Intermittent Claudication Clinical Trial
Official title:
Autologous Bone Marrow-derived Mononuclear Cells for Therapeutic Arteriogenesis in Patients With Limb Ischemia A Double Blind, Placebo Controlled, Study in Diabetic and Non-diabetic Patients
The investigators propose confirm and extend the findings of open studies on the apparent efficacy of bone-marrow derived mononuclear cells for the induction of arteriogenesis in patients with severe claudication or critical leg ischemia and pay special attention to the influence of diabetic disease on the outcome of the study and to the possible pro-atherogenic/ pro-inflammatory effects of BM-MNC injections.
Although the safety and beneficial effects of intramuscular transplantation of bone marrow
derived mononuclear cells procedure appear well documented, a number of critical question
regarding application of BM-MNC for peripheral vascular disease remain to be answered.
First, although the original study has been partially performed as semi-blinded study
(patients with double sided claudication were recruited and blindly treated with BM-MNC in
one leg and peripheral blood injections in the other leg), this approach does exclude a
placebo effect. Second, although patients with mild diabetes were included in the protocol,
the results for diabetic patients were not analyzed separately. Diabetic disease is
characterized by monocyte and endothelial progenitor cell dysfunction and it is still
unclear whether this approach is also effective in diabetic patients. Third, although
six-month results are reported long-term efficacy has not been established yet.
To address these issues, the investigators now propose confirm and extend the findings from
open studies in a randomized double-blind study in patients with severe claudication or
critical leg ischemia and pay special attention to the influence of diabetic disease on the
outcome of the study and to the possible pro-atherogenic/ pro-inflammatory effects of BM-MNC
injections.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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