Ulcere a gamba venosa non guarite trattate con cure standard con o senza BR-Ac
Uno studio prospettico, multicentrico, randomizzato e controllato di ulcere a gamba venosa non guarita trattate con cure standard con o senza BR-Ac
This study examines a patient population with a non-healing, non-infected venous leg ulcer (VLU) having adequate arterial perfusion with confirmed venous reflux. It is hypothesized that weekly applications of the human placental allograft BioREtain® Amnion Chorion (BR-AC) applied to a non-healing VLU will result in a higher proportion of wounds showing complete healing within 12 weeks of initiating therapy, compared to standard care alone.
This study has a crossover period, where subjects on standard care alone who do not achieve complete healing within 12 weeks of initiating therapy will be allowed to crossover to receive BR-AC over 12 additional weeks, to evaluate if their wound can achieve complete healing.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
This trial is a multicenter, randomized, controlled study designed to evaluate the safety and efficacy of BR-AC plus standard of care versus standard of care only in the treatment of venous leg ulcers. The eligibility criteria for this study will allow for enrollment of subjects with a VLU in the range of 2 cm^2 to 20 cm^2 in area. A lower size of 2 cm^2 was selected to exclude subjects who are likely to heal under compression therapy alone.
During the two-week run-in period, subjects who show a reduction in wound area predictive of achieving complete wound closure within 12 weeks under standardized care alone (i.e., compression therapy) will be excluded from the study. Eliminating these subjects will improve the estimated treatment effect. The criteria for duration, ≥ 4 weeks but ≤ 52 weeks, allows for the selection of those wounds that have demonstrated chronicity but may still have the potential to achieve wound closure.
The trial design will control potential variables that may affect the outcome between the treatment group and the control group by standardizing the requirements for evaluating venous insufficiency confirmed by duplex Doppler ultrasound examining valvular or venous incompetence, debridement, and compression therapy. Weekly subject visits will help monitor compliance in wound care and compression therapy, as well as to document when wound closureis achieved. The study will implement the use of an electronic imaging and measurement device (eKare inSight®) using a standardized protocol to ensure the measuring of the wound surface area is accurate, highly reproducible, and minimally variable.
There will also be a crossover treatment phase for those patients that were relegated to SOC only. After their 12-week standard of care treatment phase and for only those subjects that did not achieve complete wound closure, will be allowed to crossover for an additional 12 weeks of treatment with the BR-AC product following the protocol and procedures set forth within this document.
A follow-up phase will commence for all subjects that achieve complete wound closure, which is designed to measure longevity and durability of the closed wound. This follow-up period will consist of a four-week follow-up with two visits at each two-week interval.
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Non applicabile
Contatti e Sedi
Luoghi di studio
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Alabama
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Guntersville, Alabama, Stati Uniti, 35976
- Site 17
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California
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Castro Valley, California, Stati Uniti, 94546
- Site 2b
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Glendale, California, Stati Uniti, 91204
- Site 19b
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Oxnard, California, Stati Uniti, 93030
- Site 36
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Oxnard, California, Stati Uniti, 93036
- Site 37
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Palmdale, California, Stati Uniti, 93551
- Site 19
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San Francisco, California, Stati Uniti, 94115
- Site 02
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San Francisco, California, Stati Uniti, 94117
- Site 2a
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Sylmar, California, Stati Uniti, 91342
- Site 04
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Torrance, California, Stati Uniti, 90502
- Site 30
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Vista, California, Stati Uniti, 92081
- Site 01
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Florida
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Aventura, Florida, Stati Uniti, 33180
- Site 34
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Coral Gables, Florida, Stati Uniti, 33134
- Site 27
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Deerfield Beach, Florida, Stati Uniti, 33442
- Site 20
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Miami, Florida, Stati Uniti, 33126
- Site 35
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Miami, Florida, Stati Uniti, 33189
- Site 31
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Illinois
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O'Fallon, Illinois, Stati Uniti, 62269
- Site 06
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02118
- Site 18
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Missouri
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St Louis, Missouri, Stati Uniti, 63128
- Site 32
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New York
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Lake Success, New York, Stati Uniti, 11042
- Site 16
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Texas
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Corpus Christi, Texas, Stati Uniti, 78414
- Site 38
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Fort Worth, Texas, Stati Uniti, 76104
- Site 03
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
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Patient has signed the informed consent form.
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Male or female patient at least 18 years of age or older, as of the date of the screening visit.
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Has a VLU between the knee and ankle (at or above the malleoli), with a surface area in the range of ≥ 2.0 cm2 and ≤ 20.0 cm2 when measured by the investigator staff at the screening visit using the eKare device post debridement.
- If the subject presents with > 1, but ≤ 3 VLU on the same leg, the largest ulcer will be selected as the target ulcer.
- If the target ulcer is < 1cm from another VLU, the ulcers should be traced as a single target ulcer provided at least one of the ulcers is at least 2.0 cm2 in area and the total surface area of the VLUs is ≤ 20.0 cm2.
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Target ulcer involves a full-thickness skin loss, but without exposure of tendon, muscle, or bone.
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Target ulcer duration ≥ 4 weeks but ≤ 52 weeks (12 months).
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Venous insufficiency confirmed by duplex Doppler ultrasound examining valvular or venous incompetence.
a. Availability of a complete report of a previous examination performed 12 months of screening will be acceptable, and this examination would not be required to be repeated.
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Arterial supply adequacy confirmed by any one of the following:
- Great toe pressure ≥ 50 mm/Hg
- Systolic blood pressure Ankle Brachial Index (ABI) in the range ≥ 0.80 ≤ 1.10
- TcPO2 ≥ 40 mmHg from the foot
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Willing to follow all instructions given by the Investigator, return for all visits, and adhere to compression protocols while on the study.
Exclusion Criteria:
- A target ulcer of non-venous etiologies (e.g., sickle cell anemia, necrobiosis lipoidica diabeticorum, pyoderma gangrenosum, vasculopathic or vasculitic).
- Acute Deep Vein Thrombosis (DVT), defined as the first 10 days from onset of symptoms, or any DVT for which compression is considered by the Investigator to be contraindicated.
- Clinical evidence of ulcer bed infection, or infected hardware.
- Documented history of osteomyelitis at the target ulcer location within six (6) months preceding the screening visit.
- Refusal or inability to tolerate compression therapy.
- Pregnant women.
- Women of child-bearing potential who are unwilling to avoid pregnancy or use an effective form of birth control.
- Hemoglobin A1c (HbA1c) level is > 12% (108 mmol/mol).
- Current therapy with systemic antibiotics.
- Current therapy with cytotoxic agents.
- Current therapy with chronic (> 10 days) oral corticosteroids.
- Current therapy with TNFα inhibitors other than Trental® (pentoxifylline).
- Has tested positive for Human Immunodeficiency Virus (HIV) or has Acquired Immune Deficiency Syndrome (AIDS).
- Has malignancy or history of cancer in the preceding 5 years other than non-melanoma skin cancer.
- Currently on dialysis or planning to start dialysis.
- Is currently enrolled or participated in another device, drug, or biological trial within 30 days of screening.
- Therapy of the target ulcer with other birth tissue products, autologous skin graft, Apligraf®, or Dermagraft® within 30 days preceding the screening visit.
- Therapy of the target ulcer with topical growth factors within thirty (30) days preceding the screening visit.
- Any previous use of Vendaje®, Vendaje AC®, AmnioWrap2® applied to the target ulcer.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Separare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: BR-AC plus Standard Care
All subjects in the treatment group will receive sponsor-approved standard of care. Standard of care is defined as:
Using an appropriate size to cover the entire wound area, BR-AC should be applied directly to the wound surface following sharp debridement. It is recommended that the product be trimmed to fit the area of the wound with sterile scissors before application. |
BR-AC is an amnion layer, intermediate layer, and chorion layer placental membrane processed together with no separation of the layers. BR-AC is manufactured by BioStem Technologies, Inc. and is processed by the bioREtain method, which, briefly includes initial disinfection, processing with isotonic solutions, dehydration at 37-40°C, and electron beam sterilization. |
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Comparatore attivo: Standard Care
All subjects in the control group will receive sponsor-approved standard of care. Standard of care is defined as:
|
Standard Care is defined as:
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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To determine whether non-ischemic, non-infected VLUs treated with standard care plus BR-AC results in a higher probability of achieving complete wound closure compared to standard care alone.
Lasso di tempo: over the 12-week treatment period
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Percentage of subjects with complete wound closure over the 12-week treatment period, defined as 100% reepithelialization |
over the 12-week treatment period
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
To compare differences between treatment groups in proportions of wounds with complete wound closure, based on time in days to closure
Lasso di tempo: at 12 weeks
|
Percent change from baseline in wound surface area (cm2) at 12-weeks post-randomization |
at 12 weeks
|
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To compare differences between treatment groups in percent change in wound area (cm2)
Lasso di tempo: at 12 weeks
|
Percent change from baseline in wound surface area (cm2) at 12-weeks post-randomization |
at 12 weeks
|
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To determine the total number of applications of BR-AC needed to achieve complete wound closure
Lasso di tempo: at 12 weeks
|
Percent change from baseline in wound volume (cm3) at 12-weeks post-randomization |
at 12 weeks
|
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To determine whether subjects that crossover and receive standard care plus BR-AC results in a higher probability of achieving complete wound closure over the 12 additional weeks versus standard care alone
Lasso di tempo: over an additional 12 weeks
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Time in days from Visit 18 to initial observation of wound closure (defined as 100% reepithelialization of the wound without drainage) over an additional 12 weeks (Visits 19-30), where healing has been confirmed at two visits two weeks apart |
over an additional 12 weeks
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Number of participants that acquire clinical signs and symptoms of infections post-randomization
Lasso di tempo: over 12-weeks post-randomization
|
Differences in clinical signs and symptoms of infection from Visit 2 through end of study between the treatment groups |
over 12-weeks post-randomization
|
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Proportion of subjects experiencing adverse events, by treatment group
Lasso di tempo: over the 17-week study period
|
Spontaneously reported and elicited adverse events, coded in MedDRA |
over the 17-week study period
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: Bert Slade, MD, Independent
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Effettivo)
Completamento primario
Completamento dello studio (Effettivo)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Malattie vascolari
- Malattia cardiovascolare
- Malattie della pelle
- Ulcera della pelle
- Vene varicose
- Ulcera alla gamba
- Malattie della pelle e del tessuto connettivo
- Ulcera varicosa
- Insufficienza venosa
- Amministrazione dei servizi sanitari
- Qualità, accesso e valutazione dell'assistenza sanitaria
- Qualità dell'assistenza sanitaria
- Indicatori di qualità, assistenza sanitaria
- Standard di cura
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- BR-AC-VLU-101
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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