Atrophic Nonunion of Fracture
Conditions
Keywords
Nonunion fracture, Long bones, Pseudoarthrosis, Cell therapy, Tissue engineering, Mesenchymal stromal cells
Brief summary
The present study evaluates the effect of XCEL-MT-OSTEO-ALPHA in non-union fractures (pseudoarthrosis) of long bones in comparison to the standard treatment of autologous iliac crest. XCEL-MT-OSTEO-ALPHA is a tissue engineering product composed by ex-vivo expanded autologous mesenchymal stromal cells fixed in allogenic bone tissue, produced by Xcelia (Blood and Tissue Bank of Catalonia). The working hypothesis proposes that the tissue engineering is a valid and useful technique to achieve bone regeneration up to consolidation of non-union fractures.
Detailed description
A phase IIa, single center, prospective, randomized, parallel, two-arms, single-dose, open-label with blinded assessor pilot clinical trial to assess ex vivo expanded adult autologous mesenchymal stromal cells fixed in allogeneic bone tissue (XCEL-MT-OSTEO-ALPHA) in non hypertrophic pseudoarthrosis of long bones.
Interventions
ex-vivo expanded autologous mesenchymal stromal cells fixed in allogenic bone tissue in association with open surgery
Autologous iliac crest in association with surgery
Standard surgery for non-union fractures
Sponsors
Study design
Masking description
Radiologist will assess images in a blinded manner
Eligibility
Inclusion criteria
* 18 to 85 years of age (male and female) * Atrophic or hypotrophic metaphyseal-diaphyseal pseudarthrosis of long bones, confirmed radiographically. * Signed Informed Consent Form * The patient is able to understand the nature of the study
Exclusion criteria
* Suspicious of pseudarthrosis focus infection diagnosed by clinical inspection and blood analysis. * Positive serology for HIV (Anti-HIV I/II-Ac), Hepatitis B (HBsAg, HBcAc), Hepatitis C (Anti-HCV-Ac) or Syphilis Lúes (TP-Ac). * Significant abnormal laboratory tests that contraindicates patient's participation in the study. * Pregnant woman or without proper anticonceptive measures according to the investigator, or breath feeding * Smoker of more than 15 cigarettes a day * Congenital disorders of bones (hypophosphatemia), bone metabolic disorders associated to primary or secondary hypoparathyroidism. * Badly managed diabetes mellitus. * Patients diagnosed with peripheral arterial disorders * Previous therapeutic radiation (5 previous years) of the affected bone. * Neoplasia within the previous 5 years, or without remission * The patient is legally dependent * Participation in another clinical trial or treated with an investigational medicinal product the previous 30 days * Other pathologic conditions or circumstances that difficult participation in the study according to medical criteria * The patient does not accept to be followed-up for a period that could exceed the clinical trial length
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy assessment of XCEL-MT-OSTEO-ALPHA in non-union fractures by imaging procedures | 12 month | Hounsfield units quantification by tomography in both treatment arms |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Safety assessment of XCEL-MT-OSTEO-ALPHA in non-union fractures | 12 month | Safety will be assessed by collecting adverse events throughout the experimental phase which includes a follow-up of 12 month. |
| Efficacy assessment of XCEL-MT-OSTEO-ALPHA in non-union fractures by imaging procedures | 6 month | Characteristics of the callus by tomography and Characteristics of the callus by standard x-ray in both treatment arms |
| Efficacy assessment by quality of life test | 12 month | Quality of life will be measured by EUROQOL-5D test |
Countries
Spain