search
Back to results

VA MERIT: A Comparative Efficacy Study: Treatment of Non-Healing Diabetic (DOLCE)

Primary Purpose

Diabetic Foot Ulcer

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
SECONDARY dressing gauze and tape
debridement, irrigation
Dermagraft
Oasis
Sponsored by
VA Office of Research and Development
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcer focused on measuring Diabetic Foot Ulcer, Chronic wounds, Chronic ulcers, Oasis, Dermagraft, Adaptic

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

(Answering NO will exclude patient):

  • An Institutional Review Board (IRB) Informed Consent Form signed and dated prior to any study-related activities.
  • The area of the study ulcer after debridement is between 1 cm2 and 25 cm2 at Visit 3/Week 0.
  • Subjects between 18 and 85 years of age.
  • Subject's highest Ankle-Brachial Pressure Index (ABPI) / Ankle-Arm Index (AAI) is greater than or equal to 0.80 and lower than 1.4 (the highest ABPI/AAI value from three measurements within last 6 months shall apply).or a toe-arm index is equal to or higher than 0.6.
  • The patient has one or more diabetic ulcers on the target foot with only one ulcer selected as the study (target) ulcer. The target ulcer must be at least 4 cm from a non-target ulcer and in the Investigator's opinion, be unlikely to coalesce with another ulcer within 12 weeks of randomization.
  • Subject's study ulcer is full thickness and does not extend to bone, muscle, or tendon.
  • Subject's study ulcer has been present at least 4 weeks prior to the initial screening (Visit 1) or 6 weeks at randomization (Visit 3).
  • Subject has been diagnosed with Type 1 or Type 2 diabetes and HbA1c is less than 10%.
  • Study ulcer has no clinical feature of infection (2 signs of inflammation and elevated bacterial load of the wound).
  • For female subjects of childbearing age potential, the subject has a negative pregnancy test and is not lactating for the duration of the study.
  • Subject understands the requirements of this study and is willing to comply with all the study requirements.

Exclusion Criteria:

(Answering YES will exclude patient):

  • The subject is diagnosed with cancer and is undergoing treatment with immunosuppressive or chemotherapeutic agents, radiotherapy or systemic corticosteroids less than 30 days before enrollment.
  • The subject is diagnosed with HIV/AIDS.
  • The subject is diagnosed with any bleeding disorders.
  • The subject is diagnosed with any connective tissue diseases.
  • For female subjects, the subject is pregnant or lactating.
  • The subject has a history of illicit drug use within one year of enrollment.
  • In the past year, the subject experiences episodes of drinking more than 5 alcoholic beverages in less than two hours and/or drinking alcohol has become a problem in interpersonal relationships, work, driving and/or their behavior in general.
  • The subject has any active infected wounds or osteomyelitis (confirmed by bone biopsy, MRI or bone scan).
  • Doppler exam within the last 365 days demonstrating reflux greater than 0.5 seconds.
  • The subject is diagnosed with active Charcot as described by Saunder's classification system.
  • The subject manifests signs of poor nutritional status and/or albumin level < 2.9.
  • The subject has been exposed to Dermagraft and/or Oasis in the last 60 days.
  • The study ulcer size is less than 0.5 cm2 or greater than 25 cm2.
  • The subject has any porcine allergy or cow product allergy.
  • The subject's recent (last 30 days) chemistry tests serum creatinine is 2 times above the upper limit of normal and/or LFT's 3 times above the upper limit of normal.
  • Between Visit 1/Week -2 and Visit 3/Week 0 (randomization) the study ulcer has decreased in size by more than 40%, or increased in size by more than 50%.

Sites / Locations

  • VA Northern California Health Care System, Mather, CA

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Standard of care

Dermagraft

Oasis

Arm Description

debridement, irrigation , PRIMARY dressing Adaptic and Iodosorb, SECONDARY dressing gauze and tape

debridement, irrigation , PRIMARY dressing Dermagraft and Adaptic, SECONDARY dressing gauze and tape

debridement, irrigation , PRIMARY dressing Oasis and Adaptic, SECONDARY dressing gauze and tape

Outcomes

Primary Outcome Measures

Wound Closure by Week 15
The primary outcome of interest is defined as the wound healed completely on or before visit 15, regardless of a later recurrence.

Secondary Outcome Measures

Wound Closure at 20 Weeks
Complete wound closure at study endpoint. The Secondary outcome of interest is defined as the wound healed completely on or before visit 19, regardless of a later recurrence. The number of subjects analyzed at secondary outcome differs from primary outcome due to some subjects not completing the study.
Cost Effectiveness

Full Information

First Posted
October 7, 2011
Last Updated
August 26, 2019
Sponsor
VA Office of Research and Development
Collaborators
VA Northern California Health Care System
search

1. Study Identification

Unique Protocol Identification Number
NCT01450943
Brief Title
VA MERIT: A Comparative Efficacy Study: Treatment of Non-Healing Diabetic
Acronym
DOLCE
Official Title
A Comparative Efficacy Study: Treatments of Non-Healing Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
October 1, 2011 (Actual)
Primary Completion Date
December 14, 2017 (Actual)
Study Completion Date
April 4, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
VA Office of Research and Development
Collaborators
VA Northern California Health Care System

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to assess the effectiveness of cellular dermal replacement tissue vs. non-viable extracellular matrix (ECM) for the treatment of non-healing diabetic foot ulcers. Our hypothesis is that these devices are of equal efficacy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcer
Keywords
Diabetic Foot Ulcer, Chronic wounds, Chronic ulcers, Oasis, Dermagraft, Adaptic

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
120 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Standard of care
Arm Type
Active Comparator
Arm Description
debridement, irrigation , PRIMARY dressing Adaptic and Iodosorb, SECONDARY dressing gauze and tape
Arm Title
Dermagraft
Arm Type
Experimental
Arm Description
debridement, irrigation , PRIMARY dressing Dermagraft and Adaptic, SECONDARY dressing gauze and tape
Arm Title
Oasis
Arm Type
Experimental
Arm Description
debridement, irrigation , PRIMARY dressing Oasis and Adaptic, SECONDARY dressing gauze and tape
Intervention Type
Device
Intervention Name(s)
SECONDARY dressing gauze and tape
Intervention Description
SECONDARY dressing gauze and tape
Intervention Type
Procedure
Intervention Name(s)
debridement, irrigation
Intervention Description
debridement, irrigation
Intervention Type
Device
Intervention Name(s)
Dermagraft
Intervention Description
Dermagraft per company protocol
Intervention Type
Device
Intervention Name(s)
Oasis
Intervention Description
Oasis per company protocol
Primary Outcome Measure Information:
Title
Wound Closure by Week 15
Description
The primary outcome of interest is defined as the wound healed completely on or before visit 15, regardless of a later recurrence.
Time Frame
15 weeks
Secondary Outcome Measure Information:
Title
Wound Closure at 20 Weeks
Description
Complete wound closure at study endpoint. The Secondary outcome of interest is defined as the wound healed completely on or before visit 19, regardless of a later recurrence. The number of subjects analyzed at secondary outcome differs from primary outcome due to some subjects not completing the study.
Time Frame
20 weeks
Title
Cost Effectiveness
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: (Answering NO will exclude patient): An Institutional Review Board (IRB) Informed Consent Form signed and dated prior to any study-related activities. The area of the study ulcer after debridement is between 1 cm2 and 25 cm2 at Visit 3/Week 0. Subjects between 18 and 85 years of age. Subject's highest Ankle-Brachial Pressure Index (ABPI) / Ankle-Arm Index (AAI) is greater than or equal to 0.80 and lower than 1.4 (the highest ABPI/AAI value from three measurements within last 6 months shall apply).or a toe-arm index is equal to or higher than 0.6. The patient has one or more diabetic ulcers on the target foot with only one ulcer selected as the study (target) ulcer. The target ulcer must be at least 4 cm from a non-target ulcer and in the Investigator's opinion, be unlikely to coalesce with another ulcer within 12 weeks of randomization. Subject's study ulcer is full thickness and does not extend to bone, muscle, or tendon. Subject's study ulcer has been present at least 4 weeks prior to the initial screening (Visit 1) or 6 weeks at randomization (Visit 3). Subject has been diagnosed with Type 1 or Type 2 diabetes and HbA1c is less than 10%. Study ulcer has no clinical feature of infection (2 signs of inflammation and elevated bacterial load of the wound). For female subjects of childbearing age potential, the subject has a negative pregnancy test and is not lactating for the duration of the study. Subject understands the requirements of this study and is willing to comply with all the study requirements. Exclusion Criteria: (Answering YES will exclude patient): The subject is diagnosed with cancer and is undergoing treatment with immunosuppressive or chemotherapeutic agents, radiotherapy or systemic corticosteroids less than 30 days before enrollment. The subject is diagnosed with HIV/AIDS. The subject is diagnosed with any bleeding disorders. The subject is diagnosed with any connective tissue diseases. For female subjects, the subject is pregnant or lactating. The subject has a history of illicit drug use within one year of enrollment. In the past year, the subject experiences episodes of drinking more than 5 alcoholic beverages in less than two hours and/or drinking alcohol has become a problem in interpersonal relationships, work, driving and/or their behavior in general. The subject has any active infected wounds or osteomyelitis (confirmed by bone biopsy, MRI or bone scan). Doppler exam within the last 365 days demonstrating reflux greater than 0.5 seconds. The subject is diagnosed with active Charcot as described by Saunder's classification system. The subject manifests signs of poor nutritional status and/or albumin level < 2.9. The subject has been exposed to Dermagraft and/or Oasis in the last 60 days. The study ulcer size is less than 0.5 cm2 or greater than 25 cm2. The subject has any porcine allergy or cow product allergy. The subject's recent (last 30 days) chemistry tests serum creatinine is 2 times above the upper limit of normal and/or LFT's 3 times above the upper limit of normal. Between Visit 1/Week -2 and Visit 3/Week 0 (randomization) the study ulcer has decreased in size by more than 40%, or increased in size by more than 50%.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rivkah R. Isseroff, MD
Organizational Affiliation
VA Northern California Health Care System, Mather, CA
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA Northern California Health Care System, Mather, CA
City
Sacramento
State/Province
California
ZIP/Postal Code
95655
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
23298410
Citation
Lev-Tov H, Li CS, Dahle S, Isseroff RR. Cellular versus acellular matrix devices in treatment of diabetic foot ulcers: study protocol for a comparative efficacy randomized controlled trial. Trials. 2013 Jan 9;14:8. doi: 10.1186/1745-6215-14-8.
Results Reference
derived

Learn more about this trial

VA MERIT: A Comparative Efficacy Study: Treatment of Non-Healing Diabetic

We'll reach out to this number within 24 hrs