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Safety Study of Bone Marrow Cell Concentrate Prepared Using the Magellan System to Treat Critical Limb Ischemia (CLI) (CLI)

Primary Purpose

Critical Limb Ischemia (CLI), Peripheral Vascular Disease (PVD)

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Magellan®
Sponsored by
Arteriocyte, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Critical Limb Ischemia (CLI) focused on measuring Critical limb ischemia, Peripheral vascular disease, platelet-rich plasma

Eligibility Criteria

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

Inclusion Criteria:

  • Is able to provide written informed consent prior to study entry
  • Is male or female, 18 - 85 years of age
  • CLI with rest pain, tissue loss, or gangrene
  • No option for revascularization as a result of one of the following:

    • failed previous revascularization, such as recurrent instant restenosis or graft occlusion.
    • inadequate target vessels as determined by baseline CTA/angiogram at the time of enrollment.
    • or prohibitive medical comorbidities such as high risk cardiovascular or pulmonary disease which would restrict operative procedures
    • Final determination of no option for revascularization will be made by a vascular surgeon not associated with the clinical trial.
  • ABI less than 0.7, ankle pressure < 50 mmHg, or toe pressure < 30 mmHg.
  • TcPO2 < 40 mmHg
  • SPP < 35 mmHg
  • Female subjects must be of non childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy or hysterectomy]) or must be using adequate contraception (practicing one of the following methods of birth control):

    • Total abstinence from sexual intercourse (minimum of one complete menstrual cycle before study entry),
    • A partner who is physically unable to impregnate the subject (e.g., vasectomized)
    • Contraceptives (oral, parenteral, or transdermal) for 3 consecutive months prior to patient's cell concentrate administration,
    • Intrauterine device (IUD), or
    • Double barrier method (condoms, sponge, diaphragm, or vaginal ring with spermicidal jellies or cream)
  • If female is of childbearing potential, subject must have a negative serum pregnancy test at screening
  • Confirmation of age-appropriate cancer screening consistent with the American Cancer Society guidelines

Exclusion Criteria:

  • Patients with vascular lesions amenable to percutaneous intervention or where surgical bypass is indicated.
  • Any contraindication to stem cell or platelet-rich plasma therapy.
  • Isolated aorto-iliac stenoses or occlusions without infra-inguinal disease.
  • Pregnancy
  • Hemoglobin A1c >10 % on day of enrollment.
  • Have an active malignancy or have undergone treatment for a malignancy in the preceding 5 years, with the exception of successful treatment of non-melanoma skin cancer.
  • Stage 4 or greater chronic kidney disease (eGFR < 30 ml/min, MDRD estimate)
  • Hemoglobin < 10 g/dl.
  • Thrombocytopenia < 100,000 platelets/µL.
  • Unwilling or unable to comply with follow-up visits.
  • Proliferative retinopathy as determined by baseline retinal exam.
  • Is unable to refrain from nicotine, caffeine and alcohol for a period beginning 24 hours prior to the treatment visit
  • Has received an investigational medication or other study trial participation within 30 days prior to the Treatment Visit

Sites / Locations

  • The Ohio State University Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Bone Marrow Cell Concentrate

Arm Description

Bone Marrow Cell Concentrate Prepared Using the Magellan System

Outcomes

Primary Outcome Measures

Time to treatment failure or death
Treatment failure is defined as major amputation

Secondary Outcome Measures

Perfusion and Quality of Life measurements
Perfusion rate in treated tissue by measure of ankle-brachial index (ABI) Perfusion rate in treated tissue by transcutaneous PO2 (TcPO2) Perfusion rate in treated tissue by skin perfusion pressure (SPP) Pain intensity using Visual Analogue Scale (VAS) Quality of Life (QoL) by questionnaire

Full Information

First Posted
June 29, 2011
Last Updated
January 23, 2017
Sponsor
Arteriocyte, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01386216
Brief Title
Safety Study of Bone Marrow Cell Concentrate Prepared Using the Magellan System to Treat Critical Limb Ischemia (CLI)
Acronym
CLI
Official Title
Phase I, Non-Randomized, Feasibility Study for the Use of Bone Marrow Cell Concentrate Prepared Using the Magellan System for the Treatment of Critical Limb Ischemia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
April 2011 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Arteriocyte, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety of administration of marrow-derived autologous hematopoietic stem cells (HSC) concentrate and platelet-rich plasma (PRP) gel for the treatment of Critical Limb Ischemia (CLI).
Detailed Description
Critical limb ischemia (CLI) continues to be an important cause of atherosclerotic morbidity and mortality despite conventional therapies. Modulation of angiogenesis is a promising alternative to surgical revascularization. Trials of isolated angiogenic growth factor therapies using recombinant proteins or gene transfer have been conducted, but with disappointing results because it is unlikely that a single angiogenic factor is solely or even primarily responsible for angiogenesis. Emerging stem cell therapies represent a new approach to the modulation of angiogenesis. Pluripotent hematopoietic stem cells (HSC) hold promise because they can reproduce a pro-angiogenic milieu in the ischemic limb rather than upregulate a single angiogenic factor. For this CLI study, the Magellan® System is utilized for the preparation of autologous cell concentrate at the point of care. The bone marrow aspirate is obtained from the patient and concentrated with the cell concentration kit, and delivered intramuscularly to the affected limb for the treatment of impaired ischemic tissue in order to improve perfusion, reduce pain and revascularize tissues in patients who have inadequate tissue blood flow, prohibitive medical comorbidities, or failed previous treatments for revascularization for the prevention of amputation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Critical Limb Ischemia (CLI), Peripheral Vascular Disease (PVD)
Keywords
Critical limb ischemia, Peripheral vascular disease, platelet-rich plasma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Bone Marrow Cell Concentrate
Arm Type
Experimental
Arm Description
Bone Marrow Cell Concentrate Prepared Using the Magellan System
Intervention Type
Device
Intervention Name(s)
Magellan®
Other Intervention Name(s)
autologous cell concentrate
Intervention Description
Autologous Bone Marrow Cell Concentrate Prepared Using the Magellan System to be injected into the ischemic muscle tissue at 0.5 cc/injection for a total of 12-20 cc.
Primary Outcome Measure Information:
Title
Time to treatment failure or death
Description
Treatment failure is defined as major amputation
Time Frame
Baseline - 12 months
Secondary Outcome Measure Information:
Title
Perfusion and Quality of Life measurements
Description
Perfusion rate in treated tissue by measure of ankle-brachial index (ABI) Perfusion rate in treated tissue by transcutaneous PO2 (TcPO2) Perfusion rate in treated tissue by skin perfusion pressure (SPP) Pain intensity using Visual Analogue Scale (VAS) Quality of Life (QoL) by questionnaire
Time Frame
Baseline - 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is able to provide written informed consent prior to study entry Is male or female, 18 - 85 years of age CLI with rest pain, tissue loss, or gangrene No option for revascularization as a result of one of the following: failed previous revascularization, such as recurrent instant restenosis or graft occlusion. inadequate target vessels as determined by baseline CTA/angiogram at the time of enrollment. or prohibitive medical comorbidities such as high risk cardiovascular or pulmonary disease which would restrict operative procedures Final determination of no option for revascularization will be made by a vascular surgeon not associated with the clinical trial. ABI less than 0.7, ankle pressure < 50 mmHg, or toe pressure < 30 mmHg. TcPO2 < 40 mmHg SPP < 35 mmHg Female subjects must be of non childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy or hysterectomy]) or must be using adequate contraception (practicing one of the following methods of birth control): Total abstinence from sexual intercourse (minimum of one complete menstrual cycle before study entry), A partner who is physically unable to impregnate the subject (e.g., vasectomized) Contraceptives (oral, parenteral, or transdermal) for 3 consecutive months prior to patient's cell concentrate administration, Intrauterine device (IUD), or Double barrier method (condoms, sponge, diaphragm, or vaginal ring with spermicidal jellies or cream) If female is of childbearing potential, subject must have a negative serum pregnancy test at screening Confirmation of age-appropriate cancer screening consistent with the American Cancer Society guidelines Exclusion Criteria: Patients with vascular lesions amenable to percutaneous intervention or where surgical bypass is indicated. Any contraindication to stem cell or platelet-rich plasma therapy. Isolated aorto-iliac stenoses or occlusions without infra-inguinal disease. Pregnancy Hemoglobin A1c >10 % on day of enrollment. Have an active malignancy or have undergone treatment for a malignancy in the preceding 5 years, with the exception of successful treatment of non-melanoma skin cancer. Stage 4 or greater chronic kidney disease (eGFR < 30 ml/min, MDRD estimate) Hemoglobin < 10 g/dl. Thrombocytopenia < 100,000 platelets/µL. Unwilling or unable to comply with follow-up visits. Proliferative retinopathy as determined by baseline retinal exam. Is unable to refrain from nicotine, caffeine and alcohol for a period beginning 24 hours prior to the treatment visit Has received an investigational medication or other study trial participation within 30 days prior to the Treatment Visit
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Go, MD
Organizational Affiliation
Ohio State University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Ohio State University Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

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Safety Study of Bone Marrow Cell Concentrate Prepared Using the Magellan System to Treat Critical Limb Ischemia (CLI)

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