Safety and Efficacy of Allogeneic Adipose Tissue Mesenchymal Stem Cells in Diabetic Patients With Critical Limb Ischemia

Diabetic Foot Clinical Trial

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

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04466007
• Other study ID #: NOMA (No More Amputations)
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: January 11, 2021
• Est. completion date: April 1, 2024

Study information

• Verified date: September 2023
• Source: Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Phase II national, multicenter, double-blind, randomized, placebo-controlled, phase-3 clinical trial of 3 parallel groups.

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.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 90
• Est. completion date: April 1, 2024
• Est. primary completion date: April 1, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years to 90 Years

Eligibility

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.

Related Conditions & MeSH terms

• Chronic Limb-Threatening Ischemia
• Diabetic Foot
• Ischemia
• Limb Ischemia

Intervention

Drug:
• High dose allogeneic mesenchymal stromal cells
Allogeneic mesenchymal stromal cells derived from adipose tissue administered intramuscularly
• Low dose allogeneic mesenchymal stromal cells
Allogeneic mesenchymal stromal cells derived from adipose tissue administered intramuscularly
• Placebos
0,9% physiological saline

Locations

Country	Name	City	State
Spain	Hospital General de Alicante	Alicante
Spain	Hospital Gregorio Marañon	Madrid
Spain	Hospital Universitario Fundacion Jimenez Diaz	Madrid
Spain	La Paz University Hospital	Madrid
Spain	Hospital Clinico Universitario Virgen de la Arrixaca	Murcia
Spain	Clinica Universidad de Navarra	Pamplona
Spain	Hospital Universitario de Salamanca	Salamanca
Spain	Hospital Victoria Eugenia Cruz Roja Española	Sevilla
Spain	Hospital Universitario La Fe	Valencia
Spain	Hospital de Valladolid	Valladolid

Sponsors (10)

Lead Sponsor	Collaborator
Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz	Clinica Universidad de Navarra, Universidad de Navarra, Gregorio Marañón Hospital, Hospital Clínico Universitario de Valladolid, Hospital General Universitario de Alicante, Hospital Universitario La Fe, Hospital Universitario La Paz, Hospital Universitario Virgen de la Arrixaca, Hospital Victoria Eugenia Cruz Roja Española, University of Salamanca

Country where clinical trial is conducted

Spain, 

References & Publications (49)

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* Note: There are 49 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	SF-12 questionnaire		1 year
Other	VascuQol-6 questionnaire		1 year
Primary	Complication rate after treatment administration		1 year
Secondary	Evaluation of vascularization though RMN		1 year
Secondary	Rutherford-Becker scale		1 year
Secondary	Wifi scale		1 year
Secondary	Ankle arm index		1 year
Secondary	Temperature	(ºC)	1 year
Secondary	Twin perimeter	(cm)	1 year
Secondary	Neuropathic symptoms (altered sensitivity)		1 year
Secondary	% amputations		1 year