- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00484965
Erythrocyte-Mediated Drug Delivery for the Prevention of Stent Restenosis (TROY)
Erythrocyte-Mediated Drug Delivery for the Prevention of Restenosis After Coronary Artery Stent Implantation:TROY-Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In stent restenosis is still an unsolved problem. We know that principally in stent restenosis depends on myointimal proliferation, a biological process in which inflammatory mechanisms play a central role. We have previously demonstrated that immunosuppressive therapy with prednisone administered for 45 days after the stenting procedure reduced the incidence of restenosis at six months and clinical events at 12 months in high risk patients, with persistent higher C reactive protein levels after stenting implantation. But this therapy needs a high dosage glucocorticoids, and this is a contraindication in some subset of patients i.e. diabetics.
Recently a new method for the encapsulation of drugs into human autologous erythrocytes using an apparatus and a disposable kit has been developed. It's well known that blood erythrocytes change their membrane properties when in contact with suspensions of different osmotic values. So we developed a method to modify erythrocytes membrane properties so that they became porous and be able to absorb and then release some specific molecules. Experimental studies demonstrated that non diffusible pro-drug 21-phosphate dexamethasone can be loaded in human blood erythrocytes and then slowly dephosphorylated to the corresponding diffusible molecule to be released in human plasma. Once in-vivo due to the presence of the hydrophilic phosphate group, Dex 21-P encapsulated into RBCs cannot diffuse through RBC membrane until it is slowly dephosphorylated to the corresponding active corticosteroid by erythrocytes resident enzymes. The novelty and the advantages of this procedure are that the red blood cells act as a slow and constant drug delivery system so that, during the 30 days after the administration, there is always a low level of corticosteroid in plasma. When these erythrocytes are reinfused in the donor, they release in a continuous way a low and constant level of drug. This procedure has yet been used in some chronic inflammatory disease (i.e. bowel disease) in more than 1600 patients, with significant clinical improvement. The main objective of the study is 1) to evaluate if autologous erythrocytes modified as bioreceptor may be used to release glucocorticoids in blood circulation and 2) to reduce acute inflammatory proteins after coronary stent implantation with clinical and angiographic outcomes improvement. For this purpose 100 patients undergoing coronary artery stent implantation will be prospectively randomized in two groups:
- group A: bare metal stent implantation and treatment by 50 ml of autologous erythrocytes charged with dexamethasone 21-P
- group B: bare metal stent implantation and treatment by 50 ml of autologous erythrocytes not charged with dexamethasone 21-P The results of two groups will be compared.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Francesco Versaci, MD, FACC
- Phone Number: +390620903536
- Email: francescoversaci@yahoo.it
Study Contact Backup
- Name: Costantino Del Giudice, MD
- Phone Number: +390620903536
- Email: costantino.delgiudice@yahoo.it
Study Locations
-
-
-
Rome, Italy, 00133
- Policlinico Tor Vergata
-
Contact:
- Francesco Versaci, MD, FACC
- Phone Number: +390620903536
- Email: francescoversaci@yahoo.it
-
Contact:
- Luigi Chiariello, MD, FACC
- Phone Number: +390620903536
- Email: francescoversaci@yahoo.it
-
Principal Investigator:
- Francesco Versaci, MD, FACC
-
Sub-Investigator:
- Costantino Del Giudice, MD
-
Principal Investigator:
- Luigi Chiariello, MD, FACC
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- coronary disease
- written informed consent
- coronary stenosis
- CRP baseline levels < 0,5 mg/dl
Exclusion Criteria:
- acute myocardial infarction
- coronary bypass grafting restenosis
- vessels diameter < 2,5 mm
- corticosteroids contraindications
- corticosteroids therapy 30 days before
- active infective disease
- connective disease
- pregnancy
- cancer
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: DOUBLE
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Determine whether erythrocyte mediated dexamethasone delivery reduces circulating inflammatory markers after coronary stent implantation and improves reduction of acute phase reaction proteins
Time Frame: one year
|
one year
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Reduction of myointimal proliferation and restenosis after stenting implantation
Time Frame: one year
|
one year
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Francesco Versaci, MD, FACC, Tor Vergata University, Rome
- Study Director: Francesco Versaci, MD, FACC, Tor Vergata University, Rome
- Study Chair: Luigi Chiariello, MD, FACC, Tor Vergata University, Rome
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 72/06
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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