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Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers

Primary Purpose

Diabetic Foot Ulcer

Status
Completed
Phase
Phase 3
Locations
India
Study Type
Interventional
Intervention
Esmolol Hydrochloride
Only Standard of Care
Vehicle Gel
Sponsored by
Novalead Pharma Private Limited
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcer

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects, male or female, aged 18 to 75 years (inclusive) with Type 1 or Type 2 diabetes undergoing therapy for glycemic control
  2. Subject has glycosylated hemoglobin, HbA1C, ≤ 12%
  3. Subject with diagnosis of neuropathic foot ulcer by 10g monofilament test
  4. Subject has adequate vascular perfusion of the affected limb, confirmed by Ankle-Brachial Index (ABI) ≥ 0.65 and ≤ 1.3
  5. Presence of at least one DFU that meets all of the following criteria:

    1. A full-thickness ulcer of Grade A1 as per Texas classification system;
    2. Ulcer is located below or up to 5 cm above the malleoli (excluding ulcers between the toes);
    3. Ulcer size (area) is ≥ 2 cm2 and ≤ 15 cm2 (post-debridement);
    4. There is a minimum 3 cm margin between the qualifying Target Ulcer and any other ulcers on the specified foot, post-debridement;
    5. No exposed bone, tendon, muscle, ligament or joint capsule, and no tunneling, undermining, or sinus tracts;
    6. Unresponsive to ulcer care and open for at least 6 weeks at the time of the Screening Visit;
    7. Ulcer is non-infected as determined by clinical assessment and complete hemogram;
    8. Ulcer has a clean, granulating base free of adherent slough to the greatest extent possible as per Investigator;
    9. Ulcer area reduction < 30% from the Screening Visit to Baseline visit
  6. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Investigator
  7. Subject, if female of child-bearing potential, has a negative urine pregnancy test at Screening and willing to use acceptable methods of contraception (birth control pills, barriers) or abstinence throughout the Study
  8. Subject is able and willing to comply with Study procedures including the use of an off-loading device (as applicable for the location of the ulcer) and adhere to protocol during the Study in the opinion of Investigator
  9. A Subject or LAR agrees to sign informed consent form and allow audio visual recording of consent, if applicable

Exclusion Criteria:

  1. Actively infected ulcers with or without purulent discharge, ulcers with exposed bone or associated with osteomyelitis
  2. Subjects with more than three ulcers below knee
  3. Subjects with Target Ulcer requiring off-loading that cannot be effectively off-loaded; or unable to tolerate the off-loading method
  4. Subject has ulcers caused by a disease other than diabetes, e.g., fungal ulcerations, malignant ulcerations, and ulcerations due to venous or arterial insufficiency, or due to hematological disorders, in the opinion of the Investigator
  5. Ulcer, about which the Investigator is suspicious for cancer
  6. Subjects with a gangrenous or ischemic ulcer
  7. Subject with ulcer that in the opinion of the Investigator, may need amputation
  8. Subject with Target ulcer where wound measurement is not possible, such as ulcers between toes
  9. Body mass index (BMI) > 40 kg/m2
  10. Laboratory values at Screening of:

    1. Hemoglobin < 10.0 g/dL
    2. White Blood Cells (WBC) < 2.0 X 109 cells/L
    3. Liver function studies [Total bilirubin, aspartate aminotransferase (AST) and alanine transaminase (ALT)] > 3x the upper limit of normal
    4. Albumin < 2.5 g/dL
    5. eGFR < 25 mL/min
  11. Presence of any existing clinically significant medical condition(s) that, in the opinion of the Investigator, could interfere with wound healing
  12. Subject has received or is currently receiving or scheduled to receive any medication or therapies during the course of the Study that will modulate wound healing
  13. Subject with intolerance to β-blockers at any time in the past
  14. Has any other factor which may, in the opinion of the Investigator, compromise participation and/or follow-up in the Study

Sites / Locations

  • Yalamanchi Hospita
  • M.S. Ramaiah Medical College and Hospital
  • Sapthagiri Institute of Medical Sciences and Research Centre
  • Rajlaxmi Hospital
  • Sri Siddhartha Medical College
  • Sujata Birla Hospital & Medical Research Center
  • Deenanath Mangeshkar Hospital and Research Center
  • Chellaram Diabetes Institute
  • Appollo Hospital
  • M.V. Hospital for Diabetes Pvt Ltd
  • Madras Diabetes Research Foundation
  • Sri Ramachandra Hospital
  • Post Graduate Institute of Medical Education and Research (PGIMER)
  • Maharaja Agrasen Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Sham Comparator

Placebo Comparator

Arm Label

Galnobax® 14% gel plus SoC

SoC Only

Vehicle plus SoC

Arm Description

Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (150 subjects)

Only Standard of Care will be administered twice daily (150 subjects)

Vehicle gel along with Standard of Care (SoC) will be administered twice daily (50 subjects)

Outcomes

Primary Outcome Measures

Proportion of Subjects Achieving Target Ulcer Closure Within 12-week Treatment Phase, as Assessed by Blinded Investigator
Proportion of complete closure of wounds within 12-week treatment phase where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements evaluated in two visits two weeks apart from first observation of closure.

Secondary Outcome Measures

Proportion of Subjects Achieving Target Ulcer Closure Till End of Study, as Assessed by the Blinded Investigator.
Proportion of complete closure of wounds at 24-weeks or End of Study where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements.

Full Information

First Posted
June 24, 2019
Last Updated
August 25, 2023
Sponsor
Novalead Pharma Private Limited
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1. Study Identification

Unique Protocol Identification Number
NCT03998436
Brief Title
Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers
Official Title
A Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
December 26, 2018 (Actual)
Primary Completion Date
August 19, 2021 (Actual)
Study Completion Date
December 6, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novalead Pharma Private Limited

4. Oversight

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

5. Study Description

Brief Summary
The purpose of the current Study is to determine the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU. The study is being conducted in 350 subjects being recruited in about 30 centers in India.
Detailed Description
The current study is a Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers. The study evaluates the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Prospective, Multicenter, Randomized, Double-Blind, Parallel groups
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
The subject will be masked from the treatment by the Study Nurse (care giver) by using blinder during each treatment application. The site has two separate teams (blinded and unblinded) for masking. The unblinded investigator performs application of treatment during each treatment visit of subject to the site.
Allocation
Randomized
Enrollment
176 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Galnobax® 14% gel plus SoC
Arm Type
Active Comparator
Arm Description
Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (150 subjects)
Arm Title
SoC Only
Arm Type
Sham Comparator
Arm Description
Only Standard of Care will be administered twice daily (150 subjects)
Arm Title
Vehicle plus SoC
Arm Type
Placebo Comparator
Arm Description
Vehicle gel along with Standard of Care (SoC) will be administered twice daily (50 subjects)
Intervention Type
Drug
Intervention Name(s)
Esmolol Hydrochloride
Other Intervention Name(s)
Galnobax
Intervention Description
Galnobax-14% gel application along with Standard of Care
Intervention Type
Other
Intervention Name(s)
Only Standard of Care
Intervention Description
Only Standard of Care treatment
Intervention Type
Other
Intervention Name(s)
Vehicle Gel
Intervention Description
Vehicle gel application along with Standard of Care
Primary Outcome Measure Information:
Title
Proportion of Subjects Achieving Target Ulcer Closure Within 12-week Treatment Phase, as Assessed by Blinded Investigator
Description
Proportion of complete closure of wounds within 12-week treatment phase where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements evaluated in two visits two weeks apart from first observation of closure.
Time Frame
Wound closure assessed up to week 12 and confirmed by 2 visits 2 weeks apart; only participants with wound closure at or before Week 12 and who maintained closure after 4-weeks of follow-up reported
Secondary Outcome Measure Information:
Title
Proportion of Subjects Achieving Target Ulcer Closure Till End of Study, as Assessed by the Blinded Investigator.
Description
Proportion of complete closure of wounds at 24-weeks or End of Study where Complete wound closure is defined as complete skin re-epithelialization that is without drainage or dressing requirements.
Time Frame
24-weeks. The ulcers achieving complete closure till end of study
Other Pre-specified Outcome Measures:
Title
Proportion of Subjects With Treatment Emergent Adverse Events (TEAEs)
Description
Proportion of Treatment emergent adverse events (TEAEs) in all the groups
Time Frame
24-weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects, male or female, aged 18 to 75 years (inclusive) with Type 1 or Type 2 diabetes undergoing therapy for glycemic control Subject has glycosylated hemoglobin, HbA1C, ≤ 12% Subject with diagnosis of neuropathic foot ulcer by 10g monofilament test Subject has adequate vascular perfusion of the affected limb, confirmed by Ankle-Brachial Index (ABI) ≥ 0.65 and ≤ 1.3 Presence of at least one DFU that meets all of the following criteria: A full-thickness ulcer of Grade A1 as per Texas classification system; Ulcer is located below or up to 5 cm above the malleoli (excluding ulcers between the toes); Ulcer size (area) is ≥ 2 cm2 and ≤ 15 cm2 (post-debridement); There is a minimum 3 cm margin between the qualifying Target Ulcer and any other ulcers on the specified foot, post-debridement; No exposed bone, tendon, muscle, ligament or joint capsule, and no tunneling, undermining, or sinus tracts; Unresponsive to ulcer care and open for at least 6 weeks at the time of the Screening Visit; Ulcer is non-infected as determined by clinical assessment and complete hemogram; Ulcer has a clean, granulating base free of adherent slough to the greatest extent possible as per Investigator; Ulcer area reduction < 30% from the Screening Visit to Baseline visit Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Investigator Subject, if female of child-bearing potential, has a negative urine pregnancy test at Screening and willing to use acceptable methods of contraception (birth control pills, barriers) or abstinence throughout the Study Subject is able and willing to comply with Study procedures including the use of an off-loading device (as applicable for the location of the ulcer) and adhere to protocol during the Study in the opinion of Investigator A Subject or LAR agrees to sign informed consent form and allow audio visual recording of consent, if applicable Exclusion Criteria: Actively infected ulcers with or without purulent discharge, ulcers with exposed bone or associated with osteomyelitis Subjects with more than three ulcers below knee Subjects with Target Ulcer requiring off-loading that cannot be effectively off-loaded; or unable to tolerate the off-loading method Subject has ulcers caused by a disease other than diabetes, e.g., fungal ulcerations, malignant ulcerations, and ulcerations due to venous or arterial insufficiency, or due to hematological disorders, in the opinion of the Investigator Ulcer, about which the Investigator is suspicious for cancer Subjects with a gangrenous or ischemic ulcer Subject with ulcer that in the opinion of the Investigator, may need amputation Subject with Target ulcer where wound measurement is not possible, such as ulcers between toes Body mass index (BMI) > 40 kg/m2 Laboratory values at Screening of: Hemoglobin < 10.0 g/dL White Blood Cells (WBC) < 2.0 X 109 cells/L Liver function studies [Total bilirubin, aspartate aminotransferase (AST) and alanine transaminase (ALT)] > 3x the upper limit of normal Albumin < 2.5 g/dL eGFR < 25 mL/min Presence of any existing clinically significant medical condition(s) that, in the opinion of the Investigator, could interfere with wound healing Subject has received or is currently receiving or scheduled to receive any medication or therapies during the course of the Study that will modulate wound healing Subject with intolerance to β-blockers at any time in the past Has any other factor which may, in the opinion of the Investigator, compromise participation and/or follow-up in the Study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ashu Rastogi, MD
Organizational Affiliation
Post Graduate Institute of Medical Education and Research
Official's Role
Principal Investigator
Facility Information:
Facility Name
Yalamanchi Hospita
City
Vijayawada
State/Province
Andhra Pradesh
ZIP/Postal Code
520002
Country
India
Facility Name
M.S. Ramaiah Medical College and Hospital
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560054
Country
India
Facility Name
Sapthagiri Institute of Medical Sciences and Research Centre
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560090
Country
India
Facility Name
Rajlaxmi Hospital
City
Bangalore
State/Province
Karnataka
ZIP/Postal Code
560097
Country
India
Facility Name
Sri Siddhartha Medical College
City
Tumkūr
State/Province
Karnataka
ZIP/Postal Code
572107
Country
India
Facility Name
Sujata Birla Hospital & Medical Research Center
City
Nashik
State/Province
Maharashtra
ZIP/Postal Code
422101
Country
India
Facility Name
Deenanath Mangeshkar Hospital and Research Center
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411004
Country
India
Facility Name
Chellaram Diabetes Institute
City
Pune
State/Province
Maharashtra
ZIP/Postal Code
411021
Country
India
Facility Name
Appollo Hospital
City
Chennai
State/Province
Tamilnadu
ZIP/Postal Code
600006
Country
India
Facility Name
M.V. Hospital for Diabetes Pvt Ltd
City
Chennai
State/Province
Tamilnadu
ZIP/Postal Code
600013
Country
India
Facility Name
Madras Diabetes Research Foundation
City
Chennai
State/Province
Tamilnadu
ZIP/Postal Code
600086
Country
India
Facility Name
Sri Ramachandra Hospital
City
Chennai
State/Province
Tamilnadu
ZIP/Postal Code
600116
Country
India
Facility Name
Post Graduate Institute of Medical Education and Research (PGIMER)
City
Chandigarh
ZIP/Postal Code
110012
Country
India
Facility Name
Maharaja Agrasen Hospital
City
New Delhi
ZIP/Postal Code
110026
Country
India

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers

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