Venous Leg Ulcers Clinical Trial
Official title:
A Multi-center Randomized Controlled Clinical Trial Evaluating Two Application Regimens of Amnioband Dehydrated Human Amniotic Membrane and Standard of Care vs. Standard of Care Alone in the Treatment of Venous Leg Ulcers
Lower extremity ulcers pose significant clinical, humanistic and economic burdens on society.
Millions of Americans are afflicted with painful, open, draining sores on their lower
extremities. These sores are referred to as venous leg ulcerations (VLUs).1-5 Under the best
of circumstances these ulcers require weeks or months to heal. Not uncommonly wound care
specialists see patients who have suffered for years or faced amputation of the limb as their
only option to alleviate the pain.
Standard of care will result in healing in 50% of venous leg ulcers in 12 weeks. However,
roughly half of patients suffering from venous ulcers will require advanced therapy. Human
amniotic membrane replaces the damaged extracellular matrix characteristic of chronic ulcers.
In addition, it contains cytokines that may accelerate healing. In clinical practice and
recent studies, Dehydrated Human Amniotic Membrane has appeared to be as effective as
bioengineered skin products. This RCT is designed to evaluate Amnioband Dehydrated Human
Amniotic Membrane in venous leg ulcers.
This study is a multi-center, randomized, trial designed to evaluate the safety and
effectiveness of Amnioband Dehydrated Human Amniotic Membrane plus multi-layer compression
therapy versus multi-layer compression alone in the healing of venous leg ulcers.
The Standard of Care therapy in this study is multi-layer compression therapy. A number of
compression bandaging systems are commercially available. The choice of compression will be
at the discretion of the principle investigator.
The Screening Phase (1-14 days) consists of a series of screening assessments designed to
determine eligibility followed by, for those who meet the eligibility criteria (described in
more detail below), At or up to 14 days before the first Screening Period Visit (S1), written
informed consent from the subject will be obtained by the Investigator or suitably qualified
designee before the performance of any other protocol-specific procedure.
Subjects who have not been treated with compression therapy for the target ulcer must receive
a minimum of 14 days of compression prior to enrollment.
At the first Screening Period Visit (S1), the Investigator will select the study (target)
ulcer. Each subject will have only one VLU selected as the study (target) ulcer. In the
situation where a subject has more than one VLU at the S1 visit, the Investigator will select
the largest VLU that meets the eligibility criteria of the protocol as the study (target)
ulcer.
The Screening Period is designed to determine whether subjects are eligible to proceed to the
Treatment Period of the study.
The Treatment Phase (12 Weeks) begins with a series of assessments designed to confirm the
subjects' continued eligibility. Subjects who continue to meet eligibility criteria will be
randomized to one of three groups: (1) standard of care: multi-layer compression (2) weekly
application of Amnioband Dehydrated Human Amniotic Membrane (3) biweekly applications of
Amnioband Dehydrated Human Amniotic Membrane.
During the Treatment Phase, subjects will be evaluated on a weekly basis. Efficacy
evaluations each week will include Investigator assessment of ulcer healing and measurements
of ulcer size using a digital camera device. Safety evaluations during the Treatment Phase
will consist of adverse event assessments at each visit.
Subjects in any of the three groups whose ulcers do not achieve closure at 12 weeks will be
deemed treatment failures. Subjects in the control arm may cross over to the Amnioband arm if
they fail to achieve closure although these subjects will not be included in the analysis.
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