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Grafix® DFU: Open-Label Extension Option to Evaluate Safety & Efficacy of Grafix® for Chronic Diabetic Foot Ulcers (DFU)

Primary Purpose

Diabetic Foot Ulcers

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Tissue
Control
Sponsored by
Osiris Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcers focused on measuring Chronic DFUs, Diabetic Foot Ulcers

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Between 18 years and 80 years of age inclusive, as of the date of screening
  2. Confirmed diagnosis of Type I or Type II Diabetes
  3. An Index Ulcer defined as chronic (presence of wound for > 4 weeks) but not present for more than 52 weeks at the Screening Visit
  4. Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot
  5. The Index Ulcer is between 1cm2 and 15 cm2 at the Screening Visit
  6. The Index Ulcer extends into the dermis or subcutaneous tissue without evidence of exposed muscle, tendon, bone, or joint capsule
  7. Wound is free of necrotic debris
  8. Patient has adequate circulation to the foot as documented by either:

    • Ankle Brachial Index (ABI) > 0.70 and < 1.30, or
    • In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30, a Toe Brachial Index (TBI) ≥ 0.50
    • In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30 and TBI cannot be performed (e.g., toe is absent, wounds are present, or site cannot perform a TBI), a Doppler waveform in the posterior tibial or dorsalis pedis arteries at the ankle consistent with adequate flow in the foot (biphasic or triphasic) and other diagnostic confirmation of adequate flow (e.g., duplex imaging, normal pulse volume recording [PVR] testing).

Exclusion Criteria:

  1. Index Ulcer is of non-diabetic pathophysiology
  2. Gangrene is present on any part of the affected foot
  3. Index Ulcer is over an active Charcot deformity
  4. The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit
  5. Patient is currently receiving dialysis
  6. Patient has a glycated hemoglobin A1c (HbA1c) level of > 12%
  7. Chronic oral steroid use > 7.5 mg daily
  8. Requiring intravenous (IV) antibiotics to treat the index wound infection
  9. Patient has an ulcer within 15cm of the Index Ulcer identified for study consideration
  10. Patient is receiving oral or parenteral corticosteroids, immunosuppressive or cytotoxic agents
  11. Patient is Human Immunodeficiency Virus (HIV) positive or has Acquired Immune Deficiency Syndrome (AIDS)
  12. Current evidence of osteomyelitis, cellulitis, or other evidence of infection including fever or pus drainage from the wound site
  13. Patient has active malignancy other than non-melanoma skin cancer
  14. Patient's Index Ulcer has decreased by ≥ 30% during 1-week screening period as determined by criteria provided by the Wound Core Lab
  15. Patient's random blood sugar is > 450 mg/dl at screening
  16. Patient has untreated alcohol or substance abuse at the time of screening
  17. Pregnant women
  18. Patient is currently enrolled or participated in another investigational device, drug, or biological trial within 60 days of screening
  19. Patient has allergy to primary or secondary dressing materials used in this trial
  20. Patient has had within the last 30 days, or is currently undergoing, or is planning for wound treatments with enzymes, growth factors, living skin, dermal substitutes or other advanced biological therapies

Sites / Locations

  • Institute for Advanced Wound Care at Baptist Medical
  • Clinical Trials of Arizona, Inc.
  • ILD Laser and Research Center
  • Nature Coast Clinical Research
  • River City Clinical Research
  • Aiyan Diabetes Center
  • Ocean County Foot and Ankle Surgical Associates
  • UNC at Chapel Hill
  • Duke University Medical Center
  • Cleveland Clinic
  • Ohio Health Research Institute
  • Blair Orthopedics Associates, Inc
  • Omega Medical Research
  • UT Southwestern Medical Center at Dallas
  • Clincal Trials of Texas, Inc.

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Grafix®

Control (non-adherent dressing)

Arm Description

Outcomes

Primary Outcome Measures

Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator, anytime up to the Day 84 Visit

Secondary Outcome Measures

Time to initial wound closure
number of patients with >50% reduction in wound size by Day 28
number of applications of Grafix® versus control
number of re-occurrences of index wound post-healing
percent of wounds achieving complete closure

Full Information

First Posted
March 14, 2012
Last Updated
April 7, 2014
Sponsor
Osiris Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT01596920
Brief Title
Grafix® DFU: Open-Label Extension Option to Evaluate Safety & Efficacy of Grafix® for Chronic Diabetic Foot Ulcers
Acronym
DFU
Official Title
A Multicenter, Adaptive Design, Randomized, Single-Blind Study With an Open-Label Extension Option to Further Evaluate the Safety and Efficacy of Grafix® for the Treatment of Chronic Diabetic Foot Ulcers
Study Type
Interventional

2. Study Status

Record Verification Date
April 2014
Overall Recruitment Status
Completed
Study Start Date
April 2012 (undefined)
Primary Completion Date
August 2013 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Osiris Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of the present study is to further establish in a randomized controlled trial, the safety and efficacy of weekly Grafix® administration versus control in patients with chronic diabetic foot ulcers. The primary endpoint is complete wound closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator. Grafix® is a product regulated for use in the US by the FDA as a Human Cellular and Tissue Based Product (HCT/P) under Title 21 CFR Part 1271.
Detailed Description
The treatment indication is for chronic, diabetic foot ulcers (DFUs) between 1cm2 and 15cm2 located below the malleoli on the plantar or dorsal surface of the foot. Patients must have confirmed Type I or Type II Diabetes. Patients will receive treatment every week for 12 weeks duration in the Single-Blind Treatment phase of the trial. Patients who receive Grafix® or control will be evaluated for primary efficacy up to 84 days, and for safety and wound re-occurrence for 84 days after wound closure. Patients in the control group whose wounds are not closed at the end of treatment may be offered Grafix® in an Open-Label Treatment phase. The Open-Label Treatment phase can last up to an additional 84 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcers
Keywords
Chronic DFUs, Diabetic Foot Ulcers

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
97 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Grafix®
Arm Type
Active Comparator
Arm Title
Control (non-adherent dressing)
Arm Type
Placebo Comparator
Intervention Type
Other
Intervention Name(s)
Tissue
Intervention Description
Allograft Tissue Cellular Repair Matrix
Intervention Type
Other
Intervention Name(s)
Control
Intervention Description
Non-adherent Dressing
Primary Outcome Measure Information:
Title
Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator, anytime up to the Day 84 Visit
Time Frame
Up to 84 days
Secondary Outcome Measure Information:
Title
Time to initial wound closure
Time Frame
Up to 84 days after the Single-Blind Treatment Visits
Title
number of patients with >50% reduction in wound size by Day 28
Time Frame
Up to 84 days after the Single-Blind Treatment Visits
Title
number of applications of Grafix® versus control
Time Frame
Up to 84 days after the Single-Blind Treatment Visits
Title
number of re-occurrences of index wound post-healing
Time Frame
Up to 84 days after the Single-Blind Treatment Visits
Title
percent of wounds achieving complete closure
Time Frame
Up to 84 days after the Single-Blind Treatment Visits

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Between 18 years and 80 years of age inclusive, as of the date of screening Confirmed diagnosis of Type I or Type II Diabetes An Index Ulcer defined as chronic (presence of wound for > 4 weeks) but not present for more than 52 weeks at the Screening Visit Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot The Index Ulcer is between 1cm2 and 15 cm2 at the Screening Visit The Index Ulcer extends into the dermis or subcutaneous tissue without evidence of exposed muscle, tendon, bone, or joint capsule Wound is free of necrotic debris Patient has adequate circulation to the foot as documented by either: Ankle Brachial Index (ABI) > 0.70 and < 1.30, or In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30, a Toe Brachial Index (TBI) ≥ 0.50 In patients with non-compressible ankle vessels defined as an ABI ≥ 1.30 and TBI cannot be performed (e.g., toe is absent, wounds are present, or site cannot perform a TBI), a Doppler waveform in the posterior tibial or dorsalis pedis arteries at the ankle consistent with adequate flow in the foot (biphasic or triphasic) and other diagnostic confirmation of adequate flow (e.g., duplex imaging, normal pulse volume recording [PVR] testing). Exclusion Criteria: Index Ulcer is of non-diabetic pathophysiology Gangrene is present on any part of the affected foot Index Ulcer is over an active Charcot deformity The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit Patient is currently receiving dialysis Patient has a glycated hemoglobin A1c (HbA1c) level of > 12% Chronic oral steroid use > 7.5 mg daily Requiring intravenous (IV) antibiotics to treat the index wound infection Patient has an ulcer within 15cm of the Index Ulcer identified for study consideration Patient is receiving oral or parenteral corticosteroids, immunosuppressive or cytotoxic agents Patient is Human Immunodeficiency Virus (HIV) positive or has Acquired Immune Deficiency Syndrome (AIDS) Current evidence of osteomyelitis, cellulitis, or other evidence of infection including fever or pus drainage from the wound site Patient has active malignancy other than non-melanoma skin cancer Patient's Index Ulcer has decreased by ≥ 30% during 1-week screening period as determined by criteria provided by the Wound Core Lab Patient's random blood sugar is > 450 mg/dl at screening Patient has untreated alcohol or substance abuse at the time of screening Pregnant women Patient is currently enrolled or participated in another investigational device, drug, or biological trial within 60 days of screening Patient has allergy to primary or secondary dressing materials used in this trial Patient has had within the last 30 days, or is currently undergoing, or is planning for wound treatments with enzymes, growth factors, living skin, dermal substitutes or other advanced biological therapies
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharron E McCulloch
Organizational Affiliation
Osiris Therapeutics, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Institute for Advanced Wound Care at Baptist Medical
City
Montgomery
State/Province
Alabama
ZIP/Postal Code
36111
Country
United States
Facility Name
Clinical Trials of Arizona, Inc.
City
Glendale
State/Province
Arizona
ZIP/Postal Code
85306
Country
United States
Facility Name
ILD Laser and Research Center
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
Nature Coast Clinical Research
City
Inverness
State/Province
Florida
ZIP/Postal Code
34452
Country
United States
Facility Name
River City Clinical Research
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
Aiyan Diabetes Center
City
Evans
State/Province
Georgia
ZIP/Postal Code
30809
Country
United States
Facility Name
Ocean County Foot and Ankle Surgical Associates
City
Toms River
State/Province
New Jersey
ZIP/Postal Code
08753
Country
United States
Facility Name
UNC at Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Ohio Health Research Institute
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43214
Country
United States
Facility Name
Blair Orthopedics Associates, Inc
City
Altoona
State/Province
Pennsylvania
ZIP/Postal Code
16602
Country
United States
Facility Name
Omega Medical Research
City
Warwick
State/Province
Rhode Island
ZIP/Postal Code
02886
Country
United States
Facility Name
UT Southwestern Medical Center at Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
Facility Name
Clincal Trials of Texas, Inc.
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Grafix® DFU: Open-Label Extension Option to Evaluate Safety & Efficacy of Grafix® for Chronic Diabetic Foot Ulcers

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