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AmnioExcel® Plus vs SOC in the Management of Diabetic Foot Ulcers

Primary Purpose

Diabetic Foot Ulcer

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
AmnioExcel Plus Amniotic Membrane
Standard of Care
Sponsored by
Integra LifeSciences Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcer focused on measuring diabetic foot, diabetes mellitus, diabetes complications

Eligibility Criteria

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

Inclusion Criteria:

  • Have participated in the informed consent process and signed a study-specific informed consent document
  • Be willing to comply with study procedures, including study visits, and compliance with study required off-loading/protective device for the duration of the study
  • Be at least 18 years of age
  • If female and of child-bearing potential, must not be pregnant. To document pregnancy status, subject statement is acceptable
  • Have Type II or Type II diabetes mellitus with investigator-confirmed glycosylated hemoglobin (HbA1c) of less than or equal to 12% within 3 months prior to Screening Visit
  • Have at least one diabetic foot ulcer that meets ALL the following criteria:

    1. Ulcer which has been in existence for a minimum of four weeks, prior to signing the Informed Consent Form allowing trial participation
    2. Ulcer is a partial or full thickness diabetic foot ulcer without capsule/tendon/bone exposure
    3. Ulcer does not have tunneling, undermining, or sinus tracts that necessitates surgical OR debridement and/or penetrates to capsule/tendon/bone
    4. Ulcer is located on the foot or ankle (with no portion above the top of the malleolus)
    5. Ulcer size (area) is greater than equal to 1 cm2 and less than equal to 12 cm2 post-debridement
  • Have a minimum 4cm margin between the qualifying study ulcer and any other ulcer on that same foot, post-debridement

    (a) If the subject has more than one ulcer that meets eligibility criteria, the ulcer designated as the study ulcer will be at the discretion of the investigator

  • Have adequate vascular perfusion of the affected limb as defined by at least one of the following within the past 60 days:

    1. Ankle-Brachial Index (ABI) greater than equal to 0.7 and less than equal to 1.2, performed within 60 days of screening,
    2. Toe pressure (plethysmography) > 40 mmHg at time of screening, or
    3. TcPO2 > 50 mmHg at time of screening
  • Be willing and able to maintain required applicable dressing changes as well as study required off-loading/protective device for the duration of the study
  • Have a study wound severity Wagner I or II

Exclusion Criteria:

  • Previously randomized and treated under this clinical study protocol
  • Patients with a known history of poor compliance with medical treatments
  • Suspected or confirmed gangrene or ulcer infection of the study ulcer or is receiving systemic/IV antibiotics at the time of randomization
  • Suspected or confirmed osteomyelitis of the foot with the study ulcer
  • Participated in another clinical trial involving a device or a systemically administered investigational study drug/treatment within 28 days of randomization
  • Received within 28 days of signing Informed Consent Form, or is scheduled to receive during study participation, a medication or treatment which is known to interfere with or affect the rate and quality of ulcer healing (e.g., systemic steroids, immunosuppressive therapy, autoimmune disease therapy, dialysis, radiation therapy to the foot, vascular surgery, angioplasty, or thrombolysis)
  • History of bone cancer or metastatic disease of the affected limb, radiation therapy to the foot, or has had chemotherapy (i.e., systemic steroids, anti-rheumatics, TNF inhibitors, active chemotherapy, immunosuppressive therapy, autoimmune disease therapy) within 12 months prior to signing Informed Consent Form allowing trial participation
  • In the opinion of the investigator, the subject has a history of, or is currently diagnosed with, any illness or condition, other than diabetes, that could interfere with ulcer healing (e.g., end-stage renal disease, severe malnutrition, liver disease, aplastic anemia, connective tissue disorder, acquired immune deficiency syndrome, HIV positive, or sickle cell anemia)
  • In the opinion of the investigator, the subject has unstable Charcot foot or Charcot with bony prominence that could inhibit ulcer healing
  • Have ulcers secondary to a disease other than diabetes (e.g., vasculitis, neoplasms, or hematological disorders)
  • In the opinion of the investigator, the subject has excessive lymphedema that could interfere with off-loading and/or ulcer healing
  • Study Ulcer has received ulcer dressings that included growth factors, engineered tissues, or skin substitutes within 28 days of randomization, or is scheduled to receive such treatment during the study (e.g., Regranex, Dermagraft, Apligraf, EpiFix, Grafix, GraftJacket, OASIS, Omnigraft, or Integra BMWD)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    AmnioExcel Plus Amniotic Membrane + Standard of Care

    Standard of Care

    Arm Description

    AmnioExcel Plus is a human placental-based tissue consisting of dehydrated, tri-layer Placental (Amnion/Chorion/Amnion) Allograft Membrane (T-PAM) layers. T-PAM is a minimally manipulated placental membrane product made from tissues donated by pre-screened mothers during planned C-sections and is intended for use as a wound covering in the homologous use for the repair, reconstruction and replacement of skin at the direction of a physician. AmnioExcel Plus contains Human Cellular and Tissue Based Products (HCT/P) as defined by US FDA 21 CFR Part 1271. Standard of care includes the following: Coban™ Conforming gauze Optifoam® non-adhesive dressing Xtrasorb® for highly exudated wounds Cotton Gauze Normal saline (liquid or gel) Non-adhering dressings Steristrips Offloading boot, as appropriate

    Coban™ Conforming gauze Optifoam® non-adhesive dressing Xtrasorb® for highly exudated wounds Cotton Gauze Normal saline (liquid or gel) Steristrips Offloading boot, as appropriate

    Outcomes

    Primary Outcome Measures

    Incidence of complete wound closure
    Number of wounds with complete wound closure as assessed by the investigator. Complete wound closure is defined as 100% re-epithelialization of the ulcer surface without detectable exudate.

    Secondary Outcome Measures

    Full Information

    First Posted
    August 23, 2021
    Last Updated
    October 26, 2021
    Sponsor
    Integra LifeSciences Corporation
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05024656
    Brief Title
    AmnioExcel® Plus vs SOC in the Management of Diabetic Foot Ulcers
    Official Title
    A Prospective, Multi-Center, Randomized Controlled, Parallel Group, Trial Evaluating the Use of AmnioExcel Plus Placental Allograft Membrane for the Management of Diabetic Foot Ulcers
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Sponsor decision
    Study Start Date
    September 2021 (Anticipated)
    Primary Completion Date
    February 2024 (Anticipated)
    Study Completion Date
    June 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Integra LifeSciences Corporation

    4. Oversight

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

    5. Study Description

    Brief Summary
    This is a prospective, multicenter, randomized, parallel-group Trial comparing the outcomes associated with the use of AmnioExcel® Plus Placental Allograft Membrane (AmnioExcel® Plus) used in conjunction with Standard of Care (SOC) compared to SOC alone in the management of diabetic foot ulcers (DFUs).
    Detailed Description
    This study will have three (3) phases: (1) a Screening Phase, (2) a Treatment Phase, and (3) a Follow-up Phase. Subjects will be seen weekly in the Screening and Treatment Phases. Subjects will be seen weekly in the Screening and Treatment Phases. Subjects who achieve confirmed wound closure during the Treatment Phase will be entered into the Follow-up Phase and will return to the site four (4) weeks following that confirmation visit.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Diabetic Foot Ulcer
    Keywords
    diabetic foot, diabetes mellitus, diabetes complications

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Model Description
    This is a prospective, multicenter, randomized, parallel-group Trial comparing the outcomes associated with the use of AmnioExcel® Plus Placental Allograft Membrane (AmnioExcel® Plus) used in conjunction with Standard of Care (SOC) compared to SOC alone in the management of diabetic foot ulcers (DFUs).
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    AmnioExcel Plus Amniotic Membrane + Standard of Care
    Arm Type
    Experimental
    Arm Description
    AmnioExcel Plus is a human placental-based tissue consisting of dehydrated, tri-layer Placental (Amnion/Chorion/Amnion) Allograft Membrane (T-PAM) layers. T-PAM is a minimally manipulated placental membrane product made from tissues donated by pre-screened mothers during planned C-sections and is intended for use as a wound covering in the homologous use for the repair, reconstruction and replacement of skin at the direction of a physician. AmnioExcel Plus contains Human Cellular and Tissue Based Products (HCT/P) as defined by US FDA 21 CFR Part 1271. Standard of care includes the following: Coban™ Conforming gauze Optifoam® non-adhesive dressing Xtrasorb® for highly exudated wounds Cotton Gauze Normal saline (liquid or gel) Non-adhering dressings Steristrips Offloading boot, as appropriate
    Arm Title
    Standard of Care
    Arm Type
    Active Comparator
    Arm Description
    Coban™ Conforming gauze Optifoam® non-adhesive dressing Xtrasorb® for highly exudated wounds Cotton Gauze Normal saline (liquid or gel) Steristrips Offloading boot, as appropriate
    Intervention Type
    Other
    Intervention Name(s)
    AmnioExcel Plus Amniotic Membrane
    Intervention Description
    AmnioExcel® Plus will be applied weekly, in conjunction with SOC, if the ulcer remains open, or up to and including Week 11, whichever comes first.
    Intervention Type
    Other
    Intervention Name(s)
    Standard of Care
    Intervention Description
    The dressings, materials, and appliances used in accordance with institutional protocol or professional clinical judgement.
    Primary Outcome Measure Information:
    Title
    Incidence of complete wound closure
    Description
    Number of wounds with complete wound closure as assessed by the investigator. Complete wound closure is defined as 100% re-epithelialization of the ulcer surface without detectable exudate.
    Time Frame
    Up to 12 weeks of treatment

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Have participated in the informed consent process and signed a study-specific informed consent document Be willing to comply with study procedures, including study visits, and compliance with study required off-loading/protective device for the duration of the study Be at least 18 years of age If female and of child-bearing potential, must not be pregnant. To document pregnancy status, subject statement is acceptable Have Type II or Type II diabetes mellitus with investigator-confirmed glycosylated hemoglobin (HbA1c) of less than or equal to 12% within 3 months prior to Screening Visit Have at least one diabetic foot ulcer that meets ALL the following criteria: Ulcer which has been in existence for a minimum of four weeks, prior to signing the Informed Consent Form allowing trial participation Ulcer is a partial or full thickness diabetic foot ulcer without capsule/tendon/bone exposure Ulcer does not have tunneling, undermining, or sinus tracts that necessitates surgical OR debridement and/or penetrates to capsule/tendon/bone Ulcer is located on the foot or ankle (with no portion above the top of the malleolus) Ulcer size (area) is greater than equal to 1 cm2 and less than equal to 12 cm2 post-debridement Have a minimum 4cm margin between the qualifying study ulcer and any other ulcer on that same foot, post-debridement (a) If the subject has more than one ulcer that meets eligibility criteria, the ulcer designated as the study ulcer will be at the discretion of the investigator Have adequate vascular perfusion of the affected limb as defined by at least one of the following within the past 60 days: Ankle-Brachial Index (ABI) greater than equal to 0.7 and less than equal to 1.2, performed within 60 days of screening, Toe pressure (plethysmography) > 40 mmHg at time of screening, or TcPO2 > 50 mmHg at time of screening Be willing and able to maintain required applicable dressing changes as well as study required off-loading/protective device for the duration of the study Have a study wound severity Wagner I or II Exclusion Criteria: Previously randomized and treated under this clinical study protocol Patients with a known history of poor compliance with medical treatments Suspected or confirmed gangrene or ulcer infection of the study ulcer or is receiving systemic/IV antibiotics at the time of randomization Suspected or confirmed osteomyelitis of the foot with the study ulcer Participated in another clinical trial involving a device or a systemically administered investigational study drug/treatment within 28 days of randomization Received within 28 days of signing Informed Consent Form, or is scheduled to receive during study participation, a medication or treatment which is known to interfere with or affect the rate and quality of ulcer healing (e.g., systemic steroids, immunosuppressive therapy, autoimmune disease therapy, dialysis, radiation therapy to the foot, vascular surgery, angioplasty, or thrombolysis) History of bone cancer or metastatic disease of the affected limb, radiation therapy to the foot, or has had chemotherapy (i.e., systemic steroids, anti-rheumatics, TNF inhibitors, active chemotherapy, immunosuppressive therapy, autoimmune disease therapy) within 12 months prior to signing Informed Consent Form allowing trial participation In the opinion of the investigator, the subject has a history of, or is currently diagnosed with, any illness or condition, other than diabetes, that could interfere with ulcer healing (e.g., end-stage renal disease, severe malnutrition, liver disease, aplastic anemia, connective tissue disorder, acquired immune deficiency syndrome, HIV positive, or sickle cell anemia) In the opinion of the investigator, the subject has unstable Charcot foot or Charcot with bony prominence that could inhibit ulcer healing Have ulcers secondary to a disease other than diabetes (e.g., vasculitis, neoplasms, or hematological disorders) In the opinion of the investigator, the subject has excessive lymphedema that could interfere with off-loading and/or ulcer healing Study Ulcer has received ulcer dressings that included growth factors, engineered tissues, or skin substitutes within 28 days of randomization, or is scheduled to receive such treatment during the study (e.g., Regranex, Dermagraft, Apligraf, EpiFix, Grafix, GraftJacket, OASIS, Omnigraft, or Integra BMWD)
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Yi Arnold, PhD
    Organizational Affiliation
    Integra LifeSciences
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    AmnioExcel® Plus vs SOC in the Management of Diabetic Foot Ulcers

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