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Micronized dHACM Injectable for the Treatment of Achille Tendonitis

Primary Purpose

Tendonitis;Achilles

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Micronized DHACM
Saline Injection
Sponsored by
MiMedx Group, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Tendonitis;Achilles focused on measuring Chronic Achilles Tendonitis

Eligibility Criteria

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

Inclusion Criteria

All subjects enrolled must meet all the following criteria:

  1. Confirmed diagnosis of Achilles tendonitis for ≥ 1 month (30 days) and ≤ 18 months by the investigator
  2. VAS Pain scale of ≥ 45 at randomization
  3. Achilles Tendonitis with conservative treatment for ≥1 month (30 days) while under the direction of the healthcare provider, including any of the following modalities:

    • Rest, Ice, Compression, Elevation (RICE)
    • Stretching exercises
    • Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
    • Orthotics
  4. Diagnostic AP and lateral X-Ray within 6 months of enrollment showing view of calcaneus negative for calcaneal fracture or structural abnormalities
  5. BMI ≤ 40 kg/m2
  6. Age from 21 to 80 years
  7. Ability to sign Informed Consent and Release of Medical Information Forms
  8. Ability to receive and respond to text messages or emails on a daily basis.

Exclusion Criteria Any potential subjects meeting any of the following criteria will be excluded from enrollment and subsequent randomization.

  1. Prior surgery to the affected site.
  2. Subjects requiring bilateral Achilles tendonitis treatment at time of enrollment
  3. Prior use of any lower limb injection therapy, including corticosteroids or PRP in either limb within the last 3 months
  4. Has diabetes either Type I or Type II
  5. Systemic disorders associated with enthesopathy (disorder of entheses, i.e. bone attachments) such as Gout, Reiter's syndrome, rheumatoid arthritis, etc.
  6. The presence of diagnosed comorbidities that can be confused with or can exacerbate the condition- to be assessed by X-ray - including but not limited to:

    • Calcaneal stress fracture
    • Suspected partial thickness tear of the Achilles tendon, as assessed by the investigator
    • Calcaneal tumor
    • Tarsal tunnel syndrome (diagnosed)
    • Significant bone deformity of the foot that may interfere with the study
  7. The presence of diagnosed comorbidities that require surgery or are unlikely to improve - to be assessed by Investigator-including but not limited to:

    • Nerve entrapment syndrome
    • Acute traumatic rupture of the Achilles tendon
    • Partial thickness tears of the Achilles Tendon
  8. Affected site exhibits clinical signs and symptoms of infection
  9. Known allergy or known sensitivity to Aminoglycosides
  10. Subjects who are non-ambulatory
  11. History of more than 14 days of treatment with immune-suppressants (including systemic corticosteroids) or cytotoxic chemotherapy within 30 days prior to enrollment, or who are anticipated to require such medications during the course of the study
  12. Prior radiation at the site
  13. Use of any investigational drug(s) or therapeutic device(s) within 3 months preceding enrollment
  14. Immune system disorders including Systemic Lupus Erythematosus (SLE), Fibromyalgia, Acquired Immunodeficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV) or Lyme disease
  15. History of any conditions (including drug or alcohol abuse, medical or psychiatric condition) that is likely to impair understanding of or compliance with the study protocol, in the judgment of the investigator
  16. Pregnancy at enrollment or within last 6 months, women who are breastfeeding, or women of childbearing potential who are planning to become pregnant during the time of the study OR are unwilling/unable to use acceptable methods of contraception (birth control pills, barriers, or abstinence)
  17. Workers' compensation patients

Sites / Locations

  • Central Research Associates
  • Southern Arizona VA Health Care System
  • ILD Research Center
  • Foot and Ankle Clinic
  • Five Cities Foot Clinic
  • South Florida Veterans Affairs
  • Doctors Research Network
  • Northside Podiatry
  • Foot and Ankle Center of Illinois
  • Advanced Foot & Ankle Center
  • University Orthopedics Center
  • West Penn Hospital
  • Futuro Clinical Trials
  • Coastal Podiatry, Inc.

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Micronized DHACM

Saline Injection

Arm Description

1mL injection of 40mg Micronized dehydrated human amnion/chorion membrane (DHACM)

Injection of 1mL 0.9% Sodium Chloride Injection, USP

Outcomes

Primary Outcome Measures

Change in VAS score
Visual Analog Scale, Left end point is "No Pain". Right end point is "worst pain imaginable"
Incidence of adverse events
The incidence of related Adverse Events (AEs), Serious Adverse Events (SAEs), and Unanticipated Adverse Events during the first 12 months post injection

Secondary Outcome Measures

Foot Function Index Revised (FFI-R) (Short Form)
Subjects circle the number that correlates how bad their foot pain was in certain situation.

Full Information

First Posted
January 23, 2018
Last Updated
May 18, 2022
Sponsor
MiMedx Group, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03414255
Brief Title
Micronized dHACM Injectable for the Treatment of Achille Tendonitis
Official Title
A Phase 3, Prospective, Double-Blinded, Randomized Controlled Trial Of The Micronized dHACM Injection As Compared To Saline Placebo Injection In The Treatment Of Achilles Tendonitis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Completed
Study Start Date
January 9, 2018 (Actual)
Primary Completion Date
March 30, 2021 (Actual)
Study Completion Date
March 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
MiMedx Group, Inc.

4. Oversight

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

5. Study Description

Brief Summary
Prospective, Double-Blinded, Randomized Controlled Trial of the Micronized dHACM Injection as Compared to Saline Placebo Injection in the Treatment of Achilles Tendonitis
Detailed Description
Approximately 158 subjects will be enrolled in this study. Each patient will receive 1 injection and be evaluated for efficacy and safety during a 12 month observation period. Randomization will be 1:1. The study is expected to be completed in 24 months, inclusive of enrollment and follow-up of all subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tendonitis;Achilles
Keywords
Chronic Achilles Tendonitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
146 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Micronized DHACM
Arm Type
Experimental
Arm Description
1mL injection of 40mg Micronized dehydrated human amnion/chorion membrane (DHACM)
Arm Title
Saline Injection
Arm Type
Placebo Comparator
Arm Description
Injection of 1mL 0.9% Sodium Chloride Injection, USP
Intervention Type
Biological
Intervention Name(s)
Micronized DHACM
Other Intervention Name(s)
dHACM
Intervention Description
1 mL injection of 40mg Micronized dehydrated human amnion/chorion membrane (DHACM).
Intervention Type
Drug
Intervention Name(s)
Saline Injection
Other Intervention Name(s)
0.9% NaCL, Normal Saline, Sodium Chloride Injection, USP
Intervention Description
Injection of 1mL 0.9% Sodium Chloride Injection, USP
Primary Outcome Measure Information:
Title
Change in VAS score
Description
Visual Analog Scale, Left end point is "No Pain". Right end point is "worst pain imaginable"
Time Frame
90 days
Title
Incidence of adverse events
Description
The incidence of related Adverse Events (AEs), Serious Adverse Events (SAEs), and Unanticipated Adverse Events during the first 12 months post injection
Time Frame
365 days
Secondary Outcome Measure Information:
Title
Foot Function Index Revised (FFI-R) (Short Form)
Description
Subjects circle the number that correlates how bad their foot pain was in certain situation.
Time Frame
90 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria All subjects enrolled must meet all the following criteria: Confirmed diagnosis of Achilles tendonitis for ≥ 1 month (30 days) and ≤ 18 months by the investigator VAS Pain scale of ≥ 45 at randomization Achilles Tendonitis with conservative treatment for ≥1 month (30 days) while under the direction of the healthcare provider, including any of the following modalities: Rest, Ice, Compression, Elevation (RICE) Stretching exercises Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Orthotics Diagnostic AP and lateral X-Ray within 6 months of enrollment showing view of calcaneus negative for calcaneal fracture or structural abnormalities BMI ≤ 40 kg/m2 Age from 21 to 80 years Ability to sign Informed Consent and Release of Medical Information Forms Ability to receive and respond to text messages or emails on a daily basis. Exclusion Criteria Any potential subjects meeting any of the following criteria will be excluded from enrollment and subsequent randomization. Prior surgery to the affected site. Subjects requiring bilateral Achilles tendonitis treatment at time of enrollment Prior use of any lower limb injection therapy, including corticosteroids or PRP in either limb within the last 3 months Has diabetes either Type I or Type II Systemic disorders associated with enthesopathy (disorder of entheses, i.e. bone attachments) such as Gout, Reiter's syndrome, rheumatoid arthritis, etc. The presence of diagnosed comorbidities that can be confused with or can exacerbate the condition- to be assessed by X-ray - including but not limited to: Calcaneal stress fracture Suspected partial thickness tear of the Achilles tendon, as assessed by the investigator Calcaneal tumor Tarsal tunnel syndrome (diagnosed) Significant bone deformity of the foot that may interfere with the study The presence of diagnosed comorbidities that require surgery or are unlikely to improve - to be assessed by Investigator-including but not limited to: Nerve entrapment syndrome Acute traumatic rupture of the Achilles tendon Partial thickness tears of the Achilles Tendon Affected site exhibits clinical signs and symptoms of infection Known allergy or known sensitivity to Aminoglycosides Subjects who are non-ambulatory History of more than 14 days of treatment with immune-suppressants (including systemic corticosteroids) or cytotoxic chemotherapy within 30 days prior to enrollment, or who are anticipated to require such medications during the course of the study Prior radiation at the site Use of any investigational drug(s) or therapeutic device(s) within 3 months preceding enrollment Immune system disorders including Systemic Lupus Erythematosus (SLE), Fibromyalgia, Acquired Immunodeficiency Syndrome (AIDS), Human Immunodeficiency Virus (HIV) or Lyme disease History of any conditions (including drug or alcohol abuse, medical or psychiatric condition) that is likely to impair understanding of or compliance with the study protocol, in the judgment of the investigator Pregnancy at enrollment or within last 6 months, women who are breastfeeding, or women of childbearing potential who are planning to become pregnant during the time of the study OR are unwilling/unable to use acceptable methods of contraception (birth control pills, barriers, or abstinence) Workers' compensation patients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stuart D Miller, MD
Organizational Affiliation
MedStar Union Memorial Hospital Baltimore, MD
Official's Role
Principal Investigator
Facility Information:
Facility Name
Central Research Associates
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35205
Country
United States
Facility Name
Southern Arizona VA Health Care System
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85723
Country
United States
Facility Name
ILD Research Center
City
Carlsbad
State/Province
California
ZIP/Postal Code
92009
Country
United States
Facility Name
Foot and Ankle Clinic
City
Los Angeles
State/Province
California
ZIP/Postal Code
90057
Country
United States
Facility Name
Five Cities Foot Clinic
City
Pismo Beach
State/Province
California
ZIP/Postal Code
93449
Country
United States
Facility Name
South Florida Veterans Affairs
City
Miami
State/Province
Florida
ZIP/Postal Code
33125
Country
United States
Facility Name
Doctors Research Network
City
Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
Facility Name
Northside Podiatry
City
Buford
State/Province
Georgia
ZIP/Postal Code
30518
Country
United States
Facility Name
Foot and Ankle Center of Illinois
City
Springfield
State/Province
Illinois
ZIP/Postal Code
62704
Country
United States
Facility Name
Advanced Foot & Ankle Center
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89119
Country
United States
Facility Name
University Orthopedics Center
City
Altoona
State/Province
Pennsylvania
ZIP/Postal Code
16602
Country
United States
Facility Name
West Penn Hospital
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Facility Name
Futuro Clinical Trials
City
McAllen
State/Province
Texas
ZIP/Postal Code
78501
Country
United States
Facility Name
Coastal Podiatry, Inc.
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23464
Country
United States

12. IPD Sharing Statement

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Micronized dHACM Injectable for the Treatment of Achille Tendonitis

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