Critical Limb Ischemia Clinical Trial
Official title:
Cell Therapy in Critical Limb Ischemia by Implantation of Allogeneic Umbilical Cord-derived Mesenchymal Stem Cells
Study drug and dosage form : Umbilical cord-derived mesenchymal stem cells (HB-MSC1)
Dose and route of administration : 60 × 106 cells or 120 x 106 cells to be injected as 30
individual intramuscular injections, once at V0 within 48 hours to 2 weeks maximum after the
revascularization procedure.
Comparator, dose and route of administration : Placebo, injected as 30 individual
intramuscular injections, once at V2 within 48 hours to 2 weeks maximum after the
revascularization procedure.
Study centers : 3 centers in France
Study objectives :
Primary: Evaluation of the feasibility and systemic and local tolerance of an implantation,
via intramuscular route, of allogenic HB-MSC1, associated with a revascularization procedure,
in patients suffering from critical limb ischemia (CLI).
Secondary: Preliminary evaluation of efficacy and dose effect relationship of the MSC
implantation in hemodynamic, anatomical and functional terms.
Exploratory: Constitution of a serum bank of the patients included in the study for
inflammation and auto immunity biomarkers analysis
Study design : This will be a multicenter Phase IIa study, consisting in a first, open-label,
ascending dose feasibility and safety stage followed by a randomized placebo-controlled
feasibility, safety and preliminary efficacy stage.
Demographics, baseline and follow-up characteristics: descriptive statistics. Primary
analysis: Descriptive statistics for the rate of patients with high grade AEs (grade 2 and
more), related to the cell implantation will be computed in each arm, with its two-sided 95%
CIs.
Each dose arm will be compared to the control arm by computing the absolute difference and
the relative risk between the active dose arm and the control arm, together with their 95%
two-sided CIs.
The p-values for the comparisons of the difference between the observed absolute rate to 0
and of the relative risk to 1 will be computed, but it is not expected that the study will
have sufficient power to detect a significant difference on either of the two statistics
(absolute difference or relative risk).
Primary efficacy analysis: The primary efficacy criterion (TcPO2) will be compared between
each dose group versus the control group to test for a superiority of MSC over control.
The tested hypotheses are:
- Null hypothesis: mean (MSC dose i) ≤ mean (Control)
- Alternative hypothesis: mean (MSC dose i) > mean (Control) A mixed - model for repeated
measures will be used to model the evolution of TcPO2 over time. The significance of the
time by treatment interaction will be used to test the two hypotheses. Model adjusted
means (LS means) and their differences between treatment arms will be computed at each
timepoint.
The LS-Means for change from baseline to 180 days will be used as the primary efficacy
endpoint.
Other efficacy analyses: the same analysis model (mixed - model for repeated measures) will
be used for all the other continuous efficacy endpoints.
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