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Autologous Stromal Vascular Fraction of Cells for Treatment of Knee Articular Cartilage Dystrophy

Primary Purpose

Knee Osteoarthritis

Status
Unknown status
Phase
Phase 2
Locations
Russian Federation
Study Type
Interventional
Intervention
Liposuction
SVF isolation
Intraarticular administration of autologous SVF
Sponsored by
Central Clinical Hospital w/Outpatient Health Center of Business Administration for the President of Russian Federation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Damage of articular cartilage, Cartilage degeneration, Intraarticular injection, SVF, Stromal vascular fraction, Adipose-derived regenerative cells (ADRC), Adipose tissue, Stem cells

Eligibility Criteria

20 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Pain in the knee joint during more than a half day assessed by Visual Analog Pain Scale (score more than 40 mm)
  • At least three of the following 6 criteria: 50 years of age or older, stiffness lasting less than 30 minutes, crepitus, bony tenderness, bony enlargement, no warmth to the touch
  • Patient is able to walk without assistance
  • Patient is familiar with Participant information sheet
  • Patient signed informed consent form

Non-inclusion Criteria:

  • Medical history of endoprosthetic knee replacement
  • Medical history of lower extremity osteotomy
  • Medical history of knee surgery (including arthroscopy) during preceding 1 year prior to enrollment
  • Medical history of intraarticular injections during preceding 6 months prior to enrollment
  • Secondary osteoarthritis of the knee joint: posttraumatic osteoarthritis (developed after clinically significant injury), intra-articular fractures, clinically significant varus or valgus deformities of lower limbs, septic arthritis, joint's inflammatory disorders, gout, advanced chondrocalcinosis, Paget's disease, ochronosis, acromegaly, hemochromatosis, Wilson's disease, primary synovial osteochondromatosis, osteonecrosis, hemophilia
  • Patients prescribed for immunosuppressive treatment
  • Medical history of systemic autoimmune and inflammatory diseases
  • Significant weight loss (> 10% of body weight in the previous year) of unknown etiology
  • Medical history of venous thromboembolism or estimated high risk of venous thromboembolism
  • Patients prescribed for systemic corticosteroids or other medications treatment with proven impact on bone or cartilage tissue metabolism
  • Clinically significant abnormalities in results of laboratory tests
  • Any conditions limiting compliance (dementia, neuropsychiatric disease, drug and alcohol abuse etc.)
  • Participation in other clinical trials (or administration of investigational drugs) during 3 months prior inclusion
  • Patients with malignant tumors including postoperative period, patients receiving chemotherapy and/or radiotherapy.
  • Patient's activated partial thromboplastin time exceeds normal levels more than 1,8 times
  • Patients prescribed for anticoagulants treatment or patient received anticoagulants at least one hour prior liposuction
  • Medical history of heterotopic ossifications
  • Patients prescribed for glycoprotein inhibitors treatment

Exclusion Criteria:

  • Patient's refusal from the further participation in trial
  • Patient's refusal from compliance with the requirements of contraception during the participation in research
  • Chronic kidney disease IV- V stages (creatinine clearance < 30 mL/min estimated by Cockcroft-Gault formula)
  • Confirmed syphilis, HIV, hepatitis B or C infections

Dropout Criteria:

  • Pregnancy

Sites / Locations

  • Federal State Budgetary Institution "Central Clinical Hospital with Outpatient Health Center" of the Business Administration for the President of the Russian Federation
  • Orenburg City Clinical Hospital #4
  • Orenburg Regional Clinical Donor Blood Center
  • Orenburg Regional Clinical Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

SVF injection

Arm Description

Subjects will undergo liposuction under local anesthesia. Lipoaspirate will be processed to isolate and concentrate stromal vascular fraction of cells (SVF). After SVF isolation autologous cells suspension will be injected intraarticularly into knee joint.

Outcomes

Primary Outcome Measures

SAEs monitoring
Types, probability and severity of treatment emergent serious adverse events (SAEs)
SARs monitoring
Types, probability and severity of treatment emergent serious adverse reactions (SARs)

Secondary Outcome Measures

Quality of life monitoring-1
Quality of life estimated by validated questionnaire - the Short Form (36) Health Survey (SF-36)
Quality of life monitoring-2
Quality of life estimated by validated questionnaire - Knee Injury and Osteoarthritis Outcome Score (KOOS)
Knee pain intensity monitoring
Knee pain intensity assessed by Visual Analog Pain Scale (no pain=0; maximum pain=100 mm)
Changes in knee joint structure-1
Changes in knee joint structure assessed by ultrasonography (effusion, synovial thickening or hypertrophy, cartilage parameters, vascularity, Baker's cysts, osteophytes, tendon and ligament abnormalities, meniscal changes, bursitis, erosions and panniculitis)
Changes in knee joint structure-2
Changes in knee joint structure assessed by X-ray (joint space width, bone contour, presence of osteophytes and sclerosis)
Changes in knee joint structure-3
Changes in knee joint structure assessed by MRI (articular cartilage, osteophytes, bone marrow abnormality, meniscal integrity, synovial effusion/tissue, anterior and posterior cruciate ligaments, and medial and lateral collateral ligaments)
Changes in knee function
Changes in knee function assessed by validated questionnaire: Knee Society Score (KSS)

Full Information

First Posted
June 24, 2016
Last Updated
July 19, 2017
Sponsor
Central Clinical Hospital w/Outpatient Health Center of Business Administration for the President of Russian Federation
Collaborators
Orenburg Regional Clinical Blood Donor Center
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1. Study Identification

Unique Protocol Identification Number
NCT02827851
Brief Title
Autologous Stromal Vascular Fraction of Cells for Treatment of Knee Articular Cartilage Dystrophy
Official Title
Evaluation of Safety and Effectiveness of Intraarticular Administration of Autologous Stromal Vascular Fraction of Cells for Treatment of Knee Articular Cartilage Dystrophy
Study Type
Interventional

2. Study Status

Record Verification Date
July 2017
Overall Recruitment Status
Unknown status
Study Start Date
May 2016 (Actual)
Primary Completion Date
May 2018 (Anticipated)
Study Completion Date
November 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Central Clinical Hospital w/Outpatient Health Center of Business Administration for the President of Russian Federation
Collaborators
Orenburg Regional Clinical Blood Donor Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Stromal vascular fraction of cells (SVF) will be extracted from lipoaspirate by enzymatic digestion. SVF will be administered in a single dose intraarticularly 4 weeks after arthroscopic debridement. All patients will receive cell therapy.This is a single arm study with no control.
Detailed Description
Patients undergone arthroscopic debridement for knee osteoarthritis will be subjected to abdominal liposuction under local anaesthesia. Harvested adipose tissue will be processed according to patent pending technology based on enzymatic digestion, washing and concentration of cell pellet in 5 ml of Hartmann's solution. Isolated SVF will be administered in a single dose into anterior part of knee joint cavity 28 days after arthroscopy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Damage of articular cartilage, Cartilage degeneration, Intraarticular injection, SVF, Stromal vascular fraction, Adipose-derived regenerative cells (ADRC), Adipose tissue, Stem cells

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
SVF injection
Arm Type
Experimental
Arm Description
Subjects will undergo liposuction under local anesthesia. Lipoaspirate will be processed to isolate and concentrate stromal vascular fraction of cells (SVF). After SVF isolation autologous cells suspension will be injected intraarticularly into knee joint.
Intervention Type
Procedure
Intervention Name(s)
Liposuction
Intervention Type
Other
Intervention Name(s)
SVF isolation
Intervention Description
SVF will be isolated according to patent pending technology based on enzymatic digestion, washing and concentration of cell pellet in 5 ml of Hartmann's solution.
Intervention Type
Other
Intervention Name(s)
Intraarticular administration of autologous SVF
Primary Outcome Measure Information:
Title
SAEs monitoring
Description
Types, probability and severity of treatment emergent serious adverse events (SAEs)
Time Frame
4 weeks after treatment
Title
SARs monitoring
Description
Types, probability and severity of treatment emergent serious adverse reactions (SARs)
Time Frame
4 weeks after treatment
Secondary Outcome Measure Information:
Title
Quality of life monitoring-1
Description
Quality of life estimated by validated questionnaire - the Short Form (36) Health Survey (SF-36)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Quality of life monitoring-2
Description
Quality of life estimated by validated questionnaire - Knee Injury and Osteoarthritis Outcome Score (KOOS)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Knee pain intensity monitoring
Description
Knee pain intensity assessed by Visual Analog Pain Scale (no pain=0; maximum pain=100 mm)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Changes in knee joint structure-1
Description
Changes in knee joint structure assessed by ultrasonography (effusion, synovial thickening or hypertrophy, cartilage parameters, vascularity, Baker's cysts, osteophytes, tendon and ligament abnormalities, meniscal changes, bursitis, erosions and panniculitis)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Changes in knee joint structure-2
Description
Changes in knee joint structure assessed by X-ray (joint space width, bone contour, presence of osteophytes and sclerosis)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Changes in knee joint structure-3
Description
Changes in knee joint structure assessed by MRI (articular cartilage, osteophytes, bone marrow abnormality, meniscal integrity, synovial effusion/tissue, anterior and posterior cruciate ligaments, and medial and lateral collateral ligaments)
Time Frame
Follow up to completion (up to 24 weeks after treatment)
Title
Changes in knee function
Description
Changes in knee function assessed by validated questionnaire: Knee Society Score (KSS)
Time Frame
Follow up to completion (up to 24 weeks after treatment)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pain in the knee joint during more than a half day assessed by Visual Analog Pain Scale (score more than 40 mm) At least three of the following 6 criteria: 50 years of age or older, stiffness lasting less than 30 minutes, crepitus, bony tenderness, bony enlargement, no warmth to the touch Patient is able to walk without assistance Patient is familiar with Participant information sheet Patient signed informed consent form Non-inclusion Criteria: Medical history of endoprosthetic knee replacement Medical history of lower extremity osteotomy Medical history of knee surgery (including arthroscopy) during preceding 1 year prior to enrollment Medical history of intraarticular injections during preceding 6 months prior to enrollment Secondary osteoarthritis of the knee joint: posttraumatic osteoarthritis (developed after clinically significant injury), intra-articular fractures, clinically significant varus or valgus deformities of lower limbs, septic arthritis, joint's inflammatory disorders, gout, advanced chondrocalcinosis, Paget's disease, ochronosis, acromegaly, hemochromatosis, Wilson's disease, primary synovial osteochondromatosis, osteonecrosis, hemophilia Patients prescribed for immunosuppressive treatment Medical history of systemic autoimmune and inflammatory diseases Significant weight loss (> 10% of body weight in the previous year) of unknown etiology Medical history of venous thromboembolism or estimated high risk of venous thromboembolism Patients prescribed for systemic corticosteroids or other medications treatment with proven impact on bone or cartilage tissue metabolism Clinically significant abnormalities in results of laboratory tests Any conditions limiting compliance (dementia, neuropsychiatric disease, drug and alcohol abuse etc.) Participation in other clinical trials (or administration of investigational drugs) during 3 months prior inclusion Patients with malignant tumors including postoperative period, patients receiving chemotherapy and/or radiotherapy. Patient's activated partial thromboplastin time exceeds normal levels more than 1,8 times Patients prescribed for anticoagulants treatment or patient received anticoagulants at least one hour prior liposuction Medical history of heterotopic ossifications Patients prescribed for glycoprotein inhibitors treatment Exclusion Criteria: Patient's refusal from the further participation in trial Patient's refusal from compliance with the requirements of contraception during the participation in research Chronic kidney disease IV- V stages (creatinine clearance < 30 mL/min estimated by Cockcroft-Gault formula) Confirmed syphilis, HIV, hepatitis B or C infections Dropout Criteria: Pregnancy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ilya I Eremin, MD, PhD
Organizational Affiliation
Federal State Budgetary Institution "Central Clinical Hospital with Outpatient Health Center" of the Business Administration for the President of the Russian Federation; Center for Biomedical Technologies
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Rinat G Gilmutdinov, MD, PhD
Organizational Affiliation
Orenburg Regional Clinical Donor Blood Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sergey I Gilfanov, MD, PhD, Prof
Organizational Affiliation
Federal State Budgetary Institution "Central Clinical Hospital with Outpatient Health Center" of the Business Administration for the President of the Russian Federation
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Andrey A Averyanov, MD, PhD
Organizational Affiliation
Orenburg Regional Clinical Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Vadim A Kopylov, MD, PhD
Organizational Affiliation
Orenburg City Clinical Hospital #4
Official's Role
Principal Investigator
Facility Information:
Facility Name
Federal State Budgetary Institution "Central Clinical Hospital with Outpatient Health Center" of the Business Administration for the President of the Russian Federation
City
Moscow
ZIP/Postal Code
121359
Country
Russian Federation
Facility Name
Orenburg City Clinical Hospital #4
City
Orenburg
ZIP/Postal Code
460000
Country
Russian Federation
Facility Name
Orenburg Regional Clinical Donor Blood Center
City
Orenburg
ZIP/Postal Code
460018
Country
Russian Federation
Facility Name
Orenburg Regional Clinical Hospital
City
Orenburg
ZIP/Postal Code
460018
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Autologous Stromal Vascular Fraction of Cells for Treatment of Knee Articular Cartilage Dystrophy

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