The purpose of this clinical trial is to evaluate the safety and effectiveness of the treatment with the COMS One device in subjects with refractory diabetic foot ulcers (DFUs). The prospective randomized, double-blinded, sham-controlled trial is designed to demonstrate superiority of wound closure of the COMS One device to a sham-control device through 24 weeks post-application, when each is administered in conjunction with standard of care (SOC) in the treatment of DFUs.
The purpose of this clinical trial is to evaluate the safety and effectiveness of the treatment with the COMS One device in subjects with refractory diabetic foot ulcers (DFUs). The prospective randomized, double-blinded, sham-controlled trial is designed to demonstrate superiority of wound closure of the COMS One device to a sham-control device through 24 weeks post-application, when each is administered in conjunction with standard of care (SOC) in the treatment of DFUs. Primary Objective: The COMS One Therapy System is intended to promote wound healing in chronic DFUs. As part of the clinical investigation, the primary objective is to determine time to complete wound healing, defined as complete skin re-epithelialization without drainage confirmed by 2 consecutive trial visits 2 weeks apart. Secondary Objectives: Secondary objectives are confirmation of safety and assessment of wound healing parameters as well as subject and site reported outcomes. A total of 450 subjects with refractory DFU will be screened. It is expected that 50% of subjects will be excluded from the trial if either of the following occurs between screening and randomization: \>30% wound closure over a period of 2 weeks or \>50% wound closure over a period of 4 weeks (measured post-debridement). The remaining 224 subjects will be randomized into two groups (112 Subjects Sham device treated; 112 Subjects COMS One device treated) to account for approximately 10% missing data due to early trial withdrawal or missed endpoint assessment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
450
The COMS One device incorporates technologies for optical and magnetic stimulation. The optical stimulation component is designed to emit light by two types of light emitting diodes (LEDs) in the wavelength of 660 nm (red) and 830 nm (near infrared) range of the electromagnetic spectra. The magnetic stimulation component is generated by a coil emitting pulse modulated magnetic fields in the extremely low frequency (ELF) range of the electromagnetic spectra. The COMS One is a lightweight, portable device. The device is locally applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific feature that has been modified for the purpose of blinding is sensor detecting whether the device is lying on the skin.
The Sham device is a lightweight, portable device. The device is applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific features that have been modified for the purposes of blinding include the following: 1) therapeutic output, and 2) sensor detecting whether the device is lying on the skin.
Titan Clinical Research
Mesa, Arizona, United States
RECRUITINGSouthern Arizona VA Health Care System
Tucson, Arizona, United States
RECRUITINGCenter for Clinical Research Inc.
Castro Valley, California, United States
RECRUITINGVA Central California Healthcare
Fresno, California, United States
Complete wound healing
The primary endpoint for this pivotal trial is time to complete wound closure from randomization through 24 weeks, which is defined as complete skin re-epithelialization without drainage confirmed by 2 consecutive trial visits 2 weeks apart.
Time frame: 24 weeks post-application
Time to ≥50% wound area reduction
Time in number of days until wound area is reduced by ≥50% compared to wound area at time of randomization
Time frame: Through 24 weeks
Time to ≥90% wound area reduction
Time in number of days until wound area is reduced by ≥90% compared to wound area at time of randomization
Time frame: Through 24 weeks
Incidence of complete wound closure
Incidence of complete wound closure after 8, 12, 16, 20, and 24 weeks, which is defined as complete skin re-epithelialization without drainage
Time frame: 8 week, 12 week, 16 week, 20 week and 24 week
Partial wound closure
Percent Wound Area Reduction (PWAR) at week 8, 12, 16, 20, 24
Time frame: 8 week, 12 week, 16 week, 20 week and 24 week
Incidence of all related or serious adverse events
Number of subjects with one or more related adverse event or serious adverse events. Related adverse events are those judged by the investigator to be possibly, probably, or definitely related to the COMS One device or other trial procedures.
Time frame: Up to week 12 and week 24
Time to target diabetic foot ulcer re-occurrence
Time in number of days from randomization until re-occurrence of the target diabetic foot ulcer, assessed up to 24 weeks
Time frame: Up to 24 weeks
Time to amputation
Time in number of days from randomization until amputation associated with the target diabetic foot ulcer, assessed up to 24 weeks
Time frame: Up to 24 weeks
Pain assessment
Wong-Baker FACES Pain Rating Scale - patient chooses the face that best demonstrates the physical pain they are experiencing at four time points throughout study participation
Time frame: Week 1, Week 8, Week 12, Week 24
Quality of life survey
36-Item Short Form Survey (SF-36) - health-related quality of life questionnaire that is completed by patients at four time points throughout study participation
Time frame: Week 1, Week 8, Week 12, Week 24
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Limb Preservation Platform, Inc.
Fresno, California, United States
RECRUITINGAngel City Research, Inc.
Los Angeles, California, United States
RECRUITINGUCLA Ronald Regan - Department of Surgery
Los Angeles, California, United States
RECRUITINGCenter for Clinical Research Inc.
San Francisco, California, United States
RECRUITINGCenter for Clinical Research Inc.
San Francisco, California, United States
RECRUITINGILD Research Center
Vista, California, United States
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