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Active, Not Recruiting

NCT Number: NCT06189638

Phase II Study to Evaluate Efficacy and Safety of AMP Peptide PL-5 in Mild Infections of Diabetic Foot Ulcers

This is a Phase II, randomized, double-blind, placebo-controlled, multi-center study to evaluate the clinical efficacy and safety of Antimicrobial Peptide PL-5 Topical Spray in patients with mild infections of diabetic foot ulcers. Eligible subjects will be randomized (1:1:1) to receive twice a day, 14 days treatment of Antimicrobial Peptide PL-5 Topical Spray (1‰), Antimicrobial Peptide PL-5 Topical Spray (2‰) and topical placebo (vehicle) spray. In this study, the cut-off date for final analysis is defined as the time when all subjects have completed the last visit or discontinued the study

Active, Not Recruiting

This study is active but is not currently recruiting participants.

Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

ILD Research Center, Vista, California, United States

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About this study

This is a Phase II, randomized, double-blind, placebo-controlled, multi-center study to evaluate the clinical efficacy and safety of Antimicrobial Peptide PL-5 Topical Spray in patients with mild infections of diabetic foot ulcers. Approximately 90 patients (30 per treatment group) will be randomized in this study. Eligible subjects will be randomized (1:1:1) to receive twice a day, 14 days treatment of Antimicrobial Peptide PL-5 Topical Spray (1‰), Antimicrobial Peptide PL-5 Topical Spray (2‰) and placebo of Antimicrobial Peptide PL-5 Topical Spray (vehicle). In this study, the cut-off date for final analysis is defined as the time when all subjects have completed the last visit or discontinued the study. The duration of the whole study is planned for 24 months; the duration of each participant is about 4-5 weeks, including Screening period/Baseline (about 7 days), treatment period (about 14 days), Follow-up period (about 7-14 days). No interim analysis will be performed in this study. This study is a phase II study, and no statistical hypothesis is proposed.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age between 18 to 65 years.
  • Non-hospitalized ambulatory subjects with Diabetes mellitus, Type I or II, according to the American Diabetes Association criteria.
  • HbA1c ≤12% at screening.
  • At baseline visit (after any required debridement), presence of Grade 2 diabetic foot infection [Grade 2 of the International Working Group on the Diabetic Foot (IWGDF) classification]

Infection present, as defined by the presence of at least 2 of the following items:

  • Local swelling or induration
  • Erythema >0.5 cm to ≤2 cm around the ulcer.
  • Local tenderness or pain
  • Local increased warmth
  • Purulent discharge (thick, opaque to white, or sanguineous secretion)

Mild infection of an ulcer is defined as:

Presence of ≥2 manifestations of inflammation (purulence or erythema, tenderness, warmth, or induration), but any cellulitis/erythema extends ≤2cm around the ulcer, and infection is limited to the skin or superficial subcutaneous tissues; no other local complications or systemic illness.

  • Voluntary written consent, given before performance of any clinical investigation-related procedure not part of standard medical care, and with the understanding that consent may be withdrawn at any time without prejudice to future medical care.
  • Female subjects must meet at least one of the following additional criteria:
  • Surgically sterile with bilateral tubal ligation or hysterectomy.
  • Postmenopausal for at least one year.
  • If of childbearing potential, practicing an acceptable method of birth control for the duration of the clinical investigation as judged by the Investigator, such as condoms, foams, jellies, diaphragm, intrauterine device or abstinence

Exclusion criteria

  • Another cause of the inflammatory response of the skin around the ulcer (such as a trauma, gout, acute Charcot neuro-arthropathy, fracture, thrombosis, or venous stasis).
  • Foot deformities, calluses, corns, ingrown nails, fungal infections, which will impact infection or wound healing based on Investigator's judgement.
  • Received any topical or systemic antimicrobial therapy within 7 days prior to study entry (Day 1).
  • Infected diabetic foot ulcer that is associated with local wound complications such as prosthetic materials or protruding surgical hardware.
  • > 1 infected foot ulcer.
  • Concurrent or expected to require systemic antimicrobials during the study period for any infection, including diabetic foot ulcer.
  • Bone or joint involvement is suspected based on clinical examination or plain X-ray.
  • Arterial brachial index (ABI) <0.5 or ankle pressure <50 mmHg. If ABI is >1.3 (medial calcification is present), then only subjects meeting secondary testing requirements including either a toe pressure ≥30 mmHg, a transcutaneous pressure of oxygen ≥50 mmHg, or a skin perfusion pressure ≥40 mmHg are allowed. For subjects with ABI >1.3, only the initial secondary test after ABI should be used for this assessment. A documented ABI within 3 months prior to Screening is acceptable, as is the initially performed secondary testing method for subjects with ABI >1.3.
  • The subject is expected to be unable to care for the ulcer or return for all scheduled visits because of hospitalization, vacation, disability, etc. during the study period or cannot safely monitor the infection status at home.
  • Pregnant or lactating women.

Treatment and study plan

Antimicrobial Peptide PL-5 Topical Spray and Placebo

Drug

Antimicrobial Peptide PL-5 Topical Spray At about 5 cm vertically above the wound, the investigator sprays antimicrobial peptide PL-5 topical spray on the test wound. The cover area after spraying is a cone with a surface diameter of about 5 cm and area about 20 cm2. One spray dose is about 0.1 ml. The number of drug sprays is determined according to the wound area in the screening period, and the determined dose is applied consistently. During the operation, an effective spray operation is completely ejected with no leakage.

Other names: AMP PL-5 and Placebo

Primary outcomes

  1. Clinical response

    Time frame: At EOT (End-of-therapy: within 24 hours after the final dose)

    the Investigator will grade the clinical response as (1)"infection resolved or cured" (all signs and symptoms of infection resolved);(2)"infection improving"(most, but not all, signs and symptoms of infection improved or resolved)(3)"treatment failure" (≥1 signs or symptoms of infection substantially worsening), (4)"unevaluable"(<3 days of study treatment or patient lost to follow-up), or (5)"recurrence"(a previously cured or improved infection showing worsening of signs or symptoms of infection)

Secondary outcomes

  1. Microbiological response

    Time frame: Interim Clinical Evaluation (ICE): 7 days after the initiation of the study drug. End of Therapy (EOT): within 24 hours after the final dose. Post-therapy evaluation (PTE): 7-14 days after the final dose.

    Microbiological culture examination of wound tissue; Analysis of drug sensitivity test results; Analysis of MIC50, MIC90, geometric mean inhibitory concentration and range results of clinically isolated pathogenic bacteria. At baseline, day 1, and at all other study visits, Investigators will culture samples obtained from the wound at which culturable material and signs of infection are present. They will obtain specimens using tissue curettage with a sterile scalpel, place them into transport media, and ship them to the designated central laboratory for species identification and antibiotic susceptibility testing. For specific operations of bacteriological examination of wound tissue, please refer to the clinical microbiology operation manual. Result: 1)Resolved;2) Improved;3)Failure 4) Colonization 5) Superinfection.

  2. Comprehensive Response

    Time frame: End of Therapy (EOT): within 24 hours after the final dose. Post-therapy evaluation (PTE):7-14 days after the final dose.

    At EOT and PTE, the Investigator will grade the comprehensive response as (1)"cure"(patients are clinically cured, and the bacteria are eradicated or presumed eradicated.);(2)"failure" (patients are classified as clinical failure or/and microbiological responses are failure and superinfection) or (3)"indeterminate"(if both clinical and microbiological responses are indeterminate).

  3. Safety and tolerability

    Time frame: Interim Clinical Evaluation (ICE): 7 days after the initiation of the study drug. End of Therapy (EOT): within 24 hours after the final dose. Post-therapy evaluation (PTE): 7-14 days after the final dose

    The incidence of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs), and clinically significant changes in physical examination, vital signs, laboratory tests, and 12-lead electrocardiogram (ECG)

  4. Clinical response

    Time frame: Interim Clinical Evaluation (ICE): 7 days after the initiation of the study drug. End of Therapy (EOT): within 24 hours after the final dose. Post-therapy evaluation (PTE): 7-14 days after the final dose.

    At each visit after enrollment, the Investigator will grade the clinical response as (1)"infection resolved or cured" (all signs and symptoms of infection resolved);(2)"infection improving"(most, but not all, signs and symptoms of infection improved or resolved)(3)"treatment failure" (≥1 signs or symptoms of infection substantially worsening), (4)"unevaluable"(<3 days of study treatment or patient lost to follow-up), or (5)"recurrence"(a previously cured or improved infection showing worsening of signs or symptoms of infection)

  5. Wound infection Score and Total Wound Score

    Time frame: At baseline, day 1, and at all other study visits, investigators will compile a "total wound score" that included ratings of signs and symptoms of infection, wound measurements (maximum length, width, and depth), and assessment of granulation tissue.

    A "wound infection score" was semiquantitatively assessed by grading each of 7 parameters with a score of 0-3: (1) purulent drainage, (2) nonpurulent drainage, (3) erythema, (4) induration, (5) tenderness, (6) pain, and (7) local warmth.

Sponsors and collaborators

Lead sponsor

Jiangsu ProteLight Pharmaceutical & Biotechnology Co., Ltd.

Industry

Collaborators

  • Parexel

Registry information

Official study title

A Randomized, Double-blind, Placebo-controlled, Multi-center Study to Evaluate the Efficacy and Safety of Antimicrobial Peptide PL-5 Topical Spray in Patients With Mild Infections of Diabetic Foot Ulcers

Acronym: PL-5

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Jan 3, 2024
Registry last updated
May 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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