An Efficacy and Safety Study of Ixmyelocel-T in Patients With Critical Limb Ischemia (CLI)

NCT ID: NCT01483898

Last Updated: 2021-05-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2014-03-25

Brief Summary

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This study is designed to evaluate the efficacy and safety of ixmyelocel-T, a patient-specific expanded multicellular therapy, for the treatment of patients with critical limb ischemia (CLI). The study is a randomized, vehicle controlled (placebo)study in CLI patients who have no option for revascularization procedures. All patients randomized will undergo a small volume bone marrow aspiration in a 15-minute outpatient or in-office procedure. All patients will receive injections of either ixmyelocel-T or vehicle-control into their pre-identified index leg. Patients will be followed for 18 months.

Detailed Description

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Conditions

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Critical Limb Ischemia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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ixmyelocel-T

Group Type EXPERIMENTAL

Ixmyelocel-T

Intervention Type BIOLOGICAL

On Day 14, 20 intramuscular injections of ixmyelocel-T on pre-identified index leg.

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

On Day 14, 20 intramuscular injections of vehicle control on pre-identified index leg.

Interventions

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Ixmyelocel-T

On Day 14, 20 intramuscular injections of ixmyelocel-T on pre-identified index leg.

Intervention Type BIOLOGICAL

Placebo

On Day 14, 20 intramuscular injections of vehicle control on pre-identified index leg.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Males and nonpregnant, nonlactating females
* Ages 35 to 90 years of age
* Diagnosis of CLI with tissue loss (corresponding to Rutherford Category 5; see Appendix B) having an ulcer size of at least 0.5 cm2, a smaller sized ulcer penetrating into the subcutaneous tissue, and/or gangrene (dry). In addition, the subject must have ONE of the following documented at screening:

* Ankle systolic pressure \< 70 mm Hg
* Toe systolic pressure \< 50 mm Hg
* TcPO2 \< 30 mm Hg (in a supine position)
* Subjects must have no reasonable standard-of-care options for surgical or endovascular revascularization interventions
* Subjects must have the following:

* A narrative documenting the reasons why the site vascular specialist considers the subject "no option". A vascular specialist will be the principal investigator (PI) or subinvestigator and is defined as: vascular surgeon, interventional cardiologist, certified vascular medicine specialist, or interventional radiologist; AND
* Secondary confirmation by an independent Eligibility Review Committee (ERC; see Section 8.1) after review of appropriate documents including, but not limited to: imaging results, medical records, surgical history, site vascular specialist narrative documenting reasons for "no option," and/or lab reports.
* Major amputation in the index leg or death is not anticipated within 3 months of screening in the opinion of the vascular specialist (who must be the PI or subinvestigator)
* In the opinion of the investigator, the subject is controlled on medical therapy indicated for CLI (unless there is a documented contraindication or intolerance)
* Subject is current with all age-appropriate American Cancer Society (ACS) or similar (e.g., United States Preventative Service Task Force) screening guidelines
* Given medical history and concurrent medication, the subject is an acceptable candidate for bone marrow aspiration and intramuscular injection procedures in the opinion of the Investigator
* Subject is willing and able to comply with the scheduled visits, aspiration/injection procedure, wound care instructions treatment plan, and other study procedures for the duration of the study
* Provide a personally-signed and dated informed consent document indicating that the subject (or a legally-acceptable representative, if permitted by the site's Investigational Review Board \[IRB\]) has been informed of all pertinent aspects of the study

Exclusion Criteria

Patients presenting with any of the following will not be randomized:

Disease-specific:

* Failed open surgical revascularization (on index leg) within 4 weeks of screening Visit 1
* Acute limb-threatening ischemia, trauma, known non-atherosclerotic vascular disease (e.g., temporal/giant cell arteritis, Takayasu's arteritis, Raynaud's occlusive disease, Buerger's disease), embolic disease, aortoiliac disease with \> 50% stenosis, or history of hypercoagulable states
* Advanced CLI (i.e., nonsalvageable) defined as Rutherford Category 6
* Clinical evidence of invasive infection in index leg (e.g., cellulitis, osteomyelitis, wet gangrene)
* At screening, non-heel wound size of \> 20 cm2 (excluding toe gangrene); or wounds on the heel \> 10 cm2 on the index leg as measured by the Wound Core Lab (WCL) from photographs (and/or acetates) provided by the site
* Previous amputation at or above the talus in the index leg Medical History
* Hemoglobin A1c (HbA1c) ≥ 10% at screening
* Diabetic subjects with uncontrolled or untreated proliferative retinopathy as determined by dilated eye exam (by qualified eye care professional as per American Diabetes Association guidelines)
* Blood clotting disorder not caused by medication (e.g., thrombophilia)
* Active non-basal cell cutaneous malignancy requiring surgery, chemotherapy, and/or radiation in the past 12 months
* Current documented drug or alcohol abuse that would interfere with the subject's compliance with study procedures
* Known allergies to any equine, porcine, or bovine products
* Body mass index (BMI) ≥ 50 kg/m2 at screening
* Established chronic kidney disease (CKD) requiring dialysis (Stage 5); estimated creatinine clearance \< 15 mg/mL/min at screening
* Systolic blood pressure (SBP) \> 200 mm Hg or diastolic blood pressure (DBP) \> 120 mm Hg or papilledema noted via ophthalmoscope at screening physical exam
* Within 3 months prior to screening, a clinically significant history of cardiac disease

Laboratory Parameters:

* Abnormal laboratory values (performed at central lab) at screening:

* Platelets \< 50,000 μL
* Aspartate aminotransferase/alanine aminotransferase (AST/ALT) \> 3 times the upper limit of normal (ULN)
* Human immunodeficiency virus 1 (HIV 1), HIV 2, or syphilis positive (rapid plasma reagin \[RPR\])
* Active hepatitis B surface antigen (HBsAg) or hepatitis C virus (HCV); Exclusionary Procedures, Devices, or Medication
* Exposure to immunosuppressive therapy for oncologic or chronic non-oncologic reasons in the prior 12 months or expected requirement over the course of the study (e.g., chemotherapy, radiation therapy, methotrexate)
* Concurrent participation in another clinical trial or receiving experimental medication within 30 days of screening or having previously been exposed to Aastrom's ixmyelocel T product \[previously known as tissue repair cells (TRC), cardiac repair cells (CRC), vascular repair cells (VRC)\]
* On the index leg, use of concomitant wound treatments not currently approved for ischemic wound-healing within 30 days prior to screening or plans to initiate new, nonstandard-of-care treatments to the index leg during the study
Minimum Eligible Age

35 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Vericel Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Cardiology PC

Birmingham, Alabama, United States

Site Status

Cardio-Thoracic Surgeons, P.C.

Birmingham, Alabama, United States

Site Status

University Of Alabama At Birmingham

Birmingham, Alabama, United States

Site Status

Arizona Heart Institute

Phoenix, Arizona, United States

Site Status

Carl T. Hayden VA Medical Center

Phoenix, Arizona, United States

Site Status

University of Arizona

Tucson, Arizona, United States

Site Status

Arkansas Primary Care Clinic, P.A.

Little Rock, Arkansas, United States

Site Status

Central Arkansas Veteran's Healthcare System

Little Rock, Arkansas, United States

Site Status

John Muir Medical Center - Concord Campus

Concord, California, United States

Site Status

VA Loma Linda Healthcare

Loma Linda, California, United States

Site Status

UCLA Gonda Venous Center & Ambulatory Procedure Unit

Los Angeles, California, United States

Site Status

Sutter Medical Group - Cardiology

Sacramento, California, United States

Site Status

University of California San Diego Medical Center

San Diego, California, United States

Site Status

Kaiser Permanente Medical Center

San Diego, California, United States

Site Status

University of California San Francisco - Division of Vascular and Endovascular Surgery

San Francisco, California, United States

Site Status

University of Colorado Denver - Anschutz Medical Campus

Aurora, Colorado, United States

Site Status

Yale School of Medicine

New Haven, Connecticut, United States

Site Status

Bethesda Memorial Hospital - Clinical Research Center

Boynton Beach, Florida, United States

Site Status

Holy Cross Hospital

Fort Lauderdale, Florida, United States

Site Status

Florida Research Network, LLC

Gainesville, Florida, United States

Site Status

Malcom Randall Veterans Affairs Medical Center

Gainesville, Florida, United States

Site Status

First Coast Cardiovascular Institute, P.A.

Jacksonville, Florida, United States

Site Status

University of Miami Hospital

Miami, Florida, United States

Site Status

Orlando Health

Orlando, Florida, United States

Site Status

Baptist Hospital

Pensacola, Florida, United States

Site Status

Cardiology Consultants

Pensacola, Florida, United States

Site Status

Grove Place Surgery Center

Vero Beach, Florida, United States

Site Status

Vascular Surgical Associates, P.C.

Marietta, Georgia, United States

Site Status

Rush University Medical Center

Chicago, Illinois, United States

Site Status

University of Illinois at Chicago - Clinical Sciences North

Chicago, Illinois, United States

Site Status

Memorial Medical Center

Springfield, Illinois, United States

Site Status

Indiana/Ohio Heart

Fort Wayne, Indiana, United States

Site Status

St. Vincent Medical Group, Inc.

Indianapolis, Indiana, United States

Site Status

Heartland Vascular Medicine and Surgery

Windsor Heights, Iowa, United States

Site Status

Ochsner Clinic foundation

New Orleans, Louisiana, United States

Site Status

University of Maryland Medical Center

Baltimore, Maryland, United States

Site Status

Union Memorial Hospital

Baltimore, Maryland, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Boston Medical Center

Boston, Massachusetts, United States

Site Status

UMASS Memorial Health Care

Worcester, Massachusetts, United States

Site Status

VA Ann Arbor Healthcare System

Ann Arbor, Michigan, United States

Site Status

Cardiology and Vascular Associates, P.C.

Berkley, Michigan, United States

Site Status

Oakwood Hospital and Medical Center

Dearborn, Michigan, United States

Site Status

John D. Dingell VA Medical Center

Detroit, Michigan, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Michigan Vascular Research Center

Flint, Michigan, United States

Site Status

Integrated Vascular Vein Center of Michigan

Grand Blanc, Michigan, United States

Site Status

Michigan CardioVascular Institutue at Covenant Medical Center

Saginaw, Michigan, United States

Site Status

Saint Joseph Mercy Hospital

Ypsilanti, Michigan, United States

Site Status

Abbott Northwestern Hospital / Minneapolis Heart Institute-Vascular Clinic

Minneapolis, Minnesota, United States

Site Status

Minneapolis VA Health Care System

Minneapolis, Minnesota, United States

Site Status

University of Minnesota Medical School

Minneapolis, Minnesota, United States

Site Status

Hattiesburg Clinic, P.A.

Hattiesburg, Mississippi, United States

Site Status

Saint Luke's Hospital

Kansas City, Missouri, United States

Site Status

Omaha VAMC

Omaha, Nebraska, United States

Site Status

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, United States

Site Status

Vascular Access Center of West Orange

West Orange, New Jersey, United States

Site Status

University of Buffalo Surgeons Inc.

Buffalo, New York, United States

Site Status

Mount Sinai Medical Center

New York, New York, United States

Site Status

Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status

University of North Carolina Hospital

Chapel Hill, North Carolina, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Wake Forest Baptist Health

Winston-Salem, North Carolina, United States

Site Status

University Hospitals Case Medical Center

Cleveland, Ohio, United States

Site Status

Jobst Vascular Institute

Toledo, Ohio, United States

Site Status

University of Toledo Medical Center

Toledo, Ohio, United States

Site Status

University of Oklahoma Health Science Center

Oklahoma City, Oklahoma, United States

Site Status

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Site Status

Veterans' Administration Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

VA Pittsburgh Healthcare System

Pittsburgh, Pennsylvania, United States

Site Status

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

DFW Vascular Group, LLP

Dallas, Texas, United States

Site Status

Texas Heart Institute at St. Luke's Episcopal Hospital

Houston, Texas, United States

Site Status

The Methodist Hospital

Houston, Texas, United States

Site Status

Audie L Murphy VA Hospital - Pathology Laboratory

San Antonio, Texas, United States

Site Status

University of Utah

Salt Lake City, Utah, United States

Site Status

Swedish Medical Center

Seattle, Washington, United States

Site Status

University of Washington

Seattle, Washington, United States

Site Status

Cascade Vascular Associates, P.S.

Tacoma, Washington, United States

Site Status

Charleston Area Medical Center - Memorial Hospital

Charleston, West Virginia, United States

Site Status

University of Wisconsin

Madison, Wisconsin, United States

Site Status

Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Columbia Saint Mary's

Milwaukee, Wisconsin, United States

Site Status

Wheaton Franciscan Medical Group, Inc.

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

Related Links

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http://www.aastrom.com/

Aastrom Biosciences Homepage

http://www.vdf.org/

Vascular Disease Foundation

http://www.PADCoalition.org

Peripheral Arterial Disease Coalition

http://www.vascularweb.org

Vascular web provided by The Society for Vascular Surgery

Other Identifiers

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ABI 55-1009-1

Identifier Type: -

Identifier Source: org_study_id

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