Freshly Manufactured 35kDa Hyaluronan Fragment HA35 for the Treatment of Chronic Wounds

NCT ID: NCT05764226

Last Updated: 2023-03-10

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

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-06

Study Completion Date

2023-02-08

Brief Summary

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In this research, the patients with chronic wounds accompanied by pain were treated by injecting freshly manufactured tissue permeable hyaluronan fragment HA35 into the tissue under the heath skin immediately surrounding the chronic wounds.

Detailed Description

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Chronic wounds are wounds or ulcers that do not heal properly and are generally classified as venous, arterial, diabetic, traumatic, and pressure chronic wound. Persistent chronic inflammation is a hallmark for chronic wound or trauma and is also often associated with inflammatory and neuropathic pain.

Injections of high molecular weight hyaluronan HA into joint cavity have been used for many years in treatment of joint pain as well as associated inflammation. Still, due to the high viscosity and poor tissue permeability of high molecular weight HA, it is unsuitable for treating chronic wound or trauma pain and the associated inflammation. In this study, the investigators found that hyaluronidase PH20 could cleave high molecular weight hyaluronan into 35kDa low molecular weight hyaluronan fragment HA35. The freshly-made hyaluronan fragment HA35 had great tissue permeability compared with high molecular HA. Our previous clinical studies (http://www.clinicaltrials.gov) have shown freshly-made hyaluronan fragment HA35 effectively treating shoulder, neck and back pain as well as the severe pain associated with shingles. In this study, the tissue-permeable 35kDa hyaluronan fragment HA35 was freshly manufactured by mixing hyaluronidase PH20 injectable solution and high-molecular-weight hyaluronan HA injectable solution. The therapeutic effect of the tissue-permeable hyaluronan fragment HA35 for treatment of pain associated chronic wounds was studied in a single-arm off-label used, before and after treatment comparison, clinical study similar to others.

Both recombinant human hyaluronidase PH20 (Hylenex, Halozyme Inc) and bovine testis-derived hyaluronidase PH20 (H31022111) are able to cleave high molecule weight hyaluronan into 35 kDa hyaluronan fragments HA35 (L20200708MP07707, Ministry of Health, Mongolia). This clinical study uses 35kDa low molecular weight hyaluronan fragment HA35 which was freshly manufactured by mixing bovine testis-derived hyaluronidase PH20 injection (H31022111) with high molecular weight hyaluronan HA injection (H20174089) for 20 minutesat at room temperature.

In this study, 20 hospitalized patients with chronic wounds accompanied by pain were treated with the freshly manufactured 35 kDa low molecular weight hyaluronan fragment HA35. There were 8 patients with diabetic chronic wounds, 4 patients with chronic venous wounds, 2 patients with chronic arterial wounds, 6 patients with traumatic and chronic pressure wounds. Among these patients, there are 12 males and 8 females, having average age of 55±10 years. The creteria for the chronic wound in this study were the wound that has not been healed more than 3 months. All the chronic wounds were associated with significantly pain. All the wounds were clinically presented by surface darkenes and purulent secretions on the wounds, and darkness, redness, swelling and dryness and broken surface of the skin surrounding the wounds. This study is an open-label clinical study in which no information is withheld from participantes and investigators. In this study, the therapeutic effect was studied by comparison of those of before and after treatment in a single-arm study. The pain associated with the wounds and degree of healing of the wounds including the size of fresh granulation area on the wound, the degree of darkness or redness, dryness and broken surface of the skin surrounding the wound, and the size of the wound were observed and recorded.

Conditions

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Chronic Wounds

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

An open label single arm before and after treatment comparison clinical study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

An off-label use of an open label single arm before and after treatment comparison clinical study

Study Groups

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35 kDa HA fragment HA35 injection

100 mg of the freshly made 35 kDa low molecular weight hyaluronan fragment HA35 was injected into the tissue under the heath skin immediately surrounding the chronic wounds

Group Type EXPERIMENTAL

HA35(L20200708MP07707, Ministry of Health, Mongolia)was freshly manufactured by mixing hyaluronidase PH20 injectable solution (H31022111) and high-molecular-weight HA injectable solution (H20174089)

Intervention Type DRUG

One hundred milligrams of the freshly made 35 kDa low molecular weight HA fragment HA35 was injected into the tissue under the heath skin immediately surrounding the chronic wounds once a day for 10 days.

Interventions

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HA35(L20200708MP07707, Ministry of Health, Mongolia)was freshly manufactured by mixing hyaluronidase PH20 injectable solution (H31022111) and high-molecular-weight HA injectable solution (H20174089)

One hundred milligrams of the freshly made 35 kDa low molecular weight HA fragment HA35 was injected into the tissue under the heath skin immediately surrounding the chronic wounds once a day for 10 days.

Intervention Type DRUG

Other Intervention Names

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HA35

Eligibility Criteria

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Inclusion Criteria

1. The chronic wounds of painful diabetic wounds, venous wounds, arterial wounds, traumatic and pressure wounds which had not been closed more than 3 months.
2. All the chronic wounds were clinically presented by surface darkeness and purulent secretions on the wounds, and darkness or redness, swelling, dryness and broken.
3. Surface of the skin immediately surrounding the wounds.
4. Subject agrees to be compliant with study related visit and treatment schedule.
5. Written informed consent.

Exclusion Criteria

1. History of wound healing abnormalities or a medical condition that is known to be associated with abnormal wound healing.
2. Subjects with any known coagulation disorder.
Minimum Eligible Age

45 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mongolian National University of Medical Sciences

OTHER

Sponsor Role collaborator

Nakhia Impex LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Far East Hospital

Harbin, Heilongjiang, China

Site Status

Countries

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China

References

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Jia X, Shi M, Wang Q, Hui J, Shofaro JH, Erkhembayar R, Hui M, Gao C, Gantumur MA. Anti-Inflammatory Effects of the 35kDa Hyaluronic Acid Fragment (B-HA/HA35). J Inflamm Res. 2023 Jan 13;16:209-224. doi: 10.2147/JIR.S393495. eCollection 2023.

Reference Type RESULT
PMID: 36686276 (View on PubMed)

APPLICATION OF LOW-MOLECULAR-WEIGHT HYALURONIC ACID(LMW-HA) FRAGMENTS(INJECTION) WO/2017/186088 US20200254005 EP3479830 AU2017255833 CA3049286

Reference Type RESULT

Related Links

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Other Identifiers

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hui19970909

Identifier Type: -

Identifier Source: org_study_id

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