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Bacteriophage Therapy TP-102 in Patients With Diabetic Foot Infection (REVERSE2)

Primary Purpose

Diabetic Foot Infection

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
TP-102
Placebo
Sponsored by
Technophage, SA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Infection

Eligibility Criteria

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

Inclusion Criteria: Aged ≥18 years old; Established diagnosis of Diabetes Mellitus (type I or II); Glycosylated hemoglobin (HbA1c) value < 12.0%; Designated foot infection meets the following criteria: Present for at least 3 weeks; Below-ankle, full-thickness, cutaneous ulcer; Wound area (after debridement, if applicable) 1 to 20.0 cm2; PEDIS infection grade 2 or 3; PEDIS perfusion grade 1 or 2; PEDIS depth grade 1 or 2 (grade 3 at the discretion of the investigator e.g. if they have received appropriate surgical treatment to remove infected bones). Diabetic foot infection with at least one target bacterial strain (Pseudomonas aeruginosa, Staphylococcus aureus or Acinetobacter baumannii), susceptible to the TP-102 bacteriophage cocktail, as assessed from wound cultures; Patients of suitable physical and mental health as determined by the Investigator on the basis of medical history and general physical examination; Patients of childbearing potential must have a negative serum pregnancy test at screening; ICF signed voluntarily before any study-related procedure is performed, indicating that the patient understands the purpose of, and procedures required in the study and is willing to participate in the study. Exclusion Criteria: Infected study ulcer less than 2 cm away from other ulcers, in the case of multiple ulcers; Patient receiving hyperbaric oxygen therapy (HBOT), negative pressure wound therapy (NPWT), bioengineering skin (BES) substitutes and/or growth factors; Patient which, in the opinion of the investigator, may not comply with study related procedures; Presence of active malignant or benign tumors of any kind, (with exception to nonmelanoma skin cancer as per investigator's discretion); Being pregnant or breastfeeding; Currently participating in another clinical trial or having participated in a previous clinical trial with receipt of an investigational product within 30 days of the first administration of IP; A condition that, in the opinion of the Investigator, could compromise the well-being of the patient or course of the study, or prevent the patient from meeting or performing any study requirements; Participants with hypersensitivity to any component of investigational products.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Placebo Comparator

    Arm Label

    TP-102

    Placebo

    Arm Description

    Patients will be randomly assigned in a 1:1 ratio to one of two treatment arms at Day 1. The wound standard of care (SoC) procedures shall be in accordance to each sites normal DFI routine.

    Patients will be randomly assigned in a 1:1 ratio to one of two treatment arms at Day 1. The wound standard of care (SoC) procedures shall be in accordance to each sites normal DFI routine.

    Outcomes

    Primary Outcome Measures

    1. Number and percentage of treatment emergent adverse events (TEAEs)
    See above
    2. Mean DFUWI score (total AUC) for TP-102 versus Placebo
    See above
    3. Percentage of patients that achieve a 50% reduction in wound surface area by week 4

    Secondary Outcome Measures

    1. Change in mean CRP/ESR/PCT/WCC value for TP-102 versus Placebo
    2. Percentage of patients with a value over clinical diagnostic cut-off for DFI for CRP/ESR/PCT/WCC
    3. Percentage eradication of TP-102 susceptible strains for TP-102 versus Placebo at EOT;
    4. Percentage of patients with target strain not-susceptible to TP-102 for TP-102 versus Placebo at EOT;

    Full Information

    First Posted
    June 15, 2023
    Last Updated
    July 6, 2023
    Sponsor
    Technophage, SA
    Collaborators
    VectorB2B
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05948592
    Brief Title
    Bacteriophage Therapy TP-102 in Patients With Diabetic Foot Infection
    Acronym
    REVERSE2
    Official Title
    A Phase 2 CT to Evaluate the Safety and Efficacy of Topical Administration of Bacteriophage Therapy TP-102 in Patients With DFI
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    August 1, 2023 (Anticipated)
    Primary Completion Date
    October 31, 2023 (Anticipated)
    Study Completion Date
    December 31, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Technophage, SA
    Collaborators
    VectorB2B

    4. Oversight

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

    5. Study Description

    Brief Summary
    TP-102 is a novel bacteriophage cocktail comprised of 5 (five) lytic bacteriophages against Staphylococcus aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii. TP-102 is being developed for topical treatment of patients with wound infections including chronic ulcers; applied every other day (three times weekly (TIW)).
    Detailed Description
    This is a Phase 2b, double-blinded, randomised, placebo-controlled multicenter study to determine the safety and efficacy of TP-102, in patients with diabetic foot infection. Eighty (80) patients with an infected diabetic foot ulcer and with at least one target bacterial strain (Pseudomonas aeruginosa, Staphylococcus aureus or Acinetobacter baumannii) susceptible to TP-102. Patients will be randomised to receive TP-102 or placebo, in a 1:1 ratio. Patients will be treated with 1 (one) mL of IP/ Placebo solution applied topically per cm3 of target ulcer. Patients will be treated with a total of 12 treatments in 28 days (+3 days) with at least one day of interval in between the days of treatment (no consecutive days of treatment are allowed) and a maximum of 3 (three) days without treatment. The titre of each bacteriophage in TP-102 is 1x109 (>1x108 and < 1x1010) plaque forming units per milliliter (PFU/mL). Assessments for efficacy and safety will include concomitant medications and AEs, local tolerability, clinical laboratory tests, vital signs, physical examination, wound biopsy/swab to determine the presence, speciation and TP-102 sensitivity of bacteria and target ulcer assessment.

    6. Conditions and Keywords

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

    7. Study Design

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

    8. Arms, Groups, and Interventions

    Arm Title
    TP-102
    Arm Type
    Experimental
    Arm Description
    Patients will be randomly assigned in a 1:1 ratio to one of two treatment arms at Day 1. The wound standard of care (SoC) procedures shall be in accordance to each sites normal DFI routine.
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Arm Description
    Patients will be randomly assigned in a 1:1 ratio to one of two treatment arms at Day 1. The wound standard of care (SoC) procedures shall be in accordance to each sites normal DFI routine.
    Intervention Type
    Biological
    Intervention Name(s)
    TP-102
    Intervention Description
    Patients randomised to TP-102 will receive 1 (one) mL of IP solution, applied topically per cm3 of target ulcer. The titre of each bacteriophage in TP-102 is 1x109 PFU/mL (>1x108 PFU/mL and <1x1010 PFU/mL). All patients randomised to TP-102 will receive the same concentration per mL. TP-102 will be applied to the target ulcer using a syringe without a needle. The volume of TP-102 to be administered will be determined from the wound volume assessment at the previous visit through an automated wound measurement system (Silhouette), except on the first day of treatment where the amount applied will be determined based on the wound volume determined at that time using the automated wound measurement system (Silhouette).
    Intervention Type
    Other
    Intervention Name(s)
    Placebo
    Intervention Description
    Patients randomised to placebo, the volume calculated to be administered will be determined from the wound volume assessment at the previous visit through an automated wound measurement system (Silhouette), except on the first day of treatment where the amount applied will be determined based on the wound volume determined at that time using the automated wound measurement system (Silhouette).
    Primary Outcome Measure Information:
    Title
    1. Number and percentage of treatment emergent adverse events (TEAEs)
    Description
    See above
    Time Frame
    From baseline to EOT, aproximately 12 weeks
    Title
    2. Mean DFUWI score (total AUC) for TP-102 versus Placebo
    Description
    See above
    Time Frame
    From baseline to EOT, , aproximately 12 weeks
    Title
    3. Percentage of patients that achieve a 50% reduction in wound surface area by week 4
    Time Frame
    Week 4
    Secondary Outcome Measure Information:
    Title
    1. Change in mean CRP/ESR/PCT/WCC value for TP-102 versus Placebo
    Time Frame
    From baseline to EOT, , aproximately 12 weeks
    Title
    2. Percentage of patients with a value over clinical diagnostic cut-off for DFI for CRP/ESR/PCT/WCC
    Time Frame
    Baseline to EOT, , aproximately 12 weeks
    Title
    3. Percentage eradication of TP-102 susceptible strains for TP-102 versus Placebo at EOT;
    Time Frame
    EOT, , aproximately 12 weeks
    Title
    4. Percentage of patients with target strain not-susceptible to TP-102 for TP-102 versus Placebo at EOT;
    Time Frame
    EOT, , aproximately 12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Aged ≥18 years old; Established diagnosis of Diabetes Mellitus (type I or II); Glycosylated hemoglobin (HbA1c) value < 12.0%; Designated foot infection meets the following criteria: Present for at least 3 weeks; Below-ankle, full-thickness, cutaneous ulcer; Wound area (after debridement, if applicable) 1 to 20.0 cm2; PEDIS infection grade 2 or 3; PEDIS perfusion grade 1 or 2; PEDIS depth grade 1 or 2 (grade 3 at the discretion of the investigator e.g. if they have received appropriate surgical treatment to remove infected bones). Diabetic foot infection with at least one target bacterial strain (Pseudomonas aeruginosa, Staphylococcus aureus or Acinetobacter baumannii), susceptible to the TP-102 bacteriophage cocktail, as assessed from wound cultures; Patients of suitable physical and mental health as determined by the Investigator on the basis of medical history and general physical examination; Patients of childbearing potential must have a negative serum pregnancy test at screening; ICF signed voluntarily before any study-related procedure is performed, indicating that the patient understands the purpose of, and procedures required in the study and is willing to participate in the study. Exclusion Criteria: Infected study ulcer less than 2 cm away from other ulcers, in the case of multiple ulcers; Patient receiving hyperbaric oxygen therapy (HBOT), negative pressure wound therapy (NPWT), bioengineering skin (BES) substitutes and/or growth factors; Patient which, in the opinion of the investigator, may not comply with study related procedures; Presence of active malignant or benign tumors of any kind, (with exception to nonmelanoma skin cancer as per investigator's discretion); Being pregnant or breastfeeding; Currently participating in another clinical trial or having participated in a previous clinical trial with receipt of an investigational product within 30 days of the first administration of IP; A condition that, in the opinion of the Investigator, could compromise the well-being of the patient or course of the study, or prevent the patient from meeting or performing any study requirements; Participants with hypersensitivity to any component of investigational products.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Sofia Corte Real
    Phone
    +351215943993
    Email
    scortereal@technophage.pt
    First Name & Middle Initial & Last Name or Official Title & Degree
    Margarida Barreto
    Email
    mbarreto@technophage.pt
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jose David Suarez
    Organizational Affiliation
    Keralty Hospital, Miami
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Bacteriophage Therapy TP-102 in Patients With Diabetic Foot Infection

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