Trial Outcomes & Findings for A RCT to Compare the Effects of Two Wound Products on Biofilm Disruption in DFUs (NCT NCT02181621)

NCT ID: NCT02181621

Last Updated: 2024-02-29

Results Overview

The primary variable was the within-patient change from Baseline in log\^10 biofilm-protected bacteria count from Baseline (initial assessment) to Week 4, as measured by curettage.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

19 participants

Primary outcome timeframe

Baseline to Week 4

Results posted on

2024-02-29

Participant Flow

Initial assessment screening/enrollment occurred at a single site in the United States from 05Aug2014 to 11Sep2015. Eligible participants were randomized to receive either IODOSORB or SOLOSITE for up to 4 weeks (28 +/- 4 days) or until reference ulcer closure (whichever came first).

Participant milestones

Participant milestones
Measure
SOLOSITE
Hydrogel with preservatives, used to create a moist wound environment. SOLOSITE Gel: Hydrogel
IODOSORB
Cadexomer iodine gel IODOSORB: Cadexomer iodine gel
Overall Study
STARTED
9
10
Overall Study
Week 1 Assessment
7
8
Overall Study
Week 2 Assessment
6
8
Overall Study
Week 3 Assessment
6
7
Overall Study
Week 4 Assessment
6
7
Overall Study
COMPLETED
7
8
Overall Study
NOT COMPLETED
2
2

Reasons for withdrawal

Reasons for withdrawal
Measure
SOLOSITE
Hydrogel with preservatives, used to create a moist wound environment. SOLOSITE Gel: Hydrogel
IODOSORB
Cadexomer iodine gel IODOSORB: Cadexomer iodine gel
Overall Study
Adverse Event
1
0
Overall Study
Previously Enrolled
0
1
Overall Study
Enrollment Hold
1
1

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
SOLOSITE Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. SOLOSITE Gel: Hydrogel
IODOSORB
n=7 Participants
Cadexomer iodine gel IODOSORB: Cadexomer iodine gel
Total
n=14 Participants
Total of all reporting groups
Age, Continuous
62.7 years
STANDARD_DEVIATION 8.2 • n=7 Participants
51.4 years
STANDARD_DEVIATION 9 • n=7 Participants
57 years
STANDARD_DEVIATION 10.2 • n=14 Participants
Sex: Female, Male
Female
0 Participants
n=7 Participants
0 Participants
n=7 Participants
0 Participants
n=14 Participants
Sex: Female, Male
Male
7 Participants
n=7 Participants
7 Participants
n=7 Participants
14 Participants
n=14 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
7 Participants
n=7 Participants
7 Participants
n=7 Participants
14 Participants
n=14 Participants
Height (centimeters [cm])
178.9 cm
STANDARD_DEVIATION 12.6 • n=7 Participants
179.9 cm
STANDARD_DEVIATION 9.9 • n=7 Participants
179.4 cm
STANDARD_DEVIATION 10.9 • n=14 Participants
Weight (kilograms [kg])
91.9 kg
STANDARD_DEVIATION 31.5 • n=7 Participants
114.5 kg
STANDARD_DEVIATION 37.8 • n=7 Participants
103.2 kg
STANDARD_DEVIATION 35.5 • n=14 Participants
Baseline Reference Ulcer: Area (centimeters squared [cm^2])
9.4 cm^2
n=7 Participants
8.5 cm^2
n=7 Participants
9 cm^2
n=14 Participants
Baseline Reference Ulcer: Depth (millimeters [mm])
4 mm
n=7 Participants
2 mm
n=7 Participants
3 mm
n=14 Participants
Reference Ulcer: Volume (centimeters cubed [cm^3])
3.8 cm^3
n=7 Participants
1.7 cm^3
n=7 Participants
2.3 cm^3
n=14 Participants

PRIMARY outcome

Timeframe: Baseline to Week 4

Population: The reporting of this outcome measure is based on the confirmed biofilm analysis set, defined as all subjects admitted to the study and for which the presence of biofilm was confirmed using curettage samples. Week 4 data were included for a total of 12 subjects (SOLOSITE N= 6; IODOSORB N = 6) in the biofilm analysis set.

The primary variable was the within-patient change from Baseline in log\^10 biofilm-protected bacteria count from Baseline (initial assessment) to Week 4, as measured by curettage.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=6 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=6 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Within-patient Change From Baseline in Log^10 Biofilm-protected Bacteria Count (Colony Forming Units [Cfu]/Gram[g])
0.8 log^10 CFU/g
Interval -1.1 to 3.5
1.0 log^10 CFU/g
Interval -2.2 to 5.8

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Population: The reporting of this outcome measure is based on the confirmed biofilm analysis set, defined as all subjects admitted to the study and for which the presence of biofilm was confirmed using curettage samples (Initial Visit: N=14; Week 1: N=14; Week 2: N=13; Week 3: N=12; Week 4: N=12; Study Completion: N=14).

Calculated overall median/range measurements of the reference ulcer area (cm\^2) at each study visit as well as overall study completion ulcer area measurements were assessed for the Iodosorb and Solosite arms. The ulcer area was calculated as area = length x width x 0.785.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Ulcer Area Measurements at Each Study Visit
Week 3 Ulcer Area Measurement
8.0 cm^2
Interval 2.9 to 12.0
7.0 cm^2
Interval 0.8 to 10.4
Ulcer Area Measurements at Each Study Visit
Baseline Ulcer Area Measurement
9.4 cm^2
Interval 5.1 to 21.2
8.5 cm^2
Interval 2.1 to 13.0
Ulcer Area Measurements at Each Study Visit
Week 1 Ulcer Area Measurement
9.4 cm^2
Interval 3.9 to 19.4
7.3 cm^2
Interval 1.2 to 12.1
Ulcer Area Measurements at Each Study Visit
Week 2 Ulcer Area Measurement
8.1 cm^2
Interval 4.0 to 14.1
7.8 cm^2
Interval 0.9 to 11.2
Ulcer Area Measurements at Each Study Visit
Week 4 Ulcer Area Measurement
6.1 cm^2
Interval 4.4 to 9.7
6.8 cm^2
Interval 0.8 to 11.5
Ulcer Area Measurements at Each Study Visit
Study Completion Ulcer Area Measurement
5.5 cm^2
Interval 4.4 to 9.7
7.8 cm^2
Interval 0.8 to 11.5

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Overall percentage (%) of change in ulcer area from Baseline to final visit for the Iodosorb and Solosite arms.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Percentage (%) Change in Ulcer Area
29.4 percent change
Standard Deviation 23.1
24.8 percent change
Standard Deviation 39.0

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Population: The reporting of this outcome measure is based on the confirmed biofilm analysis set, defined as all subjects admitted to the study and for which the presence of biofilm was confirmed using curettage samples (Initial Visit: N=14; Week 1: N=14; Week 2: N=13; Week 3: N=12; Week 4: N=12; Study Completion: N=14).

Calculated median/range measurements of the reference ulcer depth (mm) at each study visit as well as overall study completion ulcer depth measurements were assessed for the Iodosorb and Solosite arms. The ulcer depth as measured by inserting the cotton applicator into the deepest part of the ulcer and measuring from the tip of the applicator to the level of the skin surface.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Ulcer Depth Measurements at Each Study Visit
Baseline Ulcer Depth Measurement
4 mm
Interval 0.7 to 20.0
2 mm
Interval 0.2 to 6.0
Ulcer Depth Measurements at Each Study Visit
Week 1 Ulcer Depth Measurement
3 mm
Interval 0.2 to 30.0
2 mm
Interval 1.0 to 4.0
Ulcer Depth Measurements at Each Study Visit
Week 2 Ulcer Depth Measurement
2.5 mm
Interval 2.0 to 28.0
2 mm
Interval 1.0 to 3.0
Ulcer Depth Measurements at Each Study Visit
Week 3 Ulcer Depth Measurement
2 mm
Interval 1.0 to 30.0
1.5 mm
Interval 1.0 to 3.0
Ulcer Depth Measurements at Each Study Visit
Week 4 Ulcer Depth Measurement
2.5 mm
Interval 1.0 to 5.0
1.5 mm
Interval 1.0 to 3.0
Ulcer Depth Measurements at Each Study Visit
Study Completion Ulcer Depth Measurement
3 mm
Interval 1.0 to 5.0
2 mm
Interval 1.0 to 3.0

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Overall percentage (%) of change in ulcer depth from Baseline to final visit for the Iodosorb and Solosite arms.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Percentage (%) Change in Ulcer Depth
-7.9 percent change
Standard Deviation 143.8
-38.1 percent change
Standard Deviation 165.2

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Population: The reporting of this outcome measure is based on the confirmed biofilm analysis set, defined as all subjects admitted to the study and for which the presence of biofilm was confirmed using curettage samples (Initial Visit: N=14; Week 1: N=14; Week 2: N=13; Week 3: N=12; Week 4: N=12; Study Completion: N=14).

Calculated median/range measurements of the ulcer volume (cm\^3) at each study visit as well as overall study completion ulcer volume measurements were assessed for the Iodosorb and Solosite arms. The ulcer volume was measured by calculating the length x width x depth of the ulcer.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Ulcer Volume Measurements at Each Study Visit
Baseline Ulcer Volume Measurement
3.8 cm^3
Interval 0.8 to 15.8
1.7 cm^3
Interval 0.0 to 6.4
Ulcer Volume Measurements at Each Study Visit
Week 1 Ulcer Volume Measurement
3.3 cm^3
Interval 0.2 to 34.3
0.9 cm^3
Interval 0.1 to 3.6
Ulcer Volume Measurements at Each Study Visit
Week 2 Ulcer Volume Measurement
2.6 cm^3
Interval 0.8 to 19.4
1.3 cm^3
Interval 0.2 to 3.4
Ulcer Volume Measurements at Each Study Visit
Week 3 Ulcer Volume Measurement
1.7 cm^3
Interval 0.6 to 22.8
1.1 cm^3
Interval 0.1 to 3.0
Ulcer Volume Measurements at Each Study Visit
Week 4 Ulcer Volume Measurement
1.8 cm^3
Interval 0.5 to 2.9
1.1 cm^3
Interval 0.1 to 2.4
Ulcer Volume Measurements at Each Study Visit
Study Completion Ulcer Volume Measurement
1.6 cm^3
Interval 0.5 to 2.9
1.1 cm^3
Interval 0.1 to 2.4

SECONDARY outcome

Timeframe: Baseline up through Week 4 +/- 4 days or End of Study Visit, up to 32 days

Overall percentage (%) of change in ulcer volume from Baseline to final visit for the Iodosorb and Solosite arms.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Percentage (%) Change in Ulcer Volume
15.0 percent change
Standard Deviation 119.1
21.5 percent change
Standard Deviation 57.5

SECONDARY outcome

Timeframe: Baseline, Week 2, Week 4

Population: The reporting of this outcome measure is based on the confirmed biofilm analysis set, defined as all subjects admitted to the study and for which the presence of biofilm was confirmed using curettage samples (Initial Visit: N=14; Week 1: N=14; Week 2: N=13; Week 3: N=12; Week 4: N=12; Study Completion: N=14).

Assessment of subjects clinically judged to have biofilm present on the wound. The presumption of biofilm was determined on visual appearance to the Investigator and compared to microbial swab laboratory test confirmation. Biofilm is a microbial colony encased in a polysaccharide matrix which can become attached to a wound surface and prevent healing. Biofilm can appear as a shiny or slimy layer (clear to yellowish in appearance) on a wound bed.

Outcome measures

Outcome measures
Measure
Solosite Gel
n=7 Participants
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=7 Participants
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Baseline · Yes
7 Participants
7 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Baseline · No
0 Participants
0 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Baseline · Yes
7 Participants
7 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Baseline · No
0 Participants
0 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Week 2 · Yes
6 Participants
6 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Week 2 · No
0 Participants
1 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Week 2 · Yes
6 Participants
5 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Week 2 · No
0 Participants
2 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Week 4 · Yes
5 Participants
4 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Laboratory Test at Week 4 · No
1 Participants
2 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Week 4 · Yes
5 Participants
4 Participants
Presence of Biofilm by Clinical Judgment Versus Presence of Biofilm by Laboratory Test
Biofilm Present by Clinical Judgment at Week 4 · No
1 Participants
2 Participants

Adverse Events

Solosite Gel

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Iodosorb

Serious events: 1 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Solosite Gel
n=9 participants at risk
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=10 participants at risk
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
General disorders
Right Foot Abscess with Osteomyelitis
0.00%
0/9 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
10.0%
1/10 • Number of events 1 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
General disorders
Spinal Infection
11.1%
1/9 • Number of events 1 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
0.00%
0/10 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).

Other adverse events

Other adverse events
Measure
Solosite Gel
n=9 participants at risk
Hydrogel with preservatives, used to create a moist wound environment. Solosite gel: Hydrogel
Iodosorb
n=10 participants at risk
Cadexomer iodine gel Iodosorb: Cadexomer iodine gel
General disorders
Foot Laceration
11.1%
1/9 • Number of events 1 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
0.00%
0/10 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
General disorders
Open Ulcer, Left Great Toe
0.00%
0/9 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).
10.0%
1/10 • Number of events 1 • Adverse event data were collected from the time of randomization up through 28 days (+/- 4 days).

Additional Information

Matthew Christensen

Smith & Nephew, Inc.

Phone: +1-303-249-5812

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place