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This study is a double-blind, one center, two-arm study with a two (2) week Run-In, evaluating the efficacy of a once-daily administration of NanoDOX™ Hydrogel topically applied to diabetic ulcers in concert with professionally administered Standard of Care (SOC) procedures as described by Standard Operating Procedure(s) of the Department of Veterans Administration Hospitals. During the run-in period patients with infected wounds will receive oral antibiotic and not be included in the topical portion of the study until the infection is shown by wound fluid analysis to be resolved. Following a two (2) week Run-In of all patients to receive SOC treatment for diabetic ulcers, patients would have either the investigational material or the placebo hydrogel applied as a part of their wound care. Each patient would receive 1.5 gm packets of either the test article or the placebo hydrogel for a once-daily home treatment accompanied by a dressing change.
Study of NanoDOX vs placebo on diabetic ulcers of the lower leg/foot.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NanoDOX™ Hydrogel | Experimental | 1.0% doxycycline gel |
|
| Placebo | Placebo Comparator | placebo gel |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| doxycycline | Drug | 1.0% doxycycline gel applied topically to the wound once daily for 20 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Without Adverse Events | Participants were monitored for 20 weeks during the study. | every 2 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Analyze the Molecular Changes in Pro-inflammatory Cytokine Levels That Occur in Diabetic Foot Ulcers as a Function of Healing Rate in the Presence /Absence of NanoDOX Hydrogel (1% Doxycycline Monohydrate Gel) | baseline, week 4, week 10, week 20 |
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Inclusion Criteria:
Have a documented history of type I or type II diabetes mellitus as defined by the American Diabetes Association
Women of childbearing potential must have a negative urine pregnancy test at screening and at baseline, and:
• Agree to use a double-barrier method of contraception during their participation in this study;
Have an ulcer on the lower extremity (distal to a line connecting the medial and lateral malleoli) that has been present for at least 3 weeks and that is 1.2 cm2 to 4.0 cm2 at initial screening
Be able to apply study drug to their ulcer, or have a caregiver do it
Adequate blood flow to target ulcer extremity as measured by transcutaneous oxygen tension (TcpO2) of >30mmHg
Target ulcer is Grade I according to the Wagner Grading Scale
Quantitative bacterial count of of < 1.0 x 1.0E5 per gram of tissue for non-infected ulcers
Quantitative bacterial count of ≥ 1.0 x 1.0E5 per gram of tissue for infected ulcers
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| John Abernethy, MD | Alachua Government Services, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| North Florida / South Georgia Veterans Administration Hospital | Gainesville | Florida | 32608 | United States |
adult subjects with diabetic lower extremity ulcers were enrolled into the study after determination that the wound was not infected
subjects were recruited through the local veterans administration clinics
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| ID | Title | Description |
|---|---|---|
| FG000 | NanoDOX™ Hydrogel | 1.0% doxycycline gel |
| FG001 | Placebo | placebo gel |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | NanoDOX™ Hydrogel | 1.0% doxycycline gel |
| BG001 | Placebo | placebo gel |
| BG002 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants Without Adverse Events | Participants were monitored for 20 weeks during the study. | Posted | Number | participants | every 2 weeks |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | NanoDOX™ Hydrogel | 1.0% doxycycline gel |
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enrollment stopped before reaching the initial 40 subjects anticipated due to slow enrollment of subjects
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| John Abernethy, MD - Medical Director | Nanotherapeutics, Inc. | 386-462-9663 | 326 | jabernethy@nanotherapeutics.com |
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| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| D014456 | Ulcer |
| D014947 | Wounds and Injuries |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
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| ID | Term |
|---|---|
| D004318 | Doxycycline |
| ID | Term |
|---|---|
| D013754 | Tetracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
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| placebo gel | Drug | placebo gel applied topically to the wound once daily for 20 weeks |
|
|
| Total |
Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
| Secondary | Analyze the Molecular Changes in Pro-inflammatory Cytokine Levels That Occur in Diabetic Foot Ulcers as a Function of Healing Rate in the Presence /Absence of NanoDOX Hydrogel (1% Doxycycline Monohydrate Gel) | Not Posted | baseline, week 4, week 10, week 20 | Participants |
| 0 |
| 8 |
| 0 |
| 8 |
| EG001 | Placebo | placebo gel | 0 | 7 | 0 | 7 |
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| D007871 |
| Leg Ulcer |
| D012883 | Skin Ulcer |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D048909 | Diabetes Complications |
| D003920 | Diabetes Mellitus |
| D004700 | Endocrine System Diseases |
| D003929 | Diabetic Neuropathies |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006844 |
| Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |