Formulated collagen gel accelerates healing rate immediately after application in patients with diabetic neuropathic foot ulcers

被引:53
作者
Blume, Peter [2 ]
Driver, Vickie R. [3 ,4 ]
Tallis, Arthur J. [5 ]
Kirsner, Robert S. [6 ]
Kroeker, Roy [7 ]
Payne, Wyatt G. [8 ]
Wali, Soma [9 ]
Marston, William [10 ]
Dove, Cyaandi [11 ]
Engler, Robert L. [12 ]
Chandler, Lois A. [1 ]
Sosnowski, Barbara K. [1 ]
机构
[1] Cardium Therapeut Inc, Tissue Repair Co, San Diego, CA 92130 USA
[2] Affiliated Foot Surg, New Haven, CT USA
[3] Boston Univ, Med Ctr, Dept Surg, Boston, MA USA
[4] Boston Univ, Sch Med, Dept Surg, Boston, MA 02118 USA
[5] Associated Foot & Ankle Specialists, Phoenix, AZ USA
[6] Univ Miami, Dept Dermatol & Cutaneous Surg, Miami, FL USA
[7] Kroeker Podiatry Clin, Fresno, CA USA
[8] Bay Pines VA Hlth Care Syst, Inst Tissue Repair Regenerat & Rehabil, Bay Pines, FL USA
[9] Olive View UCLA Med Ctr, Dept Internal Med, Sylmar, CA 91342 USA
[10] Univ N Carolina, Dept Vasc Surg, Chapel Hill, NC USA
[11] Adv Foot & Ankle Ctr, Las Vegas, NV USA
[12] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA
关键词
TISSUE-REPAIR; GROWTH; BB; CYTOKINES; WOUNDS; SAFETY; TRIAL; PDGF; AB;
D O I
10.1111/j.1524-475X.2011.00669.x
中图分类号
Q2 [细胞生物学];
学科分类号
071009 ; 090102 ;
摘要
We assessed the safety and efficacy of Formulated Collagen Gel (FCG) alone and with Ad5PDGF-B (GAM501) compared with Standard of Care (SOC) in patients with 1.5-10.0 cm2 chronic diabetic neuropathic foot ulcers that healed < 30% during Run-in. Wound size was assessed by planimetry of acetate tracings and photographs in 124 patients. Comparison of data sets revealed that acetate tracings frequently overestimated areas at some sites. For per-protocol analysis, 113 patients qualified using acetate tracings but only 82 qualified using photographs. Prior animal studies suggested that collagen alone would have little effect on healing and would serve as a negative control. Surprisingly trends for increased incidence of complete closure were observed for both GAM501 (41%) and FCG (45%) vs. Standard of Care (31%). By photographic data, Standard of Care had no significant effect on change in wound radius (mm/week) from during Run-in to Week 1 (-0.06 +/- 0.32 to 0.78 +/- 1.53, p=ns) but both FCG (-0.08 +/- 0.61 to 1.97 +/- 1.77, p < 0.002) and GAM501 (-0.02 +/- 0.58 to 1.46 +/- 1.37, p < 0.002) significantly increased healing rates that gradually declined over subsequent weeks. Both GAM501 and FCG appeared to be safe and well tolerated, and alternate dosing schedules hold promise to improve overall complete wound closure in adequately powered trials.
引用
收藏
页码:302 / 308
页数:7
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