E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Pyoderma gangrenosum |
Pyoderma gangrenosum |
|
E.1.1.1 | Medical condition in easily understood language |
Atypical chronic wounds |
Atypische chronische wonden |
|
E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Therapeutic techniques [E02] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To compare the clinical efficacy of HBO treatment on top of standard regular wound care and anti-inflammatory treatment in patients with PG, with time to wound closure as the primary outcome. Controls will be treated with regular wound care and anti-inflammatory treatment. |
|
E.2.2 | Secondary objectives of the trial |
• To assess the effect of HBOT on: 1. Changes in markers of inflammation, mRNA expression in micro-biopsies in wound edges. 2. Alterations in mitochondrial O2 levels (non-invasive) with the use of off-label 5- ALA-plaster and CE approved COMET device 3 The number of activated neutrophils in peripheral venous blood. • To assess the effect of HBOT on Pain reduction (NRS score). • To assess the effect of HBOT on Health Related-Quality of Life (WOUND-Q). • To assess the prevalence of recurrence of PG in patients treated with and without adjuvant HBOT.
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Confirmed diagnosis pyoderma gangrenosum by referring specialist (dermatologist, clinical immunologist or rheumatologist) • Unsatisfactory response of treatment after six weeks prednisone. • Fit for hyperbaric oxygen therapy as assessed by the hyperbaric physician. • Age ≥18 years at baseline • All genders • Able and willing to give written informed consent and to comply with the study requirements. |
- Bevestigde diagnose pyoderma gangrenosum door de verwijzende specialist (b.v. dermatoloog, klinisch immunoloog of rheumatoloog). - Onvoldoende respons op behandeling na 6 weken prednison - Fit om hyperbare zuurstoftherapie te ondergaan beoordeeld door de hyperbaar arts - Leeftijd 18 jaar en ouder op baseline. - Alle geslachten. - In staat en akkoord om informed consent te ondertekenen en voldoen aan de studie voorwaarden. |
|
E.4 | Principal exclusion criteria |
• Language barrier • Unable to give informed consent - Pregnancy |
- Taalbarriere - onvermogen om informed consent te geven - Zwangerschap |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the difference in wound healing time between the group with HBOT and the group without HBOT |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Wound healing time (time to full re-epithelialization) will be measured by the primary physician with a baseline of wound measurement and photography (3D validated measurement tool), after 3 weeks, 6 weeks (ending HBOT) and after 3 and 6 months (if the wounds are still present). Patients will be asked to perform weekly photographs (2D validated measurement tool) of the wounds if still present and sending these to the primary physician. |
|
E.5.2 | Secondary end point(s) |
- Difference in changes of inflammation markers, mRNA expression in micro-biopsies in wound edges in patients with pyoderma gangrenosum with and without HBOT - Difference in alterations in mitochondrial O2 levels (non-invasive) of pyoderma wounds versus patients without HBOT - Difference in the number of activated neutrophils in peripheral venous blood in patients with pyoderma gangrenosum with and without HBOT - Difference in Pain reduction (NRS score) in patients with pyoderma gangrenosum with and without HBOT - Difference in Improvement of Health Related-Quality of Life, with WOUND-Q in patients with pyoderma gangrenosum with and without HBOT - Difference in prevalence of recurrence of PG in patients treated with and without adjuvant HBOT. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
- Changes in inflammatory cytokines mRNA in pyoderma in patients with and without HBOT: start trial, week 3 and 6 - Measurement effect of HBOT in mitochondria: alterations in mitochondrial O2 levels (non-invasive) of pyoderma wounds versus patients without HBOT: start trial, week 3 and 6 - Neutrophil count in peripheral venous blood: start trial, week 3 and 6 - Pain reduction (NRS score): standard measurement once a week. - Improvement of Health Related-Quality of Life, with WOUND-Q : start trial, week 6, 12, 26 and 52. - Recurrence of PG in patients treated with and without adjuvant HBOT: 12, 26 and 52 weeks |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
|
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
|
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |