Safety, Tolerability and Efficacy of CYP-006TK in Adults with Diabetic Foot Ulcers

A Randomised, Controlled, Phase 1 Study to Investigate Safety, Tolerability and Efficacy of CYP-006TK in Adults with Diabetic Foot Ulcers

Design: A randomised, controlled, prospective trial. Participants will be patients with non-healing diabetic foot ulcers.

The study will aim to recruit 15 participants per study group (30 participants in total). Participants will be randomly allocated to one of two treatment groups:

• Group 1: CYP-006TK
• Group 2: Standard care This will be an open label study with respect to treatment allocation. However, the person reviewing images of the study ulcers to assess healing will be blind to the participant's treatment allocation.

Participants assigned to Group 1 will be treated with CYP-0006TK dressings on 8 occasions over 4 weeks. The dressings will be changed every 3 or 4 days. After the first 4 weeks, participants in Group 1 will revert to standard care for the rest of the study. Participants assigned to Group 2 will have their ulcer treated with standard care throughout the study.

Participants will attend a total of 16 scheduled visits over 24 weeks. There will be a mixture of on-site (hospital/clinic) visits, and home visits. The study will end 24 weeks after the initiation of treatment, unless the study ulcer is completely headed before then.

Inclusion Criteria:

1. Adults at least 18 years of age up to 80 years of age, inclusive.
2. Have a current diagnosis of diabetes mellitus (DM)
3. With at least one non-healing cutaneous ulcer on the foot or the lower legs
4. With ankle brachial index (ABI) ≥ 0.4 and/or toe pressure >30 mmHg on the limb with the study ulcer.
5. Participant co-morbidities are adequately managed, and the participant has a life expectancy of at least 6 months as determined by the Investigator based on medical history, physical examination, vital signs, or clinical laboratory tests, etc.
6. A negative pregnancy test, (i.e. for female participants with childbearing potential).
7. Willing to comply with birth control measures, to prevent female participants becoming pregnant for six months following administration of the study treatment.
8. Able to follow the Investigator's instruction on ulcer care (in the opinion of the Investigator).
9. Agrees to provide written informed consent.

Exclusion Criteria:

1. Planned vascular surgery, angioplasty, thrombolysis or amputation of the affected limb in the next six months.
2. Pregnant or breastfeeding.
3. Active infection in the study ulcer.
4. Any sign of osteomyelitis associated with the study ulcer.
5. Study ulcer extends to bone or periosteum (ulcers that reach a ligament, joint capsule, fascia, or tendon are not excluded).
6. Study ulcer requires daily dressing changes.
7. Known autoimmune disease other than diabetes, including but not limited to lupus erythematosus, multiple sclerosis which are considered as clinically significant by PI and/or Medical Monitor.
8. Treatment with systemic immunosuppressants within 90 days of screening.
9. Active malignancy or history of malignancy within five years prior to screening (with the exception of a past history of basal or squamous cell carcinomas).
10. Serum GGT, AST or ALT > 5 × upper limit of the normal range (ULN).
11. . Known history of HIV infection
12. Prior administration of any cell-based treatment to the limb affected by the study ulcer.
13. Received any investigational research agent within 60 days or within five half-lives of the last treatment (if the half-life of the investigational agent is known to be longer than 12 days) prior to the planned initiation of study treatment.
14. Any other medical condition or laboratory abnormality judged as clinically significant by the Investigator or study Medical Monitor which could confound the evaluation of the trial treatment.
15. With history of sensitivity to materials of bovine, porcine origin, or human serum albumin.