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Diabetic Peripheral NeuropathyNCT04720170

Exploratory Study of the Efficacy of Standard of Care Revascularization of the Lower Extremity

A study testing Revascularization in people with Diabetic Peripheral Neuropathy, run by Diabetes and Glandular Disease Clinic at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to evaluate the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for diabetic peripheral neuropathy. Read more about this study

Who is it for?
Ages 30 to 80 years
Conditions the study is for
Diabetic Peripheral Neuropathy
What is being tested?
Revascularization
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
15 Feb 2021to 15 Sep 2021
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female age 30 to 80 years (inclusive at first screening visit)
  • Clinical diagnosis of type 1 or type 2 diabetes as diagnosed by HbA1c ≥ 6.5% or current treatment
  • Clinical signs and symptoms of diabetic peripheral neuropathy bilaterally affecting the lower extremities, in the investigator's opinion, which may include neuropathic symptoms (e.g., numbness, tingling, burning sensation, sharp pains, sensitivity to touch) and decreased distal sensation (e.g., decreased vibration, pinprick or pain sensation, monofilament)
  • HbA1c ≤ 11% (historical results allowed if performed within the past 90 days)
  • Females of child-bearing potential who are willing to use contraceptive measures to prevent pregnancy for the duration of the study
  • Willing to attend all scheduled study visits and undergo all study procedures
Show all 9Show fewer
  • Clinical diagnosis of Peripheral Artery Disease (PAD)
  • Be able to understand, speak, read and write English
  • Have medical insurance or financial means to cover the cost of the revascularization procedure and follow-up visits with the Interventional Radiologist

Who cannot join

  • Inability to undergo angiogram with revascularization
  • Unilateral neuropathic findings or symptoms
  • Vitamin B-12 level < 400 pg/ml (historical results allowed if performed within the past 30 days) *
  • Known causes of peripheral neuropathy other than diabetes, e.g., Amyloidosis, Tangier disease, Fabry's disease, hereditary sensory autonomic neuropathy, alcohol-related neuropathy, drug-induced neuropathy (e.g., chemotherapy, antibiotics, anti-retroviral agents, other neurotoxic agents) hypothyroidism that is not well controlled, rheumatoid arthritis or autoimmune disorders requiring treatment with corticosteroids, anti-tumor necrosis factor or immune-modulating medicines
  • Known history of Hepatitis B, C, or HIV
  • Lower limb amputation, including toe
Show all 21Show fewer
  • Lower extremity inoperable occlusive vascular disease
  • Inability to provide informed consent
  • History of bleeding disorders
  • History of diabetic ulcers to the lower extremities
  • History of any surgical bypass of the lower extremities prior to randomization
  • History of previous revascularization of the lower extremities prior to randomization
  • End Stage Renal Disease (ESRD) requiring or on dialysis
  • Thyroid Stimulating Hormone -TSH >10.0 uu/mL*
  • Potassium > 5.5 mmol/L. *
  • Calcium < 8.5 mg/dL or > 11mg/dL *
  • Hemoglobin < 9.0 g/dL *
  • Female that is pregnant, breastfeeding or intends to become pregnant during the study period
  • Clinically significant abnormal ECG findings, in the opinion of the Investigator
  • Participation in another clinical trial with investigational drug or device at time of screening
  • Any other clinically significant disorders or prior therapy that, in the opinion of the Investigator, would make the participant unsuitable for the study or unable to comply with the protocol requirements

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Diabetes and Glandular Disease Clinic, P.A.

    San Antonio, Texas, 78229

Other trials in United States

About this study

Official title: Revascularization of the Lateral Plantar Artery and Anterior Pedal Loop of the Foot as Treatment for Diabetic Peripheral Neuropathy.

The purpose of this study is to evaluate the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for diabetic peripheral neuropathy.

Read the detailed description

This is a 26 week, single arm, single-site, Investigator-initiated, exploratory trial evaluating the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for participants with PAD, diabetic neuropathy and have a clinical diagnosis of type 1 or type 2 diabetes whose main symptoms are numbness and/or tingling of the feet with or without pain.

Participants who satisfy eligibility criteria may undergo standard of care revascularization of one lower extremity as required, with the addition of revascularization of the lateral plantar artery and anterior pedal loop followed by a 26-week follow-up phase. Standard of Care revascularization will be performed in any limb with ≥ 50% stenosis as determined by intra-vascular ultrasound (IVUS) at the time of planned study intervention.

Participants will be evaluated prior to intervention and at 2, 4, 14 and 26 weeks after the pedal loop intervention.

Being tested
Revascularization
Keywords
Diabetes, Type 1 Diabetes, Type 2 Diabetes, Neuropathy, Diabetic Peripheral Neuropathy, Peripheral Artery Disease, PAD
Medical subject headings
Diabetes Mellitus, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Peripheral Arterial Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • RevascularizationProcedure or surgery

    Angiogram and IVUS with revascularization of the lateral plantar artery and pedal arch on target foot.

Study groups in NCT04720170
Study groupRoleWhat they receive
Single ArmOtherThis is a 26 week, single arm, single-site, Investigator-initiated, exploratory trial evaluating the efficacy of the standard of care revascularization of the lower extremity with the addition of revascularization of the lateral plantar artery and anterior pedal loop of the foot as treatment for participants with PAD, diabetic neuropathy and have a clinical diagnosis of type 1 or type 2 diabetes whose main symptoms are numbness and/or tingling of the feet with or without pain.
Receives: Procedure: Revascularization

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Intra-epidermal Nerve Fiber Density

    Change from baseline in intra-epidermal nerve fiber density (IENFD) via skin biopsy of the revascularized foot over the extensor digitorum brevis muscle (EDBM) at week 26.

    Measured: 26 weeks

Secondary outcomes (7)
  1. Intra-epidermal Nerve Fiber Density

    Number and percent of participants whose IENFD have increased by at least 20% from baseline

    Measured: 14 and 26 weeks

  2. Utah Early Neuropathy Scale

    Number and percentage of participants with improvement on Utah Neuropathy Scale (UENS)

    Measured: 14 and 26 weeks

  3. Sural Nerve Action Potential Amplitude

    Number and percentage of participants with improvement of sural nerve action potential amplitude

    Measured: 14 and 26 weeks

  4. Sudoscan

    Number and percentage of participants with 20% improvement on Sudoscan

    Measured: 14 and 26 weeks

  5. Intra-epidermal Nerve Fiber Density

    Number and percentage of participants with improvement of intra-epidermal nerve fiber density

    Measured: 14 weeks

  6. Neuropathic Pain Syndrome Inventory

    Improvement in quality of life as measured by the Neuropathic Pain Syndrome Inventory

    Measured: 14 and 26 weeks

  7. Patency of Lateral Plantar Artery

    Number and percentage of participants with patency of lateral plantar artery per ultrasound

    Measured: 14 and 26 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jan 2021
  2. Study start15 Feb 2021 (estimated)
  3. Primary completion15 Jul 2021 (estimated)
  4. Study completion15 Sep 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
26 week, single arm, single site
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04720170
Sponsor's protocol ID
DBMK-001
Status last verified
Jan 2021
First submitted
20 Jan 2021
Last updated
22 Jan 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Study protocol and Informed Consent

Publications

  • Bouhassira D, Attal N, Fermanian J, Alchaar H, Gautron M, Masquelier E, Rostaing S, Lanteri-Minet M, Collin E, Grisart J, Boureau F. Development and validation of the Neuropathic Pain Symptom Inventory. Pain. 2004 Apr;108(3):248-257. doi: 10.1016/j.pain.2003.12.024.

    PubMed 15030944
  • Cameron NE, Eaton SE, Cotter MA, Tesfaye S. Vascular factors and metabolic interactions in the pathogenesis of diabetic neuropathy. Diabetologia. 2001 Nov;44(11):1973-88. doi: 10.1007/s001250100001.

    PubMed 11719828
  • Ibrahim S, Harris ND, Radatz M, Selmi F, Rajbhandari S, Brady L, Jakubowski J, Ward JD. A new minimally invasive technique to show nerve ischaemia in diabetic neuropathy. Diabetologia. 1999 Jun;42(6):737-42. doi: 10.1007/s001250051222.

    PubMed 10382594
  • Malik RA, Masson EA, Sharma AK, Lye RH, Ah-See AK, Compton AM, Tomlinson DR, Hanley SP, Boulton AJ. Hypoxic neuropathy: relevance to human diabetic neuropathy. Diabetologia. 1990 May;33(5):311-8. doi: 10.1007/BF00403326.

    PubMed 2376302
  • Newrick PG, Wilson AJ, Jakubowski J, Boulton AJ, Ward JD. Sural nerve oxygen tension in diabetes. Br Med J (Clin Res Ed). 1986 Oct 25;293(6554):1053-4. doi: 10.1136/bmj.293.6554.1053.

    PubMed 3094772
  • Ram Z, Sadeh M, Walden R, Adar R. Vascular insufficiency quantitatively aggravates diabetic neuropathy. Arch Neurol. 1991 Dec;48(12):1239-42. doi: 10.1001/archneur.1991.00530240043016.

    PubMed 1845025
  • Singleton JR, Bixby B, Russell JW, Feldman EL, Peltier A, Goldstein J, Howard J, Smith AG. The Utah Early Neuropathy Scale: a sensitive clinical scale for early sensory predominant neuropathy. J Peripher Nerv Syst. 2008 Sep;13(3):218-27. doi: 10.1111/j.1529-8027.2008.00180.x.

    PubMed 18844788
  • Tesfaye S, Harris N, Jakubowski JJ, Mody C, Wilson RM, Rennie IG, Ward JD. Impaired blood flow and arterio-venous shunting in human diabetic neuropathy: a novel technique of nerve photography and fluorescein angiography. Diabetologia. 1993 Dec;36(12):1266-74. doi: 10.1007/BF00400804.

    PubMed 8307254
  • Veves A, Donaghue VM, Sarnow MR, Giurini JM, Campbell DR, LoGerfo FW. The impact of reversal of hypoxia by revascularization on the peripheral nerve function of diabetic patients. Diabetologia. 1996 Mar;39(3):344-8. doi: 10.1007/BF00418351.

    PubMed 8721781
  • Young MJ, Veves A, Walker MG, Boulton AJ. Correlations between nerve function and tissue oxygenation in diabetic patients: further clues to the aetiology of diabetic neuropathy? Diabetologia. 1992 Dec;35(12):1146-50. doi: 10.1007/BF00401368.

    PubMed 1478366
  • Young MJ, Veves A, Smith JV, Walker MG, Boulton AJ. Restoring lower limb blood flow improves conduction velocity in diabetic patients. Diabetologia. 1995 Sep;38(9):1051-4. doi: 10.1007/BF00402174.

    PubMed 8591818

Questions about this trial

What is this clinical trial studying?

A study testing Revascularization in people with Diabetic Peripheral Neuropathy, run by Diabetes and Glandular Disease Clinic at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 22 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Terri L Ryan, RN (210-614-8612 ext. 1630, terri.ryan@dgdclinic.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Intra-epidermal Nerve Fiber Density (time frame: 26 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04720170, which also lists 11 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2021.

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