A Randomized Controlled Phase II Trial of STIMULAN VG vs Standard of Care (SoC) for the Treatment of Osteomyelitis Associated With Stage IV Pressure Ulcers.

Purpose

The purpose of this trial is to assess the safety, tolerability and between-group effect size of STIMULAN VG (with debridement) and a course of systemic antibiotics to standard of care (debridement and systemic antibiotics only) for the treatment of osteomyelitis associated stage IV pressure ulcers.

Conditions

  • Pressure Ulcer, Stage IV
  • Osteomyelitis

Eligibility

Eligible Ages
Over 18 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Criteria

In order to be eligible to participate in this study, subjects must meet all of the
following criteria:

1. Presenting with a Stage IV pressure ulcer requiring treatment of excision, bony
debridement and flap coverage/primary closure.

2. Operative candidate for flap surgery or primary closure.

3. Presence of focal osteomyelitis as suggested by imaging to show extent of infection.
Acceptable imaging techniques are Magnetic Resonance Imaging or CT scan.

4. Adults ≥ 18 years in age at the time of treatment.

5. Psychosocially, mentally, and physically able to fully comply with this protocol,
including adhering to scheduled visits, treatment plan, completing forms, and other
study procedures.

6. Ability of the subject or legal authorized representative to provide voluntary,
signed and dated informed consent prior to any study-related procedures.

Subjects who meet any of the following criteria will be excluded from participating in
this study:

1. Reasons contributing to pressure ulcer cannot be addressed.

2. Severe immunological compromised patients as determined by the clinician.

3. Patients with diffuse or widespread pelvic osteomyelitis that is not amenable to
adequate margins for debridement.

4. Patients presenting with head pressure ulcers.

5. Current or recent history (within last 2 years) of active substance abuse (e.g.,
recreational drugs, narcotics, or alcohol) that in the judgement of the
investigator, may compromise the participant's safety/recovery or ability to follow
the trial procedures.

6. Current smoker.

7. Diabetic patient with Hba1C level above 9.

8. Allergy to any component of the investigational product, such as calcium sulfate,
glycopeptide antibiotics (Vancomycin), or aminoglycoside antibiotics (Gentamicin).

9. Concurrent involvement in a study of another investigational product.

10. Pregnant or planning to become pregnant during study period.

11. Flexion contractures where patient cannot passively get full extension.

12. Uncontrolled muscle spasms.

13. Unable to comply with bedrest restriction or offloading requirements

14. Unable to provide consent.

15. Fecal or urinary incontinence with contamination of the wound.

16. Lower extremity pressure ulcer location that is vascularly compromised as defined by
an Ankle Brachial Index ≤ 0.7 mm Hg OR toe brachial index ≤ 0.6 mm OR toe pressure ≤
40 mm Hg OR transcutaneous oximetry ≤ 40 mm Hg *

17. Investigator considers the participant to be clinically malnourished.

18. Any conditions with known hypercalcemia (> 10.3 mg/dl) or posing a significant risk
for developing hypercalcemia (i.e., Hyperparathyroidism).

19. Investigator believes trial participation may compromise safety of the participant
or trial results.

- Patients presenting with lower extremity pressure ulcers that are vascularly
compromised can be rescreened followed successful revascularization

Study Design

Phase
Phase 2
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Interventional STIMULAN VG
Ulcer bursectomy and debridement and STIMULAN VG insertion into the ulcer cavity. Flap/primary closure. Peri-operative antibiotics.
  • Combination Product: STIMULAN VG
    Insertion of STIMULAN VG into the ulcer cavity prior to flap/primary closure.
  • Procedure: Standard of Care
    Standard of Care. Ulcer bursectomy, debridement and flap/primary closure. Peri-operative antibiotics.
Active Comparator
Standard of Care (SoC)
Ulcer bursectomy, debridement and flap/primary closure. Peri-operative antibiotics.
  • Procedure: Standard of Care
    Standard of Care. Ulcer bursectomy, debridement and flap/primary closure. Peri-operative antibiotics.

Recruiting Locations

Advanced Foot Care, LLC
Phoenix, Arizona 85032
Contact:
Krishna Sai Penumarthi
(480) 863-6044
kspenumarthi@axentrabio.com

Northwestern University Feinberg School of Medicine
Chicago, Illinois 60611
Contact:
Brigid Coles
312-503-3209
brigid.coles@nm.org

Henry Ford Hospital
Detroit, Michigan 48202
Contact:
Dan Molitor
dmolito2@hfhs.org

University of Mississippi Medical Center
Jackson, Mississippi 39216
Contact:
Venkata Seerapu
vseerapu@umc.edu

Missouri Orthopaedic Institute
Columbia, Missouri 65201
Contact:
Andrew Monhollen
am5hf@health.missouri.edu

University of Nebraska Medical Center
Omaha, Nebraska 68198
Contact:
Katie Ostlund
katie.ostlund@unmc.edu

Rutgers New Jersey Medical School
Newark, New Jersey 07103
Contact:
Saharsh Patel
ssp186@gsbs.rutgers.edu

NYU Langone Hospital - Long Island Clinical Research Center
Mineola, New York 11501
Contact:
Anita Farha
516 663 9582
anita.farhi@nyulangone.org

University of Pittsburgh, McGowan Institute for Regenerative Medicine
Pittsburgh, Pennsylvania 15219
Contact:
Urmila Gnyawali
412-624-5500
usg2@pitt.edu

More Details

NCT ID
NCT06283979
Status
Recruiting
Sponsor
Biocomposites Ltd

Study Contact

Keira Watts, Clinical Research Director
+44 (0) 1782 338 580
clinicaltrials@biocomposites.com

Detailed Description

The trial is an open-label, multi-center, randomized (1:1), controlled phase 2 trial in patients diagnosed with stage IV pressure ulcers.