Kusumanto 2006.
Methods |
Study design: multi‐centre double‐blind placebo‐controlled RCT Intention‐to‐treat: not specified but all participants evaluated for all endpoints Country: The Netherlands |
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Participants |
Number randomised: N = 54 (phVEGF165 n = 27; placebo n = 27) Losses to follow‐up and withdrawals: N = 0 Age (mean years (range)): phVEGF165 68.7 (45 to 85); control 68.4 (40 to 84) Gender (M): phVEGF165 59.2%; control 55.6% Inclusion criteria: type 1 or type 2 diabetes mellitus established according to current American Diabetes Association criteria; evidence of CLI including rest pain and/or ulcers that had not healed for a minimum of 2 weeks despite conventional therapy; compressible vessels with resting ankle systolic blood pressure < 50 mmHg or toe systolic blood pressure < 30 mmHg; unsuitable candidates for surgical or percutaneous revascularisation judged after contrast angiography by vascular surgeon and intervention radiologist Exclusion criteria: active proliferative diabetic retinopathy; history of malignancy; severe comorbidity, compromising comedications |
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Interventions |
Treatment: phVEGF165, 2000 µg, on days 0 and 28, 4 aliquots, 500 µg each, diluted in 1.0 mL NaCl, injected intramuscularly into the thigh and calf of the most ischaemic limb; injection sites chosen arbitrarily according to available muscle mass Control: placebo, on days 0 and 28 |
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Outcomes |
Follow‐up times: days 7, 14, 35, 42, 72, and 100 Outcomes: Amputation, ABI, TBI, Skin improvements, Pain, QoL using RAND‐36 questionnaire, Safety outcomes |
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Notes | Study period: February 2000 to January 2004 | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | Computerised block randomisation without stratification or matching, performed by the pharmacy of the University Medical Center Groningen |
Allocation concealment (selection bias) | Unclear risk | Not specified how allocation concealment was carried out |
Blinding of participants and personnel (performance bias) All outcomes | Low risk | Reported as double‐blind; "no difference between the phVEGF165 and placebo could be seen or felt by the physician who performed the injection" |
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 | Low risk | All participants accounted for |
Selective reporting (reporting bias) | Low risk | All outcomes reported |
Other bias | Unclear risk | Supported by a grant from Fornix BioSciences |