Safety Study of Bone Marrow Cell Concentrate Prepared Using the Magellan System to Treat Critical Limb Ischemia (CLI)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
Arteriocyte, Inc.
ClinicalTrials.gov Identifier:
NCT01386216
First received: June 29, 2011
Last updated: July 8, 2014
Last verified: July 2014
  Purpose

The purpose of this study is to evaluate the safety of administration of marrow-derived autologous hematopoietic stem cells (HSC) concentrate and platelet-rich plasma (PRP) gel for the treatment of Critical Limb Ischemia (CLI).


Condition Intervention Phase
Critical Limb Ischemia (CLI)
Peripheral Vascular Disease (PVD)
Device: Magellan®
Phase 1

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Safety Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase I, Non-Randomized, Feasibility Study for the Use of Bone Marrow Cell Concentrate Prepared Using the Magellan System for the Treatment of Critical Limb Ischemia

Resource links provided by NLM:


Further study details as provided by Arteriocyte, Inc.:

Primary Outcome Measures:
  • Time to treatment failure or death [ Time Frame: Baseline - 12 months ] [ Designated as safety issue: Yes ]
    Treatment failure is defined as major amputation


Secondary Outcome Measures:
  • Perfusion and Quality of Life measurements [ Time Frame: Baseline - 12 months ] [ Designated as safety issue: Yes ]
    • Perfusion rate in treated tissue by measure of ankle-brachial index (ABI)
    • Perfusion rate in treated tissue by transcutaneous PO2 (TcPO2)
    • Perfusion rate in treated tissue by skin perfusion pressure (SPP)
    • Pain intensity using Visual Analogue Scale (VAS)
    • Quality of Life (QoL) by questionnaire


Estimated Enrollment: 20
Study Start Date: April 2011
Estimated Study Completion Date: September 2015
Estimated Primary Completion Date: July 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Bone Marrow Cell Concentrate
Bone Marrow Cell Concentrate Prepared Using the Magellan System
Device: Magellan®
Autologous Bone Marrow Cell Concentrate Prepared Using the Magellan System to be injected into the ischemic muscle tissue at 0.5 cc/injection for a total of 12-20 cc.
Other Name: autologous cell concentrate

Detailed Description:

Critical limb ischemia (CLI) continues to be an important cause of atherosclerotic morbidity and mortality despite conventional therapies. Modulation of angiogenesis is a promising alternative to surgical revascularization. Trials of isolated angiogenic growth factor therapies using recombinant proteins or gene transfer have been conducted, but with disappointing results because it is unlikely that a single angiogenic factor is solely or even primarily responsible for angiogenesis. Emerging stem cell therapies represent a new approach to the modulation of angiogenesis. Pluripotent hematopoietic stem cells (HSC) hold promise because they can reproduce a pro-angiogenic milieu in the ischemic limb rather than upregulate a single angiogenic factor.

For this CLI study, the Magellan® System is utilized for the preparation of autologous cell concentrate at the point of care. The bone marrow aspirate is obtained from the patient and concentrated with the cell concentration kit, and delivered intramuscularly to the affected limb for the treatment of impaired ischemic tissue in order to improve perfusion, reduce pain and revascularize tissues in patients who have inadequate tissue blood flow, prohibitive medical comorbidities, or failed previous treatments for revascularization for the prevention of amputation.

  Eligibility

Ages Eligible for Study:   18 Years to 85 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Is able to provide written informed consent prior to study entry
  • Is male or female, 18 - 85 years of age
  • CLI with rest pain, tissue loss, or gangrene
  • No option for revascularization as a result of one of the following:

    • failed previous revascularization, such as recurrent instant restenosis or graft occlusion.
    • inadequate target vessels as determined by baseline CTA/angiogram at the time of enrollment.
    • or prohibitive medical comorbidities such as high risk cardiovascular or pulmonary disease which would restrict operative procedures
    • Final determination of no option for revascularization will be made by a vascular surgeon not associated with the clinical trial.
  • ABI less than 0.7, ankle pressure < 50 mmHg, or toe pressure < 30 mmHg.
  • TcPO2 < 40 mmHg
  • SPP < 35 mmHg
  • Female subjects must be of non childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy or hysterectomy]) or must be using adequate contraception (practicing one of the following methods of birth control):

    • Total abstinence from sexual intercourse (minimum of one complete menstrual cycle before study entry),
    • A partner who is physically unable to impregnate the subject (e.g., vasectomized)
    • Contraceptives (oral, parenteral, or transdermal) for 3 consecutive months prior to patient's cell concentrate administration,
    • Intrauterine device (IUD), or
    • Double barrier method (condoms, sponge, diaphragm, or vaginal ring with spermicidal jellies or cream)
  • If female is of childbearing potential, subject must have a negative serum pregnancy test at screening
  • Confirmation of age-appropriate cancer screening consistent with the American Cancer Society guidelines

Exclusion Criteria:

  • Patients with vascular lesions amenable to percutaneous intervention or where surgical bypass is indicated.
  • Any contraindication to stem cell or platelet-rich plasma therapy.
  • Isolated aorto-iliac stenoses or occlusions without infra-inguinal disease.
  • Pregnancy
  • Hemoglobin A1c >10 % on day of enrollment.
  • Have an active malignancy or have undergone treatment for a malignancy in the preceding 5 years, with the exception of successful treatment of non-melanoma skin cancer.
  • Stage 4 or greater chronic kidney disease (eGFR < 30 ml/min, MDRD estimate)
  • Hemoglobin < 10 g/dl.
  • Thrombocytopenia < 100,000 platelets/µL.
  • Unwilling or unable to comply with follow-up visits.
  • Proliferative retinopathy as determined by baseline retinal exam.
  • Is unable to refrain from nicotine, caffeine and alcohol for a period beginning 24 hours prior to the treatment visit
  • Has received an investigational medication or other study trial participation within 30 days prior to the Treatment Visit
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01386216

Locations
United States, Ohio
The Ohio State University Medical Center
Columbus, Ohio, United States, 43210
Sponsors and Collaborators
Arteriocyte, Inc.
Investigators
Principal Investigator: Michael Go, MD Ohio State University
  More Information

No publications provided

Responsible Party: Arteriocyte, Inc.
ClinicalTrials.gov Identifier: NCT01386216     History of Changes
Other Study ID Numbers: ART 10-001
Study First Received: June 29, 2011
Last Updated: July 8, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Arteriocyte, Inc.:
Critical limb ischemia
Peripheral vascular disease
platelet-rich plasma

Additional relevant MeSH terms:
Ischemia
Vascular Diseases
Peripheral Vascular Diseases
Peripheral Arterial Disease
Pathologic Processes
Cardiovascular Diseases
Atherosclerosis
Arteriosclerosis
Arterial Occlusive Diseases

ClinicalTrials.gov processed this record on October 02, 2014