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Peripheral Arterial DiseasePhase 1NCT02915796

Autologous CD133(+) Cells as an Adjuvant to Below the Knee Percutaneous Transluminal Angioplasty

A Phase 1 study testing G-CSF + CD133(+) cells, G-CSF and percutaneous transluminal angioplasty (PTA) in people with Peripheral Arterial Disease, run by Shanghai 10th People's Hospital at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The main aim of the present study was to evaluate the therapeutic potential and safety of transarterial infusion of granulocyte colony stimulating factor (G-CSF) mobilized cluster of differentiation (CD) 133(+) cells when combined with percutaneous transluminal angioplasty (PTA) in treatment of below the knee (BTK)… Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Peripheral Arterial Disease
What is being tested?
G-CSF + CD133(+) cells, G-CSF and percutaneous transluminal angioplasty (PTA)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
345 participants
Where
1 siteChina
Study dates
Sep 2016to Apr 2018
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age range: 18-75 years , Gender: Both
  • Patients with below the knee limb ischemia with diabetes.
  • Rutherford class 2-6.
  • Target lesions with a diameter reduction of at least 50% and have an occlusion of longer than 4 cm on angiography.
  • Have no previous history of any stem cell therapy [infusion of CD133 endothelial progenitor cell (EPC)].
  • Written informed consent signed by the patients or representatives. -

Who cannot join

  • Previous bypass surgery or stent placement at the ipsilateral lower limb
  • History of intolerance to antiplatelet therapy, heparin, or contrast media.
  • Presence of any of the following conditions:
  • severe liver disease (such as ascites, esophageal varices, liver transplantation);
  • hemodynamic instability;
  • Severely impaired renal function (serum creatinine level > 2.5 mg/dL).
Show all 11Show fewer
  • Receiving immunosuppressive therapy;
  • History of decompensated heart failure (New York Heart Association class III or IV and level) or myocardial infarction, or heart bypass surgery;
  • Bleeding diathesis;
  • Active systemic bacterial infection;
  • Acute thrombophlebitis or deep vein thrombosis of the target limb; 4) Pregnant or lactating women, or women of child bearing age unable or unwilling to use effective contraception during the study period; 5) Expected survival time of less than 24 months -

Trial locations and contacts

1 site in 1 country.

China1 site, 1 recruiting
  • Shanghai Tenth People's Hospital, Tong ji University

    Shanghai

    Mao Q Li, Ph.D, 02166313506, cjr.limaoquan@vip.163.com

    Recruiting

Other trials in China

About this study

Official title: Autologous CD133(+) Cells as an Adjuvant to Below the Knee Percutaneous Transluminal Angioplasty: A Randomized Controlled Clinical Trial in Diabetic Patients With Below the Knee Critical Limb Ischemia

The main aim of the present study was to evaluate the therapeutic potential and safety of transarterial infusion of granulocyte colony stimulating factor (G-CSF) mobilized cluster of differentiation (CD) 133(+) cells when combined with percutaneous transluminal angioplasty (PTA) in treatment of below the knee (BTK) peripheral arterial disease (PAD) in diabetic patients.

Read the detailed description

CD133+ cell, a bone marrow derived subpopulation of adult hematopoietic progenitor cells, confers high proliferative, vasculogenic and regenerative capacity in vitro and in vivo. thereby suggesting that CD133+ cells may induce vasculogenesis, improve limb perfusion, prevent tissue loss and restore ambulatory function in patients with critical limb ischemia. Although several small, randomized trials have been conducted so far demonstrating safety of autologous cells of bone marrow origin for the treatment, the reported benefits were found to be variable. A meta-analysis of autologous bone marrow derived cell therapy for critical limb ischemia trials suggested that application of autologous stem cell transplantation in curing limb ischemic patients does not have obviously effectiveness in the improvement of ankle brachial pressure (ABI) of the limb ischemic patients. But it can dramatically reduce the rate of amputation.

Therefore, in the present study, the investigators aim to evaluate the therapeutic potential and safety of transarterial infusion of g-csf-mobilized CD 133(+) cells when combined with PTA in treatment of below the knee PAD in diabetic patients.

Being tested
G-CSF + CD133(+) cells, G-CSF, percutaneous transluminal angioplasty (PTA), Placebo infusion
Keywords
Endothelial progenitor cell, Percutaneous transluminal angioplasty
Medical subject headings
Peripheral Arterial Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • G-CSF + CD133(+) cellsBiological

    Patients in the G-CSF + CD133(+) cells + PTA group, received 150 unit of recombinant human G-CSF intramuscular injection to mobilize CD 133 cells from bone marrow to peripheral blood. After 72-120 hrs, 100 ml suspension of peripheral arterial blood were collected and send to Good Products Manufacturing (GPM) certified laboratory (Shanghai Chen Chuan Biological Material Co. Ltd.) within 24 hrs of obtaining sample to isolate CD 133(+) endothelial progenitor cells (EPC) using magnetic cell separator. Subjects in this group, after vascular PTA treatment, received transarterial infusion of 50 ml suspension of isolated autologous CD 133(+) cells over 30 min via catheter opened into popliteal artery. The infusion of CD 133 cells was repeated after 24 hours.

  • G-CSFBiological

    Subjects in this group, after vascular PTA treatment, received 150 unit of recombinant human G-CSF intramuscular injection to mobilize EPCs from bone marrow to peripheral blood. But the C133 (+) cells were not isolated from the peripheral blood to infuse transarterially as in G-CSF + CD133(+) + PTA.

  • percutaneous transluminal angioplasty (PTA)Procedure or surgery

    Subjects in this group only underwent below the knee percutaneous transluminal angioplasty .

  • Placebo infusionBiological

    Neither G-CSF was injected nor CD133(+) cells. Instead, subjects received placebo infusion (50 ml of 0.9% sodium chloride injection ) over 30 min.

Study groups in NCT02915796
Study groupRoleWhat they receive
G-CSF + CD133(+) cells + PTAExperimentalIntramuscular injection of G-CSF along with transarterial infusion of CD133 (+) cells combined with percutaneous transluminal angioplasty
Receives: Biological: G-CSF + CD133(+) cells; Procedure: percutaneous transluminal angioplasty (PTA)
PTA + G-CSFActive comparatorPercutaneous transluminal angioplasty along with intramuscular injection of G-CSF
Receives: Biological: G-CSF; Procedure: percutaneous transluminal angioplasty (PTA)
Only PTAPlacebo comparatorOnly Percutaneous transluminal angioplasty along with placebo infusion of sodium chloride injection
Receives: Procedure: percutaneous transluminal angioplasty (PTA); Biological: Placebo infusion

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Restenosis rate

    Occurrence of > 50% of restenosis in the treated vessel after 12 months as assessed by digital substraction angiography (DSA) (Efficacy endpoints).

    Measured: 12 months

  2. Peak systolic velocity ratio

    Peak systolic velocity ratio ≥ 2.4 by Doppler's ultrasonography for patients who did not undergo angiography after 12 months (Efficacy endpoints).

    Measured: 12 months

  3. Severe adverse effects (SAEs)

    Number of SAEs per subject across actual treatment cohorts (Safety Endpoint).

    Measured: 12 months

Secondary outcomes (7)
  1. ABI value

    Improvement in ABI value by ≥ 0.1 after the procedure and lack of deterioration > 0.15 in relation to the maximal value recorded before the procedure.

    Measured: 6 and 12 months

  2. Rutherford classification

    improvement in Rutherford scale of at least one category after the procedure.

    Measured: 6 and 12 months

  3. Transcutaneous oxygen pressures (TcPO2)

    .Changes in TcPO2 was assessed at each follow up interval and compared to baseline.

    Measured: 6 and 12 months

  4. Amputation-free survival (AFS)

    Time to below the knee amputation of the ipsilateral leg.

    Measured: 6 and 12 months

  5. Rest pain

    Rest pain was measured using Wong-Baker FACES pain rating scale at baseline and each follow-up visit.

    Measured: 6 and 12 months

  6. Six Minute Walk test

    Walking distance, time to onset of leg cramping/pain were recorded.

    Measured: 6 and 12 months

  7. Ulcer healing rate

    Ulcer status was assessed at each follow up interval and compared to baseline.

    Measured: 6 and 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Sep 2016 (estimated)
  2. Study startSep 2016
  3. Primary completionApr 2017 (estimated)
  4. Study completionApr 2018 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
345 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02915796
Sponsor's protocol ID
2016-xjs-08
Status last verified
Sep 2016
First submitted
22 Sep 2016
Last updated
28 Sep 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Ma N, Ladilov Y, Moebius JM, Ong L, Piechaczek C, David A, Kaminski A, Choi YH, Li W, Egger D, Stamm C, Steinhoff G. Intramyocardial delivery of human CD133+ cells in a SCID mouse cryoinjury model: Bone marrow vs. cord blood-derived cells. Cardiovasc Res. 2006 Jul 1;71(1):158-69. doi: 10.1016/j.cardiores.2006.03.020. Epub 2006 Apr 3.

    PubMed 16730684
  • Gehling UM, Ergun S, Schumacher U, Wagener C, Pantel K, Otte M, Schuch G, Schafhausen P, Mende T, Kilic N, Kluge K, Schafer B, Hossfeld DK, Fiedler W. In vitro differentiation of endothelial cells from AC133-positive progenitor cells. Blood. 2000 May 15;95(10):3106-12.

    PubMed 10807776
  • Peichev M, Naiyer AJ, Pereira D, Zhu Z, Lane WJ, Williams M, Oz MC, Hicklin DJ, Witte L, Moore MA, Rafii S. Expression of VEGFR-2 and AC133 by circulating human CD34(+) cells identifies a population of functional endothelial precursors. Blood. 2000 Feb 1;95(3):952-8.

    PubMed 10648408
  • Friedrich EB, Walenta K, Scharlau J, Nickenig G, Werner N. CD34-/CD133+/VEGFR-2+ endothelial progenitor cell subpopulation with potent vasoregenerative capacities. Circ Res. 2006 Feb 17;98(3):e20-5. doi: 10.1161/01.RES.0000205765.28940.93. Epub 2006 Jan 26.

    PubMed 16439688
  • Tateishi-Yuyama E, Matsubara H, Murohara T, Ikeda U, Shintani S, Masaki H, Amano K, Kishimoto Y, Yoshimoto K, Akashi H, Shimada K, Iwasaka T, Imaizumi T; Therapeutic Angiogenesis using Cell Transplantation (TACT) Study Investigators. Therapeutic angiogenesis for patients with limb ischaemia by autologous transplantation of bone-marrow cells: a pilot study and a randomised controlled trial. Lancet. 2002 Aug 10;360(9331):427-35. doi: 10.1016/S0140-6736(02)09670-8.

    PubMed 12241713
  • Esato K, Hamano K, Li TS, Furutani A, Seyama A, Takenaka H, Zempo N. Neovascularization induced by autologous bone marrow cell implantation in peripheral arterial disease. Cell Transplant. 2002;11(8):747-52.

    PubMed 12588106
  • Fadini GP, Avogaro A. Autologous transplantation of granulocyte colony-stimulating factor- mobilized peripheral blood mononuclear cells improves critical limb ischemia in diabetes. Diabetes Care. 2006 Feb;29(2):478-9; author reply 479-80. doi: 10.2337/diacare.29.02.06.dc05-1770. No abstract available.

    PubMed 16482702
  • Miyamoto K, Nishigami K, Nagaya N, Akutsu K, Chiku M, Kamei M, Soma T, Miyata S, Higashi M, Tanaka R, Nakatani T, Nonogi H, Takeshita S. Unblinded pilot study of autologous transplantation of bone marrow mononuclear cells in patients with thromboangiitis obliterans. Circulation. 2006 Dec 12;114(24):2679-84. doi: 10.1161/CIRCULATIONAHA.106.644203. Epub 2006 Dec 4.

    PubMed 17145986
  • Kawamoto A, Katayama M, Handa N, Kinoshita M, Takano H, Horii M, Sadamoto K, Yokoyama A, Yamanaka T, Onodera R, Kuroda A, Baba R, Kaneko Y, Tsukie T, Kurimoto Y, Okada Y, Kihara Y, Morioka S, Fukushima M, Asahara T. Intramuscular transplantation of G-CSF-mobilized CD34(+) cells in patients with critical limb ischemia: a phase I/IIa, multicenter, single-blinded, dose-escalation clinical trial. Stem Cells. 2009 Nov;27(11):2857-64. doi: 10.1002/stem.207.

    PubMed 19711453
  • Lu D, Chen B, Liang Z, Deng W, Jiang Y, Li S, Xu J, Wu Q, Zhang Z, Xie B, Chen S. Comparison of bone marrow mesenchymal stem cells with bone marrow-derived mononuclear cells for treatment of diabetic critical limb ischemia and foot ulcer: a double-blind, randomized, controlled trial. Diabetes Res Clin Pract. 2011 Apr;92(1):26-36. doi: 10.1016/j.diabres.2010.12.010. Epub 2011 Jan 8.

    PubMed 21216483
  • Losordo DW, Kibbe MR, Mendelsohn F, Marston W, Driver VR, Sharafuddin M, Teodorescu V, Wiechmann BN, Thompson C, Kraiss L, Carman T, Dohad S, Huang P, Junge CE, Story K, Weistroffer T, Thorne TM, Millay M, Runyon JP, Schainfeld R; Autologous CD34+ Cell Therapy for Critical Limb Ischemia Investigators. A randomized, controlled pilot study of autologous CD34+ cell therapy for critical limb ischemia. Circ Cardiovasc Interv. 2012 Dec;5(6):821-30. doi: 10.1161/CIRCINTERVENTIONS.112.968321. Epub 2012 Nov 27.

    PubMed 23192920
  • Sun X, Ying J, Wang Y, Li W, Wu Y, Yao B, Liu Y, Gao H, Zhang X. Meta-analysis on autologous stem cell transplantation in the treatment of limb ischemic. Int J Clin Exp Med. 2015 Jun 15;8(6):8740-8. eCollection 2015.

    PubMed 26309525

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing G-CSF + CD133(+) cells, G-CSF and percutaneous transluminal angioplasty (PTA) in people with Peripheral Arterial Disease, run by Shanghai 10th People's Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Mao Q Li, Ph.D (02166313506, cjr.limaoquan@vip.163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Restenosis rate (time frame: 12 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02915796, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Sep 2016.

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