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This Phase II, double-blind, randomized, placebo-controlled pilot study is designed to determine whether injection of autologous fibroblasts can increase the mobility (decrease the restriction) of burn scars. The study will assess the effects of azficel-T (autologous fibroblasts) in subjects who have a unilateral burn scar that is no deeper than the fascia (i.e., underlying structures including ligament, tendon, muscle, and bone must not contribute to the restriction) and that is either:
Subjects will each receive 2 injections of azficel-T or placebo administered 14 days (± 7 days) apart (depending on cell availability) and will be followed for efficacy (including range of motion measurements, scar pain and ability to perform activities) to Visit 7 and for safety to Visit 9 at 1 year.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Autologous fibroblasts | Experimental | Autologous fibroblasts grown in culture from skin biopsy taken from patient. The cells will be injected into the scars to be treated. |
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| Sterile saline | Placebo Comparator | Sterile saline will be injected into the scar to be evaluated. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Autologous fibroblasts | Biological |
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| |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage Change From Baseline (CFB) of Range of Motion (ROM) of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Baseline and post-treatment (visit occurred between 194 - 208 days from baseline) |
| Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Baseline and post-treatment (visit occurred between 23 - 37 days from baseline) |
| Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Baseline and post-treatment (visit occurred between 53 - 67 days from baseline) |
| Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Baseline and post-treatment (visit occurred between 93 - 97 days from baseline) |
| Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Baseline and post-treatment (visit occurred between 113 - 127 days from baseline) |
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Inclusion Criteria:
Subject is at least 18 years of age
Subject has a unilateral burn scar of a jointed area (i.e., finger, elbow, shoulder) that is no deeper than the fascia (i.e., underlying structures including ligament, tendon, muscle, and bone must not contribute to the restriction) and that is either:
Subject's burn scar to be treated is <100 sq cm in size
Injury occurred ≤ 36 months prior to screening
By the Investigator's assessment, physical therapy will not provide significant continuous improvement to the range of motion of the subject's joint
Subject agrees to maintain any current physical therapy regimen for the duration of the study
Subject must be able to provide written informed consent and comply with the study requirements
Females of childbearing potential must have a negative urine pregnancy test at the screening visit and prior to the first treatment, and must agree to use a reliable means of birth control for the duration of the study
Subject has healthy, non-scarred post auricular skin area suitable for biopsy
Subject must have a normal complete blood count (CBC) and chemistry panel within 90 days prior to enrollment
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Daniel D Lozano, MD | Lehigh Valley Health Network | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Univ of California David Medical Center | Sacramento | California | 95817 | United States | ||
| Univ of California San Diego |
Subjects were screened to determine eligibility for the study prior to enrollment. Once the subjects were enrolled, the biopsy was performed within 14 days after screening. Subjects were then randomized sequentially as their cells were harvested and found to be acceptable.
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| ID | Title | Description |
|---|---|---|
| FG000 | Autologous Fibroblasts | Autologous fibroblasts grown in culture from skin biopsy taken from patient. The cells will be injected into the scars to be treated. Autologous fibroblasts |
| FG001 | Sterile Saline |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| placebo sterile saline |
| Biological |
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| San Diego |
| California |
| 92103 |
| United States |
| Division of Burns and Trauma, Jackson Memorial Hospital | Miami | Florida | 33136 | United States |
| Loyola University Medical Center | Maywood | Illinois | 60153 | United States |
| Richard M. Fairbanks Burn Center | Indianapolis | Indiana | 46202 | United States |
| Long Island Plastic Surgical Group | Garden City | New York | 11530 | United States |
| Lehigh Valley Health Network | Allentown | Pennsylvania | 18103 | United States |
| Center for Innovation in Restorative Medicine | Pittsburgh | Pennsylvania | 15213 | United States |
| Univ of Washington, Harborview Medical Center | Seattle | Washington | 98104 | United States |
Sterile saline will be injected into the scar to be evaluated.
Autologous fibroblasts
placebo sterile saline
| COMPLETED |
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| NOT COMPLETED |
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MITT population
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| ID | Title | Description |
|---|---|---|
| BG000 | Autologous Fibroblasts | Autologous fibroblasts grown in culture from skin biopsy taken from patient. The cells will be injected into the scars to be treated. Autologous fibroblasts |
| BG001 | Sterile Saline | Sterile saline will be injected into the scar to be evaluated. Autologous fibroblasts placebo sterile saline |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| ROM of the Affected Joint | Mean | Standard Deviation | degrees |
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| 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 | Percentage Change From Baseline (CFB) of Range of Motion (ROM) of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Modified intent to treat population (mITT) | Posted | Mean | Standard Deviation | percent change | Baseline and post-treatment (visit occurred between 194 - 208 days from baseline) |
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| ||||||||||||||||||||||||||||
| Primary | Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Modified intent to treat population | Posted | Mean | Standard Deviation | percent change | Baseline and post-treatment (visit occurred between 23 - 37 days from baseline) |
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| |||||||||||||||||||||||||||||
| Primary | Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Modified intent to treat population | Posted | Mean | Standard Deviation | percent change | Baseline and post-treatment (visit occurred between 53 - 67 days from baseline) |
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| |||||||||||||||||||||||||||||
| Primary | Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Modified intent to treat population | Posted | Mean | Standard Deviation | percent change | Baseline and post-treatment (visit occurred between 93 - 97 days from baseline) |
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| |||||||||||||||||||||||||||||
| Primary | Percentage CFB of ROM of the Affected Joint | Percentage CFB was calculated by subtracting the baseline ROM measurement from the post-treatment ROM measurement, divided by the baseline ROM measurement, and multiplying by 100. | Modified intent to treat population | Posted | Mean | Standard Deviation | percent change | Baseline and post-treatment (visit occurred between 113 - 127 days from baseline) |
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Adverse events were collected from the time of the subject's biopsy through visit 9 (i.e., 360 days from their second treatment).
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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 | Autologous Fibroblasts | Autologous fibroblasts grown in culture from skin biopsy taken from patient. The cells will be injected into the scars to be treated. Autologous fibroblasts | 0 | 5 | 0 | 5 | 2 | 5 |
| EG001 | Sterile Saline | Sterile saline will be injected into the scar to be evaluated. Autologous fibroblasts placebo sterile saline | 0 | 0 | 0 | 0 | 0 | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Injection site pain | General disorders | Non-systematic Assessment |
| ||
| Syncope | Nervous system disorders | Non-systematic Assessment |
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Early termination leading to small numbers of subjects enrolled and completed; some data uninterpretable due to late data entry. With low enrollment (three subjects in mITT population and five subjects in safety population), a meaningful statistical analysis was not possible for this study.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Head, Research and Development | Castle Creek Biosciences | 13128471291 | medinfo@castlecreekbio.com |
| ID | Term |
|---|---|
| D003286 | Contracture |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D009135 | Muscular Diseases |
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