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Safety, Hemodynamic Effects and Efficacy of Intramuscular PDA-002 in Subjects Who Have Diabetic Foot Ulcer With Peripheral Arterial Disease

Primary Purpose

Diabetic Foot, Peripheral Arterial Disease

Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
PDA-002
Placebo
Sponsored by
Celularity Incorporated
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot focused on measuring PDA-002, Diabetic Foot Ulcer, Peripheral arterial disease, Phase 2, Randomized

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males and females, at least 18 years of age or older at the time of signing the informed consent document.
  2. Diabetes mellitus Type 1 or Type 2.
  3. Diabetic foot ulcer with severity of Grade 1 (full thickness only) or Grade 2 on the Wagner Grading Scale of greater than one month duration which has not adequately responded to conventional ulcer therapy.
  4. Subjects who meet one or more of the following criteria of arterial insufficiency in the foot with the index ulcer:

    1. Peripheral arterial disease with ABI ≥ 0.40 and ≤ 0.80 or TBI ≥0.30 and ≤ 0.65.
    2. Transcutaneous oxygen measurement between 20 to 40 mmHg.
  5. No planned revascularization or amputation over the next 3 months after screening visit, in the opinion of the investigator.
  6. Dosing should not begin until at least 14 days after a failed reperfusion intervention and at least 30 days after a successful reperfusion intervention

Exclusion Criteria:

  1. Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study, at the discretion of the investigator.
  2. Any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he or she were to participate in the study, at the discretion of the investigator.
  3. Pregnant or lactating females.
  4. Subjects with a body mass index > 40 mg/m2 at Screening.
  5. Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 at Screening calculated using the Modification of Diet in Renal Disease Study equation or history of eGFR decline > 15 mL/min/1.73 m2 in the past year.
  6. Untreated chronic infection or treatment of any infection with systemic antibiotics,including the ulcer site. Subject must be antibiotic free within 1 week prior to dosing with Investigational Product (IP).
  7. Known osteomyelitis or infection or cellulitis at or adjacent to the index ulcer.
  8. Limb pain at rest due to limb ischemia.
  9. Uncontrolled hypertension (defined as diastolic blood pressure > 100 mmHg or systolic blood pressure > 180 mmHg during Screening at 2 independent measurements taken while subject is sitting and resting for at least 5 minutes).
  10. Poorly controlled diabetes mellitus (hemoglobin A1c >12% or a screening serum glucose of ≥ 300 mg/dL).
  11. Untreated proliferative retinopathy.
  12. History of malignant ventricular arrhythmia, Canadian Cardiovascular Society (CCS) Class III-IV angina pectoris, myocardial infarction/PCI (percutaneous coronary intervention)/CABG (coronary artery bypass graft) in the preceding 6 months prior to signing the Informed Consent (ICF),pending coronary revascularization in the following 3 months, transient ischemic attack/cerebrovascular accident in the preceding 6 months, prior to signing the ICF and/or New York Heart Association [NYHA] Stage III or IV congestive heart failure.
  13. Abnormal ECG: new right bundle branch block (BBB) ≥ 120 msec in the preceding 3 months prior to signing the ICF.
  14. Uncontrolled hypercoagulation syndrome.
  15. Life expectancy less than 2 years due to concomitant illnesses.
  16. In the opinion of the investigator, the subject is unsuitable for cellular therapy.
  17. History of malignancy within 5 years prior to signing the ICF except basal cell or squamous cell carcinoma of the skin or remote history of cancer now considered cured or positive Pap smear with subsequent negative follow-up.
  18. History of hypersensitivity to any of the components of the product formulation (including bovine or porcine products, dextran 40, and dimethyl sulfoxide [DMSO]).
  19. Subject has received an investigational agent -an agent or device not approved by the US Food and Drug Administration (FDA) for marketed use in any indication- within 90 days (or 5 half-lives, whichever is longer) prior to treatment with study therapy or planned participation in another therapeutic study prior to the completion of this study.
  20. Subject has received previous investigational gene or cell therapy.

Sites / Locations

  • University of Pennsylvania Health Systems

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

PDA-002 -3x10^6 cells

PDA-002 - 30X10^6 cells

Placebo

Arm Description

Subjects will be treated with Investigational Product (IP) administered intramuscular (IM) on Study Days 1, 29 and 57.

Subjects will be treated with IP administered IM on Study Days 1, 29 and 57.

Subjects will be treated with Placebo administered IM on Study Days 1, 29 and 57.

Outcomes

Primary Outcome Measures

Ankle-brachial Index (ABI)
The ankle brachial index is the ratio of the measurement of the blood pressure in the ankle and the arm.
Transcutaneous oxygen measurement (TCOM)
Transcutaneous oxygen measurement measures the oxygen flow in vessels beneath the skin surface

Secondary Outcome Measures

Adverse Events (AEs)
Number of participants with adverse events
Ulcer closure
Ulcer closure is defined as skin closure of the index ulcer without drainage or need for dressing.
Complete wound closure of the index ulcer
Complete wound closure is defined as closure of the index ulcer and retaining wound closure for the subsequent 4 weeks.
Number of ulcers
The total number of non index ulcers will be collected
Size of ulcers
The area of each ulcer will be collected.
50% closure of the index ulcer
The time to when the ulcer has closed 50 % will be collected.
Time to major amputation (above the ankle) of treated leg
The time to a major amputation (above the ankle) will be collected.
Wagner Grading Scale
The extent of the ulcer will be collected using a standard scale for ulcer assessment.
Rutherford Criteria
The extent of symptoms associated with decreased limb perfusion will be collected using a standard scale.
Leg Rest Pain Score Visual Analog Scale (VAS)
Pre and Post treatment Limb Pain level will be assessed using a VAS
Patient Global Impression of Change in Neuropathy (PGICN)
Subjects will be assessed for symptoms of diabetic neuropathy using a standard scale.

Full Information

First Posted
April 21, 2015
Last Updated
February 27, 2018
Sponsor
Celularity Incorporated
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1. Study Identification

Unique Protocol Identification Number
NCT02460081
Brief Title
Safety, Hemodynamic Effects and Efficacy of Intramuscular PDA-002 in Subjects Who Have Diabetic Foot Ulcer With Peripheral Arterial Disease
Official Title
A Phase 2, Multi-center, Randomized, Double-blind, Placebo-controlled, Dose Range Finding Study to Evaluate the Safety, Hemodynamic Effects and Efficacy of Intramuscular Injection of Human Placenta-derived Cells (Pda-002) in Subjects Who Have Diabetic Foot Ulcer With Peripheral Arterial Disease
Study Type
Interventional

2. Study Status

Record Verification Date
April 2016
Overall Recruitment Status
Withdrawn
Why Stopped
Discontinued due to significant delays in the expected availability of data.
Study Start Date
June 2015 (undefined)
Primary Completion Date
September 2017 (Anticipated)
Study Completion Date
September 2017 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Celularity Incorporated

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Study PDA-002-DFU-003 is a Phase 2, multicenter, randomized, double blind, placebo-controlled, dose range finding study in subjects who have diabetic foot ulcer (DFU) with peripheral arterial disease (PAD). The study will enroll approximately 24 subjects. This study will investigate the hemodynamic effects, clinical efficacy, and safety of 3 monthly intramuscular (IM) injections of PDA-002 in subjects who have DFU with PAD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot, Peripheral Arterial Disease
Keywords
PDA-002, Diabetic Foot Ulcer, Peripheral arterial disease, Phase 2, Randomized

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
PDA-002 -3x10^6 cells
Arm Type
Experimental
Arm Description
Subjects will be treated with Investigational Product (IP) administered intramuscular (IM) on Study Days 1, 29 and 57.
Arm Title
PDA-002 - 30X10^6 cells
Arm Type
Experimental
Arm Description
Subjects will be treated with IP administered IM on Study Days 1, 29 and 57.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects will be treated with Placebo administered IM on Study Days 1, 29 and 57.
Intervention Type
Drug
Intervention Name(s)
PDA-002
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Ankle-brachial Index (ABI)
Description
The ankle brachial index is the ratio of the measurement of the blood pressure in the ankle and the arm.
Time Frame
Approximately 1 year
Title
Transcutaneous oxygen measurement (TCOM)
Description
Transcutaneous oxygen measurement measures the oxygen flow in vessels beneath the skin surface
Time Frame
Approximately 1 year
Secondary Outcome Measure Information:
Title
Adverse Events (AEs)
Description
Number of participants with adverse events
Time Frame
Approximatly 1 year
Title
Ulcer closure
Description
Ulcer closure is defined as skin closure of the index ulcer without drainage or need for dressing.
Time Frame
Approximatly 1 year
Title
Complete wound closure of the index ulcer
Description
Complete wound closure is defined as closure of the index ulcer and retaining wound closure for the subsequent 4 weeks.
Time Frame
Approximatly 1 year
Title
Number of ulcers
Description
The total number of non index ulcers will be collected
Time Frame
Approximatly 1 year
Title
Size of ulcers
Description
The area of each ulcer will be collected.
Time Frame
Approximatly 1 year
Title
50% closure of the index ulcer
Description
The time to when the ulcer has closed 50 % will be collected.
Time Frame
Approximatly 1 year
Title
Time to major amputation (above the ankle) of treated leg
Description
The time to a major amputation (above the ankle) will be collected.
Time Frame
Approximatly 1 year
Title
Wagner Grading Scale
Description
The extent of the ulcer will be collected using a standard scale for ulcer assessment.
Time Frame
Approximatly 1 year
Title
Rutherford Criteria
Description
The extent of symptoms associated with decreased limb perfusion will be collected using a standard scale.
Time Frame
Approximately 1 year
Title
Leg Rest Pain Score Visual Analog Scale (VAS)
Description
Pre and Post treatment Limb Pain level will be assessed using a VAS
Time Frame
Approximately 1 year
Title
Patient Global Impression of Change in Neuropathy (PGICN)
Description
Subjects will be assessed for symptoms of diabetic neuropathy using a standard scale.
Time Frame
Approximately 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females, at least 18 years of age or older at the time of signing the informed consent document. Diabetes mellitus Type 1 or Type 2. Diabetic foot ulcer with severity of Grade 1 (full thickness only) or Grade 2 on the Wagner Grading Scale of greater than one month duration which has not adequately responded to conventional ulcer therapy. Subjects who meet one or more of the following criteria of arterial insufficiency in the foot with the index ulcer: Peripheral arterial disease with ABI ≥ 0.40 and ≤ 0.80 or TBI ≥0.30 and ≤ 0.65. Transcutaneous oxygen measurement between 20 to 40 mmHg. No planned revascularization or amputation over the next 3 months after screening visit, in the opinion of the investigator. Dosing should not begin until at least 14 days after a failed reperfusion intervention and at least 30 days after a successful reperfusion intervention Exclusion Criteria: Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from participating in the study, at the discretion of the investigator. Any condition including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he or she were to participate in the study, at the discretion of the investigator. Pregnant or lactating females. Subjects with a body mass index > 40 mg/m2 at Screening. Estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73 m2 at Screening calculated using the Modification of Diet in Renal Disease Study equation or history of eGFR decline > 15 mL/min/1.73 m2 in the past year. Untreated chronic infection or treatment of any infection with systemic antibiotics,including the ulcer site. Subject must be antibiotic free within 1 week prior to dosing with Investigational Product (IP). Known osteomyelitis or infection or cellulitis at or adjacent to the index ulcer. Limb pain at rest due to limb ischemia. Uncontrolled hypertension (defined as diastolic blood pressure > 100 mmHg or systolic blood pressure > 180 mmHg during Screening at 2 independent measurements taken while subject is sitting and resting for at least 5 minutes). Poorly controlled diabetes mellitus (hemoglobin A1c >12% or a screening serum glucose of ≥ 300 mg/dL). Untreated proliferative retinopathy. History of malignant ventricular arrhythmia, Canadian Cardiovascular Society (CCS) Class III-IV angina pectoris, myocardial infarction/PCI (percutaneous coronary intervention)/CABG (coronary artery bypass graft) in the preceding 6 months prior to signing the Informed Consent (ICF),pending coronary revascularization in the following 3 months, transient ischemic attack/cerebrovascular accident in the preceding 6 months, prior to signing the ICF and/or New York Heart Association [NYHA] Stage III or IV congestive heart failure. Abnormal ECG: new right bundle branch block (BBB) ≥ 120 msec in the preceding 3 months prior to signing the ICF. Uncontrolled hypercoagulation syndrome. Life expectancy less than 2 years due to concomitant illnesses. In the opinion of the investigator, the subject is unsuitable for cellular therapy. History of malignancy within 5 years prior to signing the ICF except basal cell or squamous cell carcinoma of the skin or remote history of cancer now considered cured or positive Pap smear with subsequent negative follow-up. History of hypersensitivity to any of the components of the product formulation (including bovine or porcine products, dextran 40, and dimethyl sulfoxide [DMSO]). Subject has received an investigational agent -an agent or device not approved by the US Food and Drug Administration (FDA) for marketed use in any indication- within 90 days (or 5 half-lives, whichever is longer) prior to treatment with study therapy or planned participation in another therapeutic study prior to the completion of this study. Subject has received previous investigational gene or cell therapy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Monica E Luchi, MD
Organizational Affiliation
Celularity Incorporated
Official's Role
Study Director
Facility Information:
Facility Name
University of Pennsylvania Health Systems
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

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Safety, Hemodynamic Effects and Efficacy of Intramuscular PDA-002 in Subjects Who Have Diabetic Foot Ulcer With Peripheral Arterial Disease

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