Topical Erythropoietin Hydrogel Formulation for Diabetic Foot Ulcers (Remede d'Or)
Diabetic Foot Ulcer
About this trial
This is an interventional treatment trial for Diabetic Foot Ulcer focused on measuring erythropoietin, diabetic chronic wounds, wound healing, chronic wounds, topical treatment, re-epithelization, inflammation
Eligibility Criteria
Inclusion Criteria:
Patients must satisfy all of the following inclusion criteria to be included in the study:
- Male or female over the age of 18;
- Diabetes Mellitus type 2;
- Have a single non-infected Diabetic Hard-to-Heal wound (ulcers/foot ulcers), Wagner grade I or II documented for at least 4 weeks that has not shown signs of healing despite standard treatment;
- 2 sq.cm. ≤ Wound area at start of treatment ≤ 10 sq.cm.;
- At least moderate blood perfusion into the affected limb as defined by Ankle Brachial Index (ABI) of >0.4 or if ABI >1.3 then toe pressure > 50 mmHg;
- Undergo a current physical examination, which reveals no clinically significant abnormalities, except diabetes or diabetic ulcer/wound related condition;
- Be available for the entire study period, and be able and willing to adhere to protocol requirements;
- Provide written informed consent prior to admission into the study;
- no surgical revascularization of the limb with the DFU was done in the previous two months.
Exclusion Criteria:
Patients will be excluded from the study if they meet any of the following exclusion criteria:
- Diabetes Mellitus non Type 2;
- Have a glycosylated haemoglobin (HbA1c) >10.0%;
- Have a body mass index (BMI) > 40 Kg/m2;
- Have visible bone exposure at wound site;
- Subjects whose study ulcer size decreases by more than 30% during this initial standard-of-care phase (pre-treatment phase);
- Have any signs of infection in the wound (which could be linked to raised body temperature), abscess, cellulitis, necrosis, erythema, mild drainage or known osteomyelitis;
- Have a history of HIV or a clinically significant cardiac, gastrointestinal, endocrine, neurological, liver, or kidney disease;
- Anemia (Hemoglobin < 9 g/dL) or White Blood Cells count > 11,000/μL or Platelets count < 100,000/μL or liver function tests > 3 times upper normal lab values or Creatinine > 3 mg/dL; any indication of malnourishment (Albumin < 3 g/dL); INR>2 or any other clinically significant blood and urinalysis tests per the physician's discretion
- Have any clinically significant chronic or acute illness during the 4 weeks prior to admission into the study, except diabetes type2 or during screening period;
- Patients on concomitant medications that alter blood glucose levels (e.g. ACE inhibitors, lipid lowering agents, etc.) who have not been on a stable dosage regimen for at least 4 weeks prior to entry into the study and who cannot maintain a stable dosage throughout the study;
- Malignant disease except Basal Cell Carcinoma or Cervical Carcinoma in situ; Chemotherapy treatment or severely immunosuppressed for any reason that would limit or preclude healing in the opinion of the Investigator;
- Females who are pregnant, lactating, of child-bearing potential, or post-menopausal for less than 2 years, not using a medically approved method of contraception (i.e., oral, transdermal, or implanted contraceptives, intrauterine device, diaphragm, condom, abstinence, or surgical sterility), or females who test positive on a blood-based pregnancy test;
- Participation in a clinical study or use of an investigational drug within 30 days prior to admission to this study;
- Residing in a nursing facility and/or are bed-ridden (unable to come to receive treatment at the clinic).
Sites / Locations
- HaEmek Medical Center
- Rambam Health Care Campus
- Edith Wolfson Medical Center
- Galilee Medical Center
- Poriya Medical Center (a.k.a. Baruch Padeh Medical Center)
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
Treatment group (erythropoietin)
Control group (standard of care)
10 patients receive RMD-G1 (gel with 2000 IU/ml of erythropoietin) as an adjunct therapy to standard of care (SOC). Topical application on wound bed, daily for 12 weeks.
10 patients receive SOC alone daily for 12 weeks. A moisturizing gel is applied on wound bed as a part of SOC.