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The objective of this study is to evaluate the percentage of patients with complete diabetic foot ulcer (DFU) closure following up to 12 weeks of treatment with either dehydrated human amnion/chorion membrane (dHACM) plus standard of care (SOC) or SOC alone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Other | Standard of Care: Moist Wound Therapy and Offloading |
|
| EpiFix plus Standard of Care | Experimental | Weekly application of EpiFix (up to 12 week) and standard of care (moist wound therapy and offloading) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Standard of Care: Moist Wound Therapy and Offloading | Other | Standard of Care: Moist Wound Therapy and Offloading |
|
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of subjects with complete closure of the study ulcer | Assessed by the Investigator, during treatment (Visits 1 - 13). | Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Time to complete closure for both groups | As assessed by photographic evaluation and the Investigator | Up to 12 Weeks |
| Rate of wound closure | As assessed by photographic evaluation and the Investigator |
| Measure | Description | Time Frame |
|---|---|---|
| Safety | The Safety population will be used for the analysis of safety endpoints. | Up to Week 16 |
Inclusion Criteria:
Male or female age 18 or older.
The patient is willing and able to provide informed consent and participate in all procedures and follow up evaluations necessary to complete the study.
Patient's ulcer must be diabetic in origin with a size ranging from 1 to 25 cm2. Debridement will be done prior to randomization, if clinically indicated.
Wounds should be diabetic foot ulcers located on the dorsal or plantar surface of the foot.
Patients with Type 1 or 2 diabetes (criteria for the diagnosis of diabetes mellitus per ADA).
Ulcer must be present for a minimum of 30 days before enrollment/randomization, with documented failure of prior treatment to heal the wound (≤25% wound area reduction after 14 consecutive days of therapy immediately prior to randomization when treated with standard protocol of care).
Affected leg has been offloaded (removable walker or total contact cast) for >14 consecutive days prior to randomization.
Serum Creatinine less than 3.0mg/dl (within last 6 months).
HbA1c less than 12% within previous 60 days.
Patient has adequate circulation to the affected extremity, as demonstrated by one of the following within the past 60 days:
Females of childbearing potential must be willing to use acceptable methods of contraception (birth control pills, barriers, or abstinence).
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| William Tettelbach, MD | Intermountain Health Care, Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Central Research Associates, Inc. | Birmingham | Alabama | 35205 | United States | ||
| Stockdale Podiatry Group |
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| EpiFix plus Standard of Care | Other | Weekly application of EpiFix and Standard of Care |
|
| Up to Week 12 |
| Incidence of ulcer recurrence | Incidence of ulcer recurrence at the site of the study ulcer during the follow up phase. | Up to Week 16 |
| Quality of Life | Change in quality of life metrics as measured by SF-36 Health Survey and changes in the patient's reported pain scores as measured by the Visual Analog Scale. | Up to Week 12 |
| Cost effectiveness of treatment | Cost effectiveness of treatment regimen. | Up to Week 12 |
| Bakersfield |
| California |
| 93309 |
| United States |
| Center for Clinical Research Inc | Castro Valley | California | 94546 | United States |
| Valley Vascular Surgery Associates | Fresno | California | 93720 | United States |
| Limb Preservation Platform | Fresno | California | 93721 | United States |
| Novak Urgent Care and Family Practice | Indio | California | 92201 | United States |
| Loma Linda VA Medical Center | Loma Linda | California | 92357 | United States |
| Foot & Ankle Clinic | Los Angeles | California | 90057 | United States |
| Palmtree Clinical Research, Inc. | Palm Springs | California | 92262 | United States |
| Center for Clinical Research, Inc. | Sacramento | California | 95628 | United States |
| Center for Clinical Research | San Francisco | California | 94115 | United States |
| MetroWest Medical Center | Framingham | Massachusetts | 01702 | United States |
| South Shore Hospital | Weymouth | Massachusetts | 02190 | United States |
| Jobst Vascular Institute, Promedica Toledo Hospital | Toledo | Ohio | 43606 | United States |
| Center for Clinical Research, Inc. | Eugene | Oregon | 97401 | United States |
| Dorn VA | Columbia | South Carolina | 29209 | United States |
| Futuro Clinical Trials, LLC | McAllen | Texas | 78501 | United States |
| IMC Wound Care | Murray | Utah | 84157 | United States |
| LDS Hospital | Salt Lake City | Utah | 84143 | United States |
| Coastal Podiatry, Inc. | Virginia Beach | Virginia | 23464 | United States |
| ID | Term |
|---|---|
| D017719 | Diabetic Foot |
| ID | Term |
|---|---|
| D003925 | Diabetic Angiopathies |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016523 | Foot Ulcer |
| 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 |
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| ID | Term |
|---|---|
| D059039 | Standard of Care |
| ID | Term |
|---|---|
| D019984 | Quality Indicators, Health Care |
| D011787 | Quality of Health Care |
| D006298 | Health Services Administration |
| D017530 | Health Care Quality, Access, and Evaluation |
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