A Multicentre European Study to Evaluate Granulox® Used in the Treatment Pathway of Predominantly Chronic Venous Leg Ulcers (VLUs). (Granulox01)
Primary Purpose
Venous Leg Ulcer
Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Venous Leg Ulcer Standard of Care with Granulox
Sponsored by
About this trial
This is an interventional treatment trial for Venous Leg Ulcer focused on measuring Granulox, venous ulcers, wound healing, wound reduction
Eligibility Criteria
Inclusion Criteria:
- Signed consent to participate.
- No planned hospitalization in the forthcoming 20 weeks.
- Male or female (women of childbearing age must have an acceptable method of birth control).
- Age >18 years.
- Recent (less than 12 months) doppler or duplex colour ultrasonography compatible with chronic venous insufficiency.
- ABPI (less than 3 months) ≥0.7 for both legs. If ABPI >1.4, then big toe pressure >60mmHg is required or an alternative measurement verifying normal distal arterial flow.
- At least one or more supra- or peri-malleolar leg ulcers and no foot ulcer or another chronic wound.
- In case of two or more ulcers, select ulcer with the highest PUSH score at randomization and treat the non-selected ulcer in the same way as ulcers in the control group (standard of care).
- In case of two or more ulcers on the same limb, ensure that the distance between each ulcer is 3 cm as measured from the margins of each ulcer that are closest to one another.
- Wound duration ≥ 8 weeks and ≤60 months.
- At randomization, the ulcer area should be 3 cm2 - 70 cm² and should not have decreased by more than 30% during the 2-week run-in period.
- Less than 50% of the wound area should be covered with fibrinous tissue at randomization and after debridement.
- Patients considered as compliant/adherent to the compression device during the run-in period (i.e. no more than 2 days without compression over the 2-week run-in period).
- No clinically significant comorbidities requiring the use of systemic steroids or any cytotoxic or immunosuppressive agents.
Exclusion Criteria:
- Infected ulcer according to the judgment of the investigator defined as any wound condition requiring the prescription or continuation of systemic antibiotic therapy at randomization.
- Circumferential wounds.
- Wound covered fully or partially by necrotic tissue (black tissue).
- Patients who will have problems following the protocol, especially compression therapy.
- Patients included in another on-going clinical investigation, or patients who have participated in a clinical investigation during the past 30 days.
- Wounds treated with dressings containing an active component (e.g. silver, nanooligosaccharide factor (NOSF), charcoal, chlorhexidine, iodine or ibuprofen) 14 days prior to study enrollment.
- Patient with a systemic infection not controlled by suitable antibiotic treatment.
- Current treatment with radiotherapy, chemotherapy, immunosuppressant drugs or high doses of oral corticosteroids (>10 mg Predinsolone or equivalent) if any.
- Patient with deep vein thrombosis within 3 months prior to inclusion.
- Known allergy/hypersensitivity to the ingredients of the dressings and/or Granulox®.
- Malignant wounds.
- Endovenous surgery planned or performed within the past 30 days.
- Primary lymphoedema caused by congenital/developmental defect, i.e. Milroy's disease (congenital lymphedema), Meige's disease (lymphedema praecox), or Late-onset lymphedema (lymphedema tarda).
Sites / Locations
- Klinicki odjel za vaskularnu kirurgiju
- University Hospital Dubrava
- Zavod za vaskularnu kirurgiju
- Salvatella s.r.o.
- CHIR-Chirurgické oddeleni
- U Nemocnice v Praze
- Hopital Michallon
- Hopital Nord Franche-Comte
- Hopital Rothschild - AP-HP
- Department od Dermatology, Venerology and Allergology, University of Essen
- Gemeinschaftspraxis Drees.K.CH.Busch/v.d.Ecken
- Technische Universitaet Dresden - Universitaetsklinikum Carl Gustav Carus - Klinik fuer Dermatologie
- University Hospital Erlangen
- Oberhausen Sterkrade (Zweigpraxis)
- Bugat Pal Korhaz
- DermaMed Research Kft
- Clinexpert Kft
- Debreceni Egyetem, Klinikai Kozpont, Borgyogyaszati Klinika
- Markhot Ferenc oktatókórház és rendelöintézet
- BKS Research Kft
- Uslugi Medyczne PRO-MED Sp. z.o.o
- Szpital Uniwersytecki nr 1 im. dr. A. Jurasza w Bydgoszczy Poradnia Leczenia Ran Przewleklych
- Nzoz Gam-Med
- Braci Wieniawskick 12B
- MIKOMED Sp. Z.o.o.
- Hull University Teaching Hospitals NHS Trust
- Accelerate CIC
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Venous Leg Ulcer Standard of Care
Venous Leg Ulcer Standard of Care with Granulox
Arm Description
Subjects will recieve standard of care treatment.
Subjects will recieve standard of care treatment with Granulox added as an adjunct therapy.
Outcomes
Primary Outcome Measures
Rate of complete confirmed wound closure (CCC) will be measured and compared for 254 subjects divided into standard of care versus standard of care with Granulox.
Derived by two blinded quantifications of 100% re-epithelialization by PictZar, 15 days (+/- 3 days) apart.
Secondary Outcome Measures
Healing time
Calculated from time in days from baseline to the first observation of CCC.
Wound status
Wound size measured, i.e. width, length, circumference or perimeter, via PictZar®.
Exudate amount and nature.
Tissue (i.e. fibrinous, granulation, epithelisation) type, i.e. area and percentage from total wound.
Skin condition, i.e. peri-wound, redness/irritation/eczema, maceration, blistering, stripping, trauma.
Local infection status, i.e. pain, perilesional skin erythema, oedema, malodour, levels of exudate.
Cleansing specification.
Debridement specification.
Wound Area Regression (WAR)
Calculated variables 90WAR (i.e. 90% WAR from baseline, based on wound photos) and 50WAR (i.e. 50% WAR from baseline, based on wound photos).
Rate of possible confirmed wound closure (PCC) will be measured and compared for 254 subjects divided into standard of care versus standard of care with Granulox.
derived from one measurements of 100% reepithelialization by via PictZar®.
Healing trajectories
Calculated progression of the re-epithelialization wave over time.
Pressure Ulcer Scale for Healing tool
Wound changes over time will be captured by the Pressure Ulcer Scale for Healing tool. Total score from 0 to 17 where the lower the score the better the outcome e.g when the wound has closed, score as '0'
Blind assessment of wound healing
Assessor-blinded clinical verification of CCC and PCC based on patient-series of wound photos assessed by independent and experienced clinicians, unaware of treatment allocation.
Health related Quality of Life assessment by EQ-5D-5L
Patient report outcome questionnaire to evaluate health and quality of life. The higher the score the better the outcome e.g 100 means the best health.
Wound specific Quality of Life assessment by Wound-QoL
Patient report outcome questionnaire to evaluate wound specific quality of life. A 5 point scale based on 17 questions of the wound in the last seven days from 'not at all' to 'very much'. The lower the score at 'not at all' the better the outcome e.g my wound hurt (not at all).
Numerical Rating Scale (NRS)
Patient report outcome questionnaire to evaluate pain. A total score range of 0 - 10. The lower the score the better the outcome e.g 0 is no pain.
Acceptability of care
Assessment of acceptability of care by means of a 5-item scale (e.g. very poor, poor, average, good, very good) where very good is a better outcome. This will be performed at the final visit only.
Ease of care
Assessment of ease of care by means of a 5-item scale (e.g. very poor, poor, average, good, very good) where very good is a better outcome. This will be performed at the final visit only.
Evaluation of patient compliant to venous compression
Evaluation will be based on a 3 point scale from fully compliance, moderately compliance or no compliance to compression therapy where fully compliance is a better outcome. Compliance to compression therapy will be defined as the following:
Fully compliance (defined as 7/7 days) = continue in study
Moderately compromised compliance (defined as 2 or 3 days maximum without compression) = continue in study
No compliance (defined as >3 without compression) = discontinue from study
Cost Effectiveness
Collection of cost parameters such as micro costing and resource utilization will be made in the study. These include:
Wound care consumables associated with dressings (captured both at site by investigator and in the patient specific diary by the study nurse)
Frequency of dressings changes (captured both at site by investigator and in the patient specific diary by the study nurse). In addition, reporting of adverse events (i.e. infection and hospitalization) will be used as a basis for economic information together with country-specific costs.
Full Information
NCT ID
NCT04181320
First Posted
November 22, 2019
Last Updated
January 16, 2023
Sponsor
Molnlycke Health Care AB
1. Study Identification
Unique Protocol Identification Number
NCT04181320
Brief Title
A Multicentre European Study to Evaluate Granulox® Used in the Treatment Pathway of Predominantly Chronic Venous Leg Ulcers (VLUs).
Acronym
Granulox01
Official Title
Multicentre, Prospective, Randomized, Open-label, Assessor Blinded Study to Evaluate Granulox® Used as Adjunct Therapy to Defined Standard of Care vs. Defined Standard of Care for the Treatment of Predominantly Chronic Venous Leg Ulcers (VLUs)
Study Type
Interventional
2. Study Status
Record Verification Date
January 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
June 8, 2020 (Actual)
Primary Completion Date
December 30, 2023 (Anticipated)
Study Completion Date
December 30, 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Molnlycke Health Care AB
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The investigation is designed as an open label, randomized, prospective, assessor blinded, multi centre investigation.
254 evaluable subjects will be randomized to either standard of care group or standard of care with Granulox added as an adjunct therapy in predominantly venous leg ulcer subjects. Standard of care wound management will be completed, including wound cleansing, debridement if necessary and application of a suitable dressing and compression system until complete wound closure.
The study will be divided into two phases. Firstly, a two week run-in period to ensure compliance to compression therapy followed by a 20 weeks treatment period starting with randomization and allocation of treatment.
Detailed Description
The current study is designed to verify previous clinical findings and to pinpoint clinically relevant efficacy, associated to intended use of Granulox® as a therapy added to a defined standard of care in the management of chronic VLUs. The most relevant outcome is considered to be an increase in healing of chronic VLUs over a period of 20 weeks.
This is a multi-centre European open label randomised 2-arm parallel group study. The study will include multiple European counties (e.g. France, Germany, UK, Poland, Croatia and Czech Republic), with approximately 2-7 clinics per country.
The study will run with a two-phase set-up, with a 14 days run-in period and a an up to 20 weeks treatment period starting with randomization and allocation of treatment. Confirmation of wound closure is further assessed after a 15 day followup period.
The primary objective of the study is to compare wound healing between management of chronic VLUs with or without added Granulox®. The main efficacy criterion is Confirmed Complete wound Closure (CCC).
Secondary objectives include comparisons of management of chronic VLUs with or without added Granulox® with regards to:
Wound healing by means of Possible Complete wound Closure (PCC), Wound Area Regression (WAR), time to healing, trajectories, pressure ulcer scale for healing (PUSH) score, and clinical assessment.
Patient Reported Outcomes (PRO) for health-related quality of life (HRQoL)/quality of life (QoL), pain and pain intensity, and impression of change.
Acceptability of and compliance to therapy.
Cost-effectiveness.
Safety by means of Adverse Events (AE) and Serious Adverse Events (SAE) reporting.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Venous Leg Ulcer
Keywords
Granulox, venous ulcers, wound healing, wound reduction
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Multicentre, prospective, randomized, European open label, assessor blinded, 2-arm parallel group study.
Masking
Outcomes Assessor
Masking Description
Wound closure (CCC and PCC) will be assessed through ulcer photos by 2 independent and experienced clinicians unaware of treatment allocation (blind review).
Allocation
Randomized
Enrollment
110 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Venous Leg Ulcer Standard of Care
Arm Type
No Intervention
Arm Description
Subjects will recieve standard of care treatment.
Arm Title
Venous Leg Ulcer Standard of Care with Granulox
Arm Type
Experimental
Arm Description
Subjects will recieve standard of care treatment with Granulox added as an adjunct therapy.
Intervention Type
Device
Intervention Name(s)
Venous Leg Ulcer Standard of Care with Granulox
Other Intervention Name(s)
Granulox
Intervention Description
Granulox will be added as an adjunct therapy to defined standard of care in subjects with predominantly venous leg ulcers.
Primary Outcome Measure Information:
Title
Rate of complete confirmed wound closure (CCC) will be measured and compared for 254 subjects divided into standard of care versus standard of care with Granulox.
Description
Derived by two blinded quantifications of 100% re-epithelialization by PictZar, 15 days (+/- 3 days) apart.
Time Frame
20 weeks
Secondary Outcome Measure Information:
Title
Healing time
Description
Calculated from time in days from baseline to the first observation of CCC.
Time Frame
20 weeks
Title
Wound status
Description
Wound size measured, i.e. width, length, circumference or perimeter, via PictZar®.
Exudate amount and nature.
Tissue (i.e. fibrinous, granulation, epithelisation) type, i.e. area and percentage from total wound.
Skin condition, i.e. peri-wound, redness/irritation/eczema, maceration, blistering, stripping, trauma.
Local infection status, i.e. pain, perilesional skin erythema, oedema, malodour, levels of exudate.
Cleansing specification.
Debridement specification.
Time Frame
20 weeks
Title
Wound Area Regression (WAR)
Description
Calculated variables 90WAR (i.e. 90% WAR from baseline, based on wound photos) and 50WAR (i.e. 50% WAR from baseline, based on wound photos).
Time Frame
20 weeks
Title
Rate of possible confirmed wound closure (PCC) will be measured and compared for 254 subjects divided into standard of care versus standard of care with Granulox.
Description
derived from one measurements of 100% reepithelialization by via PictZar®.
Time Frame
20 weeks
Title
Healing trajectories
Description
Calculated progression of the re-epithelialization wave over time.
Time Frame
20 weeks
Title
Pressure Ulcer Scale for Healing tool
Description
Wound changes over time will be captured by the Pressure Ulcer Scale for Healing tool. Total score from 0 to 17 where the lower the score the better the outcome e.g when the wound has closed, score as '0'
Time Frame
20 weeks
Title
Blind assessment of wound healing
Description
Assessor-blinded clinical verification of CCC and PCC based on patient-series of wound photos assessed by independent and experienced clinicians, unaware of treatment allocation.
Time Frame
20 weeks
Title
Health related Quality of Life assessment by EQ-5D-5L
Description
Patient report outcome questionnaire to evaluate health and quality of life. The higher the score the better the outcome e.g 100 means the best health.
Time Frame
20 weeks
Title
Wound specific Quality of Life assessment by Wound-QoL
Description
Patient report outcome questionnaire to evaluate wound specific quality of life. A 5 point scale based on 17 questions of the wound in the last seven days from 'not at all' to 'very much'. The lower the score at 'not at all' the better the outcome e.g my wound hurt (not at all).
Time Frame
20 weeks
Title
Numerical Rating Scale (NRS)
Description
Patient report outcome questionnaire to evaluate pain. A total score range of 0 - 10. The lower the score the better the outcome e.g 0 is no pain.
Time Frame
20 weeks
Title
Acceptability of care
Description
Assessment of acceptability of care by means of a 5-item scale (e.g. very poor, poor, average, good, very good) where very good is a better outcome. This will be performed at the final visit only.
Time Frame
20 weeks
Title
Ease of care
Description
Assessment of ease of care by means of a 5-item scale (e.g. very poor, poor, average, good, very good) where very good is a better outcome. This will be performed at the final visit only.
Time Frame
20 weeks
Title
Evaluation of patient compliant to venous compression
Description
Evaluation will be based on a 3 point scale from fully compliance, moderately compliance or no compliance to compression therapy where fully compliance is a better outcome. Compliance to compression therapy will be defined as the following:
Fully compliance (defined as 7/7 days) = continue in study
Moderately compromised compliance (defined as 2 or 3 days maximum without compression) = continue in study
No compliance (defined as >3 without compression) = discontinue from study
Time Frame
20 weeks
Title
Cost Effectiveness
Description
Collection of cost parameters such as micro costing and resource utilization will be made in the study. These include:
Wound care consumables associated with dressings (captured both at site by investigator and in the patient specific diary by the study nurse)
Frequency of dressings changes (captured both at site by investigator and in the patient specific diary by the study nurse). In addition, reporting of adverse events (i.e. infection and hospitalization) will be used as a basis for economic information together with country-specific costs.
Time Frame
20 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed consent to participate.
No planned hospitalization in the forthcoming 20 weeks.
Male or female (women of childbearing age must have an acceptable method of birth control).
Age >18 years.
Recent (less than 12 months) doppler or duplex colour ultrasonography compatible with chronic venous insufficiency.
ABPI (less than 3 months) ≥0.7 for both legs. If ABPI >1.4, then big toe pressure >60mmHg is required or an alternative measurement verifying normal distal arterial flow.
At least one or more supra- or peri-malleolar leg ulcers and no foot ulcer or another chronic wound.
In case of two or more ulcers, select ulcer with the highest PUSH score at randomization and treat the non-selected ulcer in the same way as ulcers in the control group (standard of care).
In case of two or more ulcers on the same limb, ensure that the distance between each ulcer is 3 cm as measured from the margins of each ulcer that are closest to one another.
Wound duration ≥ 8 weeks and ≤60 months.
At randomization, the ulcer area should be 3 cm2 - 70 cm² and should not have decreased by more than 30% during the 2-week run-in period.
Less than 50% of the wound area should be covered with fibrinous tissue at randomization and after debridement.
Patients considered as compliant/adherent to the compression device during the run-in period (i.e. no more than 2 days without compression over the 2-week run-in period).
No clinically significant comorbidities requiring the use of systemic steroids or any cytotoxic or immunosuppressive agents.
Exclusion Criteria:
Infected ulcer according to the judgment of the investigator defined as any wound condition requiring the prescription or continuation of systemic antibiotic therapy at randomization.
Circumferential wounds.
Wound covered fully or partially by necrotic tissue (black tissue).
Patients who will have problems following the protocol, especially compression therapy.
Patients included in another on-going clinical investigation, or patients who have participated in a clinical investigation during the past 30 days.
Wounds treated with dressings containing an active component (e.g. silver, nanooligosaccharide factor (NOSF), charcoal, chlorhexidine, iodine or ibuprofen) 14 days prior to study enrollment.
Patient with a systemic infection not controlled by suitable antibiotic treatment.
Current treatment with radiotherapy, chemotherapy, immunosuppressant drugs or high doses of oral corticosteroids (>10 mg Predinsolone or equivalent) if any.
Patient with deep vein thrombosis within 3 months prior to inclusion.
Known allergy/hypersensitivity to the ingredients of the dressings and/or Granulox®.
Malignant wounds.
Endovenous surgery planned or performed within the past 30 days.
Primary lymphoedema caused by congenital/developmental defect, i.e. Milroy's disease (congenital lymphedema), Meige's disease (lymphedema praecox), or Late-onset lymphedema (lymphedema tarda).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joachim Dissemond, Professor Dr.
Organizational Affiliation
University Hospital, Essen
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinicki odjel za vaskularnu kirurgiju
City
Split
ZIP/Postal Code
21000
Country
Croatia
Facility Name
University Hospital Dubrava
City
Zagreb
ZIP/Postal Code
10000
Country
Croatia
Facility Name
Zavod za vaskularnu kirurgiju
City
Zagreb
ZIP/Postal Code
10000
Country
Croatia
Facility Name
Salvatella s.r.o.
City
Třinec
State/Province
Dolni Lomna
ZIP/Postal Code
739 61
Country
Czechia
Facility Name
CHIR-Chirurgické oddeleni
City
Jihlava
ZIP/Postal Code
58633
Country
Czechia
Facility Name
U Nemocnice v Praze
City
Prague
ZIP/Postal Code
12808
Country
Czechia
Facility Name
Hopital Michallon
City
Grenoble
State/Province
La Tronche
ZIP/Postal Code
38700
Country
France
Facility Name
Hopital Nord Franche-Comte
City
Belfort
State/Province
Trevenans
ZIP/Postal Code
90015
Country
France
Facility Name
Hopital Rothschild - AP-HP
City
Paris
State/Province
Île-de-France
ZIP/Postal Code
75012
Country
France
Facility Name
Department od Dermatology, Venerology and Allergology, University of Essen
City
Essen
State/Province
North Rhine-Westphalia
ZIP/Postal Code
45147
Country
Germany
Facility Name
Gemeinschaftspraxis Drees.K.CH.Busch/v.d.Ecken
City
Dortmund
ZIP/Postal Code
44137
Country
Germany
Facility Name
Technische Universitaet Dresden - Universitaetsklinikum Carl Gustav Carus - Klinik fuer Dermatologie
City
Dresden
ZIP/Postal Code
01307
Country
Germany
Facility Name
University Hospital Erlangen
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
Oberhausen Sterkrade (Zweigpraxis)
City
Oberhausen
ZIP/Postal Code
46145
Country
Germany
Facility Name
Bugat Pal Korhaz
City
Gyöngyös
State/Province
Heves
ZIP/Postal Code
3200
Country
Hungary
Facility Name
DermaMed Research Kft
City
Orosháza
State/Province
Oroshaza
ZIP/Postal Code
5900
Country
Hungary
Facility Name
Clinexpert Kft
City
Budapest
ZIP/Postal Code
1033
Country
Hungary
Facility Name
Debreceni Egyetem, Klinikai Kozpont, Borgyogyaszati Klinika
City
Debrecen
ZIP/Postal Code
4002
Country
Hungary
Facility Name
Markhot Ferenc oktatókórház és rendelöintézet
City
Eger
ZIP/Postal Code
3300
Country
Hungary
Facility Name
BKS Research Kft
City
Hatvan
ZIP/Postal Code
3000
Country
Hungary
Facility Name
Uslugi Medyczne PRO-MED Sp. z.o.o
City
Gliwice
State/Province
Gliwicie
ZIP/Postal Code
44109
Country
Poland
Facility Name
Szpital Uniwersytecki nr 1 im. dr. A. Jurasza w Bydgoszczy Poradnia Leczenia Ran Przewleklych
City
Bydgoszcz
ZIP/Postal Code
85-094
Country
Poland
Facility Name
Nzoz Gam-Med
City
Kielce
ZIP/Postal Code
25315
Country
Poland
Facility Name
Braci Wieniawskick 12B
City
Lublin
ZIP/Postal Code
20-844
Country
Poland
Facility Name
MIKOMED Sp. Z.o.o.
City
Łódź
ZIP/Postal Code
94238
Country
Poland
Facility Name
Hull University Teaching Hospitals NHS Trust
City
Hull
ZIP/Postal Code
HU3 2JZ
Country
United Kingdom
Facility Name
Accelerate CIC
City
London
ZIP/Postal Code
E8 4SA
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
A Multicentre European Study to Evaluate Granulox® Used in the Treatment Pathway of Predominantly Chronic Venous Leg Ulcers (VLUs).
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