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NCT05758545NARecruiting

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

Piomic Medical

Start Date

6/19/2023

Completion Date

6/19/2027

Summary

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

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.

Eligibility Criteria

Age Range: 22 years to 90 years

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%

Interventions

DEVICE

COMS One device

DEVICE

Sham device

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Conditions

Diabetic Foot Ulcer

Locations

Titan Clinical Research

Mesa, Arizona 85202

United States

Southern Arizona VA Health Care System

Tucson, Arizona 85723

United States

Center for Clinical Research Inc.

Castro Valley, California 94546

United States

VA Central California Healthcare

Fresno, California 93703

United States

Limb Preservation Platform, Inc.

Fresno, California 93710

United States

Angel City Research, Inc.

Los Angeles, California 90010

United States

UCLA Ronald Regan - Department of Surgery

Los Angeles, California 90095

United States

Center for Clinical Research Inc.

San Francisco, California 94115

United States

Center for Clinical Research Inc.

San Francisco, California 94117

United States

ILD Research Center

Vista, California 92081

United States

Bay Pines VA Healthcare System

Bay Pines, Florida 33744

United States

MCR Health

Bradenton, Florida 34208

United States

University of Florida Health Jacksonville

Jacksonville, Florida 32209

United States

Clever Medical Research LLC

Miami, Florida 33126

United States

The Angel Medical Research Corporation

Miami Lakes, Florida 33016

United States

Vital Medical Research

Sweetwater, Florida 33174

United States

Aiyan Diabetes Center

Augusta, Georgia 30907

United States

Northwestern University Feinberg School of Medicine

Chicago, Illinois 60611

United States

Rush University

Chicago, Illinois 60612

United States

Gateway Clinical Trials

O'Fallon, Illinois 62269

United States

Curalta Clinical Trials

Westwood, New Jersey 07675

United States

Veteran Affairs of WNY Healthcare System

Buffalo, New York 14215

United States

Northwell Comprehensive Wound Healing Center

Lake Success, New York 11042

United States

UNC Medical Center

Chapel Hill, North Carolina 27514

United States

The Ohio State University

Columbus, Ohio 43210

United States

UPMC McKeesport

McKeesport, Pennsylvania 15132

United States

Vanderbilt University Medical Center - Vanderbilt Wound Center

Nashville, Tennessee 37232

United States

Richard C. Galperin DPM PA

Dallas, Texas 75208

United States

HCA Healthcare Houston Medical Center

Houston, Texas 77004

United States

Futuro Clinical Trials, LLC

McAllen, Texas 78501

United States