Diabetic Foot UlcersPhase 2DUNENCT01490879
A Study to Investigate the Safety and Clinical Effect of Nexagon® as a Topical Treatment for Subjects With a Diabetic Foot Ulcer (DUNE)
A Phase 2 study testing Nexagon® Low Dose, Nexagon® Medium Dose and Nexagon® High Dose in people with Diabetic Foot Ulcers, run by OcuNexus Therapeutics, Inc. at 25 sites in 3 countries.
Trial summary
This study is for Type I or Type II diabetic subjects with with a diabetic foot ulcer. The study is being done to determine if Nexagon® plus standard of care is more effective than placebo plus standard of care. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetic Foot Ulcers
- What is being tested?
- Nexagon® Low Dose, Nexagon® Medium Dose and Nexagon® High Dose
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 168 participants
- Where
- 25 sitesin 3 countries
- Study dates
- Jul 2012to Apr 2014
- Phase
- Phase 2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Diagnosis of diabetes mellitus (Type I or II)
- HbA1c of less than or equal to 12.0%
- Diagnosis of neuropathic foot ulcer with partial or complete neuropathy
- Cutaneous ulcer on the plantar or dorsal aspect of the foot or toe that is greater or equal to 1.0cm2 and less than or equal to 8.0 cm2 in area at the end of the screening period and is full thickness with no exposed ligament, tendon, joint capsule or bone. Surface area will be measured by digital planimetry.
- The Medical Monitor(or delegate)must confirm that the reference diabetic foot ulcer (RDFU)is suitable for inclusion after reviewing digital photographs
- Wound bed consisting of completely viable tissue or one where completely viable tissue will be achieved by the end of the screening period.
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- An Ankle Branchial Index (ABI) of greater or equal to 0.80 in concert with a bi- or tri-phasic Doppler flow pattern; or adequate circulation as demonstrated by any of the following methods: peri-wound transcutaneous partial pressure oxygen (TcpO2)greater or equal to 40 mmHg; or a toe pressure of greater or equal to 40 mmHg; or skin perfusion pressure of greater or equal to 40 mmHg.
- Ulcer present for 4 weeks or more or less than or equal to 12 months.
- Willing to wear a Removable Cast Walker (RCW) between study visits for the duration of the study.
- Signed informed consent form.
Who cannot join
- Any unstable medical condition that would cause the study to be detrimental to the subject.
- Decrease in RDFU size by more than 40% or increase in the ulcer size by more than 40% during the 14-day screening period as measured by digital planimetry.
- Ulcers caused primarily by untreated vascular insufficiency or ulcers with an etiology not related to diabetes.4. Ulcers above the ankle.
- 5. Ulcers that cannot be effectively off-loaded using the cast walker and sole insert provided in this study (ulcers not located on the weight bearing surface of the foot do not require off-loading).
- 6. Ulcers on the toes not accessible for photography (e.g. in the web space). 7. Presence of other ulcers within 2cm of the perimeter of the RDFU. 8. BMI > 45 9. Cannot tolerate or will not comply with the off-loading method, or non-compliance with standard or care.
- 10.The RDFU is infected (clinical assessment of infection)and/or biopsy proof of greater than 100,000 organisms per gram of tissue during the screening period.
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- 11. Subjects presenting with the clinical characteristics of cellulitis at the ulcer site. 12. Necrosis, purulence, or sinus tracts that cannot be removed by debridement.13. Definite or suspected osteomyelitis within any wound located anywhere on the subjects body.14. Acute Charcot's neuroarthropathy as determined by clinical and/or previous radiographic examination.
- 15. Severe Charcot deformity or rocker bottom foot with an associated plantar mid-foot or heel ulcer.
- 16. Revascularization surgery on the leg with the wound to be treated less than or equal to 4 weeks prior to the start of the screening period.
- 17. Requirement for concurrent topical antimicrobials to treat the RDFU after the end of the screening period.
- 18. Received dermal substitute or living skin equivalent (e.g. Dermagraft® or Apligraf®) within 14 days prior of the start of the screening period.
- 19. Severe complications of diabetes that in the opinion of the Investigator could interfere with wound healing or impede the subject's participation.
- 20. Subjects on concurrent immunosuppressive therapy to include oral corticosteroid therapy equivalent to greater than 5 mg/day of prednisone.
- 21. Any history of radiation therapy to the foot. 22. Female subjects who are pregnant or lactating. 23. Pre-menopausal women not using effective birth control methods as determined by the Investigator. 24. Life expectancy of < 12 months. 25. Subjects on renal replacement therapy. 26. Cancer within the last 3 years except basal and squamous cell carcinoma. 27. Cancer within the RDFU
Trial locations and contacts
25 sites in 3 countries.
25 sites in 3 countries
United States9 sites
Center For Clinical Research Inc.
Castro Valley, California, 94546
Advanced Foot Care and Clinical Research Center
Fresno, California, 93722
Barry University Clinical Research
Hialeah, Florida, 33013
Houston Foot and Ankle Care
Houston, Texas, 77074
Advanced Foot and Ankle Center
Las Vegas, Nevada, 89119
Univeristy of Miami, Miller School of Medicine, Dermatology Research
Miami, Florida, 33136
Associated Foot and Ankle Specialists, LLC
Phoenix, Arizona, 85015
Doctors Research Network
South Miami, Florida, 33143
University of Arizona Medical Center
Tucson, Arizona, 85724
Russia9 sites
Kemerovo Regional Clinical Hospital
Kemerovo, 650066
City Clinical Hospital #13
Moscow, 1154280
Endocrinology Science Center
Moscow, 117036
Endocrinology Clinic of Moscow, Department of Healthcare
Moscow, 119034
Moscow Medical University n.a.
Moscow, 119435
Federal bureau of medical and social expertise, Moscow
Moscow, 127486
St Petersburg City Hospital of St Elizabeth
Saint Petersburg, 198099
St Petersburg Diagnostic Center
Saint Petersburg, 198255
Voronezh Regional Clinical Consultative Diagnostic Center
Voronezh
Ukraine7 sites
Cherkasy Regional Clinical Hospital, Endocrinology Department
Cherkasy, 18009
Dnipropetrovsk Regional Clinical Hospitaln. a. I.I. Mechnikov
Dnipropetrovsk, 49005
Ivano-Frankivsk Central City Clinical Hospital
Ivano-Frankivsk, 76025
Regional Clinical Hospital, Cardiovascular Surgery Department
Kharkiv, 61022
Kyiv City Clinical Hospital #1
Kyiv, 02091
Institute of Endocrinology and Methabolism n.a. V.P. Komisarenko, Clinical Diabetology Department
Kyiv, 04114
Zaporizhzhya City Clinical Hospital #9
Zaporizhzhya, 69096
About this study
Official title: A Randomized, Prospective, Double-blind, Vehicle-controlled, Dose-ranging, Multi-center Study to Assess the Safety and Clinical Effect of Nexagon® in the Treatment of Subjects With a Diabetic Foot Ulcer
This study is for Type I or Type II diabetic subjects with with a diabetic foot ulcer. The study is being done to determine if Nexagon® plus standard of care is more effective than placebo plus standard of care. Standard of care will include debridement of the ulcer, standardized dressings and standardized off-loading using a Removable Cast Walker.
- Conditions
- Diabetic Foot Ulcers
- Being tested
- Nexagon® Low Dose, Nexagon® Medium Dose, Nexagon® High Dose, Nexagon® vehicle
- Keywords
- DFU, Diabetic Foot Ulcer, Ulcers, Foot Ulcers, chronic wound, wounds, Nexagon, CoDa
- Medical subject headings
- Diabetic Foot, Ulcer, Foot Ulcer, Wounds and Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Nexagon® Low DoseDrug
Twice weekly, topical application of Nexagon® low dose in addition to a Removable Cast Walker
Nexagon® Medium DoseDrug
Twice weekly, topical application of Nexagon® medium dose in addition to a Removable Cast Walker
Nexagon® High DoseDrug
Twice weekly, topical application of Nexagon® high dose in addition to a Removable Cast Walker
Nexagon® vehicleDrug
Twice weekly, topical application of Nexagon® vehicle in addition to a Removable Cast Walker
| Study group | Role | What they receive |
|---|---|---|
| Nexagon® Low Dose | Experimental | Twice weekly applications of Nexagon® low dose in addition to off-loading using a Removable Cast Walker Receives: Drug: Nexagon® Low Dose |
| Nexagon® Medium Dose | Experimental | Twice weekly applications of Nexagon® medium dose in addition to off-loading using a Removable Cast Walker Receives: Drug: Nexagon® Medium Dose |
| Nexagon® High Dose | Experimental | Twice weekly applications of Nexagon® high dose in addition to off-loading using a Removable Cast Walker Receives: Drug: Nexagon® High Dose |
| Nexagon® vehicle | Placebo comparator | Twice weekly applications of Nexagon® vehicle in addition to off-loading using a Removable Cast Walker Receives: Drug: Nexagon® vehicle |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of Reference Diabetic Foot Ulcer (RDFU) complete closure determined by Investigator Assessment
Measured: Within 12 weeks
Secondary outcomes (5)
Percentage change in RDFU surface area
Measured: Within 12 weeks
Time to RDFU complete closure
Measured: Within 12 weeks
Percentage of granulation tissue in RDFU
Measured: 12 weeks
Incidence of ulcer recurrence
Measured: 12 weeks post-closure
Incidence of adverse events
Measured: 12 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Dec 2011 (estimated)
- Study startJul 2012
- Primary completionFeb 2014
- Study completionApr 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Diabetic Foot UlcersStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 168 participants (actual)
Sponsor and investigators
- Lead sponsor
- OcuNexus Therapeutics, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- David G Armstrong, DPM MD PhD, Principal investigator, S.A.L.S.A. , University of Arizona, Tucson, AZ
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01490879
- Sponsor's protocol ID
- NEX-ULC-011
- Acronym
- DUNE
- Status last verified
- Apr 2014
- First submitted
- 11 Dec 2011
- Last updated
- 1 May 2014
- Results posted
- No
- Data monitoring committee
- Yes
Study at a glance
From the registry record, last updated by the sponsor on 1 May 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Prospective, Double-blind, Vehicle-controlled, Dose-ranging, Multi-center Study to Assess the Safety and Clinical Effect of Nexagon® in the Treatment of Subjects With a Diabetic Foot Ulcer
- ClinicalTrials.gov ID
- NCT01490879
- Acronym / sponsor ID
- DUNE / NEX-ULC-011
- Conditions
- Diabetic Foot Ulcers
- Keywords
- DFU, Diabetic Foot Ulcer, Ulcers, Foot Ulcers, chronic wound, wounds, Nexagon, CoDa
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 168 participants (actual)
- Lead sponsor
- OcuNexus Therapeutics, Inc.Industry (pharma, biotech, devices)
- Study start
- Jul 2012
- Primary completion
- Feb 2014 (actual)
- Study completion
- Apr 2014 (actual)
- First posted
- 13 Dec 2011 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study is for Type I or Type II diabetic subjects with with a diabetic foot ulcer. The study is being done to determine if Nexagon® plus standard of care is more effective than placebo plus standard of care. Standard of care will include debridement of the ulcer, standardized dressings and standardized off-loading using a Removable Cast Walker.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 4
| Arm | Type | Receives |
|---|---|---|
| Nexagon® Low Dose | Experimental | Drug: Nexagon® Low DoseTwice weekly applications of Nexagon® low dose in addition to off-loading using a Removable Cast Walker |
| Nexagon® Medium Dose | Experimental | Drug: Nexagon® Medium DoseTwice weekly applications of Nexagon® medium dose in addition to off-loading using a Removable Cast Walker |
| Nexagon® High Dose | Experimental | Drug: Nexagon® High DoseTwice weekly applications of Nexagon® high dose in addition to off-loading using a Removable Cast Walker |
| Nexagon® vehicle | Placebo comparator | Drug: Nexagon® vehicleTwice weekly applications of Nexagon® vehicle in addition to off-loading using a Removable Cast Walker |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Diagnosis of diabetes mellitus (Type I or II)
- HbA1c of less than or equal to 12.0%
- Diagnosis of neuropathic foot ulcer with partial or complete neuropathy
- Cutaneous ulcer on the plantar or dorsal aspect of the foot or toe that is greater or equal to 1.0cm2 and less than or equal to 8.0 cm2 in area at the end of the screening period and is full thickness with no exposed ligament, tendon, joint capsule or bone. Surface area will be measured by digital planimetry.
- The Medical Monitor(or delegate)must confirm that the reference diabetic foot ulcer (RDFU)is suitable for inclusion after reviewing digital photographs
Key exclusion criteria (14 listed)
- Any unstable medical condition that would cause the study to be detrimental to the subject.
- Decrease in RDFU size by more than 40% or increase in the ulcer size by more than 40% during the 14-day screening period as measured by digital planimetry.
- Ulcers caused primarily by untreated vascular insufficiency or ulcers with an etiology not related to diabetes.4. Ulcers above the ankle.
- 5. Ulcers that cannot be effectively off-loaded using the cast walker and sole insert provided in this study (ulcers not located on the weight bearing surface of the foot do not require off-loading).
- 6. Ulcers on the toes not accessible for photography (e.g. in the web space). 7. Presence of other ulcers within 2cm of the perimeter of the RDFU. 8. BMI > 45 9. Cannot tolerate or will not comply with the off-loading method, or non-compliance with standard or care.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Nexagon® Low DoseTwice weekly, topical application of Nexagon® low dose in addition to a Removable Cast Walker | Drug | Nexagon® Low Dose |
| Nexagon® Medium DoseTwice weekly, topical application of Nexagon® medium dose in addition to a Removable Cast Walker | Drug | Nexagon® Medium Dose |
| Nexagon® High DoseTwice weekly, topical application of Nexagon® high dose in addition to a Removable Cast Walker | Drug | Nexagon® High Dose |
| Nexagon® vehicleTwice weekly, topical application of Nexagon® vehicle in addition to a Removable Cast Walker | Drug | Nexagon® vehicle |
Primary outcome
Incidence of Reference Diabetic Foot Ulcer (RDFU) complete closure determined by Investigator Assessment
Time frame: Within 12 weeks
5 secondary outcomes
Percentage change in RDFU surface area
Time frame: Within 12 weeks
Time to RDFU complete closure
Time frame: Within 12 weeks
Percentage of granulation tissue in RDFU
Time frame: 12 weeks
Incidence of ulcer recurrence
Time frame: 12 weeks post-closure
Incidence of adverse events
Time frame: 12 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 May 2014.
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Wearable Insoles for Recurrent Diabetic Ulcer Prevention
Diabetes, Peripheral Neuropathy
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Evaluation of Personalized Nutritional Intervention on Wound Healing of Cutaneous Ulcers in Diabetics
Foot, Diabetic
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Efficacy Evaluation of Turmeric-Derived Nanoparticle Hydrogel for the Treatment of Diabetic Foot Ulcer Wounds
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Better Care Closer to Home: Enhancing Primary and Community Care
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David G Armstrong, DPM MD PhD principal investigator
S.A.L.S.A. , University of Arizona, Tucson, AZ
25 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Nexagon® Low Dose, Nexagon® Medium Dose and Nexagon® High Dose in people with Diabetic Foot Ulcers, run by OcuNexus Therapeutics, Inc. at 25 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 1 May 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 25 sites in United States, Russia, Ukraine. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incidence of Reference Diabetic Foot Ulcer (RDFU) complete closure determined by Investigator Assessment (time frame: Within 12 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 May 2014.