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Efficacy and Safety of Stempeucel® in Patients With Critical Limb Ischemia (CLI) Due to Peripheral Arterial Disease

Primary Purpose

Critical Limb Ischemia, Peripheral Arterial Disease

Status
Not yet recruiting
Phase
Phase 4
Locations
Malaysia
Study Type
Interventional
Intervention
Stempeucel®
Sponsored by
Cell Biopeutics Resources Sdn Bhd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Critical Limb Ischemia focused on measuring critical limb ischemia, peripheral arterial disease, bone marrow-derived mesenchymal stem cell

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Patients between 18-65 years old Patients diagnosed with atherosclerotic peripheral arterial disease Patients not eligible for or have failed surgical or percutaneous revascularization (No option patients) Patients with at least one ulcer (between 0.5 to 10 cm2 size) Ankle brachial pressure index (ABPI) ≤ 0.6 (toe brachial index (TBI) if ABPI out of range; TBI ≤ 0.5) Patients who are able and willing to provide consent and agrees to comply with study procedures and follow-up evaluations Exclusion Criteria: Patients diagnosed with Buerger's disease by Shionoya criteria Patients eligible for surgical or percutaneous revascularization Patients with a history of participating in another stem cell trial or therapy within 3 months Patients who are unsuitable to participate the clinical trial as determined by investigators

Sites / Locations

  • Hospital Canselor Tunku Mukhriz

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Stempeucel®

Arm Description

Stempeucel® (Ex-vivo cultured MSCs) supplied in 15 ml cryo bags consisting of 200 million or 150 million MSCs, 85% PlasmaLyte-A, 5% HSA and 10% DMSO in a total volume of 15 ml. Following thawing, 35 ml of PlasmaLyte A will be added to the Stempeucel® to make a total volume of 50 ml (Refer section 6.6 IMP Preparation and Designation). The final concentration of components will be 1.5% HSA and 3% DMSO.

Outcomes

Primary Outcome Measures

Change in ischemic rest pain
Change in visual analog score (VAS) compared to screening
Change in size of the ulcer
Change in size of the ulcer compared to screening
Change in ankle brachial pressure index (ABPI)
Change in ankle brachial pressure index (ABPI) compared to screening
Change in total walking distance
Change in total walking distance on a treadmill compared to screening
Change in major amputation-free survival
Change in amputation-free survival compared to screening
Change in angiogenesis
Change in angiogenesis measured by digital subtraction angiogram (DSA) compared to screening

Secondary Outcome Measures

The type of AE(s), number of AE(s) and proportion of patients with AE(s)
Monitored and recorded as voluntarily disclosed by the patients and as observed by the Investigator throughout the study
Incidence of abnormal laboratory test results (serum chemistry, haematology, liver function test)
The following lab tests will be conducted: serum chemistry, haematology, liver function test. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Incidence of abnormal urine test results
Urine test will be conducted. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Incidence of abnormal TNF-α
TNF-α test will be conducted. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Incidence of abnormal vital signs
The following assessments will be conducted: blood pressure, heart rate, respiratory rate and temperature. In case of abnormal results, they shall be recorded as an adverse event or excluded from the study (screening).
Incidence of abnormal physical examination
The following examinations will be conducted: visual, heart, lungs, abdomen, nervous system, muscoskeletal system and etc. In case of abnormal conditions, they shall be recorded as an adverse event or excluded from the study (screening).
Incidence of abnormal ECG parameters
The following assessments will be conducted: 12 lead ECG recordings with long Lead II, and two-dimensional echocardiography (2D ECHO; if needed). In case of abnormal conditions, they shall be recorded as an adverse event or excluded from study (screening).
Incidence of abnormal chest condition
Chest x-ray will be conducted. In case of abnormal conditions, they shall be recorded as an adverse event or excluded from study (screening).

Full Information

First Posted
March 30, 2023
Last Updated
May 2, 2023
Sponsor
Cell Biopeutics Resources Sdn Bhd
Collaborators
Stempeutics Research Pvt Ltd, National University of Malaysia
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1. Study Identification

Unique Protocol Identification Number
NCT05854641
Brief Title
Efficacy and Safety of Stempeucel® in Patients With Critical Limb Ischemia (CLI) Due to Peripheral Arterial Disease
Official Title
An Observational, Practice-Based, Open Label, Feasibility Study to Observe the Efficacy and Safety of Intramuscular Administration of Stempeucel® in Malaysian Patients With Critical Limb Ischemia (CLI) Due to Peripheral Arterial Disease.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
May 2023 (Anticipated)
Primary Completion Date
October 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cell Biopeutics Resources Sdn Bhd
Collaborators
Stempeutics Research Pvt Ltd, National University of Malaysia

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The goal of this observational, practice-based feasibility study is to observe the efficacy and safety of intramuscular administration of Stempeucel® in Malaysian patients with critical limb ischemia (CLI) due to peripheral arterial disease. The main questions it aims to answer are: Can intramuscular administration of Stempeucel® reduce symptoms of CLI due to peripheral arterial disease while improving the healing rate and functional outcomes? Does intramuscular administration of Stempeucel® causes any serious adverse events in CLI due to peripheral arterial disease patients? Study patients will be assessed by the PI before administering the Stempeucel® for any other organ with inflammation. The study patients will also be followed up to the duration of 1 year after study treatment administration for safety and efficacy assessment.
Detailed Description
Title: An Observational, Practice-Based, Open Label, Feasibility Study to Observe the Efficacy and Safety of Intramuscular Administration of Stempeucel® in Malaysian Patients with Critical Limb Ischemia (CLI) Due to Peripheral Arterial Disease Study Design: Single arm, practice-based, feasibility study Study Duration: Estimated duration for the main protocol (e.g. from starts of screening to last subject processed and end of the study) is approximately 18 months Study Center: Universiti Kebangsaan Malaysia Medical Centre (UKMMMC), Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Wilayah Persekutuan, Malaysia Objectives: To observe the efficacy and safety of Stempeucel® (adult human bone marrow derived, cultured, pooled, allogeneic mesenchymal stromal cells) in Malaysian patients with critical limb ischemia (CLI) due to peripheral arterial disease. Investigational Medicinal Product Description • Ex-vivo cultured allogeneic mesenchymal stem cells (MSCs) supplied in cryo-bags consisting of 150 or 200 million, suspended in 50 ml of Plasmalyte A containing 1.5% human serum albumin (HSA) and 3% dimethyl sulfoxide (DMSO). Dosage • Dosing of Stempeucel® is based on body weight. The recommended dose is 2 million cells/kg body weight. Administration • 40 - 60 injections administered as 0.6 ml/kg (200 million bag) or 0.8 ml/kg (150 million bag) intramuscularly into different points on the muscle. Additional injections of 2 ml (200 million bag) or 3 ml (150 million bag) administered around the ulcer Number of Subjects: 10 patients Data Analysis Data Management: Electronic case record form (eCRF) will be used for data entry. Oracle clinical (or other suitable alternatives with audit trail) will be used for data management. Statistical Method: The SPSS® package (IBM Inc., USA, version 22) will be used for statistical evaluation. All patients in the study with relevant efficacy and safety data will be considered for the analysis. Efficacy analysis will be done using GEE (Generalized Estimating Equations) method or paired t test as appropriate. Adverse events monitored using information voluntarily disclosed by the patients and as observed by the PI will be summarized descriptively by total number of AE(s). AEs will be categorized as: all AEs, all treatment-emergent AEs, all severe AEs, treatment-related AEs and severe treatment-related AEs. These events will be reported as appropriate and summarized.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Critical Limb Ischemia, Peripheral Arterial Disease
Keywords
critical limb ischemia, peripheral arterial disease, bone marrow-derived mesenchymal stem cell

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Stempeucel®
Arm Type
Experimental
Arm Description
Stempeucel® (Ex-vivo cultured MSCs) supplied in 15 ml cryo bags consisting of 200 million or 150 million MSCs, 85% PlasmaLyte-A, 5% HSA and 10% DMSO in a total volume of 15 ml. Following thawing, 35 ml of PlasmaLyte A will be added to the Stempeucel® to make a total volume of 50 ml (Refer section 6.6 IMP Preparation and Designation). The final concentration of components will be 1.5% HSA and 3% DMSO.
Intervention Type
Biological
Intervention Name(s)
Stempeucel®
Intervention Description
• Ex-vivo cultured allogeneic mesenchymal stem cells (MSCs) supplied in cryo-bags consisting of 150 or 200 million, suspended in 50 ml of Plasmalyte A containing 1.5% human serum albumin (HSA) and 3% dimethyl sulfoxide (DMSO).
Primary Outcome Measure Information:
Title
Change in ischemic rest pain
Description
Change in visual analog score (VAS) compared to screening
Time Frame
Screening (Day -14 to -1), Day 30, 90, 180 and 360
Title
Change in size of the ulcer
Description
Change in size of the ulcer compared to screening
Time Frame
Screening (Day -14 to -1), Day 30, 90, 180 and 360
Title
Change in ankle brachial pressure index (ABPI)
Description
Change in ankle brachial pressure index (ABPI) compared to screening
Time Frame
Screening (Day -14 to -1), Day 30, 90, 180 and 360
Title
Change in total walking distance
Description
Change in total walking distance on a treadmill compared to screening
Time Frame
Screening (Day -14 to -1), Day 30, 90, 180 and 360
Title
Change in major amputation-free survival
Description
Change in amputation-free survival compared to screening
Time Frame
Screening (Day -14 to -1), Day 30, 90, 180 and 360
Title
Change in angiogenesis
Description
Change in angiogenesis measured by digital subtraction angiogram (DSA) compared to screening
Time Frame
Screening (Day -14 to -1), Day 180
Secondary Outcome Measure Information:
Title
The type of AE(s), number of AE(s) and proportion of patients with AE(s)
Description
Monitored and recorded as voluntarily disclosed by the patients and as observed by the Investigator throughout the study
Time Frame
Screening (Day -14 to -1)
Title
Incidence of abnormal laboratory test results (serum chemistry, haematology, liver function test)
Description
The following lab tests will be conducted: serum chemistry, haematology, liver function test. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Time Frame
Screening (Day -14 to -1), Day 7, 30, 90, 180 and 360
Title
Incidence of abnormal urine test results
Description
Urine test will be conducted. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Time Frame
Screening (Day -14 to -1), Day 180
Title
Incidence of abnormal TNF-α
Description
TNF-α test will be conducted. In case of abnormal results, they shall be recorded as an adverse event or excluded from study (screening).
Time Frame
Screening (Day -14 to -1), Day 7 and 30
Title
Incidence of abnormal vital signs
Description
The following assessments will be conducted: blood pressure, heart rate, respiratory rate and temperature. In case of abnormal results, they shall be recorded as an adverse event or excluded from the study (screening).
Time Frame
Screening (Day -14 to -1), Baseline, Day 7, 30, 90, 180 and 360
Title
Incidence of abnormal physical examination
Description
The following examinations will be conducted: visual, heart, lungs, abdomen, nervous system, muscoskeletal system and etc. In case of abnormal conditions, they shall be recorded as an adverse event or excluded from the study (screening).
Time Frame
Screening (Day -14 to -1), Baseline, Day 7, 30, 90, 180 and 360
Title
Incidence of abnormal ECG parameters
Description
The following assessments will be conducted: 12 lead ECG recordings with long Lead II, and two-dimensional echocardiography (2D ECHO; if needed). In case of abnormal conditions, they shall be recorded as an adverse event or excluded from study (screening).
Time Frame
Screening (Day -14 to -1), Baseline, Day 7, 30, 90, 180 and 360
Title
Incidence of abnormal chest condition
Description
Chest x-ray will be conducted. In case of abnormal conditions, they shall be recorded as an adverse event or excluded from study (screening).
Time Frame
Screening (Day -14 to -1), Day 180

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients between 18-65 years old Patients diagnosed with atherosclerotic peripheral arterial disease Patients not eligible for or have failed surgical or percutaneous revascularization (No option patients) Patients with at least one ulcer (between 0.5 to 10 cm2 size) Ankle brachial pressure index (ABPI) ≤ 0.6 (toe brachial index (TBI) if ABPI out of range; TBI ≤ 0.5) Patients who are able and willing to provide consent and agrees to comply with study procedures and follow-up evaluations Exclusion Criteria: Patients diagnosed with Buerger's disease by Shionoya criteria Patients eligible for surgical or percutaneous revascularization Patients with a history of participating in another stem cell trial or therapy within 3 months Patients who are unsuitable to participate the clinical trial as determined by investigators
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jezamine Lim, PhD
Phone
+60176073103
Email
info@cellbiopeutics.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hanafiah Harunarashid, MS
Organizational Affiliation
National University of Malaysia
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Canselor Tunku Mukhriz
City
Kuala Lumpur
ZIP/Postal Code
56000
Country
Malaysia
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Farhana Raduan, MS
Phone
+603-9145
Ext
8299
Email
farhana@ppukm.ukm.edu.my
First Name & Middle Initial & Last Name & Degree
Hanafiah Harunarashid, MS
First Name & Middle Initial & Last Name & Degree
Lenny Suryani Safri, MS
First Name & Middle Initial & Last Name & Degree
Mohamad Azim Md Idris, MS

12. IPD Sharing Statement

Plan to Share IPD
No
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Efficacy and Safety of Stempeucel® in Patients With Critical Limb Ischemia (CLI) Due to Peripheral Arterial Disease

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