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Feasibility Study of DermGEN for Diabetic Foot Ulcer Treatment

Primary Purpose

Diabetes Type I, Diabetes Type II

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
DermGEN
Sponsored by
Dr. Paul F. Gratzer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Type I focused on measuring Diabetic, Chronic Ulcer, Wound Healing, Leg

Eligibility Criteria

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

Inclusion Criteria:

A subject will be considered eligible to participate in this study if each of the following inclusion criteria is satisfied:

  1. Patient with documented stable Type I or II diabetes (HbA1C >7.0 within 1 month prior to Day 0).
  2. Patient's ulcer has been present for a minimum of 2 weeks as of Day 0.
  3. Study ulcer has healed <30% in size during the 2 weeks prior to Day 0.
  4. Ulcer area is ≥1 cm2 prior to debridement at Day 0 of study.
  5. Ulcer extends through dermis and into subcutaneous tissue but without exposure of muscle, tendon, bone or joint capsule.
  6. Ulcer is free of necrotic debris and clinical infection, and is comprised of healthy vascular tissue suitable for skin grafting on Day 0.
  7. Patient has adequate circulation to the foot as evidenced by palpable pulse or pulse detectable with Doppler ultrasound, and lack of visible cyanosis in skin bordering the ulcer.
  8. Female patients are not pregnant at time of, or during study.
  9. Patient and caregiver ready and willing to participate and comply with follow-up regime.
  10. Patient or legal representative has read and signed the Institutional Ethics Review Board approved informed consent form.

Exclusion Criteria:

A subject will not be considered eligible to participate in this study if any one of the following exclusion criteria is satisfied:

  1. Evidence of gangrene on affected foot.
  2. Ulcer is over Charcot deformity (fractures or dislocation).
  3. Ulcer is non-diabetic in etiology.
  4. Ulcer has tunnels or sinus tracts that cannot be completely debrided.
  5. Medical condition(s) that in the Investigator's opinion make the patient inappropriate for study
  6. Patient has/had malignant disease not in remission for 5 years or more
  7. Patient has acute or chronic hepatitis, cirrhosis, serum albumin <2.0 gm/dL, or has alkaline phosphatase or LDH at twice the normal upper limit
  8. Patient receiving oral or parenteral corticosteroids, immunosuppression or cytotoxic agents, or is anticipated to require such agents during study
  9. Patient received radiation therapy within 30 days of Day 0 of study
  10. Patient has AIDS or is infected with HIV
  11. Patient has participated in another study using investigational drug(s) or device within the previous 30 days
  12. Obvious clinical signs and symptoms of ongoing cellulitis or osteomyelitis
  13. Patient has any other condition which seriously compromises their ability to complete the study
  14. Patient has known allergies to antibiotics, such as penicillin and streptomycin
  15. Patient has a history of bleeding disorder
  16. Patient received elective osseous procedures to the study foot within 30 days prior to screening visit, except that patients whose DFU overlies an area of treated osteomyelitis may be included, providing there exists a suitable base for application of the DermGEN.

Sites / Locations

  • Queen Elizabeth II Health Sciences Center
  • St. Michael's Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

DermGEN Decellularized Dermal Matrix

Arm Description

DermGEN is a product created by a patented process that decellularizes and sterilizes donated human tissue.

Outcomes

Primary Outcome Measures

Percentage of Wound Area Reduction Compared to Baseline
Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100.

Secondary Outcome Measures

Percentage of Patients With Complete Healing at Any Time Point
Complete healing is defined as 100% epithelialization without drainage. Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100.
Number of Patients With Adverse Events
Reporting the number of patients participating in the study having adverse events
Number of Patients With Ulcer Reoccurrence in the Same Location After Complete Healing
Number of patients that reported a reoccurrence of the ulcer in the same location after complete healing at 1 year post treatment.
Percent Change in Wound Size Compared to Baseline
Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100. Note 100% equals complete closure of the wound.
Percent Change in Wound Area From Baseline
change in area of wound in percent from initial presentation

Full Information

First Posted
July 3, 2014
Last Updated
September 13, 2019
Sponsor
Dr. Paul F. Gratzer
Collaborators
Canadian Institutes of Health Research (CIHR), Nova Scotia Health Authority
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1. Study Identification

Unique Protocol Identification Number
NCT02184455
Brief Title
Feasibility Study of DermGEN for Diabetic Foot Ulcer Treatment
Official Title
A Feasibility Study of DermGEN Dermal Regeneration Scaffold for the Treatment of Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
July 1, 2016 (Actual)
Primary Completion Date
May 1, 2017 (Actual)
Study Completion Date
May 1, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Dr. Paul F. Gratzer
Collaborators
Canadian Institutes of Health Research (CIHR), Nova Scotia Health Authority

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this clinical trial is to perform a limited pilot study to determine the safety and feasibility of DermGEN in the treatment of non-healing diabetic foot ulcers (DFU). This will be a one-arm prospective study. It is hypothesized that DermGEN treatment will result in positive healing outcomes with no significant adverse effects.
Detailed Description
This will be a one-arm prospective study. This study in Halifax will be mirrored in one other participating health care center in Toronto, Ontario, Canada with each centre anticipated to enrol 5-10 patients for a total of 15-20 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Type I, Diabetes Type II
Keywords
Diabetic, Chronic Ulcer, Wound Healing, Leg

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
Diabetic type I/II patients with chronic ulcer present
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DermGEN Decellularized Dermal Matrix
Arm Type
Experimental
Arm Description
DermGEN is a product created by a patented process that decellularizes and sterilizes donated human tissue.
Intervention Type
Biological
Intervention Name(s)
DermGEN
Intervention Description
DermGEN is a product created by a patented process that decellularizes and sterilizes donated human tissue.
Primary Outcome Measure Information:
Title
Percentage of Wound Area Reduction Compared to Baseline
Description
Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100.
Time Frame
4 weeks
Secondary Outcome Measure Information:
Title
Percentage of Patients With Complete Healing at Any Time Point
Description
Complete healing is defined as 100% epithelialization without drainage. Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100.
Time Frame
20 weeks
Title
Number of Patients With Adverse Events
Description
Reporting the number of patients participating in the study having adverse events
Time Frame
20 weeks
Title
Number of Patients With Ulcer Reoccurrence in the Same Location After Complete Healing
Description
Number of patients that reported a reoccurrence of the ulcer in the same location after complete healing at 1 year post treatment.
Time Frame
1 year
Title
Percent Change in Wound Size Compared to Baseline
Description
Digital photography was utilized to capture the appearance and size of the ulcer at each visit. In the photograph a measurement scale was shown beside the wound. The area of the wound was calculated by manually outlining wound edges on a digital image and then using the open source program ImageJ to calculate the area of the wound. For calculating the percentage change in area of the wound, the wound areas at each time point were divided by the size of the wound at baseline and multiplied by 100. Note 100% equals complete closure of the wound.
Time Frame
20 weeks
Title
Percent Change in Wound Area From Baseline
Description
change in area of wound in percent from initial presentation
Time Frame
12 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A subject will be considered eligible to participate in this study if each of the following inclusion criteria is satisfied: Patient with documented stable Type I or II diabetes (HbA1C >7.0 within 1 month prior to Day 0). Patient's ulcer has been present for a minimum of 2 weeks as of Day 0. Study ulcer has healed <30% in size during the 2 weeks prior to Day 0. Ulcer area is ≥1 cm2 prior to debridement at Day 0 of study. Ulcer extends through dermis and into subcutaneous tissue but without exposure of muscle, tendon, bone or joint capsule. Ulcer is free of necrotic debris and clinical infection, and is comprised of healthy vascular tissue suitable for skin grafting on Day 0. Patient has adequate circulation to the foot as evidenced by palpable pulse or pulse detectable with Doppler ultrasound, and lack of visible cyanosis in skin bordering the ulcer. Female patients are not pregnant at time of, or during study. Patient and caregiver ready and willing to participate and comply with follow-up regime. Patient or legal representative has read and signed the Institutional Ethics Review Board approved informed consent form. Exclusion Criteria: A subject will not be considered eligible to participate in this study if any one of the following exclusion criteria is satisfied: Evidence of gangrene on affected foot. Ulcer is over Charcot deformity (fractures or dislocation). Ulcer is non-diabetic in etiology. Ulcer has tunnels or sinus tracts that cannot be completely debrided. Medical condition(s) that in the Investigator's opinion make the patient inappropriate for study Patient has/had malignant disease not in remission for 5 years or more Patient has acute or chronic hepatitis, cirrhosis, serum albumin <2.0 gm/dL, or has alkaline phosphatase or LDH at twice the normal upper limit Patient receiving oral or parenteral corticosteroids, immunosuppression or cytotoxic agents, or is anticipated to require such agents during study Patient received radiation therapy within 30 days of Day 0 of study Patient has AIDS or is infected with HIV Patient has participated in another study using investigational drug(s) or device within the previous 30 days Obvious clinical signs and symptoms of ongoing cellulitis or osteomyelitis Patient has any other condition which seriously compromises their ability to complete the study Patient has known allergies to antibiotics, such as penicillin and streptomycin Patient has a history of bleeding disorder Patient received elective osseous procedures to the study foot within 30 days prior to screening visit, except that patients whose DFU overlies an area of treated osteomyelitis may be included, providing there exists a suitable base for application of the DermGEN.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Glazebrook, PhD,MD
Organizational Affiliation
Queen Elizabeth II Health Sciences Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Queen Elizabeth II Health Sciences Center
City
Halifax
State/Province
Nova Scotia
ZIP/Postal Code
B3H3A7
Country
Canada
Facility Name
St. Michael's Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada

12. IPD Sharing Statement

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Feasibility Study of DermGEN for Diabetic Foot Ulcer Treatment

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