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A Prospective Randomized, Double-Blind, Placebo-Controlled Trial Comparing VitroGro® ECM to Placebo in Patients With Venous Leg Ulcers

Primary Purpose

Venous Leg Ulcer

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
VitroGro® ECM
Dulbecco's Phosphate Buffered Saline
Sponsored by
Tissue Therapies Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Venous Leg Ulcer focused on measuring Venous Leg Ulcer, Leg Ulcer, Venous Hypertension, Venous Reflux, Deep Venous System, Chronic leg ulceration, Calf perforator

Eligibility Criteria

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

Abbreviations:

  • Study Ulcer: SU
  • Post-debridement: PD

Inclusion Criteria: Potential subjects are required to meet all of the following criteria for enrollment into the study and subsequent randomization.

  1. 18≤ years old.
  2. Ankle Brachial Pressure Index ≥0.80. (Calculations made using measurements from posterior tibial & dorsalis pedis arteries & both arms).
  3. Presence of a venous leg ulcer extending through the full thickness of the skin, but not down to muscle, tendon, or bone. The largest ulcer will be designated the SU and the only one included in the study. If other ulcerations are present on the same leg they must be more than 2 cm apart from the SU.
  4. Venous disease confirmed by Doppler ultrasound to demonstrate reflux of > 0.5 seconds in saphenous (great or small), calf perforators or the deep venous system. Subjects with prior venous surgery may be included if they still demonstrate significant reflux in a remaining venous segment and the SU continues to suffer poor healing because of venous hypertension.
  5. SU has been present 1 ≤ x ≤ 12 months prior to the initial screening visit, and is excluded if it has undergone 12 months of continuous high strength compression therapy over its duration.
  6. SU with a 2.5 ≤ x ≤ 20 cm2 at the T1 visit (PD).
  7. SU with a clean, granulating base free of adherent slough at the T1 visit (PD).
  8. In the case of a female patient of childbearing potential, willingness to use acceptable methods of contraception. A urine pregnancy test at the T1 visit must be administered, and must be negative for inclusion.
  9. Understanding of and willingness by the patient to participate in the clinical study and ability to comply with study procedures and study visit schedule.
  10. Reading, approval, and signature by the patient of the IRB/IEC ICF before screening procedures are undertaken.

Exclusion Criteria:Potential subjects meeting any of the following criteria will be excluded from enrollment and subsequent randomization:

  1. Ulcer(s) deemed by the Investigator to be caused by a medical condition other than venous insufficiency. These may include, but are not limited to: ulcerations due to fungal, malignant, diabetic, and/or arterial insufficiency causes.
  2. Ulcer exhibits clinical signs and symptoms of infection at S1 or T1. The infection should be treated & afterward the patient may be re-assessed for eligibility for study re-entry.
  3. Known allergy to any of the protocol-stipulated treatment procedures or non-tolerance of multi-layer compression therapy.
  4. Ulcer, in the opinion of the Investigator, is suspicious for cancer.
  5. A history of more than 2 weeks treatment with immunosuppressants (including systemic corticosteroids), cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within 1 month prior to S1, or treatments with such medications during screening, or anticipated requirement of such medications during the course of the study.
  6. Treatment with any investigational drug(s) or therapeutic device(s) within 30 days preceding S1; or anticipated use of any of these therapies during the course of the study.
  7. Malignant disease not in remission for 5 or more years, other than basal cell or squamous cell carcinomas of the skin that have been medically or surgically treated without evidence of metastases.
  8. History of radiation at the SU site.
  9. As determined by medical history, presence of one or more medical conditions including renal, hepatic, hematologic, active auto-immune or immune diseases that, in the opinion of the Investigator, would make the subject an inappropriate candidate for this ulcer healing study.
  10. Known history of having AIDS or history of HIV infection.
  11. Previous participation in any VitroGro® ECM trial within the past 6 months.
  12. SU has been previously treated with tissue engineered materials or other scaffold materials within 30 days prior to S1.
  13. SU which in the opinion of the Investigator might require negative pressure wound therapy or hyperbaric oxygen during the course of the trial.
  14. Presence of any condition(s) that seriously compromise(s) the subject's ability to complete this study, or a known history of poor adherence with medical treatment.
  15. NYHA Class III and IV congestive heart failure (CHF), as defined by the following criteria:

    • Class III: Symptoms with moderate exertion
    • Class IV: Symptoms at rest
  16. Uncontrolled Diabetes Mellitus, as measured by an HbA1c >10%.
  17. Ulcer on the dorsum of the foot or with more than 50% of the ulcer below the malleolus is excluded.
  18. Pregnancy or breast-feeding.
  19. Increase or decrease by >30% in the SU surface area at the T1 visit (PD) as compared to the SU surface area as measured at the S1 visit (PD).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Placebo Comparator

    Arm Label

    VitroGro®ECM

    Dulbecco's Phosphate Buffered Saline

    Arm Description

    A topical application of synthetic extracellular matrix (ECM) protein formulation to the wound bed) plus Standard Care (moisture retentive dressing and multi-layer compression therapy).

    Dulbecco's Phosphate Buffered Saline plus Standard Care (moisture retentive dressing and multi-layer compression therapy).

    Outcomes

    Primary Outcome Measures

    Time to complete wound closure within Treatment Phase
    The primary efficacy endpoint for the study is the time to complete wound closure, within the 8-week Treatment Phase, as assessed by the investigator. Complete wound closure is defined as 100% re-epithelialization with no presence of scab or drainage as assessed by the Investigator at PH0 and confirmed at PH2. The date of complete healing is defined as the date of the first assessment of complete closure (100% re-epithelialization with no presence of scab or drainage) when complete wound closure is confirmed at a study visit 14 days (±3 days) later. For the purposes of this study, the initial assessment of complete closure will occur at PH0 and complete closure will be confirmed at PH2.

    Secondary Outcome Measures

    Percentage (%) change from baseline in ulcer surface area at the end of the Treatment Phase, as measured by SilhoutteStarTM
    Incidence of complete healing within Treatment Phase, as determined by Investigator assessment
    Incidence of complete healing at each visit within the 8-week Treatment Phase, as determined by Investigator assessment
    Percentage (%) surface area reduction from baseline, at each visit within the 8-week Treatment Phase, as measured by SilhoutteStarTM
    Time to first instance of no pain (i.e., pain score less than 5mm on VAS)
    Time to first instance when the patient expectation was met as assessed by Patient Benefit Index
    Incidence of ulcer recurrence, at the site of the ulcer, during the Post-Healing Phase
    Change in Quality of Life metrics at study end.

    Full Information

    First Posted
    November 5, 2013
    Last Updated
    May 24, 2017
    Sponsor
    Tissue Therapies Ltd.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01982318
    Brief Title
    A Prospective Randomized, Double-Blind, Placebo-Controlled Trial Comparing VitroGro® ECM to Placebo in Patients With Venous Leg Ulcers
    Official Title
    A Prospective, Multi-Center, Randomized, Double Blind, Placebo-Controlled Trial Comparing Vitrogro® ECM To Placebo As An Adjunct To Standard Care In Patients With Venous Leg Ulcers
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    May 2017
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study discontinued. Superseded by NCT02973893 VF00102.
    Study Start Date
    January 2017 (undefined)
    Primary Completion Date
    June 2018 (Anticipated)
    Study Completion Date
    June 2019 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Tissue Therapies Ltd.

    4. Oversight

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

    5. Study Description

    Brief Summary
    The objective of this study is to assess the efficacy and safety of VitroGro® combined with standard care in the treatment of Venous Leg Ulcers (VLUs) compared to Placebo with standard care over the course of the 8-week treatment phase.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Venous Leg Ulcer
    Keywords
    Venous Leg Ulcer, Leg Ulcer, Venous Hypertension, Venous Reflux, Deep Venous System, Chronic leg ulceration, Calf perforator

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2, Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantCare ProviderInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    VitroGro®ECM
    Arm Type
    Active Comparator
    Arm Description
    A topical application of synthetic extracellular matrix (ECM) protein formulation to the wound bed) plus Standard Care (moisture retentive dressing and multi-layer compression therapy).
    Arm Title
    Dulbecco's Phosphate Buffered Saline
    Arm Type
    Placebo Comparator
    Arm Description
    Dulbecco's Phosphate Buffered Saline plus Standard Care (moisture retentive dressing and multi-layer compression therapy).
    Intervention Type
    Drug
    Intervention Name(s)
    VitroGro® ECM
    Intervention Type
    Drug
    Intervention Name(s)
    Dulbecco's Phosphate Buffered Saline
    Primary Outcome Measure Information:
    Title
    Time to complete wound closure within Treatment Phase
    Description
    The primary efficacy endpoint for the study is the time to complete wound closure, within the 8-week Treatment Phase, as assessed by the investigator. Complete wound closure is defined as 100% re-epithelialization with no presence of scab or drainage as assessed by the Investigator at PH0 and confirmed at PH2. The date of complete healing is defined as the date of the first assessment of complete closure (100% re-epithelialization with no presence of scab or drainage) when complete wound closure is confirmed at a study visit 14 days (±3 days) later. For the purposes of this study, the initial assessment of complete closure will occur at PH0 and complete closure will be confirmed at PH2.
    Time Frame
    8 weeks
    Secondary Outcome Measure Information:
    Title
    Percentage (%) change from baseline in ulcer surface area at the end of the Treatment Phase, as measured by SilhoutteStarTM
    Time Frame
    8 weeks
    Title
    Incidence of complete healing within Treatment Phase, as determined by Investigator assessment
    Time Frame
    8 weeks
    Title
    Incidence of complete healing at each visit within the 8-week Treatment Phase, as determined by Investigator assessment
    Time Frame
    8 weeks
    Title
    Percentage (%) surface area reduction from baseline, at each visit within the 8-week Treatment Phase, as measured by SilhoutteStarTM
    Time Frame
    8 weeks
    Title
    Time to first instance of no pain (i.e., pain score less than 5mm on VAS)
    Time Frame
    12 weeks
    Title
    Time to first instance when the patient expectation was met as assessed by Patient Benefit Index
    Time Frame
    12 weeks
    Title
    Incidence of ulcer recurrence, at the site of the ulcer, during the Post-Healing Phase
    Time Frame
    Up to 4 weeks post-treatment
    Title
    Change in Quality of Life metrics at study end.
    Time Frame
    12 weeks

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Abbreviations: Study Ulcer: SU Post-debridement: PD Inclusion Criteria: Potential subjects are required to meet all of the following criteria for enrollment into the study and subsequent randomization. 18≤ years old. Ankle Brachial Pressure Index ≥0.80. (Calculations made using measurements from posterior tibial & dorsalis pedis arteries & both arms). Presence of a venous leg ulcer extending through the full thickness of the skin, but not down to muscle, tendon, or bone. The largest ulcer will be designated the SU and the only one included in the study. If other ulcerations are present on the same leg they must be more than 2 cm apart from the SU. Venous disease confirmed by Doppler ultrasound to demonstrate reflux of > 0.5 seconds in saphenous (great or small), calf perforators or the deep venous system. Subjects with prior venous surgery may be included if they still demonstrate significant reflux in a remaining venous segment and the SU continues to suffer poor healing because of venous hypertension. SU has been present 1 ≤ x ≤ 12 months prior to the initial screening visit, and is excluded if it has undergone 12 months of continuous high strength compression therapy over its duration. SU with a 2.5 ≤ x ≤ 20 cm2 at the T1 visit (PD). SU with a clean, granulating base free of adherent slough at the T1 visit (PD). In the case of a female patient of childbearing potential, willingness to use acceptable methods of contraception. A urine pregnancy test at the T1 visit must be administered, and must be negative for inclusion. Understanding of and willingness by the patient to participate in the clinical study and ability to comply with study procedures and study visit schedule. Reading, approval, and signature by the patient of the IRB/IEC ICF before screening procedures are undertaken. Exclusion Criteria:Potential subjects meeting any of the following criteria will be excluded from enrollment and subsequent randomization: Ulcer(s) deemed by the Investigator to be caused by a medical condition other than venous insufficiency. These may include, but are not limited to: ulcerations due to fungal, malignant, diabetic, and/or arterial insufficiency causes. Ulcer exhibits clinical signs and symptoms of infection at S1 or T1. The infection should be treated & afterward the patient may be re-assessed for eligibility for study re-entry. Known allergy to any of the protocol-stipulated treatment procedures or non-tolerance of multi-layer compression therapy. Ulcer, in the opinion of the Investigator, is suspicious for cancer. A history of more than 2 weeks treatment with immunosuppressants (including systemic corticosteroids), cytotoxic chemotherapy, or application of topical steroids to the ulcer surface within 1 month prior to S1, or treatments with such medications during screening, or anticipated requirement of such medications during the course of the study. Treatment with any investigational drug(s) or therapeutic device(s) within 30 days preceding S1; or anticipated use of any of these therapies during the course of the study. Malignant disease not in remission for 5 or more years, other than basal cell or squamous cell carcinomas of the skin that have been medically or surgically treated without evidence of metastases. History of radiation at the SU site. As determined by medical history, presence of one or more medical conditions including renal, hepatic, hematologic, active auto-immune or immune diseases that, in the opinion of the Investigator, would make the subject an inappropriate candidate for this ulcer healing study. Known history of having AIDS or history of HIV infection. Previous participation in any VitroGro® ECM trial within the past 6 months. SU has been previously treated with tissue engineered materials or other scaffold materials within 30 days prior to S1. SU which in the opinion of the Investigator might require negative pressure wound therapy or hyperbaric oxygen during the course of the trial. Presence of any condition(s) that seriously compromise(s) the subject's ability to complete this study, or a known history of poor adherence with medical treatment. NYHA Class III and IV congestive heart failure (CHF), as defined by the following criteria: Class III: Symptoms with moderate exertion Class IV: Symptoms at rest Uncontrolled Diabetes Mellitus, as measured by an HbA1c >10%. Ulcer on the dorsum of the foot or with more than 50% of the ulcer below the malleolus is excluded. Pregnancy or breast-feeding. Increase or decrease by >30% in the SU surface area at the T1 visit (PD) as compared to the SU surface area as measured at the S1 visit (PD).

    12. IPD Sharing Statement

    Learn more about this trial

    A Prospective Randomized, Double-Blind, Placebo-Controlled Trial Comparing VitroGro® ECM to Placebo in Patients With Venous Leg Ulcers

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