Treatment of Chronic Wounds in Diabetic Foot Syndrome With Allogeneic Adipose Derived Mesenchymal Stem Cells (1ABC)

October 8, 2021 updated by: Medical University of Warsaw

Evaluation of the Safety and Efficacy of the Treatment of Chronic Wounds in Diabetic Foot Syndrome With the Use of Allogeneic Stem Cells Isolated From Adipose Tissue

The aim of this study is to investigate efficiency of applying of adipose-derived mesenchymal stem cells (ADSC) in treatment of chronic wounds in diabetic foot syndrome.

Study Overview

Detailed Description

The product will contain an active ingredient- human allogeneic adipose-derived mesenchymal stem cells (ADSC) cells suspended in the fibrin solution applied directly onto prepared wound bed, to form thin gel layer on the wound surface.

Study Type

Interventional

Enrollment (Actual)

46

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Warsaw, Poland
        • Medical University of Warsaw, Department of Diabetology and Internal Diseases

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Signing informed consent form.
  2. Above the age of 18
  3. Voluntary participation in the research, following the requirements of the protocol and acceptance for procedures related with its implementation
  4. Chronic wound in the course of diabetic foot syndrome, with the wound surface between 1 - 25 sq. cm, without evidence of active infection of the wound at the time of qualification to participate in the study
  5. Blood level of glycated haemoglobin (HbA1c) <=11%
  6. Satisfactory blood supply to the wound verified by the measurement of the oxygen level in the foot tissue (>=30 mmHg), or by the measurement of systolic blood pressure in posterior or anterior tibial artery (>=50 mmHg) of the affected limb.
  7. General health condition, which according to the investigator's opinion, allows patient's participation in all study procedures.

Exclusion Criteria:

  1. Lack of patient's cooperation
  2. Wound etiology other than diabetic foot syndrome
  3. Clinicaly significant limb ischemia as verified by the measurement of the oxygen level in the foot tissue (<30 mmHg), or by the measurement of systolic blood pressure in posterior or anterior tibial artery (<50 mmHg)
  4. Active wound infection, which would require the treatment with antibiotics
  5. Known allergy to ingredients of study product (thrombin, penicillin).
  6. Active venous thromboembolism
  7. Any systemic disease (acute or chronic) in the stage of exacerbation or not stabilized, that in the opinion of the investigator may hinder or make impossible a patient's participation in the study
  8. Active cancer during chemotherapy or radiotherapy, or recent cancer, if the remission occured less than 5 years before joining the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Allogeneic ADSC cells in fibrin solution

Application of allogeneic ADSC stem cells in fibrin gel, to cover wound surface with thin cells layer.

Therapy is based on standard procedure of diabetic foot ulcer treatment combined with application of allogeneic ADSC stem cells in fibrin solution onto the wound surface.

Chronic wounds in diabetic foot ulcer will be covered with ADSC suspended in fibrin gel - single dose will be administered followed by weekly wound control.
Active Comparator: Standard care in diabetic foot ulcer with aplication of fibrin gel to cover wound surface.
Application of fibrin gel to cover wound surface.
Chronic wounds in diabetic foot ulcer will be covered with fibrin gel followed by weekly wound control.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in wound size
Time Frame: 8 weeks

The comparison of the time required for the 50% reduction of initial wound size between patients in both study arms.

The wound size changes will be assessed using digital 3D wound imaging medical device with image processing software, according to the following rules:

  • for wounds deeper than 0.5 cm - measurement of wound volume, or
  • for shallow wounds (less than 0.5 cm depth) - measurement of wound surface.
8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in wound morphology
Time Frame: 8 weeks

Clinical assessment of wound morphology (and its changes during the treatment) in each treated patient, as well, as between patients in both study arms, expressed as:

  • the amount (1) and features (2) of wound exudate,
  • the presence of redness (3) and/or edema (4) in the wound surrounding skin,
  • the presence of granular tissue and fibrin (5) or epithelium (6) in the wound bed.

The listed parameters will be assessed using simplified questionnaire adopted from Bates-Jensen Wound Assessment Tool (positions 7-13 from B-JWAT).

Each of 6 abovementioned features will be assessed semiquantitatively using 1-5 points scale, (with "1" for a best state, and "5" for a worst state). The sum of points allocated to each parameter will be recorded as the wound score and used for further analysis.

The healthy skin/healed wound should receive 6 points, whereas active wound, with exudate and inflammation will receive 30 points (the lower = the better / the higher = the worse).

8 weeks
Changes in pro-angiogenic factors expression
Time Frame: 8 weeks

Evaluation of the expression (and its changes during the treatment) of selected pro-angiogenic factors, measured in wound biopsies.

The changes will be analyzed for each tested individual separately, and compared between both study arms.

8 weeks
Changes in wound-associated pain
Time Frame: 8 weeks

Evaluation of the wound-associated pain, assessed by the patient using visual analogue scale. The minimum value is 0 and means "no pain" and the maximum value is 10 and means "the worst possible pain". The lower value the better outcome.

The changes will be analyzed for each tested individual separately, and compared between both study arms.

8 weeks
Changes in the quality of life
Time Frame: 8 weeks

Evaluation of the patient's quality of life, assessed by the dedicated QoL questionnaire. The QoL questionnaire consists of 10 questions. Each question is scored 1 to 5. The minimum score is 10 and it means "the best possible state of health", and the maximum score is 50, which means ,,the worst possible state of health".

The changes will be analyzed for each tested individual separately, and compared between both study arms.

8 weeks
Record of adverse events
Time Frame: 8 weeks
Evaluation of the safety of ADSC application, assessed by the occurrence of any adverse events.
8 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Beata Mrozikiewicz-Rakowska, . Assoc.Prof., Medical University of Warsaw, Department of Diabetology and Internal Diseases

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2019

Primary Completion (Actual)

March 31, 2021

Study Completion (Actual)

September 30, 2021

Study Registration Dates

First Submitted

November 8, 2018

First Submitted That Met QC Criteria

March 5, 2019

First Posted (Actual)

March 6, 2019

Study Record Updates

Last Update Posted (Actual)

October 14, 2021

Last Update Submitted That Met QC Criteria

October 8, 2021

Last Verified

September 1, 2021

More Information

Terms related to this study

Other Study ID Numbers

  • 1ABC Therapy
  • 267976/13/NCBR/2015 (Other Grant/Funding Number: The National Center for Research and Development, Poland)
  • PL008125 (Other Identifier: EU tissue establishment code)
  • Z4217 (Other Identifier: ISBT128 (Facility Identification Number))
  • 2016-004109-15 (EudraCT Number)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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