chronic diabetic foot ulcer

The primary objective is to explore the mechanistic role of ON101 cream in healing diabetic foot ulcers by determining the molecular targets of ON101 cream.

ON101 cream

PA-F4 及 S1

cream

1 cc per 5 cm2 ulcer size

Primary endpoint:
 Percentage change from baseline in the expression level of individual target
gene(s) at protein and/or mRNA level.
Secondary endpoints:
1. Comparison of the gene and/or protein expression level of individual target
between ON101 and Placebo groups
2. Change from baseline in the wound microbiota composition in each group
3. Comparison of the wound microbiota composition between ON101 and Placebo
groups
4. Comparison of the wound reduction rate in each group
5. Correlation of wound reduction rate with the alternated level of each target gene
in each group.
Safety endpoints:
 Incidence of treatment-emergent adverse event (AE)
 Change from baseline in vital signs, physical examination, and laboratory tests

1. Subjects, male or female, aged 20 to 80 years (inclusive) with Type 1 or Type 2
diabetes undergoing therapy for glycemic control.
2. Subjects has a glycosylated hemoglobin, HbA1c < 12%.
3. Presence of at least one diabetic foot ulcer that meets all of the following criteria:
a. At the time of Visit 0 (V0), the ulcer has existed for at least one month;
b. At the time of Visit 1 (V1), the post-debridement ulcer presents Grade 2 or
Grade 3 (without osteomyelitis or active infection) in Wagner Ulcer
Classification System assessment; and
c. Area should be ≥ 4 cm2 and ≤ 25 cm2;
d. No higher than the ankle.
4. Subject has adequate vascular perfusion of the affected limb, confirmed by
Ankle-Brachial Index (ABI) ≥ 0.8 and ≤ 1.3.
5. Clinically normal resting ECG at the first Screening Visit (V0) or, if abnormal,
considered to be not clinically significant by the Investigator.
6. Subject must use an off-loading method for the target ulcer on the plantar during
the whole study period.
7. Subject, if female of child-bearing potential, has a negative pregnancy test on
urine at screening, must not be breastfeeding, and willing to use two medically
accepted methods of contraception (e.g., barrier contraceptives [female condom
or diaphragm with a spermicidal gel], hormonal contraceptives [implants,
injectables, combination oral contraceptives, transdermal patches, or
contraceptives rings], and intrauterine devices) during the course of the study
(excluding women who are not of childbearing potential and/or who have been
sterilized).
8. Subject is able and willing to comply with the study procedures.
9. A signed and dated informed consent form has been obtained from the subject

1. In response to standard of care (SoC), ulcer size reduction is ≥20% during the
two-week run-in screening period (between the first Screening Visit/V0 and
Baseline Visit/V1).
2. Ulcers with exposed bone or associated with osteomyelitis.
Note: The osteomyelitis should be ruled out by clinical examination (probing of
the wound) or X-ray findings where find necessary by the Investigator.
3. Presence of necrosis, purulence, or sinus tracts that cannot be removed by
debridement.
4. Laboratory values at Screening of:
a. Liver function test (total bilirubin, aspartate aminotransferase [AST], or
alanine transaminase [ALT]) > 3x the upper limit of normal, or
b. Albumin < 2.5 g/dL, or
c. Renal function test (serum creatinine or urea) > 2x the upper limit of
normal
5. Presence of any clinically significant medical condition(s) in medical history
during screening period that, in the opinion of the Investigator, could interfere
with wound healing, including but not limited to the following:
a. Acute or unstable Charcot foot
b. Current sepsis
c. Active malignant disease. A subject, who has had a malignant disease in the
past, was treated and is currently disease-free, maybe considered for study
entry.
d. Acquired immune deficiency syndrome (AIDS) or HIV positive
6. Subject is currently receiving (i.e., within 30 days of randomization visit) or
scheduled to receive any of the following medication or therapies, could interfere
with wound healing during the course of the study:
a. Immunosuppressive or chemotherapeutic agents, radiotherapy, or systemic
corticosteroids
b. Autoimmune disease therapy
c. Lower limb revascularization surgery (e.g., angioplasty, artery bypass
surgery)
d. Hyperbaric oxygen therapy
e. Bioengineered tissue or skin substitutes
f. Use of any investigational drug(s)
g. Cell therapy
7. More than two (2) ulcers located on or below the malleoli on the target foot.
8. A psychiatric condition (e.g., suicidal ideation), current or chronic alcohol or
drug abuse problem, determined from the subject’s medical history, which in the
opinion of the Investigator, may pose a threat to subject compliance.
9. Has any other factor which may, in the opinion of the Investigator, compromise
participation and/or follow-up in the study.
10. Body mass index (BMI) >40 with plantar ulcer.
11. Heavy smoker (>1 pack per day).