MediWound Ltd. has announced the initiation of its Phase III VALUE trial to assess the efficacy and safety of EscharEx in treating venous leg ulcers (VLUs). The global, multicenter, prospective, randomized, double-blind, placebo-controlled trial will be conducted across 40 sites in the U.S. and Europe, enrolling 216 patients. This trial marks a significant step in MediWound's strategy to strengthen its market position and the commercial potential of EscharEx.
The primary objective of the VALUE trial is to evaluate EscharEx's ability to achieve effective debridement and prepare the wound bed for healing in VLUs. Patients will be randomized 1:1 to receive either EscharEx or a placebo, with up to eight daily applications over two weeks, followed by ten weeks of standardized wound management. Patients who achieve wound bed preparation will receive a cellular/tissue-based product (CTP) or an autograft, and those with complete wound closure will be monitored for an additional 12 weeks.
Study Endpoints and Design
The co-primary endpoints of the VALUE study are the incidence of complete debridement and the incidence of complete wound closure. Secondary endpoints include the incidence of complete granulation tissue, time to debridement, time to complete wound closure, and changes in wound area. The safety and tolerability of EscharEx will be assessed throughout the trial. An interim sample size assessment is planned after 65% of patients complete treatment, expected in mid-2026, allowing for potential adaptive adjustments.
Strategic Collaborations
To support the trial, MediWound has established strategic research collaborations with Solventum, Mölnlycke, and MIMEDX. These industry leaders will provide advanced products to ensure consistent wound management across all study sites and optimize patient outcomes.
Current Treatment Landscape and Unmet Needs
Venous leg ulcers affect approximately 2% of individuals aged 65 and older, with over 1.5 million new cases reported annually in the U.S. These ulcers typically develop on the lower extremities due to chronic venous insufficiency and are characterized by large, shallow wounds that can cause severe pain, infection, and disability. Debridement, a critical first step in managing these wounds, is performed in 68% of cases and is commonly achieved through enzymatic methods, autolytic debridement, or sharp debridement.
According to MediWound CEO Ofer Gonen, EscharEx has the potential to redefine the standard of care for chronic wound debridement, as there have been no new FDA-approved drugs in this category since 1965. Phase II trials have demonstrated EscharEx's ability to effectively and rapidly debride chronic wounds, surpassing the current market leader in wound debridement, Santyl.
Future Studies
In addition to the VALUE study, MediWound plans to initiate a randomized, head-to-head Phase II study in 2025, comparing EscharEx to collagenase in VLU patients. This Phase II trial is designed to support the U.S. Biologics License Application (BLA) submission for EscharEx and strengthen MediWound’s commercialization strategy. Furthermore, the company is advancing preparations for an adaptive design Phase II/III clinical trial targeting diabetic foot ulcers (DFUs), which is expected to begin in 2026.
About EscharEx
EscharEx is a bioactive, multimodal debridement therapy for the treatment of chronic and other hard-to-heal wounds, currently in advanced clinical development stages. It comprises a concentrate of proteolytic enzymes enriched with bromelain, designed for topical and easy-to-use daily applications. Previous Phase II trials have shown EscharEx to be safe and well-tolerated, demonstrating efficacy in debridement, the promotion of granulation tissue, and the reduction of bioburden and biofilm in various hard-to-heal wounds.
