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Study of the Efficacy and Safety of Granexin® Gel to Improve Burn Wound Healing

Primary Purpose

Second Degree Burn, Thermal Burn

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Granexin® gel (200 μM)
Vehicle gel
Sponsored by
Xequel Bio, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Second Degree Burn

Eligibility Criteria

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

Subjects will be eligible for randomization in the study if they meet all of the following inclusion criteria:

  1. Aged 18 years or older
  2. Women of childbearing potential (WOCBP) must have a negative pregnancy test at Screening and must agree to use hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence from the time of informed consent through Day 28 of the study; or female subjects must be postmenopausal (defined as 12 months since last menstruation) or surgically sterilized.

    Male subjects must abstain from sex with WOCBP or use an adequate method of contraception (as described above) from the time of informed consent through Day 28 of the study.

  3. Must have two comparable (similar body location, similar burn area and burn severity), noncontiguous deep second-degree thermal burns (target burns) caused by a fire/flame, scalds, or a hot object.
  4. Must have two target burns:

    1. No single target burn less than 1% TBSA
    2. All burns less than 20% cumulative TBSA
  5. Any treatment administered prior to randomization must be similar to both target burns and must be removed or discontinued prior to randomization.
  6. Signed informed consent form

Subjects will not be eligible for randomization in the study if any of the following exclusion criteria are met:

  1. Chemical, radiation, or electrical burns
  2. Burns older than 36 hours prior to study randomization
  3. Target burns more severe than deep second-degree
  4. Target burns to the hands, face, neck, or feet. Burn area may include hands and feet where target burn will only include areas extending above the wrist or ankle.
  5. Target burns that are superficial second-degree burn wounds expected to heal within two weeks
  6. Evidence of active infection, including cellulitis, at the site of the target burns
  7. Known collagen vascular diseases
  8. Any history of malignancy within the last 5 years or the presence of any active systemic cancer (exception will be basal cell skin cancer in a non-burned area)
  9. History of clinically significant cardio/pulmonary conditions
  10. Clinically significant medical conditions as determined by the clinical Investigator, which would impair wound healing including renal, hepatic, hematologic, neurologic, or immune disease
  11. Known inability or unavailability to complete required study visits
  12. Critical illnesses such as those requiring ventilator support, or having a systemic infection or hemodynamic instability, defined as a mean arterial pressure less than 60 mm Hg or requiring vasoactive medications to support blood pressure
  13. Major acute or chronic medical illnesses that could affect wound healing (e.g. peripheral vascular disease, insulin dependent diabetes, blood clotting disorder)
  14. Currently receiving treatment with medications that inhibit or compromise wound healing. Examples include immunosuppressive agents, topical growth factors, therapeutic anticoagulants, antiplatelet drugs, and systemic steroids such as warfarin, clopidogrel, or prednisone. The use of anticoagulants does not include deep vein thrombosis (DVT) prophylaxis. Subjects may use aspirin or lovenox.
  15. Any condition which, in the opinion of the Investigator, places the subject at unacceptable risk if he/she were to participate in the study
  16. Clinically relevant serious co-morbid medical conditions including, but not limited to: unstable angina, symptomatic congestive heart failure, uncontrolled hypertension, uncontrolled cardiac arrhythmias, chronic obstructive or chronic restrictive pulmonary disease, active central nervous system (CNS) disease uncontrolled by standard of care
  17. Known positive status for human immunodeficiency virus (HIV), or active hepatitis B or C, or cirrhosis
  18. Psychiatric illness/social situations that would limit compliance with study requirements
  19. Pregnant or breastfeeding
  20. Treatment with another investigational drug within 30 days or 5 half-lives of drug prior to Screening, whichever is longer
  21. Known hypersensitivity to the ingredients in Granexin® or ACTICOAT Flex 3TM
  22. Known hypersensitivity or allergy to silver or polyester
  23. Any other factor, which may, in the opinion of the Investigator, compromise participation and follow-up in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    Granexin gel

    Vehicle Gel

    Arm Description

    Within-subject comparison of Granexin® Gel versus vehicle gel (placebo). Granexin® gel 200 μM will be applied daily over ten days. Granexin® will be applied to one of two selected target burns.

    Within-subject comparison of Granexin® Gel versus vehicle gel (placebo). Vehicle gel will be applied daily over ten days. Vehicle will be applied to one of two selected target burns.

    Outcomes

    Primary Outcome Measures

    Time to re-epithelization
    Time (in days) to 100% re-epitheliazation of deep second degree burns as determined through clinical assessments

    Secondary Outcome Measures

    Reduction in scar severity at Month 12
    Assessed using the Vancouver Scar Scale. The Vancouver Scar Scale has 4 variables: Vascularity, Height (thickness), Pliability, Pigmentation. Each variable has three to six possible scores. The scores for the four components will be added to obtain the total score. The total score ranges from 0 to 13, whereby a score of 0 reflects normal skin.
    Proportion of burns that convert from partial thickness burns to full thickness burns
    Burn conversion is determined through clinical assessment.
    Proportion of subjects needing additional burn interventions
    Determined by the initiation of burn interventions, including surgery and skin grafts
    Time to skin grafting
    Determined by time (in days) to skin grafting
    Incidence of infection
    Determined by Investigator's assessment of presence or absence of infection
    Incidence of treatment related adverse events (AEs)
    Assessed using Common Terminology Criteria for Adverse Events (CTCAE) v 5.0. Events that are probably, possible, and definitely related will be considered treatment related events.

    Full Information

    First Posted
    December 17, 2020
    Last Updated
    June 19, 2023
    Sponsor
    Xequel Bio, Inc.
    Collaborators
    United States Department of Defense
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04684121
    Brief Title
    Study of the Efficacy and Safety of Granexin® Gel to Improve Burn Wound Healing
    Official Title
    A Phase 2, Prospective, Randomized, Double-Blind, Parallel-Group, Within-Subject Vehicle Controlled Multicenter Study of the Efficacy and Safety of Granexin® Gel to Improve Burn Wound Healing
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    No longer aligned with company strategy
    Study Start Date
    August 1, 2022 (Anticipated)
    Primary Completion Date
    August 1, 2024 (Anticipated)
    Study Completion Date
    August 1, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Xequel Bio, Inc.
    Collaborators
    United States Department of Defense

    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
    To evaluate the efficacy of Granexin® gel to promote accelerated healing of second-degree (deep partial thickness) thermal burns.
    Detailed Description
    Multi-center, prospective, randomized, double-blind, parallel-group, within-subject Vehicle controlled, safety and efficacy trial involving subjects with two comparable (similar body location, similar burn area and burn severity), noncontiguous deep second-degree thermal burns of less than 20% TBSA. A total of 30 subjects will have two target burns randomly assigned in a ratio of 1:1 to two treatment groups. Granexin® gel (200 μM) plus ACTICOAT Flex 3TM Vehicle gel plus ACTICOAT Flex 3TM The study procedures are divided into the following three periods: Screening (within 36 hours of the time of injury) Treatment (daily for 10 days) Follow-up (Day 10 through Month 12) The anticipated total duration of a given subject's participation in this study is 12 months. Screening can occur up to 36 hours prior to Day 0; Screening and Day 0 may occur on the same day. Treatment period visits occur daily from Day 0 through Day 9, on-site and remotely. During the treatment period, each subject will be treated with Granexin® gel (200 μM) plus ACTICOAT Flex 3TM on one target burn and Vehicle gel plus ACTICOAT Flex 3TM on the second target burn. After Day 9, the subject will return to clinic on Day 10 and be followed-up (on-site or remotely) every other day thereafter until Day 28, with on-site visits on Days 14, 20, and 28. The subject will then return to the clinic for follow-up visits at Months 6, 9, and 12. Safety will be assessed during the study by monitoring adverse events and measuring vital signs at each on-site visit, electrocardiograms (ECG), and clinical laboratory tests at selected time points before and after treatment with Granexin® gel and Vehicle gel. Concomitant medications will be reviewed at every visit.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Second Degree Burn, Thermal Burn

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Granexin gel
    Arm Type
    Experimental
    Arm Description
    Within-subject comparison of Granexin® Gel versus vehicle gel (placebo). Granexin® gel 200 μM will be applied daily over ten days. Granexin® will be applied to one of two selected target burns.
    Arm Title
    Vehicle Gel
    Arm Type
    Placebo Comparator
    Arm Description
    Within-subject comparison of Granexin® Gel versus vehicle gel (placebo). Vehicle gel will be applied daily over ten days. Vehicle will be applied to one of two selected target burns.
    Intervention Type
    Drug
    Intervention Name(s)
    Granexin® gel (200 μM)
    Intervention Description
    Granexin® gel (200 μM) will be topically applied once daily for 10 days in association with standard of care (SOC) wound cleaning and ACTICOAT Flex 3TM dressing.
    Intervention Type
    Drug
    Intervention Name(s)
    Vehicle gel
    Intervention Description
    Vehicle gel will be topically applied once daily for 10 days in association with standard of care (SOC) wound cleaning and ACTICOAT Flex 3TM dressing.
    Primary Outcome Measure Information:
    Title
    Time to re-epithelization
    Description
    Time (in days) to 100% re-epitheliazation of deep second degree burns as determined through clinical assessments
    Time Frame
    From Day 0 to Month 12
    Secondary Outcome Measure Information:
    Title
    Reduction in scar severity at Month 12
    Description
    Assessed using the Vancouver Scar Scale. The Vancouver Scar Scale has 4 variables: Vascularity, Height (thickness), Pliability, Pigmentation. Each variable has three to six possible scores. The scores for the four components will be added to obtain the total score. The total score ranges from 0 to 13, whereby a score of 0 reflects normal skin.
    Time Frame
    Month 12
    Title
    Proportion of burns that convert from partial thickness burns to full thickness burns
    Description
    Burn conversion is determined through clinical assessment.
    Time Frame
    From Day 0 to Day 28
    Title
    Proportion of subjects needing additional burn interventions
    Description
    Determined by the initiation of burn interventions, including surgery and skin grafts
    Time Frame
    From Day 0 to Day 28
    Title
    Time to skin grafting
    Description
    Determined by time (in days) to skin grafting
    Time Frame
    From Day 0 to Month 12
    Title
    Incidence of infection
    Description
    Determined by Investigator's assessment of presence or absence of infection
    Time Frame
    From Day 0 to Month 12
    Title
    Incidence of treatment related adverse events (AEs)
    Description
    Assessed using Common Terminology Criteria for Adverse Events (CTCAE) v 5.0. Events that are probably, possible, and definitely related will be considered treatment related events.
    Time Frame
    From Day 0 to Month 12
    Other Pre-specified Outcome Measures:
    Title
    Reduction in scar severity
    Description
    Assessed using the Vancouver Scar Scale. The Vancouver Scar Scale has 4 variables: Vascularity, Height (thickness), Pliability, Pigmentation. Each variable has three to six possible scores. The scores for the four components will be added to obtain the total score. The total score ranges from 0 to 13, whereby a score of 0 reflects normal skin.
    Time Frame
    Months 6 and 9
    Title
    Histological examination of burns
    Description
    Analysis of punch biopsies taken from the center of each target burn: depth of injury to dermis measured as vertical height (microns) to the most deeply injured area measured from each histologic section, assessment of inflammatory cell infiltration via direct counting of inflammatory cells from each histologic section, scoring of collagen organization from each histologic section.
    Time Frame
    Punch biopsies collected from each target burn on Day 0, Day 7 and Month 12
    Title
    Exploratory gene expression for markers of wound healing and scar formation
    Description
    Gene expression levels of pharmacodynamic markers of wound healing and scar formation will be evaluated by multiplex direct gene counting assay.
    Time Frame
    Collected from each target burn on Day 0, Day 7 and Month 12

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Subjects will be eligible for randomization in the study if they meet all of the following inclusion criteria: Aged 18 years or older Women of childbearing potential (WOCBP) must have a negative pregnancy test at Screening and must agree to use hormonal contraceptive, intra-uterine device, diaphragm with spermicide, condom with spermicide, or abstinence from the time of informed consent through Day 28 of the study; or female subjects must be postmenopausal (defined as 12 months since last menstruation) or surgically sterilized. Male subjects must abstain from sex with WOCBP or use an adequate method of contraception (as described above) from the time of informed consent through Day 28 of the study. Must have two comparable (similar body location, similar burn area and burn severity), noncontiguous deep second-degree thermal burns (target burns) caused by a fire/flame, scalds, or a hot object. Must have two target burns: No single target burn less than 1% TBSA All burns less than 20% cumulative TBSA Any treatment administered prior to randomization must be similar to both target burns and must be removed or discontinued prior to randomization. Signed informed consent form Subjects will not be eligible for randomization in the study if any of the following exclusion criteria are met: Chemical, radiation, or electrical burns Burns older than 36 hours prior to study randomization Target burns more severe than deep second-degree Target burns to the hands, face, neck, or feet. Burn area may include hands and feet where target burn will only include areas extending above the wrist or ankle. Target burns that are superficial second-degree burn wounds expected to heal within two weeks Evidence of active infection, including cellulitis, at the site of the target burns Known collagen vascular diseases Any history of malignancy within the last 5 years or the presence of any active systemic cancer (exception will be basal cell skin cancer in a non-burned area) History of clinically significant cardio/pulmonary conditions Clinically significant medical conditions as determined by the clinical Investigator, which would impair wound healing including renal, hepatic, hematologic, neurologic, or immune disease Known inability or unavailability to complete required study visits Critical illnesses such as those requiring ventilator support, or having a systemic infection or hemodynamic instability, defined as a mean arterial pressure less than 60 mm Hg or requiring vasoactive medications to support blood pressure Major acute or chronic medical illnesses that could affect wound healing (e.g. peripheral vascular disease, insulin dependent diabetes, blood clotting disorder) Currently receiving treatment with medications that inhibit or compromise wound healing. Examples include immunosuppressive agents, topical growth factors, therapeutic anticoagulants, antiplatelet drugs, and systemic steroids such as warfarin, clopidogrel, or prednisone. The use of anticoagulants does not include deep vein thrombosis (DVT) prophylaxis. Subjects may use aspirin or lovenox. Any condition which, in the opinion of the Investigator, places the subject at unacceptable risk if he/she were to participate in the study Clinically relevant serious co-morbid medical conditions including, but not limited to: unstable angina, symptomatic congestive heart failure, uncontrolled hypertension, uncontrolled cardiac arrhythmias, chronic obstructive or chronic restrictive pulmonary disease, active central nervous system (CNS) disease uncontrolled by standard of care Known positive status for human immunodeficiency virus (HIV), or active hepatitis B or C, or cirrhosis Psychiatric illness/social situations that would limit compliance with study requirements Pregnant or breastfeeding Treatment with another investigational drug within 30 days or 5 half-lives of drug prior to Screening, whichever is longer Known hypersensitivity to the ingredients in Granexin® or ACTICOAT Flex 3TM Known hypersensitivity or allergy to silver or polyester Any other factor, which may, in the opinion of the Investigator, compromise participation and follow-up in the study.

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Study of the Efficacy and Safety of Granexin® Gel to Improve Burn Wound Healing

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