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Systemic sclerosis (SSc) is an auto-immune orphan disease mainly characterized by an alteration of the microvascular network, and by cutaneous and visceral fibrosis. Hands are frequently affected, as a consequence of ischemic phenomena and cutaneous fibrosis. As a result, patients suffer from everyday disability, with consequences on their occupational activities and social contact, sometimes severely altering their quality of life. To date, no anti-fibrosis treatment has proven effective; existing vasodilation treatments are unfortunately not very effective, and are associated with adverse effects or restrictions. It is consequently of utmost importance that an effective treatment for sclerodermic hands be developed. The injection of adipose autologous tissue is a common practice in plastic surgery, and has been known for over a century. Adipose tissue, originally used to increase volume, is also characterized by trophic properties associated to stromal vascular fraction (SVF), which contain multipotent stem cells, capable of tissue repair. Interestingly, some SVF cells can be angiogenic and anti-inflammatory, which could improve damage seen with SSc. The injection of SVF into the fingers would also make it possible to control the production of the extracellular matrix and to improve the balance between fibrosis and fibrolysis, resulting in an improvement of cutaneous sclerosis
The main purpose is to evaluate the efficacy of SVF injections in the fingers of patients suffering from SSc on the Cochin hand functional scale evaluated at 12 months, in comparison to the control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PLACEBO | Placebo Comparator | Patients will receive an injection of placebo |
|
| DRUG : Stromal Vascular Fraction | Experimental | Patients will receive an injection of Stromal Vascular Fraction injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Stromal Vascular fraction | Drug |
| ||
| Ringer lactate |
| Measure | Description | Time Frame |
|---|---|---|
| Cochin hand functional scale | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| the severity (frequency and intensity of crises) of Raynaud's phenomenon | 12 months | |
| the strength (Jamar et Pinch test) | 12 months | |
| the trouble trophicity (health assesment questionnaire) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Brigitte GRANEL | Contact | brigitte.granel@ap-hm.fr | ||
| alexandra GIULIANI | Contact | alexandra.giuliani@ap-hm.fr |
| Name | Affiliation | Role |
|---|---|---|
| catherine GEINDRE | ASSISTANCE PUBLIQUE HOPITAUX MARSEILLE | Study Director |
| BRIGITTE GRANEL | ASSISTANCE PUBLIQUE HOPITAUX MARSEILLE | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Assistance Publique Hopitaux de Marseille | Marseille | 13354 | France |
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| ID | Term |
|---|---|
| D012595 | Scleroderma, Systemic |
| ID | Term |
|---|---|
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D012871 | Skin Diseases |
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| ID | Term |
|---|---|
| D000077325 | Ringer's Lactate |
| ID | Term |
|---|---|
| D000077324 | Crystalloid Solutions |
| D007552 | Isotonic Solutions |
| D012996 | Solutions |
| D004364 | Pharmaceutical Preparations |
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| Drug |
|
|
| 12months |
| the pain in the hands (EVA pain scale), | 12 months |