Bacteriophage Therapy in Patients With Diabetic Foot Osteomyelitis

Launched by ADAPTIVE PHAGE THERAPEUTICS, INC. · Dec 15, 2021

Keywords

ClinConnect Summary

This clinical trial is studying a new treatment called bacteriophage therapy for patients with diabetic foot osteomyelitis, which is an infection in the bone of the foot that can happen in people with diabetes. The researchers want to find out if this therapy can help patients recover better than standard treatments. The trial is currently looking for participants aged 18 to 85 who have diabetes and are scheduled for a surgical procedure to clean out the infection. To qualify, patients must have a specific type of bacteria called Staphylococcus aureus found in their bone culture and have a matching bacteriophage available for treatment.

If you join the trial, you will receive either the new bacteriophage therapy or the usual care for your condition. The study will ensure that you continue receiving standard treatments, including antibiotics, during this time. It’s important to know that certain conditions, such as having an active cancer related to the ulcer, severe liver issues, or being pregnant, may prevent you from participating. The trial aims to enroll a diverse group of participants, so if you think you meet the criteria, consider discussing it with your healthcare provider to learn more about the potential benefits and risks.

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Eligibility criteria

• Inclusion Criteria:
• • Male or female ≥18 to \<85 years of age.
• • Ongoing diagnosis of diabetes.
• • Have undergone or are scheduled to undergo surgical debridement for DFO as part of SoC, with the associated bone culture positive for S. aureus
• • Availability of at least 1 matching phage for S. aureus cultured from the bone culture
• • Receiving SoC treatment for DFO, including antibiotics after debridement and before randomization
• • Meet defined study ulcer requirements as defined in the protocol
• • Adequate circulation to the affected extremity demonstrated within 3 months prior to randomization and no revascularization procedure anticipated
• • History of compliance with prior appointments and treatments in the investigator's opinion and willingness to receive and comply with SOC antimicrobial and clinical treatments for the study ulcer, including offloading
• Exclusion Criteria:
• • Healing of the ulcer by more than 30% between screening and randomization.
• • Treated with hyperbaric oxygen or cellular/tissue products with 30 days of screening
• • Suspicion of neoplasm associated with the study ulcer or any non-study diabetic ulcer independent of biopsy result.
• • Presence of any cellulitis not localized to the study ulcer.
• • Indwelling hardware at the site of the DFO.
• • Body weight \<50 kg.
• • Presence of above ankle ulcer, with \>50% above medial malleolus
• • Hemoglobin \< 7g/dL
• • Abnormal liver function tests
• • History of underlying liver disease at screening or within last 3 months
• • Positive test for HIV-1 and /or HIV-2
• • Any other clinically significant or severe disease that in the judgment of the investigator makes the patient unfit for the study or likely to withdraw prematurely from the study, or that could jeopardize the safety of the patient or confound the results of the study.
• • Known allergy to phage products.
• • Pregnant and/or breastfeeding.
• • Immunocompromised at screening in the judgment of the investigator.
• • Taking any systemic or topical antibacterial antibiotic within 2 weeks prior to the start of study treatment, for a condition other than Diabetic Foot Infection and DFO.
• • Taking any antiviral medication within 2 weeks prior to the start of study treatment and up through the last administration of study treatment.
• • Taking and/or receiving any therapies for the study ulcer that are not considered to be SOC.
• • More than 30 days has elapsed between screening and randomization (start of treatment)
• • Participating in another clinical trial within 4 weeks prior to screening.
• • Inability to obtain or provide informed consent or adhere to the protocol in the judgment of the investigator.
• • Once approximately 30% of subjects are enrolled with DFO involving digits, additional subjects will be excluded.