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Diosmiplex (Vasculera®) in Primary and Secondary Raynaud's Phenomenon

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02683408
Recruitment Status : Completed
First Posted : February 17, 2016
Last Update Posted : August 17, 2017
Information provided by (Responsible Party):
Primus Pharmaceuticals

Brief Summary:
Diosmiplex is a product marketed for the management of diseases due to venous and microvascular dysfunction. Raynaud's phenomenon is a disorder of characterized by spasm of small arteries and impaired microvascular flow. This study will examine the effects of diosmiplex on the frequency and severity of Raynaud's episodes in susceptible people.

Condition or disease Intervention/treatment Phase
Raynaud's Disease Other: placebo Dietary Supplement: diosmiplex Not Applicable

Detailed Description:

Raynaud's phenomenon is a disorder characterized by spasm of digital arteries leading to blanching, coldness and discomfort of the affected digit, affecting up to 3-5% of the population at some time in their lives. Raynaud's is roughly classified into primary and secondary forms. The primary form may occur without apparent cause or following such things as acute trauma, repetitive vibrating trauma or frostbite. Secondary Raynaud's occurs in association with a variety of systemic immunological diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SS) and Sjogren's syndrome. Perhaps the most severe forms are associated with systemic sclerosis, less often in SLE where severe microvascular changes can lead to digital ulcerations which are difficult to heal and produce considerable functional impairment Treatment of Raynaud's has been a significant clinical challenge. The primary modality is to avoid cold exposure. Many drug classes have been shown to have some, but highly variable and potential toxicities.

Diosmiplex is a prescription medical food product composed of the botanical based flavonoid molecule, diosmin, and a proprietary systemic blood alkalinizing agent, Alka4-complex. Diosmin has been used successfully in Europe as a drug for chronic venous insufficiency and its complications, including venous ulcers for more than 35 years. There is a large body of published literature regarding the molecular activity, clinical efficacy and safety of the active molecule in diosmin as well as its effects on the microvasculature where it has been shown to reduce inflammation, improve structural integrity, reduce capillary damage and improve capillary flow but no prospective clinical studies have been published regarding its effect in Raynaud's phenomenon. This will be the first prospective study to examine the efficacy and safety of diosmin, as diosmiplex, in both primary and secondary Raynaud's. The study will intentionally seek to enroll a subset of subjects with scleroderma with Raynaud's complicated by digital ulcers.

This will be a two (2) month randomized, double blind, placebo controlled study. Patients with either primary or secondary Raynaud's phenomenon present for at least 12 months and either untreated or inadequately controlled on therapy, defined as having at least four (4) vasospastic episodes/week, will be eligible for enrollment

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 87 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Prevention
Official Title: Diosmiplex (Vasculera®) in Primary and Secondary Raynaud's Phenomenon
Actual Study Start Date : February 2016
Actual Primary Completion Date : July 2017
Actual Study Completion Date : July 2017

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: diosmiplex
diosmiplex 630 mg BID administered orally
Dietary Supplement: diosmiplex
diosmiplex is an FDA regulated medical food product
Other Name: Vasculera

Placebo Comparator: placebo
placebo BID administrered orally
Other: placebo
inactive placebo

Primary Outcome Measures :
  1. percentage of subjects with by at least 50% reduction in number of vasospastic episodes [ Time Frame: 8 weeks ]
    For each primary and secondary endpoint, the number and percentage of subjects meeting the criterion will be presented by treatment group at Week 4 and Week 8.

Secondary Outcome Measures :
  1. percentage of subjects with at least 50% reduction in severity of vasospastic episodes [ Time Frame: 8 eeks ]
    For each primary and secondary endpoint, the number and percentage of subjects meeting the criterion will be presented by treatment group at Week 4 and Week 8.

Information from the National Library of Medicine

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, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • either gender, ages 18-80
  • established diagnosis of primary or secondary Raynaud's phenomenon
  • minimum of 4 vasospastic episodes/week
  • medication specifically for Raynaud's must be stable for 30 days prior to the screening visit and must be maintained unchanged for the duration of the study medication specifically for digital ulceration must be stable for 60 days prior to the screening visit and must be maintained unchanged for the duration of the study
  • not pregnant or breast feeding
  • using approved method of birth control if capable of becoming pregnant (Appendix II)
  • capable of reading and understanding the informed consent document

Exclusion Criteria:

  • pregnant or nursing women
  • any change in dose of oral medication specifically for Raynaud's or digital ulcers including, but not limited to, vasodilators, adrenergic blockers, antihypertensives, calcium channel blockers, ACE inhibitors, phosphodiesterase inhibitors (e.g., sildenofil,) endothelin receptor antagonists (e.g., bosentan), prostanoids (e.g., iloprost) within the 30 days prior to the screening visit for Raynaud's and /or 60 days for digital ulcers and during the duration of the study.
  • any intravenous or intra-arterial Raynaud's therapy within 1 month prior to the screening visit
  • Raynaud's secondary to mechanical (non-thermal) trauma
  • concomitant use of diclofenac or metronidazole
  • history of unstable coronary artery disease, chronic hepatic disease with ALT, AST, or alkaline phosphatase >1.3 time upper limit of normal for reference laboratory, renal disease with serum creatinine >2.5 or any gastrointestinal disease that could potentially interfere with absorption of the study product.
  • history of substance abuse including "recreational drugs" and/or alcohol intake in excess of one unit daily. For the purposes of this study a unit of alcohol is defined as 12 ox. of beer, 6 oz. of wine or 1.5 oz. of hard liquor.
  • history of any significant medical condition that, in the opinion of the investigator might put the subject at risk in this trial
  • participation in another clinical trial within 30 days of the screening visit or 7 half lives of the study product, whichever is longer

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02683408

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United States, Arizona
Sun Valley Arthritis Center
Peoria, Arizona, United States, 85381
Advanced Arthritis Care and Research
Scottsdale, Arizona, United States, 85258
United States, California
Valerius Medical Group
Los Alamitos, California, United States, 90720
United States, Florida
Science and Research Institute, Inc.
Jupiter, Florida, United States, 33458
Jeffrey Alper, MD
Naples, Florida, United States, 34102
Steven Kimmel MD
Tamarac, Florida, United States, 33321
United States, Indiana
Diagnostic Rheumatology
Indianapolis, Indiana, United States, 46227
United States, Maryland
Arthritis Treatment Center
Frederick, Maryland, United States, 21702
United States, Michigan
Henry Ford Hospital
Detroit, Michigan, United States, 48202
United States, Pennsylvania
Altoona Center for Clinical Research
Duncansville, Pennsylvania, United States, 16635
United States, West Virginia
West Virginai Research Institute
Charleston, West Virginia, United States, 25309
Sponsors and Collaborators
Primus Pharmaceuticals
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Study Director: Robert Levy, MD Primus Pharmaceuticals
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Responsible Party: Primus Pharmaceuticals Identifier: NCT02683408    
Other Study ID Numbers: PVR-02
First Posted: February 17, 2016    Key Record Dates
Last Update Posted: August 17, 2017
Last Verified: August 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Raynaud Disease
Peripheral Vascular Diseases
Vascular Diseases
Cardiovascular Diseases