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Trial registered on ANZCTR
Registration number
ACTRN12612001124820
Ethics application status
Approved
Date submitted
18/10/2012
Date registered
22/10/2012
Date last updated
22/10/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Topical Platelet Derived Growth Factor (PDGF) Versus Placebo Therapy of Diabetic Foot Ulcers Off-Loaded with Windowed Casts
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Scientific title
Topical Platelet Derived Growth Factor (PDGF) Regranex Shows Equivalent Rate of Healing to Placebo for Diabetic Foot Ulcers Off-loaded with Windowed Casts
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Secondary ID [1]
281409
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Nil
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Universal Trial Number (UTN)
U1111-1135-9766
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetic Foot Ulcer
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Condition category
Condition code
Surgery
287994
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0
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Other surgery
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Metabolic and Endocrine
287999
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
All patients had the affected leg treated with a short leg walking cast windowed over the ulcer. The cast consists of five layers: a thick hydrocolloid protective layer applied directly to the skin around the wound; then a layer of cotton gauze; then water resistant foam padding; then cotton padding; then fiberglass. A window is then cut with a cast saw over a pre-marked area of the cast that is over the ulcer. The cast application process takes approximately one hour. This was continued for 4 months with evaluation every two weeks. The PDGF gel was applied daily to the ulcer approximately 2 mm thick after cleaning the ulcer with saline. A bandage was applied over the gel and the window in the cast was then replaced and taped in place.
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Intervention code [1]
285899
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Treatment: Drugs
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Intervention code [2]
285904
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Treatment: Surgery
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Comparator / control treatment
The placebo gel is identical in appearance and consistency to the Regranex gel except without PDGF. All patients had windowed casts.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The primary outcome is ulcer healing rate at four months. Clinical assessments were scheduled every two weeks from randomization until 4 months of treatment were complete. The assessments consisted of removal of the cast window for wound inspection. Healing was defined as complete epithelialization of the wound.
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Assessment method [1]
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Timepoint [1]
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Every two weeks from randomization until four months of treatment were complete.
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Secondary outcome [1]
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The patients with unhealed ulcers at 4 months were followed until wound healing or amputation. These final results for ulcer healing are included in the data and thus can be considered a secondary outcome. At nine months after randomization all patients had either healed, dropped out of the study or had an amputation of the affected limb.
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Assessment method [1]
299596
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Timepoint [1]
299596
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nine months
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Eligibility
Key inclusion criteria
Wagner Grade 1 Diabetic Foot Ulcer, ulcer area between 1-16 square centimerters
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Minimum age
No limit
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Wagner Grade 2 ulcer or above, osteomyelitis or infection requiring antibiotics, ulcer area outside of range 1-16 square centimeters, more then two full thickness wounds on the involved extremity, moderate to severe peripheral arterial disease (ABI < 0.7), concomitant use of Pletal (cilostazol), inability to tolerate casting or unsteady gait, active neoplasia, concomitant steroid use, chronic alcohol or drug abuse
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Subjects were screened in a surgical wound clinic for inclusion and exclusion criteria. Treatment allocation to placebo or PDGF was randomized on a 1:1 basis as follows. An equal number of pieces of paper labelled with placebo or Regranex were placed in a bag and at the time of randomization a secretary not involved in patient treatment or outcome assessment drew a piece of paper from the bag. The secretary then assigend the patient to the corresponding group and procured the study or placebo medication in a container that prevented identification of its contents. Thus both the patient and the treating physicians were blinded to which treatment group was selected. The physicians assessing outcomes were also blinded, as only the secretary had access to the randomization information.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
See above.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
46
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4608
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United States of America
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State/province [1]
4608
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CA
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Funding & Sponsors
Funding source category [1]
286170
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Commercial sector/Industry
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Name [1]
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Heritage Provider Network, Inc
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Address [1]
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8510 Balboa Boulevard Suite 285
Northridge, CA 91325
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Country [1]
286170
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United States of America
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Primary sponsor type
Commercial sector/Industry
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Name
Heritage Provider Network, Inc
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Address
8510 Balboa Boulevard Suite 285
Northridge, CA 91325
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Country
United States of America
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Veterans Affairs Long Beach Healthcare System
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Address [1]
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5901 East 7th Street
Long Beach, CA 90822
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Country [1]
284981
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United States of America
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Other collaborator category [1]
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Hospital
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Name [1]
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Veterans Affairs Greater Los Angeles Healthcare System
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Address [1]
277132
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11301 Wilshire Blvd.
Los Angeles, CA 90073
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Country [1]
277132
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United States of America
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288236
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Institutional Review Board at Veterans Affairs Long Beach Healthcare System
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Ethics committee address [1]
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5901 East 7th St Long Beach, CA 90822
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Ethics committee country [1]
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United States of America
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Date submitted for ethics approval [1]
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11/12/2006
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Approval date [1]
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05/04/2007
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Ethics approval number [1]
288236
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00778
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Summary
Brief summary
The was a multi-centered, randomized, controlled study to evaluate the efficacy of topical platelet derived growth factor (PDGF) in the treatment of diabetic foot ulcers. Forty six male patients with Wagner Grade 1 diabetic foot ulcers were randomized to treatment with PDGF hydrogel (tradename Regranex) versus placebo hydrogel, and all patients received treatment with a windowed cast for ulcer off-loading. Patients with abscess, osteomyelitis or infection requiring antibiotics were excluded. The patients were evaluated at four months after randomization for wound healing. Fifty two percent of the patients treated with PDGF plus windowed casts healed at four months compared to 57% of the placebo patients, yielding a non-significant p-value 0.79. Regranex gel does not appear to improve ulcer healing when combined with effective off-loading. Windowed casting is a safe and effective means of treating diabetic foot ulcers.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Ian L Gordon, M.d., Ph.D.
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Address
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Veterans Affairs Long Beach Healthcare System
Department of Surgery
Building 8, Room 324
5901 East 7th Street
Long Beach, CA 90822
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Country
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United States of America
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Phone
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1-562-826-8000 extension 5957
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Fax
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1-562-826-5666
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Email
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[email protected]
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Contact person for scientific queries
Name
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Ian L Gordon, M.d., Ph.D.
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Address
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Veterans Affairs Long Beach Healthcare System
Department of Surgery
Building 8, Room 324
5901 East 7th Street
Long Beach, CA 90822
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Country
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United States of America
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Phone
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1-562-826-8000 extension 5957
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Fax
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1-562-826-5666
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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