1-2 Phase of Safety and Efficacy of Patient Intraneural Injections of VEGF165 Plasmid Gene Therapy on Regeneration After Total Severance or Disruption of the Entire Nerve Fiber
Overview
- Phase
- Phase 1
- Intervention
- Neovasculgen
- Conditions
- Peripheral Nerve Injury
- Sponsor
- Human Stem Cell Institute, Russia
- Enrollment
- 45
- Primary Endpoint
- Disabilities of the Arm, Shoulder and Hand (DASH) Measure
- Last Updated
- 11 years ago
Overview
Brief Summary
The purpose of this study is to determine safety and efficacy of pl-vegf165 ("Neovasculgen") for regeneration of peripheral nerve. Pl-vegf165 ("Neovasculgen") is the permitted in Russian Federation angiogenic medication that induce growth of new vessels and included in a complex therapy for patients with peripheral arterial diseases in Russia. It has also been shown to enhance nerve regeneration and muscle reinnervation in animals but these properties have not previously been studied in patients. Moreover, currently there is no method in clinical use to speed the rate of recovery after nerve injury. The objective of this study is to explore the ability of pl-vegf165 to benefit the treatment of patients with peripheral nerve injury. The investigators hypothesize that treatment with intraneural injections with pl-vegf165 after peripheral nerve reconstruction will accelerate nerve regeneration, reduce the period of denervation and improve muscle reinnervation and recovery in patients with peripheral nerve injury.
Detailed Description
All patients enrolled into the study will receive standard surgery procedures indicated in accordance with medical care standards for the certain disease. Patients after nerve injury classified as neurotmesis will receive surgical repair of injured nerves what will be added by intraneural injections of pl-vegf165. Safety and efficacy of gene therapy will be assessed by physical examination, comprehensive laboratory tests over next 18 month after surgical nerve reconstruction.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients with confirmed transection injury between shoulder and wrist
- •Isolated injury of ulnar or median nerve (not mixed injury of several nerves)
- •Nerve injuries which are amenable to direct end-to-end repair
- •Length of the gap between of stumps of transected nerve no longer than 3,5 centimeters
- •Early delayed (secondary) repair performed between 2 to 6 weeks after nerve injury
Exclusion Criteria
- •Length of the gap between of stumps of transected nerve more than 3,5 centimeters
- •Simultaneous injury of several peripheral nerves
- •Localization of nerve injury beyond of forearm
- •Presence of neurological deficit preceding to nerve injury
- •Systemic disease of connective tissue
- •Large surgical procedures planned for next one and a half year
- •Presence of oncological diseases
- •Pregnancy and breastfeeding
- •Alcohol and drug addiction
- •Patient ability to adhere strictly to the rules of the current clinical trial protocol
Arms & Interventions
Neovasculgen 1
Gene therapy drug Neovasculgen will be administered by several intraneural injections after surgical nerve reconstruction before wound closing. A dose is 0,6 mg will be dissolved in 1 ml of aqueous vehicle (water for injection) prior to injection.
Intervention: Neovasculgen
Neovasculgen 2
Gene therapy drug Neovasculgen will be administered by several intraneural injections after surgical nerve reconstruction before wound closing. A dose is 1,2 mg will be dissolved in 1 ml of aqueous vehicle (water for injection) prior to injection.
Intervention: Neovasculgen
Outcomes
Primary Outcomes
Disabilities of the Arm, Shoulder and Hand (DASH) Measure
Time Frame: 540 days
The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Measure is a 30-item, self-report questionnaire designed to measure physical function and symptoms in patients with any or several musculoskeletal disorders of the upper limb. The questionnaire was designed to help describe the disability experienced by people with upper-limb disorders and also to monitor changes in symptoms and function over time. Testing has shown that the DASH performs well in both these roles.
Adverse events
Time Frame: 540 days
Secondary Outcomes
- Medical Research Council (MRC) Scale for Muscle Strength(90 days;180 days; 270 days; 360 days; 450 days; 540 days)
- The Short Form (36) Health Survey(90 days;180 days; 270 days; 360 days; 450 days; 540 days)
- Nerve conduction velocity(180 days; 360 days; 540 days)
- Electromyography(180 days; 360 days; 540 days)