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DiabetesNCT03626623

Diabetic Foot Ulcer Study Comparing Cytal Wound Matrix 1-Layer to Standard of Care

A study testing Cytal Wound Matrix 1-Layer in people with Diabetes and Diabetic Foot, run by Integra LifeSciences Corporation at 3 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a two-armed randomized controlled trial (RCT) primarily aimed at determining if application of Cytal Wound Matrix 1-Layer intervention to diabetic foot ulcers shows improved wound closure rates when compared to standard care intervention. Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Diabetes, Diabetic Foot, Diabetes Mellitus, Type 2
What is being tested?
Cytal Wound Matrix 1-Layer
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
15 participants
Where
3 sitesUnited States
Study dates
21 May 2019to 18 Feb 2020
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • In order to be eligible to participate in this study, an individual must meet all of the following criteria:
  • Provision of signed and dated informed consent form by subject or legally authorized representative.
  • Stated willingness to comply with all study procedures and availability for the duration of the study. Subject is able and willing to tolerate non-removable offloading device for the duration of the run-in and intervention phases of the study.
  • Subject is male or female and at least 21years of age.
  • Subject has a clinical diagnosis of type 1 or type 2 diabetes.
  • Subject's current foot ulcer(s) has been present for > 30 days and ≤ 365 days.
Show all 15Show fewer
  • Subject's current foot ulcer(s), post-debridement is/are predominantly below the malleoli and on the plantar surface of the foot.
  • Subject's foot ulcer(s) must be Wagner type 1 or type 2.
  • Post debridement, subject's ulcer(s) are free of necrotic debris and appear to be comprised of healthy, vascularized tissue.
  • All qualifying ulcers are ≥ 5cm away from any other ulcer on the same foot.
  • Subject's ulcer(s) is ≥ 1cm2 and ≤ 20cm2 at randomization (length x width).
  • Subject's HbA1C reading is ≤10%.
  • Subject's Serum Creatinine ≤ 3.0mg/dL.
  • Subject has adequate circulation to the foot as measured by Ankle-Brachial Index (ABI) ≥ 0.7.
  • Negative pregnancy test at randomization for women.

Who cannot join

  • An individual who meets any of the following criteria will be excluded from participation in this study:
  • Subject is pregnant, breastfeeding, or unwilling to practice birth control during participation in the study, if applicable.
  • Allergy or hypersensitivity to materials in porcine-based study products (per subject report) or personal preference.
  • Subject report of concurrent participation in another clinical trial that involves a drug.
  • The subject has any condition that, in the Investigator's opinion, would warrant exclusion from the study or prevent the subject from completing the study.
  • Subject has clinical evidence of gangrene on any part of the affected foot.
Show all 24Show fewer
  • The subject's ulcer(s) is/are due to a non-diabetic etiology, ulcers of arterial, venous stasis, pressure, radiation, traumatic, rheumatoid, vasculitis, collagen vascular disease, or other non-diabetic etiologies.
  • Subject has unstable Charcot foot, Charcot foot with a bony prominence(s) or Charcot amputation.
  • Qualifying wound(s) is connected to another ulcer via a fistula.
  • Subject has one or more medical condition(s) including: renal, hepatic, hematological, neurologic, or immune disease that in the opinion of the Investigator would make the subject an inappropriate candidate for this wound healing study.
  • Subject has or has had a malignant disease (other than basal cell carcinoma) that has not been in remission for at least five years.
  • Subject is receiving oral or parenteral corticosteroids, immunosuppressive or cytotoxic agents, or is anticipated to require such during the course of the study.
  • Subject has acute osteomyelitis of the affected foot.
  • Subject's ulcer(s) is accompanied by active cellulitis.
  • Subject has received growth factor or enzymatic therapy within 2 weeks of consent.
  • Subject is currently receiving or has received radiation, radiologic implants, or chemotherapy.
  • Subject is allergic to any of the primary or secondary dressing materials, including occlusive dressings and the adhesives on such dressings.
  • Subject's ulcer(s) has decreased in size by >30% during the run-in phase.
  • Subject's ulcer(s) has increased in size by >50% during the run-in phase.
  • Subject's ulcer(s) has tunnels or sinus tracts that cannot be completely debrided.
  • Subject has severe malnutrition as evidenced by albumin <2.0 g/dL.
  • Subject has a bleeding disorder as documented by a diagnosis of a bleeding disorder.
  • Subject is on dialysis.
  • Any DFU(s) is infected and has not been treated for any clinically suspected infection prior to application of any product.

Trial locations and contacts

3 sites in 1 country.

United States3 sites
  • Limb Preservation Platform, Inc.

    Fresno, California, 93710

  • MedStar Health Research Institute

    Hyattsville, Maryland, 20782

  • Louisiana State University Health Science Center (LSUHSC)

    New Orleans, Louisiana, 70112

Other trials in United States

About this study

Official title: A Prospective, Randomized, Controlled Trial Comparing Cytal Wound Matrix 1-Layer to Standard of Care (SOC) in the Management of Diabetic Foot Ulcers (DFUs)

This is a two-armed randomized controlled trial (RCT) primarily aimed at determining if application of Cytal Wound Matrix 1-Layer intervention to diabetic foot ulcers shows improved wound closure rates when compared to standard care intervention.

Read the detailed description

This is a prospective, two-armed, multi-center randomized controlled trial (RCT) comparing Cytal Wound Matrix 1-Layer intervention to standard of care (SOC) intervention in patients presenting with diabetic foot ulcers (DFU). Up to one hundred and fifty patients recruited from US based medical centers and randomized (using a 2(active):1(control) randomization scheme) to receive either Cytal Wound Matrix 1-Layer intervention or standard of care intervention.Complete wound closure incidence, wound healing rates, wound recurrence, and various health related quality of life (HRQOL) outcomes will be compared between study arms. Additionally, a cost effective analysis (i.e. direct and indirect costs) and review of individual and group changes in narcotic prescription patterns will also be evaluated. While incidence of wound closure rates will be evaluated through 12 weeks, protocol defined patient follow-up is for two years.

Data will be captured for remaining study objectives during these two years. An independent biostatistician will review all participant data for power and futility analysis. In addition, a clinical events committee (CEC) will adjudicate all adverse events (AEs) and serious adverse events (SAEs).

Being tested
Cytal Wound Matrix 1-Layer, Standard of Care (SOC)
Keywords
Diabetes, Foot Ulcer
Medical subject headings
Diabetes Mellitus, Diabetic Foot, Diabetes Mellitus, Type 2, Diabetes Mellitus, Type 1, Foot Ulcer

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Cytal Wound Matrix 1-LayerDevice

    Cytal® Wound Matrix 1-Layer is composed of a porcine (pig) derived extracellular matrix known as urinary bladder matrix. It is intended for the management of a variety of wounds.The individual device is intended for one time use.

  • Standard of Care (SOC)Other

    Standard of care (SOC) is defined as the usual care a licensed health care provider would give patients to treat diabetic foot ulcers or wounds. SOC associated procedures and policies may vary across clinical settings.

Study groups in NCT03626623
Study groupRoleWhat they receive
Standard of Care (SOC)Placebo comparatorThe usual care a licensed health care provider would give patients to treat diabetic foot ulcers or wounds.
Receives: Other: Standard of Care (SOC)
Cytal Wound Matrix 1-LayerActive comparatorThe application of the Cytal Wound Matrix 1-Layer device according to the Cytal Wound Matrix 1-Layer instructions for use (IFU).
Receives: Device: Cytal Wound Matrix 1-Layer

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Wounds With Wound Closure

    The primary endpoint of the study is to measure the incidence of complete wound closure (defined as 100% epithelialization) between randomized groups. Number of wounds was calculated as the total across all participants.

    Measured: up to 12 weeks

Secondary outcomes (14)
  1. Wound Size Change

    Measure changes in wound size, measured in cm2/week between randomized groups.

    Measured: up to 12 weeks

  2. Complete Wound Closure Time

    Measure time to complete wound closure between randomized groups.

    Measured: up to 12 weeks

  3. Wound Recurrence

    Measure wound recurrence after healing is complete between randomized groups.

    Measured: at 26 week visit and 52 week visit

  4. Short Form-20 (SF-20)

    The Short Form-20 is a 20-item questionnaire used to assess generic health outcomes from the participant's perspective. Scores are linearly measured from 0 (worst) to 100 (best) health functioning scores, respectively.

    Measured: Baseline visit, visit #7, visit #13, 26 wk. visit, and 52 wk.visit

  5. Diabetic Foot Ulcer Scale- Short Form (DFS-SF)

    The diabetic foot ulcer scale- short form (DFS-SF) is a 29-item questionnaire designed to assess the impact of diabetic foot ulcers (DFUs) and their intervention on quality of life of participants diagnosed with diabetes. Scores measured from 0 (lower) to 100 (higher) quality of life, respectively.

    Measured: Baseline visit, 26 week visit, and 52 week visit

  6. Visual Analogue Scale (VAS) for Pain

    The visual analogue scale (VAS) is a psychometric response scale for pain. It measures subjective characteristics or attitudes regarding perceived pain levels from participants. Participants are asked to draw a vertical line on a 10 cm horizontal line indicating what their current pain level would be. The distance between the start of the horizontal line to the vertical line is calculated in cm with a higher score (100) indicating greater pain intensity.

    Measured: Up to 52 week visit (until study completion)

  7. Katz Index of Independence in Activities of Daily Living (KATZ ADL)

    The Katz ADL is a 6-item questionnaire measuring independence in activities of daily living such as bathing, dressing, toileting, transfers, feeding, and continence. Each item is dichotomized as either having a score of zero (i.e. dependence) or one (i.e. independence). This will be completed with the aid of a trained study staff member.

    Measured: Baseline visit, visit 7, visit 13, 26 wk visit, and 52 wk visit

  8. Adverse Events Frequency

    This outcome measures diabetic foot ulcer (DFU) related adverse event frequency including unexpected adverse device events (UADEs) or serious adverse experiences (SAEs) throughout the duration of the study as well as evaluate such adverse event frequencies between randomized groups.

    Measured: up to 52 week visit (until study completion)

  9. Narcotic Prescription Changes Between Trial Arms

    This outcome measures changes in number of diabetic foot ulcer (DFU) related narcotic prescriptions by study participant and between randomized groups.

    Measured: up to 52 week visit (until study completion)

  10. Participant Ambulatory Status

    This outcome measures any changes in ambulatory status (i.e. bed, wheel chair, walk w/ assistance, or walk independent) by study participant and between randomized groups.

    Measured: up to 52 week visit (until study completion)

  11. Return to Work Status

    This outcome measures differences in "return to work status" and/or "reported work status", activities of daily living, or disability status by study participant and between randomized groups.

    Measured: up to 52 week visit (until study completion)

  12. Diabetic Foot Ulcer (DFU) Specific Ancillary Medical Care

    This outcome measures the incidence of diabetic foot ulcer (DFU) specific related medical care a study participant receives outside of the medical care provided by the investigator. Examples of ancillary care include, but are not limited to, emergency room (ER) visits, urgent care visits, outside medical procedures such as surgery, etc. The incidence of subjects requiring ancillary medical care will be tabulated and compared between randomized groups. This data will be collected via two questions (i.e. "Did participant receive any ancillary medical care?" and "If "yes", then specify where"). Responses are verified using source documentation.

    Measured: up to 52 week visit (until study completion)

  13. Diabetic Foot Ulcer (DFU) Related Direct Product(s) Costs

    This outcome measures direct costs of the products by total cost per subject stratified by healed vs. non healed DFU.

    Measured: up to 52 week visit (until study completion)

  14. Indirect Diabetic Foot Ulcer (DFU) Product(s) Costs

    This outcome measures total indirect and incidental costs of diabetic foot ulcer products used per study participant by each visit.

    Measured: up to 52 week visit (until study completion)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Aug 2018
  2. Study start21 May 2019
  3. Primary completion18 Feb 2020
  4. Study completion18 Feb 2020

Why it stopped: Sponsor Discretion

Resources

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
15 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03626623
Sponsor's protocol ID
CR2017-006
Status last verified
Aug 2021
First submitted
12 Jun 2018
Last updated
25 Aug 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Chen YH, DeMets DL, Lan KK. Increasing the sample size when the unblinded interim result is promising. Stat Med. 2004 Apr 15;23(7):1023-38. doi: 10.1002/sim.1688.

    PubMed 15057876
  • Dumville JC, O'Meara S, Deshpande S, Speak K. Hydrogel dressings for healing diabetic foot ulcers. Cochrane Database Syst Rev. 2013 Jul 12;2013(7):CD009101. doi: 10.1002/14651858.CD009101.pub3.

    PubMed 23846869
  • Wu L, Norman G, Dumville JC, O'Meara S, Bell-Syer SE. Dressings for treating foot ulcers in people with diabetes: an overview of systematic reviews. Cochrane Database Syst Rev. 2015 Jul 14;2015(7):CD010471. doi: 10.1002/14651858.CD010471.pub2.

    PubMed 26171906
  • Bann CM, Fehnel SE, Gagnon DD. Development and validation of the Diabetic Foot Ulcer Scale-short form (DFS-SF). Pharmacoeconomics. 2003;21(17):1277-90. doi: 10.2165/00019053-200321170-00004.

    PubMed 14986739
  • Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes. 2015 Feb 15;6(1):37-53. doi: 10.4239/wjd.v6.i1.37.

    PubMed 25685277
  • Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons NB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651-8. doi: 10.2337/dc13-2176. Epub 2013 Nov 1.

    PubMed 24186882
  • Margolis DJ, Kantor J, Berlin JA. Healing of diabetic neuropathic foot ulcers receiving standard treatment. A meta-analysis. Diabetes Care. 1999 May;22(5):692-5. doi: 10.2337/diacare.22.5.692.

    PubMed 10332667

Questions about this trial

What is this clinical trial studying?

A study testing Cytal Wound Matrix 1-Layer in people with Diabetes and Diabetic Foot, run by Integra LifeSciences Corporation at 3 sites in United States.

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 15 inclusion and 24 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: stopped early, as of the sponsor's last update on 25 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in United States. 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.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Feb 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Number of Wounds With Wound Closure (time frame: up to 12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03626623, which also lists 7 linked publications.

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 25 Aug 2021.

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Clinical Trial NCT03626623 | AzTrials