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A Comparison of the dermaPACE® (Pulsed Acoustic Cellular Expression) Device in Conjunction With Standard of Care Versus Standard of Care Alone in the Treatment of Diabetic Foot Ulcers

Primary Purpose

Diabetic Foot Ulcers

Status
Unknown status
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Electrohydraulic-generated shock wave
Sham device plus standard of care
Sponsored by
SANUWAVE, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcers focused on measuring foot, ulcers, diabetes, wound, healing

Eligibility Criteria

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

Inclusion Criteria:

  1. Is >=22 years of age at Visit 1;
  2. If female of child-bearing potential, both of the following must be met at Visit 1:

    • Practices one of the following methods of contraception and continues through the duration of the study: hormonal contraceptives, IUD, spermicide and barrier or implantable device, and
    • Has a negative urine qualitative beta-HCG pregnancy test;
  3. If female and post-menopausal one of the following must be met at Visit 1:

    • Has had a complete hysterectomy, bilateral salpingo-oophorectomy or tubal ligation or otherwise be incapable of pregnancy, or
    • Is postmenopausal for at least one year;
  4. Has at least one DFU that is located in the ankle area or below that has persisted a minimum of 30 days prior to Visit 1.
  5. Has Type I or Type II Diabetes Mellitus with a HbA1c <= 11% at Visit 1;
  6. Is capable of wound care at home;
  7. Has a target ulcer >= 1.0 cm2 and <= 16 cm2 at Visits 1 and 2;
  8. Has a target ulcer that is Grade 1 or 2, Stage A according to the University of Texas Diabetic Wound Classification system, at Visits 1 and 2
  9. In the leg with the target ulcer has an ABI >= 0.70 and <= 1.20 OR if the ABI is >1.20 has a toe pressure >50 mmHg OR tcpO2 > 40 mmHg at Visit 1;
  10. Subject agrees, or if applicable, the subject's legal representative agrees that the subject can participate in the study

Exclusion Criteria:

  1. Is currently pregnant or plans to become pregnant during the study;
  2. Is nursing or actively lactating;
  3. Is morbidly obese (Body Mass Index >= 40) at Visit 1;
  4. Has clinically significant renal disease defined as having an estimated creatinine clearance of <=40mL/min at Visit 1;
  5. Has osteomyelitis in the foot or ankle on which the target ulcer is located at Visit 1 or 2;
  6. Has evidence of a prior ulcer in the same area as the target ulcer;
  7. Has a target ulcer that has decreased in volume by 50% or more at Visit 2 as compared to the volume at Visit 1;
  8. Has multiple foot ulcers that are connected by fistulas or has an ulcer(s) that are within 5 cm of the target ulcer at Visit 1 or 2;
  9. Has a target ulcer that tunnels into wound tracks which cannot be fully visualized from the wound surface at Visit 1 or 2;
  10. Has active cellulitis either at the site of, or in the surrounding area of, the target ulcer at Visit 1 or 2;
  11. Has a target ulcer that has visually purulent exudates or that has malodorous exudates on examination at Visit 1 or 2;
  12. Has PVD, per Doppler Ultrasound, requiring vascular surgery intervention at Visit 1 or 2;
  13. Requires use of off-loading Diabetic Walker device for the foot intended for study application for a reason other than for a target ulcer on the plantar surface of the foot at Visit 1 or 2;
  14. Has had a lower extremity revascularization procedure within eight weeks of Visit 1;
  15. Has active Charcot foot at Visit 1 or 2;
  16. Has had a surgical procedure to correct biomechanical abnormities within eight weeks of Visit 1;
  17. Has had a deep vein thrombosis within six months of Visit 1;
  18. Has clinical evidence of lymphedema at Visit 1;
  19. Has had chemotherapy within 60 days of Visit 1;
  20. Has a life expectancy <=2 years;
  21. Has previously participated in a dermaPACE diabetic foot ulcer study;
  22. Has had treatment of the target ulcer with growth factors, prostaglandin therapy, negative pressure or vasodilator therapy within two weeks of Visit 1;
  23. Is receiving >=10 mg/day of steroid therapy;
  24. Has sickle cell anemia;
  25. Has a known immunodeficiency disorder to include, but not be limited to: AIDS, HIV, etc.
  26. Has received radiation treatment within 120 days of Visit 1;
  27. Has received treatment with immunosuppressants within sixty days of Visit 1;
  28. Has received treatment with biologically active cellular products on the target ulcer, e.g. Apligraf®, Dermagraft®, etc. within sixty days of Visit 1;
  29. Has received treatment with acellular (collagen-based) products on the target ulcer, e.g. Alloderm®, Integra®, etc. within 30 days of Visit 1;
  30. Has a current history of substance abuse (current is defined as within 120 days of Visit 1);
  31. Has a history of major systemic infections requiring hospitalization within three months of Visit 1 ;
  32. Has a current malignancy or a history of malignancy within five years, of Visit 1 except for basal cell carcinoma that has been treated with local excision and is no longer present;
  33. Has a physical or mental disability or geographical concerns that would inhibit compliance with required study visits;
  34. Is planning to undergo an exclusionary treatment or procedure during the study; or
  35. Has participated in another investigation within 30 days of Visit 1

Sites / Locations

  • Associated Foot and Ankle SpecialistsRecruiting
  • Southern Arizona VA Healthcare SystemRecruiting
  • Long Beach VA Healthcare SystemRecruiting
  • Foot and Ankle ClinicRecruiting
  • Alameda County Medical Center - Highlands CampusRecruiting
  • Lucius J. Hill DPMRecruiting
  • Paul and Margaret Brand Research Center at Barry UniversityRecruiting
  • The Research CenterRecruiting
  • River City Clinical ResearchRecruiting
  • St. Paul Medical ResearchRecruiting
  • Advanced Pharma CRRecruiting
  • Northwestern University, Div of Plastic and Reconstructive SurgeryRecruiting
  • Foot Healthcare AssociatesRecruiting
  • Moore Foot and Ankle SpecialistsRecruiting
  • Wound Center - ACMHRecruiting
  • Podiatric Medical Partners of TexasRecruiting
  • UT Southwestern Medical CenterRecruiting
  • Foot and Ankle Associates of SW VirginiaRecruiting
  • The Mayer InstituteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Sham Comparator

Arm Label

Active device plus standard of care

Sham device plus standard of care

Arm Description

Active device plus standard of care

dermaPACE device that uses a dummy applicator that does not emit shock waves

Outcomes

Primary Outcome Measures

Complete closure
Complete closure will be assessed by visual inspection by the principal or sub-investigator according to the following complete closure definition: 100% skin re-epithelializion without drainage or dressing requirements confirmed at two consecutive study visits. A re-epithelialized target ulcer is defined as the tissue surface having at least a thin layer of epithelium covering the prior, previously denuded, target ulcer area.

Secondary Outcome Measures

Volumetric reduction
Digital planimetry will be used to assess volumetric reduction between follow-up visits.
Area reduction
Digital planimetry will be used to assess area reduction between follow-up visits.
Rate of recurrence
Rate of amputation and other adverse events

Full Information

First Posted
April 1, 2013
Last Updated
March 4, 2014
Sponsor
SANUWAVE, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01824407
Brief Title
A Comparison of the dermaPACE® (Pulsed Acoustic Cellular Expression) Device in Conjunction With Standard of Care Versus Standard of Care Alone in the Treatment of Diabetic Foot Ulcers
Official Title
A Double-Blind, Multi-center, Randomized, Sham-Controlled, Parallel Group Comparison of the dermaPACE® (Pulsed Acoustic Cellular Expression) Device in Conjunction With Standard of Care Versus Standard of Care Alone in the Treatment of Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
March 2014
Overall Recruitment Status
Unknown status
Study Start Date
March 2013 (undefined)
Primary Completion Date
April 2014 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SANUWAVE, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Sponsor of this study, SANUWAVE, Inc., has developed an investigational device known as the dermaPACE® (Pulsed Acoustic Cellular Expression) device for the possible treatment of diabetic foot ulcers. This device generates acoustic (sound) pressure waves designed to act on the cells in your body to generate proteins that may lead to wound closure. The dermaPACE® device has not been approved for the treatment of diabetic foot ulcers; therefore its use in this study is investigational. The purpose of the study is to evaluate the ability of the dermaPACE® device to help diabetic foot ulcers heal more quickly. The active study device, the dermaPACE®, will be compared to an inactive look-alike device (called a "Sham") in this study. The sham device will not provide any treatment to your diabetic foot ulcer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcers
Keywords
foot, ulcers, diabetes, wound, healing

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Active device plus standard of care
Arm Type
Active Comparator
Arm Description
Active device plus standard of care
Arm Title
Sham device plus standard of care
Arm Type
Sham Comparator
Arm Description
dermaPACE device that uses a dummy applicator that does not emit shock waves
Intervention Type
Device
Intervention Name(s)
Electrohydraulic-generated shock wave
Other Intervention Name(s)
dermaPACE
Intervention Type
Device
Intervention Name(s)
Sham device plus standard of care
Primary Outcome Measure Information:
Title
Complete closure
Description
Complete closure will be assessed by visual inspection by the principal or sub-investigator according to the following complete closure definition: 100% skin re-epithelializion without drainage or dressing requirements confirmed at two consecutive study visits. A re-epithelialized target ulcer is defined as the tissue surface having at least a thin layer of epithelium covering the prior, previously denuded, target ulcer area.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Volumetric reduction
Description
Digital planimetry will be used to assess volumetric reduction between follow-up visits.
Time Frame
12 weeks
Title
Area reduction
Description
Digital planimetry will be used to assess area reduction between follow-up visits.
Time Frame
12 weeks
Title
Rate of recurrence
Time Frame
24 weeks
Title
Rate of amputation and other adverse events
Time Frame
24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is >=22 years of age at Visit 1; If female of child-bearing potential, both of the following must be met at Visit 1: Practices one of the following methods of contraception and continues through the duration of the study: hormonal contraceptives, IUD, spermicide and barrier or implantable device, and Has a negative urine qualitative beta-HCG pregnancy test; If female and post-menopausal one of the following must be met at Visit 1: Has had a complete hysterectomy, bilateral salpingo-oophorectomy or tubal ligation or otherwise be incapable of pregnancy, or Is postmenopausal for at least one year; Has at least one DFU that is located in the ankle area or below that has persisted a minimum of 30 days prior to Visit 1. Has Type I or Type II Diabetes Mellitus with a HbA1c <= 11% at Visit 1; Is capable of wound care at home; Has a target ulcer >= 1.0 cm2 and <= 16 cm2 at Visits 1 and 2; Has a target ulcer that is Grade 1 or 2, Stage A according to the University of Texas Diabetic Wound Classification system, at Visits 1 and 2 In the leg with the target ulcer has an ABI >= 0.70 and <= 1.20 OR if the ABI is >1.20 has a toe pressure >50 mmHg OR tcpO2 > 40 mmHg at Visit 1; Subject agrees, or if applicable, the subject's legal representative agrees that the subject can participate in the study Exclusion Criteria: Is currently pregnant or plans to become pregnant during the study; Is nursing or actively lactating; Is morbidly obese (Body Mass Index >= 40) at Visit 1; Has clinically significant renal disease defined as having an estimated creatinine clearance of <=40mL/min at Visit 1; Has osteomyelitis in the foot or ankle on which the target ulcer is located at Visit 1 or 2; Has evidence of a prior ulcer in the same area as the target ulcer; Has a target ulcer that has decreased in volume by 50% or more at Visit 2 as compared to the volume at Visit 1; Has multiple foot ulcers that are connected by fistulas or has an ulcer(s) that are within 5 cm of the target ulcer at Visit 1 or 2; Has a target ulcer that tunnels into wound tracks which cannot be fully visualized from the wound surface at Visit 1 or 2; Has active cellulitis either at the site of, or in the surrounding area of, the target ulcer at Visit 1 or 2; Has a target ulcer that has visually purulent exudates or that has malodorous exudates on examination at Visit 1 or 2; Has PVD, per Doppler Ultrasound, requiring vascular surgery intervention at Visit 1 or 2; Requires use of off-loading Diabetic Walker device for the foot intended for study application for a reason other than for a target ulcer on the plantar surface of the foot at Visit 1 or 2; Has had a lower extremity revascularization procedure within eight weeks of Visit 1; Has active Charcot foot at Visit 1 or 2; Has had a surgical procedure to correct biomechanical abnormities within eight weeks of Visit 1; Has had a deep vein thrombosis within six months of Visit 1; Has clinical evidence of lymphedema at Visit 1; Has had chemotherapy within 60 days of Visit 1; Has a life expectancy <=2 years; Has previously participated in a dermaPACE diabetic foot ulcer study; Has had treatment of the target ulcer with growth factors, prostaglandin therapy, negative pressure or vasodilator therapy within two weeks of Visit 1; Is receiving >=10 mg/day of steroid therapy; Has sickle cell anemia; Has a known immunodeficiency disorder to include, but not be limited to: AIDS, HIV, etc. Has received radiation treatment within 120 days of Visit 1; Has received treatment with immunosuppressants within sixty days of Visit 1; Has received treatment with biologically active cellular products on the target ulcer, e.g. Apligraf®, Dermagraft®, etc. within sixty days of Visit 1; Has received treatment with acellular (collagen-based) products on the target ulcer, e.g. Alloderm®, Integra®, etc. within 30 days of Visit 1; Has a current history of substance abuse (current is defined as within 120 days of Visit 1); Has a history of major systemic infections requiring hospitalization within three months of Visit 1 ; Has a current malignancy or a history of malignancy within five years, of Visit 1 except for basal cell carcinoma that has been treated with local excision and is no longer present; Has a physical or mental disability or geographical concerns that would inhibit compliance with required study visits; Is planning to undergo an exclusionary treatment or procedure during the study; or Has participated in another investigation within 30 days of Visit 1
Facility Information:
Facility Name
Associated Foot and Ankle Specialists
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Norma Ramos
Phone
602-339-8262
Email
norma.ramos@questoffice.net
First Name & Middle Initial & Last Name & Degree
Arthur Tallis, DPM
Facility Name
Southern Arizona VA Healthcare System
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85723
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Phyllis Houston
Phone
520-792-1450
Ext
4548
Email
Phyllis.Houston@va.gov
First Name & Middle Initial & Last Name & Degree
Jodi L Walters, DPM
Facility Name
Long Beach VA Healthcare System
City
Long Beach
State/Province
California
ZIP/Postal Code
90822
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nancy Anderson-Berman
Phone
562-826-8000
Ext
2889
Email
nancy.berman@va.gov
First Name & Middle Initial & Last Name & Degree
Ian Gordon, MD, PhD
Facility Name
Foot and Ankle Clinic
City
Los Angeles
State/Province
California
ZIP/Postal Code
90010
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Suni Allen
Phone
213-365-0793
Email
sunigmka@aol.com
First Name & Middle Initial & Last Name & Degree
Felix Sigal, DPM
Facility Name
Alameda County Medical Center - Highlands Campus
City
Oakland
State/Province
California
ZIP/Postal Code
94602
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kathleen Edmunds
Phone
510-869-6511
Ext
5629
Email
kedmunds@samuelmerritt.edu
First Name & Middle Initial & Last Name & Degree
Timothy Dutra, DPM
Facility Name
Lucius J. Hill DPM
City
San Bernardino
State/Province
California
ZIP/Postal Code
92404
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brittany Griffith
Phone
909-886-7700
Email
bgriffith@trialogic.com
First Name & Middle Initial & Last Name & Degree
Lucius J Hill, DPM
Facility Name
Paul and Margaret Brand Research Center at Barry University
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33013
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Maria Swartz
Phone
305-836-7550
Email
mswartz@mail.barry.edu
First Name & Middle Initial & Last Name & Degree
Robert F Snyder, DPM
Facility Name
The Research Center
City
Hialeah
State/Province
Florida
ZIP/Postal Code
33016
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Elisa Betancourt
Phone
786-391-1928
Email
research@doctor.com
First Name & Middle Initial & Last Name & Degree
Gilberto J Acosta, DPM
Facility Name
River City Clinical Research
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
William Namen II, DPM
Phone
904-861-3050
Email
wnamen@encoredocs.com
First Name & Middle Initial & Last Name & Degree
William Namen II, DPM
Facility Name
St. Paul Medical Research
City
Miami
State/Province
Florida
ZIP/Postal Code
33126
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jacqueline Gorra
Phone
305-507-8237
Email
sitedirectorjg@gmail.com
First Name & Middle Initial & Last Name & Degree
John G Padron, MD
Facility Name
Advanced Pharma CR
City
Miami
State/Province
Florida
ZIP/Postal Code
33137
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yvette Lopez
Phone
305-220-2727
Email
Ilopez@advancedpharma.com
First Name & Middle Initial & Last Name & Degree
Gilbert Weiner, MD
Facility Name
Northwestern University, Div of Plastic and Reconstructive Surgery
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Catherine Piserchia
Phone
312-695-6022
Email
kpiserch@nmh.org
First Name & Middle Initial & Last Name & Degree
Robert Galiano, MD
Facility Name
Foot Healthcare Associates
City
Southfield
State/Province
Michigan
ZIP/Postal Code
48076
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sonja Gerald
Phone
248-798-7168
Email
sgerald@michiganpodiatry.com
First Name & Middle Initial & Last Name & Degree
Neal Mozen, DPM
Facility Name
Moore Foot and Ankle Specialists
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28806
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lily Moore, DPM
Phone
828-350-1880
Email
Mfas828@aol.com
First Name & Middle Initial & Last Name & Degree
J. Christopher Moore, DPM
Facility Name
Wound Center - ACMH
City
Kittaning
State/Province
Pennsylvania
ZIP/Postal Code
16201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Connell
Phone
724-543-8993
Email
connellh@acmh.org
First Name & Middle Initial & Last Name & Degree
Matthew Sabo, DPM
Facility Name
Podiatric Medical Partners of Texas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rena Killebrew
Phone
214-330-9299
Email
renakillebrew@gmail.com
First Name & Middle Initial & Last Name & Degree
Richard C Galperin, DPM
Facility Name
UT Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75390
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Deanna S Adams, RN
Phone
214-645-8907
Email
deanna.adams@utsouthwestern.edu
First Name & Middle Initial & Last Name & Degree
Lawrence Lavery, DPM
Facility Name
Foot and Ankle Associates of SW Virginia
City
Roanoke
State/Province
Virginia
ZIP/Postal Code
24016
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Morgan Stepanek
Phone
540-797-2726
Email
mstepanek@periedu.com
First Name & Middle Initial & Last Name & Degree
Charles M. Zelen, DPM
Facility Name
The Mayer Institute
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8R 2R3
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ivana Roth-Albin
Phone
905-523-1444
Ext
232
Email
roth.ivana@gmail.com
First Name & Middle Initial & Last Name & Degree
Perry Mayer, MD

12. IPD Sharing Statement

Learn more about this trial

A Comparison of the dermaPACE® (Pulsed Acoustic Cellular Expression) Device in Conjunction With Standard of Care Versus Standard of Care Alone in the Treatment of Diabetic Foot Ulcers

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