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Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With An Uninfected Foot Ulcer

Primary Purpose

Diabetic Foot Ulcer

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
gentamicin-collagen sponge
placebo collagen sponge
Sponsored by
Innocoll
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Diabetic Foot Ulcer focused on measuring Diabetes, Foot Ulcer

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Is a man or woman aged ≥ 18 and ≤ 80 years.
  • Has diabetes mellitus according to the American Diabetes Association criteria.
  • Has a single skin ulcer below the knee, defined as "uninfected" by the Infectious Disease Society of America Guidelines (Wound lacking purulence or any manifestations of inflammation).
  • Has had an x-ray of the affected area within the 2 days immediately preceding or at Visit 1 (Baseline/Randomization) that is negative for osteomyelitis.
  • Has an ankle-brachial index (ABI) ≥ 0.7 and ≤ 1.3. (Note: Patients with ABI < 0.7 or > 1.3 may be included if they have either a transcutaneous oxygen pressure or a toe pressure ≥ 40 mm Hg on the limb with the target ulcer.)
  • Meets certain minimal laboratory criteria.
  • If female, is nonpregnant (negative pregnancy tests at the Baseline/Randomization Visit) and nonlactating.
  • If female, is either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or practicing 1 of the following medically-acceptable methods of birth control and agrees to continue with the regimen throughout the study:

Oral, implantable or injectable contraceptives for 3 consecutive months before the Baseline/Randomization Visit.

Total abstinence from sexual intercourse (minimum of 1 complete menstrual cycle before the Baseline/Randomization Visit).

Intrauterine device (IUD). Double barrier method (condoms, sponge, diaphragm or vaginal ring with spermicidal jellies or cream).

  • Willing to return to the study facility for the Posttreatment Evaluation Visit.
  • Must be able to fluently speak and understand English and be able to provide meaningful written informed consent for the study.

Exclusion Criteria:

  • Has a known history of hypersensitivity to gentamicin (or other systemic aminoglycosides) or any of the test article or reference product components.
  • Has a known hypersensitivity to bovine collagen.
  • Has any uncontrolled illnesses that, in the opinion of the Investigator, would interfere with interpreting the results of the study.
  • Has a target ulcer with a wound size > 5 × 5 cm.
  • Has gangrene or infection of the affected limb.
  • Has a wound associated with prosthetic material or device.
  • Received any topical or systemic antimicrobial therapy within the 2 weeks prior to study entry (Visit 1 [Day 1]).
  • Has documented osteomyelitis.
  • If severely immunocompromised, may be excluded at the discretion of the Investigator.
  • Has a history of alcohol or substance abuse in the past 12 months.
  • Is undergoing dialysis (renal or peritoneal) or has history of kidney transplant.
  • Has history of myasthenia gravis or other neurological condition where gentamicin use is contraindicated as determined by the Investigator.

Sites / Locations

  • Chesapeake Foot and Ankle Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

A

B

Arm Description

Daily standard wound care and topical application of the gentamicin-collagen sponge twice weekly

Daily standard wound care and topical application of the placebo sponge twice weekly

Outcomes

Primary Outcome Measures

The percentage of patients who remain free of signs and symptoms of infection until the end of the study

Secondary Outcome Measures

Time (days) to complete wound closure
Time (days) to presence of ≥ 1 of the signs and symptoms of infection
Absolute and percent decrease in total wound surface area
Pathogen burden in patients who discontinue because of infection
Treatment emergent Adverse Events

Full Information

First Posted
April 10, 2008
Last Updated
March 22, 2012
Sponsor
Innocoll
Collaborators
Premier Research Group plc
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1. Study Identification

Unique Protocol Identification Number
NCT00658957
Brief Title
Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With An Uninfected Foot Ulcer
Official Title
A Phase II, Randomized, Parallel, Double-blind, Placebo-controlled Study to Assess Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With Uninfected Lower Extremity Skin Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
March 2012
Overall Recruitment Status
Terminated
Why Stopped
Business Decision
Study Start Date
April 2008 (undefined)
Primary Completion Date
October 2009 (Actual)
Study Completion Date
October 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Innocoll
Collaborators
Premier Research Group plc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine the safety and efficacy of the topical gentamicin collagen sponge (gentamicin sponge) combined with standard of care (daily wound care, off-loading, diabetic control and debridement by a physician or podiatrist), compared with placebo sponge combined with standard of care, in preventing infection of diabetic lower extremity skin ulcers.
Detailed Description
Infected skin ulcers with diabetes can be very debilitating because they are difficult to heal. Diabetic ulcers are responsible for frequent health care visits, and are a major predictor of amputation. Diabetic ulcers can be caused by a patient's inability to sense pain or warmth as well as peripheral vascular disease, which causes diminished blood flow to the foot. Early aggressive treatment is necessary to prevent infection and ultimately prevent the need for amputation. Gentamicin is an antibiotic that is effective in treating certain kinds of infection. Collagen is a protein that is found in all mammals. The gentamicin-collagen sponge is a thin flat sponge made out of collagen that comes from cow tendons and containing gentamicin. When applied to an open ulcer, the collagen breaks down and the gentamicin is released into the ulcer, but very little is absorbed into the blood stream. The high levels of gentamicin in the open infected ulcer may help treat the infection. In this study, all subjects will be given the necessary supplies and taught how to take care their foot ulcer. Subjects will be randomly assigned to receive either the gentamicin-collagen sponge or a plain collagen sponge. The sponge will be applied into the ulcer twice a week during the treatment period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcer
Keywords
Diabetes, Foot Ulcer

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
49 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
Daily standard wound care and topical application of the gentamicin-collagen sponge twice weekly
Arm Title
B
Arm Type
Placebo Comparator
Arm Description
Daily standard wound care and topical application of the placebo sponge twice weekly
Intervention Type
Drug
Intervention Name(s)
gentamicin-collagen sponge
Other Intervention Name(s)
Collatamp G
Intervention Description
5 × 5 cm sponge
Intervention Type
Drug
Intervention Name(s)
placebo collagen sponge
Intervention Description
5 × 5 cm sponge
Primary Outcome Measure Information:
Title
The percentage of patients who remain free of signs and symptoms of infection until the end of the study
Time Frame
Up to 3 months
Secondary Outcome Measure Information:
Title
Time (days) to complete wound closure
Time Frame
Actual time
Title
Time (days) to presence of ≥ 1 of the signs and symptoms of infection
Time Frame
Actual time
Title
Absolute and percent decrease in total wound surface area
Time Frame
End of Study
Title
Pathogen burden in patients who discontinue because of infection
Time Frame
Throughout study period
Title
Treatment emergent Adverse Events
Time Frame
Throughout study period

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is a man or woman aged ≥ 18 and ≤ 80 years. Has diabetes mellitus according to the American Diabetes Association criteria. Has a single skin ulcer below the knee, defined as "uninfected" by the Infectious Disease Society of America Guidelines (Wound lacking purulence or any manifestations of inflammation). Has had an x-ray of the affected area within the 2 days immediately preceding or at Visit 1 (Baseline/Randomization) that is negative for osteomyelitis. Has an ankle-brachial index (ABI) ≥ 0.7 and ≤ 1.3. (Note: Patients with ABI < 0.7 or > 1.3 may be included if they have either a transcutaneous oxygen pressure or a toe pressure ≥ 40 mm Hg on the limb with the target ulcer.) Meets certain minimal laboratory criteria. If female, is nonpregnant (negative pregnancy tests at the Baseline/Randomization Visit) and nonlactating. If female, is either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or practicing 1 of the following medically-acceptable methods of birth control and agrees to continue with the regimen throughout the study: Oral, implantable or injectable contraceptives for 3 consecutive months before the Baseline/Randomization Visit. Total abstinence from sexual intercourse (minimum of 1 complete menstrual cycle before the Baseline/Randomization Visit). Intrauterine device (IUD). Double barrier method (condoms, sponge, diaphragm or vaginal ring with spermicidal jellies or cream). Willing to return to the study facility for the Posttreatment Evaluation Visit. Must be able to fluently speak and understand English and be able to provide meaningful written informed consent for the study. Exclusion Criteria: Has a known history of hypersensitivity to gentamicin (or other systemic aminoglycosides) or any of the test article or reference product components. Has a known hypersensitivity to bovine collagen. Has any uncontrolled illnesses that, in the opinion of the Investigator, would interfere with interpreting the results of the study. Has a target ulcer with a wound size > 5 × 5 cm. Has gangrene or infection of the affected limb. Has a wound associated with prosthetic material or device. Received any topical or systemic antimicrobial therapy within the 2 weeks prior to study entry (Visit 1 [Day 1]). Has documented osteomyelitis. If severely immunocompromised, may be excluded at the discretion of the Investigator. Has a history of alcohol or substance abuse in the past 12 months. Is undergoing dialysis (renal or peritoneal) or has history of kidney transplant. Has history of myasthenia gravis or other neurological condition where gentamicin use is contraindicated as determined by the Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Prior
Organizational Affiliation
Innocoll
Official's Role
Study Director
Facility Information:
Facility Name
Chesapeake Foot and Ankle Center
City
Pasadena
State/Province
Maryland
ZIP/Postal Code
21122
Country
United States

12. IPD Sharing Statement

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Prevention of Infection Using a Topical Gentamicin-Collagen Sponge in Diabetic Patients With An Uninfected Foot Ulcer

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