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Study Terminated due to lack of Funding
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| Name | Class |
|---|---|
| United States Department of Defense | FED |
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The primary objective of this study is to evaluate the safety of ICX-RHY-013 in the treatment of stable, restrictive scars in subjects who have suffered a burn injury. Evaluation will be achieved through regular assessment of adverse events, vital signs, blood work monitoring and laboratory analysis cellular properties of the scar through biopsy.
The secondary objectives of this study are to evaluate improvement in symptoms of scars including reduced pain, discomfort and itching, improvement in mobility and daily function, improvement in appearance and scar texture.
Restrictive scar contracture (a condition where tissue thickens and tightens, pulling the surrounding healthy skin toward the damaged area) due to a serious burn injury can result in long term aesthetic and physical consequences.
Skin contractures adjacent to a joint lead to joint deformities that severely restrict range of motion (ROM) of the affected joint. Skin contractures are also often accompanied by crippling levels of chronic pain resulting in a high level of dependency on pain medications. These isolated or combined factors can lead to a significant disruption in both social and professional life, leading to a marked impact on an individual's quality of life.
The current standard of care for restrictive scar contracture involves the surgical excision of the contracture itself and/ or skin grafting. These standard therapies require extensive and often repeated surgeries. Physicians are continually seeking less invasive therapies to treat patients with burn contractures.
ICX-RHY-013 is an investigational medicinal product comprised of viable allogeneic human dermal fibroblast (HDFs) cells suspended in HypoThermosol®-FRS. HDFs are isolated from neonatal foreskin, cryopreserved, thawed and expanded in culture under good manufacturing practice at Intercytex Ltd., United Kingdom. The drug formulation will be 20 million cells per 1 milliliter of HypoThermosol® and will be administered to subjects via intradermal injections at a maximum dose of 0.25 ml (or 5 million cells) per cm² of tissue.
If determined to be safe and effective, it is believed this therapy could, in the future, be delivered in a series of superficial injections and can be carried out in a doctor's office. This treatment could represent a new less invasive therapy of choice for patients with burn contractures, where current recourse would be to surgery. This advance could have significant positive benefits to the patient in terms of:
Cohort 1 will consist of 4 participants who are scheduled to have elective body contouring surgery which will consist of the removal of an abdominal incision scar. The investigational drug will be injected into the existing surgical incision (scar) with the investigational drug, ICX-RHY-013. The purpose of this cohort is to evaluate the initial safety of the investigational drug (ICX-RHY-013) in a series of doses on your surgical scar that will then be surgically removed.
Cohorts 2 through 5 will consist of 4 participants each who have burn scars with restrictive scar contractures. The purpose of these cohorts is to evaluate the ongoing safety of the investigational drug (ICX-RHY-013) in post burn scars with restrictive scar contractures. The investigational drug will be injected directly into these scar contractures. Each cohort is unique in that the dose and frequency of the investigational drug received will be different. We will evaluate the safety of the drug between each cohort by assessing all side effects that the participants may experience.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Safety Cohort | Experimental | Stable restrictive scar contractures resulting from abdominal surgical incision, not transversing a joint. The minimum scar length of 7 cm and a maximum scar area size of 80cm². The scar is divided into five injection areas with a minimum of 0.5 cm uninjected areas between the 5 sites.Drug Dosing for Cohort 1:
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| 2.5M cells/cm2 | Active Comparator | Participants receive intervention treatment of 2.5 million cells/ cm2, single administration injected into the scar. |
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| 5M cells/cm2 | Active Comparator | Participants receive intervention treatment of 5 million cells /cm2, single administration |
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| 2.5M cells/cm2 at 4 weeks | Active Comparator | Participants receive intervention treatment of 2.5 million cells/ cm2, repeat dose administration @ 4 weeks |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ICX-RHY-013 | Drug | Drug Dosing for Cohorts as follows: Cohorts (N=4) Safety Cohort 1:
At day 0, the subject will receive a total of 3 different injections and at week 4 the subject will receive a total of 2 different injections. Cohort 2: 2.5 million cells/ cm2, single administration Cohort 3: 5 million cells /cm2, single administration Cohort 4: 2.5 million cells/ cm2, repeat dose administration @ 4 weeks Cohort 5: 5million cells / cm2 repeat dose administration @ 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Adverse Events | The evaluation of safety of ICX-RHY-013 in the treatment of stable, restrictive hypertrophic scars through assessment of adverse events. The primary objective of the safety (no injection) cohort is to evaluate initial safety of multiple doses through assessment of adverse events. The primary objective of remaining cohorts is to evaluate the ongoing safety of ICX-RHY-013 in post-burn hypertrophic scars that are not planned for excision through assessment of adverse events. | Days 0, 7, 14, 28, 56, 84 |
| Number of Participants With Serious Adverse Events Reported | The evaluation of tolerability of ICX-RHY-013 in the treatment of stable, restrictive hypertrophic scars through regular assessment of adverse events. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Subjects Worse Hypertrophic Scars | The secondary objectives of this study are to evaluate improvement in symptoms of hypertrophic scars. | Endpoints assessed at Day 84. |
| Vancouver Scar Scale |
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Inclusion Criteria:
Subjects who are male or female, military or civilian, age 18 to 65 years of age and able to provide informed consent
Subjects who have suffered an injury which has occurred no less than 6 weeks prior to their screening date which has resulted in a stable restrictive scar contracture
Subjects will have a minimum scar length of 7 cm and a maximum scar area size of 80cm² (Cohort 1 only)
Subjects will have a minimum scar area size of 1cm² and a maximum scar area size of 80cm² (Cohort 2-5 only).
Subjects who are, in the opinion of the Investigator, able to understand the study, comply with the study design and are willing to return to the clinic for all the research required follow-up visits
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| J. Peter Rubin, MD | University of Pittsburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pittsburgh | Pittsburgh | Pennsylvania | 15213 | United States |
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All of the subjects who were enrolled (signed consent) were randomized to 1 of 4 cohorts.
Multiple approaches for subject recruitment were implemented.The Center for Innovation in Restorative (CIRM) hired a marketing specialist who investigated the use of non-traditional mechanisms within and outside the existing infrastructure including but not limited to social media outlet,use of internal/external physician networks,TV advertising
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| ID | Title | Description |
|---|---|---|
| FG000 | No Injection | Safety cohort. 4 subjects received empty control. No injection |
| FG001 | Vehicle Only | Vehicle only (0.5 ml of solution) |
| FG002 | Single Admin Drug Day 0 | Single administration of study drug on day 0 |
| FG003 | Single Admin Drug Day 28 | Single administration on Day 28 |
| FG004 | Admin Drug Day 0 and 28 | Single administration day 0 and 28 |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | No Injection | Empty safety control, no injection |
| BG001 | Vehicle Only | Vehicle only (0.5 ml of HypoThermosol solution) |
| Units | Counts |
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| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Number |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Adverse Events | The evaluation of safety of ICX-RHY-013 in the treatment of stable, restrictive hypertrophic scars through assessment of adverse events. The primary objective of the safety (no injection) cohort is to evaluate initial safety of multiple doses through assessment of adverse events. The primary objective of remaining cohorts is to evaluate the ongoing safety of ICX-RHY-013 in post-burn hypertrophic scars that are not planned for excision through assessment of adverse events. | Posted | Number | participants | Days 0, 7, 14, 28, 56, 84 |
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Vehicle Only, | Adverse events in each cohort included pain, swelling and redness at the site of injection that resolved within 8 hours of treatment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Redness | Skin and subcutaneous tissue disorders |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Amy Steele, RN, MSN, CCRC | University of Pittsburgh | 412-641-3728 | steeleam@upmc.edu |
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| ID | Term |
|---|---|
| D002921 | Cicatrix |
| ID | Term |
|---|---|
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| 5M cells/cm2 at 4 weeks |
| Active Comparator |
Participants receive intervention treatment of 5 million cells / cm2 repeat dose administration @ 4 weeks |
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Vancouver scar scale will be evaluated for each cohort. The Vancouver scar scale is the most frequently cited assessment of scar severity used in clinical studies. Pigmentation, vascularity, pliability, and scar height are graded producing a composite score. A score of 0 represents normal skin with higher grades representing greater deformity with a maximum possible rating of 14.
| 12 weeks |
| Patient and Observer Scar Assessment Scale (POSAS) | POSAS aims to measure scar quality, it is a comprehensive scale designed for the evaluation of all types of scars by professionals and patients. It contains two scales with six items, scored numerically from 0-10, where 0 is normal skin and 10 is the worst scar imaginable. the total scoring range is from 0-120. | 12 weeks |
| Disability Index-Disability of Arm, Shoulder and Hand | The six subjects suffering from upper extremity and cervical scar contractures were evaluated with the Disability of Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire evaluates symptoms and functional status. A lowest score of 0 indicates normal skin and highest score of 100 represents the greatest possible morbidity. | 12 weeks |
| Quality of Life Measurement - Satisfaction With Appearance Scale (SWAP) | SWAP is a psychological test for personality diagnosis. there are 9 questions evaluated by a score of 7 (most descriptive to the patient) to 0 (not descriptive or irrelevant) for a total scoring range of 0-63. | 12 weeks |
| Withdrawal by Subject |
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| funding lost, study ended |
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| BG002 | Single Admin Day 0 | 5 million cells / cm² , single administration at Day 0 |
| BG003 | Single Admin Day 28 | 5 million cells/ cm² , single administration at day 28 |
| BG004 | Admin Day 0 and 28 | 5 million cells/cm² , single administration at Day 0 , repeat administration of this dose @ day 28 |
| BG005 | Total | Total of all reporting groups |
| participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex/Gender, Customized | Number | participants |
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| Region of Enrollment | Number | participants |
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| OG002 | Single Admin Drug Day 0 | Single administration of study drug on day 0 |
| OG003 | Single Admin Drug Day 28 | Single administration of study drug on day 28 |
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| Primary | Number of Participants With Serious Adverse Events Reported | The evaluation of tolerability of ICX-RHY-013 in the treatment of stable, restrictive hypertrophic scars through regular assessment of adverse events. | Posted | Number | participants | 12 weeks |
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| Secondary | Percentage of Subjects Worse Hypertrophic Scars | The secondary objectives of this study are to evaluate improvement in symptoms of hypertrophic scars. | Posted | Number | percentage of paricipants | Endpoints assessed at Day 84. |
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| Secondary | Vancouver Scar Scale | Vancouver scar scale will be evaluated for each cohort. The Vancouver scar scale is the most frequently cited assessment of scar severity used in clinical studies. Pigmentation, vascularity, pliability, and scar height are graded producing a composite score. A score of 0 represents normal skin with higher grades representing greater deformity with a maximum possible rating of 14. | Posted | Mean | Standard Deviation | scores on a scale | 12 weeks |
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|
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| Secondary | Patient and Observer Scar Assessment Scale (POSAS) | POSAS aims to measure scar quality, it is a comprehensive scale designed for the evaluation of all types of scars by professionals and patients. It contains two scales with six items, scored numerically from 0-10, where 0 is normal skin and 10 is the worst scar imaginable. the total scoring range is from 0-120. | Posted | Mean | Standard Deviation | scores on a scale | 12 weeks |
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|
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| Secondary | Disability Index-Disability of Arm, Shoulder and Hand | The six subjects suffering from upper extremity and cervical scar contractures were evaluated with the Disability of Arm, Shoulder and Hand (DASH) questionnaire. The DASH questionnaire evaluates symptoms and functional status. A lowest score of 0 indicates normal skin and highest score of 100 represents the greatest possible morbidity. | Posted | Mean | Standard Deviation | scores on a scale | 12 weeks |
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| Secondary | Quality of Life Measurement - Satisfaction With Appearance Scale (SWAP) | SWAP is a psychological test for personality diagnosis. there are 9 questions evaluated by a score of 7 (most descriptive to the patient) to 0 (not descriptive or irrelevant) for a total scoring range of 0-63. | Posted | Mean | Standard Deviation | units on a scale | 12 weeks |
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| 0 |
| 5 |
| 0 |
| 5 |
| 5 |
| 5 |
| EG001 | Single Admin Day 0 | Adverse events in each cohort included pain, swelling and redness at the site of injection that resolved within 8 hours of treatment | 0 | 4 | 0 | 4 | 4 | 4 |
| EG002 | Single Admin Day 28 | Adverse events in each cohort included pain, swelling and redness at the site of injection that resolved within 8 hours of treatment | 0 | 2 | 0 | 2 | 2 | 2 |
| EG003 | Admin Day 0 and 28 | Adverse events in each cohort included pain, swelling and redness at the site of injection that resolved within 8 hours of treatment | 0 | 0 | 0 | 0 | 0 | 0 |
| EG004 | no Injection | Adverse events in each cohort included pain, swelling and redness at the site of injection that resolved within 8 hours of treatment | 0 | 4 | 0 | 4 | 0 | 4 |
| Itching | Skin and subcutaneous tissue disorders |
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| Bruising | Skin and subcutaneous tissue disorders |
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| Swelling | Skin and subcutaneous tissue disorders |
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| Warmth | Skin and subcutaneous tissue disorders |
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| Pain | Skin and subcutaneous tissue disorders |
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| Bleeding | Blood and lymphatic system disorders | Bleeding from injection and also biopsy |
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