Adipose Stem/Stromal Cells in RSD, CRPS, Fibromyalgia

NCT ID: NCT02987855

Last Updated: 2021-02-16

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

WITHDRAWN

Clinical Phase

PHASE1/PHASE2

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-15

Study Completion Date

2024-06-30

Brief Summary

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Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), Causalgia, and Fibromyalgia represent progressive systemic pain conditions which often worsen over time. They appear to be dysregulation of the central nervous system (CNS) and the autonomic system (sympathetic/parasympathetic) which cause extensive functional losses, impairment, and disabilities. They are often associated with injury sites (including surgical) which produce constant, often disabling pain and motor-sensory losses.

Treatments are often ineffective and include medications (often high dose opiates), Physical Therapy (PT), and surgical interventions (sympathectomy, ablation) or insertion stimulators of the CNS.

Study is an interventional study to document the safety and efficacy of use of adipose-derived cellular stromal vascular fraction (AD-cSVF) in chronic pain and dysfunction disease groups.

Detailed Description

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Reflex Sympathetic Dystrophy (RSD), Complex Regional Pain Syndrome (CRPS), Causalgia, and Fibromyalgia represent progressive systemic pain conditions which often worsen over time. They appear to be dysregulation of the central nervous system (CNS) and the autonomic system (sympathetic/parasympathetic) which cause extensive functional losses, impairment, and disabilities. They are often associated with injury sites (including surgical) which produce constant, often disabling pain and motor-sensory losses.

Treatments are often ineffective and include medications (often high dose opiates), physical therapy (PT(, and surgical interventions (sympathectomy, ablation) or insertion stimulators of the CNS.

Clinical Features include neurogenic inflammation, nociceptive sensitization, vasomotor dysfunction and maladaptive neuroplasticity. As these often seem related to specific injury sites (trauma, surgical, etc.) which are followed with severe pain sensations such as stabbing, burning, throbbing, and local muscular spasms or hemiparesis. In addition, there are many reports of visual change, dropping attacks (sudden falling), joint soreness, and other systemic symptoms associated with potentially any organ in the body.

Diagnosis typically recognizes 3 distinct "types" which do not appear to be sequential in nature. Type 1 characterization is severe, burning sensory change near an injury site, musculoskeletal and joint stiffness. Type 2 demonstrates very high pain levels, swelling, muscular atrophy, joint degeneration, depression, and other concomitant dysfunctions. Type 3 features irreversible changes to skin/bone, and extreme loss of function of muscle (atrophic primarily) and tendons. A significant percentage (13-70 ) are felt to be at risk if neurological injuries, hemiplegia, enhanced vasomotor issues due to enhanced sympathetic actions and neurotransmission issues.

This study includes microcannula harvesting of subdermal adipose tissues, incubation, digestion and isolation of AD-cSVF. This stromal cellular pellet (without actual extracellular matrix or stromal elements) is then suspended in 500 cc sterile Normal Saline (NS) and deployed via peripheral intravenous route. Evaluations of safety issues are measured at intervals (both severe and non-severe categories) and by repeated pulmonary function studies.

Conditions

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RSD (Reflex Sympathetic Dystrophy) CRPS - Complex Regional Pain Syndrome Type I Fibromyalgia

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Lipoaspiration Arm 1

Acquisition of Adipose-Derived tissue Stromal Vascular Fraction (AD-tSVF) via closed syringe lipoaspiration harvest of subdermal fat

Group Type EXPERIMENTAL

Lipoaspiration

Intervention Type PROCEDURE

Closed syringe harvesting subdermal fat

AD-cSVF Arm 2

ADcSVF Isolation of cellular stem/stromal cells from subdermal adipose-derived cellular stromal vascular fraction

Group Type EXPERIMENTAL

ADcSVF isolation

Intervention Type PROCEDURE

Isolation of AD-cSVF from lipoaspirate via enzymatic digestion

Normal Saline IV Arm 3

Normal Saline IV with AD-cSVF cells

Group Type EXPERIMENTAL

Normal Saline IV

Intervention Type PROCEDURE

Normal Saline IV containing autologous AD-cSVF

Interventions

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Lipoaspiration

Closed syringe harvesting subdermal fat

Intervention Type PROCEDURE

ADcSVF isolation

Isolation of AD-cSVF from lipoaspirate via enzymatic digestion

Intervention Type PROCEDURE

Normal Saline IV

Normal Saline IV containing autologous AD-cSVF

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients with confirmed diagnosis of RSD, CRPS, and severe Fibromyalgia
* Ability to provide Informed Consent (or as parent or legal guardian)

Exclusion Criteria

* Patients with severe comorbidities which, in opinion of PI or provider associates. would be unsafe or not advised to be able to comply with study or follow up requirements
* Patients with documented Opiate abuse
* Patient taking corticosteroid therapy, immune suppression, or chemotherapeutic regimen within 6 months of entry
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Healeon Medical Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Robert W. Alexander, MD, FICS

Principal Investigator, Science

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Glenn C Terry, MD

Role: PRINCIPAL_INVESTIGATOR

Global Alliance for Regenerative Medicine (GARM)

Locations

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Regenevita LLC

Stevensville, Montana, United States

Site Status

GARM

Roatán, Hn, Honduras

Site Status

Countries

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United States Honduras

References

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Schwartzman RJ, Erwin KL, Alexander GM. The natural history of complex regional pain syndrome. Clin J Pain. 2009 May;25(4):273-80. doi: 10.1097/AJP.0b013e31818ecea5.

Reference Type BACKGROUND
PMID: 19590474 (View on PubMed)

Marinus J, Moseley GL, Birklein F, Baron R, Maihofner C, Kingery WS, van Hilten JJ. Clinical features and pathophysiology of complex regional pain syndrome. Lancet Neurol. 2011 Jul;10(7):637-48. doi: 10.1016/S1474-4422(11)70106-5.

Reference Type BACKGROUND
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Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993 Oct 23;342(8878):1012-6. doi: 10.1016/0140-6736(93)92877-v.

Reference Type BACKGROUND
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Maihofner C, Forster C, Birklein F, Neundorfer B, Handwerker HO. Brain processing during mechanical hyperalgesia in complex regional pain syndrome: a functional MRI study. Pain. 2005 Mar;114(1-2):93-103. doi: 10.1016/j.pain.2004.12.001. Epub 2005 Jan 26.

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Birklein F. Complex regional pain syndrome. J Neurol. 2005 Feb;252(2):131-8. doi: 10.1007/s00415-005-0737-8.

Reference Type BACKGROUND
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Lee BH, Scharff L, Sethna NF, McCarthy CF, Scott-Sutherland J, Shea AM, Sullivan P, Meier P, Zurakowski D, Masek BJ, Berde CB. Physical therapy and cognitive-behavioral treatment for complex regional pain syndromes. J Pediatr. 2002 Jul;141(1):135-40. doi: 10.1067/mpd.2002.124380.

Reference Type BACKGROUND
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van de Meent H, Oerlemans M, Bruggeman A, Klomp F, van Dongen R, Oostendorp R, Frolke JP. Safety of "pain exposure" physical therapy in patients with complex regional pain syndrome type 1. Pain. 2011 Jun;152(6):1431-1438. doi: 10.1016/j.pain.2011.02.032. Epub 2011 Apr 6.

Reference Type BACKGROUND
PMID: 21474244 (View on PubMed)

Swart CM, Stins JF, Beek PJ. Cortical changes in complex regional pain syndrome (CRPS). Eur J Pain. 2009 Oct;13(9):902-7. doi: 10.1016/j.ejpain.2008.11.010. Epub 2008 Dec 19.

Reference Type BACKGROUND
PMID: 19101181 (View on PubMed)

Chopra P, Cooper MS. Treatment of Complex Regional Pain Syndrome (CRPS) using low dose naltrexone (LDN). J Neuroimmune Pharmacol. 2013 Jun;8(3):470-6. doi: 10.1007/s11481-013-9451-y. Epub 2013 Apr 2.

Reference Type BACKGROUND
PMID: 23546884 (View on PubMed)

Azari P, Lindsay DR, Briones D, Clarke C, Buchheit T, Pyati S. Efficacy and safety of ketamine in patients with complex regional pain syndrome: a systematic review. CNS Drugs. 2012 Mar 1;26(3):215-28. doi: 10.2165/11595200-000000000-00000.

Reference Type BACKGROUND
PMID: 22136149 (View on PubMed)

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Reference Type BACKGROUND
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Varenna M, Adami S, Rossini M, Gatti D, Idolazzi L, Zucchi F, Malavolta N, Sinigaglia L. Treatment of complex regional pain syndrome type I with neridronate: a randomized, double-blind, placebo-controlled study. Rheumatology (Oxford). 2013 Mar;52(3):534-42. doi: 10.1093/rheumatology/kes312. Epub 2012 Nov 30.

Reference Type BACKGROUND
PMID: 23204550 (View on PubMed)

Gainer MJ. Hypnotherapy for reflex sympathetic dystrophy. Am J Clin Hypn. 1992 Apr;34(4):227-32. doi: 10.1080/00029157.1992.10402852.

Reference Type BACKGROUND
PMID: 1349789 (View on PubMed)

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Reference Type BACKGROUND
PMID: 534104 (View on PubMed)

Other Identifiers

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RSD-CRPS

Identifier Type: -

Identifier Source: org_study_id

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