- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03296436
A Pilot Study to Assess the Efficacy of NEOX® CORD 1K® in the Treatment of Complex Diabetic Wounds
February 25, 2019 updated by: Johns Hopkins University
Patients presenting to Johns Hopkins with a diabetic ulcer classified by the UT Grade 2 or 3 who meet all of the inclusion and none exclusion criteria and give their informed consent, will receive an application of NEOX CORD 1K in addition to standard of care procedures.
Those patients will be seen in follow-up at weekly visits until the wound closes and epithelize, achieving complete closure.
Subjects that do not achieve complete ulcer closure prior to or at the end of the 16 treatment weeks will exit the study.
Study Overview
Status
Withdrawn
Conditions
Intervention / Treatment
Detailed Description
A prospective investigator initiated trial will be conducted in diabetic patients with lower extremity wounds managed with NEOX CORD 1K umbilical cord product supplied by Amniox (a subsidiary of TissueTech, Inc.).
The patient population will be comprised of Type 1 or Type 2 diabetics presenting to our hospital for the treatment of lower extremity wounds occurring on the dorsal and plantar foot.
The wounds will be treated in the Operating Room (OR) arena including surgical debridement, resection of bone necrosis, biopsy, etc. to treat the associated morbidity.
These wounds are classified utilizing the University of Texas (UT) Classification System as Grades: 2 (wounds penetrating to tendon or capsule) and 3 (wounds penetrating to bone or joint) with Stages: A (no infection or ischemia), B (Infection present), C (ischemia present) and D (Infection and ischemia present).
This morbidity will comprise of complex wounds that exhibit exposed muscle, tendon, bone and may include the presence of treated osteomyelitis.
This patient population oftentimes include diabetics with lower extremity ischemia or end stage renal disease and their associated comorbidities.
These wounds are challenging in their care being they trend towards a poor prognosis including high morbidity and mortality as well as high major limb amputation rates.
Hence, this trial will provide associated data to the efficacy of the above referenced material towards evaluating its effectiveness in these wound types towards enhancing wound healing and subsequently reducing amputation rates.
Study Type
Interventional
Phase
- Early Phase 1
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 100 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Male/female age 18 or older
- Type 1 or Type 2 diabetes mellitus
- Signed informed consent
- Wound present for minimum for four (4) weeks
- Wound location foot to include the dorsal or plantar surface
- Serum creatinine < 3.0 mg/dL
- HbA1c< 12% taken prior to randomization
- Patient presents with adequate circulation to the effected extremity, as demonstrated
- by one of the following within sixty (60) days:
- Ankle-Brachial Index (ABI) with results of >0.6 and <1.2
- Doppler arterial waveforms which are triphasic or biphasic at ankle of affected lower extremity
Wound is diabetic in origin with and area of > 1 cm2 and < 16 cm2 at time of screening
Exclusion Criteria:
- Unwilling to follow the visit requirements and instructions outlined by the protocol
- Currently receiving radiation therapy or chemotherapy
- Non-vascular surgical site
- The subject's wound can be addressed by primary closure
- Received growth factors, living skin, dermal substitutes, silver-containing products, amniotic membrane or umbilical cord products or other advanced biological therapies for wounds within 30 days of screening
- Pregnant or breast feeding
- HbA1c: > 12% within previous ninety (90) days
- Serum creatinine level > 3.0 mg/dL Taking medications that are considered immune system modulators
- Uncontrolled autoimmune surgical sites
- Known or suspected local skin malignancy
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Treatment Group
Group that will be receiving the investigational product
|
NEOX CORD 1K is a cryopreserved human umbilical cord product derived from donated human placental tissue following healthy, live, caesarian section, full-term births after determination of donor eligibility and placenta suitability.
NEOX CORD 1K is manufactured by TissueTech Inc. utilizing a proprietary CRYOTEK® process, which devitalizes the living cells but retains the natural structural and biological characteristics relevant to this tissue.
NEOX CORD 1K is aseptically processed in compliance with current Good Tissue Practices (cGTP).
NEOX CORD 1K of various sizes is stored in a medium of Dulbecco's Modified Eagle Medium/Glycerol (1:1) containing Amphotericin B (an anti-fungal agent).
NEOX CORD 1K will be applied to completely cover the wound area and is maintained stationary with sutures or even negative pressure wound therapy after adequate sharp debridement.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
complete ulcer closure
Time Frame: 16 weeks
|
Proportion of subjects with confirmed complete ulcer closure at sixteen (16) weeks, confirmed by being closed for 30 days.
|
16 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
NEOX CORD 1K applications
Time Frame: 16 weeks
|
Total number of NEOX CORD 1K applications the subject received over the treatment period
|
16 weeks
|
ulcer surface area
Time Frame: 16 weeks
|
Percent change in the ulcer surface area (cm2) at each visit from baseline
|
16 weeks
|
number of days to complete wound closure
Time Frame: 16 weeks
|
Time in number of days to complete wound closure over the 16-week treatment period
|
16 weeks
|
Mean cost to closure
Time Frame: 16 weeks
|
Mean cost to closure
|
16 weeks
|
recurrent ulcer-related complications
Time Frame: 16 weeks
|
• Proportion of subjects who experience recurrent ulcer-related complications (e.g., sepsis, osteomyelitis, limb amputation)
|
16 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Rondald Sherman, DPM, MBA, Johns Hopkins University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Anticipated)
January 1, 2020
Primary Completion (Anticipated)
January 1, 2021
Study Completion (Anticipated)
October 1, 2021
Study Registration Dates
First Submitted
September 25, 2017
First Submitted That Met QC Criteria
September 27, 2017
First Posted (Actual)
September 28, 2017
Study Record Updates
Last Update Posted (Actual)
February 27, 2019
Last Update Submitted That Met QC Criteria
February 25, 2019
Last Verified
February 1, 2019
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB00145403
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
UNDECIDED
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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