Deev 2015.
Methods |
Study design: multi‐centre phase IIb/III open‐label RCT Intention‐to‐treat: not specified; for PWD, n = 5 in treatment group and n = 1 in control group had amputation before enrolment and therefore could not perform treadmill test; reported "analyzed population in the study included 94 patients: 70‐in the test group and 24‐in the control group" Country: Russia |
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Participants |
Number randomised: N = 100 (pCMV‐vegf165 n = 75; control n = 25) Losses to follow‐up and withdrawals: not specified Age (mean years ± SD): pCMV‐vegf165 67.8 ± 9.0; control 70.9 ± 7.8 Gender (M): pCMV‐vegf165 80%; control 80% Inclusion criteria: inclusion decision made by a team of vascular surgeons and radiologists based on angiographic and echographic findings, history of the disease, previous procedures, and concomitant pathology; age > 40 years; history of stable claudication for at least 3 months; stage II to III chronic ischaemia according to Fontaine classification; absence of haemodynamically significant (> 70%) stenosis of the aortoiliofemoral arterial segment or (if present) a patent proximal bypass graft if revascularisation surgery was performed no earlier than 3 months before inclusion in the study; satisfactory patency of the deep femoral artery in the presence of haemodynamically significant femoropopliteal arterial lesions; presence of haemodynamically significant stenosis (stenosis > 70% and/or occlusion); diffuse lesions of the anterior and/or posterior tibial arteries; voluntary informed consent signed Exclusion criteria: CLI of non‐atherosclerotic genesis (autoimmune disorders, Buerger's disease, congenital abnormalities, vascular injuries, etc.); stage IV chronic ischaemia according to Fontaine classification; severe concomitant pathology with life expectancy < 1 year; infectious disease; history of cancer or suspected malignancy; decompensated diabetes mellitus |
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Interventions |
Treatment: pCMV‐vegf165 (Neovasculgen) ‐ intramuscular injection of 1.2 mg of pCMV‐vegf165, administered at 4 to 5 injection sites in the lower and middle thirds of the posterior part of the calf; a second 1.2‐mg injection administered 14 days after first treatment, in conjunction with standard treatment Control: standard treatment only |
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Outcomes |
Follow‐up times: 6 months, 1 and 2 years Outcomes: PWD, ABI, Blood flow velocity; Additionally QoL (SF‐36) at 6 months only; Safety (adverse events, blood and urine lab tests, chest X‐rays, and abdominal echography) |
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Notes |
Study period: protocol approved April 2010 NCT03068585 |
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Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | Insufficient information provided to determine adequate random sequence generation; randomised to 2 groups at a ratio of 3:1 |
Allocation concealment (selection bias) | Unclear risk | Insufficient information provided to determine allocation concealment |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Blinding not undertaken and not feasible due to the nature of treatment and control |
Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Insufficient information provided to determine blinding of outcome assessment |
Incomplete outcome data (attrition bias) All outcomes | Unclear risk | Losses and withdrawals not reported |
Selective reporting (reporting bias) | Unclear risk | ClinicalTrials.gov protocol states researchers will evaluate transcutaneous oximetry, but this is not reported in the results |
Other bias | Unclear risk | With 3:1 randomisation, there were only 25 participants in the control group, which limited the subgroup analysis; as stated in the report, no participants in the control group had stage IIa disease Sample size calculation estimated 28 participants in each group to detect a 0.75 standardised difference (80% power) Several study authors are employees of the OJSC Human Stem Cell Institute, which funded the study |