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The Sorbact® Antimicrobial Dressing in the Holistic Wound Management Of Diabetic Foot ulCers (Phase III Study) (ADHOC)

Primary Purpose

Foot Ulcer, Diabetic

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Sorbact®
Best local cares
Sponsored by
INRESA Pharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Foot Ulcer, Diabetic focused on measuring Sorbact, Best local Cares, DFU

Eligibility Criteria

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

Inclusion Criteria:

  1. Written consent to participate obtained.
  2. Male or female patient aged at least 18 years without superior limit.
  3. Type 1 or 2 diabetes.
  4. Less than one month HbA1c <=10%.
  5. Presence, on at least one foot, of a full-thickness ulcer for at least 4 weeks (location below the malleola).
  6. Neuropathy confirmed by insensitivity to monofilament (Semmes-Weinstein 5.07 monofilament according to diagnosis criteria presented in appendix 05).
  7. No ulcer should present a moderate or severe infection at baseline. Concomitant treatment with systemic antibiotics at baseline is accepted if all ulcers meet none of the criteria defining moderate or severe infection.
  8. All ulcers are appropriately debrided (less than 10% black tissue covering wound area on a colorimetric scale, adequate removal of hyperkeratosis).
  9. All ulcers are of Grade 1 or 2 of the Wagner classification.
  10. Ulcers should meet one of the following criteria:

    If only one ulcer is present, its largest diameters has to be ≥1 cm or this ulcer is categorized as grade 2 according to Wagner classification If more than one ulcer is present, the sum of all largest diameters has to be ≥2 cm or one ulcer is categorized as grade 2 according to Wagner classification

  11. For both legs: ABPI ≥0.6 and <1.3 AND ankle systolic pressure ≥70 mmHg or systolic toe pressure ≥50 mmHg or TcPo2 ≥30 mmHg (decubitus).

    If ABPI ≥1.3, patent femoral artery inflow should be confirmed by digital angiography, magnetic resonance, or CT angiography or doppler ultrasonography <6 months before randomization.

  12. Patient compliant to one of the accepted off-loading system.

Exclusion Criteria:

  1. Previous history of major amputation (cf. § 10.3.3.2 for definition) or planned major amputation within the first month after randomization.
  2. Revascularization procedure of lower leg, or any other treatment (e.g. neurostimulation) of any leg <8 weeks before randomization.
  3. Patient unable to be treated with one of the accepted type of off-loading system.
  4. Active Charcot foot.
  5. Presence of any ulcer with evidence of skin cancer.
  6. Presence of another chronic wound (i.e. present for 4 weeks or more) not involving the foot or involving the foot but extending above malleolus.
  7. Patient suffering from any known active malignancy, other than basal-cell carcinoma and cervical carcinoma in situ, requiring any general, local, surgical or radiation therapy.
  8. Patient suffering from severe morbid obesity (BMI ≥50 kg/m2).
  9. Severe hypertension with systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg (measured at two occasions separated by a 4 week period in a patient sitting for at least 5 min).
  10. Patient with a severe comorbid disorder, not expected to survive more than 12 months
  11. Acute cardiovascular events (e.g. myocardial infarction, stroke, recent coronary intervention) within 3 months before randomisation
  12. Patient who are in the exclusion period following a previous participation to another trial or who are currently participating to any concomitant study with any drug or device.
  13. Known intolerance to the tested medical device.

Sites / Locations

  • Faculty of Medicine MU a FH St. Ann Brno
  • Cardiologic and pediatric ambulance s.r.o.
  • Institute for Clinical and Experimental Medicine
  • Podiatrie - Ustredni vojenska nemocnice - Vojenska fakultni nemocnice Praha
  • Bulovka Hospital
  • Hôpital Cardio-vasculaire Louis Pradel
  • CHRU LILLE Hôpital Claude Huriez
  • CHRU Lapeyronie
  • Hopital Civil
  • Maison de santé protestante de Bordeaux Bagatelle
  • Gdański Uniwersytet Medyczny
  • Instytut Medycny Wsi
  • Angiodiabetica
  • Warszawski Uniwersytet Medyczny
  • PODOS

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Sorbact®

Best local cares

Arm Description

The basic Sorbact® presentation is an antimicrobial, non-adhesive absorbent wound dressing. It consists of a highly absorbent hydropolymer matrix with an antimicrobial Sorbact® mesh (Sorbact® acetate fabric coated with dialkyl carbamoyl chloride - DACC) and is covered by a semipermeable polyurethane film.

Dressing requirements in this study have to be consistent with international guidelines.

Outcomes

Primary Outcome Measures

Favourable healing outcome (FHO)
A FHO is considered to have occurred in a given patient if all the following composite endpoints are met: I. Total wound area (sum of areas of all present wounds on both limbs) has decreased, compared to baseline, by 50% or more at last available evaluation. II. No minor or major amputation decided during the follow-up period. III. No moderate/severe infection of any present wound has been detected during the follow-up period.

Secondary Outcome Measures

Comparative evaluation of each of the items used to define a FHO.
Time to reach a 50% total wound area reduction.
Comparative evaluation of the number of complete wound closure.
Comparative evaluation of total absolute and relative wound area regression and of total wound edge migration (Gilman's formula; sum of the score of each individual ulcer) over 12 weeks (centralized analysis of wound area tracings).
Number of local cares requiring instrumental debridement (surgical or sharp debridement).

Full Information

First Posted
December 11, 2014
Last Updated
August 30, 2017
Sponsor
INRESA Pharma
Collaborators
RCTs
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1. Study Identification

Unique Protocol Identification Number
NCT02334241
Brief Title
The Sorbact® Antimicrobial Dressing in the Holistic Wound Management Of Diabetic Foot ulCers (Phase III Study)
Acronym
ADHOC
Official Title
The Sorbact® Antimicrobial Dressing in the Holistic Wound Management Of Diabetic Foot ulCers (Phase III Study)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2017
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
April 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
INRESA Pharma
Collaborators
RCTs

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of this study is to demonstrate, during a 12-week follow-up, a greater efficacy of using Sorbact® dressing technology in addition to best local cares compared to best local cares alone in the management of diabetic foot ulcers
Detailed Description
This study will select a target population of diabetic patients treated for foot ulcers of neuropathic origin, with or without arterial disease but not presenting critical limb ischaemia. No definitive wound infection should be present at inclusion. According to randomization, all present ulcers at baseline will be treated either with best local cares not including Sorbact® dressing or including systematically for all ulcers this medical device. The main study endpoint will be a composite criterion defining a favourable limb outcome for a given patient. This criterion will be considered as present if total open wound area has decreased by 50% or more at last available evaluation whereas no definitive infection has occurred and no amputation has been required. Patients will be followed over a maximal period of 12 weeks. At D0 (inclusion), W2, W4, W6, W8, W10 and W12 a detailed description of ulcer aspect will be done. Applied dressing will be removed according to a standardized procedure. Wound area tracing and photography of all ulcers will be performed. Off-loading system's adherence will be checked. Between these weekly evaluations, all performed local cares will be reported and each dressing removal will be performed by using a similar procedure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Foot Ulcer, Diabetic
Keywords
Sorbact, Best local Cares, DFU

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sorbact®
Arm Type
Experimental
Arm Description
The basic Sorbact® presentation is an antimicrobial, non-adhesive absorbent wound dressing. It consists of a highly absorbent hydropolymer matrix with an antimicrobial Sorbact® mesh (Sorbact® acetate fabric coated with dialkyl carbamoyl chloride - DACC) and is covered by a semipermeable polyurethane film.
Arm Title
Best local cares
Arm Type
Active Comparator
Arm Description
Dressing requirements in this study have to be consistent with international guidelines.
Intervention Type
Device
Intervention Name(s)
Sorbact®
Intervention Description
Sorbact® is available in many types and sizes. These different presentations are available allowing management of quite all types of wounds of various anatomical locations, sizes or depths. Application of any of these presentations is allowed and may change during study course according to wound evolution.
Intervention Type
Device
Intervention Name(s)
Best local cares
Intervention Description
Participating centers will provide a list of dressings they planned to use in the best local cares arm. This list must be validated by the study Steering Committee members
Primary Outcome Measure Information:
Title
Favourable healing outcome (FHO)
Description
A FHO is considered to have occurred in a given patient if all the following composite endpoints are met: I. Total wound area (sum of areas of all present wounds on both limbs) has decreased, compared to baseline, by 50% or more at last available evaluation. II. No minor or major amputation decided during the follow-up period. III. No moderate/severe infection of any present wound has been detected during the follow-up period.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Comparative evaluation of each of the items used to define a FHO.
Time Frame
12 weeks
Title
Time to reach a 50% total wound area reduction.
Time Frame
12 weeks
Title
Comparative evaluation of the number of complete wound closure.
Time Frame
12 weeks
Title
Comparative evaluation of total absolute and relative wound area regression and of total wound edge migration (Gilman's formula; sum of the score of each individual ulcer) over 12 weeks (centralized analysis of wound area tracings).
Time Frame
12 weeks
Title
Number of local cares requiring instrumental debridement (surgical or sharp debridement).
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Written consent to participate obtained. Male or female patient aged at least 18 years without superior limit. Type 1 or 2 diabetes. Less than one month HbA1c <=10%. Presence, on at least one foot, of a full-thickness ulcer for at least 4 weeks (location below the malleola). Neuropathy confirmed by insensitivity to monofilament (Semmes-Weinstein 5.07 monofilament according to diagnosis criteria presented in appendix 05). No ulcer should present a moderate or severe infection at baseline. Concomitant treatment with systemic antibiotics at baseline is accepted if all ulcers meet none of the criteria defining moderate or severe infection. All ulcers are appropriately debrided (less than 10% black tissue covering wound area on a colorimetric scale, adequate removal of hyperkeratosis). All ulcers are of Grade 1 or 2 of the Wagner classification. Ulcers should meet one of the following criteria: If only one ulcer is present, its largest diameters has to be ≥1 cm or this ulcer is categorized as grade 2 according to Wagner classification If more than one ulcer is present, the sum of all largest diameters has to be ≥2 cm or one ulcer is categorized as grade 2 according to Wagner classification For both legs: ABPI ≥0.6 and <1.3 AND ankle systolic pressure ≥70 mmHg or systolic toe pressure ≥50 mmHg or TcPo2 ≥30 mmHg (decubitus). If ABPI ≥1.3, patent femoral artery inflow should be confirmed by digital angiography, magnetic resonance, or CT angiography or doppler ultrasonography <6 months before randomization. Patient compliant to one of the accepted off-loading system. Exclusion Criteria: Previous history of major amputation (cf. § 10.3.3.2 for definition) or planned major amputation within the first month after randomization. Revascularization procedure of lower leg, or any other treatment (e.g. neurostimulation) of any leg <8 weeks before randomization. Patient unable to be treated with one of the accepted type of off-loading system. Active Charcot foot. Presence of any ulcer with evidence of skin cancer. Presence of another chronic wound (i.e. present for 4 weeks or more) not involving the foot or involving the foot but extending above malleolus. Patient suffering from any known active malignancy, other than basal-cell carcinoma and cervical carcinoma in situ, requiring any general, local, surgical or radiation therapy. Patient suffering from severe morbid obesity (BMI ≥50 kg/m2). Severe hypertension with systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg (measured at two occasions separated by a 4 week period in a patient sitting for at least 5 min). Patient with a severe comorbid disorder, not expected to survive more than 12 months Acute cardiovascular events (e.g. myocardial infarction, stroke, recent coronary intervention) within 3 months before randomisation Patient who are in the exclusion period following a previous participation to another trial or who are currently participating to any concomitant study with any drug or device. Known intolerance to the tested medical device.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jan APELQVIST
Organizational Affiliation
University Hospital of Malmö
Official's Role
Principal Investigator
Facility Information:
Facility Name
Faculty of Medicine MU a FH St. Ann Brno
City
Brno
ZIP/Postal Code
656 91
Country
Czechia
Facility Name
Cardiologic and pediatric ambulance s.r.o.
City
Ostrava-vitkovice
ZIP/Postal Code
703 00
Country
Czechia
Facility Name
Institute for Clinical and Experimental Medicine
City
Praha 4
ZIP/Postal Code
140 21
Country
Czechia
Facility Name
Podiatrie - Ustredni vojenska nemocnice - Vojenska fakultni nemocnice Praha
City
Praha 6
ZIP/Postal Code
169 02
Country
Czechia
Facility Name
Bulovka Hospital
City
Praha 8
ZIP/Postal Code
180 81
Country
Czechia
Facility Name
Hôpital Cardio-vasculaire Louis Pradel
City
Bron
ZIP/Postal Code
69677
Country
France
Facility Name
CHRU LILLE Hôpital Claude Huriez
City
Lille
ZIP/Postal Code
59037
Country
France
Facility Name
CHRU Lapeyronie
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Hopital Civil
City
Strasbourg
ZIP/Postal Code
67000
Country
France
Facility Name
Maison de santé protestante de Bordeaux Bagatelle
City
Talence
ZIP/Postal Code
33401
Country
France
Facility Name
Gdański Uniwersytet Medyczny
City
Gdansk
ZIP/Postal Code
80-952
Country
Poland
Facility Name
Instytut Medycny Wsi
City
Lublin
ZIP/Postal Code
20-090
Country
Poland
Facility Name
Angiodiabetica
City
Poznan
ZIP/Postal Code
61-541
Country
Poland
Facility Name
Warszawski Uniwersytet Medyczny
City
Warsaw
ZIP/Postal Code
02-097
Country
Poland
Facility Name
PODOS
City
Warsaw
ZIP/Postal Code
02-541
Country
Poland

12. IPD Sharing Statement

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The Sorbact® Antimicrobial Dressing in the Holistic Wound Management Of Diabetic Foot ulCers (Phase III Study)

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