Assessment of the Safety and Efficacy of DERMASTREAM™ - ENZYSTREAM™ System for the Treatment of Chronic Venous Ulcers - Full Text View

Sponsor:	EnzySurge
Information provided by:	EnzySurge
ClinicalTrials.gov Identifier:	NCT00485329

Purpose

The study objectives are to evaluate DermastreamTM - EnzystreamTM system safety, tolerability and efficacy, as a potent method for debridement of nonhealing lower extremity chronic venous ulcers patients.

Condition	Intervention	Phase
Lower Extremity Chronic Venous Ulcers	Other: Papain	Phase I Phase II

Study Type:	Interventional
Study Design:	Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double-Blind Primary Purpose: Treatment
Official Title:	A Phase I/II Randomized, Double Blind, Placebo-Controlled Dose- Escalating Study, to Assess The Safety and Efficacy of Enzystream™ Debriding Solution (Papain) Applied by Dermastream™ Device for the Treatment of Lower Extremity Chronic Venous Ulcers

Resource links provided by NLM:

Drug Information available for: Papain

U.S. FDA Resources

Further study details as provided by EnzySurge:

Primary Outcome Measures:

To demonstrate Dermastream-Enzystream safety [ Time Frame: Up to 88 days ] [ Designated as safety issue: Yes ]
Skin irritation score
To demonstrate Dermastream-Enzystream safety [ Time Frame: Up to 88 days ] [ Designated as safety issue: Yes ]
Severity and incidence of adverse events
To demonstrate Dermastream-Enzystream safety [ Time Frame: 5 days ] [ Designated as safety issue: Yes ]
No deterioration in clinical laboratory parameters

Secondary Outcome Measures:

•Assessment of changes in wound debridement status during treatment period [ Time Frame: Days 1-5 ] [ Designated as safety issue: No ]
Change in non viable tissue area
Assessment of wound closure [ Time Frame: Up to 88 days ] [ Designated as safety issue: No ]
Reduction of nonviable tissue area
Assessment of wound closure [ Time Frame: Up to 88 days ] [ Designated as safety issue: No ]
Increase of granulation tissue area
Assessment of wound closure [ Time Frame: Up to 88 days ] [ Designated as safety issue: No ]
Time (in days) for wound closure

Enrollment:	48
Study Start Date:	July 2007
Study Completion Date:	March 2009
Primary Completion Date:	March 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Low dose papain Ratio of drug to placebo treated patients will be 4:1	Other: Papain 15,000 USP U/ml
Experimental: Medium dose papain Ratio of drug to placebo treated patients will be 4:1	Other: Papain 30,000 USP U/ml
Experimental: High dose papain Ratio of drug to placebo treated patients will be 4:1	Other: Papain 60,000 USP U/ml

Detailed Description:

This is a phase I/II prospective, randomized, double blind, placebo controlled, dose escalating, three patient-group study, to evaluate the safety and efficacy of DermaStream™ - EnzyStream™ System in non-healing lower extremity chronic venous ulcers patients. The DermaStream™ - EnzyStream™ System will be evaluated during continues streaming of 3 different doses of EnzystreamTM (papain based) solution given in an escalating order (15,000, 30,000 and 60,000 papain USP units/ml) up to 5 consecutive treatment days. Each treatment session lasts for 6 hours. This study is a Multi center trial. It is anticipated that three (3) sites will enroll subjects into this study. Overall, forty eight (48) patients will be recruited, and randomly allocated to placebo or EnzyStream™ treatment in each study dose group prior to EnzyStream™ administration. The ratio of drug to placebo treated patients will be 4;1, namely 12 patients will be administered with EnzyStream™ solution and 4 patients will be placebo treated in each of the three respective EnzyStream™ dose groups. Treatment will start with the lowest dose (15,000 papain USP units/ml) administered over a 6 hour period followed with saline wash for an additional half an hour. The treatment dose will be increased to the next highest dose, for the next patients group only following safety analysis, and the procedure will be repeated.

The treatment period will be followed by a 3 month follow up period. During the follow up period patients will be observed for every 2 weeks during the first month and once a month (every 20 days) during the 2 additional months (allowing a time window of ± 3 days).

Eligibility

Ages Eligible for Study:	18 Years to 85 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Patient must have a venous leg ulcer
Participants, either men or women are between 18 and 85 years of age.
Clinical presentation of venous insufficiency demonstrated by Doppler
Ankle-Brachial Index > 0.7 by Doppler
Good palpable pulses in the Posterior Tibial and the Dorsalis Pedis arteries.
Wound present for at least 6 weeks prior to enrolment.
Wound length is in the range of: 1.5 - 7 centimeters.
The necrotic tissue area is at least 20% of wound area. (by clinical evaluation, i.e., inspection).
Wound San Antonio classification: Grade 1 or 2, Stage A or B.
Wound location: foot or calf, at a location where the device can be attached properly.
Participant understands the nature of the procedure and provides written informed consent prior to any study procedure.
Women of child bearing potential must use adequate birth-control precautions.

Exclusion Criteria:

Documented sensitivity to Papain, by medical history records.
Patients in need of surgical debridement.
Patients with general skin disorders (Psoriasis, Peniculitis ect) that might deteriorate as a result of local trauma.
Patients with skin disorders unrelated to the ulcer that are presented adjacent to the wound.
Pain sensation is completely absent (wound area is anesthetic).
Patients with renal failure. (Cr > 2 mg/dl).
Patients with impaired hepatic function (ALT, AST or GGT 2-fold higher than normal upper limit value).
Patients having Hypoalbuminemia: (Albumin < 2gr/dl ).
Patients with general Immunological disorders that might deteriorate as a result of local trauma.
Right-side congestive heart failure (CHF) with edema of legs: (NYHA class 2 or higher see APPENDIX 5).
Participation in another clinical trial within 1 month prior to start of this study.
Subject unwilling or unable to comply with the requirements of the protocol

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00485329

Locations

Israel
Hillel Yafe Medical Center
Hadera, Israel, 38101
Rambam Medical Center
Haifa, Israel, 35254
Assaf Harofe Medical Center
Zriffin, Israel

Sponsors and Collaborators

EnzySurge

Investigators

Principal Investigator:	Arie Bass, Prof.	Assaf Harofe Medical Center
Principal Investigator:	Sami Nitezki, Dr.	Rambam Health Care Campus

More Information

Additional Information:

Related Info This link exits the ClinicalTrials.gov site

No publications provided

ClinicalTrials.gov Identifier:	NCT00485329 History of Changes
Other Study ID Numbers:	ENZ-DER-002-IL
Study First Received:	June 10, 2007
Last Updated:	May 24, 2010
Health Authority:	Israel: Ministry of Health - MOH

Keywords provided by EnzySurge:

Chronic Wounds, Venous Ulcers, Papain, Debridement, Continuous streaming
DermaStream-EnzyStream

Additional relevant MeSH terms:

Ulcer
Varicose Ulcer
Pathologic Processes
Varicose Veins
Vascular Diseases

Cardiovascular Diseases
Leg Ulcer
Skin Ulcer
Skin Diseases

ClinicalTrials.gov processed this record on February 12, 2012