GrafixCORE®: Open-Label Study to Evaluate the Safety and Efficacy of GrafixCORE® for Complex Diabetic Foot Wounds

A Multicenter, Open-label, Single-Arm Study to Evaluate the Safety and Efficacy of GrafixCORE® for the Treatment of Complex Diabetic Foot Wounds With Exposed Tendon and/or Bone

A multicenter, open-label, single-arm study to evaluate the safety and efficacy of GrafixCORE® for the treatment of complex diabetic foot wounds with exposed tendon and/or bone.

Study Overview

• Status: Completed
• Conditions: Complex Diabetic Foot Wounds
• Intervention / Treatment: Other: Grafix®

• Study Type: Interventional
• Enrollment (Actual): 31
• Phase: Phase 4

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85012
      • Carl T. Hayden Medical Research Foundation
    • Tucson, Arizona, United States, 85723
      • Southern Arizona VA Health Care System
  • Florida
    • Miami, Florida, United States, 33125
      • Miami VA
  • Massachusetts
    • Weymouth, Massachusetts, United States, 02190
      • South Shore Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Between 18 years and 85 years of age inclusive, as of the date of screening
2. Confirmed diagnosis of Type I or Type II Diabetes
3. Index wound graded in the Texas Classification System as Grade II-III, Stage A or C (without active infection)
4. Wound is located on the foot below the malleoli
5. Wound accommodates up to three (3) 5 cm x 5 cm pieces of GrafixCORE® that completely cover the wound
6. Patient's wound extends through the dermis and into subcutaneous tissue with evidence of exposed muscle, tendon, bone, and/or joint capsule

7. Patient has adequate circulation to the foot as documented by either:

   • Ankle Brachial Index (ABI) ≥ 0.5 and ≤ 1.2, or
   • In patients with non-compressible ankle vessels, a Toe BP ≥ 40 mmHg or TcPO2 > 30 mmHg, or
   • Skin perfusion pressure > 30 mmHg

Exclusion Criteria:

1. Index Wound is of non-diabetic pathophysiology
2. Gangrene is present on any part of the affected foot
3. Index Wound is over a Charcot deformity
4. The longest dimension of the Index Wound exceeds 15 cm at the Baseline Visit
5. Patient has a glycated hemoglobin A1 (HbA1c) level of >14%
6. Requiring intravenous (IV) antibiotics to treat the index wound infection at enrollment
7. Patient has a wound within 15cm of the Index Ulcer identified for study consideration
8. Patient is receiving oral or parenteral corticosteroids, immunosuppressive or cytotoxic agents
9. Patient is Human Immunodeficiency Virus (HIV) positive or has Acquired Immune Deficiency Syndrome (AIDS)
10. Current evidence of osteomyelitis, cellulitis, or other evidence of infection including fever or pus drainage from the wound site
11. Patient has active malignancy other than non-melanoma skin cancer
12. Patient's random blood sugar is >450 mg/dl at screening
13. Patient has untreated alcohol or substance abuse at the time of screening, or is deemed to be non-adherent to the protocol by the Investigator
14. Pregnant women
15. Patient is currently enrolled or participated in another investigational device, drug, or biological trial within 30 days of screening
16. Patient has allergy to primary or secondary dressing materials used in this trial
17. Patient has had within the last 14 days, or is currently undergoing, or is planning for wound treatments with enzymes, growth factors, living skin, dermal substitutes or other advanced biological therapies
18. In the opinion of the Investigator, the patient is unsuitable for participation in the study

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
Other: Open-Label; Grafix®: Cryopreserved Placental Membrane	Other: Grafix®; The treatment indication is for complex diabetic foot wounds with exposed tendon and/or bone that can accommodate up to three 5cm x 5cm pieces of Grafix®. Patients will be treated for up to 16 weeks. Patients will be evaluated at screening and then weekly throughout the study or until wound closure.; Other Names: Tissue; Allograft Tissue

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
100% granulation of wound as determined by the investigator	Up to 16 weeks after the Initial Treatment Visit

Secondary Outcome Measures

Outcome Measure	Time Frame
Time to 100% granulation	Up to 16 weeks after the Initial Treatment Visit
Number of applications of Grafix®	Up to 16 weeks after the Initial Treatment Visit
Measurement of percent wound area reduction as determined by the investigator	Up to 16 weeks after the Initial Treatment Visit
Closure of wound defined by 100% re-epithelialization	Up to 16 weeks after the Initial Treatment Visit

Collaborators and Investigators

• Sponsor: Osiris Therapeutics

Study record dates

Study Major Dates

• Study Start: October 1, 2014
• Primary Completion (Actual): October 1, 2015

Study Registration Dates

• First Submitted: October 6, 2014
• First Submitted That Met QC Criteria: October 6, 2014
• First Posted (Estimate): October 9, 2014

Study Record Updates

• Last Update Posted (Estimate): February 2, 2016
• Last Update Submitted That Met QC Criteria: February 1, 2016
• Last Verified: February 1, 2016

More Information

Terms related to this study

• Keywords: DFU; Diabetic Foot Ulcer; Complex Wound; GrafixCORE; Exposed tendon; Exposed bone; Allograft tissue
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Skin Diseases; Endocrine System Diseases; Diabetic Angiopathies; Leg Ulcer; Skin Ulcer; Diabetes Complications; Diabetes Mellitus; Diabetic Neuropathies; Foot Ulcer; Diabetic Foot; Wounds and Injuries
• Other Study ID Numbers: Osiris Protocol 310