NEOX® CORD 1K vs Standard of Care in Non-healing Diabetic Foot Ulcers (CONDUCT I)
Primary Purpose
Foot Ulcer, Diabetic
Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NEOX® CORD 1K
Standard of Care (Pressure Bandage)
Sponsored by
About this trial
This is an interventional treatment trial for Foot Ulcer, Diabetic focused on measuring Foot, Ulcer, Diabetes, Amputation, Limb salvage
Eligibility Criteria
Inclusion Criteria:
- Between 18 years and 80 years of age inclusive
- Confirmed diagnosis of Type I or Type II Diabetes
- Males and Females diagnosed with a diabetic foot ulcer that is 1-25cm²
- At least one foot ulcer that is UT Grade IA
- Evidence of proper circulation which includes: An Index Ulcer defined as chronic (presence of wound for > 4 weeks) but not present for more than 52 weeks at the Screening Visit
- The Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot
- The Index Ulcer extends into the dermis or subcutaneous tissue with no evidence of exposed muscle, tendon, bone, or joint capsule
- Wound is free of necrotic debris and clinical signs of infection
- Patient has adequate circulation to the foot
- In patients with non-compressible ankle vessels there is adequate flow to the foot.
Exclusion Criteria:
- The Index Ulcer is of non-diabetic pathophysiology and/or over an active Charcot deformity
- The Index Ulcer is UT Grade IB or higher (worsening)
- Gangrene is present on any part of the affected foot
- The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit
- Patient is currently receiving renal dialysis
- Patient has a glycated hemoglobin A1c (HbA1c) level of > 12%
- Patient has significant renal impairment
- 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 purulent drainage from the wound site
- Patient has active malignancy other than non-melanoma skin cancer
- Patient's Index Ulcer has decreased by ≥ 30% during 2-week screening period
- 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 biologic trial within 60 days of screening
- Patient has allergy to primary or secondary dressing materials used in this trial
- Patient has an allergy to amphotericin-B or Dulbecco's Modified Eagle Medium (DMEM)
- 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
- University of Arizona
- Center for Clinical Research, Inc.
- Ankle and Foot Centers of Georgia
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Active Comparator
Experimental
Arm Label
NEOX® CORD 1K
Pressure bandage
Standard of Care Cross over to NEOX
Arm Description
Cryopreserved, umbilical cord allograft (NEOX® CORD 1K) with off-loading instructions.
Standard of Care Pressure bandage with off-loading instructions
Subjects in the Standard of Care (pressure bandage) group that have not healed greater than 50% at the Week 12 visit, or have a wound that is worsening, will be offered participation in the cross-over arm of the trial. The cross-over arm of the study will be treated with NEOX CORD 1K and followed for 12 weeks.
Outcomes
Primary Outcome Measures
Complete wound closure
Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator
Number of participants with adverse events
Number of participants with adverse events will be compared between the two groups.
Secondary Outcome Measures
Number of applications
Number of applications of study product (up to 12 weeks from Baseline)
Blinded Reader Assessment
Percent of wounds achieving complete closure per the assessment of a Blinded Reader (by blinded photograph of wound and measurement acetate).
Time to Initial Wound Closure
Time to initial wound closure (Up to12 weeks from Baseline or 24 weeks for crossover group)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02166294
Brief Title
NEOX® CORD 1K vs Standard of Care in Non-healing Diabetic Foot Ulcers
Acronym
CONDUCT I
Official Title
A Multi-center, Randomized, Parallel, Crossover Design Study of Non-healing Diabetic Foot Ulcers, Treated With Cryopreserved, Umbilical Cord Allograft (NEOX® CORD 1K) Versus Standard of Care That Are Followed for 12 Weeks
Study Type
Interventional
2. Study Status
Record Verification Date
June 2017
Overall Recruitment Status
Terminated
Why Stopped
Sponsor decision
Study Start Date
June 2014 (undefined)
Primary Completion Date
June 2015 (Actual)
Study Completion Date
June 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amniox Medical, Inc.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
In this randomized, multi-center, cross-over study, the efficacy and safety of NEOX® CORD 1K will be evaluated in patients suffering from non-healing diabetic foot ulcers. NEOX® CORD 1K is a cryopreserved human Amniotic Membrane and Umbilical Cord (AM/UC) matrix intended for use as a wound covering for dermal ulcers and defects. It is designated as a Human Cell & Tissue Product (HCT/P) by the U.S. FDA.
Detailed Description
Patients identified for the study will have a non-healing diabetic ulcer, between 1-25cm² in size. The patient's wound(s) will be monitored for 2 weeks to document the wound pathology. Patients with less than 30% wound area reduction during the 2 week screening period and who meet all of the inclusion and none of the exclusion criteria, will be enrolled in the study. All patients will be assigned to a study or control group and undergo sharp debridement. NEOX® CORD 1K matrix will be applied to the treatment group on the day of debridement, covered with a wound veil, and standard dressing. Both groups will be monitored weekly, and the % decrease in wound size will be recorded at Baseline and Weeks 1, 2, 3, 4, 6, 8 and 12. If the wound is not progressing, additional application of NEOX® CORD 1K may be applied. The time to complete closure will be recorded for both groups. The study duration will be 12 weeks. Subjects in the control group that continue to suffer a non-healing wound at the week 12 visit will be offered an opportunity to cross-over to NEOX treatment and followed for an additional 12 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Foot Ulcer, Diabetic
Keywords
Foot, Ulcer, Diabetes, Amputation, Limb salvage
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
18 (Actual)
8. Arms, Groups, and Interventions
Arm Title
NEOX® CORD 1K
Arm Type
Experimental
Arm Description
Cryopreserved, umbilical cord allograft (NEOX® CORD 1K) with off-loading instructions.
Arm Title
Pressure bandage
Arm Type
Active Comparator
Arm Description
Standard of Care Pressure bandage with off-loading instructions
Arm Title
Standard of Care Cross over to NEOX
Arm Type
Experimental
Arm Description
Subjects in the Standard of Care (pressure bandage) group that have not healed greater than 50% at the Week 12 visit, or have a wound that is worsening, will be offered participation in the cross-over arm of the trial. The cross-over arm of the study will be treated with NEOX CORD 1K and followed for 12 weeks.
Intervention Type
Other
Intervention Name(s)
NEOX® CORD 1K
Other Intervention Name(s)
cryopreserved, umbilical cord allograft, cryopreserved human amniotic membrane and umbilical cord, c-hAMUC, AM/UC
Intervention Description
Amniotic Membrane Tissue is fetal membrane tissue that comprises the innermost layer of the human placenta, and the outermost lining of the umbilical cord. In addition to amniotic membrane, the umbilical cord also contains Wharton's jelly, a rich source of proteoglycans and growth factors. These tissues share the same cell origin as the fetus and serve to protect the fetus during development. This product does not contain live cells.
Intervention Type
Procedure
Intervention Name(s)
Standard of Care (Pressure Bandage)
Intervention Description
Standard of Care wound, pressure dressing applied as needed at each visit.
Primary Outcome Measure Information:
Title
Complete wound closure
Description
Complete closure of the index wound, defined as 100% re-epithelialization as determined by the Investigator
Time Frame
12 weeks
Title
Number of participants with adverse events
Description
Number of participants with adverse events will be compared between the two groups.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Number of applications
Description
Number of applications of study product (up to 12 weeks from Baseline)
Time Frame
12 weeks
Title
Blinded Reader Assessment
Description
Percent of wounds achieving complete closure per the assessment of a Blinded Reader (by blinded photograph of wound and measurement acetate).
Time Frame
12 weeks and 24 weeks
Title
Time to Initial Wound Closure
Description
Time to initial wound closure (Up to12 weeks from Baseline or 24 weeks for crossover group)
Time Frame
Up to 12 weeks or 24 weeks (Crossover)
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
Confirmed diagnosis of Type I or Type II Diabetes
Males and Females diagnosed with a diabetic foot ulcer that is 1-25cm²
At least one foot ulcer that is UT Grade IA
Evidence of proper circulation which includes: An Index Ulcer defined as chronic (presence of wound for > 4 weeks) but not present for more than 52 weeks at the Screening Visit
The Index Ulcer is located below the malleoli on the plantar or dorsal surface of the foot
The Index Ulcer extends into the dermis or subcutaneous tissue with no evidence of exposed muscle, tendon, bone, or joint capsule
Wound is free of necrotic debris and clinical signs of infection
Patient has adequate circulation to the foot
In patients with non-compressible ankle vessels there is adequate flow to the foot.
Exclusion Criteria:
The Index Ulcer is of non-diabetic pathophysiology and/or over an active Charcot deformity
The Index Ulcer is UT Grade IB or higher (worsening)
Gangrene is present on any part of the affected foot
The longest dimension of the Index Ulcer exceeds 5 cm at the Baseline Visit
Patient is currently receiving renal dialysis
Patient has a glycated hemoglobin A1c (HbA1c) level of > 12%
Patient has significant renal impairment
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 purulent drainage from the wound site
Patient has active malignancy other than non-melanoma skin cancer
Patient's Index Ulcer has decreased by ≥ 30% during 2-week screening period
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 biologic trial within 60 days of screening
Patient has allergy to primary or secondary dressing materials used in this trial
Patient has an allergy to amphotericin-B or Dulbecco's Modified Eagle Medium (DMEM)
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
Charles I. Romano
Organizational Affiliation
Amniox Medical, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
Center for Clinical Research, Inc.
City
Castro Valley
State/Province
California
ZIP/Postal Code
94115
Country
United States
Facility Name
Ankle and Foot Centers of Georgia
City
Newnan
State/Province
Georgia
ZIP/Postal Code
30265
Country
United States
12. IPD Sharing Statement
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NEOX® CORD 1K vs Standard of Care in Non-healing Diabetic Foot Ulcers
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