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Study to Evaluate the Safety and Efficacy of CHAM* for the Treatment of Diabetic Foot Ulcers (*OTI-15-01)

Primary Purpose

Chronic Diabetic Foot Ulcers

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
CHAM
Control
Sponsored by
Osiris Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Diabetic Foot Ulcers

Eligibility Criteria

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

Inclusion Criteria:

  1. Between 18 years and 80 years of age inclusive, as of the date of screening
  2. Confirmed diagnosis of Type I or Type II Diabetes
  3. An Index Ulcer defined as chronic (presence of wound for > 4 weeks), but not present for more than 52 weeks at the Screening Visit
  4. Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot
  5. The Index Ulcer is between 1 cm2 and 15 cm2, inclusive, at the Screening Visit
  6. The Index Ulcer extends into the dermis or subcutaneous tissue without evidence of exposed muscle, tendon, bone, or joint capsule
  7. Wound is free of necrotic debris
  8. Patient has adequate circulation to the foot as documented by either:

    • Ankle Brachial Index (ABI) > 0.70 and < 1.30, or
    • In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30, a Toe Brachial Index (TBI) ≥ 0.50, or
    • In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30 and TBI cannot be performed (e.g., toe is absent, wounds are present, or site cannot perform a TBI), a Doppler waveform in the posterior tibial or dorsalis pedis arteries at the ankle consistent with adequate flow in the foot (biphasic or triphasic) and other diagnostic confirmation of adequate flow (e.g., duplex imaging, normal pulse volume recording [PVR] testing).

Exclusion Criteria:

  1. Index Ulcer is of non-diabetic pathophysiology
  2. Gangrene is present on any part of the affected foot
  3. Index Ulcer is over an active Charcot deformity
  4. The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit
  5. Patient is currently receiving dialysis or planning to go on dialysis
  6. Patient has had 2 or more previous disease-related amputations of the lower extremities
  7. Patient has a glycated hemoglobin A1c (HbA1c) level of >10%
  8. Chronic oral steroid use >7.5 mg daily for longer than 3 months at the time of screening
  9. Patient is receiving IV corticosteroids, immunosuppressive or cytotoxic agents at the time of screening
  10. Requiring intravenous (IV) antibiotics to treat the index wound infection at the time of screening
  11. Patient has an ulcer within 5 cm of the Index Ulcer identified for study consideration
  12. Patient is Human Immunodeficiency Virus (HIV) positive or has Acquired Immune Deficiency Syndrome (AIDS)
  13. Current evidence of cellulitis, or other evidence of infection including fever or pus drainage from the wound site
  14. Current evidence of osteomyelitis or history of osteomyelitis within 30 days of screening
  15. Patient has active malignancy other than non-melanoma skin cancer
  16. Patient's Index Ulcer has decreased by ≥20% during 1-week screening period
  17. Patient's random blood sugar is >350 mg/dl at screening
  18. Patient has untreated alcohol or substance abuse at the time of screening
  19. Pregnant women and women who are breastfeeding
  20. Patient is currently enrolled or participated in another investigational device, drug, or biological trial within 30 days of screening
  21. Patient has had within the last 30 days, or is currently undergoing, or is planning for wound treatments with growth factors, living skin, dermal substitutes or other advanced biological therapies
  22. Patient is an employee, or an immediate family member of an employee, of the sponsor company or site research staff conducting the study
  23. Patients who have already been randomized in Protocol 303 at any center may not be considered for screening or for re-entry into the trial at any center, even after the end of their follow-up period
  24. Patients with a history of poor compliance, or an unwillingness or inability to adhere to the requirements of the protocol.

Sites / Locations

  • SAVAHCS
  • ILD Research Center
  • Center for Clinical Research
  • Center for Clinical Research
  • Stanford University
  • MedStar Georgetown University Hospital
  • Barry University Clinical Research
  • SSH
  • Ocean County Foot & Ankle Surgical Associates
  • NSLIJHS
  • UNC
  • Duke University
  • Cleveland Clinic
  • University Orthopedics
  • Temple University
  • Spartanburg Regional Healthcare System
  • North Texas Podiatric Medicine and Surgery Associates
  • Texas Gulf Coast Medical Group

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

CHAM

Control

Arm Description

Cryopreserved Human Amniotic Membrane

Standard of Care

Outcomes

Primary Outcome Measures

Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator, by the End of Single-Blind Treatment Visit with follow-up confirmation of continued closure at 2 consecutive study visits 2 weeks apart

Secondary Outcome Measures

Complete index wound closure by the End of Single-Blind Treatment Visit as defined by 100% re-epithelialization, as determined by the Investigator.
Time to initial wound closure among patients that receive CHAM versus those that receive control as measured by Kaplan-Meier analysis.
Proportion of patients receiving CHAM that achieve a 50% reduction or greater in wound size by Day 28 (± 3 days) versus those that receive control.
Number of applications of CHAM versus control
Percentage of patients who achieve complete wound closure, defined as 100% re-epithelialization as determined by the Investigator, who participate in the Open-Label Treatment Phase

Full Information

First Posted
October 6, 2015
Last Updated
October 5, 2017
Sponsor
Osiris Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT02571738
Brief Title
Study to Evaluate the Safety and Efficacy of CHAM* for the Treatment of Diabetic Foot Ulcers
Acronym
*OTI-15-01
Official Title
A Multicenter, Randomized, Single-Blind Study With an Open-Label Extension Option to Further Evaluate the Safety and Efficacy of Cryopreserved Human Amniotic Membrane for the Treatment of Chronic Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Terminated
Why Stopped
Company's desire to allocate more research and development resources to other clinical programs. Decision not driven by any safety concerns.
Study Start Date
October 2015 (Actual)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
June 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Osiris Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A Multicenter, Randomized, Single-Blind Study with an Open-Label Extension Option to Further Evaluate the Safety and Efficacy of Cryopreserved Human Amniotic Membrane for the Treatment of Chronic Diabetic Foot Ulcers

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Diabetic Foot Ulcers

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
108 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CHAM
Arm Type
Active Comparator
Arm Description
Cryopreserved Human Amniotic Membrane
Arm Title
Control
Arm Type
Placebo Comparator
Arm Description
Standard of Care
Intervention Type
Biological
Intervention Name(s)
CHAM
Intervention Description
The treatment indication is for chronic diabetic foot ulcers that can accommodate up to one 5cm x 5cm piece of CHAM
Intervention Type
Other
Intervention Name(s)
Control
Intervention Description
Standard of Care
Primary Outcome Measure Information:
Title
Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator, by the End of Single-Blind Treatment Visit with follow-up confirmation of continued closure at 2 consecutive study visits 2 weeks apart
Time Frame
Up to 112 days after Baseline Visit
Secondary Outcome Measure Information:
Title
Complete index wound closure by the End of Single-Blind Treatment Visit as defined by 100% re-epithelialization, as determined by the Investigator.
Time Frame
Up to 84 days after Baseline Visit
Title
Time to initial wound closure among patients that receive CHAM versus those that receive control as measured by Kaplan-Meier analysis.
Time Frame
Up to 84 days after Baseline Visit
Title
Proportion of patients receiving CHAM that achieve a 50% reduction or greater in wound size by Day 28 (± 3 days) versus those that receive control.
Time Frame
Up to 28 days after Baseline
Title
Number of applications of CHAM versus control
Time Frame
Up to 77 days after Baseline
Title
Percentage of patients who achieve complete wound closure, defined as 100% re-epithelialization as determined by the Investigator, who participate in the Open-Label Treatment Phase
Time Frame
Up to 91 days after Single-Blind Treatment Phase
Other Pre-specified Outcome Measures:
Title
Wound re-occurrence for up to 3 months after initial wound closure in patients receiving CHAM versus control.
Time Frame
Up to 84 days after Single-Blind Treatment Phase
Title
Number and types of Adverse Events (AE) and Serious Adverse Events (SAE)
Time Frame
Up to 84 days after Single-Blind Treatment Phase
Title
Number of patients with worsening of wound defined by a 50% increase in wound size
Time Frame
Up to 84 days after Baseline
Title
Change in Quality of Life from Baseline, as determined by the Cardiff Wound Impact Schedule (CWIS)
Time Frame
Up to 84 days after Baseline

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: Between 18 years and 80 years of age inclusive, as of the date of screening Confirmed diagnosis of Type I or Type II Diabetes An Index Ulcer defined as chronic (presence of wound for > 4 weeks), but not present for more than 52 weeks at the Screening Visit Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot The Index Ulcer is between 1 cm2 and 15 cm2, inclusive, at the Screening Visit The Index Ulcer extends into the dermis or subcutaneous tissue without evidence of exposed muscle, tendon, bone, or joint capsule Wound is free of necrotic debris Patient has adequate circulation to the foot as documented by either: Ankle Brachial Index (ABI) > 0.70 and < 1.30, or In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30, a Toe Brachial Index (TBI) ≥ 0.50, or In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30 and TBI cannot be performed (e.g., toe is absent, wounds are present, or site cannot perform a TBI), a Doppler waveform in the posterior tibial or dorsalis pedis arteries at the ankle consistent with adequate flow in the foot (biphasic or triphasic) and other diagnostic confirmation of adequate flow (e.g., duplex imaging, normal pulse volume recording [PVR] testing). Exclusion Criteria: Index Ulcer is of non-diabetic pathophysiology Gangrene is present on any part of the affected foot Index Ulcer is over an active Charcot deformity The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit Patient is currently receiving dialysis or planning to go on dialysis Patient has had 2 or more previous disease-related amputations of the lower extremities Patient has a glycated hemoglobin A1c (HbA1c) level of >10% Chronic oral steroid use >7.5 mg daily for longer than 3 months at the time of screening Patient is receiving IV corticosteroids, immunosuppressive or cytotoxic agents at the time of screening Requiring intravenous (IV) antibiotics to treat the index wound infection at the time of screening Patient has an ulcer within 5 cm of the Index Ulcer identified for study consideration Patient is Human Immunodeficiency Virus (HIV) positive or has Acquired Immune Deficiency Syndrome (AIDS) Current evidence of cellulitis, or other evidence of infection including fever or pus drainage from the wound site Current evidence of osteomyelitis or history of osteomyelitis within 30 days of screening Patient has active malignancy other than non-melanoma skin cancer Patient's Index Ulcer has decreased by ≥20% during 1-week screening period Patient's random blood sugar is >350 mg/dl at screening Patient has untreated alcohol or substance abuse at the time of screening Pregnant women and women who are breastfeeding Patient is currently enrolled or participated in another investigational device, drug, or biological trial within 30 days of screening Patient has had within the last 30 days, or is currently undergoing, or is planning for wound treatments with growth factors, living skin, dermal substitutes or other advanced biological therapies Patient is an employee, or an immediate family member of an employee, of the sponsor company or site research staff conducting the study Patients who have already been randomized in Protocol 303 at any center may not be considered for screening or for re-entry into the trial at any center, even after the end of their follow-up period Patients with a history of poor compliance, or an unwillingness or inability to adhere to the requirements of the protocol.
Facility Information:
Facility Name
SAVAHCS
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85723
Country
United States
Facility Name
ILD Research Center
City
Carlsbad
State/Province
California
ZIP/Postal Code
92009
Country
United States
Facility Name
Center for Clinical Research
City
Castro Valley
State/Province
California
ZIP/Postal Code
94546
Country
United States
Facility Name
Center for Clinical Research
City
San Francisco
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
MedStar Georgetown University Hospital
City
Washington, D.C.
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
Barry University Clinical Research
City
North Miami Beach
State/Province
Florida
ZIP/Postal Code
33169
Country
United States
Facility Name
SSH
City
South Weymouth
State/Province
Massachusetts
ZIP/Postal Code
02190
Country
United States
Facility Name
Ocean County Foot & Ankle Surgical Associates
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08753
Country
United States
Facility Name
NSLIJHS
City
Lake Success
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Facility Name
UNC
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Duke University
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
University Orthopedics
City
Altoona
State/Province
Pennsylvania
ZIP/Postal Code
16602
Country
United States
Facility Name
Temple University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Spartanburg Regional Healthcare System
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
North Texas Podiatric Medicine and Surgery Associates
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
Facility Name
Texas Gulf Coast Medical Group
City
Webster
State/Province
Texas
ZIP/Postal Code
77598
Country
United States

12. IPD Sharing Statement

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Study to Evaluate the Safety and Efficacy of CHAM* for the Treatment of Diabetic Foot Ulcers

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