The purpose of this trial is to evaluate the safety and between-group effect size of STIMULAN VG compared to SoC treatment in patients with diabetic foot osteomyelitis (DFO).
This trial is an open-label, multi-center, randomized, controlled feasibility trial. All participants will undergo surgical debridement and receive either STIMULAN VG and an abbreviated course of systemic antibiotic therapy (3 days ±2 days) or a full course (4-6 weeks) of systemic antibiotic therapy. The total duration of study is Approximately 55 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
61
Participants will receive STIMULAN VG via implantation during debridement surgery on Day 1.
Participants will receive Antibiotics per site-specific requirements.
Titan Clinical Research
Mesa, Arizona, United States
Axsendo Clinical Research
Phoenix, Arizona, United States
Perseverance Research Center, LLC
Scottsdale, Arizona, United States
Number of participants with confirmed absence of clinical signs of osteomyelitis or surgical infection at the index site
Confirmed absence of clinical signs of osteomyelitis or surgical site infection at the index site will be evidenced by Negative Probe to Bone Test (PTB), absence of draining sinus presumed to be from underlying bone and MRI scan at Week 24.
Time frame: Week 24
Number of participants with no clinical need for further antibiotic therapy for infection at the index site
Need for further antibiotic therapy for infection at the index site will be assessed at Week 24.
Time frame: Week 24
Number of participants with no clinical need for further additional surgical procedure or debridement to treat infection at the index site
Need for further additional surgical procedure or debridement to treat infection at the index site will be assessed at Week 24.
Time frame: Week 24
Ulcer healing per the University of Texas (UT) Staging System for Diabetic Foot Ulcers
The Investigator will assess the ulcer for healing using the UT Staging System for Diabetic Foot Ulcers which grades DFUs by grade (0, I, II, III) and stage (A, B, C, D), depending on the presence or absence of infection and ischemia. The grades are referred to as follows: grade 0 (pre-or post-ulcerative site that has healed), grade 1 (superficial ulcer not involving tendon, capsule, or bone), and grade 2 (ulcer penetrating to tendon or capsule), and grade 3 (ulcer penetrating bone or joint). The patient will be scored based on Grade score and stage score together. Grade 0, stage A considered being low severity, and Grade 3, stage D considered to be more severe.
Time frame: Week 12
Number of participants with occurrence of reinfection at the index site
Number of participants with the occurrence of reinfection at the index site will be assessed via PTB, absence of draining sinus presumed to be from underlying bone and MRI at Week 52.
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Advanced Footcare LLC
Scottsdale, Arizona, United States
NEA Baptist Clinic
Jonesboro, Arkansas, United States
Viable Clinical Research
Henderson, Nevada, United States
Equitable Health Partners - NJ
Mountainside, New Jersey, United States
Mount Sinai West
New York, New York, United States
UNC School Medicine
Chapel Hill, North Carolina, United States
Seaside Clinical Research Institute
Wilmington, North Carolina, United States
Time frame: Week 52
Number of participants with no clinical need for further antibiotic therapy for infection at the index site
Need for further antibiotic therapy for infection at the index site will be assessed at Week 52.
Time frame: Week 52
Number of participants with no clinical need for further additional surgical procedure or debridement to treat infection at the index site
Need for further additional surgical procedure or debridement to treat infection at the index site will be assessed at Week 52.
Time frame: Week 52
Relative change from baseline in Cardiff Wound Impact Schedule (CWIS) quality of life assessment
The CWIS is designed and validated to specifically assess the quality of life (QoL) of subjects with chronic wounds (leg ulcers and diabetic foot ulcers (DFU)). This questionnaire contains 47 items divided into four scales: demographic and clinical characteristics (3 items), global health-related quality of life (HRQoL) (1 item), satisfaction with HRQoL (1 item) and impact of the wound on lifestyle. This last scale includes 3 domains: social life (14 items in total, 7 related to stress and 7 to experience), wellbeing (7 items), and physical symptoms and everyday living (24 items in total, 12 related to stress and 12 to experience). All three domains are scored on a 5-point scale, from "not at all" to "always". Thus, the total score includes the patient's perception of the experience and the associated stress. The final score ranges from 0 (poorer QoL) to 100 points (higher QoL) where a high score indicates a positive rating
Time frame: Week 24
Number of participants with adverse events
The number of participants with adverse events will be assessed.
Time frame: Week 52
Number of participants discontinuing therapy prematurely due to a treatment related event
The number of participants discontinuing therapy prematurely due to a treatment-related event will be assessed during the course of the trial and recorded on the participants electronic case report form (eCRF).
Time frame: Week 52
Number of hospitalizations/re-hospitalizations as a result of treatment for osteomyelitis or ulceration at the index site
The number of hospitalizations/re-hospitalizations as a result of treatment for osteomyelitis will be assessed during the course of the trial and recorded on the participants eCRF.
Time frame: Week 52
Number of participants undergoing amputation at the index site
The number of participants undergoing amputation at the index site will be assessed during the course of the trial and recorded on the participants eCRF.
Time frame: Week 52
Number of systemic antibiotic free days since trial surgery
The total number of days from Day 1 to week 24 without the use of antibiotics.
Time frame: Week 52