Nu-3 Gel for Infected Diabetic Foot Ulcers

Phase 2

Not yet recruiting

• Conditions: Diabetic Foot Infection
• Interventions: Drug: 5% Nu-3 gel; Drug: 10% Nu-3 gel; Drug: Placebo

• Registration Number: NCT06020235
• Lead Sponsor: Lakewood-Amedex Inc

Brief Summary

The goal of this clinical trial is to test a topical drug in patients with mild infections of their diabetic foot ulcer. The main questions it aims to answer are:

What strength does the drug need to be in order to make the infection better? How frequently does the drug need to be applied in order to make the infection better? Participants will be asked to apply the medicine on their foot ulcer twice a day for 2 weeks and remain off of that foot during that time.

Participants will receive the medication either once a day or twice a day, in either a 5% or 10% gel, or placebo.

Researchers will compare the 5% and 10% gels to placebo to see if the infection improves.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2023-08-08
• Study First Submitted QC: 2023-08-27
• Study First Posted: 2023-08-31
• Status Verified: 2025-03
• Last Update Submitted: 2025-03-03
• Last Update Posted: 2025-03-06
• Study Start: 2025-12
• Primary Completion: 2026-06
• Study Completion: 2026-08

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• 1. Male and female subjects ≥18 years of age. 2. Voluntary written informed consent, including information about the provisions of the Health Insurance Portability and accountability act (HIPAA) as applicable.

  2. Non-hospitalized ambulatory subjects diagnosed with diabetes mellitus, Type I or II per ADA criteria with signs of a localized mild foot infection as defined by the IDSA infection severity criteria (Lipsky,2012)

  a. the presence of purulent drainage or at least two of the following criteria: i. erythema, ii. warmth, iii. pain or tenderness, iv. edema, or v. induration (The diagnosis of mild infection must be confirmed immediately following debridement at Baseline).

  4. The target ulcer is classified as a grade 1 ulcer according to the Wagner Scale (Wagner 1979). The ulcer is a superficial, full-thickness ulcer limited to the dermis, not extending to the subcutis. Target ulcer is >1 cm2 and <12 cm2 post debridement at baseline and must be no higher than the ankle, on or below the malleolus (ankle bone) with ≥50% below the malleolus.

  5. Adequate vascular perfusion as evidenced by one of the following:

  6. Dorsal transcutaneous oxygen measurement (TCOM) or a skin perfusion pressure (SPP) measurement of ≥ 40 mmHg

  7. Ankle Branchial Index (ABI) between 0.9 and 1.3 within 3 months of Screening using the extremity with the target ulcer.

  8. Arterial Doppler ultrasound evaluating for biphasic or triphasic dorsalis pedis and posterior tibial vessels at the level of the ankle or a TBI (Toe Brachial Index) of >0.75.

     6. Subject has a caregiver who will attend the Baseline visit (V2) and/or watch the dosing and dressing demonstration video and apply wound treatment along with study dressings for the study duration.

     7. Must meet one of the following criteria:

  a. Female subjects of Non-Child-Bearing Potential i. Postmenopausal for at least 1 year ii. Surgically sterilized (i.e., hysterectomy or bilateral oophorectomy more than 3 months prior to Screening) iii. Bilateral tube ligation > 6 months prior to screening iv. A negative serum β-hCG pregnancy test at screening and no breastfeeding after the administration of the study drug.

  b. Male subjects of Non-Childbearing Potential defined as: i. Vasectomized subjects for > 6 months prior to Screening ii. Those diagnosed as sterile by a physician. c. Females and Males of Childbearing Potential who practice an acceptable method of contraception defined as the i. Use of any form of hormonal contraceptive ii. Use of a barrier method with spermicide, condoms, intrauterine device, iii. Abstinence from sexual intercourse starting at least 60 days prior to Screening and continuing at least 14 days following the last treatment.

  8. Subjects must be willing to undergo all clinical investigation-related procedures, attend all required visits, and cooperate fully with the investigator and site personnel.

  9. Subject must be willing to wear offloading RCW, if necessary, throughout the duration of the clinical treatment.

  10. Subject must have plain radiograph taken at screening and prior to randomization showing no evidence of bony abnormalities consistent with osteomyelitis, or gas compatible with tissue crepitus, in the affected foot.

Exclusion Criteria

• 1. Ulceration with exposed tendon, capsule, or bone 2. IDSA-defined moderate or severe DFU infection. 3. Infected diabetic foot ulcer that is associated with local wound complication such as prosthetic materials or protruding surgical hardware.

  2. > 1 infected foot ulcer 5. Subject is currently receiving topical antimicrobial treatment for a localized infection of the study ulcer and whose infection is improving in response to treatment.

  3. Subject has received a systemic antibiotic within 48 hours prior to Screening.

  4. Concurrent or expected to require systemic antimicrobials during the study period for any infection including diabetic foot ulcer.

  5. Any subject that has active viral hepatitis (A, B, C) and/or untreated HIV/AIDS.

  6. Any subject that has vascular compromise requiring surgical intervention or has undergone vascular reconstruction or angioplasty less than 1 month prior to randomization. Any planned surgical procedures during the study participation 10. eGFR <60 and/or subject on hemodialysis within 3 months prior to randomization.

  7. Hemoglobin A1c (HbA1c) >12% within 3 months prior to randomization. 12. Aspartate Aminotransferase (AST, GOT) and/or Alanine Aminotransferase (ALT, GPT) >3.0 x the upper limit of normal and/or bilirubin >1.5 x the upper limit of normal within 3 months prior to randomization.

  8. Acute active Charcot foot 14. Any subject that would be unable to safely monitor the infection status at home and return for scheduled visits.

  9. History of immunosuppression within 3 months prior to randomization, or taking immunosuppressive agents including systemic corticosteroids, except stable daily doses of 5 mg/day or less for chronic conditions 16. Any subject with a life expectancy ≤ 6 months 17. Use of investigational drugs within 28 days prior to screening 18. Use of Aspirin® or acetylsalicylic acid containing medication (except low-dose aspirin) < 7 days before baseline, 19. Use of oral anticoagulants (e.g., warfarin, Xarelto® or comparable products).

  10. History of concurrent condition that, in the Investigator's opinion, would jeopardize the safety of the subject or compliance with the protocol including known or suspected active abuse of alcohol, narcotics, or non-prescription drugs.

  11. Prior randomization in this clinical trial, or a previous Bisphosphocin study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
5% Nu-3 gel once daily	5% Nu-3 gel	The 5% Nu-3 gel is applied once per day and placebo is applied once per day.
5% Nu-3 gel once daily	Placebo	The 5% Nu-3 gel is applied once per day and placebo is applied once per day.
5% Nu-3 gel twice daily	5% Nu-3 gel	The 5% Nu-3 gel is applied twice per day.
10% Nu-3 gel once daily	10% Nu-3 gel	The 10% Nu-3 gel is applied once per day and placebo is applied once per day.
10% Nu-3 gel once daily	Placebo	The 10% Nu-3 gel is applied once per day and placebo is applied once per day.
10% Nu-3 gel twice daily	10% Nu-3 gel	The 10% Nu-3 gel is applied twice per day.
Placebo	Placebo	The placebo is applied twice per day.

Primary Outcome Measures

Name	Time	Method
Safety	Day 0 to Day 28	Number of AEs overall and those assessed by the investigators as possibly, probably, and definitely related to the study drug; number of SAEs per patient and cohort
Efficacy	Day 0 to Day 14	The rate of reduction in CFUs by \>=2 logs per pathogen identified as typical and highly suspicious for being the cause of the infection, in each treatment group compared to placebo group at Day 7 compared to Day 0, and Day 14 compared to Day 0.

Secondary Outcome Measures

Name	Time	Method
Pharmacokinetics	Day 0 to Day 13	Maximum concentration in the first 20 patients sampled for PK across all dosing groups after initial and repeated dosing
Treatment failure rate per treatment regimen	Day 0 to Day 14	Number of treatment failures, defined as need to switch to oral antibiotic treatment based on clinical wound-infection assessment by the PI, per cohort
Safety	Day 0 to Day 28	Change in parameters indicative of skin irritation and/or skin sensitization compared to baseline