Evaluating the Efficacy of Dual Layer Amniotic Membrane (Artacent®)

NCT ID: NCT04457752

Last Updated: 2022-11-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-01

Study Completion Date

2023-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

A Randomized Controlled Multicenter Clinical Trial, Evaluating the Efficacy of Dual Layer Amniotic Membrane (Artacent®) and Standard of Care versus Standard of Care alone in the healing Chronic Diabetic Foot Ulcers. Multi-center, open label, randomized controlled trial. Study is estimated to require 12 months from first subject enrolled to last subject visit.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Diabetic foot ulcers (DFUs) challenge the most experienced wound care specialist. The US Wound Registry reports that only 40% of DFUs heal in 12 weeks1. Woundologists have adopted the phrase, "time is tissue." This adage reminds clinicians that the longer a DFU remains open, the greater the risk of infection, major amputation and death. The diabetic with a foot ulcer has a mortality rate of 47% which exceeds the mortality2 from most common cancers3. Beyond patient suffering, the treatment of DFUs cost the US health care system more than 15 billion dollars annually4.

In recent years, several clinical trials have demonstrated that products derived from human placental membranes promote the healing of DFUs5. Research has confirmed that growth factors present in amniotic membrane induce angiogenesis, stimulate human dermal fibroblast proliferation, and recruit stem cells important to wound repair and regeneration to the DFU6. All these factors are highly desirable properties in the healing of chronic DFUs.

A novel dual layer amniotic membrane (DLAM, Artacent™, Tides Medical. Lafayette, LA) potentially can increase the delivery of growth factors due to its double layer of amniotic membrane. A prospective case series demonstrated good healing rates in DFUs: 65% healing at 12 weeks7. The current study is the first randomized clinical trial evaluating the efficacy of DLAM in DFUs.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Chronic Diabetic Foot Ulcers

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Dual Layer Amniotic Membrane (DLAM). Artacent® Artacent® is a double layer of dehydrated amniotic membrane. The amnion is harvested from human placenta obtained during planned Caesarean sections. Tides Medical uses a proprietary process to clean and decellularize the amniotic membrane. The amnion is then folded into a bi-layer with the stromal sides facing outward. The dual layer is dried and cut into various sizes. In the final step the DLAM is terminally sterilized.

Atracent®, like all other placental-derived products, is FDA cleared for homologous use through the 361 pathway. It is indicated for non-healing ulcers applied to a debrided, clean and uninfected ulcers.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Dual Layer Amniotic Membrane (DLAM) + SOC

DLAM (Up to 10 weekly DLAM applications) + Standard of Care (sharp debridement, offloading, and proper moisture balance).

Group Type ACTIVE_COMPARATOR

Dual Layer Amniotic Membrane (DLAM). Artacent®

Intervention Type BIOLOGICAL

Artacent® is a double layer of dehydrated amniotic membrane. The amnion is harvested from human placenta obtained during planned Caesarean sections. Tides Medical uses a proprietary process to clean and decellularize the amniotic membrane. The amnion is then folded into a bi-layer with the stromal sides facing outward. The dual layer is dried and cut into various sizes. In the final step the DLAM is terminally sterilized.

Atracent®, like all other placental-derived products, is FDA cleared for homologous use through the 361 pathway. It is indicated for non-healing ulcers applied to a debrided, clean and uninfected ulcers.

Standard of Care

Standard of Care: sharp debridement, offloading, and proper moisture balance.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Dual Layer Amniotic Membrane (DLAM). Artacent®

Artacent® is a double layer of dehydrated amniotic membrane. The amnion is harvested from human placenta obtained during planned Caesarean sections. Tides Medical uses a proprietary process to clean and decellularize the amniotic membrane. The amnion is then folded into a bi-layer with the stromal sides facing outward. The dual layer is dried and cut into various sizes. In the final step the DLAM is terminally sterilized.

Atracent®, like all other placental-derived products, is FDA cleared for homologous use through the 361 pathway. It is indicated for non-healing ulcers applied to a debrided, clean and uninfected ulcers.

Intervention Type BIOLOGICAL

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Subjects must be at least 18 years of age or older,
2. Subjects must have a diagnosis of type 1 or 2 Diabetes mellitus.
3. At randomization subjects must have a target ulcer with a minimum surface area of 0.7 cm2 and a maximum surface area of 20.0 cm2 measured post debridement with the Tissue Analytics photographic planimetry App.
4. The target ulcer must have been present for a minimum of 4 weeks and a maximum of 52 weeks of standard of care prior to the initial screening visit.
5. The target ulcer must be located on the foot with at least 50% of the ulcer below the malleolus.
6. The target ulcer must be full thickness without exposed bone.
7. The affected limb must have adequate perfusion confirmed by vascular assessment. Any of the following methods performed within 3 months of the first screening visit are acceptable:

1. ABI between 0.7 and ≤ 1.3;
2. TBI ≥ 0.6;
3. TCOM ≥ 40 mmHg;
4. PVR: biphasic.

Exclusion Criteria

9. Target ulcers located on the plantar aspect of the foot must be offloaded for at least 30 days prior to randomization.
10. The subject must consent to using the prescribed off-loading method for the duration of the study.
11. The subject must agree to attend the weekly study visits required by the protocol.
12. The subject must be willing and able to participate in the informed consent process.


1. A subject known to have a life expectancy of \< 6 months is excluded.
2. The subject is excluded if the target ulcer is not secondary to diabetes.
3. If the target ulcer is infected or if there is cellulitis in the surrounding skin, the subject is excluded.
4. If there is evidence of osteomyelitis complicating the target ulcer, the subject is excluded.
5. A potential subject cannot have an infection in the target ulcer or in a remote location that requires systemic antibiotic therapy.
6. A subject receiving immunosuppressants (including systemic corticosteroids at doses greater than 10 mg of Prednisone per day or equivalent) or cytotoxic chemotherapy is excluded.
7. The topical application of steroids to the ulcer surface within one month of initial screening is not permitted.
8. A subject with a previous partial amputation on the affected foot is excluded if the resulting deformity impedes proper offloading of the target ulcer.
9. If a subject has glycated hemoglobin (HbA1c) greater than or equal to 12% within 3 months of the initial screening visit he/she is excluded.
10. The subject is excluded if the surface area measurement of the Target ulcer decreases by 40% or more during the 4-week screening phase: the 4 weeks from the initial screening visit (SV1) to the TV-1/randomization visit during which time the subject received SOC.
11. A Subject with an acute Charcot foot, or an inactive Charcot foot, that impedes proper offloading of the target ulcer is excluded.
12. Women who are pregnant or considering becoming pregnant within the next 6 months are excluded.
13. A potential subject with end stage renal disease requiring dialysis is excluded.
14. A subject who participated in a clinical trial involving treatment with an investigational product within the previous 30 days is excluded.
15. A subject who in the opinion of the investigator, has a medical or psychological condition that may interfere with study assessments is excluded.
16. A Subject treated with hyperbaric oxygen therapy or a Cellular and/or Tissue Product (CTP) in the 30 days prior to the initial screening visit is excluded.
17. A Subject is excluded if the MolecuLight Device shows a positive fluorescence image in the wound bed on TV1
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Tides Medical

INDUSTRY

Sponsor Role collaborator

SerenaGroup, Inc.

NETWORK

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Thomas E Serena, MD,FACS

Role: PRINCIPAL_INVESTIGATOR

Serena Group, Inc

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Titan Research

Phoenix, Arizona, United States

Site Status RECRUITING

New Hope Podiatry

Los Angeles, California, United States

Site Status RECRUITING

Royal Research

Pembroke Pines, Florida, United States

Site Status RECRUITING

Pharma Research Associates

Westchester, Florida, United States

Site Status COMPLETED

Regional Infectious Disease and Infusion Center, Inc

La Grange, Georgia, United States

Site Status RECRUITING

Hoosier Foot and Ankle

Fishers, Indiana, United States

Site Status RECRUITING

Serena Group Baton Rouge

Baton Rouge, Louisiana, United States

Site Status RECRUITING

Opelousas Medical Research Consultants, LLC

Opelousas, Louisiana, United States

Site Status RECRUITING

Mount Sinai St. Luke's Hospital

New York, New York, United States

Site Status RECRUITING

Cleveland Foot and Ankle Clinic

Cleveland, Ohio, United States

Site Status RECRUITING

Heal Foundation

Tulsa, Oklahoma, United States

Site Status RECRUITING

The Foot and Ankle Wellness Center of Western Pennsylvania

Ford City, Pennsylvania, United States

Site Status RECRUITING

Armstrong County Memorial Hospital - Wound Clinic

Kittanning, Pennsylvania, United States

Site Status RECRUITING

Martin Foot and Ankle

York, Pennsylvania, United States

Site Status RECRUITING

Mt.Olympus Medical Research

Sugar Land, Texas, United States

Site Status COMPLETED

Clinical Research Management Group

Coto Laurel, , Puerto Rico

Site Status COMPLETED

Countries

Review the countries where the study has at least one active or historical site.

United States Puerto Rico

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Thomas E Serena, MD,FACS

Role: CONTACT

814-688-4000

Doug Payne

Role: CONTACT

888-494-4441

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Kwadjo Walker

Role: primary

Noreen Rana

Role: backup

Francis Morfin

Role: primary

Demitric Lopez

Role: backup

Yalily Perez

Role: primary

Yaili Perez

Role: backup

Bhuvan Doneepudi, MS

Role: primary

Cheri Britt

Role: primary

James Vestile, DPM

Role: backup

Thomas E Serena, MS, FACS

Role: primary

Khristina Serena

Role: backup

Kerry Thibodeaux, MD

Role: primary

Marcus Speyrer

Role: backup

Denise Alabi

Role: primary

Windy Cole, DPM

Role: primary

Stacey Coe

Role: backup

Lam Le, MD

Role: primary

Phil Salon

Role: backup

Nicole Schrecengost

Role: primary

724-664-3843

Bryan Doner, DO

Role: primary

Nicole Schrecengost, LPN

Role: backup

Beth Mincer

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

HITIDE

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.