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Study of HGF Via Plasmid Vector to Improve Perfusion in Critical Limb Ischemia

Primary Purpose

Arterial Occlusive Disease, Peripheral Vascular Disease, Ischemia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HGF plasmid
Sponsored by
AnGes USA, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arterial Occlusive Disease focused on measuring Critical Limb Ischemia

Eligibility Criteria

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

Inclusion Criteria: Subjects will have one or more clinical indications diagnostic of CLI such as: distal extremity pain at rest that requires the subject to use analgesics for >2 weeks; or peripheral ischemic ulcer(s); or areas of gangrene. The subject will have a TcPO2 of </= 40 mmHg. Subjects will have one or both of the following hemodynamic indicators of severe peripheral arterial occlusive disease: (a) Ankle systolic pressure of </= 70 mmHg; (b)Toe systolic pressure </= 50 mmHg. The subject is a poor candidate for standard revascularization treatment options for peripheral arterial disease, based on inadequate bypass conduit, unfavorable anatomy, or poor operative risk. Subject has signed an informed consent form either directly or through a legally authorized representative If female, the subject must be (a) at least one year post-menopausal, or (b) surgically sterile, or (c) if the subject is of child-bearing potential, she must have been practicing contraception for at least 12 weeks prior to entering the study. If subject is of reproductive potential, he or she must be using an accepted and effective (barrier) form of birth control during the study. Subjects will be on a statin and an anti-platelet agent as part of their standard of care and must be stable on these regimens for at least 4 weeks prior to treatment. Exclusion Criteria: Subjects, who in the opinion of the investigator, have a vascular disease prognosis that indicates they would require a major amputation (at or above the ankle) within 4 weeks of start of treatment. Subjects with a diagnosis of Buerger's disease (Thromboangitis Obliterans). Subjects with hemodynamically significant aorto-iliac occlusive disease. Subjects who have had a revascularization procedure within 12 weeks prior to treatment initiation that remains patent. Revascularization procedures that are evidenced to have failed for >2 weeks prior to treatment initiation are acceptable. Subjects who require a change in their hypertension medication as part of their standard of care within 4 weeks prior to treatment. Evidence or history of malignant neoplasm (clinical, laboratory or imaging), except for basal cell carcinoma of the skin. Subjects who have proliferative diabetic retinopathy or severe, non-proliferative retinopathy Subjects with end stage renal disease (ESRD) defined as significant renal dysfunction evidenced by a creatinine of > 2.5, or receiving chronic hemodialysis therapy. A subject who has hepatic cirrhosis, viral hepatitis, or is HIV positive. Subjects with a clinically significant liver enzyme abnormality (i.e., AST or ALT more than two times the upper limit of normal and/or bilirubin more than 50% the upper limit of normal). Subjects requiring the use of hyperbaric oxygen treatment for wound healing during the screening and 6 month follow-up period.

Sites / Locations

  • Cardiology, P.C.
  • Central Arkansas Veteran's Healthcare System
  • Cedars-Sinai Medical Center
  • Falk Cardiovascular Research Center
  • VA Medical Center Surgical Service (112)
  • Basptist Hospital
  • University of South Florida College of Medicine
  • American Cardiovascular Research Institute
  • University of Chicago Hospitals
  • The Care Group, LLC
  • The Ochsner Heart and Vascular Institute
  • Minneapolis Heart Institute Foundation
  • Dartmouth - Hitchcock Medical Center
  • Diabetes Foot and Ankle Center
  • NYPH-NY Weill Cornell Medical Center
  • University of Rochester
  • Pitt County Memorial Hospital
  • The Lindner Clinical Trial Center
  • The Cleveland Clinic Foundation
  • Jobst Vascular Center
  • Medical College of Ohio
  • University of Oklahoma Health Sciences Center
  • Baylor College of Medicine
  • Peripheral Vascular Associates

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

1

2

3

4

Arm Description

0.4 mg AMG0001 on days 0, 14, and 28

4.0 mg AMG0001 on days 0, 14, and 28

4.0 mg AMG0001 on days 0 and 28; placebo on day 14

Placebo (saline) on days 0, 14, and 28

Outcomes

Primary Outcome Measures

Tissue perfusion as measured by TcPO2

Secondary Outcome Measures

Ulcer healing

Full Information

First Posted
May 15, 2003
Last Updated
January 9, 2008
Sponsor
AnGes USA, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00060892
Brief Title
Study of HGF Via Plasmid Vector to Improve Perfusion in Critical Limb Ischemia
Official Title
A Phase II Double-Blind, Randomized, Placebo-Controlled Study to Assess the Safety and Efficacy of AMG0001 to Improve Perfusion in Critical Leg Ischemia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2008
Overall Recruitment Status
Completed
Study Start Date
April 2003 (undefined)
Primary Completion Date
May 2006 (Actual)
Study Completion Date
January 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
AnGes USA, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary purpose of this study was to assess the overall safety of different dose regimens of AMG0001 (HGF transferred via plasmid vector) as well as evaluate the improvement of blood perfusion in subjects with critical limb ischemia (CLI). This study also evaluated the improvement in wound healing without adverse effects on the quality of life, as well as the potential reduction of amputation, mortality and rest pain in the CLI population.
Detailed Description
The primary goal of this study was to assess the safety of AMG0001, detect potential angiogenesis response to AMG0001 treatment and to correlate these changes to clinical endpoints dependent upon improvement in tissue perfusion for relief of CLI complications. The objectives of this study were to: Assess the overall safety of different exposure regimens of AMG0001 in the CLI subject population. Evaluate the potential effect of angiogenesis associated with different doses and dose regimens of AMG0001 as measured by improvement in tissue perfusion. Evaluate the activity of different exposure regimens of AMG0001 to benefit clinical outcomes of reduction of amputation and mortality, wound healing, rest-pain reduction and improvement in subject's ability to function without adverse consequences on quality of life.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arterial Occlusive Disease, Peripheral Vascular Disease, Ischemia
Keywords
Critical Limb Ischemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
104 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
0.4 mg AMG0001 on days 0, 14, and 28
Arm Title
2
Arm Type
Active Comparator
Arm Description
4.0 mg AMG0001 on days 0, 14, and 28
Arm Title
3
Arm Type
Active Comparator
Arm Description
4.0 mg AMG0001 on days 0 and 28; placebo on day 14
Arm Title
4
Arm Type
Placebo Comparator
Arm Description
Placebo (saline) on days 0, 14, and 28
Intervention Type
Genetic
Intervention Name(s)
HGF plasmid
Intervention Description
Intramuscular injections into index leg on Days 0, 14, and 28
Primary Outcome Measure Information:
Title
Tissue perfusion as measured by TcPO2
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Ulcer healing
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects will have one or more clinical indications diagnostic of CLI such as: distal extremity pain at rest that requires the subject to use analgesics for >2 weeks; or peripheral ischemic ulcer(s); or areas of gangrene. The subject will have a TcPO2 of </= 40 mmHg. Subjects will have one or both of the following hemodynamic indicators of severe peripheral arterial occlusive disease: (a) Ankle systolic pressure of </= 70 mmHg; (b)Toe systolic pressure </= 50 mmHg. The subject is a poor candidate for standard revascularization treatment options for peripheral arterial disease, based on inadequate bypass conduit, unfavorable anatomy, or poor operative risk. Subject has signed an informed consent form either directly or through a legally authorized representative If female, the subject must be (a) at least one year post-menopausal, or (b) surgically sterile, or (c) if the subject is of child-bearing potential, she must have been practicing contraception for at least 12 weeks prior to entering the study. If subject is of reproductive potential, he or she must be using an accepted and effective (barrier) form of birth control during the study. Subjects will be on a statin and an anti-platelet agent as part of their standard of care and must be stable on these regimens for at least 4 weeks prior to treatment. Exclusion Criteria: Subjects, who in the opinion of the investigator, have a vascular disease prognosis that indicates they would require a major amputation (at or above the ankle) within 4 weeks of start of treatment. Subjects with a diagnosis of Buerger's disease (Thromboangitis Obliterans). Subjects with hemodynamically significant aorto-iliac occlusive disease. Subjects who have had a revascularization procedure within 12 weeks prior to treatment initiation that remains patent. Revascularization procedures that are evidenced to have failed for >2 weeks prior to treatment initiation are acceptable. Subjects who require a change in their hypertension medication as part of their standard of care within 4 weeks prior to treatment. Evidence or history of malignant neoplasm (clinical, laboratory or imaging), except for basal cell carcinoma of the skin. Subjects who have proliferative diabetic retinopathy or severe, non-proliferative retinopathy Subjects with end stage renal disease (ESRD) defined as significant renal dysfunction evidenced by a creatinine of > 2.5, or receiving chronic hemodialysis therapy. A subject who has hepatic cirrhosis, viral hepatitis, or is HIV positive. Subjects with a clinically significant liver enzyme abnormality (i.e., AST or ALT more than two times the upper limit of normal and/or bilirubin more than 50% the upper limit of normal). Subjects requiring the use of hyperbaric oxygen treatment for wound healing during the screening and 6 month follow-up period.
Facility Information:
Facility Name
Cardiology, P.C.
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35211
Country
United States
Facility Name
Central Arkansas Veteran's Healthcare System
City
Little Rock
State/Province
Arkansas
ZIP/Postal Code
72205
Country
United States
Facility Name
Cedars-Sinai Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Falk Cardiovascular Research Center
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
VA Medical Center Surgical Service (112)
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20422
Country
United States
Facility Name
Basptist Hospital
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32501
Country
United States
Facility Name
University of South Florida College of Medicine
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Facility Name
American Cardiovascular Research Institute
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
University of Chicago Hospitals
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
The Care Group, LLC
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46290
Country
United States
Facility Name
The Ochsner Heart and Vascular Institute
City
Metairie
State/Province
Louisiana
ZIP/Postal Code
70002
Country
United States
Facility Name
Minneapolis Heart Institute Foundation
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407
Country
United States
Facility Name
Dartmouth - Hitchcock Medical Center
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Diabetes Foot and Ankle Center
City
New York
State/Province
New York
ZIP/Postal Code
10003
Country
United States
Facility Name
NYPH-NY Weill Cornell Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Pitt County Memorial Hospital
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
The Lindner Clinical Trial Center
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
The Cleveland Clinic Foundation
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Jobst Vascular Center
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43606
Country
United States
Facility Name
Medical College of Ohio
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43614
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Peripheral Vascular Associates
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
18559703
Citation
Powell RJ, Simons M, Mendelsohn FO, Daniel G, Henry TD, Koga M, Morishita R, Annex BH. Results of a double-blind, placebo-controlled study to assess the safety of intramuscular injection of hepatocyte growth factor plasmid to improve limb perfusion in patients with critical limb ischemia. Circulation. 2008 Jul 1;118(1):58-65. doi: 10.1161/CIRCULATIONAHA.107.727347. Epub 2008 Jun 16.
Results Reference
derived

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Study of HGF Via Plasmid Vector to Improve Perfusion in Critical Limb Ischemia

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