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Safety and Efficacy of Gentamicin Topical Gel (AppliGel-G) for Treatment of Mild to Moderately Infected Diabetic Foot Ulcers

Primary Purpose

Diabetic Foot Ulcers

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Gentamicin Topical Gel
Ciprofloxacin
Doxycycline
Sponsored by
Royer Biomedical, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcers focused on measuring Foot Ulcer, Diabetic Foot, Gentamicins, infection

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is 18 years of age or older
  2. Subject has a mild to moderately infected (IDSA Mild or Moderate/ PEDIS Grade 2 or 3) diabetic foot ulcer and without a previous history of partial foot amputation.
  3. Subject has Diabetes Mellitus (type 1 or type 2).
  4. Wound area measurement between 1-25 cm2 and does not exceed 25 cm2.
  5. Subject is in general good health in the opinion of the investigator as determined by medical history, vital signs and a physical examination.
  6. Female subjects must have a negative urine pregnancy test at screening and be willing and able to use a medically acceptable method of birth control or declare that they are abstaining from sexual intercourse, from the screening visit through the study termination visit or be surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) or post-menopausal. Postmenopausal women are defined as women with menstruation cessation for 12 consecutive months prior to signing of the informed consent form.
  7. Subject has either no renal failure or only mild renal failure (i.e.: glomerular filtration rate (GFR) must be above 60 mL/min/1.73m2)
  8. Subject is willing and committed to comply with the research protocol and complete all outcome measures.
  9. Subject is able to self-consent.
  10. Subject is able to speak and read English..

Exclusion Criteria:

  1. Subject is non-diabetic
  2. Subject's foot lesion(s) are of etiology other than diabetic neuropathy
  3. DFU is PEDIS Infection Grade 1 or 4
  4. Infected DFU measures >25 cm2
  5. The wound involves bone, tendon or joint damage not due to infection
  6. Wound with sinus tracts
  7. HbA1c>11%
  8. Subject with skin disorders unrelated to the ulcer that are presented adjacent to the wound
  9. Clinically significant arterial vascular disease based on Skin Perfusion Pressure System (SensiLase) measurement of skin perfusion pressure (SPP) of <30 mm Hg.
  10. Subject is receiving, or has received within one month prior to enrollment any treatment known to impair wound healing, including but not limited to: corticosteroids, immuno-suppressive drugs, cytotoxic agents, radiation therapy and chemotherapy.
  11. Known history of a significant medical disorder, which in the investigator's judgment contraindicates the subject's participation.
  12. Has active malignant disease of any kind. A subject, who has had a malignant disease in the past, was treated and is currently disease-free, may be considered for study entry.
  13. Subjects who present with significant metabolic co morbidity that would preclude wound healing such as end stage renal failure, dialysis or severe liver dysfunction.
  14. Known hypersensitivity and/or allergy to gentamicin or the study oral antibiotics or related drugs.
  15. Drug or alcohol abuse (by history). 16 Subjects participating in any other trials in regards to the diabetic foot ulcer or antibiotic therapy.

17 History of myasthenia gravis 18 Any condition or use of prescribed medication in which participation in this study would impact the safety of the individual participant.

Sites / Locations

  • Georgetown University Hospital Center
  • GF Professional Research, Corp.
  • Florida Medical Center & Research, Inc.
  • Advanced Foot and Ankle Institute of Georgia LLC
  • Union Memorial Hospital
  • Detroit Clinical Research Center, PC
  • Utah Valley Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

AppliGel-G with oral Ciprofloxacin and Doxycycline

Oral Ciprofloxacin and Doxycycline only

Arm Description

AppliGel-G (Gentamicin Topical Gel) in conjunction with oral Ciprofloxacin and Doxycycline

Ciprofloxacin and Doxycycline

Outcomes

Primary Outcome Measures

Complete wound clearing of infection
Proportion of subjects with foot ulcer infection completely cleared at or by 28 days of AppliGel-G treatment compared to proportion of subjects with foot ulcer infection completely cleared at or by 28 days of control treatment

Secondary Outcome Measures

Incidence of infection cleared
Incidence of infection cleared at Day 14
DFU Volume % Change
percent change in DFU volume, measured weekly and compared to baseline
DFU Area % Change
percent change in DFU area, measured weekly and compared to baseline

Full Information

First Posted
January 10, 2014
Last Updated
May 13, 2015
Sponsor
Royer Biomedical, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02036528
Brief Title
Safety and Efficacy of Gentamicin Topical Gel (AppliGel-G) for Treatment of Mild to Moderately Infected Diabetic Foot Ulcers
Official Title
A Phase I/II, Open Label, Controlled Study to Evaluate the Safety and Efficacy of AppliGel-G [Gentamicin Sulfate Topical Gel] for Treatment of Mild to Moderately Infected Diabetic Foot Ulcers in Patients With Type 1 and Type 2 Diabetes
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Terminated
Study Start Date
January 2014 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Royer Biomedical, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether AppliGel-G (Gentamicin topical gel) plus oral Ciprofloxacin / Doxycycline are safe and effective in the treatment of mild to moderately infected foot ulcers in diabetic patients.
Detailed Description
Infection of a diabetic foot ulcer (DFU) is a serious and common complication of diabetes and is among the most common diabetes-related cause of hospitalization and the leading cause of diabetes-associated lower limb amputation. The effectiveness of various systemic antibiotics, particularly the fluoroquinolones, in treating infected DFUs has been demonstrated. An alternative or adjunct to systemic antibiotic treatment of infected DFU's is topical antibiotic treatment. Topical treatment would have the advantages of avoiding systemic adverse effects, providing increased target site concentration, and allowing the use of antibiotics not approved for systemic treatment. AppliGel-G is a topically applied hydrogel formulation of gentamicin sulfate (GMS). Once in place the product remains in contact with the wound bed and releases Gentamicin to the wound bed.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AppliGel-G with oral Ciprofloxacin and Doxycycline
Arm Type
Experimental
Arm Description
AppliGel-G (Gentamicin Topical Gel) in conjunction with oral Ciprofloxacin and Doxycycline
Arm Title
Oral Ciprofloxacin and Doxycycline only
Arm Type
Active Comparator
Arm Description
Ciprofloxacin and Doxycycline
Intervention Type
Drug
Intervention Name(s)
Gentamicin Topical Gel
Intervention Type
Drug
Intervention Name(s)
Ciprofloxacin
Intervention Type
Drug
Intervention Name(s)
Doxycycline
Primary Outcome Measure Information:
Title
Complete wound clearing of infection
Description
Proportion of subjects with foot ulcer infection completely cleared at or by 28 days of AppliGel-G treatment compared to proportion of subjects with foot ulcer infection completely cleared at or by 28 days of control treatment
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Incidence of infection cleared
Description
Incidence of infection cleared at Day 14
Time Frame
28 days
Title
DFU Volume % Change
Description
percent change in DFU volume, measured weekly and compared to baseline
Time Frame
28 days
Title
DFU Area % Change
Description
percent change in DFU area, measured weekly and compared to baseline
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is 18 years of age or older Subject has a mild to moderately infected (IDSA Mild or Moderate/ PEDIS Grade 2 or 3) diabetic foot ulcer and without a previous history of partial foot amputation. Subject has Diabetes Mellitus (type 1 or type 2). Wound area measurement between 1-25 cm2 and does not exceed 25 cm2. Subject is in general good health in the opinion of the investigator as determined by medical history, vital signs and a physical examination. Female subjects must have a negative urine pregnancy test at screening and be willing and able to use a medically acceptable method of birth control or declare that they are abstaining from sexual intercourse, from the screening visit through the study termination visit or be surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy) or post-menopausal. Postmenopausal women are defined as women with menstruation cessation for 12 consecutive months prior to signing of the informed consent form. Subject has either no renal failure or only mild renal failure (i.e.: glomerular filtration rate (GFR) must be above 60 mL/min/1.73m2) Subject is willing and committed to comply with the research protocol and complete all outcome measures. Subject is able to self-consent. Subject is able to speak and read English.. Exclusion Criteria: Subject is non-diabetic Subject's foot lesion(s) are of etiology other than diabetic neuropathy DFU is PEDIS Infection Grade 1 or 4 Infected DFU measures >25 cm2 The wound involves bone, tendon or joint damage not due to infection Wound with sinus tracts HbA1c>11% Subject with skin disorders unrelated to the ulcer that are presented adjacent to the wound Clinically significant arterial vascular disease based on Skin Perfusion Pressure System (SensiLase) measurement of skin perfusion pressure (SPP) of <30 mm Hg. Subject is receiving, or has received within one month prior to enrollment any treatment known to impair wound healing, including but not limited to: corticosteroids, immuno-suppressive drugs, cytotoxic agents, radiation therapy and chemotherapy. Known history of a significant medical disorder, which in the investigator's judgment contraindicates the subject's participation. Has active malignant disease of any kind. A subject, who has had a malignant disease in the past, was treated and is currently disease-free, may be considered for study entry. Subjects who present with significant metabolic co morbidity that would preclude wound healing such as end stage renal failure, dialysis or severe liver dysfunction. Known hypersensitivity and/or allergy to gentamicin or the study oral antibiotics or related drugs. Drug or alcohol abuse (by history). 16 Subjects participating in any other trials in regards to the diabetic foot ulcer or antibiotic therapy. 17 History of myasthenia gravis 18 Any condition or use of prescribed medication in which participation in this study would impact the safety of the individual participant.
Facility Information:
Facility Name
Georgetown University Hospital Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
GF Professional Research, Corp.
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33016
Country
United States
Facility Name
Florida Medical Center & Research, Inc.
City
Miami
State/Province
Florida
ZIP/Postal Code
33142
Country
United States
Facility Name
Advanced Foot and Ankle Institute of Georgia LLC
City
Smyrna
State/Province
Georgia
ZIP/Postal Code
30080
Country
United States
Facility Name
Union Memorial Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21218
Country
United States
Facility Name
Detroit Clinical Research Center, PC
City
Farmington Hills
State/Province
Michigan
ZIP/Postal Code
48334
Country
United States
Facility Name
Utah Valley Medical Center
City
Provo
State/Province
Utah
ZIP/Postal Code
84604
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety and Efficacy of Gentamicin Topical Gel (AppliGel-G) for Treatment of Mild to Moderately Infected Diabetic Foot Ulcers

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