Foot Ulcer, DiabeticPhase 3COACT-2NCT02447172
Study of a Topical Gentamicin-Collagen Sponge Along With Systemic Antibiotic in Infected Diabetic Foot Ulcers
A Phase 3 study testing Gentamicin Collagen sponge in people with Foot Ulcer, Diabetic and Infection, run by Innocoll at 91 sites in 16 countries.
Trial summary
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a… Read more about this study
- Who is it for?
- Ages 18 to 85 years
- Conditions the study is for
- Foot Ulcer, Diabetic, Infection
- What is being tested?
- Gentamicin Collagen sponge
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 524 participants
- Where
- 91 sitesin 16 countries
- Study dates
- Jun 2015to Sep 2016
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
None listed.
Who cannot join
- Has a known history of hypersensitivity to gentamicin (or other aminoglycosides).
- Has a known or suspected hypersensitivity to bovine collagen.
- Has an ulcer infection which, based upon the patient's known history of hypersensitivity and/or as otherwise in the opinion of the investigator, cannot be adequately treated with at least one of the empiric systemic antibiotic regimens allowed by this protocol.
- Has an ulcer associated with prosthetic material or an implanted device.
- Has received any systemic or topical antibiotic therapy for any reason within 7 days of randomization unless it was administered to specifically treat the infected ulcer(s) and only within 36 hours of randomization.
- Requires or is likely to require treatment with any concomitant topical product or wound therapy before the first follow-up study visit.
Show all 11Show fewer
- Is severely immunocompromised, or likely to become severely immunocompromised during the study, in the opinion of the investigator.
- Has a history of myasthenia gravis or other neurological condition where gentamicin use is contraindicated as determined by the investigator.
- Has a history of epilepsy.
- Has a history of alcohol or substance abuse in the past 12 months.
- Has an uncontrolled illness that, in the opinion of the investigator, is likely to cause the patient to be withdrawn from the trial or would otherwise interfere with interpreting the results of the study
Trial locations and contacts
91 sites in 16 countries.
91 sites in 16 countries
United Kingdom12 sites
Study site
Bradford, BD96RJ
Study site
Bristol, BS10 5NB
Study site
Burton-on-Trent, DE13 0RB
Study site
Coventry, CV22DX
Study site
Derby, DE22 3NE
Study site
Edinburgh, EH16 4SA
Study site
Lancaster, LA1 4RP
Study site
Liverpool, L7 8XP
Study site
London, NW3 2QG
Study site
Manchester, M23 9LT
Study site
Merthyr, CF47 9DT
Study site
Stoke-on-Trent, ST4 6QG
Poland11 sites
Study site
Chorzów, 41-400
Study site
Częstochowa, 42-202
Study site
Gdansk, 80-952
Study site
Krakow, 30-347
Study site
Lodz, 90-553
Study site
Lublin, 20-081
Study site
Poznan, 616-111
Study site
Studzionka, 43-245
Study site
Warsaw, 02-541
Study site
Wroclaw, Lower Silesian Voivodeship, 51-124
Study site
Zabrze, 41-819
Germany10 sites
Study site
Aschaffenburg, Bavaria, 63739
Study site
Bad Mergentheim, Baden-Wurttemberg, 97980
Study site
Berlin, 10787
Study site
Bosenheim, Reinland-Pfalz, 55545
Study site
Dortmund, North Rhine-Westphalia, 44137
Study site
Dresden, Saxony, 01279
Study site
Duisburg, North Rhine-Westphalia, 47051
Study site
Fulda, Hesse, 36037
Study site
Münster, North Rhine-Westphalia, 48145
Study site
Pirna, Saxony, 01796
Czechia8 sites
Study site
Brno, 656 91
Study site
Pardubice, 532 03
Study site
Prague, 100 34
Study site
Prague, 128 08
Study site
Prague, 140 59
Study site
Prague, 169 02
Study site
Třinec, 739 61
Study site
Zlín, 760 01
Spain8 sites
Study site
Alcorcón, Madrid, 23922
Study site
Badalona, Barcelona, 08916
Study site
Donostia / San Sebastian, Gipuzkoa, 20014
Study site
Girona, 17007
Study site
Lleida, 25198
Study site
Madrid, 28040
Study site
Madrid, 46940
Study site
Manises, Valencia, 46940
Netherlands7 sites
Study site
Almere Stad, 1315RA
Study site
Eindhoven, 5631BM
Study site
Maastricht, 6229 HX
Study site
Nijmegen, 6525 GA
Study site
Nijmegen, 6532 SZ
Study site
The Hague, 2526HW
Study site
Utrecht, 3582KE
Hungary6 sites
Study site
Debrecen, 4032
Study site
Hatvan, 3000
Study site
Orosháza, 5900
Study site
Sátoraljaújhely, 3980
Study site
Székesfehérvár, 8000
Study site
Szekszárd, 7100
Slovakia6 sites
Study site
Bratislava, 81369
Study site
Bratislava, 83103
Study site
Ľubochňa, 034 91
Study site
Nitra, 95001
Study site
Trenćín, 91171
Study site
Trnava, 917 75
Belgium5 sites
Study site
Brussels, 1090
Study site
Edegem, 2650
Study site
Kortrijk, 8500
Study site
Liége, 4000
Study site
Pellenberg, 3212
Italy5 sites
Study site
Abano Terme, PD, 35031
Study site
Bassano del Grappa, VI, 36061
Study site
Campobasso, CB, 86100
Study site
Pavia, PV, 27100
Study site
Pistoia, Point, 51100
Austria3 sites
Study site
Graz, Styria, 8036
Study site
Vienna, 1030
Study site
Vienna, 1130
Sweden3 sites
Study site
Linköping, 58185
Study site
Lund, 22185
Study site
Stockholm, 17176
United States2 sites
Study site
Anniston, Alabama, 36207
Study site
Las Vegas, Nevada, 89109
Australia2 sites
Study site
Cowra, New South Wales, 2794
Study site
Spring Hill, Queensland, 4006
About this study
Official title: A Phase 3 Randomized, Placebo-Controlled, Blinded Study to Investigate the Safety and Efficacy of a Topical Gentamicin-Collagen Sponge in Combination With Systemic Antibiotic Therapy in Diabetic Patients With an Infected Foot Ulcer
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. After completing treatment, patients will return to the clinic for scheduled follow-up visits approximately 10, 30, 60 and 90 days after treatment is stopped.
Read the detailed description
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized using an electronic randomization system to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. The investigator will be blinded to the patient's treatment group assignment and patients randomized to one of the 2 sponge groups will be blinded as to whether the sponge is active or placebo.
If a patient has multiple infected ulcers, the assigned treatment will be administered to all infected ulcers. The investigator will determine the highest severity ulcer to be used for all efficacy evaluations and will also determine the size and number of sponges (up to 4) that a patient will use in order to completely cover all infected ulcers. The investigator will prescribe an empiric systemic antibiotic therapy based on protocol instructions.
Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. The investigator will stop study treatment if a patient achieves clinical cure by or after the 3rd treatment visit (approximately study day 15). After completing treatment, patients will return to the clinic for scheduled follow-up visits or until ulcer closure. The final efficacy assessments used in the primary efficacy analyses will be obtained at the first follow-up visit approximately 10 days after treatment is stopped. The remaining follow-up visits will occur at approximately 30, 60 and 90 days after treatment is stopped when patients will be assessed for ulcer closure and any re-infection.
- Conditions
- Foot Ulcer, Diabetic, Infection
- Being tested
- Gentamicin Collagen sponge, Placebo
- Medical subject headings
- Diabetic Foot, Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Gentamicin Collagen spongeDrug
Also called Cogenzia
Up to 4 topical Gentamicin Collagen Sponges each containing 50 mg of gentamicin sulfate (equivalent to 32.5 mg of gentamicin base)
PlaceboOther
Matching placebo sponge
| Study group | Role | What they receive |
|---|---|---|
| Gentamicin sponge group | Experimental | Topical Gentamicin Collagen Sponge: Up to four collagen sponges each containing 50 mg of gentamicin sulfate (equivalent to 32.5 mg of gentamicin base) administered daily, with systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. Receives: Drug: Gentamicin Collagen sponge |
| Placebo sponge group | Placebo comparator | Matching placebo collagen sponge administered daily, with systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. Receives: Other: Placebo |
| No sponge group | No intervention | Systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percent of Patients With a Clinical Outcome of Clinical Cure (Resolution of All Clinical Signs and Symptoms of Infection)
The primary efficacy variable is the percent of patients with a clinical outcome of clinical cure (Resolution of all clinical signs and symptoms of infection) at F/U visit 1
Measured: approximately 10 days after end of treatment
Secondary outcomes (3)
Number of Patients With Re-infections
Measured: up to 90 days after treatment stopped
Time to Clinical Response
Time in Days to Clinical Cure
Measured: up to 90 days after treatment stopped
Percent of Subjects That Had an Amputation Associated With the Target Ulcer
Modified Intent-to-Treat Population - Percent of subjects that had an amputation associated with the target ulcer
Measured: up to 90 days after treatment stopped
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 May 2015 (estimated)
- Study startJun 2015
- Primary completionSep 2016
- Study completionSep 2016
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Foot Ulcer, DiabeticStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Investigator, Outcomes assessor
- Enrolment
- 524 participants (actual)
Sponsor and investigators
- Lead sponsor
- Innocoll
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Nigel Jones, Study director, Vice President, Global Clinical Operations, Innocoll Pharmaceutical
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02447172
- Sponsor's protocol ID
- INN-TOP-005
- Acronym
- COACT-2
- Status last verified
- Sep 2021
- First submitted
- 14 May 2015
- Last updated
- 29 Sep 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Sep 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3 Randomized, Placebo-Controlled, Blinded Study to Investigate the Safety and Efficacy of a Topical Gentamicin-Collagen Sponge in Combination With Systemic Antibiotic Therapy in Diabetic Patients With an Infected Foot Ulcer
- ClinicalTrials.gov ID
- NCT02447172
- Acronym / sponsor ID
- COACT-2 / INN-TOP-005
- Conditions
- Foot Ulcer, Diabetic, Infection
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 524 participants (actual)
- Lead sponsor
- InnocollIndustry (pharma, biotech, devices)
- Study start
- Jun 2015
- Primary completion
- Sep 2016 (actual)
- Study completion
- Sep 2016 (actual)
- First posted
- 18 May 2015 (estimated)
- Results
- Posted 27 Aug 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. After completing treatment, patients will return to the clinic for scheduled follow-up visits approximately 10, 30, 60 and 90 days after treatment is stopped.
Detailed description
This is a phase 3, randomized, controlled, blinded, multicenter study conducted in 3 parallel cohorts of diabetic patients with at least 1 infected foot ulcer. Patients will be randomized using an electronic randomization system to receive 1 of 3 study treatments; systemic antibiotic therapy and standard ulcer care with either (A) daily application of a gentamicin-sponge, (B) daily application of a placebo-sponge or (C) no-sponge, in the ratio 2:1:1. The investigator will be blinded to the patient's treatment group assignment and patients randomized to one of the 2 sponge groups will be blinded as to whether the sponge is active or placebo.
If a patient has multiple infected ulcers, the assigned treatment will be administered to all infected ulcers. The investigator will determine the highest severity ulcer to be used for all efficacy evaluations and will also determine the size and number of sponges (up to 4) that a patient will use in order to completely cover all infected ulcers. The investigator will prescribe an empiric systemic antibiotic therapy based on protocol instructions.
Patients will be treated for approximately 28 days and return to the clinic weekly for safety and efficacy assessments. The investigator will stop study treatment if a patient achieves clinical cure by or after the 3rd treatment visit (approximately study day 15). After completing treatment, patients will return to the clinic for scheduled follow-up visits or until ulcer closure. The final efficacy assessments used in the primary efficacy analyses will be obtained at the first follow-up visit approximately 10 days after treatment is stopped. The remaining follow-up visits will occur at approximately 30, 60 and 90 days after treatment is stopped when patients will be assessed for ulcer closure and any re-infection.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (investigator, outcomes assessor)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Gentamicin sponge group | Experimental | Drug: Gentamicin Collagen spongeTopical Gentamicin Collagen Sponge: Up to four collagen sponges each containing 50 mg of gentamicin sulfate (equivalent to 32.5 mg of gentamicin base) administered daily, with systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. |
| Placebo sponge group | Placebo comparator | Other: PlaceboMatching placebo collagen sponge administered daily, with systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. |
| No sponge group | No intervention | –Systemic antibiotic therapy and standard ulcer care (gentamicin-sponge group) for up to 28 days. |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (0 listed)
Key exclusion criteria (11 listed)
- Has a known history of hypersensitivity to gentamicin (or other aminoglycosides).
- Has a known or suspected hypersensitivity to bovine collagen.
- Has an ulcer infection which, based upon the patient's known history of hypersensitivity and/or as otherwise in the opinion of the investigator, cannot be adequately treated with at least one of the empiric systemic antibiotic regimens allowed by this protocol.
- Has an ulcer associated with prosthetic material or an implanted device.
- Has received any systemic or topical antibiotic therapy for any reason within 7 days of randomization unless it was administered to specifically treat the infected ulcer(s) and only within 36 hours of randomization.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Gentamicin Collagen spongeAlso: CogenziaUp to 4 topical Gentamicin Collagen Sponges each containing 50 mg of gentamicin sulfate (equivalent to 32.5 mg of gentamicin base) | Drug | Gentamicin sponge group |
| PlaceboMatching placebo sponge | Other | Placebo sponge group |
Primary outcome
Percent of Patients With a Clinical Outcome of Clinical Cure (Resolution of All Clinical Signs and Symptoms of Infection)
Time frame: approximately 10 days after end of treatment
The primary efficacy variable is the percent of patients with a clinical outcome of clinical cure (Resolution of all clinical signs and symptoms of infection) at F/U visit 1
3 secondary outcomes
Number of Patients With Re-infections
Time frame: up to 90 days after treatment stopped
Time to Clinical Response
Time frame: up to 90 days after treatment stopped
Percent of Subjects That Had an Amputation Associated With the Target Ulcer
Time frame: up to 90 days after treatment stopped
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Sep 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nigel Jones study director
Vice President, Global Clinical Operations, Innocoll Pharmaceutical
91 sites in 16 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Gentamicin Collagen sponge in people with Foot Ulcer, Diabetic and Infection, run by Innocoll at 91 sites in 16 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 0 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 91 sites in United Kingdom, Poland, Germany, Czechia, Spain and 11 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 27 Aug 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percent of Patients With a Clinical Outcome of Clinical Cure (Resolution of All Clinical Signs and Symptoms of Infection) (time frame: approximately 10 days after end of treatment). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Sep 2021.