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Randomized Clinical Study Assessing NuShield Versus Standard of Care in Diabetic Foot Ulcers (DFUs)

Primary Purpose

Diabetic Foot Ulcer

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NuShield
Sponsored by
Organogenesis
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcer focused on measuring DFU, Chronic Diabetic Foot Ulcer, Non-healing DFU

Eligibility Criteria

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

Inclusion Criteria:

  1. At least 18 years old and maximum of 85 years old.
  2. Subjects with a diabetic foot ulcer that is either superficial, e.g. not involving tendon, capsule, or bone; or wounds that penetrate into tendon, capsule, bone and/or joint.
  3. Subjects, with the presence of Diabetes, must have a Glycosylated hemoglobin (HbA1c) ≤ 12% within 4 weeks prior to randomization
  4. Index ulcer (i.e. current episode of ulceration) has been present for greater than 4 weeks prior to the initial screening visit with no upper limit in duration of non-healing.
  5. Subject has adequate circulation to the foot as documented by either: Skin perfusion pressure (SPP) measurement of ≥ 45 mmHg, Toe-brachial index (TBI) ≥ 0.6/ Toe pressure greater than 40, Ankle-brachial index (ABI) between 0.60 and ≤ 1.3
  6. Index ulcer is a minimum of 0.5 cm2 and a maximum of 25cm2 at randomization, prior to first study treatment.
  7. The index ulcer has been offloaded for 14 days prior to randomization.
  8. Index ulcer has not reduced in area > 20% from Day -14 to Day 0, prior to randomization.
  9. Subject understands and is willing to participate in the clinical study and can comply with weekly visits and the follow-up regimen.
  10. Subject, or their Legally Authorized Representative (LAR), has read, understood, and signed the IRB/IEC approved Informed Consent Form before screening procedures are undertaken.

Exclusion Criteria:

  1. Index ulcer(s) deemed by the investigator to be caused by a medical condition other than diabetes.
  2. Treatment with HBO wound dressings that include growth factors, bioengineered tissues, or skin substitutes within 30 days of randomization.
  3. History of bone cancer or metastatic disease of the affected limb or chemotherapy within the 12 months prior to randomization.
  4. Subjects with a history of more than two weeks treatment with immunosuppressants (including prednisone 10 mg daily or an equivalent does of other oral steroids cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within one month prior to first Screening Visit, or who receive such medications during the screening period, or who are anticipated to require such medications during the course of the study.
  5. Subject is on any investigational drug(s) or therapeutic device(s) within 30 days preceding the first Screening Visit.
  6. History of radiation at the ulcer site.
  7. Index ulcer has been previously treated or will need to be treated with any prohibited therapies within 30 days prior to randomization.
  8. Presence of any condition(s) which seriously compromises the subject's ability to complete this study or has a known history of poor adherence with medical treatment.
  9. Active infection at the index ulcer at the time of Randomization.
  10. Acute osteomyelitis or bone infection of the affected foot, where subject has received less than 4 weeks of systemic antibiotics at the time of Screening and less than 6 weeks prior to Randomization (systemic antibiotic regimen must be completed at the time of Randomization).
  11. Subject's with suspected infection who have received less than 2 weeks of systemic antibiotics, or have not had surgical resection of clinically diagnosed osteomyelitis
  12. Subjects with suspected osteomyelitis who have not had an X-ray, CT scan or MRI within 14 days prior to Randomization.
  13. Subject is unwilling or unable to comply with the study requirement for offloading the index wound
  14. Subject is pregnant or breast feeding.

Sites / Locations

  • ILD Research CenterRecruiting
  • Limb Preservation PlatformRecruiting
  • University of Southern CaliforniaRecruiting
  • Stanford UniversityRecruiting
  • Family Foot & Ankle SpecialistsRecruiting
  • Doctors Research NetworkRecruiting
  • Extremity HealthcareRecruiting
  • NYU Winthrop HospitalRecruiting
  • Futuro Clinical TrialsRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

No Intervention

Arm Label

NuShield

Standard of Care

Arm Description

NuShield® is a sterile, dehydrated placental allograft

Standard of Care (SOC) includes, but is not limited to, surgical debridement, aggressive infection management, offloading, and maintenance of appropriate cleansing at the time of each dressing change.

Outcomes

Primary Outcome Measures

Length of time that a wound achieves complete wound closure (CWC)
Duration (number of days) to achieve CWC from baseline to week 12 assessed between both groups

Secondary Outcome Measures

Greater than 40% wound closure at week 4 from baseline
Proportion of subjects achieving ≥ 40% wound closure at Week 4 from baseline
Change in wound area
Mean percent change from baseline in wound area at Week 12
Incidence of prescribed pain and/or neuropathic medications
Cumulative amount of pain and neuropathic medications taken between baseline and Week 12 assessed between both groups.
Reduction in subject reported pain at week 12 from baseline assessed between both groups via the Numeric Pain Rating Scale (NPRS)
Mean percent change at week 12 in subject reported pain, assessed via the NPRS pain scale where 0 = no pain and 10 = worst pain imaginable, on a scale of 0 to 10.
Utilization of healthcare resources assessment
Utilization of healthcare resources through Week 12
Improvement in subject reported quality of life at week 12 from baseline assessed via the Wound-QoL (Questionnaire on quality of life with chronic wounds).
Mean percent change at week 12 from baseline in subject reported quality of life scores between both groups. The 17 item Wound-QoL tool measures the disease-specific, health-related quality of life of patients with chronic wounds. A global score is computed by averaging all 17 items where subjects answer each question on a scale of 0 to 4, where 0=not at all and 4=very much.
Time to complete wound closure (CWC) by or on 24 weeks
Length of time wounds achieve CWC at week 24 from baseline

Full Information

First Posted
February 22, 2019
Last Updated
May 24, 2021
Sponsor
Organogenesis
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1. Study Identification

Unique Protocol Identification Number
NCT03855514
Brief Title
Randomized Clinical Study Assessing NuShield Versus Standard of Care in Diabetic Foot Ulcers
Acronym
DFUs
Official Title
A Prospective, Multicenter, Randomized, Controlled Clinical Study Of NuShield® and Standard of Care (SOC) Compared to SOC Alone For The Management Of Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Unknown status
Study Start Date
February 8, 2019 (Actual)
Primary Completion Date
November 2021 (Anticipated)
Study Completion Date
December 30, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Organogenesis

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This prospective, multi-center, randomized, controlled clinical study compares NuShield® plus SOC to SOC alone in subjects with chronic DFUs. NuShield® will be used along with standard of care on diabetic foot ulcers of greater than 6 weeks which have not adequately responded to conventional ulcer therapy.
Detailed Description
Two hundred (200) subjects with a chronic DFU ranging in size from 0.5cm2 and 25 cm2 will be randomized 1:1 to either NuShield® and SOC or SOC alone following the 14 day screening period. Following screening and randomization, subjects shall be seen weekly for up to 24 weeks. For subjects that heal prior to week 24, a healing confirmation visit shall occur two weeks later to confirm maintenance of complete wound closure. Subjects that are randomized into the SOC group whose DFU has not healed by week 12 may be crossed over to receive NuShield® and followed for an additional 12-14 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcer
Keywords
DFU, Chronic Diabetic Foot Ulcer, Non-healing DFU

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
NuShield
Arm Type
Active Comparator
Arm Description
NuShield® is a sterile, dehydrated placental allograft
Arm Title
Standard of Care
Arm Type
No Intervention
Arm Description
Standard of Care (SOC) includes, but is not limited to, surgical debridement, aggressive infection management, offloading, and maintenance of appropriate cleansing at the time of each dressing change.
Intervention Type
Other
Intervention Name(s)
NuShield
Intervention Description
NuShield® is a dehydrated placental allograft.
Primary Outcome Measure Information:
Title
Length of time that a wound achieves complete wound closure (CWC)
Description
Duration (number of days) to achieve CWC from baseline to week 12 assessed between both groups
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Greater than 40% wound closure at week 4 from baseline
Description
Proportion of subjects achieving ≥ 40% wound closure at Week 4 from baseline
Time Frame
4 weeks
Title
Change in wound area
Description
Mean percent change from baseline in wound area at Week 12
Time Frame
12 weeks
Title
Incidence of prescribed pain and/or neuropathic medications
Description
Cumulative amount of pain and neuropathic medications taken between baseline and Week 12 assessed between both groups.
Time Frame
12 weeks
Title
Reduction in subject reported pain at week 12 from baseline assessed between both groups via the Numeric Pain Rating Scale (NPRS)
Description
Mean percent change at week 12 in subject reported pain, assessed via the NPRS pain scale where 0 = no pain and 10 = worst pain imaginable, on a scale of 0 to 10.
Time Frame
12 weeks
Title
Utilization of healthcare resources assessment
Description
Utilization of healthcare resources through Week 12
Time Frame
12 weeks
Title
Improvement in subject reported quality of life at week 12 from baseline assessed via the Wound-QoL (Questionnaire on quality of life with chronic wounds).
Description
Mean percent change at week 12 from baseline in subject reported quality of life scores between both groups. The 17 item Wound-QoL tool measures the disease-specific, health-related quality of life of patients with chronic wounds. A global score is computed by averaging all 17 items where subjects answer each question on a scale of 0 to 4, where 0=not at all and 4=very much.
Time Frame
12 weeks
Title
Time to complete wound closure (CWC) by or on 24 weeks
Description
Length of time wounds achieve CWC at week 24 from baseline
Time Frame
24 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: At least 18 years old and maximum of 85 years old. Subjects with a diabetic foot ulcer that is either superficial, e.g. not involving tendon, capsule, or bone; or wounds that penetrate into tendon, capsule, bone and/or joint. Subjects, with the presence of Diabetes, must have a Glycosylated hemoglobin (HbA1c) ≤ 12% within 4 weeks prior to randomization Index ulcer (i.e. current episode of ulceration) has been present for greater than 4 weeks prior to the initial screening visit with no upper limit in duration of non-healing. Subject has adequate circulation to the foot as documented by either: Skin perfusion pressure (SPP) measurement of ≥ 45 mmHg, Toe-brachial index (TBI) ≥ 0.6/ Toe pressure greater than 40, Ankle-brachial index (ABI) between 0.60 and ≤ 1.3 Index ulcer is a minimum of 0.5 cm2 and a maximum of 25cm2 at randomization, prior to first study treatment. The index ulcer has been offloaded for 14 days prior to randomization. Index ulcer has not reduced in area > 20% from Day -14 to Day 0, prior to randomization. Subject understands and is willing to participate in the clinical study and can comply with weekly visits and the follow-up regimen. Subject, or their Legally Authorized Representative (LAR), has read, understood, and signed the IRB/IEC approved Informed Consent Form before screening procedures are undertaken. Exclusion Criteria: Index ulcer(s) deemed by the investigator to be caused by a medical condition other than diabetes. Treatment with HBO wound dressings that include growth factors, bioengineered tissues, or skin substitutes within 30 days of randomization. History of bone cancer or metastatic disease of the affected limb or chemotherapy within the 12 months prior to randomization. Subjects with a history of more than two weeks treatment with immunosuppressants (including prednisone 10 mg daily or an equivalent does of other oral steroids cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within one month prior to first Screening Visit, or who receive such medications during the screening period, or who are anticipated to require such medications during the course of the study. Subject is on any investigational drug(s) or therapeutic device(s) within 30 days preceding the first Screening Visit. History of radiation at the ulcer site. Index ulcer has been previously treated or will need to be treated with any prohibited therapies within 30 days prior to randomization. Presence of any condition(s) which seriously compromises the subject's ability to complete this study or has a known history of poor adherence with medical treatment. Active infection at the index ulcer at the time of Randomization. Acute osteomyelitis or bone infection of the affected foot, where subject has received less than 4 weeks of systemic antibiotics at the time of Screening and less than 6 weeks prior to Randomization (systemic antibiotic regimen must be completed at the time of Randomization). Subject's with suspected infection who have received less than 2 weeks of systemic antibiotics, or have not had surgical resection of clinically diagnosed osteomyelitis Subjects with suspected osteomyelitis who have not had an X-ray, CT scan or MRI within 14 days prior to Randomization. Subject is unwilling or unable to comply with the study requirement for offloading the index wound Subject is pregnant or breast feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Galen Hale
Phone
(205) 541-9682
Email
GHale@organo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Andrea Black
Phone
(781) 830-2364
Email
ABlack@organo.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christine McLennan
Organizational Affiliation
Organogenesis Inc.
Official's Role
Study Director
Facility Information:
Facility Name
ILD Research Center
City
Carlsbad
State/Province
California
ZIP/Postal Code
92002
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eric Martinez
Email
eric@ildresearch.com
First Name & Middle Initial & Last Name & Degree
Dean Vayser, DPM
Facility Name
Limb Preservation Platform
City
Fresno
State/Province
California
ZIP/Postal Code
94063
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Destiny Blackstone
Email
destiny@lppresearch.com
First Name & Middle Initial & Last Name & Degree
Shawn Cazzell
Facility Name
University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
91208
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Karen DHuyvetter
Email
Karen.DHuyvetter@med.usc.edu
First Name & Middle Initial & Last Name & Degree
David Armstrong
Facility Name
Stanford University
City
Redwood City
State/Province
California
ZIP/Postal Code
94063
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shannon Meyer
Email
smeyer27@stanford.edu
First Name & Middle Initial & Last Name & Degree
Geoffrey Gurtner
Facility Name
Family Foot & Ankle Specialists
City
Bridgeport
State/Province
Connecticut
ZIP/Postal Code
06606
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Catherine Porter
Email
familypodiatryct@gmail.com
First Name & Middle Initial & Last Name & Degree
Daniel Davis
Facility Name
Doctors Research Network
City
Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nara Neiva
Email
nneiva@miamifoot.com
First Name & Middle Initial & Last Name & Degree
Jason Hanft
Facility Name
Extremity Healthcare
City
Roswell
State/Province
Georgia
ZIP/Postal Code
30076
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amelia Sobhani
Email
asobhani@vpcenters.com
First Name & Middle Initial & Last Name & Degree
Ira Kraus
Facility Name
NYU Winthrop Hospital
City
New York
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Helen Yiu
Email
helen.yiu@nyulangone.org
First Name & Middle Initial & Last Name & Degree
Scott Gorenstein
Facility Name
Futuro Clinical Trials
City
McAllen
State/Province
Texas
ZIP/Postal Code
78501
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Chrissy Rodriguez
Email
chrissycffc@gmail.com
First Name & Middle Initial & Last Name & Degree
Joseph Caporusso

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Randomized Clinical Study Assessing NuShield Versus Standard of Care in Diabetic Foot Ulcers

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