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Phase III Study to Evaluate Efficacy and Safety of DSC127 in Diabetic Foot Ulcers (STRIDE 1)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01830348
Recruitment Status : Terminated
First Posted : April 12, 2013
Last Update Posted : December 12, 2017
Information provided by (Responsible Party):
Integra LifeSciences Corporation

Brief Summary:
The purpose of the study is to determine if DSC127 is effective in increasing incidence of complete wound closure at 10 weeks confirmed at a visit 2 weeks later when compared to the vehicle (gel without active ingredient) in subjects with diabetes mellitus (DM) who have chronic Wagner Grade 1 or 2 plantar neuropathic foot ulcers, 0.75 - 6 cm2 in size.

Condition or disease Intervention/treatment Phase
Diabetic Foot Ulcers Drug: DSC127 Drug: placebo vehicle gel Phase 3

Detailed Description:

Subjects will undergo a two week screening period to assess plantar ulcer healing, and those healing less than 30% will be eligible for randomization, providing they meet all other inclusion criteria. Four weeks of blinded "treatment" follows the screening period, and an observation period of six weeks (to 10 weeks post first treatment) follows the 4-week treatment period. If the ulcer closes during the treatment or observation period, the closure will be confirmed two weeks later, and at this time the subject enters a durability assessment period of up to 12 weeks.

All aspects of Standard of Care are followed throughout the study period.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 266 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Parallel-group, Vehicle-controlled Phase 3 Clinical Trial to Evaluate the Efficacy and Safety of DSC127 in Treating Non-healing Foot Ulcers in Subjects With Diabetes Mellitus
Study Start Date : February 2013
Actual Primary Completion Date : December 2015
Actual Study Completion Date : December 2015

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: DSC127
DSC127 0.03% in a vehicle gel (hydroxyethyl cellulose (HEC) with parabens)
Drug: DSC127
DSC127 0.03%, daily topical application to diabetic foot ulcer for a period of up to 28 days or until ulcer closure, whichever is sooner

Placebo Comparator: Vehicle gel
Vehicle gel comprising HEC with parabens
Drug: placebo vehicle gel

Primary Outcome Measures :
  1. The proportion of subjects with a target ulcer which achieves complete wound closure (skin re-epithelialization without drainage or dressing requirements) up to 10 weeks (confirmed at a study visit 2 weeks later). [ Time Frame: Target ulcer must achieve complete wound closure by 10 weeks post first treatment ]
    Primary endpoint of complete closure is assessed by the Principal Investigator at the site; ulcer measurements are calculated through tracings submitted to the Canfield system and photographs are collected as confirmation of closure via the Canfield system.

Secondary Outcome Measures :
  1. Time to the visit where the target ulcer achieves confirmed complete wound closure [ Time Frame: Weekly assessments to ten weeks post first treatment dose ]

Other Outcome Measures:
  1. Percent reduction in ulcer area per week (closure rate) [ Time Frame: Weekly ulcer tracings to calculate area of ulcer, measurements continue to ten weeks post first treatment dose ]
    Calculated weekly for up to ten weeks

  2. Incidence of target ulcer recurrence, time to ulcer recurrence, and number of days target ulcer remains closed after confirmed complete wound closure has been established. [ Time Frame: Assessed during a 12 week durability period following the confirmation of complete wound closure ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Male or female ambulatory subject age ≥18 years at the time of informed consent
  2. Has type 1 or type 2 DM under metabolic control as confirmed by a glycosylated hemoglobin (HbA1c) of ≤12% and a serum creatinine level of ≤3mg/dL
  3. At Screening and at Baseline (prior to randomization), subject has at least one ulcer that fulfills all of the following criteria:

    • Present for ≥1 month and ≤1 year
    • Partial- or full- thickness and not involving bone, tendon, or capsule (probing to tendon or capsule), i.e. Wagner Grade 1 or 2
    • Has no sign of infection or osteomyelitis
    • Plantar neuropathic ulcer; ulcer must be predominantly on the plantar surface of the foot to ensure adequate off-loading and may include the toes
    • Size of the target ulcer must be 0.75 - 6 cm2
    • Target ulcer must be non-healing as defined as <30% reduction in size in response to standard of care during the two week Screening Period

      • If more than one ulcer is present that meets the inclusion criteria, the largest one will be considered the Target ulcer.
      • If there are two ulcers of the same size that meet all criteria, the one with the higher Wagner Grade will be considered the Target ulcer.
      • If there are two ulcers of the same size and the same Wagner Grade, the one present for the longest qualifying time will be the Target ulcer.
  4. Has an ankle brachial index (ABI) ≥ 0.7 on the foot with the target ulcer
  5. Has an assessment of the baseline level of neuropathy of the foot using Semmes-Weinstein filaments.
  6. A female subject of childbearing potential must have a negative serum pregnancy test at the time of Screening, and must be willing to use a medically acceptable method of birth control, such as Essure®, hormonal contraception (oral pills, implantable device, or skin patch), intrauterine device, tubal ligation, or double barrier throughout the study. A female subject of childbearing potential who practices abstinence is not required to employ birth control.
  7. Has the ability and willingness to understand and comply with study procedures and to give written informed consent prior to enrollment in the study or initiation of study procedures

Exclusion Criteria:

  1. Has a known hypersensitivity to any of the investigational drug or vehicle components
  2. Has been exposed to any investigational agent within 30 days of entry into the study
  3. A female who is pregnant or nursing
  4. Has active malignant disease of any kind except for basal cell carcinoma (of the skin). A subject, who has had a malignant disease in the past, was treated and is currently disease-free, may be considered for study entry.
  5. Has a hemoglobin of less than 8.5 gm/dL.
  6. Transaminase levels greater than 3 × normal
  7. Is receiving hemodialysis or chronic ambulatory peritoneal dialysis (CAPD) therapy
  8. Has had prior radiation therapy of any part of the foot with the target ulcer under study
  9. Use of systemic corticosteroids and immunosuppressants (within the 8 weeks prior to screening)
  10. Has an ulcer primarily ischemic in etiology
  11. Has sickle-cell anemia, Reynaud's, or other peripheral vascular disease
  12. Has received a biologic agent, growth factors or skin equivalents (Regranex®, Apligraft, or Dermagraft), in the past 30 days
  13. Has a target ulcer which is determined to be clinically infected and requires antimicrobials. Any antibiotic therapy must be completed or discontinued at screening.
  14. Has a Wagner Grade 3 or greater DFU, deep abscess, or gangrene
  15. Has uncontrolled hypertension, in the opinion of the Investigator.
  16. Any other finding, which in the opinion of the Investigator, may interfere with the assessment of the product or participation of the subject in the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01830348

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Sponsors and Collaborators
Integra LifeSciences Corporation
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Study Director: Gere S diZerega, MD Integra LifeSciences Corporation
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Responsible Party: Integra LifeSciences Corporation Identifier: NCT01830348    
Other Study ID Numbers: DSC127-2012-01
First Posted: April 12, 2013    Key Record Dates
Last Update Posted: December 12, 2017
Last Verified: December 2017
Keywords provided by Integra LifeSciences Corporation:
diabetic foot ulcers
Wagner Grade 1 or 2 foot ulcers
Additional relevant MeSH terms:
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Diabetic Foot
Foot Ulcer
Pathologic Processes
Diabetic Angiopathies
Vascular Diseases
Cardiovascular Diseases
Leg Ulcer
Skin Ulcer
Skin Diseases
Diabetes Complications
Diabetes Mellitus
Endocrine System Diseases
Diabetic Neuropathies
Foot Diseases