Adipose tissue-derived stromal vascular fraction for treating hands of patients with systemic sclerosis: a multicentre randomized trial Autologous AD-SVF versus placebo in systemic sclerosis

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Daumas, Aurélie | Magalon, Jérémy | Jouve, Elisabeth | Casanova, Dominique | Philandrianos, Cécile | Abellan Lopez, Maxime | Mallet, Stéphanie | Veran, Julie | Auquit-Auckbur, Isabelle | Farge, Dominique | Levesque, Hervé | Benhamou, Ygal | Arnaud, Laurent | Giraudo, Laurent | Dumoulin, Chloé | Giverne, Camille | Boyer, Olivier | Giuliani, Alexandra | Bourgarel, Véronique | Harlé, Jean-Robert | Schleinitz, Nicolas | Brunet, Julie | Pers, Yves-Marie | Ferreira, Rosanna | Cras, Audrey | Bocara, David | Larghero, Jérôme | Château, Joseph | Hot, Arnaud | Dignat-George, Françoise | Magalon, Guy | Sabatier, Florence | Granel, Brigitte

Edité par CCSD ; Oxford University Press (OUP) -

International audience. Objective: To assess the superiority of adipose tissue-derived stromal vascular fraction (AD-SVF) injection into the fingers vs placebo in reducing hand disability in systemic sclerosis (SSc) patients.Methods: We performed a double-blind, multicentre, phase II trial from October 2015 to January 2018 in France. SSc patients with a Cochin Hand Function Scale (CHFS) ≥20/90 were randomized 1:1 to receive injection of AD-SVF or placebo. AD-SVF was obtained using the automated processing Celution®800/CRS system. The placebo was lactated Ringer's solution. The primary efficacy end point was the change of the CHFS score from baseline to 3 months. Secondary efficacy endpoints included the CHFS score at 6 months, hands function, vasculopathy, hands pain, skin fibrosis, sensitivity of the finger' pulps, Scleroderma Health Assessment Questionnaire, patients and physician satisfaction and the safety.Results: 40 patients were randomized. The AD-SVF and placebo groups were comparable for age, sex ratio, disease duration, skin fibrosis of the hands and main cause of hand disability. After 3 month-follow-up, hand function significantly improved in both groups with no between-group difference of CHFS (mean change of -9.2 ± 12.2 in the AD-SVF group vs -7.6 ± 13.2 in the placebo group). At 6 months, hand function improved in both groups.Conclusion: This study showed an improvement of hand function in both groups other time, with no superiority of the AD-SVF. Considering the limits of this trial, studies on a larger population of patients with homogeneous phenotype and hand handicap, should be encouraged to accurately assess the benefit of AD-SVF therapy.

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