Trial to Evaluate the Safety and Effectiveness of Treatment With COMS One Device in Subjects With Diabetic Foot Ulcers

NCT ID: NCT05758545

Last Updated: 2025-03-28

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

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

450 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-06-19

Study Completion Date

2027-06-19

Brief Summary

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The purpose of this clinical trial is to evaluate the safety and effectiveness of the treatment with the COMS One device in subjects with refractory diabetic foot ulcers (DFUs). The prospective randomized, double-blinded, sham-controlled trial is designed to demonstrate superiority of wound closure of the COMS One device to a sham-control device through 24 weeks post-application, when each is administered in conjunction with standard of care (SOC) in the treatment of DFUs.

Detailed Description

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The purpose of this clinical trial is to evaluate the safety and effectiveness of the treatment with the COMS One device in subjects with refractory diabetic foot ulcers (DFUs). The prospective randomized, double-blinded, sham-controlled trial is designed to demonstrate superiority of wound closure of the COMS One device to a sham-control device through 24 weeks post-application, when each is administered in conjunction with standard of care (SOC) in the treatment of DFUs.

Primary Objective:

The COMS One Therapy System is intended to promote wound healing in chronic DFUs. As part of the clinical investigation, the primary objective is to determine time to complete wound healing, defined as complete skin re-epithelialization without drainage confirmed by 2 consecutive trial visits 2 weeks apart.

Secondary Objectives:

Secondary objectives are confirmation of safety and assessment of wound healing parameters as well as subject and site reported outcomes.

A total of 450 subjects with refractory DFU will be screened. It is expected that 50% of subjects will be excluded from the trial if either of the following occurs between screening and randomization: \>30% wound closure over a period of 2 weeks or \>50% wound closure over a period of 4 weeks (measured post-debridement). The remaining 224 subjects will be randomized into two groups (112 Subjects Sham device treated; 112 Subjects COMS One device treated) to account for approximately 10% missing data due to early trial withdrawal or missed endpoint assessment.

Conditions

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Diabetic Foot Ulcer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The purpose of this clinical trial is to evaluate the safety and effectiveness of the treatment with the COMS One device in subjects with refractory diabetic foot ulcers (DFUs). The prospective randomized, double-blinded, sham-controlled trial is designed to demonstrate superiority of wound closure of the COMS One device to a sham-control device through 24 weeks post-application, when each is administered in conjunction with standard of care (SOC) in the treatment of DFUs.

Following randomization, subjects will be assigned treatment with either COMS One device or the Sham device in conjunction with SOC. At least 50% of subjects are required to be 65 years or older at randomization.

Prospective, randomized, double-blinded, placebo-controlled trials provide the most objective methods for analyzing the outcomes of multiple treatment groups. The blinded use of a sham device allows for a true comparison of COMS One treatment in conjunction with SOC to SOC alone.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Permuted block randomization will be applied to generate randomization codes using a mix of blocks of size 2 and 4. Randomization will be stratified by site and age (\<65 years, ≥65 years). Both the COMS One device and the Sham device will be prepared to appear to be identical to the subject to achieve the double-blind purposes and each device will be given a unique serial identifier.

To avoid assessment bias, each site will have an Inter-observer (blinded assessor) who will be blinded to treatment and perform and document all assessments of the target DFU evolution. Following target DFU assessment, the treatment will be performed by another assigned clinician, who will not have any involvement with the Inter-observer. Furthermore, both parties will be instructed not to discuss target DFU evolution or treatment with each other. This will provide an adequate level of masking to ensure that the trial is double-blinded.

Study Groups

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COMS One device

The COMS One device is the housing unit for the user controls, displays and functions including embedded software, lithium-ion battery, optical (LEDs) and a magnetic stimulation coil. The COMS One device is reusable (the component can be used on multiple subjects and is cleaned between uses).

The COMStouch is a sterile single-use component. The COMStouch provides a base and sterile barrier for the COMS One device.

The COMSfix component is a self-adhesive single-use strap used to hold the COMS One device and COMStouch components in place during treatment.

Group Type ACTIVE_COMPARATOR

COMS One device

Intervention Type DEVICE

The COMS One device incorporates technologies for optical and magnetic stimulation. The optical stimulation component is designed to emit light by two types of light emitting diodes (LEDs) in the wavelength of 660 nm (red) and 830 nm (near infrared) range of the electromagnetic spectra. The magnetic stimulation component is generated by a coil emitting pulse modulated magnetic fields in the extremely low frequency (ELF) range of the electromagnetic spectra. The COMS One is a lightweight, portable device. The device is locally applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific feature that has been modified for the purpose of blinding is sensor detecting whether the device is lying on the skin.

Sham device

The sham device is the housing unit for the user controls, displays and functions including embedded software, lithium-ion battery, optical (LEDs) and a magnetic stimulation coil. The sham device is reusable (the component can be used on multiple subjects and is cleaned between uses).

The COMStouch is a sterile single-use component. The COMStouch provides a base and sterile barrier for the sham device.

The COMSfix component is a self-adhesive single-use strap used to hold the sham device and COMStouch components in place during treatment.

Group Type SHAM_COMPARATOR

Sham device

Intervention Type DEVICE

The Sham device is a lightweight, portable device. The device is applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific features that have been modified for the purposes of blinding include the following: 1) therapeutic output, and 2) sensor detecting whether the device is lying on the skin.

Interventions

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COMS One device

The COMS One device incorporates technologies for optical and magnetic stimulation. The optical stimulation component is designed to emit light by two types of light emitting diodes (LEDs) in the wavelength of 660 nm (red) and 830 nm (near infrared) range of the electromagnetic spectra. The magnetic stimulation component is generated by a coil emitting pulse modulated magnetic fields in the extremely low frequency (ELF) range of the electromagnetic spectra. The COMS One is a lightweight, portable device. The device is locally applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific feature that has been modified for the purpose of blinding is sensor detecting whether the device is lying on the skin.

Intervention Type DEVICE

Sham device

The Sham device is a lightweight, portable device. The device is applied via a single use disposable component (COMStouch) that provides a base and sterile barrier for the unit. The device is attached via a single use strap (COMSfix). The device has been slightly adapted in order to make sure blinding is achieved/maintained. The specific features that have been modified for the purposes of blinding include the following: 1) therapeutic output, and 2) sensor detecting whether the device is lying on the skin.

Intervention Type DEVICE

Other Intervention Names

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Concurrent Optical and Magnetic Stimulation

Eligibility Criteria

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Inclusion Criteria

1. Subjects are male or female, ≥22 and ≤90 years of age
2. Female subjects of childbearing potential must be willing to use acceptable methods of contraception (birth control pills, barriers, or abstinence) starting at screening and throughout the duration of their study participation.
3. The participant (or LAR if applicable) must be able to understand and sign the informed consent form (ICF) and comply with requirements set in the protocol including trial visits, trial treatment and dressing regimens and compliance with required offloading device (if applicable)
4. Type 1 or Type 2 diabetes mellitus
5. Presence of one full-thickness DFU located at or below the malleoli (If the subject has more than one DFU that meets eligibility criteria, the investigator will designate one DFU as the target DFU to be treated in the trial)
6. Wagner Grade 1 or 2 (without bone exposure)
7. There is a minimum 2 cm margin between the target DFU and any other ulcer on that same foot, post-debridement
8. Target DFU duration \>30 days and \<52 weeks
9. Target DFU area between 0.5 - 25 cm2 at screening (Target DFU is ≥ 0.5cm2 after debridement at start of Run-In Phase)
10. Adequate vascular perfusion of the target limb (same limb as where the target DFU is located) as evidenced by: either a skin perfusion pressure (SPP) measurement of ≥30mmHg OR an ankle-brachial index (ABI) \>0.7 but less than 1.2 or a toe-brachial index (TBI) \>0.4 but less than 1.1 or a transcutaneous oxygen pressure (TcPO2) \>40mmHg

Exclusion Criteria

1. Known pregnancy or lactating
2. Active skin cancer, a history of skin cancer or any other localized cancer, precancerous lesions or large moles in the areas to be treated.
3. Subject who is taking any medications the Investigator believes may interfere with healing of the target DFU
4. Subject who is currently undergoing treatment for an active systemic infection, including osteomyelitis
5. Wagner Grade 3, 4 or 5
6. Participation in another trial with investigational drug or device within the 30 days preceding and during the present trial
7. Any co-morbid medical condition which places the subject at unreasonable risks in the opinion of the Investigator
8. Subject has chronic renal insufficiency requiring dialysis (end stage renal disease)
9. Subject is being treated with systemic corticosteroids (prednisone, dexamethasone, hydrocortisone, methylprednisolone, or similar) \>10mg/day for more than 10 days or any dose \>30 days
10. For subjects in the 2-Week Run-In Phase: more than 30% closure of target DFU at Screening Run-In Phase Visit I or Randomization/Baseline Visit or more than 50% closure of target DFU between the 2 Week Historical Period and Randomization/Baseline Visit (measured post-debridement)
11. For subjects in the 4-Week Run-In Phase: more than 30% closure of target DFU at Screening Run-In Visit II or between Screening Run-In Phase Visit II and Randomization/Baseline Visit or more than 50% closure of target DFU between Screening Run-In Phase Visit I and Randomization/Baseline Visit (measured post-debridement)
12. Blood chemistry or counts values as follows (based on subject's medical files):

1. Pre-albumin \<10 mg/dL OR albumin \<2.8 g/dL
2. Serum BUN \>60 mg/dL
3. Serum creatinine \>4.0 mg/dL
4. WBC \<2.0 x 109/L
5. Hemoglobin \<8.0 g/dL
6. Absolute neutrophil \<1.0 x 109/L
7. Platelet count \<50 x 109/L
8. HbA1C \>12%
Minimum Eligible Age

22 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NAMSA

OTHER

Sponsor Role collaborator

Piomic Medical

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aksone Nouvong, DPM

Role: PRINCIPAL_INVESTIGATOR

University of California, Los Angeles

Locations

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Titan Clinical Research

Mesa, Arizona, United States

Site Status RECRUITING

Southern Arizona VA Health Care System

Tucson, Arizona, United States

Site Status RECRUITING

Center for Clinical Research Inc.

Castro Valley, California, United States

Site Status RECRUITING

Limb Preservation Platform, Inc.

Fresno, California, United States

Site Status RECRUITING

Angel City Research, Inc.

Los Angeles, California, United States

Site Status RECRUITING

UCLA Ronald Regan - Department of Surgery

Los Angeles, California, United States

Site Status RECRUITING

Center for Clinical Research Inc.

San Francisco, California, United States

Site Status RECRUITING

Center for Clinical Research Inc.

San Francisco, California, United States

Site Status RECRUITING

ILD Research Center

Vista, California, United States

Site Status RECRUITING

Bay Pines VA Healthcare System

Bay Pines, Florida, United States

Site Status RECRUITING

University of Florida Health Jacksonville

Jacksonville, Florida, United States

Site Status WITHDRAWN

Clever Medical Research LLC

Miami, Florida, United States

Site Status RECRUITING

The Angel Medical Research Corporation

Miami Lakes, Florida, United States

Site Status WITHDRAWN

Aiyan Diabetes Center

Augusta, Georgia, United States

Site Status RECRUITING

Northwestern University Feinberg School of Medicine

Chicago, Illinois, United States

Site Status RECRUITING

Rush University

Chicago, Illinois, United States

Site Status WITHDRAWN

Gateway Clinical Trials

O'Fallon, Illinois, United States

Site Status RECRUITING

Curalta Clinical Trials

Westwood, New Jersey, United States

Site Status RECRUITING

Veteran Affairs of WNY Healthcare System

Buffalo, New York, United States

Site Status RECRUITING

Northwell Comprehensive Wound Healing Center

Lake Success, New York, United States

Site Status WITHDRAWN

UNC Medical Center

Chapel Hill, North Carolina, United States

Site Status RECRUITING

The Ohio State University

Columbus, Ohio, United States

Site Status RECRUITING

UPMC McKeesport

McKeesport, Pennsylvania, United States

Site Status RECRUITING

Vanderbilt University Medical Center - Vanderbilt Wound Center

Nashville, Tennessee, United States

Site Status RECRUITING

Richard C. Galperin DPM PA

Dallas, Texas, United States

Site Status RECRUITING

HCA Healthcare Houston Medical Center

Houston, Texas, United States

Site Status RECRUITING

Futuro Clinical Trials, LLC

McAllen, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Rejelle Williams

Role: CONTACT

+41 44 244 19 78

Bernard Laurel

Role: CONTACT

+1-855-574-6642

Facility Contacts

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Noreen Rana

Role: primary

Lorrie Mills

Role: primary

520-792-1450 ext. 1-4068

Maria Peralta

Role: primary

Destiny Blackstone

Role: primary

Maira Jackson

Role: primary

Marco Morcos

Role: primary

Maria Paralta

Role: primary

Maria Peralta

Role: primary

Eric Martinez

Role: primary

Ashlee Tavernier

Role: primary

727 398 6661 ext. 17842

Margarita Hernandez

Role: primary

Vishnu Gardasu

Role: primary

Rena Li

Role: primary

Valerie Anderson

Role: primary

Radhika Gajera

Role: primary

Ann Galla

Role: primary

Kari Walls

Role: primary

Chelsea Fredrick

Role: primary

Celia Núñez

Role: primary

Mena Azer

Role: backup

Leisa Guerrero

Role: primary

Brianna De Roche

Role: primary

Pedro Gonzalez

Role: primary

References

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Galiano RD, Li RA, Lantis JC, Oropallo A, Ulloa J, Iafrati M, Lavery LA, O'Connell J, Nouvong A, Cavalcante VMV. The trial design of the concurrent optical and magnetic stimulation (COMS) therapy study for refractory diabetic foot ulcers (MAVERICKS): a multicenter, randomized, sham-controlled, double-blind investigational device exemption clinical study. Wounds. 2025 Aug;37(8):275-282. doi: 10.25270/wnds/25037.

Reference Type DERIVED
PMID: 40931367 (View on PubMed)

Other Identifiers

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COMS_03

Identifier Type: -

Identifier Source: org_study_id

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