To evaluate the safety and efficacy of recombinant human hepatocyte growth factor (HGF) bare plasmid injection for local intramuscular injection in the treatment of patients with severe lower limb hemorrhagic disease (Rutherford grade 4)
Management of CLI process consumes a significant amount of healthcare resources,and the new therapeutic approaches are required. Hepatocyte growth factor (HGF) has been shown to be a potent angiogenic growth factor stimulating the growth of endothelial cells and migration of vascular smooth muscle cells. Because of its pluripotent capabilities, increasing the availability of HGF in ischemic tissues to achieve therapeutic angiogenesis has been a growing area of research. This study will use NL003, which is a DNA plasmid that contains novel genomic cDNA hybrid human HGF coding sequence (HGF-X7) expressing two isoforms of HGF, HGF 728 and HGF 723. As there are currently no approved drugs that can reverse CLI and as most patients have exhausted surgical and endovascular intervention options, inducing angiogenesis in the affected limb with NL003 may result in an increase in tissue perfusion, which, in turn improve wound healing, reduce pain and improve limb salvage rates.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
302
Day 0: 8mg of NL003 (32 injections of 0.5ml of NL003) Day 14: 8mg of NL003 (32 injections of 0.5ml of NL003) Day 28: 8mg of NL003 (32 injections of 0.5ml of NL003)
Day 0: 16ml of Normal Saline (32 injections ) Day 14: 16ml of Normal Saline (32 injections ) Day 28: 16ml of Normal Saline (32 injections )
Beijing Hospitai
Beijing, Beijing Municipality, China
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China
The Ninth People's Hospital of Chongqing
Chongqing, Chongqing Municipality, China
Complete pain relief rate
1.Day180 visit (5-7 days prior to visit, including the visit day), mean daily pain score was 0;2.A pain score of 0 must be measured without the use of analgesics.
Time frame: Day180
The time when the pain completely goes away
The time when the pain completely goes away.
Time frame: Day180
Complete pain relief rate
Day90 visit (5-7 days prior to visit, including the visit day), mean daily pain score was 0.
Time frame: Day90
Changes in site visits, pain scores after use of the study drug
The Numerical Rating Scale(NRS) was used to record changes in pain in subjects, who chose a number that best represented their pain in the past 24 hours, ranging from 0 (painless) to 10 (the most intense pain imaginable).The NRS scale is pain free (0), mild pain (1-3), moderate pain (4-6), and severe pain (7-10).
Time frame: Day14,Day28,Day60,Day90,Day120,Day180
Percent of Participants with a 50% reduction in pain score from baseline
Percent of Participants with a 50% reduction in pain score from baseline.
Time frame: Day180
The type and dose of analgesics varied from baseline
The types and dosages of analgesics varied from baseline at each site after the use of the study drug.
Time frame: Day14,Day28,Day60,Day90,Day120,Day180
Changes in Rutherford grading from baseline to Day180
The severity of critical Limb ischemia was assessed by Rutherford grading at screening, D14, D28, D60, D90, and D180, respectively.Rutherford grades chronic limb ischemic disease into grades 0 to 6, of which 4, 5 and 6 are chronic severe ischemia.
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Zhangzhou Municipal Hospital of Fujian Province
Zhangzhou, Fujian, China
The Second Xiangya Hospital of Central South University
Changsha, Hunan, China
The Third Xiangya Hospital of Central South University
Changsha, Hunan, China
Xuzhou Mining Group General Hospital
Xuzhou, Jiangsu, China
Chifeng Municipal Hospital
Chifeng, Neimenggu, China
The Affiliated Hospital of Qingdao University
Qingdao, Shandong, China
Shanghai seventh people's hospital
Shanghai, Shanghai Municipality, China
...and 3 more locations
Time frame: Day14,Day28,Day60,Day90,Day120,Day180
Changes in quality of life scores from baseline to Day180
The WHOQOL-BREF was conducted to evaluate the subjective perception of Critical Limb Ischemia, including the subjects' perception of quality of life, health, or other aspects of life.The whoqol-bref has 26 questions. Each question is rated on a scale of 1 to 5, with 1 for poor quality of life and 5 for good quality of life.
Time frame: Day14,Day28,Day60,Day90,Day120,Day180
Changes in the ABI from the baseline to Day180
Ankle-brachial index (ABI) refers to the ratio of systolic blood pressure of the anterior tibial artery (dorsal foot artery) or posterior tibial artery to the systolic blood pressure of the brachial artery.Participants were tested for ankle-brachial index (ABI).The normal value of ABI is 0.9-1.4, where \<0.4 is severe ischemia,0.41-0.9 is mild to moderate ischemia, and ABI\>1.4 indicates vascular wall calcification.
Time frame: Day60,Day90,Day120,Day180
Percentage of patients who underwent revascularization (open surgery or interventional therapy) had a large amputation rate and mortality
Day180, percentage of patients undergoing revascularization (open surgery or interventional therapy) major amputation rate mortality.
Time frame: Day180