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喷雾应用异体人成纤维细胞和角质细胞治疗慢性静脉性腿部溃疡的愈合持久性:6 个月随访。

Durability of healing from spray-applied cell therapy with human allogeneic fibroblasts and keratinocytes for the treatment of chronic venous leg ulcers: a 6-month follow-up.

机构信息

Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida.

出版信息

Wound Repair Regen. 2013 Sep-Oct;21(5):682-7. doi: 10.1111/wrr.12076. Epub 2013 Aug 8.

DOI:10.1111/wrr.12076
PMID:23927847
Abstract

Patients who participated in a Phase 2 trial of HP802-247 for venous leg ulcers were invited to participate in this 24-week follow-up study to assess the durability of healing, document additional ulcer closures, and evaluate posttreatment safety. Consent was given by 90% (206/228), with 80% (183/228) completing all visits. Blinding was retained from the previous trial in which subjects had been randomized to vehicle or one of four cell therapy regimens. Visits were every 8 weeks. Among the 183 subjects, 43% (21/49) previously treated with cells and entering follow-up with an open wound achieved closure, compared with 35% (7/20) previously treated with vehicle, while 10% (11/106) and 17% (3/18), respectively, experienced reopening of a previously closed wound. Subjects previously treated with cells closed more open wounds than those previously treated with vehicle (OR 1.39, 95% CI 0.47-4.10; p = 0.739), and less subjects with a previously closed wound reopened (OR 0.65, CI 0.16-2.60; p = 0.821); however, these findings were not statistically significant. At the final visit, the difference in proportion of subjects with wounds closed continued to favor the best dose from the prior trial (83% closed vs. 58%, delta 25%). Follow-up beyond 12 weeks is necessary to evaluate the full benefit of this therapy, as treatment with cells may provide stimulus toward healing that persists for up to several weeks following the last application. The results show that the greater proportional benefit achieved by HP802-247 relative to standard care after 12 weeks of treatment persists over a meaningful timeframe.

摘要

参与 HP802-247 治疗静脉性腿部溃疡的 2 期临床试验的患者被邀请参加这项 24 周的随访研究,以评估愈合的持久性,记录额外的溃疡愈合,并评估治疗后的安全性。228 名患者中有 90%(206/228)同意参加,其中 80%(183/228)完成了所有访视。在之前的试验中,受试者被随机分配到载体或四种细胞治疗方案中的一种,因此保留了盲法。访视间隔为每 8 周一次。在 183 名患者中,43%(21/49)之前接受过细胞治疗并进入随访时伤口未愈合的患者实现了愈合,而之前接受过载体治疗的患者为 35%(7/20),分别有 10%(11/106)和 17%(3/18)的患者之前已愈合的伤口重新开放。之前接受细胞治疗的患者比之前接受载体治疗的患者关闭更多的开放性伤口(OR 1.39,95%CI 0.47-4.10;p = 0.739),且较少之前已愈合的伤口重新开放(OR 0.65,CI 0.16-2.60;p = 0.821);然而,这些发现没有统计学意义。在最后一次访视时,倾向于先前试验中最佳剂量的患者比例差异继续存在(83%闭合,58%,差值 25%)。需要超过 12 周的随访来评估这种治疗的全部益处,因为细胞治疗可能会提供持续数周的愈合刺激,直至最后一次应用后。结果表明,在接受 12 周治疗后,HP802-247 相对于标准治疗的更大比例获益持续时间较长。

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