Non-healing Venous Leg Ulcers Treated With Standard Care With or Without BR-AC

NCT ID: NCT06811909

Last Updated: 2026-01-23

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-02-14
• Study Completion Date: 2026-10-31

Brief Summary

This study examines a patient population with a non-healing, non-infected venous leg ulcer (VLU) having adequate arterial perfusion with confirmed venous reflux. It is hypothesized that weekly applications of the human placental allograft BioREtain® Amnion Chorion (BR-AC) applied to a non-healing VLU will result in a higher proportion of wounds showing complete healing within 12 weeks of initiating therapy, compared to standard care alone.

This study has a crossover period, where subjects on standard care alone who do not achieve complete healing within 12 weeks of initiating therapy will be allowed to crossover to receive BR-AC over 12 additional weeks, to evaluate if their wound can achieve complete healing.

Detailed Description

This trial is a multicenter, randomized, controlled study designed to evaluate the safety and efficacy of BR-AC plus standard of care versus standard of care only in the treatment of venous leg ulcers. The eligibility criteria for this study will allow for enrollment of subjects with a VLU in the range of 2 cm^2 to 20 cm^2 in area. A lower size of 2 cm^2 was selected to exclude subjects who are likely to heal under compression therapy alone.

During the two-week run-in period, subjects who show a reduction in wound area predictive of achieving complete wound closure within 12 weeks under standardized care alone (i.e., compression therapy) will be excluded from the study. Eliminating these subjects will improve the estimated treatment effect. The criteria for duration, ≥ 4 weeks but ≤ 52 weeks, allows for the selection of those wounds that have demonstrated chronicity but may still have the potential to achieve wound closure.

The trial design will control potential variables that may affect the outcome between the treatment group and the control group by standardizing the requirements for evaluating venous insufficiency confirmed by duplex Doppler ultrasound examining valvular or venous incompetence, debridement, and compression therapy. Weekly subject visits will help monitor compliance in wound care and compression therapy, as well as to document when wound closureis achieved. The study will implement the use of an electronic imaging and measurement device (eKare inSight®) using a standardized protocol to ensure the measuring of the wound surface area is accurate, highly reproducible, and minimally variable.

There will also be a crossover treatment phase for those patients that were relegated to SOC only. After their 12-week standard of care treatment phase and for only those subjects that did not achieve complete wound closure, will be allowed to crossover for an additional 12 weeks of treatment with the BR-AC product following the protocol and procedures set forth within this document.

A follow-up phase will commence for all subjects that achieve complete wound closure, which is designed to measure longevity and durability of the closed wound. This follow-up period will consist of a four-week follow-up with two visits at each two-week interval.

Conditions

Non-infected Venous Leg Ulcer; Venous Leg Ulcer; Venous Insufficiency; Venous Stasis; Venous Reflux

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

BR-AC plus Standard Care

All subjects in the treatment group will receive sponsor-approved standard of care. Standard of care is defined as:

• Sharp debridement,
• Wound cleansing with a neutral, non-irritating and non-toxic solution,
• Non-adherent wound contact layer followed by an alginate or foam pad to maintain a moist, warm wound bed, and
• The UrgoK2™ dual compression system providing around 40 mmHg.

Using an appropriate size to cover the entire wound area, BR-AC should be applied directly to the wound surface following sharp debridement. It is recommended that the product be trimmed to fit the area of the wound with sterile scissors before application.

Group Type: EXPERIMENTAL

BR-AC

Intervention Type: OTHER

BR-AC is an amnion layer, intermediate layer, and chorion layer placental membrane processed together with no separation of the layers. BR-AC is manufactured by BioStem Technologies, Inc. and is processed by the bioREtain method, which, briefly includes initial disinfection, processing with isotonic solutions, dehydration at 37-40°C, and electron beam sterilization.

Standard Care

All subjects in the control group will receive sponsor-approved standard of care. Standard of care is defined as:

• Sharp debridement,
• Wound cleansing with a neutral, non-irritating and non-toxic solution,
• Non-adherent wound contact layer followed by an alginate or foam pad to maintain a moist, warm wound bed, and
• The UrgoK2™ dual compression system providing around 40 mmHg.

Group Type: ACTIVE_COMPARATOR

Standard Care

Intervention Type: OTHER

Standard Care is defined as:

• Sharp debridement,
• Wound cleansing with a neutral, non-irritating and non-toxic solution,
• Non-adherent wound contact layer followed by an alginate or foam pad to maintain a moist, warm wound bed, and
• The UrgoK2™ dual compression system providing around 40 mmHg.

Interventions

BR-AC

BR-AC is an amnion layer, intermediate layer, and chorion layer placental membrane processed together with no separation of the layers. BR-AC is manufactured by BioStem Technologies, Inc. and is processed by the bioREtain method, which, briefly includes initial disinfection, processing with isotonic solutions, dehydration at 37-40°C, and electron beam sterilization.

Intervention Type: OTHER

Standard Care

Standard Care is defined as:

• Sharp debridement,
• Wound cleansing with a neutral, non-irritating and non-toxic solution,
• Non-adherent wound contact layer followed by an alginate or foam pad to maintain a moist, warm wound bed, and
• The UrgoK2™ dual compression system providing around 40 mmHg.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

1. Patient has signed the informed consent form.

2. Male or female patient at least 18 years of age or older, as of the date of the screening visit.

3. Has a VLU between the knee and ankle (at or above the malleoli), with a surface area in the range of ≥ 2.0 cm2 and ≤ 20.0 cm2 when measured by the investigator staff at the screening visit using the eKare device post debridement.

1. If the subject presents with > 1, but ≤ 3 VLU on the same leg, the largest ulcer will be selected as the target ulcer.

2. If the target ulcer is < 1cm from another VLU, the ulcers should be traced as a single target ulcer provided at least one of the ulcers is at least 2.0 cm2 in area and the total surface area of the VLUs is ≤ 20.0 cm2.

4. Target ulcer involves a full-thickness skin loss, but without exposure of tendon, muscle, or bone.

5. Target ulcer duration ≥ 4 weeks but ≤ 52 weeks (12 months).

6. Venous insufficiency confirmed by duplex Doppler ultrasound examining valvular or venous incompetence.

a. Availability of a complete report of a previous examination performed 12 months of screening will be acceptable, and this examination would not be required to be repeated.

7. Arterial supply adequacy confirmed by any one of the following:

1. Great toe pressure ≥ 50 mm/Hg

2. Systolic blood pressure Ankle Brachial Index (ABI) in the range ≥ 0.80 ≤ 1.10

3. TcPO2 ≥ 40 mmHg from the foot

8. Willing to follow all instructions given by the Investigator, return for all visits, and adhere to compression protocols while on the study.

Exclusion Criteria

1. A target ulcer of non-venous etiologies (e.g., sickle cell anemia, necrobiosis lipoidica diabeticorum, pyoderma gangrenosum, vasculopathic or vasculitic).

2. Acute Deep Vein Thrombosis (DVT), defined as the first 10 days from onset of symptoms, or any DVT for which compression is considered by the Investigator to be contraindicated.

3. Clinical evidence of ulcer bed infection, or infected hardware.

4. Documented history of osteomyelitis at the target ulcer location within six (6) months preceding the screening visit.

5. Refusal or inability to tolerate compression therapy.

6. Pregnant women.

7. Women of child-bearing potential who are unwilling to avoid pregnancy or use an effective form of birth control.

8. Hemoglobin A1c (HbA1c) level is > 12% (108 mmol/mol).

9. Current therapy with systemic antibiotics.

10. Current therapy with cytotoxic agents.

11. Current therapy with chronic (> 10 days) oral corticosteroids.

12. Current therapy with TNFα inhibitors other than Trental® (pentoxifylline).

13. Has tested positive for Human Immunodeficiency Virus (HIV) or has Acquired Immune Deficiency Syndrome (AIDS).

14. Has malignancy or history of cancer in the preceding 5 years other than non-melanoma skin cancer.

15. Currently on dialysis or planning to start dialysis.

16. Is currently enrolled or participated in another device, drug, or biological trial within 30 days of screening.

17. Therapy of the target ulcer with other birth tissue products, autologous skin graft, Apligraf®, or Dermagraft® within 30 days preceding the screening visit.

18. Therapy of the target ulcer with topical growth factors within thirty (30) days preceding the screening visit.

19. Any previous use of Vendaje®, Vendaje AC®, AmnioWrap2® applied to the target ulcer.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

BioStem Technologies

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Bert Slade, MD

Role: STUDY_DIRECTOR

Independent

Locations

Site 17

Guntersville, Alabama, United States

Site Status: RECRUITING

Site 2b

Castro Valley, California, United States

Site Status: RECRUITING

Site 19b

Glendale, California, United States

Site Status: RECRUITING

Site 36

Oxnard, California, United States

Site Status: RECRUITING

Site 37

Oxnard, California, United States

Site Status: RECRUITING

Site 19

Palmdale, California, United States

Site Status: RECRUITING

Site 02

San Francisco, California, United States

Site Status: RECRUITING

Site 2a

San Francisco, California, United States

Site Status: RECRUITING

Site 04

Sylmar, California, United States

Site Status: RECRUITING

Site 30

Torrance, California, United States

Site Status: RECRUITING

Site 01

Vista, California, United States

Site Status: RECRUITING

Site 34

Aventura, Florida, United States

Site Status: RECRUITING

Site 27

Coral Gables, Florida, United States

Site Status: RECRUITING

Site 20

Deerfield Beach, Florida, United States

Site Status: RECRUITING

Site 33

Fort Walton Beach, Florida, United States

Site Status: WITHDRAWN

Site 35

Miami, Florida, United States

Site Status: RECRUITING

Site 31

Miami, Florida, United States

Site Status: TERMINATED

Site 06

O'Fallon, Illinois, United States

Site Status: RECRUITING

Site 18

Boston, Massachusetts, United States

Site Status: RECRUITING

Site 32

St Louis, Missouri, United States

Site Status: RECRUITING

Site 16

Lake Success, New York, United States

Site Status: RECRUITING

Site 38

Corpus Christi, Texas, United States

Site Status: RECRUITING

Site 03

Fort Worth, Texas, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Nick McCoy

Role: CONTACT

nmccoy@biostemtech.com

2144571996

Other Identifiers

BR-AC-VLU-101

Identifier Type: -

Identifier Source: org_study_id