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出境医 / 临床实验 / Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers

Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers

Study Description
Brief Summary:
The purpose of the current Study is to determine the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU. The study is being conducted in 350 subjects being recruited in about 30 centers in India.

Condition or disease Intervention/treatment Phase
Diabetic Foot Ulcer Drug: Esmolol Hydrochloride Other: Only Standard of Care Other: Vehicle Gel Phase 3

Detailed Description:
The current study is a Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers. The study evaluates the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU.
Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 350 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Prospective, Multicenter, Randomized, Double-Blind, Parallel groups
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Masking Description: The subject will be masked from the treatment by the Study Nurse (care giver) by using blinder during each treatment application. The site has two separate teams (blinded and unblinded) for masking. The unblinded investigator performs application of treatment during each treatment visit of subject to the site.
Primary Purpose: Treatment
Official Title: A Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers
Actual Study Start Date : December 26, 2018
Estimated Primary Completion Date : June 30, 2020
Estimated Study Completion Date : October 30, 2020
Arms and Interventions
Arm Intervention/treatment
Active Comparator: Galnobax® 14% gel plus SoC
Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (150 subjects)
Drug: Esmolol Hydrochloride
Galnobax-14% gel application along with Standard of Care
Other Name: Galnobax

Sham Comparator: SoC Only
Only Standard of Care will be administered twice daily (150 subjects)
Other: Only Standard of Care
Only Standard of Care treatment

Placebo Comparator: Vehicle plus SoC
Vehicle gel along with Standard of Care (SoC) will be administered twice daily (50 subjects)
Other: Vehicle Gel
Vehicle gel application along with Standard of Care

Outcome Measures
Primary Outcome Measures :
  1. Proportion of Subjects achieving Target Ulcer Closure within 12-week Treatment Phase, as assessed by blinded Investigator [ Time Frame: 12-weeks ]
    Primary efficacy endpoint


Secondary Outcome Measures :
  1. Time to Target Ulcer Closure during the 12-week Treatment Phase, as assessed by the blinded Investigator. [ Time Frame: 12-weeks ]
    Secondary efficacy endpoint

  2. Proportion of Subjects achieving Target Ulcer Closure till End of Study, as assessed by the blinded Investigator. [ Time Frame: 24-weeks ]
    Secondary efficacy endpoint


Other Outcome Measures:
  1. Proportion of Subjects with treatment emergent adverse events (TEAEs) [ Time Frame: 24-weeks ]
    Safety endpoint

  2. Proportion of Subjects with events related to the local wound assessment of Target Ulcer in Vehicle plus Standard of Care group. [ Time Frame: 24-weeks ]
    Safety endpoint


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subjects, male or female, aged 18 to 75 years (inclusive) with Type 1 or Type 2 diabetes undergoing therapy for glycemic control
  2. Subject has glycosylated hemoglobin, HbA1C, ≤ 12%
  3. Subject with diagnosis of neuropathic foot ulcer by 10g monofilament test
  4. Subject has adequate vascular perfusion of the affected limb, confirmed by Ankle-Brachial Index (ABI) ≥ 0.65 and ≤ 1.3
  5. Presence of at least one DFU that meets all of the following criteria:

    1. A full-thickness ulcer of Grade A1 as per Texas classification system;
    2. Ulcer is located below or up to 5 cm above the malleoli (excluding ulcers between the toes);
    3. Ulcer size (area) is ≥ 2 cm2 and ≤ 15 cm2 (post-debridement);
    4. There is a minimum 3 cm margin between the qualifying Target Ulcer and any other ulcers on the specified foot, post-debridement;
    5. No exposed bone, tendon, muscle, ligament or joint capsule, and no tunneling, undermining, or sinus tracts;
    6. Unresponsive to ulcer care and open for at least 6 weeks at the time of the Screening Visit;
    7. Ulcer is non-infected as determined by clinical assessment and complete hemogram;
    8. Ulcer has a clean, granulating base free of adherent slough to the greatest extent possible as per Investigator;
    9. Ulcer area reduction < 30% from the Screening Visit to Baseline visit
  6. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Investigator
  7. Subject, if female of child-bearing potential, has a negative urine pregnancy test at Screening and willing to use acceptable methods of contraception (birth control pills, barriers) or abstinence throughout the Study
  8. Subject is able and willing to comply with Study procedures including the use of an off-loading device (as applicable for the location of the ulcer) and adhere to protocol during the Study in the opinion of Investigator
  9. A Subject or LAR agrees to sign informed consent form and allow audio visual recording of consent, if applicable

Exclusion Criteria:

  1. Actively infected ulcers with or without purulent discharge, ulcers with exposed bone or associated with osteomyelitis
  2. Subjects with more than three ulcers below knee
  3. Subjects with Target Ulcer requiring off-loading that cannot be effectively off-loaded; or unable to tolerate the off-loading method
  4. Subject has ulcers caused by a disease other than diabetes, e.g., fungal ulcerations, malignant ulcerations, and ulcerations due to venous or arterial insufficiency, or due to hematological disorders, in the opinion of the Investigator
  5. Ulcer, about which the Investigator is suspicious for cancer
  6. Subjects with a gangrenous or ischemic ulcer
  7. Subject with ulcer that in the opinion of the Investigator, may need amputation
  8. Subject with Target ulcer where wound measurement is not possible, such as ulcers between toes
  9. Body mass index (BMI) > 40 kg/m2
  10. Laboratory values at Screening of:

    1. Hemoglobin < 10.0 g/dL
    2. White Blood Cells (WBC) < 2.0 X 109 cells/L
    3. Liver function studies [Total bilirubin, aspartate aminotransferase (AST) and alanine transaminase (ALT)] > 3x the upper limit of normal
    4. Albumin < 2.5 g/dL
    5. eGFR < 25 mL/min
  11. Presence of any existing clinically significant medical condition(s) that, in the opinion of the Investigator, could interfere with wound healing
  12. Subject has received or is currently receiving or scheduled to receive any medication or therapies during the course of the Study that will modulate wound healing
  13. Subject with intolerance to β-blockers at any time in the past
  14. Has any other factor which may, in the opinion of the Investigator, compromise participation and/or follow-up in the Study
Contacts and Locations

Locations
Layout table for location information
India
M.S. Ramaiah Medical College and Hospital Recruiting
Bangalore, Karnataka, India, 560054
Contact: Sanjay Desai, MS    9845290575    scdesai@hotmail.com   
Deenanath Mangeshkar Hospital and Research Center Recruiting
Pune, Maharashtra, India, 411004
Contact: Manisha Deshmukh, MD    9823129387    mandeshmukh@rediffmail.com   
Chellaram Diabetes Institute Recruiting
Pune, Maharashtra, India, 411021
Contact: A G Unnikrishnan, MD    9689287337    unnikrishnanag@gmail.com   
M.V. Hospital for Diabetes Pvt Ltd Recruiting
Chennai, Tamilnadu, India, 600013
Contact: Vijay Viswanathan, M.D.    9840055535    drvijay@mvdiabetes.com   
Madras Diabetes Research Foundation Recruiting
Chennai, Tamilnadu, India, 600086
Contact: Muthu Ramu, F. Diab.    9840923632    tmcramu2000@yahoo.co.in   
Sri Ramachandra Hospital Recruiting
Chennai, Tamilnadu, India, 600116
Contact: Sudhagar Singh, MD    9003178899    drsingh7071@gmail.com   
Post Graduate Institute of Medical Education and Research (PGIMER) Recruiting
Chandigarh, India, 110012
Contact: Ashu Rastogi, MD    9781001046    ashuendo@gmail.com   
Maharaja Agrasen Hospital Recruiting
New Delhi, India, 110026
Contact: Deepak Khandelwal, MD    9968878561    khandelwalaiims@gmail.com   
Sponsors and Collaborators
Novalead Pharma Private Limited
Tracking Information
First Submitted Date  ICMJE June 24, 2019
First Posted Date  ICMJE June 26, 2019
Last Update Posted Date June 26, 2019
Actual Study Start Date  ICMJE December 26, 2018
Estimated Primary Completion Date June 30, 2020   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: June 25, 2019)
Proportion of Subjects achieving Target Ulcer Closure within 12-week Treatment Phase, as assessed by blinded Investigator [ Time Frame: 12-weeks ]
Primary efficacy endpoint
Original Primary Outcome Measures  ICMJE Same as current
Change History No Changes Posted
Current Secondary Outcome Measures  ICMJE
 (submitted: June 25, 2019)
  • Time to Target Ulcer Closure during the 12-week Treatment Phase, as assessed by the blinded Investigator. [ Time Frame: 12-weeks ]
    Secondary efficacy endpoint
  • Proportion of Subjects achieving Target Ulcer Closure till End of Study, as assessed by the blinded Investigator. [ Time Frame: 24-weeks ]
    Secondary efficacy endpoint
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures
 (submitted: June 25, 2019)
  • Proportion of Subjects with treatment emergent adverse events (TEAEs) [ Time Frame: 24-weeks ]
    Safety endpoint
  • Proportion of Subjects with events related to the local wound assessment of Target Ulcer in Vehicle plus Standard of Care group. [ Time Frame: 24-weeks ]
    Safety endpoint
Original Other Pre-specified Outcome Measures Same as current
 
Descriptive Information
Brief Title  ICMJE Phase 3 Study to Evaluate the Safety and Efficacy of Galnobax® in Treating Diabetic Foot Ulcers
Official Title  ICMJE A Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers
Brief Summary The purpose of the current Study is to determine the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU. The study is being conducted in 350 subjects being recruited in about 30 centers in India.
Detailed Description The current study is a Prospective, Multicenter, Randomized, Double-Blind, Phase 3 Study to Evaluate the Safety and Efficacy of a Gel Formulation of Esmolol Hydrochloride (Galnobax®) in Treating Diabetic Foot Ulcers. The study evaluates the safety and effectiveness of Galnobax® plus Standard of Care versus only Standard of Care, in treating Diabetic Foot Ulcers (DFU). In addition, Study is designed to investigate the safety of Galnobax® vehicle for establishing non-deleterious effects of Vehicle on wound healing in the Subjects with DFU.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 3
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:
Prospective, Multicenter, Randomized, Double-Blind, Parallel groups
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Masking Description:
The subject will be masked from the treatment by the Study Nurse (care giver) by using blinder during each treatment application. The site has two separate teams (blinded and unblinded) for masking. The unblinded investigator performs application of treatment during each treatment visit of subject to the site.
Primary Purpose: Treatment
Condition  ICMJE Diabetic Foot Ulcer
Intervention  ICMJE
  • Drug: Esmolol Hydrochloride
    Galnobax-14% gel application along with Standard of Care
    Other Name: Galnobax
  • Other: Only Standard of Care
    Only Standard of Care treatment
  • Other: Vehicle Gel
    Vehicle gel application along with Standard of Care
Study Arms  ICMJE
  • Active Comparator: Galnobax® 14% gel plus SoC
    Galnobax 14% gel along with Standard of Care (SoC) will be administered twice daily (150 subjects)
    Intervention: Drug: Esmolol Hydrochloride
  • Sham Comparator: SoC Only
    Only Standard of Care will be administered twice daily (150 subjects)
    Intervention: Other: Only Standard of Care
  • Placebo Comparator: Vehicle plus SoC
    Vehicle gel along with Standard of Care (SoC) will be administered twice daily (50 subjects)
    Intervention: Other: Vehicle Gel
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Unknown status
Estimated Enrollment  ICMJE
 (submitted: June 25, 2019)
350
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE October 30, 2020
Estimated Primary Completion Date June 30, 2020   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Subjects, male or female, aged 18 to 75 years (inclusive) with Type 1 or Type 2 diabetes undergoing therapy for glycemic control
  2. Subject has glycosylated hemoglobin, HbA1C, ≤ 12%
  3. Subject with diagnosis of neuropathic foot ulcer by 10g monofilament test
  4. Subject has adequate vascular perfusion of the affected limb, confirmed by Ankle-Brachial Index (ABI) ≥ 0.65 and ≤ 1.3
  5. Presence of at least one DFU that meets all of the following criteria:

    1. A full-thickness ulcer of Grade A1 as per Texas classification system;
    2. Ulcer is located below or up to 5 cm above the malleoli (excluding ulcers between the toes);
    3. Ulcer size (area) is ≥ 2 cm2 and ≤ 15 cm2 (post-debridement);
    4. There is a minimum 3 cm margin between the qualifying Target Ulcer and any other ulcers on the specified foot, post-debridement;
    5. No exposed bone, tendon, muscle, ligament or joint capsule, and no tunneling, undermining, or sinus tracts;
    6. Unresponsive to ulcer care and open for at least 6 weeks at the time of the Screening Visit;
    7. Ulcer is non-infected as determined by clinical assessment and complete hemogram;
    8. Ulcer has a clean, granulating base free of adherent slough to the greatest extent possible as per Investigator;
    9. Ulcer area reduction < 30% from the Screening Visit to Baseline visit
  6. Clinically normal resting 12-lead ECG at Screening Visit or, if abnormal, considered not clinically significant by the Investigator
  7. Subject, if female of child-bearing potential, has a negative urine pregnancy test at Screening and willing to use acceptable methods of contraception (birth control pills, barriers) or abstinence throughout the Study
  8. Subject is able and willing to comply with Study procedures including the use of an off-loading device (as applicable for the location of the ulcer) and adhere to protocol during the Study in the opinion of Investigator
  9. A Subject or LAR agrees to sign informed consent form and allow audio visual recording of consent, if applicable

Exclusion Criteria:

  1. Actively infected ulcers with or without purulent discharge, ulcers with exposed bone or associated with osteomyelitis
  2. Subjects with more than three ulcers below knee
  3. Subjects with Target Ulcer requiring off-loading that cannot be effectively off-loaded; or unable to tolerate the off-loading method
  4. Subject has ulcers caused by a disease other than diabetes, e.g., fungal ulcerations, malignant ulcerations, and ulcerations due to venous or arterial insufficiency, or due to hematological disorders, in the opinion of the Investigator
  5. Ulcer, about which the Investigator is suspicious for cancer
  6. Subjects with a gangrenous or ischemic ulcer
  7. Subject with ulcer that in the opinion of the Investigator, may need amputation
  8. Subject with Target ulcer where wound measurement is not possible, such as ulcers between toes
  9. Body mass index (BMI) > 40 kg/m2
  10. Laboratory values at Screening of:

    1. Hemoglobin < 10.0 g/dL
    2. White Blood Cells (WBC) < 2.0 X 109 cells/L
    3. Liver function studies [Total bilirubin, aspartate aminotransferase (AST) and alanine transaminase (ALT)] > 3x the upper limit of normal
    4. Albumin < 2.5 g/dL
    5. eGFR < 25 mL/min
  11. Presence of any existing clinically significant medical condition(s) that, in the opinion of the Investigator, could interfere with wound healing
  12. Subject has received or is currently receiving or scheduled to receive any medication or therapies during the course of the Study that will modulate wound healing
  13. Subject with intolerance to β-blockers at any time in the past
  14. Has any other factor which may, in the opinion of the Investigator, compromise participation and/or follow-up in the Study
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 75 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE India
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03998436
Other Study ID Numbers  ICMJE NG-A16
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Novalead Pharma Private Limited
Study Sponsor  ICMJE Novalead Pharma Private Limited
Collaborators  ICMJE Not Provided
Investigators  ICMJE Not Provided
PRS Account Novalead Pharma Private Limited
Verification Date June 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP