MediWound Ltd. has published groundbreaking clinical evidence demonstrating a strong correlation between wound bed preparation and wound closure in patients with chronic venous leg ulcers. The post hoc analysis, published in Advances in Wound Care, provides the first clinical evidence supporting wound bed preparation as a critical step in the healing process for these challenging wounds.
Clinical Evidence from 119 Patients
The analysis examined data from 119 chronic venous leg ulcer patients who were randomized in a 3:3:2 ratio to receive up to two weeks of daily treatments with either EscharEx, a placebo gel vehicle, or non-surgical standard of care, followed by standard dressings applied weekly for 12 weeks. Wound bed preparation was defined as complete removal of nonviable tissue and full coverage of the wound bed with healthy granulation tissue.
The study compared wound closure rates between patients who achieved wound bed preparation by day 14 and those who did not, as well as between those who achieved wound bed preparation at any time during the study period versus those who never achieved it.
Significant Clinical Outcomes
The analysis revealed compelling statistical evidence for the importance of wound bed preparation in chronic wound healing:
- Wounds that achieved wound bed preparation were 4.1 times more likely to close compared to those that did not (p = 0.0004)
- Wounds that failed to achieve wound bed preparation had a 90% probability of not healing, representing a negative predictive value of 90%
- Early achievement of wound bed preparation within 14 days was associated with a significantly increased likelihood of healing (Relative Risk = 2.4, p = 0.0005)
- Wounds that failed to reach wound bed preparation had a 12-fold higher risk of remaining unhealed throughout the study period (Hazard Ratio = 12, p < 0.0001)
Expert Commentary on Clinical Significance
Dr. Marissa J. Carter, a clinical trial specialist and biostatistician focused on chronic wound care research, emphasized the broader implications of the findings: "While wound bed preparation has long been accepted as the conceptual foundation for managing chronic wounds, this landmark analysis provides evidence, for the first time, that there is a strong correlation between the two. Importantly, the findings indicate a high negative predictive value associated with the lack of wound bed preparation. In other words, wounds that are not adequately prepared are highly unlikely to proceed to closure, underscoring the essential role of wound bed preparation in the healing process. Without adequate wound bed preparation, chronic wounds rarely heal."
EscharEx Therapeutic Profile
EscharEx is a bromelain-based, bioactive enzymatic therapy designed for topical, once-daily application in the debridement of chronic and hard-to-heal wounds. The therapy has demonstrated a favorable safety profile and effective wound bed preparation capabilities in multiple Phase II trials, showing the ability to remove non-viable tissue, promote granulation tissue, and reduce bioburden and biofilm.
The data validates EscharEx's therapeutic potential to improve healing outcomes by accelerating wound bed preparation in patients with venous leg ulcers. EscharEx has shown clinical advantages over the leading enzymatic debridement product and targets a substantial global market opportunity.
Development Pipeline Progress
A global Phase III study in venous leg ulcers is currently underway, with a clinical study in diabetic foot ulcers in preparation. The company is also advancing its FDA-approved biologic NexoBrid, which is indicated for the enzymatic removal of eschar in thermal burns and is marketed in the U.S., European Union, Japan, and other international markets.
