Diabetic FootPhase 3NCT06140303
SkinTE® for the Treatment of Wagner 1 Diabetic Foot Ulcers (COVER DFUS II)
A Phase 3 study testing SkinTE in people with Diabetic Foot, run by PolarityTE at 23 sites in United States.
Trial summary
The purpose of this study is to assess the safety and efficacy of SkinTE for treatment of Wagner grade 1 diabetic foot ulcers. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Diabetic Foot
- What is being tested?
- SkinTE
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 120 participants
- Where
- 23 sitesUnited States
- Study dates
- 22 Feb 2024to 30 Apr 2026
- Phase
- Phase 3
- Are there results?
- None posted in the registry
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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- At least 18 years of age.
- Documented history of Type I or Type II Diabetes Mellitus requiring oral and/or insulin replacement therapy.
- Presence of a DFU Wagner 1 grade wound on any aspect of the foot, provided that if the malleolus is involved, not more than 50% of the wound is above the mid-point of the medial malleolus. [NOTE: DFU must maintain Wagner 1 Grade for the duration of study run-in period - i.e., screening visit 1 (SV1) to randomization visit 1 (RV1).]
- If other wounds are present on the same foot, they must be more than 2 cm distant from the index ulcer. [NOTE: If two or more DFUs are present with the same grade, the index ulcer is the largest ulcer and the only one evaluated in the study.]
- Index ulcer (i.e., current episode of ulceration) has been present for ≥ four weeks (≥28 days) prior to the initial screening visit (SV1).
- Index ulcer (post-debridement) is a minimum of 1.0 cm2 and a maximum of 15 cm2 at first screening visit (SV1) and first randomization visit (RV1).
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- Adequate circulation to the affected foot as documented by a dorsal transcutaneous oxygen measurement (TCOM) or a skin perfusion pressure (SPP) measurement of ≥ 30 mmHg, or an Ankle Branchial Index (ABI) of ≥ 0.7 and ≤ 1.2, or Arterial Doppler with a minimum of biphasic flow or Toe Brachial Index (TBI) ≥ 0.75, using the affected study extremity within 30 days of screening visit (SV1).
- Index ulcer and/or index ulcer limb may have had prior infection(s), but infection(s) must be adequately treated and controlled as defined by IDSA Guidelines PEDIS Grade level 1.
- The index ulcer has been offloaded with protocol defined offloading device throughout study run-in period for at least 14 days prior to randomization (Run-in period defined as Screening through RV1/Randomization).
- Negative pregnancy test for females of childbearing potential (e.g., not post- menopausal for at least one year or surgically sterile).
- Subject understands and is willing to participate in the clinical study and can comply with study visits and the follow-up regimen.
- Females of childbearing potential must agree to use effective methods of c contraception (birth control pills, barriers, or abstinence) (Screening through End of Study (EOS) and undergo pregnancy tests.
- Properly obtained written informed consent.
- Subject must have stable living environment in order to manage offloading and wound care management.
- The index ulcer has a clean base, free of necrotic debris, and infection at time of placement of treatment product.
Who cannot join
- Index ulcer and/or index limb with presence of gangrene or unstable ischemia at screening (SV1).
- Revascularization surgery on the lower extremity on which the index ulcer is located within 30 days of screening visit (SV1).
- Index ulcer in the opinion of the investigator, is suspicious for cancer and should undergo an ulcer biopsy to rule out a neoplasm of the ulcer.
- Subjects with history of radiation on the same limb as the index ulcer (regardless of time since last radiation treatment).
- Subjects with exposed internal fixation on the same limb as the index ulcer [NOTE: External fixation is allowed if deemed stable by principal investigator.]
- Subjects on any investigational drug(s) or therapeutic device(s) within 30 days preceding the first screening visit (SV1). [NOTE: NPWT is allowed up to the day of screening (SV1), if in the opinion of the Principal Investigator NPWT may be discontinued.]
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- Index ulcer treated within the last 30 days prior to screening with a prohibited treatment as defined in full protocol.
- Subjects with a history of more than two weeks treatment with immunosuppressants (including systemic corticosteroids > 10mg prednisone (or equivalent) daily dose), cytotoxic chemotherapy, or application of topical steroids to the index ulcer surface within 30 days prior to first screening visit (SV1), or who receive such medications during the run-in period, or who are anticipated to require such medications during the study.
- Presence of any condition(s) which seriously compromises the subject's ability to complete this study or has a known history of poor adherence to medical treatment.
- In the opinion of the Investigator, the subject is non-compliant with offloading or index ulcer dressing during the run-in period.
- Active Charcot's arthropathy of the index ulcer limb as verified by clinical evaluation, and/or imaging (x-ray or MRI) within 30 days prior to randomization (RV1).
- Subjects with chronic osteomyelitis and/or cellulitis on the same limb as the index ulcer as verified by clinical evaluation, and/or imaging (x-ray or MRI) within 30 days prior to randomization (RV1).
- Subject is pregnant or breast-feeding.
- Presence of diabetes with poor metabolic control as documented with an HbA1c ≥12.0 within 30 days prior to randomization (RV1).
- Subjects with end stage renal disease requiring treatment with dialysis and/or evident by an eGFR <30 mL/min/1.73m2 within 120 days of randomization (RV1). [NOTE: Subjects with two documented eGFR values within 120 days, the most recent value may be used if the eGFR ≥30 mL/min/1.73m2 and is, in the opinion of the principal investigator, stable and the subject will not require treatment with dialysis for the duration of study participation.]
- Index ulcer has reduced or increased in area by 30% or more after 14 days of SOC from SV1 to the RV1/randomization visit.
- Evidence of unstable human immunodeficiency virus (HIV), hepatitis B, and/or hepatitis C in the opinion of the investigator at screening (SV1).
- Documented history of New York Heart Association Class III or IV congestive heart failure or unstable cardiovascular disease requiring intervention within 60 days prior to screening (SV1).
- Requiring surgical intervention (excluding debridement) at the time of consenting and/or increased probability of requiring surgical intervention during study participation. [NOTE: non-invasive surgical intervention is allowed if, per the Principal Investigator, treatment will not affect subject's ability to participate in clinical trial.]
- Any clinically significant finding, in the judgment of the investigator, that would place the subject at health risk, impact the study, or affect the completion of the study.
Trial locations and contacts
23 sites in 1 country.
23 sites in 1 country
United States23 sites
LEIRT (Lower Extremity Institute for Research and Therapy)
Boardman, Ohio, 44512
Center for Clinical Research
Castro Valley, California, 94546
Cutting Edge Research LLC
Circleville, Ohio, 43123
LEIRT (Lower Extremity Institute for Research and Therapy)
East Liverpool, Ohio, 43920
Limb Preservation Platform, Inc.
Fresno, California, 93710
Cutting Edge Research LLC
Grove City, Ohio, 43123
FASMA - Hagerstown
Hagerstown, Maryland, 21742
Viable Research Management
Henderson, Nevada, 89014
Las Mercedes Medical Research, Inc.
Hialeah, Florida, 33010
Perfizien Clinical Research LLC.
Houston, Texas, 77055
Angel City Research
Los Angeles, California, 90010
Clemente Clinical Research Inc.
Los Angeles, California, 92704
Titan Clinical Research
Mesa, Arizona, 85202
Doctors Research Network
Miami, Florida, 33156
Northwell Health, Inc.
New Hyde Park, New York, 11042
Mount Sinai West Hospital
New York, New York, 10019
DMI Research
Pinellas Park, Florida, 33782
Baylor Scott & White Health
Plano, Texas, 75093
Foot and Ankle Specialists of the Mid-Atlantic
Salem, Virginia, 24153
Center for Clinical Research
San Francisco, California, 94115
Clemente Clinical Research Inc.
Santa Ana, California, 92704
Barry University Clinical Research
Tamarac, Florida, 33321
ILD Research
Vista, California, 92081
About this study
Official title: Multi-Center, Prospective, Randomized Controlled Trial Evaluating SkinTE® for the Treatment of Wagner 1 Diabetic Foot Ulcers. Closure Obtained With Vascularized Epithelial Regeneration for DFUs With SkinTE® II (COVER DFUS II)
The purpose of this study is to assess the safety and efficacy of SkinTE for treatment of Wagner grade 1 diabetic foot ulcers.
Read the detailed description
This study is a prospective, multi-center, randomized controlled trial (RCT) designed to assess the safety and efficacy of SkinTE with standard of care (SOC) dressings compared to SOC dressings alone (wound debridement, silicone dressing, multi-layer compression dressings, and offloading) in the treatment of Wagner grade 1 diabetic foot ulcers (DFUs) ranging in size from 1 to 15 cm2. After being informed about the study and potential risks, all patients giving written informed consent who meet eligibility criteria will undergo a 2-week screening period of SOC. Patients meeting eligibility criteria following the screening period will be randomized in a single-blind manner (closure confirmed by 3 blinded adjudicators) in a 1:1 ratio to SkinTE with SOC or SOC alone. Patients will be followed weekly for 6 months for wound closure.
- Conditions
- Diabetic Foot
- Being tested
- SkinTE, Control
- Keywords
- diabetic foot ulcer, regenerative medicine, SkinTE, skin regeneration, chronic wounds, Wagner 1
- Medical subject headings
- Diabetic Foot
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SkinTEBiological
Also called Autologous Heterogeneous Skin Construct
SkinTE is an Autologous Heterogeneous Skin Construct (AHSC), which is manufactured from a small piece of healthy full-thickness skin harvested from the patient at the time of randomization to the SkinTE arm. SkinTE is manufactured aseptically by PolarityTE following current Good Manufacturing Practice (cGMP). SkinTE is not cultured ex vivo; rather, it is returned to the provider expeditiously to maintain cellular viability. SkinTE includes various multicellular segments as a result of the manufacturing process. The different multicellular segments contain different types of skin cells, such as keratinocytes, dermal fibroblasts, dermal endothelial cells, and follicular cells, as well as extracellular matrix. The multicellular segments have a surface area-to-volume ratio for improved sustenance by imbibition prior to engraftment.
ControlOther
Also called Standard of Care
Standard care is defined in this protocol to include the following:
- Debridement
- Collagen dressing
- Local offloading
- Foam
- Multi-layer compression dressing
- Off-loading device such as a controlled ankle motion (CAM) boot
| Study group | Role | What they receive |
|---|---|---|
| SkinTE | Experimental | SkinTE plus standard care Receives: Biological: SkinTE |
| Control | Other | Standard care alone Receives: Other: Control |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incidence of index ulcers closed
Wound closure is confirmed at two consecutive visits each two weeks apart
Measured: 12 weeks
Secondary outcomes (4)
Percent area reduction (PAR)
Change in wound area from the time of randomization
Measured: Assessed at 4, 8, and 12 weeks
Total number of in person wound care clinic visits and/or hospital days related to the index ulcer.
Measured: 24 weeks
Total days of CAM Boot use related to the index ulcer
Measured: 24 weeks
Time to closure
Measured: 24 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Nov 2023
- Study start22 Feb 2024
- Primary completion30 Jan 2026
- Study completion30 Apr 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Diabetic FootStudies 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
- Model description
- multi-center, randomized controlled trial
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 120 participants (actual)
Sponsor and investigators
- Lead sponsor
- PolarityTE
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Professional Education and Research Institute
- Responsible party
- Sponsor
- Investigators
- Nikolai Sopko, MD, PhD, Study director, PolarityBio
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06140303
- Sponsor's protocol ID
- COVER DFUs II
- Status last verified
- Nov 2026
- First submitted
- 15 Nov 2023
- Last updated
- 5 Nov 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 5 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Multi-Center, Prospective, Randomized Controlled Trial Evaluating SkinTE® for the Treatment of Wagner 1 Diabetic Foot Ulcers. Closure Obtained With Vascularized Epithelial Regeneration for DFUs With SkinTE® II (COVER DFUS II)
- ClinicalTrials.gov ID
- NCT06140303
- Acronym / sponsor ID
- COVER DFUs II
- Conditions
- Diabetic Foot
- Keywords
- diabetic foot ulcer, regenerative medicine, SkinTE, skin regeneration, chronic wounds, Wagner 1
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 120 participants (actual)
- Lead sponsor
- PolarityTEIndustry (pharma, biotech, devices)
- Collaborators
- Professional Education and Research Institute
- Study start
- 22 Feb 2024 (actual)
- Primary completion
- 30 Jan 2026 (actual)
- Study completion
- 30 Apr 2026 (actual)
- First posted
- 18 Nov 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to assess the safety and efficacy of SkinTE for treatment of Wagner grade 1 diabetic foot ulcers.
Detailed description
This study is a prospective, multi-center, randomized controlled trial (RCT) designed to assess the safety and efficacy of SkinTE with standard of care (SOC) dressings compared to SOC dressings alone (wound debridement, silicone dressing, multi-layer compression dressings, and offloading) in the treatment of Wagner grade 1 diabetic foot ulcers (DFUs) ranging in size from 1 to 15 cm2. After being informed about the study and potential risks, all patients giving written informed consent who meet eligibility criteria will undergo a 2-week screening period of SOC. Patients meeting eligibility criteria following the screening period will be randomized in a single-blind manner (closure confirmed by 3 blinded adjudicators) in a 1:1 ratio to SkinTE with SOC or SOC alone. Patients will be followed weekly for 6 months for wound closure.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
- Model description
- multi-center, randomized controlled trial
| Arm | Type | Receives |
|---|---|---|
| SkinTE | Experimental | Biological: SkinTESkinTE plus standard care |
| Control | Other | Other: ControlStandard care alone |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (15 listed)
- At least 18 years of age.
- Documented history of Type I or Type II Diabetes Mellitus requiring oral and/or insulin replacement therapy.
- Presence of a DFU Wagner 1 grade wound on any aspect of the foot, provided that if the malleolus is involved, not more than 50% of the wound is above the mid-point of the medial malleolus. [NOTE: DFU must maintain Wagner 1 Grade for the duration of study run-in period - i.e., screening visit 1 (SV1) to randomization visit 1 (RV1).]
- If other wounds are present on the same foot, they must be more than 2 cm distant from the index ulcer. [NOTE: If two or more DFUs are present with the same grade, the index ulcer is the largest ulcer and the only one evaluated in the study.]
- Index ulcer (i.e., current episode of ulceration) has been present for ≥ four weeks (≥28 days) prior to the initial screening visit (SV1).
Key exclusion criteria (20 listed)
- Index ulcer and/or index limb with presence of gangrene or unstable ischemia at screening (SV1).
- Revascularization surgery on the lower extremity on which the index ulcer is located within 30 days of screening visit (SV1).
- Index ulcer in the opinion of the investigator, is suspicious for cancer and should undergo an ulcer biopsy to rule out a neoplasm of the ulcer.
- Subjects with history of radiation on the same limb as the index ulcer (regardless of time since last radiation treatment).
- Subjects with exposed internal fixation on the same limb as the index ulcer [NOTE: External fixation is allowed if deemed stable by principal investigator.]
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 |
|---|---|---|
| SkinTEAlso: Autologous Heterogeneous Skin ConstructSkinTE is an Autologous Heterogeneous Skin Construct (AHSC), which is manufactured from a small piece of healthy full-thickness skin harvested from the patient at the time of randomization to the SkinTE arm. SkinTE is manufactured aseptically by PolarityTE following current Good Manufacturing Practice (cGMP). SkinTE is not cultured ex vivo; rather, it is returned to the provider expeditiously to maintain cellular viability. SkinTE includes various multicellular segments as a result of the manufacturing process. The different multicellular segments contain different types of skin cells, such as keratinocytes, dermal fibroblasts, dermal endothelial cells, and follicular cells, as well as extracellular matrix. The multicellular segments have a surface area-to-volume ratio for improved sustenance by imbibition prior to engraftment. | Biological | SkinTE |
| ControlAlso: Standard of CareStandard care is defined in this protocol to include the following: * Debridement * Collagen dressing * Local offloading * Foam * Multi-layer compression dressing * Off-loading device such as a controlled ankle motion (CAM) boot | Other | Control |
Primary outcome
Incidence of index ulcers closed
Time frame: 12 weeks
Wound closure is confirmed at two consecutive visits each two weeks apart
4 secondary outcomes
Percent area reduction (PAR)
Time frame: Assessed at 4, 8, and 12 weeks
Total number of in person wound care clinic visits and/or hospital days related to the index ulcer.
Time frame: 24 weeks
Total days of CAM Boot use related to the index ulcer
Time frame: 24 weeks
Time to closure
Time frame: 24 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Nov 2026.
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Evaluation of Personalized Nutritional Intervention on Wound Healing of Cutaneous Ulcers in Diabetics
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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.
Nikolai Sopko, MD, PhD study director
PolarityBio
23 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing SkinTE in people with Diabetic Foot, run by PolarityTE at 23 sites in United States.
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 15 inclusion and 20 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 5 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 23 sites in United States. 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. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Incidence of index ulcers closed (time frame: 12 weeks). 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 5 Nov 2026.