Clinical trial NCT01475786: Safety and Efficacy Study for the Treatment of Painful Diabetic Neuropathy
Official title: A Phase II, Double-Blind, Randomized, Placebo-Controlled, Multicenter Study to Assess the Safety and Efficacy of Engensis (VM202) in Subjects With Painful Diabetic Peripheral Neuropathy
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE2
Conditions: Painful Diabetic Neuropathies
Keywords: nerve pain
diabetic nerve pain
throbbing
burning
painful feet
tingling
numbness
Engensis (VM202)
Lead sponsor: Helixmith Co., Ltd.
Sponsor class: INDUSTRY
First posted: 2011-11-21
Enrollment: 104
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine if Engensis (VM202) is safe and effective in treating painful diabetic neuropathy.

Detailed description: Peripheral neuropathy is a serious complication of diabetes. This form of neuropathy carries a high risk of pain, trophic changes and autonomic dysfunction. There is currently no effective treatment for diabetic neuropathy, and good glycemic control is the only way to minimize the risk of occurrence. Clearly, it would be desirable to prevent, impede, or reverse the disrupting and often life-threatening manifestations of peripheral neuropathy by stimulating growth or regeneration of peripheral nerve axons.

Eligibility criteria: Inclusion Criteria:

* Age ≥ 18 years to ≤ 75 years
* Documented history of Type I or II diabetes with current treatment control (glycosylated hemoglobin A1c of ≤ 10.0% at Screening) and currently on oral medication and/or insulin
* Diagnosis of painful diabetic peripheral neuropathy in both lower extremities
* Lower extremity pain for at least 6 months
* Visual analog scale (VAS) score of ≥ 40 mm at Initial Screening (0 mm = no pain - 100 mm very severe pain)
* Symptoms from the Brief Pain Neuropathy Screening (BPNS) is ≤ 5 point difference between legs at Initial Screening
* The average daily pain intensity score of the Daily Pain and Sleep Interference Diary completed after medication wash-out is ≥ 4 with a standard deviation ≤ 2
* The physical examination component of the Michigan Neuropathy Screening Instrument Score (MNSI) is ≥ 3 at Screening
* Stable treatment of diabetes for at least 3 months with no anticipated changes in medication regimen, and no new symptoms associated with diabetes
* If female of childbearing potential, negative urine pregnancy test at screening and using acceptable method of birth control during the study

Exclusion Criteria:

* Peripheral neuropathy caused by condition other than diabetes
* Other pain more severe than neuropathic pain
* Progressive or degenerative neurological disorder
* Myopathy
* Inflammatory disorder of the blood vessels (inflammatory angiopathy, such as Buerger's disease)
* Active infection
* Chronic inflammatory disease (e.g., Crohn's disease, rheumatoid arthritis)
* Positive HIV or HTLV at Screening
* Active Hepatitis B or C as determined by Hepatitis B core antibody (HBcAB), antibody to Hepatitis B antigen (IgG and IgM; HbsAb), Hepatitis B surface antigen (HBsAg) and Hepatitis C antibodies (Anti-HCV) at Screening
* Subjects with known immunosuppression or currently receiving immunosuppressive drugs, chemotherapy or radiation therapy
* Stroke or myocardial infarction within last 3 months
* Ophthalmologic conditions pertinent to proliferative retinopathy or conditions that preclude standard ophthalmologic examination
* Specific laboratory values at Screening including: Hemoglobin \< 8.0 g/dL, WBC \< 3,000 cells per microliter, platelet count \<75,000/mm3, Creatinine \> 2.0 mg/dL; AST and/or ALT \> 3 times the upper limit of normal or any other clinically significant lab abnormality which in the opinion of the investigator should be exclusionary
* Uncontrolled hypertension as defined as sustained systolic blood pressure (SBP) \> 200 mmHg or diastolic BP (DBP) \> 110 mmHg at Screening
* Patients with a recent history (\< 5 years) of or new screening finding of malignant neoplasm except basal cell carcinoma or squamous cell carcinoma of the skin (if excised and no evidence of recurrence); patients with family history of colon cancer in any first degree relative are excluded unless they have undergone a colonoscopy in the last 12 months with negative findings
* Subjects requiring \> 81 mg daily of acetylsalicylic acid; If ≥ 81 mg are taken at screening, subjects may be enrolled if willing/able to switch to another medication
* Use of any opioids; subjects may be enrolled if willing and able to discontinue use of these drugs 14 days prior to starting the 7 Day Daily Pain and Sleep Interference Diary and refrain from taking these drugs for the duration of the study
* Subjects requiring regular COX-2 inhibitor drug(s) or non-specific COX-1/COX-2 inhibiting drugs, or high dose steroids (excepting inhaled steroids).Subjects may be enrolled if willing/able to undergo medication wash-out prior to the first dosing and to refrain from taking these drugs for the duration of the study;
* Major psychiatric disorder in within last 6 months
* Body mass index (BMI) \> 45 kg/m2 at Screening
* Any lower extremity amputation
* Use of an investigational drug or treatment in past 6 months
* Unable or unwilling to give informed consent

Primary outcomes:
measure: The Primary Study Endpoint Was the Change in Average 24-hour Pain Score From Baseline to the 6-month Follow-up.
timeFrame: seven (7) days before 9 Month visit
Secondary outcomes:
Other outcomes:
Locations:
city: Walnut Creek
country: United States
facility: Diablo Clinical Research
state: California
city: Orlando
country: United States
facility: Compass Research
state: Florida
city: Palm Beach Gardens
country: United States
facility: Palm Beach Neurological Center
state: Florida
city: Chicago
country: United States
facility: Northwestern University
state: Illinois
city: Boston
country: United States
facility: Beth Israel Deaconess
state: Massachusetts
city: Albany
country: United States
facility: The Neurosciences Institute Albany Medical College
state: New York
city: New York
country: United States
facility: Mount Sinai Medical Center
state: New York
city: Oklahoma City
country: United States
facility: University of Oklahoma Harold Hamm Diabetes Center
state: Oklahoma
city: Houston
country: United States
facility: Houston Neurocare
state: Texas
city: Houston
country: United States
facility: The Methodist Hospital
state: Texas
city: Salt Lake City
country: United States
facility: University of Utah
state: Utah
city: Norfolk
country: United States
facility: East Virginia Medical School Strelitz Diabetes Center
state: Virginia
city: Seattle
country: United States
facility: Rainier Clinical Research
state: Washington
city: Seongnam
country: Korea, Republic of
facility: Seoul National University Bundang Hospital
state: Bundang-gu
city: Seoul
country: Korea, Republic of
facility: Yonsei University College of Medicine Severance Hospital
state: Seodaemun-gu
city: Bucheon
country: Korea, Republic of
facility: Sejong General Hospital
state: Sosa-gu
city: Seoul
country: Korea, Republic of
facility: The Catholic University of Korea Youido St. Mary's Hospital
state: Yeongdeungpo-gu
Study officials:
affiliation: Northwestern University
name: Jack Kessler, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Kessler JA, Smith AG, Cha BS, Choi SH, Wymer J, Shaibani A, Ajroud-Driss S, Vinik A; VM202 DPN-II Study Group. Double-blind, placebo-controlled study of HGF gene therapy in diabetic neuropathy. Ann Clin Transl Neurol. 2015 May;2(5):465-78. doi: 10.1002/acn3.186. Epub 2015 Mar 5.