Cell Therapy for Venous Leg Ulcers Pilot Study
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Purpose
Chronic venous leg ulcers (CVU) represent a medical problem associated with significant morbidity, increased work absenteeism and earlier retirement as a consequence of disability. This strongly affects the patient's quality of life and has a significant economic impact on healthcare systems.
Reports of studies with animal models show that treatment with bone marrow-derived stem cells has a beneficial effect in healing chronic skin wounds.
The purpose of this pilot study is to determine the safety and feasibility of cell therapy with bone marrow derived cells (BMDC) as a complementary healing therapy in chronic venous leg ulcers, and in addition to evaluate its effectiveness. The knowledge gained in the pilot study will be used to refine the clinical protocol procedures of a subsequent randomized study.
Patients with venous legs ulcers meeting eligibility criteria and providing appropriate written informed consent will be enrolled for study participation. Enrolled patients will receive Autologous BMDC implantation at de venous ulcer in conjunction with standard of care (SOC) treatment.
During follow up, adverse events will be assessed by ulcer clinical examination. Effectiveness of the experimental treatment will be assessed by evaluating ulcer healing (reduction of the ulcer area) and pain reduction over a six-month period.
| Condition | Intervention | Phase |
|---|---|---|
|
Venous Ulcer |
Biological: Autologous BMDC implantation at the venous ulcer |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Autologous Bone Marrow Derived Cells in the Treatment of Venous Leg Ulcers Pilot Study |
- Reduction of the ulcer area at 2 months [ Time Frame: 2 months ] [ Designated as safety issue: No ]Measurement of the ulcer area (cm2) and comparison with baseline.
- Reduction of the ulcer area at 4 months [ Time Frame: 4 months ] [ Designated as safety issue: No ]Measurement of the ulcer area (cm2) and comparison with baseline.
- Reduction of the ulcer area at 6 months [ Time Frame: 6 months ] [ Designated as safety issue: No ]Measurement of the ulcer area (cm2) and comparison with baseline.
- Pain reduction at 2 months [ Time Frame: 2 months after intervention ] [ Designated as safety issue: No ]Assess of pain by visual analog score
- Pain reduction at 4 months [ Time Frame: 4 months after intervention ] [ Designated as safety issue: No ]Assess of pain by visual analog score
- Pain reduction at 6 months [ Time Frame: 6 months after intervention ] [ Designated as safety issue: No ]Assess of pain by visual analog score
- Absence of adverse events related with the intervention [ Time Frame: From date of cells implantation until the date of the event, assesed up to 7 days ] [ Designated as safety issue: Yes ]Clinical examination of the site of cells implantation for signs of infection, hematoma, edema or eczema. Asses of pain by visual analog score.
| Estimated Enrollment: | 6 |
| Study Start Date: | May 2011 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | June 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Autologous BMDC implantation at the venous ulcer
Autologous BMDC implantation at the venous ulcer in conjunction with SOC treatment (advanced wound management plus pressure therapy)
|
Biological: Autologous BMDC implantation at the venous ulcer
An autologous bone marrow derived cell concentrate is obtained by bone marrow harvest (300 ml) from the iliac crest and subsequent processing using 6% hydroxyethyl starch to concentrate nucleated cells. The cells are injected using a 27 Gauge needle, in aliquots of 0.2 ml, along the venous ulcer edge. SOC treatment consisting of advanced wound management plus pressure therapy is administered simultaneously.
|
Eligibility| Ages Eligible for Study: | 40 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age from 40 to 75 years
- Patients with primary venous insufficiency
- Patients with venous ulcers with area larger than 2 cm2, who have received SOC treatment in the previous three months.
- Ulcers with negative bacterial cultures or with polymicrobial flora.
Exclusion Criteria:
- Patients with decompensated heart failure.
- Patients with lower limb edema of nonvenous etiology.
- Patients with diagnosis of diabetes mellitus.
- Patients with body mass index (BMI) ≤ 18.5 or > 40.
Contacts and Locations| Contact: Cristina Touriño, MD, PhD | +59824871515 ext 2517 | ctourino@hc.edu.uy |
| Contact: Gabriela Otero, MD | +59824871515 ext 2321 | gabyoter@gmail.com |
| Uruguay | |
| Universidad de la República- Hospital de Clínicas Dr. Manuel Quintela | Recruiting |
| Montevideo, Uruguay, 11600 | |
| Contact: Cristina Touriño +59824871515 ext 2517 | |
| Contact: Gabriela Otero +59824871515 ext 2321 | |
| Principal Investigator: Gabriela Otero, MD | |
| Principal Investigator: | Gabriela Otero, MD | Cátedra de Dermatología |
| Study Director: | Cristina Touriño, MD, PhD | Área de Terapia Celular y Medicina Regenerativa |
More Information
No publications provided
| Responsible Party: | Cristina Touriño, MD, PhD, Coordinator of the "Área de Terapia Celular y Medicina Regenerativa", Hospital de Clínicas Dr. Manuel Quintela |
| ClinicalTrials.gov Identifier: | NCT01750749 History of Changes |
| Other Study ID Numbers: | TUV2011 |
| Study First Received: | December 13, 2012 |
| Last Updated: | May 14, 2013 |
| Health Authority: | Uruguay: Ministry of Health |
Keywords provided by Hospital de Clínicas Dr. Manuel Quintela:
|
Venous ulcer Cell therapy |
Additional relevant MeSH terms:
|
Leg Ulcer Ulcer Varicose Ulcer Skin Ulcer Skin Diseases |
Pathologic Processes Varicose Veins Vascular Diseases Cardiovascular Diseases |
ClinicalTrials.gov processed this record on May 19, 2013