Non-healing Diabetic Foot Ulcers Treated With Standard Care With or Without BR-AM

Last updated: March 25, 2025
Sponsor: BioStem Technologies
Overall Status: Active - Recruiting

Phase

N/A

Condition

Ulcers

Diabetes Mellitus Types I And Ii

Diabetes And Hypertension

Treatment

Standard Care

BR-AM

Clinical Study ID

NCT06565156
BR-AM-DFU-101
  • Ages > 18
  • All Genders

Study Summary

This trial is a multicenter, randomized, controlled study designed to evaluate the safety and efficacy of BioREtain® Amniotic Membrane (BR-AM) plus standard of care versus standard of care only in the treatment of diabetic foot ulcers. The trial design will control potential variables that may affect the outcome between the treatment group and the control group by standardizing the requirements for debridement, wound dressings, and offloading. Weekly subject visits will help monitor compliance in wound care and off-loading, as well as to document when wound closure is achieved. The study will also implement the use of an electronic imaging and measurement device using a standardized protocol to ensure the measuring of the wound surface area and volume is accurate, highly reproducible, and minimally variable.

There will also be a crossover treatment phase for those patients that were relegated to standard care only. After their 12-week standard of care treatment phase and for only those subjects that did not achieve complete wound closure, will be allowed to crossover for an additional 12 weeks of treatment with the BR-AM product following the protocol and procedures set forth within this document.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patient has signed the informed consent form.

  • Male or female patient at least 18 years of age or older, as of the date of thescreening visit.

  • Confirmed diagnosis of Type 1 or Type 2 Diabetes.

  • Has a DFU that is located below the malleoli at least 1.0 cm2 or up to 20.0 cm2 whenmeasured by the investigator staff at the screening visit using the eKare devicepost debridement. a. If more than one ulcer is present the selected target ulcer must be at least 2 cmfrom the nearest edge of any adjacent ulcers.

  • The depth of the target foot ulcer is graded as Wagner Grade I or II, i.e., with noevidence of exposed muscle, tendon, bone, or joint capsule.

  • The target ulcer is "chronic, hard-to-heal," defined as having a duration of > 4weeks but ≤ 52 weeks at the time of the screening visit.

  • Arterial supply adequacy to the foot with the target ulcer confirmed by any one ofthe following:

  1. Great toe pressure ≥ 40 mm/Hg

  2. Systolic blood pressure Ankle Brachial Index (ABI) in the range ≥ 0.70 ≤ 1.20

  3. TcPO2 ≥ 30 mmHg from the foot

  4. Toe Brachial Index or TBI ≥ 0.50

  • Willing to follow all instructions given by the Investigator, return for all visits,and adhere to off-loading protocols while on the study.

Exclusion

Exclusion Criteria:

  • Hemoglobin A1c (HbA1c) level is > 12% (108 mmol/mol).

  • Chronic oral steroid use of > 7.5 mg daily within the previous 30 days precedingscreening.

  • Chronic oral or parenteral corticosteroids, or any cytotoxic agents within theprevious 30 days preceding screening.

  • Has tested positive for Human Immunodeficiency Virus (HIV) or has Acquired ImmuneDeficiency Syndrome (AIDS).

  • Has malignancy or history of cancer in 5 years preceding the screening visit otherthan non-melanoma skin cancer.

  • Pregnant women.

  • Women of child-bearing potential who are unwilling to avoid pregnancy or use aneffective form of birth control.

  • Currently on dialysis or planning to start dialysis.

  • Is currently enrolled or participated in another device, drug, or biological trialwithin 30 days of screening.

  • Has used wound treatments with enzymes, growth factors, living skin, dermalsubstitutes including other amniotic or umbilical cord tissue therapies, or otheradvanced biological therapies within the last 30 days.

  • Current use of topical anti-microbial or silver-containing products.

  • Target ulcer is over an active or inactive Charcot deformity.

  • The depth of the target ulcer is graded as Wagner Grade III or higher, i.e., withevidence of exposed muscle, tendon, bone, and/or joint capsule.

  • Gangrene is present on any part of the affected foot.

  • Current suspicion of osteomyelitis, cellulitis, or other clinical signs or symptomsof target ulcer infection.

  • Any previous use of Vendaje®, Vendaje AC®, AmnioWrap2® applied to the target ulcer.

The following additional exclusion criteria should be reviewed for all subjects at the end of the screening run-in period prior to randomization for eligibility determination:

  • The target ulcer has decreased > 30% in wound area post debridement at baselinefollowing the two-week run-in period.

  • Use of excluded concomitant medications, therapies, or procedures during thetwo-week run-in period.

  • Has clinical signs or symptoms of infection within the target ulcer.

Study Design

Total Participants: 60
Treatment Group(s): 2
Primary Treatment: Standard Care
Phase:
Study Start date:
October 28, 2024
Estimated Completion Date:
January 31, 2026

Study Description

This study examines a patient population with a diabetic foot ulcer (DFU) having adequate perfusion without clinical signs and symptoms of infection. Historical data has demonstrated that around 30% of DFUs heal within 12 weeks using standard care alone. However, roughly half of patients suffering from DFUs require additional measures, including advanced therapy. It is hypothesized that weekly applications of the human placental allograft BR-AM applied to a nonhealing DFU will result in a higher rate of wounds showing complete healing within 12 weeks of initiating therapy, compared to standard care alone.

This study has a crossover period, where subjects on standard care alone who do not achieve complete healing within 12 weeks of initiating therapy will be allowed to crossover to receive BR-AC over 12 additional weeks, to evaluate if their wound can achieve complete healing.

A follow-up phase will commence for all subjects that achieve complete wound closure, which is designed to measure longevity and durability of the closed wound. This follow up period will consist of a four-week follow up with two visits at each two-week interval.

Connect with a study center

  • Site 17

    Guntersville, Alabama 35976
    United States

    Active - Recruiting

  • Site 22

    Mesa, Arizona 85206
    United States

    Active - Recruiting

  • Site 25

    Tucson, Arizona 85723
    United States

    Active - Recruiting

  • Site 19

    Palmdale, California 93551
    United States

    Active - Recruiting

  • Site 13

    Torrance, California 90502
    United States

    Site Not Available

  • Site 27

    Coral Gables, Florida 33134
    United States

    Active - Recruiting

  • Site 20

    DeLand, Florida 33442
    United States

    Site Not Available

  • Site 28

    DeLand, Florida 32720
    United States

    Site Not Available

  • Site 20

    Deerfield Beach, Florida 33442
    United States

    Active - Recruiting

  • Site 23

    Springfield, Illinois 62704
    United States

    Active - Recruiting

  • Site 18

    Boston, Massachusetts 02118
    United States

    Active - Recruiting

  • Site 26

    Detroit, Michigan 48201
    United States

    Active - Recruiting

  • Site 16

    Lake Success, New York 11042
    United States

    Active - Recruiting

  • Site 15

    Chapel Hill, North Carolina 27599
    United States

    Site Not Available

  • Site 21

    Burleson, Texas 76028
    United States

    Active - Recruiting

  • Site 24

    San Antonio, Texas 78229
    United States

    Active - Recruiting

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