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SIMPADICO - Study of Immune Modulation Therapy in Peripheral Arterial Disease and Intermittent Claudication Outcomes

Primary Purpose

Peripheral Arterial Disease, Arterial Occlusive Diseases, Intermittent Claudication

Status
Terminated
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Celacade™ system
Sponsored by
Vasogen
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peripheral Arterial Disease focused on measuring Intermittent Claudication, Peripheral Arterial Disease, Immune modulation therapy, Inflammation

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: History of intermittent claudication (Fontaine stage II) due to peripheral arterial disease, which has been stable (both clinically and therapeutically) for 3 months prior to screening. Resting ankle-brachial index (ABI) in at least one limb ≤ 0.85. For diabetics with falsely elevated ABI due to non-compressible tibial arteries, the toe brachial index (TBI) will be measured and has to be ≤ 0.7 at rest. An absolute claudication distance (ACD) of≥ 50 meters confirmed on two consecutive visits at least one week apart. The change in ACD between the two consecutive assessments (i.e. Visit 0 and 1 or Visit 1 and 2) has to be within ± 20%. Walking distance must be limited by IC, which will be confirmed by a ≥ 20% decrease in ABI in the worse claudicating limb immediately following the screening treadmill tests. The worse claudicating limb (or "index leg") will be defined either as (1) the most symptomatic leg or (2) the leg with the lowest resting ABI and documented prior to the first (pre-screening) treadmill test. Post-exercise and resting ABIs will be compared within the same leg at each screening treadmill test. This criterion will not apply to diabetics with non-compressible tibial arteries (i.e. only the resting TBI will be measured in these patients). Age ≥40 years Exclusion Criteria: Women who are pregnant, lactating, or of childbearing potential not using accepted contraceptive methods, as assessed by the investigator. Clinically relevant abnormal findings in the clinical history or physical examination at the screening assessment that would interfere with the objectives of the study or that would, in the investigator's opinion, preclude safe completion of the study. Abnormal findings could include: hepatitis, HIV infection, AIDS, other immune deficiency syndromes, serious active infections, gastrointestinal tract bleeding or any severe or acute concomitant illness or injury. Critical limb ischemia (CLI) defined as ischemic rest pain, ulcerative lesions or gangrene [Rutherford-Becker Classification Grade II-III (corresponding to Fontaine stage III-IV)]. Previous endovascular or surgical revascularization within 6 months prior to study entry or anticipated during the first 6 months of the study. Active inflammatory vascular disease (e.g. Buerger's disease). Major peripheral neuropathies, including severe diabetic neuropathy to the extent that it may interfere with the evaluation of claudication. Any condition that limits walking ability, other than claudication (e.g. arthritis, angina, chronic obstructive pulmonary disease [COPD], etc.) Malignancy within five years prior to screening. Basal cell carcinoma, provided that it is neither infiltrating nor sclerosing, and carcinoma in situ of the cervix are exemptions. Organ transplant recipients. Allergy to sodium citrate, or any "caine" type of local anesthetic. Systemic corticosteroids, antineoplastics and immunosuppressive drug therapy (e.g. cyclophosphamide, methotrexate, cyclosporine, azathioprine, etc.), DNA depleting or cytotoxic drugs taken within 4 weeks prior to study treatment. Currently taking medications indicated for intermittent claudication (i.e. pentoxifylline or cilostazol). To be eligible, patient must not have taken these medications for at least 8 weeks prior to study enrollment. Participation in another study involving an investigational or licensed drug or device in the 4 weeks preceding enrollment or during this study. Previous Celacade™ treatment. Any other medical, social, or geographical factor, which would make it unlikely that the patient will comply with study procedures (e.g. alcohol abuse, lack of permanent residence, severe depression, disorientation, distant location, and a history of non-compliance).

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Absolute claudication distance (ACD)

    Secondary Outcome Measures

    Health-related quality of life
    Functional status
    Combined incidence of peripheral arterial disease (PAD)-related clinical outcomes

    Full Information

    First Posted
    May 25, 2005
    Last Updated
    March 30, 2010
    Sponsor
    Vasogen
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00111826
    Brief Title
    SIMPADICO - Study of Immune Modulation Therapy in Peripheral Arterial Disease and Intermittent Claudication Outcomes
    Official Title
    Multi-Center, Randomized, Double-Blind, Placebo-Controlled Study of Efficacy and Safety of the Celacade™ System in Improving Walking Distance in Patients With Intermittent Claudication Secondary to Peripheral Arterial Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    November 2007
    Overall Recruitment Status
    Terminated
    Study Start Date
    January 2003 (undefined)
    Primary Completion Date
    undefined (undefined)
    Study Completion Date
    December 2005 (undefined)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Vasogen

    4. Oversight

    5. Study Description

    Brief Summary
    The purpose of this study is to assess the effects of the Celacade™ system in patients with intermittent claudication.
    Detailed Description
    SIMPADICO was a multicenter, randomized, double-blind, placebo-controlled trial that enrolled 553 patients with claudication at 50 sites in Canada and the United States. The mean (±SD) patient age was 67±10 years; 72% were males. The duration of claudication was 6.0±6.1 years at entry; 91% had a history of smoking and 34% were current smokers; 36.5% had diabetes. Resting ABI was 0.59+0.14; baseline ICD was 132±104 and ACD 307±209 meters. Results showed that there was no increase in ACD or ICD at 26 weeks with immune modulation therapy (IMT using the Celacade™ system, Vasogen Inc.) compared to placebo and no measurable improvement in quality of life with IMT compared to placebo. However, there was a significant decrease in CRP (high sensitivity assay) in) in the IMT group compared to the placebo group. Conclusion: Immune modulation therapy did not improve walking distance in patients with symptomatic peripheral arterial disease but the decrease in CRP suggests a biologic effect of IMT and will warrant further study. Reference: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of Immune Modulation Therapy in Patients with Symptomatic Peripheral Arterial Disease: The SIMPADICO Trial. Author: Jeffrey W. Olin, Mount Sinai School of Medicine, New York, NY. Presented at Smaller Trial Late-Breaking Clinical trials I, Sunday March 12, 2006. American College of Cardiology 55th Annual Scientific Sessions, March 11-14, 2006, Atlanta, GA.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Peripheral Arterial Disease, Arterial Occlusive Diseases, Intermittent Claudication
    Keywords
    Intermittent Claudication, Peripheral Arterial Disease, Immune modulation therapy, Inflammation

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    Double
    Allocation
    Randomized
    Enrollment
    500 (false)

    8. Arms, Groups, and Interventions

    Intervention Type
    Device
    Intervention Name(s)
    Celacade™ system
    Primary Outcome Measure Information:
    Title
    Absolute claudication distance (ACD)
    Secondary Outcome Measure Information:
    Title
    Health-related quality of life
    Title
    Functional status
    Title
    Combined incidence of peripheral arterial disease (PAD)-related clinical outcomes

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: History of intermittent claudication (Fontaine stage II) due to peripheral arterial disease, which has been stable (both clinically and therapeutically) for 3 months prior to screening. Resting ankle-brachial index (ABI) in at least one limb ≤ 0.85. For diabetics with falsely elevated ABI due to non-compressible tibial arteries, the toe brachial index (TBI) will be measured and has to be ≤ 0.7 at rest. An absolute claudication distance (ACD) of≥ 50 meters confirmed on two consecutive visits at least one week apart. The change in ACD between the two consecutive assessments (i.e. Visit 0 and 1 or Visit 1 and 2) has to be within ± 20%. Walking distance must be limited by IC, which will be confirmed by a ≥ 20% decrease in ABI in the worse claudicating limb immediately following the screening treadmill tests. The worse claudicating limb (or "index leg") will be defined either as (1) the most symptomatic leg or (2) the leg with the lowest resting ABI and documented prior to the first (pre-screening) treadmill test. Post-exercise and resting ABIs will be compared within the same leg at each screening treadmill test. This criterion will not apply to diabetics with non-compressible tibial arteries (i.e. only the resting TBI will be measured in these patients). Age ≥40 years Exclusion Criteria: Women who are pregnant, lactating, or of childbearing potential not using accepted contraceptive methods, as assessed by the investigator. Clinically relevant abnormal findings in the clinical history or physical examination at the screening assessment that would interfere with the objectives of the study or that would, in the investigator's opinion, preclude safe completion of the study. Abnormal findings could include: hepatitis, HIV infection, AIDS, other immune deficiency syndromes, serious active infections, gastrointestinal tract bleeding or any severe or acute concomitant illness or injury. Critical limb ischemia (CLI) defined as ischemic rest pain, ulcerative lesions or gangrene [Rutherford-Becker Classification Grade II-III (corresponding to Fontaine stage III-IV)]. Previous endovascular or surgical revascularization within 6 months prior to study entry or anticipated during the first 6 months of the study. Active inflammatory vascular disease (e.g. Buerger's disease). Major peripheral neuropathies, including severe diabetic neuropathy to the extent that it may interfere with the evaluation of claudication. Any condition that limits walking ability, other than claudication (e.g. arthritis, angina, chronic obstructive pulmonary disease [COPD], etc.) Malignancy within five years prior to screening. Basal cell carcinoma, provided that it is neither infiltrating nor sclerosing, and carcinoma in situ of the cervix are exemptions. Organ transplant recipients. Allergy to sodium citrate, or any "caine" type of local anesthetic. Systemic corticosteroids, antineoplastics and immunosuppressive drug therapy (e.g. cyclophosphamide, methotrexate, cyclosporine, azathioprine, etc.), DNA depleting or cytotoxic drugs taken within 4 weeks prior to study treatment. Currently taking medications indicated for intermittent claudication (i.e. pentoxifylline or cilostazol). To be eligible, patient must not have taken these medications for at least 8 weeks prior to study enrollment. Participation in another study involving an investigational or licensed drug or device in the 4 weeks preceding enrollment or during this study. Previous Celacade™ treatment. Any other medical, social, or geographical factor, which would make it unlikely that the patient will comply with study procedures (e.g. alcohol abuse, lack of permanent residence, severe depression, disorientation, distant location, and a history of non-compliance).
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Michael E Shannon, MD
    Organizational Affiliation
    Vasogen Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Learn more about this trial

    SIMPADICO - Study of Immune Modulation Therapy in Peripheral Arterial Disease and Intermittent Claudication Outcomes

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