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Phase III Study to Evaluate Efficacy and Safety of DSC127 in Diabetic Foot Ulcers (STRIDE 1)

Primary Purpose

Diabetic Foot Ulcers

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
DSC127
placebo vehicle gel
Sponsored by
Integra LifeSciences Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Foot Ulcers focused on measuring diabetic foot ulcers, Wagner Grade 1 or 2 foot ulcers

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female ambulatory subject age ≥18 years at the time of informed consent
  2. Has type 1 or type 2 DM under metabolic control as confirmed by a glycosylated hemoglobin (HbA1c) of ≤12% and a serum creatinine level of ≤3mg/dL
  3. At Screening and at Baseline (prior to randomization), subject has at least one ulcer that fulfills all of the following criteria:

    • Present for ≥1 month and ≤1 year
    • Partial- or full- thickness and not involving bone, tendon, or capsule (probing to tendon or capsule), i.e. Wagner Grade 1 or 2
    • Has no sign of infection or osteomyelitis
    • Plantar neuropathic ulcer; ulcer must be predominantly on the plantar surface of the foot to ensure adequate off-loading and may include the toes
    • Size of the target ulcer must be 0.75 - 6 cm2
    • Target ulcer must be non-healing as defined as <30% reduction in size in response to standard of care during the two week Screening Period

      • If more than one ulcer is present that meets the inclusion criteria, the largest one will be considered the Target ulcer.
      • If there are two ulcers of the same size that meet all criteria, the one with the higher Wagner Grade will be considered the Target ulcer.
      • If there are two ulcers of the same size and the same Wagner Grade, the one present for the longest qualifying time will be the Target ulcer.
  4. Has an ankle brachial index (ABI) ≥ 0.7 on the foot with the target ulcer
  5. Has an assessment of the baseline level of neuropathy of the foot using Semmes-Weinstein filaments.
  6. A female subject of childbearing potential must have a negative serum pregnancy test at the time of Screening, and must be willing to use a medically acceptable method of birth control, such as Essure®, hormonal contraception (oral pills, implantable device, or skin patch), intrauterine device, tubal ligation, or double barrier throughout the study. A female subject of childbearing potential who practices abstinence is not required to employ birth control.
  7. Has the ability and willingness to understand and comply with study procedures and to give written informed consent prior to enrollment in the study or initiation of study procedures

Exclusion Criteria:

  1. Has a known hypersensitivity to any of the investigational drug or vehicle components
  2. Has been exposed to any investigational agent within 30 days of entry into the study
  3. A female who is pregnant or nursing
  4. Has active malignant disease of any kind except for basal cell carcinoma (of the skin). A subject, who has had a malignant disease in the past, was treated and is currently disease-free, may be considered for study entry.
  5. Has a hemoglobin of less than 8.5 gm/dL.
  6. Transaminase levels greater than 3 × normal
  7. Is receiving hemodialysis or chronic ambulatory peritoneal dialysis (CAPD) therapy
  8. Has had prior radiation therapy of any part of the foot with the target ulcer under study
  9. Use of systemic corticosteroids and immunosuppressants (within the 8 weeks prior to screening)
  10. Has an ulcer primarily ischemic in etiology
  11. Has sickle-cell anemia, Reynaud's, or other peripheral vascular disease
  12. Has received a biologic agent, growth factors or skin equivalents (Regranex®, Apligraft, or Dermagraft), in the past 30 days
  13. Has a target ulcer which is determined to be clinically infected and requires antimicrobials. Any antibiotic therapy must be completed or discontinued at screening.
  14. Has a Wagner Grade 3 or greater DFU, deep abscess, or gangrene
  15. Has uncontrolled hypertension, in the opinion of the Investigator.
  16. Any other finding, which in the opinion of the Investigator, may interfere with the assessment of the product or participation of the subject in the study.

Sites / Locations

  • WILMAX Clinical Research Inc
  • Center for Clinical Research
  • Roy O Kroeker, DPM, Inc
  • Foot and Ankle Clinic
  • Brian O'Carroll, DPM, Inc.
  • UCLA Medical Center - Olive View
  • Orange County Research Center
  • Advanced Research Institute of Miami
  • UF Health Orthopaedic Surgery Clinic
  • GF Professional Research
  • Miami Dade Medical Research Institute
  • Barry University Clinical Research
  • Professional Health Care of Pinellas
  • Memorial Medical Group
  • LaPorte Medical Group
  • Boston University Medical Center
  • East Carolina Foot and Ankle Specialists
  • Clinical Research Center
  • Center for Clinical Research
  • Carolina Musculoskeletel Institute
  • ClinSearch, LLC
  • Dallas VA Medical Center
  • Fort Worth Diagnostic Clinic
  • Endeavor Clinical Trials
  • Professional Education and Research Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

DSC127

Vehicle gel

Arm Description

DSC127 0.03% in a vehicle gel (hydroxyethyl cellulose (HEC) with parabens)

Vehicle gel comprising HEC with parabens

Outcomes

Primary Outcome Measures

The proportion of subjects with a target ulcer which achieves complete wound closure (skin re-epithelialization without drainage or dressing requirements) up to 10 weeks (confirmed at a study visit 2 weeks later).
Primary endpoint of complete closure is assessed by the Principal Investigator at the site; ulcer measurements are calculated through tracings submitted to the Canfield system and photographs are collected as confirmation of closure via the Canfield system.

Secondary Outcome Measures

Time to the visit where the target ulcer achieves confirmed complete wound closure

Full Information

First Posted
March 15, 2013
Last Updated
December 8, 2017
Sponsor
Integra LifeSciences Corporation
Collaborators
Integrium
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1. Study Identification

Unique Protocol Identification Number
NCT01830348
Brief Title
Phase III Study to Evaluate Efficacy and Safety of DSC127 in Diabetic Foot Ulcers
Acronym
STRIDE 1
Official Title
A Randomized, Double-blind, Parallel-group, Vehicle-controlled Phase 3 Clinical Trial to Evaluate the Efficacy and Safety of DSC127 in Treating Non-healing Foot Ulcers in Subjects With Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Terminated
Study Start Date
February 2013 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the study is to determine if DSC127 is effective in increasing incidence of complete wound closure at 10 weeks confirmed at a visit 2 weeks later when compared to the vehicle (gel without active ingredient) in subjects with diabetes mellitus (DM) who have chronic Wagner Grade 1 or 2 plantar neuropathic foot ulcers, 0.75 - 6 cm2 in size.
Detailed Description
Subjects will undergo a two week screening period to assess plantar ulcer healing, and those healing less than 30% will be eligible for randomization, providing they meet all other inclusion criteria. Four weeks of blinded "treatment" follows the screening period, and an observation period of six weeks (to 10 weeks post first treatment) follows the 4-week treatment period. If the ulcer closes during the treatment or observation period, the closure will be confirmed two weeks later, and at this time the subject enters a durability assessment period of up to 12 weeks. All aspects of Standard of Care are followed throughout the study period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Foot Ulcers
Keywords
diabetic foot ulcers, Wagner Grade 1 or 2 foot ulcers

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
266 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DSC127
Arm Type
Active Comparator
Arm Description
DSC127 0.03% in a vehicle gel (hydroxyethyl cellulose (HEC) with parabens)
Arm Title
Vehicle gel
Arm Type
Placebo Comparator
Arm Description
Vehicle gel comprising HEC with parabens
Intervention Type
Drug
Intervention Name(s)
DSC127
Intervention Description
DSC127 0.03%, daily topical application to diabetic foot ulcer for a period of up to 28 days or until ulcer closure, whichever is sooner
Intervention Type
Drug
Intervention Name(s)
placebo vehicle gel
Primary Outcome Measure Information:
Title
The proportion of subjects with a target ulcer which achieves complete wound closure (skin re-epithelialization without drainage or dressing requirements) up to 10 weeks (confirmed at a study visit 2 weeks later).
Description
Primary endpoint of complete closure is assessed by the Principal Investigator at the site; ulcer measurements are calculated through tracings submitted to the Canfield system and photographs are collected as confirmation of closure via the Canfield system.
Time Frame
Target ulcer must achieve complete wound closure by 10 weeks post first treatment
Secondary Outcome Measure Information:
Title
Time to the visit where the target ulcer achieves confirmed complete wound closure
Time Frame
Weekly assessments to ten weeks post first treatment dose
Other Pre-specified Outcome Measures:
Title
Percent reduction in ulcer area per week (closure rate)
Description
Calculated weekly for up to ten weeks
Time Frame
Weekly ulcer tracings to calculate area of ulcer, measurements continue to ten weeks post first treatment dose
Title
Incidence of target ulcer recurrence, time to ulcer recurrence, and number of days target ulcer remains closed after confirmed complete wound closure has been established.
Time Frame
Assessed during a 12 week durability period following the confirmation of complete wound closure

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female ambulatory subject age ≥18 years at the time of informed consent Has type 1 or type 2 DM under metabolic control as confirmed by a glycosylated hemoglobin (HbA1c) of ≤12% and a serum creatinine level of ≤3mg/dL At Screening and at Baseline (prior to randomization), subject has at least one ulcer that fulfills all of the following criteria: Present for ≥1 month and ≤1 year Partial- or full- thickness and not involving bone, tendon, or capsule (probing to tendon or capsule), i.e. Wagner Grade 1 or 2 Has no sign of infection or osteomyelitis Plantar neuropathic ulcer; ulcer must be predominantly on the plantar surface of the foot to ensure adequate off-loading and may include the toes Size of the target ulcer must be 0.75 - 6 cm2 Target ulcer must be non-healing as defined as <30% reduction in size in response to standard of care during the two week Screening Period If more than one ulcer is present that meets the inclusion criteria, the largest one will be considered the Target ulcer. If there are two ulcers of the same size that meet all criteria, the one with the higher Wagner Grade will be considered the Target ulcer. If there are two ulcers of the same size and the same Wagner Grade, the one present for the longest qualifying time will be the Target ulcer. Has an ankle brachial index (ABI) ≥ 0.7 on the foot with the target ulcer Has an assessment of the baseline level of neuropathy of the foot using Semmes-Weinstein filaments. A female subject of childbearing potential must have a negative serum pregnancy test at the time of Screening, and must be willing to use a medically acceptable method of birth control, such as Essure®, hormonal contraception (oral pills, implantable device, or skin patch), intrauterine device, tubal ligation, or double barrier throughout the study. A female subject of childbearing potential who practices abstinence is not required to employ birth control. Has the ability and willingness to understand and comply with study procedures and to give written informed consent prior to enrollment in the study or initiation of study procedures Exclusion Criteria: Has a known hypersensitivity to any of the investigational drug or vehicle components Has been exposed to any investigational agent within 30 days of entry into the study A female who is pregnant or nursing Has active malignant disease of any kind except for basal cell carcinoma (of the skin). A subject, who has had a malignant disease in the past, was treated and is currently disease-free, may be considered for study entry. Has a hemoglobin of less than 8.5 gm/dL. Transaminase levels greater than 3 × normal Is receiving hemodialysis or chronic ambulatory peritoneal dialysis (CAPD) therapy Has had prior radiation therapy of any part of the foot with the target ulcer under study Use of systemic corticosteroids and immunosuppressants (within the 8 weeks prior to screening) Has an ulcer primarily ischemic in etiology Has sickle-cell anemia, Reynaud's, or other peripheral vascular disease Has received a biologic agent, growth factors or skin equivalents (Regranex®, Apligraft, or Dermagraft), in the past 30 days Has a target ulcer which is determined to be clinically infected and requires antimicrobials. Any antibiotic therapy must be completed or discontinued at screening. Has a Wagner Grade 3 or greater DFU, deep abscess, or gangrene Has uncontrolled hypertension, in the opinion of the Investigator. Any other finding, which in the opinion of the Investigator, may interfere with the assessment of the product or participation of the subject in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gere S diZerega, MD
Organizational Affiliation
Integra LifeSciences Corporation
Official's Role
Study Director
Facility Information:
Facility Name
WILMAX Clinical Research Inc
City
Mobile
State/Province
Alabama
ZIP/Postal Code
36680
Country
United States
Facility Name
Center for Clinical Research
City
Fair Oaks
State/Province
California
ZIP/Postal Code
95628
Country
United States
Facility Name
Roy O Kroeker, DPM, Inc
City
Fresno
State/Province
California
ZIP/Postal Code
93710
Country
United States
Facility Name
Foot and Ankle Clinic
City
Los Angeles
State/Province
California
ZIP/Postal Code
90010
Country
United States
Facility Name
Brian O'Carroll, DPM, Inc.
City
Pismo Beach
State/Province
California
ZIP/Postal Code
93449
Country
United States
Facility Name
UCLA Medical Center - Olive View
City
Sylmar
State/Province
California
ZIP/Postal Code
91342
Country
United States
Facility Name
Orange County Research Center
City
Tustin
State/Province
California
ZIP/Postal Code
92780
Country
United States
Facility Name
Advanced Research Institute of Miami
City
Homestead
State/Province
Florida
ZIP/Postal Code
33030
Country
United States
Facility Name
UF Health Orthopaedic Surgery Clinic
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
Facility Name
GF Professional Research
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33016
Country
United States
Facility Name
Miami Dade Medical Research Institute
City
Miami
State/Province
Florida
ZIP/Postal Code
33176
Country
United States
Facility Name
Barry University Clinical Research
City
North Miami Beach
State/Province
Florida
ZIP/Postal Code
33013
Country
United States
Facility Name
Professional Health Care of Pinellas
City
Saint Petersburg
State/Province
Florida
ZIP/Postal Code
33713
Country
United States
Facility Name
Memorial Medical Group
City
Granger
State/Province
Indiana
ZIP/Postal Code
46530
Country
United States
Facility Name
LaPorte Medical Group
City
LaPorte
State/Province
Indiana
ZIP/Postal Code
46350
Country
United States
Facility Name
Boston University Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02118
Country
United States
Facility Name
East Carolina Foot and Ankle Specialists
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
Clinical Research Center
City
Eugene
State/Province
Oregon
ZIP/Postal Code
97401
Country
United States
Facility Name
Center for Clinical Research
City
Portland
State/Province
Oregon
ZIP/Postal Code
97232
Country
United States
Facility Name
Carolina Musculoskeletel Institute
City
Aiken
State/Province
South Carolina
ZIP/Postal Code
29801
Country
United States
Facility Name
ClinSearch, LLC
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37421
Country
United States
Facility Name
Dallas VA Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
75216
Country
United States
Facility Name
Fort Worth Diagnostic Clinic
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Endeavor Clinical Trials
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Professional Education and Research Institute
City
Roanoke
State/Province
Virginia
ZIP/Postal Code
24016
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase III Study to Evaluate Efficacy and Safety of DSC127 in Diabetic Foot Ulcers

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