Safety and Efficacy of Apligraf in Nonhealing Wounds of Subjects With Junctional or Dystrophic Epidermolysis Bullosa (EB)

Epidermolysis Bullosa Dystrophica Clinical Trial

Official title:

A Prospective, Multicenter, Within Subject Controlled Study to Evaluate the Effect of Apligraf in Nonhealing Wounds of Subjects With Junctional or Dystrophic Epidermolysis Bullosa

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT00587223
• Other study ID #: 06-EB-001-AG
• Status: Terminated
• Phase: Phase 3
• First received: December 21, 2007
• Last updated: June 25, 2010
• Start date: December 2007
• Est. completion date: December 2008

Study information

• Verified date: June 2010
• Source: Organogenesis
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug Administration
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the use of Apligraf for the treatment of nonhealing wounds in subjects with dystrophic or junctional epidermolysis bullosa. Apligraf will be evaluated for efficacy and safety compared to a conventional nonadherent dressing. A matched-pair design will be used to evaluate Apligraf treatment versus conventional treatment in 68 study pairs.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 1
• Est. completion date: December 2008
• Est. primary completion date: December 2008
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 2 Years to 65 Years

Eligibility

Inclusion Criteria:

• Subject is between 2 and 65 years of age.

• Subject with clinical and histological diagnosis of junctional or dystrophic EB with documented electron microscopy or immunofluorescence microscopy.

• Subject has at least two non-adjacent EB lesions, at least 4 cm apart. The two selected EB lesions must be relatively matched in terms of diagnosis, location, level of erosion and size. Lesions may be on the same limb.

• Subject with dystrophic or junctional EB lesions between 10-44 cm2 present for at least 6 weeks. For the purposes of this study, a lesion is defined as a wound resulting from a post blister erosion.

• Subject who is a female of child-bearing potential (females >10 years of age) must have a documented negative urine or serum pregnancy test. Sexually active females must be practicing a medically proven form of contraception during the course of the study period.

• Subject or legal guardian must have read, understood and signed an institutional review board (IRB) approved Informed Consent Form or Assent Form.

• Subject and/or legal guardian must be able and willing to follow study procedures and instructions.

Exclusion Criteria:

• Subject with lesions only on the soles, posterior thigh or gluteus maximus.

• Subject whose lesion has healed 20% or greater in area from post debridement (if applicable) Baseline Screen (Visit 1) to post debridement Day 0 (Visit 2) as determined by wound tracings.

• Subject with uncontrolled diabetes mellitus (glycosylated HbA1C > 10%), cancer (biopsy confirmed active malignancy), or positive HIV test.

• Subject is a child (<18 years of age) who is currently receiving or has received oral steroid therapy exceeding a total daily dose of 0.5mg/kg for more than two weeks, radiation or other immuno-suppressive therapy which would interfere with wound healing within the past four weeks.

• Subject is an adult (>18 years of age) who is currently receiving or has received chronic high dose steroid therapy exceeding a total daily dose of 20mg for more than two weeks, radiation or other immuno-suppressive therapy which would interfere with wound healing within the past four weeks.

• Subject who is currently on or has received topical steroidal therapy within 30 days before screening. Inhaled steroids are allowed.

• Subject with the presence of acute infections in the areas intended for treatment.

• Subject with a history of squamous cell carcinoma.

• Known hypersensitivity to bovine collagen or to the components of the Apligraf agarose shipping medium.

• Subject who is lactating or pregnant (hCG positive as determined by lab testing).

• Subject is a child (<18 years of age) with liver (ALT/SGPT, ALP, AST/SGOT, bilirubin, total protein, LDH) and/or renal function (BUN and creatinine) tests > 2 x upper limit of normal (ULN). Albumin < 2.0 mg/dL.

• Subject is an adult (>18 years of age) with liver (ALT/SGPT, ALP, AST/SGOT, bilirubin, total protein, LDH) and/or renal function (BUN and creatinine) tests > 2 x upper limit of normal (ULN). Albumin < 2.0 mg/dL.

• Subject enrolled in any wound or investigational device study for any disease within the past four weeks.

• Subject who has received an investigational drug or biological treatment within three months.

• Subject previously treated with Apligraf, Dermagraft or any other cell therapy at the target sites.

• Subject with a history of alcohol or substance abuse within the previous year, which could interfere with study compliance such as inability to attend scheduled study visits or compliance with home dressing changes.

• Subject who, in the opinion of the investigator, for any reason other than those listed above, will not be able to complete the study per protocol.

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Related Conditions & MeSH terms

• Epidermolysis Bullosa
• Epidermolysis Bullosa Dystrophica
• Epidermolysis Bullosa, Junctional

Intervention

Device:
• Apligraf
Up to 3 applications: Day 0, Month 1, Month 2.

Other:
• Standard dressing regimen
Dressing regimen will be comprised of a primary nonadherent dressing, nonstick gauze and standard dressing retainer

Locations

Country	Name	City	State
United States	Children's Hospital of Cincinnati	Cincinnati	Ohio
United States	University of Texas	Houston	Texas
United States	University of Miami - Miller School of Medicine	Miami	Florida
United States	Columbia University Medical Center	New York	New York
United States	Stanford University School of Medicine	Stanford	California

Sponsors (1)

Lead Sponsor	Collaborator
Organogenesis

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Proportion of Wounds First Achieving 100% Epithelialization of Tissue With the Absence of Drainage (i.e. Complete Wound Closure) Through Study Week 12		Through 12 weeks	No
Secondary	Time Until Complete Closure		through 12 weeks	No
Secondary	Rate of Complete Wound Closure Over Time		through 12 weeks	No
Secondary	Recurrence of Epidermolysis Bullosa (EB) Lesions		through 12 months	No
Secondary	Reduction of Intensity of Pain		through 12 weeks	No
Secondary	Proportion of Wounds Experiencing an Adverse Event		through 12 months	Yes