- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04040660
Use of NexoBrid for Treatment of Acute Deep Partial and Full Thickness Burn Injuries (NEXT)
Enzymatic eschar removal with NexoBrid allows initiating and completing the phase of removal of the offending eschar earlier upon admission, enabling earlier visualization of the wound bed for assessment of burn wound depth as well as preservation of viable dermal tissues, as further elaborated and supported by previous clinical studies. The depth determination is important for the planning and execution of the post eschar removal stage of wound closure phase (grafting or spontaneous epithelialization).
Additional clinically meaningful attributes of NexoBrid enzymatic eschar removal is the ability to lower surgical burden as it allows to remove eschar in wounds that otherwise would have to undergo surgical excision as no other non-surgical treatment is available for early and effective eschar removal.
MediWound has completed the recruitment of patients to study MW2010-03-02 (DETECT Study). The timeline for patients' follow-up and potential for approval in 2021/2022, creates a significant gap in the ability of clinical practitioner's to maintain their knowledge and skills in using NexoBrid as they no longer treat eligible patients. The expanded access protocol will allow to expand treatment to additional patients in up to 30 US burn centers (DETECT sites and additional sites), until the completion of the BLA assessment and possible marketing authorization of NexoBrid in the US. The proposed protocol will allow product availability to eligible population and keep the clinical use of the product knowledge active in the burn care community introducing it to their routine burn care.
The purpose of this treatment protocol is to provide NexoBrid to patients with DPT and FT thermal burns on up to 30% TBSA.
This protocol is also designed to collect and evaluate the safety and clinical performance of NexoBrid in this patient population.
Study Overview
Detailed Description
This is an Expanded Access (treatment) protocol to allow ongoing treatment of burn patients with NexoBrid following completion of the enrollment stage of protocol MW2010-03-02 (DETECT study).
This protocol is also designed to collect and evaluate the safety and clinical performance of NexoBrid in patients suffering from DPT and FT thermal burns.
Following the enrollment of a patient to the protocol, physicians will identify one or more target wounds (TWs) per patient according to the TW definition. All patient's DPT and FT burns that comply with the specified entrance criteria will be treated with NexoBrid and, therefore, must be designated as TWs. This will further allow an evaluation of the patient's systemic safety by allowing treatment of the patient's entire deep burns.
Prior to initiation of eschar removal treatment, patients will be medicated with appropriate analgesia and undergo wound cleansing and dressing of all wounds with antibacterial solutions according to product instruction for use in order to ensure clean and moist eschar covered wound bed for NexoBrid application. Vital signs (Blood Pressure, Heart Rate and temperature) measurements and pain assessment will be performed within 24 hrs before start of treatment as well as haematology, biochemistry blood tests & PTT/INR. Pressure measurements for circumferential extremity wounds will be performed 1 hour before start of treatment and will be closely monitored during treatment. Following wound cleansing and soaking treatments, patients will undergo the eschar removal process. TWs of up to 15% total body surface area (TBSA) will be treated with a single application of NexoBrid for 4 hours. Patients with TWs >15% TBSA and up to 30% TBSA will be treated with 2 consecutive applications of 4 hours each. NexoBrid should not be applied to more than 15% TBSA in one session. PK samples will be taken from sub-set of patients with TWs area >15% TBSA. Pressure measurements for circumferential extremity wounds will be performed after the removal of NexoBrid.
Post eschar removal completion, patients will undergo daily vital signs (Blood Pressure, Heart Rate and temperature measurements) and pain assessments for 1 week, starting on the morning following start of eschar removal. Blood tests (haematology and biochemistry) will be performed 24 ± 6 hrs post eschar removal as well as PTT/INR. Weekly assessments of wound healing progress including the dressings used until complete wound closure will be performed.
Cosmesis (scar quality) evaluation (using MVSS) will be performed at 3 and 12 months post wound closure confirmation visit.
Study Type
Expanded Access Type
- Treatment IND/Protocol
Contacts and Locations
Study Contact
- Name: Limor Klein, PhD
- Phone Number: 972-77-9714176
- Email: limord@mediwound.com
Study Contact Backup
- Name: Keren David-Zarbiv
- Phone Number: 972-77-9714103
- Email: kerend@mediwound.com
Study Locations
-
-
Alabama
-
Mobile, Alabama, United States, 36617
- Available
- University of South Alabama
-
Contact:
- Andrew Bright, DO
- Phone Number: 251-471-7971
- Email: abright@health.southalabama.edu
-
Contact:
- Kelley Prutzman, RN
-
Principal Investigator:
- Andrew Bright, DO
-
-
Arizona
-
Phoenix, Arizona, United States, 85008
- Available
- Maricopa Medical Center
-
Principal Investigator:
- Kevin Foster, MD
-
Contact:
- Kevin Foster, MD
- Phone Number: 602-344-5624
- Email: kevin_foster@dmgaz.org
-
Contact:
- Suzanne Osborne, RN
- Phone Number: 602-344-5141
- Email: suzanne.osborn@mihs.org
-
-
District of Columbia
-
Washington, District of Columbia, United States, 20010
- Available
- MedStar Washington Hospital Center
-
Contact:
- Jeffrey Shupp, MD
- Phone Number: 202-877-7347
- Email: jeffrey.w.shupp@medstar.net
-
Contact:
- Melissa McLawhorn
- Phone Number: 202-877-6181
- Email: Melissa.M.Mclawhorn@medstar.net
-
Principal Investigator:
- Jeffrey Shupp, MD
-
-
Florida
-
Gainesville, Florida, United States, 32610
- Available
- University of Florida
-
Contact:
- Joshua Carson, MD
- Email: Joshua.Carson@surgery.ufl.edu
-
Contact:
- Tera Thigpin
- Phone Number: 352-265-0111
- Email: tera.thigpin@surgery.ufl.edu
-
Principal Investigator:
- Joshua Carson, MD
-
Miami, Florida, United States, 33136
- Available
- Jackson Memorial Hospital
-
Contact:
- Louis Pizano, MD
- Phone Number: 305-585-1178
- Email: lpizano@med.miami.edu
-
Contact:
- Ron Manning
- Phone Number: 305-355-4990
- Email: rmanning@med.miami.edu
-
Principal Investigator:
- Louis Pizano, MD
-
-
Iowa
-
Iowa City, Iowa, United States, 52242
- Available
- University of Iowa Hospitals and Clinics
-
Contact:
- Lucy Wibbenmeyer, MD
- Phone Number: 319-356-1304
- Email: lucy-wibbenmeyer@uiowa.edu
-
Iowa City, Iowa, United States, 52242
- Available
- The University of Iowa Hospitals and Clinics
-
Principal Investigator:
- Lucy Wibbenmeyer, MD
-
Contact:
- lucy wibbenmeyer, MD
- Phone Number: 319-356-3551
- Email: lucy-wibbenmeyer@uiowa.edu
-
Contact:
- Elizabeth Morgan
- Phone Number: 319-356-1304
- Email: elizabeth-morgan@uiowa.edu
-
-
Kansas
-
Kansas City, Kansas, United States, 66160
- Available
- Burnett Burn Center at The University of Kansas Hospital
-
Contact:
- Dhaval Bhavsar, MD
- Phone Number: 913-588-2000
- Email: dbhavsar@kumc.edu
-
Contact:
- Jessica Reynolds, RN
- Phone Number: 913-588-0068
- Email: jreynolds11@kumc.edu
-
Principal Investigator:
- Dhaval Bhavsar, MD
-
-
Maryland
-
Baltimore, Maryland, United States, 21287
- Available
- Johns Hopkins Burn Center
-
Contact:
- Julie Caffrey, MD
- Email: jcaffre5@jhmi.edu
-
Contact:
- Vidhi Javia
- Phone Number: 443-287-7848
- Email: vjavia1@jhmi.edu
-
Principal Investigator:
- Julie Caffrey, MD
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02114
- Available
- The General Hospital Corporation d/b/a Massachusetts General Hospital
-
Contact:
- Jeremy Goverman, MD
- Phone Number: 617-726-3712
- Email: JGOVERMAN@mgh.harvard.edu
-
Contact:
- Jennifer Levin, RN
- Email: Jlevin7@partners.org
-
Principal Investigator:
- Jeremy Goverman, MD
-
-
Minnesota
-
Minneapolis, Minnesota, United States, 55415
- Available
- Hennepin Healthcare
-
Contact:
- Frederick Endorf, MD
- Email: Frederick.Endorf@hcmed.org
-
Contact:
- Emily Kittelson
- Phone Number: 612-873-6396
- Email: Emily.Kittelson@hcmed.org
-
Principal Investigator:
- Frederick Endorf, MD
-
-
Missouri
-
Columbia, Missouri, United States, 65212
- Available
- University of Missouri Health Care
-
Contact:
- Jeffrey Litt, DO
- Phone Number: 573-884-6779
- Email: littjs@health.missouri.edu
-
Contact:
- Jennifer Randolph, RN
- Phone Number: 573-882-4387
- Email: randolphjl@health.missouri.edu
-
Principal Investigator:
- Jeffrey Litt, MO
-
-
New York
-
New York, New York, United States, 10065
- Available
- New-York Presbyterian Hospital
-
Contact:
- James Gallagher, MD
- Phone Number: 212-746-7913
- Email: jag9027@med.cornell.edu
-
Contact:
- Angela Rabbitts, RN
- Phone Number: 212-746-5881
- Email: anr2002@med.cornell.edu
-
Principal Investigator:
- James Gallagher, MD
-
Stony Brook, New York, United States, 11794
- Available
- Emergency Medicine Stony Brook University Hospital
-
Principal Investigator:
- Adam Singer, MD
-
Contact:
- Adam Singer, Dr
- Phone Number: 631-444-7857
- Email: adam.singer@stonybrookmedicine.edu
-
Contact:
- Maria (Merry) Taylor, RN
- Phone Number: 631-444-8345
- Email: PhaMaria.Taylor@stonybrookmedicine.edu
-
-
Oregon
-
Portland, Oregon, United States, 972227
- Available
- The Oregon Clinic
-
Contact:
- Kristin Hickey
- Phone Number: 503-413-5447
-
Principal Investigator:
- Michael J Mosier, MD
-
-
Pennsylvania
-
Allentown, Pennsylvania, United States, 18103
- Available
- Lehigh Valley Hospital and Health Network
-
Contact:
- Sigrid Blome-Eberwein, MD
- Phone Number: 610-402-1485
- Email: Sigri.Blome-Eberwein@lvhn.org
-
Contact:
- Mary Sobotor, CCRC
- Phone Number: 610-402-1592
- Email: Mary.Sobotor@lvhn.org
-
Principal Investigator:
- Sigrid Blome-Eberwein, MD
-
-
Tennessee
-
Memphis, Tennessee, United States, 38103
- Available
- Firefighters Regional Burn Center
-
Contact:
- William Hickerson, MD
- Phone Number: 901-448-2579
- Email: whicker@uthsc.edu
-
Principal Investigator:
- William Hickerson, MD
-
-
Utah
-
Salt Lake City, Utah, United States, 84132
- Available
- University of Utah Hospital
-
Contact:
- Giavonni Lewis, MD
- Phone Number: 801-581-8990
- Email: giavonni.lewis@hsc.utah.edu
-
Contact:
- Martin Carricaburu
- Phone Number: 801-581-3363
- Email: martin.carricaburu@hsc.utah.edu
-
Principal Investigator:
- Giavonni Lewis, MD
-
-
Washington
-
Seattle, Washington, United States, 98104
- Available
- Harborview Medical Center
-
Contact:
- Tam Pham, MD
- Phone Number: 206-744-3140
- Email: tpham94@uw.edu
-
Contact:
- Emily Eschelbach, RN
- Phone Number: 206-744-3587
- Email: eschee13@uw.edu
-
Principal Investigator:
- Tam Pham, MD
-
-
Wisconsin
-
Milwaukee, Wisconsin, United States, 53211
- Available
- Colombia St Mary's, Inc.
-
Contact:
- Nicholas Meyer, MD
- Email: whicker@uthsc.edu
-
Contact:
- Margaret Wilson
- Phone Number: 414-585-1498
- Email: Margaret.Wilson2@ascension.org
-
Principal Investigator:
- Nicholas Meyer, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria patient level:
- Males and females ≥ 18 years of age,
- Thermal burns caused by fire/flame, scalds or contact,
- Patient total burns area ≥ 1% DPT and / or FT with eschar that should be removed in SOC,
- Patient total burns area to be treated should be ≤ 30% TBSA; SPT, DPT and/or FT in depth,
- Informed consent can be obtained within 84h of the burn injury,
Patients who are willing and able to sign a written consent . Inclusion Criteria - Wound level
- At least one wound (a continuous burn area) that is ≥0.5% TBSA (DPT and/or FT) (this minimal wound size should not include face, perineal or genital)
All planned TWs should meet the following criteria:
- SPT areas that cannot be demarcated from DPT and FT areas should be less than 50% of the % TBSA of the TW, with eschar that should be removed in SOC,
- Wound's blisters can be removed/ unroofed, as judged by the investigator.
Exclusion Criteria patient level:
- Modified Baux index ≥ 80,
- Patients with burned, charred fingers, 3rd degree in depth and possibly devoid of circulation,
- Patients with abraded wound/s that cannot be treated by an enzymatic debrider application (NexoBrid),
- Patients with pre enrolment escharotomy,
- Patients with electrical or chemical burns,
- The following pre-enrollment dressings: a. Flammacerium, b. Silver Nitrate (AgNO3),
- Patients with pre-enrolment wounds which are covered by eschar heavily saturated with Silver, Iodine or by SSD pseudoeschar (pseudoeschar as a result of > 12 hrs SSD treatment),
- Patients with diagnosed infections as described in the protocol,
- Diagnosis of smoke inhalation injury [12],
- Pregnant women (serum positive pregnancy test) or nursing mothers,
- Poorly controlled diabetes mellitus (HbA1c>11%) in patients with known diabetes as captured in the medical history,
- BMI greater than 39.0 kg/m2 in patients with burns area of up to 15% TBSA or BMI greater than 34.0 kg/m2 in patients with burns area of more than 15% %TBSA,
- American Society of Anesthesiologists (ASA) physical status classification system greater than 2
- Cardio-pulmonary disease (MI within 6 months prior to injury, severe or unstable Ischemic Heart Disease, severe or unstable heart failure, severe pulmonary hypertension, severe COPD or pre-existing oxygen-dependent pulmonary diseases, severe broncho-pneumonia within 1 month prior to injury, steroid dependent asthma or uncontrolled asthma),
- Pre-existing diseases which interfere with circulation (severe peripheral vascular disease, severe circulatory edema and/or lymphedema, regional lymph nodes dissection, significant varicose veins),
- Any conditions that would preclude safe treatment or adding further risk to the basic acute burn trauma (such as severe immuno-compromising diseases, life threatening trauma, severe pre-existing coagulation disorder, severe cardiovascular disorder, significant pulmonary disorder, significant liver disorder including post alcoholic abuse impaired function or neoplastic disease, blast injury),
- Chronic systemic steroid intake,
- History of allergy and/or known sensitivity to pineapples, papaya, Bromelain or papain.
Enrollment in any investigational drug trial within 4 weeks prior to screening.
-
Study Plan
How is the study designed?
Collaborators and Investigators
Sponsor
Study record dates
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- MW2018-06-21
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.
Clinical Trials on Thermal Burn
-
University of FloridaTerminated
-
Stratatech, a Mallinckrodt CompanyActive, not recruitingFull Thickness Thermal BurnUnited States
-
Cairo UniversityCompleted
-
Stratatech, a Mallinckrodt CompanyCompleted
-
Xequel Bio, Inc.United States Department of DefenseWithdrawnThermal Burn | Second Degree Burn
-
Cytori TherapeuticsCompleted
-
HealthPartners InstituteTerminated
-
Cytori TherapeuticsSuspendedThermal BurnUnited States
-
Stedical Scientific, Inc.RecruitingThermal BurnUnited States
-
American Burn AssociationUnited States Department of DefenseRecruitingBurn Injury | Physical Injury | Thermal BurnUnited States
Clinical Trials on NexoBrid
-
MediWound LtdActive, not recruitingThermal BurnsUnited States, United Kingdom, Spain, Georgia, Belgium, Poland, Germany, Hungary, India, Italy, Netherlands, Romania, Slovakia, Ukraine
-
MediWound LtdCompletedThermal BurnsUnited States, Israel, Belgium, Czechia, Georgia, Germany, Italy, Romania