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RecruitingNCT06303752REP-PAFUpdated Nov 5, 2024

Tissue Therapy of Transsphincteric Anal Fistula

A Phase 1/2 interventional study of ADRC injection and ADRC001 injection in Anal Fistula, sponsored by University of Southern Denmark. Recruiting at 1 site in Denmark. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-05.

Sponsored by University of Southern Denmark · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
75
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This clinical study aims to evaluate the outcome of the treatment of complex perianal fistulas (PAF) by the combination of minimal surgical debridement with regenerative cellular therapeutics.

Read the detailed description

After being informed about the study and potential risks, all patients giving written informed consent will undergo screening serology and preoperative work-up to determine eligibility for study entery. Patients who meet the eligibility requirements will be treated for their fistulas by combined minor surgical debridement of the fistula tract and closure of the internal orifice as well as liposuction from the abdominal wall. Regenerative cells- enriched lipoaspirate will be injected around the entire length of the fistula tract. The first five patients will receive their own regenerative cells and act as donors for the next included patients, but they will not be included in the final analysis. The rest of the included patients (70) will be randomized in double-blinded manner (participant and investigator) in a 1:1 ratio to either recieve own regenerative cells (ADRC Adipose-Derived Regeneative Cells) or donated cultured regenerative cells (ADRC001). All included patients will be scheduled for follow-up at 3, 6 and 12 months after treatment.

02

Conditions studied

  • Anal Fistula

Keywords

  • anal fistula
  • stem cells
  • ADRC
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Adult patients (>= 18years) with complex anal fistula (high transsphincteric or suprasphincteric), with involvement of more 30% of the anal sphincter referred to the surgical department at Odense University Hospital for treatment, and who are:

  • able to communicate with Danish language
  • able to provide informed consent
  • having address in the region of southern Denmark during the study

Exclusion criteria

Exclusion criteria:

  1. Signs of suppuration/cavitation around the fistula
  2. Simple or low anal fistula, which can be treated by simple surgical incision
  3. Ano-vaginal and recto-vaginal fistula
  4. The presence of more than one fistula tract, more than two external orifices or more than one internal orifice
  5. Inflammatory Bowel Disease
  6. Immunosuppression (due to clinical condition or medical therapy)
  7. Malignancy within 5 years
  8. Previous radiotherapy of the abdomen and pelvis
  9. BMI under 18.5
  10. Allergy against the antibiotics: Penicillin and streptomycin.
  11. Coagulopathy
  12. Pregnancy and lactation (positive HCG (human chorionic gonadotropin) test)
  13. Verified syphilis, HIV, or hepatitis on screening test
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
75 participants (estimated)

Study arms

  • Experimental
    Autologous ADRC

    Allocated patients will be treated for the fistula by combined surgical debridement of the fistula tract, closure of the internal orifice and injection of 30 ml lipoaspirate around the entire length of the fistula tract. Lipoaspirate will be harvested from the anterior abdominal wall under the same operation. Two hours later, the patient will receive injection of 5 ml suspension including 30 million autologous adipose-derived regenerative cells ADRC and injected at the same site of the lipoaspirate injection.

    Drug: ADRC injection

  • Experimental
    allogenic ADRC001

    Allocated patients will be treated for the fistula by combined surgical debridement of the fistula tract, closure of the internal orifice and injection of 30 ml lipoaspirate around the entire length of the fistula tract. Lipoaspirate will be harvested from the anterior abdominal wall under the same operation. Two hours later, the patient will receive injection of 5 ml suspension including 30 million cultured allogenic adipose-derived regenerative cells ADRC001 and injected at the same site of the lipoaspirate injection.

    Drug: ADRC001 injection

Interventions

  • DrugADRC injection

    Allocated patients will receive injection of 5 ml suspension including 30 million autologous adipose-derived regenerative cells ADRC and injected at the same site of the lipoaspirate injection.

    Also known as: Liposuction, Surgical debridement of fistula tract and closure of internal orifice, Injection of lipoaspirate

  • DrugADRC001 injection

    Allocated patients will receive injection of 5 ml suspension including 30 million allogenic adipose-derived regenerative cells ADRC001 and injected at the same site of the lipoaspirate injection.

    Also known as: Liposuction, Surgical debridement of fistula tract and closure of internal orifice, Injection of lipoaspirate

05

What researchers measure

Primary outcomes

  1. Healing rate (percentage)

    Clinical healing is defined as closure of the external opening(s), absence/cessation of discharge and swelling by palpation.

    Time frame: at 6 and 12 months follow-up

Secondary outcomes

  1. QoL

    functional outcome regarding quality of life, measured by Short Form SF-36 Rand questionnaire.

    Time frame: at12 months follow-up.

  2. Fecal Incontinence

    functional outcome regarding fecal incontinence, measured by Wexner Fecal Incontinence score.

    Time frame: at12 months follow-up.

  3. Risk factors for recurrence of fistula.

    Risk factors for recurrence of fistula including demography, prevoius surgery for fistula, disease duration and treatment arm.

    Time frame: at12 months follow-up.

  4. Radiological healing.

    Radiological healing, defined as no visible fistula or fluid collection more than 5 mm at MR imaging.

    Time frame: at12 months follow-up.

  5. Treatment efficacy.

    comparison of the healing rate of the fistula between patients receiving ADRC and patients receiving ADRC001 (autologous vs. allogenic cells)

    Time frame: at12 months follow-up.

  6. Cellular composition

    Definition of the cellular compisition of the ADRC and ADRC001 regarding cellular surface markers (CD14, CD31, CD34, CD45, CD73, CD90, CD105, CD235a, HLA-ABC og HLA-DR) using flowcytometry.

    Time frame: at 3 months follow-up.

  7. Transplantation-related alloantibodies

    Registration of the number of patients developing serum alloantibodies specific to donor genotypes, by assessment of anti-HLA (class I and II).

    Time frame: at12 months follow-up.

06

Study locations

1 of 1 sites recruiting
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT06303752
Lead sponsor
University of Southern Denmark
Responsible party
Karam Matlub Sørensen, PhD (Primary Investigator (PI), University of Southern Denmark) — Principal investigator
First posted
Mar 12, 2024
Start date
Oct 9, 2024
Primary completion
Oct 8, 2027 (estimated)
Completion
Oct 8, 2028 (estimated)
Last update
Nov 5, 2024

Study contacts

Karam M Sørensen, Ph.D
Contact
ouh.a.forskningsenheden@rsyd.dk
+4565415190
Tina D Hansen
Contact
ouh.a.forskningsenheden@rsyd.dk
+4565415190
Karam M Sørensen
principal investigator · OUH

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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