Unique ID issued by UMIN | UMIN000002280 |
---|---|
Receipt number | R000002791 |
Scientific Title | Randomized controlled trial of G-CSF-mobilized peripheral blood mononuclear cells transplantation for the treatment of patients with Peripheral Arterial Disease |
Date of disclosure of the study information | 2009/08/01 |
Last modified on | 2018/08/08 18:13:39 |
Randomized controlled trial of G-CSF-mobilized peripheral blood mononuclear cells transplantation for the treatment of patients with Peripheral Arterial Disease
IMPACT STUDY
Randomized controlled trial of G-CSF-mobilized peripheral blood mononuclear cells transplantation for the treatment of patients with Peripheral Arterial Disease
IMPACT STUDY
Japan |
Peripheral Arterial Disease (arteriosclerosis obliterans, buerger's disease)
Cardiology | Nephrology | Vascular surgery |
Others
NO
To evaluate the safety and efficacy of G-CSF-mobilized peripheral blood mononuclear cells transplantation for the patients with PAD(ASO, Buerger's disease), who are unresponsive to standard therapy, we compare the recommended treatment group, the recommended treatment and cells transplantation group, and the cells transplantation group.
The recommended therapy is performed based on TASC2 and'Guideline 2 diagnosis and treatment for inferior ASO'edited by Japanese college of angiology.
Safety,Efficacy
Confirmatory
Phase III
Progression-free survival
1) Changes of Fontaine classification or Rutherford classification
2) Overall survival
3) Time-to-amputation
4) Amputation-free survival
5) Ulcer /Gangrene size
6) Severity of ischemic pain in lower limbs
7) ABI (TBI in measurable patients)
8) ICD and ACD
Interventional
Parallel
Randomized
Cluster
Open -no one is blinded
Active
YES
YES
Institution is not considered as adjustment factor.
YES
Central registration
2
Treatment
Medicine |
Recommended treatment group
The recommended therapy is performed based on TASC2 and 'Guideline 2 diagnosis and treatment for inferior ASO' edited by Japanese college of angiology.
Recommended treatment and Cells transplantation group
20 | years-old | <= |
75 | years-old | >= |
Male and Female
1) Patients with ASO or Buerger's disease confirmed obstruction or stenosis by leg angiography
2) Patients whose Fontaine classification is 2-4 and Rutherford classification is 1-5 in either limb.
3) Patients without indication of angioplasty and bypass surgery to arteria poplitea (constricted portion is diffuse or at peripheral micro artery), or uncontrollable the disease by these traditional treatment(No option patients)
4) Nonsmoking for over a month
5) Age is between 20 and 75. Patients who can give informed consent themselves in writing
1) Patients with severity progression of Fontaine classification or Rutherford classification within 1 month
2) Major amputation of lower limb is planned
3) Patients who performed angioplasty, bypass surgery, other surgical therapy or LDL apheresis within 1 month.
4) Patients who have serious allergic reaction or adverse reaction to G-CSF or apheresis
5) Patients with uncontrolled ischemic heart disease, heart failure or arrhythmia
6) Patients with severe stenotic lesion at major artery in intracranial or extracranial
7) Less than 6 months since last episode of myocardial/brain infarction, brain hemorrhage or TIAs.
8) Dialysis patients of Fontaine4, who have a history of ischemic heart disease, brain infarction or brain hemorrhage.
9) Patients with diabetic proliferating retinopathy (new Fukuda classification BI to BV).
10) Patients with malignant tumor within 3 years
11) Leukocytes less than 4,000/µL or exceeding 10,000/µL., platelets less than 50,000/µL, AST (GOT) exceeding 100 IU/L or ALT (GPT) exceeding 100 IU/L
12) Patients who have coexisting or history of interstitial pneumonia, or take the medicine with possibility of causing interstitial pneumonia
13) Patients who complicated by infection with fever over 38C
14) Patients with splenomegaly
15) Patients with claudication symptom, rest pain, ulcer or gangrene unrelated to primary disease
16) Patients with severe neuropathy in the lower limbs, and be difficult to evaluate in this trial
17) Patients with uncontrollable mental disorders
18) Patients with coexisting or history of hyperfunction of thyroid gland
19) Patient who is within 6 months from the end of other trails
20) The females who are in pregnancy or lactation, may be pregnant, or are planning to become pregnant before the end of trial period. The males who desire pregnancy of partner.
144
1st name | |
Middle name | |
Last name | Takashi Horie |
Sapporo Hokuyu Hospital
Department of Surgery
6-5-1, Higasisapporo 6-Jo,
011-865-0111
saiseichiryo@hokuyu_aoth.org
1st name | |
Middle name | |
Last name | Takashi Horie |
Sapporo Hokuyu Hospital
Department of Surgery
6-5-1, Higasisapporo 6-Jo,
011-865-0111
http://padct.jp/
saiseichiryo@hokuyu-aoth.org
Japan Study group of peripheral vascular regeneration cell therapy
Resarch Foundation for Community Medicine
Non profit foundation
YES
TRIPAD0708
TRI
2009 | Year | 08 | Month | 01 | Day |
Published
https://www.jstage.jst.go.jp/article/circj/82/8/82_CJ-17-1220/_article
Background:The clinical usefulness of peripheral blood (PB) mononuclear cell (MNC) transplantation in patients with peripheral arterial disease (PAD), especially in those with mild-to-moderate severity, has not been fully clarified.
Methods?and?Results:A randomized clinical trial was conducted to evaluate the efficacy and safety of granulocyte colony-stimulating factor (G-CSF)-mobilized PBMNC transplantation in patients with PAD (Fontaine stage 2-3 and Rutherford category 1-5) caused by arteriosclerosis obliterans or Buergers disease. The primary endpoint was progression-free survival (PFS). In total, 107 subjects were enrolled. At baseline, Fontaine stage was 2/3 in 82 patients and 4 in 21, and 54 patients were on hemodialysis. A total of 50 patients had intramuscular transplantation of PBMNC combined with standard of care (SOC) (cell therapy group), and 53 received SOC only (control group). PFS tended to be improved in the cell therapy group than in the control group (P=0.07). PFS in Fontaine stage 2/3 subgroup was significantly better in the cell therapy group than in the control group. Cell therapy-related adverse events were transient and not serious.
Conclusions:In this first randomized, large-scale clinical trial of G-CSF-mobilized PBMNC transplantation, the cell therapy was tolerated by a variety of PAD patients. The PBMNC therapy was significantly effective for inhibiting disease progression in mild-to-moderate PAD.
Completed
2009 | Year | 06 | Month | 22 | Day |
2009 | Year | 08 | Month | 01 | Day |
2015 | Year | 01 | Month | 01 | Day |
2009 | Year | 08 | Month | 01 | Day |
2018 | Year | 08 | Month | 08 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000002791