Status
Completed
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
NL003
NL003
NL003
Normal Saline
Sponsored by
Beijing Northland Biotech. Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arterial Occlusive Disease focused on measuring HGF, Gene, Critical Limb Ischemia

Eligibility Criteria

30 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female, between 30 and 80years of age
  • Diagnosis of critical limb ischemia(ASO、TAO、DAO),Rutherford Class 4 or 5, including:

    • A resting ankle systolic pressure of ≤ 70 mmHg in the affected limb; or
    • A resting toe systolic pressure of ≤ 50 mmHg in the affected limb; or
    • For patients in which measurement of ankle systolic pressure is not feasible , TcPO2 ≤ 30mmHg; Only unilateral affected limb receive treatment。
  • Significant stenosis (≥ 75%) of one or more of the following arteries:

superficial femoral, popliteal as verified by angiography(DSA、CTA、MRA) within 12 months prior to enrollment

  • Be willing to maintain current drug therapy for peripheral arterial disease throughout the course of the study
  • Be willing to maintain ulcer treatment
  • Be willing to infertility throughout the course of the study
  • If the subject is of child-bearing potential, she must have a negative urine pregnancy test result prior to study enrollment
  • Tumor screening result is no clinic meaning,including:
  • Signing the informed consent document prior to being subjected to any study related procedures

Exclusion Criteria:

  • Subjects who have undergone a successful revascularization procedure or sympathectomy within 12 weeks prior to study entry.
  • Acute advanced CLI
  • Subjects that will require an amputation in the target leg within 4 weeks, or significant stenosis (≥ 75%) of Aortoiliac
  • Subjects with evidence of active infection or deep ulceration exposing bone or tendon in the extremity planned for treatment
  • Heart Failure with a NYHA classification of III or IV
  • Stroke、myocardial infarction or unstable angina within last 3 months
  • Uncontrolled hypertension defined as sustained systolic blood pressure (SBP) > 180 mmHg or diastolic BP (DBP) > 110 mmHg
  • Ophthalmologic conditions pertinent to proliferative retinopathy or conditions that preclude standard ophthalmologic examination
  • Can not correctly describe the symptoms and feeling
  • Subjects with advanced liver disease including decompensated cirrhosis, jaundice, ascites or bleeding varices
  • Subjects currently receiving immunosuppressive medications chemotherapy, or radiation therapy
  • Positive HIV,active Hepatitis B(determined by HBsAb\ HBcAb\HBsAg) or C infection
  • Specific laboratory values at Screening including: Hemoglobin < 8.0 g/dL, WBC < 3,000 cells per microliter, platelet count <75,000/mm3, AST and/or ALT > 3 times the upper limit of normal or any other clinically significant lab abnormality which in the opinion of the investigator should be exclusionary
  • Elevated PSA unless prostate cancer has been excluded
  • Patients with a recent history (< 5 years) of or new screening finding of malignant neoplasm except basal cell carcinoma or squamous cell carcinoma of the skin (if excised and no evidence of recurrence); patients with family history of colon cancer in any first degree relative are excluded unless they have undergone a colonoscopy in the last 12 months with negative findings
  • Subjects requiring > 100 mg daily of acetylsalicylic acid,COX-2 inhibitor drug(s) or high dose steroids (excepting inhaled steroids)
  • Subjects with any co- morbid conditions likely to interfere with assessment of safety or efficacy or with an estimated life expectancy of less than 12 months
  • History of drug or alcohol abuse / dependence in the past 12 months
  • Use of an investigational drug or treatment in past 3 months

Sites / Locations

  • Peking Union Medical College Hospital
  • Beijing Shijitan Hospital
  • Xuanwu Hospital Capital Medical University
  • The General Hospital of the People's Liberation Army
  • Wuhan Union Hospital
  • The Second Xiangya Hospital of Central South University
  • Nanjing Drum Tower Hospital
  • First Hospital of Jilin University
  • The Second Hospital of Dalian Medical University

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

High Dose

Middle Dose

Low Dose

Placebo

Arm Description

Patients in this treatment group will receive 8mg NL003 respective in D0、14、28

Patients in this treatment group will receive 6mg NL003 respective in D0、14、28

Patients in this treatment group will receive 4mg NL003 in D0、14、28

Patients in this group will receive normal saline respective in D0、14、18

Outcomes

Primary Outcome Measures

The difference in ulcer area between baseline and the D180.
Rutherford 5 only
The difference in pain level between baseline and the D180 as determined by VAS

Secondary Outcome Measures

Change in tissue oxygenation (TcPO2) from baseline to D180
Difference in percentage of pain level decreased by 50% determined by VAS from baseline to D180
Difference in percentage of ulcer area decreased by 50% from baseline to D180
Difference in ABI and TBI from baseline to D180
Difference in QOL score (VascuQol) from baseline to D180
Percentage of ulcer complete healing
Situation of ulcer healing
Ulcer healing after gangrene treatment
Major amputation rate

Full Information

First Posted
March 5, 2012
Last Updated
January 18, 2020
Sponsor
Beijing Northland Biotech. Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT01548378
Brief Title
Safety and Efficacy Study Using Gene Therapy for Critical Limb Ischemia
Acronym
NL003CLI-II
Official Title
A Phase II, Double-Blind, Randomized, Placebo-Controlled, Multicenter Study to Assess the Safety and Efficacy of NL003 in Subject With Critical Limb Ischemia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
March 2012 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
June 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Beijing Northland Biotech. Co., Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate whether intramuscular injections of NL003 into the calf is safe and effective in the treatment of critical limb ischemia
Detailed Description
Management of CLI process consumes a significant amount of healthcare resources,and the new therapeutic approaches are required. Hepatocyte growth factor (HGF) has been shown to be a potent angiogenic growth factor stimulating the growth of endothelial cells and migration of vascular smooth muscle cells. Because of its pluripotent capabilities, increasing the availability of HGF in ischemic tissues to achieve therapeutic angiogenesis has been a growing area of research. This study will use NL003, which is a DNA plasmid that contains novel genomic cDNA hybrid human HGF coding sequence (HGF-X7) expressing two isoforms of HGF, HGF 728 and HGF 723. As there are currently no approved drugs that can reverse CLI and as most patients have exhausted surgical and endovascular intervention options, inducing angiogenesis in the affected limb with NL003 may result in an increase in tissue perfusion, which, in turn improve wound healing, reduce pain and improve limb salvage rates.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arterial Occlusive Disease, Ulcers, Ischemia, Peripheral Vascular Disease
Keywords
HGF, Gene, Critical Limb Ischemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
High Dose
Arm Type
Experimental
Arm Description
Patients in this treatment group will receive 8mg NL003 respective in D0、14、28
Arm Title
Middle Dose
Arm Type
Experimental
Arm Description
Patients in this treatment group will receive 6mg NL003 respective in D0、14、28
Arm Title
Low Dose
Arm Type
Experimental
Arm Description
Patients in this treatment group will receive 4mg NL003 in D0、14、28
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Patients in this group will receive normal saline respective in D0、14、18
Intervention Type
Genetic
Intervention Name(s)
NL003
Other Intervention Name(s)
HGF plasmid, pCK-HGF-X7
Intervention Description
Day 0: 8mg of NL003 (32 injections of 0.5ml of NL003) Day 14: 8mg of NL003 (32 injections of 0.5ml of NL003) Day 28: 8mg of NL003 (32 injections of 0.5ml of NL003)
Intervention Type
Genetic
Intervention Name(s)
NL003
Other Intervention Name(s)
HGF plasmid, pCK-HGF-X7
Intervention Description
Day 0: 6mg of NL003 (24 injections of 0.5ml of NL003) and 4ml normal saline(8 injections) Day 14: 6mg of NL003 (24 injections of 0.5ml of NL003) and 4ml normal saline(8 injections) Day 28: 6mg of NL003 (24 injections of 0.5ml of NL003) and 4ml normal saline(8 injections)
Intervention Type
Genetic
Intervention Name(s)
NL003
Other Intervention Name(s)
HGF plasmid, pCK-HGF-X7
Intervention Description
Day 0: 4mg of NL003 (16 injections of 0.5ml of NL003) and 8ml normal saline(16 injections) Day 14: 4mg of NL003 (16 injections of 0.5ml of NL003) and 8ml normal saline(16 injections) Day 28: 4mg of NL003 (16 injections of 0.5ml of NL003) and 8ml normal saline(16 injections)
Intervention Type
Other
Intervention Name(s)
Normal Saline
Other Intervention Name(s)
Placebo
Intervention Description
Day 0: 16ml of Normal Saline (32 injections ) Day 14: 16ml of Normal Saline (32 injections ) Day 28: 16ml of Normal Saline (32 injections )
Primary Outcome Measure Information:
Title
The difference in ulcer area between baseline and the D180.
Description
Rutherford 5 only
Time Frame
Day180
Title
The difference in pain level between baseline and the D180 as determined by VAS
Time Frame
Day 180
Secondary Outcome Measure Information:
Title
Change in tissue oxygenation (TcPO2) from baseline to D180
Time Frame
Day0、14、28、60、90、180
Title
Difference in percentage of pain level decreased by 50% determined by VAS from baseline to D180
Time Frame
Day0、14、28、60、90、180
Title
Difference in percentage of ulcer area decreased by 50% from baseline to D180
Time Frame
Day0、14、28、60、90、180
Title
Difference in ABI and TBI from baseline to D180
Time Frame
Day0、14、28、60、90、180
Title
Difference in QOL score (VascuQol) from baseline to D180
Time Frame
Day0、14、28、60、90、180
Title
Percentage of ulcer complete healing
Time Frame
Day180
Title
Situation of ulcer healing
Time Frame
Day180
Title
Ulcer healing after gangrene treatment
Time Frame
Day180
Title
Major amputation rate
Time Frame
Day180

10. Eligibility

Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, between 30 and 80years of age Diagnosis of critical limb ischemia(ASO、TAO、DAO),Rutherford Class 4 or 5, including: A resting ankle systolic pressure of ≤ 70 mmHg in the affected limb; or A resting toe systolic pressure of ≤ 50 mmHg in the affected limb; or For patients in which measurement of ankle systolic pressure is not feasible , TcPO2 ≤ 30mmHg; Only unilateral affected limb receive treatment。 Significant stenosis (≥ 75%) of one or more of the following arteries: superficial femoral, popliteal as verified by angiography(DSA、CTA、MRA) within 12 months prior to enrollment Be willing to maintain current drug therapy for peripheral arterial disease throughout the course of the study Be willing to maintain ulcer treatment Be willing to infertility throughout the course of the study If the subject is of child-bearing potential, she must have a negative urine pregnancy test result prior to study enrollment Tumor screening result is no clinic meaning,including: Signing the informed consent document prior to being subjected to any study related procedures Exclusion Criteria: Subjects who have undergone a successful revascularization procedure or sympathectomy within 12 weeks prior to study entry. Acute advanced CLI Subjects that will require an amputation in the target leg within 4 weeks, or significant stenosis (≥ 75%) of Aortoiliac Subjects with evidence of active infection or deep ulceration exposing bone or tendon in the extremity planned for treatment Heart Failure with a NYHA classification of III or IV Stroke、myocardial infarction or unstable angina within last 3 months Uncontrolled hypertension defined as sustained systolic blood pressure (SBP) > 180 mmHg or diastolic BP (DBP) > 110 mmHg Ophthalmologic conditions pertinent to proliferative retinopathy or conditions that preclude standard ophthalmologic examination Can not correctly describe the symptoms and feeling Subjects with advanced liver disease including decompensated cirrhosis, jaundice, ascites or bleeding varices Subjects currently receiving immunosuppressive medications chemotherapy, or radiation therapy Positive HIV,active Hepatitis B(determined by HBsAb\ HBcAb\HBsAg) or C infection Specific laboratory values at Screening including: Hemoglobin < 8.0 g/dL, WBC < 3,000 cells per microliter, platelet count <75,000/mm3, AST and/or ALT > 3 times the upper limit of normal or any other clinically significant lab abnormality which in the opinion of the investigator should be exclusionary Elevated PSA unless prostate cancer has been excluded Patients with a recent history (< 5 years) of or new screening finding of malignant neoplasm except basal cell carcinoma or squamous cell carcinoma of the skin (if excised and no evidence of recurrence); patients with family history of colon cancer in any first degree relative are excluded unless they have undergone a colonoscopy in the last 12 months with negative findings Subjects requiring > 100 mg daily of acetylsalicylic acid,COX-2 inhibitor drug(s) or high dose steroids (excepting inhaled steroids) Subjects with any co- morbid conditions likely to interfere with assessment of safety or efficacy or with an estimated life expectancy of less than 12 months History of drug or alcohol abuse / dependence in the past 12 months Use of an investigational drug or treatment in past 3 months
Facility Information:
Facility Name
Peking Union Medical College Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100032
Country
China
Facility Name
Beijing Shijitan Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100038
Country
China
Facility Name
Xuanwu Hospital Capital Medical University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100053
Country
China
Facility Name
The General Hospital of the People's Liberation Army
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100853
Country
China
Facility Name
Wuhan Union Hospital
City
Wuhan
State/Province
Hubei
ZIP/Postal Code
430022
Country
China
Facility Name
The Second Xiangya Hospital of Central South University
City
Changsha
State/Province
Hunan
Country
China
Facility Name
Nanjing Drum Tower Hospital
City
Nanjing
State/Province
Jiangsu
ZIP/Postal Code
210008
Country
China
Facility Name
First Hospital of Jilin University
City
Changchun
State/Province
Jilin
ZIP/Postal Code
130021
Country
China
Facility Name
The Second Hospital of Dalian Medical University
City
Dalian
State/Province
Liaoning
Country
China

12. IPD Sharing Statement

Links:
URL
http://www.northland-bio.com/
Description
Related Info

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Safety and Efficacy Study Using Gene Therapy for Critical Limb Ischemia

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