Beta Blocker for Chronic Wound Healing

The purpose of this study is to evaluate the efficacy and safety of treatment of chronic cutaneous ulcers and burn wounds with topical beta adrenergic antagonists (Timoptic®).

The purpose of this study is to learn more about how to heal venous leg ulcers faster and to test the safety of a drug and see what effects it has on a venous leg ulcer.

You will:

• be interviewed and examined
• have a physical exam
• have blood and urine tested
• have photographs taken of the wound
• apply medication to the leg ulcer as directed

• Ulcer
• Burns

• Drug: Timoptic
  Timoptic to be applied to the target wound daily for up to 12 weeks.
  Other Name: beta adrenergic antagonists
• Other: Placebo
  Saline solution with no active ingredients to be applied to the target wound daily for up to 12 weeks.

• Experimental: 1
  This group receives topical beta adrenergic antagonists (Timoptic) plus standard of care.
  Intervention: Drug: Timoptic
• Placebo Comparator: 2
  The group will be given standard of care with placebo medication.
  Intervention: Other: Placebo

Inclusion Criteria:

• Any race btwn 18 and 85 years of age, inclusive;
• Male or female, neither pregnant nor lactating.
• Informed consent;

• Have at least 1 lower extremity ulcer in the gaiter area (knee to ankle):

  1. Surface area of ≥2 sq. cm. to ≤20 sq. cm.; Ulcer with largest surface area meeting inclusion criteria will be selected.
  2. If 2 ulcers present with the same surface area, ulcer of longest duration selected.
  3. Study ulcer must be at least 2 cm from any other ulcer on same extremity.

  4. A viable wound bed free of necrotic tissue post-debridement, if debridement is indicated.

     5. Have an Ankle Brachial Index (ABI) >0.7; 6. Presence of either dorsalis pedis or posterior tibialis pulses by Doppler on the study extremity; 7. Have a non-healing (open) ulcer for at least 1 month. Subjects who failed conservative therapy are eligible for the study; 8. Comply with a trial (13 to 17 days) of protocol-specified standard care prior to randomization; 9. Two or more of the following: dermatitis, atrophie blanche, varicosities, hyperpigmentation or lipodermatosclerosis;

     Exclusion Criteria:

• Decrease in wound surface area of >35% btwn Screening and Visit 1 (Randomization);
• Cellulitis, osteomyelitis, ulcer with exposed bone, tendon or fascia, or purulent exudates in ulcer area;
• Grade IV ulcer;
• Evidence of study ulcer infection;
• Study ulcer of non-venous etiology;
• Acquired or are known to be infected with HIV;
• Uncontrolled diabetes mellitus;
• Immunodeficiency as defined by serum IgG, IgA, and IgM less than one-half the lower limit of normal;
• Severe protein malnutrition as defined by serum albumin <2.5 g/dL;
• Severe anemia defined as a total of hemoglobin of <10 g/dL for males or <8 g/dL for females;
• Chronic renal insufficiency requiring dialysis;
• Serum aspartate aminotransferase (AST, SGOT, GOT) or serum alanine aminotransferase (ALT, SGPT, GPT) levels greater than twice the upper limit of normal;
• New York Heart Association Functional Classification of IV;
• Deep vein thrombosis (DVT) w/in last 6 weeks or clinical evidence of current DVT;
• Arterial revascularization of the study extremity w/in previous 6 months from the date of Screening Visit;
• History, w/in previous 12 months from date of Screen Visit, of alcohol or drug abuse, particularly methadone or heroin;
• Received previous treatment with the following during the 60 days prior to Screening: Immunosuppressive agents, radiation, chemotherapy, growth factors at the site of the study ulcer, split- or full-thickness skin graft at the site of the study ulcer, biologically-active cellular or acellular product(s) at the site of the study ulcer, investigational drug or device
• Received previous treatment with systemic corticosteroids prior to Screening (Chronic corticosteroids w/in 90 days or short course corticosteroids w/in 30 days)
• Been hospitalized for treatment of any venous ulcer w/in the previous 30 days from Screening.
• Asthma or a history of asthma, obstructive pulmonary disease, myasthenia gravis, hyperthyroidism, history of heart block