Full-thickness wound in athymic (nude) mice grafted with Apligraf
“The purpose of this study was to characterize the in vivo tissue maturation, remodeling, and cellular persistence of Apligraf in a full-thickness wound in athymic mice.”
✓ VerifiedFDA pharmacology/toxicology review, p. 16Source ↗
Why that model
Already approved as a device (PMA) for ulcers, so limited additional preclinical studies were done
“Apligraf®, which is identical to Apligraf® (oral), is approved under a PMA filing (reviewed by CDRH) for the treatment of venous leg and diabetic foot ulcers; therefore, limited additional preclinical studies were conducted in support of this BLA.”
✓ VerifiedFDA pharmacology/toxicology review, p. 48Source ↗
Reviewer's view of the efficacy data
Murine wound models did not directly support the proposed healing-by-secondary-intention mechanism; graft behaved as a skin graft
“Although the sponsor’s hypothesis is that Apligraf® functions to enhance wound healing by secondary intention, the results from the in vivo studies in the murine wound models did not provide direct evidence to support this position.”
✓ VerifiedFDA pharmacology/toxicology review, p. 49Source ↗
autologous cultured chondrocytes on porcine collagen membrane · Autologous chondrocytes
Analogous MACI (animal cells on same membrane) in critical-sized knee/stifle cartilage defects in rabbits and horses: improved repair vs membrane alone or empty defect