Safety Evaluation of the KLOX BioPhotonic System in Diabetic Foot Ulcers

A Prospective Case Series Evaluating the Safety of the KLOX BioPhotonic System in Diabetic Foot Ulcers

The primary objective of these case series is to evaluate the safety and tolerability of the KLOX BioPhotonic System as adjunctive therapy to Standard Of Care (SOC) in patients with diabetic foot ulcers.

Study Overview

• Status: Completed
• Conditions: Diabetic Foot Ulcers
• Intervention / Treatment: Device: KLOX BioPhotonic System

• Study Type: Interventional
• Enrollment (Actual): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Canada
  • Quebec
    • Chicoutimi, Quebec, Canada, G7H 7Y8
      • Q&T Research Chicoutimi
    • Laval, Quebec, Canada, H7T 2P5
      • Centre de Recherche Clinique de Laval
    • Westmount, Quebec, Canada, H3Z 1C3
      • Victoria Park Medispa

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male or female 18 years of age and older;
• The subject or legal guardian must have signed an informed consent form;
• Female of child bearing potential must have a negative pregnancy test result at Baseline and both male and female patients must be willing to adhere to a medically-accepted birth control method during the course of the study;
• Willingness to return for all study visits;
• Willing and able to adhere to an off-loading protocol. Patient must adhere to wearing orthopedic shoe for the study duration (from first day of Screening until end of study);
• Target cutaneous, full thickness ulcer with University of Texas classification I-A (superficial, non-infected, non-ischemic wound not involving tendon, capsules, or bone) or II-A (non-infected, non-ischemic wound penetrating to tendon or capsule but not in the bone or joint). A patient with more than one diabetic foot ulcer may be included in the trial but only one ulcer will be selected for the investigational treatment, based on investigator's judgment;
• Ulcer present for more than 4 weeks prior to study entry (Screening/Visit 1);
• Ulcer area between 1 and 16 cm2 inclusive. The maximum diameter of the wound must not exceed 8 cm;
• Diabetes mellitus (Type 1 or 2) with an A1C < 12% at Screening;
• Diagnosis of neuropathic foot ulcer (10 grams pressure using Semmes-Weinstein 5.07 monofilament in the peri-ulcer area and/or biothesiometry or tuning fork 128 Hz);
• Wound area has not changed by more than +/- 30% between Screening visit and Week 1/Visit 1 (before treatment).
• Adequate arterial blood perfusion (ABI (ankle brachial index) between 0.7 and 1.3, inclusive, or toe pressure > 50 mmHg, or tcPO2 > 40 mmHg).

Exclusion Criteria:

• Diabetic foot ulcer present for more than 12 months;
• Target ulcer is over a deformity (such as Charcot deformity) that interferes with off-loading based on investigator's opinion;
• Patient cannot tolerate off-loading method;
• The ulcer to be treated is planned for operative debridement;
• The ulcer has significant necrotic tissue (e.g., more than 20% of the ulcer area);
• Major uncontrolled medical disorder(s) such as serious cardiovascular, renal, liver or pulmonary disease, lupus, palliative care or sickle cell anemia;
• Severe or significant hypoalbuminemia (albuminemia < 30 g/L, and/or pre-albumin < 5 mg/dL), or hypoproteinemia (proteinemia < 55g/L);
• Patient with moderate to severe anemia (Hb < 90g/L);
• Patient currently treated for an active malignant disease;
• Patient with history of malignancy within the wound;
• Patient with history of radiation therapy to the wound region;
• Patient with prior diagnosis of active malignant disease who is less than 1 year disease-free;
• Patient with a known osteomyelitis or active cellulitis;
• Patients that are immunosuppressed or on high dose chronic steroid use;
• Patients on systemic corticosteroids (a completion of corticosteroid course at least 30 days prior to study enrolment is required);
• Patient with active or systemic infection (note that the patient is however eligible for re-screening after the systemic infection has subsided);
• Successful revascularization surgery of the leg with the ulcer to be treated less than 8 weeks prior to Screening;
• Patients with severely uncontrolled diabetes mellitus (defined as A1C > 12%);
• Raynaud disease or other severe peripheral microvascular disease;
• Dermatologic comorbid disease (e.g., cutis laxa or collagen vascular disease);
• Active bleeding;
• Pregnancy, or breast feeding;
• Patients with bleeding diathesis;
• Patients on Warfarin or IV Heparin;
• The subject has any physical or psychiatric condition that in the Investigator's opinion would warrant exclusion from the study or prevent the subject from completing the study (e.g., severe morbid obesity, recent hip fracture, suspected non-compliance, etc.);
• Patients with ulcers from burns (from exposure to high heat), pressure ulcers or venous leg ulcers;
• Concurrent disease or drugs known to induce severe photosensitivity of the skin, such as porphyria;
• Patient has received biological-based therapy in any wound within 3 months of Screening;
• Concurrent participation in another clinical trial that involves an investigational drug or device that wound interfere with this study;
• Previous participation in other interventional wound healing clinical investigation within the 60 days prior to Screening visit.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: KLOX BioPhotonic System; Treatment with KLOX BioPhotonic System in adjunction to Standard Of Care for diabetic foot ulcers.	Device: KLOX BioPhotonic System; KLOX BioPhotonic System (Multi-LED Light and KLOX Photo Converter Wound Gel) will be administered until wound closure or for a maximum of 24 weeks, followed by a 8-week follow-up period, in association with Standard Of Care for diabetic foot ulcers.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety and tolerability of the KLOX BioPhotonic System in patients with diabetic foot ulcers.	Occurrence of adverse events, serious adverse events and incidents; pain assessment with Visual Analog Scale; clinical laboratory parameters; vital signs; physical examination; percentage of patients with clinical infection requiring systemic antimicrobial therapy; concomitant medications and treatments.	32 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Optimal frequency of treatment with KLOX BioPhotonic System on diabetic foot ulcers.	Exploration of the optimal frequency of treatment with KLOX BioPhotonic System on diabetic foot ulcers, with dosing flexibility according to Investigator's clinical opinion.	32 weeks
Rate of complete wound closure.		32 weeks
Time to complete wound closure.		32 weeks
Incidence of wound breakdown.		32 weeks
Wound area reduction over time.		32 weeks
Wound volume reduction over time.		32 weeks

Other Outcome Measures

Outcome Measure	Time Frame
Impact of treatment on Health-related quality of life.	32 weeks

Collaborators and Investigators

• Sponsor: KLOX Technologies Inc.
• Investigators: Principal Investigator: Andreas Nikolis, Dr, Victoria Park Medispa

Study record dates

Study Major Dates

• Study Start: April 1, 2013
• Primary Completion (Actual): February 1, 2016

Study Registration Dates

• First Submitted: August 19, 2014
• First Submitted That Met QC Criteria: August 19, 2014
• First Posted (Estimate): August 21, 2014

Study Record Updates

• Last Update Posted (Estimate): September 5, 2016
• Last Update Submitted That Met QC Criteria: September 1, 2016
• Last Verified: September 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Skin Diseases; Endocrine System Diseases; Diabetic Angiopathies; Leg Ulcer; Skin Ulcer; Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Foot Diseases; Diabetic Foot; Foot Ulcer; Ulcer
• Other Study ID Numbers: CL-K1002-P009