Safety and Efficacy of Allogeneic Adipose Tissue Mesenchymal Stem Cells in Diabetic Patients With Critical Limb Ischemia
Primary Purpose
Limb Ischemia, Diabetic Foot
Status
Active
Phase
Phase 2
Locations
Spain
Study Type
Interventional
Intervention
High dose allogeneic mesenchymal stromal cells
Low dose allogeneic mesenchymal stromal cells
Placebos
Sponsored by
About this trial
This is an interventional treatment trial for Limb Ischemia
Eligibility Criteria
Inclusion Criteria:
Patients must meet ALL of the following criteria to be included in the study:
- Patients of both sexes.
- Age between 40 and 90 years.
- Severe grade vascular arteriosclerosis (category RB 4 and 5 mono or bilateral).
- Impossibility of surgical or endovascular revascularization or failure in revascularization surgery performed, at least 30 days before inclusion in the study, defining failure as direct non-arrival of vessels to the plantar arch.
Normal biochemical parameters defined by:
- Leukocytes> 3000 / mm3
- Neutrophils> 1500 / mm3
- Platelets> 100,000 / mm3
- AST / ALT <2.5x upper limit of normal
- In patients with an ischemic ulcer, it must be stable for at least 1 week.
- Patients under conventional medical treatment for CLI.
- Women of childbearing age must obtain a negative result in a urine pregnancy test performed at the time of inclusion in the study and commit to using an effective contraceptive method during their participation in the study.
- Patients who have not participated in any other clinical trial during the 3 months prior to the inclusion visit.
- Patients who sign the informed consent.
Exclusion Criteria:
Patients who present SOME of the following criteria may not be selected to participate in this study:
- CLI with tissue loss in the target member (category 6 of RB).
- Previous major amputation in the target member.
- Uncontrolled hypertension (defined as PAS> 180 or PAD> 110 in at least 2 determinations during the selection period).
- Patients with severe heart failure or ejection fraction less than 30%.
- Patients with a previous diagnosis of ventricular arrhythmias or unstable angina.
- Patients with septicemia.
- Patients diagnosed with deep vein thrombosis in the 3 months prior to their inclusion in the study.
- Concomitant therapy that includes hyperbaric oxygen, angiogenic agents or Cox II inhibitors.
- Contraindication to perfusion NMR.
- Proliferative retinopathy without treatment.
- Diabetic nephropathy in hemodialysis.
- Patients previously treated with cell therapy, gene therapy or growth factors in the last year.
- Concomitant disease that limits life expectancy to 1 year or that does not ensure the follow-up period.
- Patients who have suffered a stroke or myocardial infarction in the 3 months prior to the inclusion visit.
- Severe anemia (hemoglobin <7.9g / dl) in the inclusion analysis.
- Patients with a previous diagnosis of chronic alcoholism.
- Any clinically significant anomaly detected in the Selection Period and which, in the opinion of the investigator, constitutes an impediment to the correct participation of the patient in the study or the fulfillment of the procedures established therein.
Sites / Locations
- Hospital General de Alicante
- Hospital Gregorio Marañon
- Hospital Universitario Fundacion Jimenez Diaz
- La Paz University Hospital
- Hospital Clinico Universitario Virgen de la Arrixaca
- Clinica Universidad de Navarra
- Hospital Universitario de Salamanca
- Hospital Victoria Eugenia Cruz Roja Española
- Hospital Universitario La Fe
- Hospital de Valladolid
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Placebo Comparator
Experimental
Experimental
Arm Label
Control arm
Low dose treatment arm
High dose treatment arm
Arm Description
0.9% physiological saline
Low dose allogeneic mesenchymal stem cells derived from adipose tissue
High dose allogeneic mesenchymal stem cells derived from adipose tissue
Outcomes
Primary Outcome Measures
Complication rate after treatment administration
Secondary Outcome Measures
Evaluation of vascularization though RMN
Rutherford-Becker scale
Wifi scale
Ankle arm index
Temperature
(ºC)
Twin perimeter
(cm)
Neuropathic symptoms (altered sensitivity)
% amputations
Full Information
NCT ID
NCT04466007
First Posted
July 1, 2020
Last Updated
October 2, 2023
Sponsor
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz
Collaborators
Clinica Universidad de Navarra, Universidad de Navarra, Hospital Universitario La Paz, Gregorio Marañón Hospital, Hospital Clínico Universitario de Valladolid, Hospital Universitario Virgen de la Arrixaca, University of Salamanca, Hospital General Universitario de Alicante, Hospital Universitario La Fe, Hospital Victoria Eugenia Cruz Roja Española
1. Study Identification
Unique Protocol Identification Number
NCT04466007
Brief Title
Safety and Efficacy of Allogeneic Adipose Tissue Mesenchymal Stem Cells in Diabetic Patients With Critical Limb Ischemia
Official Title
Multicenter, Randomized, Dose-search, Parallel, Double-blind, and Placebo-controlled Clinical Trial to Evaluate the Safety and Efficacy of Intramuscular Administration of Allogeneic Adipose Tissue Adult Mesenchymal Stem Cells in Diabetic Patients With Critical Limb Ischemia Without Possibility of Revascularization
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 11, 2021 (Actual)
Primary Completion Date
April 1, 2024 (Anticipated)
Study Completion Date
April 1, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz
Collaborators
Clinica Universidad de Navarra, Universidad de Navarra, Hospital Universitario La Paz, Gregorio Marañón Hospital, Hospital Clínico Universitario de Valladolid, Hospital Universitario Virgen de la Arrixaca, University of Salamanca, Hospital General Universitario de Alicante, Hospital Universitario La Fe, Hospital Victoria Eugenia Cruz Roja Española
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Phase II national, multicenter, double-blind, randomized, placebo-controlled, phase-3 clinical trial of 3 parallel groups.
Detailed Description
Disease or disorder under study: Critical ischemia of the lower limbs in diabetic patients without the possibility of revascularization.
Main valuation variable: Proportion of Adverse Events related to treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Limb Ischemia, Diabetic Foot
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Control arm
Arm Type
Placebo Comparator
Arm Description
0.9% physiological saline
Arm Title
Low dose treatment arm
Arm Type
Experimental
Arm Description
Low dose allogeneic mesenchymal stem cells derived from adipose tissue
Arm Title
High dose treatment arm
Arm Type
Experimental
Arm Description
High dose allogeneic mesenchymal stem cells derived from adipose tissue
Intervention Type
Drug
Intervention Name(s)
High dose allogeneic mesenchymal stromal cells
Intervention Description
Allogeneic mesenchymal stromal cells derived from adipose tissue administered intramuscularly
Intervention Type
Drug
Intervention Name(s)
Low dose allogeneic mesenchymal stromal cells
Intervention Description
Allogeneic mesenchymal stromal cells derived from adipose tissue administered intramuscularly
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
0,9% physiological saline
Primary Outcome Measure Information:
Title
Complication rate after treatment administration
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Evaluation of vascularization though RMN
Time Frame
1 year
Title
Rutherford-Becker scale
Time Frame
1 year
Title
Wifi scale
Time Frame
1 year
Title
Ankle arm index
Time Frame
1 year
Title
Temperature
Description
(ºC)
Time Frame
1 year
Title
Twin perimeter
Description
(cm)
Time Frame
1 year
Title
Neuropathic symptoms (altered sensitivity)
Time Frame
1 year
Title
% amputations
Time Frame
1 year
Other Pre-specified Outcome Measures:
Title
SF-12 questionnaire
Time Frame
1 year
Title
VascuQol-6 questionnaire
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must meet ALL of the following criteria to be included in the study:
Patients of both sexes.
Age between 40 and 90 years.
Severe grade vascular arteriosclerosis (category RB 4 and 5 mono or bilateral).
Impossibility of surgical or endovascular revascularization or failure in revascularization surgery performed, at least 30 days before inclusion in the study, defining failure as direct non-arrival of vessels to the plantar arch.
Normal biochemical parameters defined by:
Leukocytes> 3000 / mm3
Neutrophils> 1500 / mm3
Platelets> 100,000 / mm3
AST / ALT <2.5x upper limit of normal
In patients with an ischemic ulcer, it must be stable for at least 1 week.
Patients under conventional medical treatment for CLI.
Women of childbearing age must obtain a negative result in a urine pregnancy test performed at the time of inclusion in the study and commit to using an effective contraceptive method during their participation in the study.
Patients who have not participated in any other clinical trial during the 3 months prior to the inclusion visit.
Patients who sign the informed consent.
Exclusion Criteria:
Patients who present SOME of the following criteria may not be selected to participate in this study:
CLI with tissue loss in the target member (category 6 of RB).
Previous major amputation in the target member.
Uncontrolled hypertension (defined as PAS> 180 or PAD> 110 in at least 2 determinations during the selection period).
Patients with severe heart failure or ejection fraction less than 30%.
Patients with a previous diagnosis of ventricular arrhythmias or unstable angina.
Patients with septicemia.
Patients diagnosed with deep vein thrombosis in the 3 months prior to their inclusion in the study.
Concomitant therapy that includes hyperbaric oxygen, angiogenic agents or Cox II inhibitors.
Contraindication to perfusion NMR.
Proliferative retinopathy without treatment.
Diabetic nephropathy in hemodialysis.
Patients previously treated with cell therapy, gene therapy or growth factors in the last year.
Concomitant disease that limits life expectancy to 1 year or that does not ensure the follow-up period.
Patients who have suffered a stroke or myocardial infarction in the 3 months prior to the inclusion visit.
Severe anemia (hemoglobin <7.9g / dl) in the inclusion analysis.
Patients with a previous diagnosis of chronic alcoholism.
Any clinically significant anomaly detected in the Selection Period and which, in the opinion of the investigator, constitutes an impediment to the correct participation of the patient in the study or the fulfillment of the procedures established therein.
Facility Information:
Facility Name
Hospital General de Alicante
City
Alicante
Country
Spain
Facility Name
Hospital Gregorio Marañon
City
Madrid
Country
Spain
Facility Name
Hospital Universitario Fundacion Jimenez Diaz
City
Madrid
Country
Spain
Facility Name
La Paz University Hospital
City
Madrid
Country
Spain
Facility Name
Hospital Clinico Universitario Virgen de la Arrixaca
City
Murcia
Country
Spain
Facility Name
Clinica Universidad de Navarra
City
Pamplona
Country
Spain
Facility Name
Hospital Universitario de Salamanca
City
Salamanca
Country
Spain
Facility Name
Hospital Victoria Eugenia Cruz Roja Española
City
Sevilla
Country
Spain
Facility Name
Hospital Universitario La Fe
City
Valencia
Country
Spain
Facility Name
Hospital de Valladolid
City
Valladolid
Country
Spain
12. IPD Sharing Statement
Plan to Share IPD
Undecided
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Safety and Efficacy of Allogeneic Adipose Tissue Mesenchymal Stem Cells in Diabetic Patients With Critical Limb Ischemia
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