Phase IV Study to Evaluate the Efficacy of AMNIOEXCEL in Diabetic Foot Ulcers

Not Applicable

Completed

• Conditions: Diabetic Foot Ulcers
• Interventions: Other: Standard of Care, Diabetic Foot Ulcers; Other: AMNIOEXCEL

• Registration Number: NCT02209051
• Lead Sponsor: Integra LifeSciences Corporation

Brief Summary

The primary goal of the study is to demonstrate the increased rate of complete wound closure by AMNIOEXCEL® compared to routine care in patients with chronic diabetic foot ulcers

Detailed Description

Potential study candidates will be Screened for Inclusion and Exclusion criteria after providing informed consent. Candidates will have their wound cleansed and debrided (if necessary), photographed and measured. Blood will be drawn for laboratory analyses. Patients will return two weeks later for assessment.

Upon return, per the original protocol, patient would have been randomized at \<20% closure; per Amendment 1, if the wound has closed \<30% in area during the 2 week Screening Period and all other eligibility criteria are met, the patient will be randomized (1:1) to receive either AMNIOEXCEL® with Standard of Care (SOC) or SOC alone.

All patients enrolled in this study will receive SOC. For the purposes of this study, Standard of Care (SOC) includes debridement of necrotic/non-viable tissue, moist wound dressings, off-loading (where appropriate, DH Walker only) and infection surveillance and management. For those randomized to receive AMNIOEXCEL®, in addition to SOC, the tissue will be applied after the wound has been debrided and hemostasis achieved. The wound will then be dressed with a non-adherent dressing (e.g. Adaptic) and covered with a moisture retentive dressing.

The patient will return once weekly for wound care, photographs and ulcer measurement. At each visit, the wound will be assessed and AMNIOEXCEL® reapplied as appropriate, based upon physician judgment. All patients complete their participation at Week 6.

This is an open label study and no attempt will be made to blind subjects or Investigators to randomization allocation.

Study Timeline

• Study Start: 2014-07
• Study First Submitted: 2014-07-31
• Study First Submitted QC: 2014-08-04
• Study First Posted: 2014-08-05
• Primary Completion: 2015-08
• Study Completion: 2015-08
• Status Verified: 2017-11
• Last Update Submitted: 2017-11-30
• Last Update Posted: 2017-12-02

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

1. an ambulatory person at least 18 years of age at the time of informed consent.

2. type 1 or type 2 diabetes mellitus.

3. glycosylated hemoglobin (HbA1c) of ≤12%

4. at least one wound that is/has:

   • Wagner grade 1 or superficial 2 (without bone, tendon or joint exposure),
   • duration of at least 1 month,
   • no clinical signs of infection or osteomyelitis,
   • between 1cm2 and 25cm2 in area,
   • per original protocol, closed <20% in area during the Screening Period; per Amendment #1, closed <30% in area during Screening and
   • located on the foot, distal to malleoli.

5. adequate circulation to the affected extremity

6. serum creatinine of <3.0mg/dl.

Exclusion Criteria

1. participated in another clinical trial within 30 days prior to consent,
2. Active Charcot deformity of the study foot (i.e. erythematous, warm, edematous and actively remodeling)
3. receiving radiation or chemotherapy of any kind,
4. known or suspected malignancy of current ulcer,
5. pregnant or breast feeding,
6. an active malignant disease,
7. receiving hemo- or peritoneal dialysis,
8. sickle cell anemia or Raynaud's syndrome,
9. diagnosis of autoimmune connective tissue disease,
10. received a biologic agent, growth factor, xenograft or skin equivalent in the 30 days prior to consent,
11. exposed bone, tendon or joint capsule in the study ulcer,
12. currently receiving antibiotics (for any reason), or
13. taking medications considered to be immune system modulators.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard of Care, Diabetic Foot Ulcers	Standard of Care, Diabetic Foot Ulcers	Advanced wound care dressings and offloading of wound.
AMNIOEXCEL	AMNIOEXCEL	Human Amniotic Membrane Allograft
AMNIOEXCEL	Standard of Care, Diabetic Foot Ulcers	Human Amniotic Membrane Allograft

Primary Outcome Measures

Name	Time	Method
Proportion of patients with complete wound closure (i.e. complete skin re-epithelialization without drainage or dressing requirements) at 6 weeks after initiation of study treatment	8 weeks

Secondary Outcome Measures

Name	Time	Method
Time to complete wound closure of the target ulcer	8 weeks
Rate of wound closure	8 Weeks
Incidence, severity and type of adverse events	8 Weeks	This outcome measure represents a composite of collected adverse event data.
Changes in Quality of Life assessment	8 Weeks

Trial Locations

Locations (8)

Center for Clinical Research, Inc.; 🇺🇸 Castro Valley, California, United States

Beth Israel Deaconess Hospital - Plymouth; 🇺🇸 Plymouth, Massachusetts, United States

Barry University Clinical Research; 🇺🇸 North Miami Beach, Florida, United States

Duke University; 🇺🇸 Durham, North Carolina, United States

First Coast Cardiovascular Institute; 🇺🇸 Jacksonville, Florida, United States

Pacific Wound Center; 🇺🇸 Stockton, California, United States

Wayne Memorial Hospital; 🇺🇸 Goldsboro, North Carolina, United States

Associated Foot and Ankle Specialists, LLC; 🇺🇸 Phoenix, Arizona, United States