Scleroderma, Systemic Clinical Trial
Official title:
Subcutaneous Injection of Autologous Adipose Tissue-derived Stromal Vascular Fraction Into the Fingers of Patients With Systemic Sclerosis : Controlled Clinical Trial With Efficacy Assessment
Systemic sclerosis (SSc) is an auto-immune orphan disease mainly characterized by an
alteration of the microvascular network, and by cutaneous and visceral fibrosis. Hands are
frequently affected, as a consequence of ischemic phenomena and cutaneous fibrosis.
. The injection of adipose autologous tissue is a common practice in plastic surgery, and has
been known for over a century. Adipose tissue, originally used to increase volume, is also
characterized by trophic properties associated to stromal vascular fraction (SVF), which
contain multipotent stem cells, capable of tissue repair. Interestingly, some SVF cells can
be angiogenic and anti-inflammatory, which could improve damage seen with SSc.
A prior study (the SCLERADEC protocol: ClinicalTrials.gov NCT01813279) has already allowed
the safety and tolerance at 6 months of the subcutaneous injection of SVF in the fingers of
twelve patients to be proven.
The encouraging results have encouraged us to propose a trial which would bear on a higher
number of patients and include a control group.
Systemic sclerosis (SSc) is an auto-immune orphan disease mainly characterized by an
alteration of the microvascular network, and by cutaneous and visceral fibrosis. Hands are
frequently affected, as a consequence of ischemic phenomena and cutaneous fibrosis. As a
result, patients suffer from everyday disability, with consequences on their occupational
activities and social contact, sometimes severely altering their quality of life. To date, no
anti-fibrosis treatment has proven effective; existing vasodilation treatments are
unfortunately not very effective, and are associated with adverse effects or restrictions. It
is consequently of utmost importance that an effective treatment for sclerodermic hands be
developed. The injection of adipose autologous tissue is a common practice in plastic
surgery, and has been known for over a century. Adipose tissue, originally used to increase
volume, is also characterized by trophic properties associated to stromal vascular fraction
(SVF), which contain multipotent stem cells, capable of tissue repair. Interestingly, some
SVF cells can be angiogenic and anti-inflammatory, which could improve damage seen with SSc.
The injection of SVF into the fingers would also make it possible to control the production
of the extracellular matrix and to improve the balance between fibrosis and fibrolysis,
resulting in an improvement of cutaneous sclerosis.
A prior study (the SCLERADEC protocol: ClinicalTrials.gov NCT01813279) has already allowed
the safety and tolerance at 6 months of the subcutaneous injection of SVF in the fingers of
twelve patients to be proven. Secondary efficacy endpoints evaluated at 2 months (M2) and 6
months (M6) showed an improvement in disability, pain, severity of Raynaud's phenomenon,
trophicity, the number of digital ulcers, hand mobility and in the quality of life. These
encouraging results have encouraged the investigators to propose a trial which would bear on
a higher number of patients and include a control group.
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