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Stromal Vascular Fraction (SVF) for Knee Post-Trauma Osteoarthritis (PTOA) (SVF)

Primary Purpose

Osteoarthritis

Status
Not yet recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
Adipose Derived (AD) Stromal Vascular Fraction (SVF)
Sponsored by
Wake Forest University Health Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis focused on measuring degenerative joint disease, degenerative arthritis, Knee trauma

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males and females 18 - 45 with a preceding history (>1 and < 20 years ago) of significant knee trauma or trauma- related knee surgery
  • Post-Trauma Osteoarthritis (PTOA) as diagnosed by K-L Grade II or III OA (weight bearing X-ray) and physician review
  • Subjects must present with symptomatic (injured knee) visual analog scale (VAS) pain > 4. If bilateral disease, Knee Osteoarthritis (KOA) pain in the other knee must be less than/equal to 3 on the VAS for pain
  • Subjects must have an adjusted Western Ontario and McMaster Universities Arthritis Index (WOMAC) (100-point scale) of > 25 and <90
  • Study Subjects must have continued knee pain despite at least two conservative prescribed therapies (pain medications, physical therapy, knee injections, or weight loss), spanning a period of at least 3 months
  • Study Subjects must be willing to voluntarily give written Informed Consent to participate in the study and sign the Health Insurance Portability and Accountability Act (HIPAA) authorization before any study procedures are performed
  • Subjects will be in good health (ASA Class I-II) with a Body mass index (BMI) < 35
  • Subjects must speak, read, and understand English
  • Subjects must be reasonably able to return for multiple follow-up visits, to include procedure visits

Exclusion Criteria:

  • Subjects whose knee pain is caused by, (i) diffuse edema, (ii) cartilage lesion greater than 1 cm width and grade 4 depth by MRI or (iii) osteochondritis dissecans
  • Subjects who have had surgery of either knee within 12 months prior to the screening visit
  • Subjects who have had an injection in either knee in the prior 3 months, including corticosteroids, viscosupplementation, stem cells, or platelet rich plasma (PRP)
  • Subjects who have gout, rheumatoid arthritis, lupus arthropathy, psoriatic arthritis, avascular necrosis, severe bone deformity, infection of the knee joint, fibromyalgia, or neurogenic or vascular claudication
  • Subjects who have symptomatic Osteoarthritis (OA) of the hips, spine, or ankle that would interfere with the evaluation of the treated knee
  • Subjects that are unwilling to stop taking prescription or over the counter pain and anti-inflammatory medication for 7 days prior to any visit
  • Subjects that are allergic to lidocaine, epinephrine, or valium or other sedatives
  • Subjects with a history of bleeding disorders, anticoagulation therapy that cannot be stopped prior to IA injection
  • Subjects with systemic immunosuppressant use within six (6) weeks from screening
  • Subjects with human immunodeficiency virus (HIV)/viral hepatitis B or human T-lymphotropic virus type 1 (C/HTLV)
  • Subjects with chondrocalcinosis, Paget's disease and Villonodular synovitis
  • Subjects that use any form of tobacco
  • Women that are pregnant or planning to become pregnant during the study
  • Subjects on long term use of oral steroids or disease-modifying anti-rheumatic drugs
  • History of any chemotherapy or radiation therapy of the targeted/treatment leg or adipose harvest site
  • Subjects currently on worker's compensation

Sites / Locations

  • Wake Forest University Health Sciences

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

a single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF)

Arm Description

a single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF) for the treatment of knee Post Traumatic Osteoarthritis (PTOA)

Outcomes

Primary Outcome Measures

Number of Adverse Events
number of safety events post injection

Secondary Outcome Measures

Full Information

First Posted
August 22, 2022
Last Updated
September 26, 2023
Sponsor
Wake Forest University Health Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT05515523
Brief Title
Stromal Vascular Fraction (SVF) for Knee Post-Trauma Osteoarthritis (PTOA)
Acronym
SVF
Official Title
Pilot Trial of Intra-articular Stromal Vascular Fraction for the Treatment of Knee Post-Trauma Osteoarthritis and Biomarker Identification
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
November 2023 (Anticipated)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, non-randomized, interventional, dual site, before-after clinical trial to determine feasibility and safety of a single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF) for the treatment of knee Post Traumatic Osteoarthritis (PTOA).
Detailed Description
Clinical treatment generally involves a life-long combination of exercise, lifestyle modifications, and/or analgesics. If pain becomes debilitating, different surgical options exist, including arthroscopic joint debridement and mechanical axis change through osteotomies around the knee and eventually joint replacement surgery for severe cases to improve the quality of life. However, patients under 40 years of age, who expect to continue an active lifestyle, have only a 40% "good or excellent" function score after total knee replacement, they are most likely to outlive their initial replacement and need revision.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis
Keywords
degenerative joint disease, degenerative arthritis, Knee trauma

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Model Description
single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF) for the treatment of knee Post Traumatic Osteoarthritis (PTOA)
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
a single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF)
Arm Type
Experimental
Arm Description
a single injection of autologous Adipose Derived (AD) Stromal Vascular Fraction (SVF) for the treatment of knee Post Traumatic Osteoarthritis (PTOA)
Intervention Type
Genetic
Intervention Name(s)
Adipose Derived (AD) Stromal Vascular Fraction (SVF)
Intervention Description
autologous stromal vascular fraction cells from adipose tissue for reintroduction to the same patient during a single surgical procedure for treatment of pain and function associated with OA of the knee joint
Primary Outcome Measure Information:
Title
Number of Adverse Events
Description
number of safety events post injection
Time Frame
Year 1
Other Pre-specified Outcome Measures:
Title
Knee Pain scores - Visual Analog Scale (VAS)
Description
Using a ruler, the score is determined by measuring the distance (mm) on the 10-cm line between the "no pain" anchor and the patient's mark, providing a range of scores from 0-100. A higher score indicates greater pain intensity
Time Frame
Baseline, Month 1, Month 3, Month 6, and Year 1
Title
Knee Pain scores - The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Description
The WOMAC Pain score ranges from 0 to 20 with higher scores equating to greater pain with activities of daily living
Time Frame
Baseline, Month 1, Month 3, Month 6, and Year 1
Title
Synovial Fluid Inflammatory Biomarker measurements
Description
Biomarkers will be measured before and after SVF treatment, and their relationships to post-trauma knee pain and function examined - Spearman correlation (measures the degree of association between two variables) will be used between changes in VAS or WOMAC score and changes in the eight biomarkers: (cluster of differentiation 14 (CD14), high-affinity receptor of human hemoglobin-haptoglobin complexes (CD163), Matrix metalloproteinase-3 (MMP-3), Vascular endothelial growth factor (VEGF), metallopeptidase inhibitor 1 (TIMP-1), Monocyte chemoattractant protein-1 (MCP-1), Soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) and Soluble intercellular adhesion molecule-1 (sICAM-1)
Time Frame
Baseline, Month 1, Month 3, Month 6, and Year 1
Title
General Health scores - Patient-Reported Outcomes Measurement Information System (PROMIS 29)
Description
There is no total score, but each axis forms its own score. PROMIS assessments use an Item Response Theory (IRT) based score called Expected A Posteriori (EAP) scores, which are then transformed onto a final T-score metric - profile measure assesses pain intensity using a single 0-10 numeric rating item and seven health domains (physical function, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, and sleep disturbance) using four items for each domain
Time Frame
Baseline, Month 1, Month 3, Month 6, and Year 1

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females 18 - 45 with a preceding history (>1 and < 20 years ago) of significant knee trauma or trauma- related knee surgery Post-Trauma Osteoarthritis (PTOA) as diagnosed by K-L Grade II or III OA (weight bearing X-ray) and physician review Subjects must present with symptomatic (injured knee) visual analog scale (VAS) pain > 4. If bilateral disease, Knee Osteoarthritis (KOA) pain in the other knee must be less than/equal to 3 on the VAS for pain Subjects must have an adjusted Western Ontario and McMaster Universities Arthritis Index (WOMAC) (100-point scale) of > 25 and <90 Study Subjects must have continued knee pain despite at least two conservative prescribed therapies (pain medications, physical therapy, knee injections, or weight loss), spanning a period of at least 3 months Study Subjects must be willing to voluntarily give written Informed Consent to participate in the study and sign the Health Insurance Portability and Accountability Act (HIPAA) authorization before any study procedures are performed Subjects will be in good health (ASA Class I-II) with a Body mass index (BMI) < 35 Subjects must speak, read, and understand English Subjects must be reasonably able to return for multiple follow-up visits, to include procedure visits Exclusion Criteria: Subjects whose knee pain is caused by, (i) diffuse edema, (ii) cartilage lesion greater than 1 cm width and grade 4 depth by MRI or (iii) osteochondritis dissecans Subjects who have had surgery of either knee within 12 months prior to the screening visit Subjects who have had an injection in either knee in the prior 3 months, including corticosteroids, viscosupplementation, stem cells, or platelet rich plasma (PRP) Subjects who have gout, rheumatoid arthritis, lupus arthropathy, psoriatic arthritis, avascular necrosis, severe bone deformity, infection of the knee joint, fibromyalgia, or neurogenic or vascular claudication Subjects who have symptomatic Osteoarthritis (OA) of the hips, spine, or ankle that would interfere with the evaluation of the treated knee Subjects that are unwilling to stop taking prescription or over the counter pain and anti-inflammatory medication for 7 days prior to any visit Subjects that are allergic to lidocaine, epinephrine, or valium or other sedatives Subjects with a history of bleeding disorders, anticoagulation therapy that cannot be stopped prior to IA injection Subjects with systemic immunosuppressant use within six (6) weeks from screening Subjects with human immunodeficiency virus (HIV)/viral hepatitis B or human T-lymphotropic virus type 1 (C/HTLV) Subjects with chondrocalcinosis, Paget's disease and Villonodular synovitis Subjects that use any form of tobacco Women that are pregnant or planning to become pregnant during the study Subjects on long term use of oral steroids or disease-modifying anti-rheumatic drugs History of any chemotherapy or radiation therapy of the targeted/treatment leg or adipose harvest site Subjects currently on worker's compensation
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mario Cuadra, MD
Phone
704-751-6916
Email
Mario.Cuadra@atriumhealth.org
First Name & Middle Initial & Last Name or Official Title & Degree
Claude T Moorman, MD
Phone
704-304-5610
Email
Claude.Moorman@atriumhealth.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Claude T Moorman, MD
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mario Cuadra, MD
Phone
704-751-6916
First Name & Middle Initial & Last Name & Degree
Claude T Moorman, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Stromal Vascular Fraction (SVF) for Knee Post-Trauma Osteoarthritis (PTOA)

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