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Preliminary Testing of New Treatment for Chronic Leg Wounds
This study is currently recruiting patients.
Sponsored by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Gene Vector Laboratory
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Information provided by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
Purpose
Most chronic (long-lasting) wounds of the leg (also known as venous ulcers) fail to heal in a reasonable period of time. Although researchers have made great progress in understanding how the body repairs wounds, attempts to develop new treatments have been disappointing. In general, treatments based on recent findings about the details of wound repair have not greatly reduced the number of people who have chronic wounds. The long-term goal of this study is to evaluate a new approach for healing a chronic wound. Current methods of directly applying substances that are involved in wound healing to a chronic wound do not cause enough healing. We think that PDGF-B (platelet-derived growth factor B), a factor associated with wound healing, will dramatically enhance healing if we inject a genetically engineered virus into the wound that causes cells in the wound to produce PDGF-B in large quantities.
Condition | Treatment or Intervention | Phase |
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Varicose Ulcer |
Drug: PDGF-B/Ad5 |
Phase I |
MedlinePlus related topics: Leg Injuries and Disorders; Varicose Veins
Study Type: Interventional
Study Design: Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety Study
Official Title: Phase I Trial to Evaluate the Safety of PDGF-B and a Limb Compression Bandage in Venous Leg Ulcers
Expected Total Enrollment: 24
Study completion: February 2006
Most chronic wounds of the leg fail to heal in a reasonable period of time. In fact, despite considerable advances in elucidating the molecular basis of wound repair, attempts to develop new therapies have been disappointing. In general, therapies based on recently elucidated mechanisms of wound repair have had minimal effect on the overall number of individuals with a treated healed chronic wound. The long-term goal of this study is to evaluate a new approach for healing a chronic wound. Current methods of applying cytokines as a topical protein to treat chronic wounds result in an inadequate response. We hypothesize that PDGF-B, a growth factor associated with wound healing, will dramatically enhance wound healing when produced in large quantities in the wound bed via adenovirus-mediated gene overexpression by the cells of the wound bed.
This study consists of two trials. The goal of Trial A, a dose-escalation trial, is to determine the maximum tolerated dose (MTD) of PDGF-B/Ad5, an adenovirus vector designed to overexpress PDGF-B, with respect to local and systemic toxicity and biologic feasibility. Our primary objective is to evaluate the acute safety, both local and systemic, of an intra-ulcer injection of PDGF-B/Ad5, thereby determining the recommended dose. After we evaluate the patients, we will treat them with a single intra-ulcer injection of PDGF-B/Ad5 in the wound. We will give patients only one dose, which we will administer during a 72-hour inpatient stay in a research unit at the Hospital of the University of Pennsylvania.
This study will use a standard three-six dose-escalation scheme. The MTD is defined as the highest dose for which fewer than two of six subjects experience a severe adverse reaction. We will closely monitor each patient for clinical adverse reactions resulting from treatment with PDGF-B/Ad5. We will grade toxicity according to the National Cancer Institute's Common Toxicity Criteria Scale.
The primary objective of Trial B is to evaluate the safety and biologic feasibility of the MTD of PDGF-B/Ad5 reported in Trial A in a standard 24-week trial for treatment of a venous leg ulcer. For this study, we will treat 15 consecutive patients using the MTD. We will give all patients a single intra-ulcer injection of PDGF-B/Ad5 and a limb compression bandage to be changed weekly. We will follow study participants for 24 weeks, which is the length of most FDA-approved venous leg ulcer trials.
Eligibility
Ages Eligible for Study: 18 Years - 90 Years, Genders Eligible for Study: Both
Criteria
Inclusion Criteria:
Exclusion Criteria:
Location and Contact Information
More Information
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