A Study to Evaluate the Efficacy and Safety of NexoBrid in Subjects With Thermal Burns
Thermal Burns
About this trial
This is an interventional treatment trial for Thermal Burns focused on measuring fire/flame, scalds, contact
Eligibility Criteria
Inclusion Criteria- Patient level
- Males and females; ≥ 18
- Thermal burns caused by fire/flame, scalds or contact,
- Patient total burns area ≥ 3% DPT and / or FT,
- Patient total burns area should be ≤ 30% TBSA; SPT, DPT and/or FT in depth,
- Informed consent can be obtained within 84 hours of the burn injury,
- Patients who are willing and able to sign a written consent form.
Inclusion Criteria - Wound level
At least one wound (a continuous burn area) that is ≥0.5% TBSA (DPT and/or FT) (this minimal wound size should not including face, perineal or genital area.
All planned target wounds (TWs) should meet the following criteria:
- SPT area that cannot be demarcated from DPT and FT areas should be less than 50% of the % TBSA of the TW.
- Wound's blisters can be removed/ unroofed, as judged by the investigator.
Exclusion Criteria- Patient level
- Patients who are unable to follow study procedures and follow up period.
- Modified Baux index ≥ 80,
- Patients with burned charred fingers, 3rd degree in depth and possibly devoid of circulation,
- Patients with abraded wound/s that cannot be treated by an enzymatic debrider application (NexoBrid) will be excluded from the study,
- Patients with electrical or chemical burns,
- Patients with circumferential (≥ 80% of the limb circumference) DPT and/or FT burns defined as Extremities at Risk (EAR) 2 as described in the protocol.
- The following pre-enrollment dressings: a. Flammacerium, b. Silver Nitrate (AgNO3),
- Patients with pre-enrolment wounds which are covered by eschar heavily saturated with iodine or by SSD pseudoeschar (e.g. pseudoeschar as a result of > 12 hours SSD treatment),
- Patients with pre-enrollment escharotomy.
- Patients with diagnosed infections as described in Section 11.9 of study protocol,
- Diagnosis of smoke inhalation injury.
- Pregnant women (positive pregnancy test) or nursing mothers.
- Poorly controlled diabetes mellitus (HbA1c>11%) in patients with known diabetes as captured in the medical history.
- BMI greater than 39.0 kg/m2 in patients with burn area up to 15% TBSA or BMI greater than 34.0 kg/m2 in patients with burn area more than 15% TBSA.
- ASA greater than 2 (Appendix 13- ASA classification system)
- Cardio-pulmonary disease (MI within 6 months prior to injury, severe pulmonary hypertension, severe COPD or pre-existing oxygen-dependent pulmonary diseases, severe broncho-pneumonia within 1 month prior to injury , steroid dependent asthma or uncontrolled asthma).
- Pre-existing diseases which interfere with circulation (severe peripheral vascular disease, edema, lymphedema, regional lymph nodes, significant varicose veins),
- Any conditions that would preclude safe participation in the study or adding further risk to the basic acute burn trauma (such as severe immuno-compromising diseases, life threatening trauma, severe pre-existing coagulation disorder,severe cardiovascular disorder,significant pulmonary disorder, significant liver disorder including post alcoholic abuse impaired function or neoplastic disease, blast injury)
- Chronic systemic steroid intake,
- History of allergy and/or known sensitivity to pineapples, papaya, Bromelain or papain,
- Current (within 12 months prior to screening) suicide attempt,
- Mentally incapacitated adults who are incapable of giving legal consent
- Enrollment in any investigational drug trial within 4 weeks prior to screening,
- Current (within 12 months prior to screening) alcohol or drug abuse (see definition in section 1.1)
- Prisoners and incarcerated,
- Patients who might depend on the clinical study site or investigator.
Sites / Locations
- University of South Alabama Department of Surgery
- Maricopa Medical Center
- University of Colorado at Denver, Teaching
- Medstar Washington Hospital Center
- University of Florida- Dept. of Surgery
- Joseph M. Still Research Foundation, Inc.
- The University of Iowa Hospitals and Clinics
- Burnett Burn Center at The University of Kansas Hospital
- Johns Hopkins Bayview Medical Center
- The General Hospital Corporation d/b/a Massachusetts General Hospital
- New-York Presbyterian Hospital
- Emergency Medicine Stony Brook University Hospital
- Lehigh Valley Hospital and Health Network
- Regional Medical Center ,Regional One Health
- University of Texas Medical Branch
- University of Utah Hospital
- HarborView Medical Center
- Columbia St. Mary's, Inc.
- University Hospital, Department of Plastic Surgery
- Klinika popálenin a rekonstrukční chirurgie, Fakultní nemocnice Brno
- Khechinashvili University Hospital - Thermal Injuries
- Unfallkrankenhaus Berlin Zentrum für Schwerbrandverletzte mit Plastischer Chirurgie
- BG Universitätsklinikum Bergmannsheil GmbH
- Rambam Medical Center
- Hospital A. Cardarelli of Napoli
- Ospedale di Cisanello
- Spitalul Clinic de Urgenta de Chirurgie Plastica, Reparatorie si Arsuri
- Spitalul Clinic de Urgenta "Sf. Ioan"
- Spitalul Clinic de Urgenta "Bagdasar-Arseni"
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Placebo Comparator
Active Comparator
NexoBrid Gel
Gel Vehicle
Standard of Care (SOC)
NexoBrid Gel is applied to the burn wound at a dose of 2 g NexoBrid sterile powder mixed with 20g sterile Gel Vehicle per 1% of TBSA (~ surface of an adult palm) for four hours.
Gel Vehicle is applied to the burn wound at a dose of 20 g sterile Gel per 1% of TBSA (~ surface of an adult palm) for four hours.
Subjects in the SOC group may be treated with a combination of surgical and non-surgical eschar removal procedures, according to the investigator's judgment.