PriMatrix for the Management of Diabetic Foot Ulcers

Diabetic Foot Ulcer Clinical Trial

Official title:

Prospective, Multi-center, Randomized, Controlled Trial Evaluating the Use of PriMatrix Dermal Repair Scaffold for the Management of Diabetic Foot Ulcers

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03010319
• Other study ID #: T-PMXDFU-001
• Status: Completed
• Phase: N/A
• Start date: January 2017
• Est. completion date: August 2020

Study information

• Verified date: April 2022
• Source: Integra LifeSciences Corporation
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The study will evaluate the efficacy of PriMatrix Dermal Repair Scaffold in the management of diabetic foot ulcers in subjects with diabetes mellitus versus the Standard of Care treatment. Half of patients will be treated using PriMatrix while the other half will receive Standard of Care treatment.

Description:

A diabetic foot ulcer (DFU) is a major health complication that affects up to 15% of individuals with diabetes mellitus over their lifetime. The treatment of DFUs is extremely challenging as these ulcers may not respond to standard of care (SC) treatment and frequently become infected. Advanced wound therapies like PriMatrix have become an important strategy in the treatment of hard-to-heal chronic DFUs by trapping and binding the patients' own cells to rebuild the dermis layer of the skin to aid in healing. The study will evaluate the efficacy of PriMatrix Dermal Repair Scaffold in the closure of DFUs in subjects with diabetes mellitus in comparison to Standard of Care treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 226
• Est. completion date: August 2020
• Est. primary completion date: August 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria Subjects are required to meet all of the following criteria for enrollment into the study

and subsequent randomization:

1. The subject has signed and dated an informed consent form.

2. In the opinion of the investigator, subject is able and willing to comply with study procedures, including study visits, study dressing regimens and compliance with study required off-loading device.

3. The subject is = 18 years of age.

4. The subject, if female of child-bearing potential, must not be pregnant. To document pregnancy status, subject statement is acceptable.

5. The subject has Type I or Type II diabetes mellitus with investigator-confirmed glycosylated hemoglobin (HbA1c) of = 12% within 3 months prior to screening visit.

6. The subject has at least one diabetic foot ulcer that meets ALL of the following

criteria:

• Ulcer which has been in existence for a minimum of two weeks, prior to signing the Informed Consent Form for trial participation.
• Ulcer is a partial or full thickness diabetic foot ulcer without capsule/tendon/bone exposure.
• Ulcer does not have tunneling, undermining, or sinus tracts that necessitates surgical OR debridement and/or penetrates to capsule/tendon/bone.
• Ulcer is located on the foot or ankle (with no portion above the top of the malleolus).
• Ulcer size (area) is > 1 cm2 and < 12 cm2 post-debridement.

7. There is a minimum 1 cm margin between the qualifying study ulcer and any other ulcer on that same foot, post-debridement.

• If the subject has more than one ulcer that meets the eligibility criteria, the ulcer designated as the study ulcer will be at the discretion of the investigator.

8. The subject has adequate vascular perfusion of the affected limb as defined by at

least one of the following:

• Ankle-Brachial Index (ABI) = 0.65 or =1.2, performed within 3 months of screening,
• Toe pressure (plethysmography) > 50 mmHg at time of screening,
• TcPO2 > 40 mmHg at time of screening

9. The subject or responsible caregiver is willing and able to maintain required applicable dressing changes as well as study required off-loading/protective device for the duration of the study. Exclusion Criteria

Subjects will not be enrolled in the study if any of the following criteria are met:

1. The subject was previously randomized and treated under this clinical study protocol.

2. The subject has suspected or confirmed gangrene or ulcer infection of the study ulcer or receiving systemic antibiotics for the treatment of such.

3. The subject has suspected or confirmed osteomyelitis of the foot with the study ulcer.

4. The subject has a history of hypersensitivity to bovine collagen, as determined by prior medical history. Protocol Number: T-PMXDFU-01 Confidential Page 23 of 64 Version 5.0 06 Nov 2018

5. The subject has participated in another clinical trial involving a device or a systemically administered investigational study drug/treatment within 28 days of randomization.

6. The subject has received, within 28 of signing Informed Consent Form, or is scheduled to receive during study participation, a medication or treatment which is known to interfere with or affect the rate and quality of ulcer healing (e.g., systemic steroids, immunosuppressive therapy, autoimmune disease therapy, dialysis, radiation therapy to the foot, vascular surgery, angioplasty, or thrombolysis).

7. The subject has a history of bone cancer or metastatic disease of the affected limb, radiation therapy to the foot, or has had chemotherapy within the 12 months prior to signing Informed Consent Form for trial participation.

8. In the opinion of the investigator, the subject has a history of, or is currently diagnosed with, any illness or condition, other than diabetes, that could interfere with ulcer healing (e.g., end-stage renal disease, severe malnutrition, liver disease, aplastic anemia, connective tissue disorder, acquired immune deficiency syndrome, HIV positive, or sickle cell anemia).

9. In the opinion of the investigator, the subject has unstable Charcot foot or Charcot with bony prominence that could inhibit ulcer healing.

10. The subject has ulcers secondary to a disease other than diabetes (e.g., vasculitis, neoplasms, or hematological disorders).

11. In the opinion of the investigator, the subject has excessive lymphedema that could interfere with off-loading and/or ulcer healing.

12. The study ulcer has received ulcer dressings that included growth factors, engineered tissues, or skin substitutes within 28 days of randomization or is scheduled to receive treatment during the study (e.g., Regranex, Dermagraft, Apligraf, EpiFix, GraftJacket, OASIS, Omnigraft, or Integra BMWD).

13. At the end of the screening phase and based on planimetric assessment, the area of the study ulcer after sharp debridement has decreased by more than 30% over the two-week screening period.

Related Conditions & MeSH terms

• Diabetic Foot
• Diabetic Foot Ulcer
• Foot Ulcer
• Ulcer

Intervention

Device:
• PriMatrix Dermal Repair Scaffold
Application of PriMatrix to ulcer
• Secondary Dressings
Dressings to ensure moist wound environment
• Offloading device
Offloading device to decrease pressure to wound area

Locations

Country	Name	City	State
United States	Podiatry 1st	Belleville	Illinois
United States	ILD Research Center	Carlsbad	California
United States	Podiatric Medical Partners of Texas, P.A.	Dallas	Texas
United States	UT Southwestern Medical Center	Dallas	Texas
United States	JPS Health Network	Fort Worth	Texas
United States	LA Foot & Ankle Clinic	Los Angeles	California
United States	Futuro Clinical Trials	McAllen	Texas
United States	The Mount Sinai Medical Center	New York	New York
United States	Barry University Clinical Research	North Miami	Florida
United States	Foot and Ankle Institute	Saint George	Utah
United States	Element Research Group	San Antonio	Texas
United States	Center for Clinical Research, Inc.	San Francisco	California
United States	Central Valley Vein and Wound	Selma	California
United States	Wound Care of Tulsa	Tulsa	Oklahoma
United States	Georgetown University	Washington	District of Columbia
United States	LA Podiatry Group	West Palm Beach	Florida
United States	Martin Foot and Ankle	York	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
Integra LifeSciences Corporation

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Subjects With Complete Wound Closure, as Assessed by the Investigator, at or Before Week 12 of the Treatment Phase	Complete wound closure was defined as 100% re-epithelialization of the ulcer surface without detectable exudate, confirmed on 2 consecutive study visits 1 week apart.	12-week Treatment Phase
Secondary	Percentage of Subjects With Complete Wound Closure, as Assessed by Computerized Planimetry, at or Before Week 12 of the Treatment Phase		12-week treatment phase
Secondary	Time to Complete Wound Closure, as Assessed by the Investigator		12-week Treatment Phase
Secondary	Time to Complete Wound Closure, as Assessed by Computerized Planimetry.		12-week Treatment Phase
Secondary	Rate of Wound Closure, as Assessed by Computerized Planimetry.	Rate of Wound closure was recorded as the percentage of the wound that was closed, per week.; NOTE1: Rate (% closed/week) = 7 * [(Baseline wound size) - (Post-baseline wound size)]/[(Baseline wound size) * (days in trial)] NOTE2: Missing data is imputed using LOCF method for this analysis	Weeks 1-12 during Treatment Phase

External Links

•   Fetal Bovine Acellular Dermal Matrix for the Closure of Diabetic Foot Ulcers: A Prospective Randomised Controlled Trial; Journal of Wound Care Vol. 30, No. Sup7