The primary objective is to explore the mechanistic role of ON101 cream in healing diabetic foot ulcers by determining the molecular targets of ON101 cream. Primary endpoint: Percentage change from baseline in the expression level of individual target gene(s) at protein and/or mRNA level. Secondary endpoints: 1. Comparison of the gene and/or protein expression level of individual target between ON101 and Placebo groups 2. Change from baseline in the wound microbiota composition in each group 3. Comparison of the wound microbiota composition between ON101 and Placebo groups 4. Comparison of the wound reduction rate in each group 5. Correlation of wound reduction rate with the alternated level of each target gene in each group. Safety endpoints: Incidence of treatment-emergent adverse event (AE) Change from baseline in vital signs, physical examination, and laboratory tests
This is a multicenter, randomized, double-blind, placebo-controlled study to explore the mechanism of action (MOA) of ON101 in treating chronic diabetic foot ulcers (DFUs). There will be 6 subjects ON101 treatment (Arm A) and 6 subjects in Placebo (Arm B) . Twelve(12) eligible subjects with DFUs and are not undergoing dialysis will be enrolled and randomly assigned to receive either ON101 treatment (Arm A) or Placebo (Arm B) for six weeks. Treatment arm allocation will be done through randomization in a double-blind fashion. SoC will be provided throughout the study period.Subjects with DFUs not undergoing dialysis, N = 12 Arm A: ON101 plus SoC, N = 6 Arm B: Placebo plus SoC, N =6 SoC will be provided throughout the study period (from screening to end of treatment). SoC includes evaluation to ensure adequate arterial flow, wound cleaning, removal of necrotic, infected and/or nonviable tissue by debridement, maintenance of moist wound environment via regular changing of dressings, and management of infection through oral antibiotics, if necessary. The study will have three periods, a Screening/Run-in Period, a Treatment Period, and a Safety Follow-up Period. Screening/Run-in Period (14 days): Treatment Period (up to 6 weeks ± allow window): There will be five (5) visits during the Treatment Period. Baseline/V1 (Day 1 ± 3 days) Visit 2 to Visit 5/EOT (Day 14 to Day 42/EOT) Safety Follow-up Period (Day 49±1 or Day of EOT + 6-8 days)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
13
Active ingredients: Extracts of Plectranthus amboinicus and Centella Asiatica
Placebo
Kueiho Chen
Taipei, Taiwan
Primary endpoint:Q-RT-PCR, for the inflammation stage and the remodeling stage
Percentage change from baseline in the expression level of individual target gene(s) at protein and/or mRNA level, usch as Q-RT-PCR, Cytokine, Chmokine, GFs.
Time frame: Through study completion, an average of 1 year
Secondary endpoint (1): IL-1b, IL-6, TNF, TGF, CXCL9, FGF2, and IL1RN!..ect.
Comparison of the gene and/or protein expression level of individual target between ON101 and Placebo groups, through Q-RT-PCR, between inflammation stage and remodeling stage
Time frame: Based on each visit window for the first review, and through study completion, an average of 1 year for the final review
Secondary endpoint (2): iNOS, CD86, CD80, CD163, CD206, KRT14, MMP12..ect.
Change from baseline in the wound microbiota composition in each group, through IHC, analysis macrophage marker, epithelization, fibroblast maker, collagen, EPC and angiogenesis
Time frame: Based on each visit window for the first review, and through study completion, an average of 1 year for the final review
Secondary endpoint (3): CO15A1, CD71, CD34..ect
Comparison of the wound microbiota composition between ON101 and Placebo groups, through IHC, between inflammation stage and remodeling stage.
Time frame: Based on each visit window for the first review, and through study completion, an average of 1 year for the final review
Secondary endpoint (4):target ulcer size evaluation report (Area: perimeter, length, width )
Comparison of the wound reduction rate in each group,through target ulcer size evaluation report (Area: perimeter, length, width )
Time frame: Based on each visit window for the first review, and through study completion, an average of 1 year for the final review
Secondary endpoint (5): wound reduction rate of each target gene in each group
Correlation of wound reduction rate with the alternated level of each target gene in each group, through IHC and target ulcer report.
Time frame: Based on each visit window for the first review, and through study completion, an average of 1 year for the final review
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