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Autologous Platelet Rich Plasma (PRP) for the Treatment of Chronic Non-Healing Ulcers

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03026855
Recruitment Status : Completed
First Posted : January 20, 2017
Last Update Posted : January 20, 2017
Sponsor:
Information provided by (Responsible Party):
TotipotentRX Cell Therapy Pvt. Ltd.

Study Description
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Brief Summary:
The purpose of this study is to evaluate the safety and efficacy of autologous PRP injection in combination with topical application of PRP gel in treating chronic or non-healing ulcers on lower extremity using a rapid, intra-operative, point-of-care technology at the patient's bedside.

Condition or disease Intervention/treatment Phase
Chronic Ulcer Biological: Autologous PRP Gel and PRP Injection Phase 1

Detailed Description:

Platelet Rich Plasma (PRP) therapy is an innovative treatment that uses body's own cells to relieve pain and promote accelerated healing of Non-healing Foot Ulcer /Wound. The body's response to any tissue injury is to deliver platelets, which play an instrumental role in the normal healing process by secreting growth factors and attracting stem cells-critical components of the healing cascade.

Any wound or ulcer on skin that has been present for 4-5 weeks duration, without healing is called a non-healing ulcer. Non-healing ulcers include venous, arterial, diabetic, pressure and traumatic ulcers. Cellular therapies using Autologous Platelet Rich Plasma provides new options for wound healing. The efficacy of the treatment has been proven in surgical applications, in the treatment of severe burns and in transplantation of cells and tissues.

Local application of a solution of plasma enriched in platelets derived from the patient's blood intends to trigger the healing process in non-responsive chronic wound, increase the wound repair rate and reduce pain. PRP is a good option for non-healing wounds because it utilizes the body's natural healing processes to jump-start wound healing. Plasma which contains very valuable growth factors is separated from other blood components utilizing a point of care technology based on density gradient centrifugation. The platelet rich plasma is harvested and then activated by a mixture of human thrombin and calcium chloride for initiating the healing cascade followed by PRP injection directly into the ulcer/wound periphery or spread over a wound in the form of a PRP gel.

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 24 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
Official Title: To Demonstrate the Safety and Efficacy of Autologous Platelet Rich Plasma (PRP) for the Treatment of Chronic Non-Healing Ulcers
Study Start Date : June 2014
Actual Primary Completion Date : April 2016
Actual Study Completion Date : May 2016

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
Experimental: Autologous PRP Gel and PRP Injection
Autologous PRP will be prepared using an advanced rapid point-of-care technology, the Res-Q™ 60 PRP system at the patient's bed side. The Activator solution for PRP gel will be prepared by combining human thrombin (500 IU/ml) with 1% Calcium Chloride.
 Biological: Autologous PRP Gel and PRP Injection

Autologous PRP prepared using the Res-Q™ 60 PRP system from patient's whole blood, will be injected subcutaneously around the periphery of the wound/ulcer.

Based on the wound size and area, autologous platelet gel obtained by spraying simultaneously equal volumes of PRP and activator solution (thrombin with calcium chloride) will be applied topically over the ulcer or wound.

Single dose of PRP injections and application of PRP gel will be administered, only on the day of treatment.


Outcome Measures
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Primary Outcome Measures :
  1. Number of Wound/ Ulcers Healed [ Time Frame: 24 weeks ]
    The number of wound/ ulcers healed will be assessed by visual inspection of reduction in wound size at 24 weeks post PRP therapy


Secondary Outcome Measures :
  1. Time to Ulcer Healing [ Time Frame: 24 weeks ]
    The average time taken for the ulcers to heal post PRP administration

  2. Reduction in Pain using VAS pain score [ Time Frame: 24 weeks ]
    Improvement in Pain and discomfort following PRP therapy

  3. Changes in Quality of Life using the SF-36 Questionnaire [ Time Frame: 24 weeks ]
    Improvement in Quality of Life of the patients following PRP therapy

  4. Number of participants with treatment-related Adverse Events [ Time Frame: 24 weeks ]
    Safety of the treatment will be assessed by measuring the number of treatment related adverse events and adverse reactions during the follow-up period


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or Female 18 to 85 years of age
  • Chronic or Non-healing ulcer of any etiology (venous, pressure, arterial or diabetic foot ulcer) which is at least 4 weeks old
  • Index foot ulcer located on the plantar, medial or lateral aspect of the foot (including all toe surfaces)
  • Wound area (length x width) measurement must be between 0.5 cm^2 and 10 cm^2, inclusive
  • If more than one non-healing ulcers is present, the largest wound will be selected
  • Index ulcer must be clinically non-infected
  • Full-thickness ulcer without exposure of bone, muscle, ligament or tendon
  • Written informed consent must be obtained from either the patient or the patients legally acceptable representative prior to enrollment

Exclusion Criteria:

  • Patients with known sensitivity to components of the PRP kit (calcium chloride, thrombin, acid citrate dextrose solution A (ACD-A))
  • Smokers and individuals with systemic disease or history of anticoagulant, immuno-suppressive or antibiotic therapy in the last 3 months
  • Platelet count < 105 x 10^3/ uL (according to CBC)
  • Hemoglobin level < 10 g/dL (according to CBC)
  • Wound is clinically infected
  • Presence of platelet dysfunction syndrome or critical thrombocytopenia
  • Bleeding disorders, collagen vascular disease or severe cardiovascular disorder
  • Any malignancy other than non-melanoma skin cancer
  • Patient is currently receiving or has received radiation or chemotherapy within 3 months prior to treatment
  • If female, patient is pregnant, nursing or plans to become pregnant during the duration of the study
  • Subject has inadequate venous access for blood draw required for PRP preparation
  • Any chronic condition requiring the use of systemic corticosteroids 30 days prior to study entry and anytime during the course of the study
  • Subject is on dialysis or has uncontrolled sugar levels
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03026855


Locations
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India
Fortis Escorts Heart Institute and Research Centre
Delhi, India, 110025
Sponsors and Collaborators
TotipotentRX Cell Therapy Pvt. Ltd.
Investigators
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Principal Investigator: Dr. Suhail N Bukhari, MBBS, DNB Fortis Escorts Heart Institute and Research Centre
More Information
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Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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Responsible Party: TotipotentRX Cell Therapy Pvt. Ltd.
ClinicalTrials.gov Identifier: NCT03026855    
Other Study ID Numbers: TPRX/PRP/NHU/141005
First Posted: January 20, 2017    Key Record Dates
Last Update Posted: January 20, 2017
Last Verified: January 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by TotipotentRX Cell Therapy Pvt. Ltd.:
Autologous PRP
Non-healing ulcer
Point-of-care
Additional relevant MeSH terms:
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Ulcer
Pathologic Processes