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Use of AC5® Advanced Wound System in the Treatment of Diabetic Foot Ulcers

Primary Purpose

Non-healing Wound, Diabetic Foot Ulcer

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
AC5® Advanced Wound System
Fibracol Plus Collagen Dressing
Sponsored by
Arch Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Non-healing Wound focused on measuring DFU, self-assembling peptide, chronic wounds, Synthetic matrix

Eligibility Criteria

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

Inclusion Criteria: Males and females aged 18 or older. Subject is willing to sign informed consent and participate in all procedures with follow up evaluations as necessary to complete the study. Study ulcer is diabetic in origin, located on the foot or below the malleolus with ulcer extending through the dermis but not into tendon, muscle or bone (UT Grade 1A). Study ulcer size is a minimum of 2 cm2 and maximum 25 cm2 after the run-in period. Study ulcer has been present for a minimum of 4 weeks before enrollment and less than 1 year old, with documented failure of prior treatment to heal the wound. Study ulcer has been offloaded for at least 14 days prior to randomization. A two-week run-in period will precede enrollment in the trial to document the indolent nature of the subjects selected; healing rate is not to be > 40% during this period. Subject does not exhibit clinical signs / symptoms of infection upon gross observation or have been diagnosed with an active infection at time of screening. Subject has adequate control of diabetes demonstrated by Hemoglobin A1c < 12% within 90 days of screening. Subject has adequate circulation to the affected extremity, as demonstrated by one of the following within the past 60 days of the first screening visit: Dorsal transcutaneous oxygen measurements (TCOM) ≥ 30mmHg. Ankle-Brachial Index with results of ≥ 0.8 and ≤ 1.5 or had past intervention. Exclusion Criteria: Study ulcer wound surface is area greater than 25 cm2. Study ulcer has > 40% wound healing during the 14 days screening period. Subject has a known history of poor compliance with medical treatments. Subject is presently participating in another clinical trial. Subject has a known or suspected local malignancy to the Study diabetic ulcer, or systemic malignancy. Subject has been diagnosed with autoimmune connective tissues diseases. Subject has received graft material or topical growth factors on the study ulcer within the previous 30 days. Subject has received application of topical steroids on the study ulcer surface within the previous 30 days. Subject is pregnant or breast feeding. Subject is on dialysis. Subject is taking medications that are considered immune system modulators or cytotoxic chemotherapies. Subject cannot be on systemic antibiotics prior to randomization, however, during the treatment phase infection management may include systemic antibiotics if in conjunction with debridement. Subject has a known allergy to ingredients/components of AC5. Subject has osteomyelitis, and/or bony prominences present in the wound. Subject has ulcer probing to bone and tendon. (UT Grade II or III A-D). Subject is unable to comply with planned study procedures and treatments.

Sites / Locations

  • Dr. Christopher Gauland
  • Dr. Brock LidenRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Arm 1-AC5® Advanced Wound System

Arm2- Fibracol Plus Collagen dressing

Arm Description

The intervention in this arm is the application of a synthetic self assembling peptide matrix (AC5) to UT Grade 1A diabetic foot ulcers

The intervention in this arm is the application of collagen dressings to UT Grade 1A diabetic foot ulcers

Outcomes

Primary Outcome Measures

Percentage of wounds closed
100% epithelialization
Change in wound area size
Assess the percent change in wound area
Days to complete wound closure
median and mean

Secondary Outcome Measures

Number of units used to achieve wound closure
number of units used
Changes in quality of life
Pain, odor, itch intensity and activities of daily living are assessed before any ulcer manipulations. Subject will fill out the quality of life form which utilizes a numeric scale from 0 (minimum) to indicate no pain, no odor, no itch, normal activities of daily living -10 (maximum) to indicate worst possible pain, extremely strong odor, worst possible itch and not able to perform activities of daily living.

Full Information

First Posted
August 26, 2023
Last Updated
September 7, 2023
Sponsor
Arch Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT06028386
Brief Title
Use of AC5® Advanced Wound System in the Treatment of Diabetic Foot Ulcers
Official Title
A Prospective Pilot Study Evaluating Wound Closure With the Application of AC5® Advanced Wound System in the Treatment of Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 15, 2023 (Actual)
Primary Completion Date
April 30, 2024 (Anticipated)
Study Completion Date
August 30, 2024 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this clinical evaluation is to collect and compare outcomes data from patients with UT 1A diabetic foot ulcers treated with 510K FDA cleared, commercially available self-assembling peptide, AC5®Advanced Wound System, as compared to an advanced standard of care. Patient outcomes will be compared at the end of the study.
Detailed Description
This study is a prospective, multi-center randomized controlled study designed to collect patient outcomes data for the treatment of diabetic foot ulcers. (DFU) All subjects will receive standard of care procedures (SOC) such as wound cleaning, appropriate sharp debridement, and appropriate offloading of the DFU (e.g., offloading Camboot or post op shoe with offloading/wound care insole). Subjects will be randomized and receive treatments to either of the following arms: Arm 1 - Subject will receive SOC that will include AC5® Advanced Wound System as an active synthetic cellular tissue product, covered with a non-adherent dressing plus an appropriate outer dressing to maintain moisture balance, then wrapped with stretch gauze and self-adherent wrap. AC5 will be applied weekly and outer dressings will be redressed, if necessary, using the allowed secondary dressings. Arm 2 - Subject will receive SOC that will include Fibracol Plus collagen dressing as an active dressing. This will be followed with an appropriate outer dressing to maintain moisture balance, then wrapped with stretch gauze and self-adherent wrap as needed. Fibracol Plus will be applied 3 x a week and any outer dressings will be redressed, if necessary, using the allowed dressings. The study involves two phases: Screening and Treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Non-healing Wound, Diabetic Foot Ulcer
Keywords
DFU, self-assembling peptide, chronic wounds, Synthetic matrix

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Arm 1-AC5® Advanced Wound System
Arm Type
Active Comparator
Arm Description
The intervention in this arm is the application of a synthetic self assembling peptide matrix (AC5) to UT Grade 1A diabetic foot ulcers
Arm Title
Arm2- Fibracol Plus Collagen dressing
Arm Type
Placebo Comparator
Arm Description
The intervention in this arm is the application of collagen dressings to UT Grade 1A diabetic foot ulcers
Intervention Type
Device
Intervention Name(s)
AC5® Advanced Wound System
Intervention Description
This group will receive AC5® Advanced Wound system, a synthetic self-assembling peptide matrix to the wound and covered with non-adherent dressing followed with appropriate outer dressing to maintain moisture balance. AC5 is applied weekly and outer dressing will be redressed as necessary.
Intervention Type
Device
Intervention Name(s)
Fibracol Plus Collagen Dressing
Intervention Description
This group will receive Fibracol Plus collagen dressing to the wound and covered with appropriate out dressing. Treatment will be done 3x a week.
Primary Outcome Measure Information:
Title
Percentage of wounds closed
Description
100% epithelialization
Time Frame
before or at 12 weeks
Title
Change in wound area size
Description
Assess the percent change in wound area
Time Frame
from randomization through to end of study (at 12 weeks) for non-closed wounds
Title
Days to complete wound closure
Description
median and mean
Time Frame
before or at 12 weeks
Secondary Outcome Measure Information:
Title
Number of units used to achieve wound closure
Description
number of units used
Time Frame
before or at 12 weeks
Title
Changes in quality of life
Description
Pain, odor, itch intensity and activities of daily living are assessed before any ulcer manipulations. Subject will fill out the quality of life form which utilizes a numeric scale from 0 (minimum) to indicate no pain, no odor, no itch, normal activities of daily living -10 (maximum) to indicate worst possible pain, extremely strong odor, worst possible itch and not able to perform activities of daily living.
Time Frame
before or at 12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females aged 18 or older. Subject is willing to sign informed consent and participate in all procedures with follow up evaluations as necessary to complete the study. Study ulcer is diabetic in origin, located on the foot or below the malleolus with ulcer extending through the dermis but not into tendon, muscle or bone (UT Grade 1A). Study ulcer size is a minimum of 2 cm2 and maximum 25 cm2 after the run-in period. Study ulcer has been present for a minimum of 4 weeks before enrollment and less than 1 year old, with documented failure of prior treatment to heal the wound. Study ulcer has been offloaded for at least 14 days prior to randomization. A two-week run-in period will precede enrollment in the trial to document the indolent nature of the subjects selected; healing rate is not to be > 40% during this period. Subject does not exhibit clinical signs / symptoms of infection upon gross observation or have been diagnosed with an active infection at time of screening. Subject has adequate control of diabetes demonstrated by Hemoglobin A1c < 12% within 90 days of screening. Subject has adequate circulation to the affected extremity, as demonstrated by one of the following within the past 60 days of the first screening visit: Dorsal transcutaneous oxygen measurements (TCOM) ≥ 30mmHg. Ankle-Brachial Index with results of ≥ 0.8 and ≤ 1.5 or had past intervention. Exclusion Criteria: Study ulcer wound surface is area greater than 25 cm2. Study ulcer has > 40% wound healing during the 14 days screening period. Subject has a known history of poor compliance with medical treatments. Subject is presently participating in another clinical trial. Subject has a known or suspected local malignancy to the Study diabetic ulcer, or systemic malignancy. Subject has been diagnosed with autoimmune connective tissues diseases. Subject has received graft material or topical growth factors on the study ulcer within the previous 30 days. Subject has received application of topical steroids on the study ulcer surface within the previous 30 days. Subject is pregnant or breast feeding. Subject is on dialysis. Subject is taking medications that are considered immune system modulators or cytotoxic chemotherapies. Subject cannot be on systemic antibiotics prior to randomization, however, during the treatment phase infection management may include systemic antibiotics if in conjunction with debridement. Subject has a known allergy to ingredients/components of AC5. Subject has osteomyelitis, and/or bony prominences present in the wound. Subject has ulcer probing to bone and tendon. (UT Grade II or III A-D). Subject is unable to comply with planned study procedures and treatments.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Evelyn Quintin
Phone
6174312308
Email
equintin@archtherapeutics.com
First Name & Middle Initial & Last Name or Official Title & Degree
Terry Norchi, MD
Phone
800-937-9030
Email
tnorchi@archtherapeutics.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Brock Liden, DPM
Organizational Affiliation
WAFL, Inc.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dr. Christopher Gauland
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christopher Gauland
Email
chris@ecfanc.com
Facility Name
Dr. Brock Liden
City
Circleville
State/Province
Ohio
ZIP/Postal Code
44113
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brock Liden
Email
dpmresearch@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
21951763
Citation
Warriner RA, Snyder RJ, Cardinal MH. Differentiating diabetic foot ulcers that are unlikely to heal by 12 weeks following achieving 50% percent area reduction at 4 weeks. Int Wound J. 2011 Dec;8(6):632-7. doi: 10.1111/j.1742-481X.2011.00860.x. Epub 2011 Sep 23.
Results Reference
background
PubMed Identifier
29381543
Citation
Rahmani G, Prats J, Norchi T, Kates S, McInerney V, Woods J, Kelly J. First Safety and Performance Evaluation of T45K, a Self-Assembling Peptide Barrier Hemostatic Device, After Skin Lesion Excision. Dermatol Surg. 2018 Jul;44(7):939-948. doi: 10.1097/DSS.0000000000001468.
Results Reference
background
PubMed Identifier
26707893
Citation
Koutsopoulos S. Self-assembling peptide nanofiber hydrogels in tissue engineering and regenerative medicine: Progress, design guidelines, and applications. J Biomed Mater Res A. 2016 Apr;104(4):1002-16. doi: 10.1002/jbm.a.35638. Epub 2016 Jan 25.
Results Reference
background
PubMed Identifier
35108216
Citation
Kapp D, Pfendler L, D'Oro L, Wolcott R. Early clinical performance of an adaptive self-assembling barrier scaffold in nonhealing chronic wounds: a review of six cases. Wounds. 2022 Jan;33(1):20-30. doi: 10.25270/wnds/2022.2030.
Results Reference
background

Learn more about this trial

Use of AC5® Advanced Wound System in the Treatment of Diabetic Foot Ulcers

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