ENERGI-F703 gel, as a new topical treatment for diabetic foot and leg ulcers: A multicenter, randomized, double-blind, phase II trial

Jui Yung Yang, Cha Chun Chen, Shun Cheng Chang, Jiun Ting Yeh, Hui Fu Huang, Hwang Chi Lin, Shang Hsi Lin, Yu Hsien Lin, Lin Gwei Wei, Tom J. Liu, Shih Yuan Hung, Hui Mei Yang, Hui Hsiu Chang, Chih Hsin Wang, Yuan Sheng Tzeng, Chieh Huei Huang, Chang Yi Chou, Ying Sheng Lin, Shih Yi Yang, Han Min ChenJiun Tsai Lin, Yi Fang Cheng, Guang Huar Young, Chun Fang Huang, Ya Chun Kuo, Niann Tzyy Dai*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

4 Scopus citations

Abstract

Background: Diabetic foot and leg ulcers are a major cause of disability among patients with diabetes mellitus. A topical gel called ENERGI-F703, applied twice daily and with adenine as its active pharmaceutical ingredient, accelerated wound healing in diabetic mice. The current study evaluated the safety and efficacy of ENERGI-F703 for patients with diabetic foot and leg ulcers. Methods: This randomized, double-blind, multicenter, phase II trial recruited patients from eight medical centers in Taiwan. Patients with intractable diabetic foot and leg ulcers (Wagner Grade 1–3 without active osteomyelitis) were randomly assigned (2:1) to receive topical ENERGI-F703 gel or vehicle gel twice daily for 12 weeks or until complete ulcer closure. The investigator, enrolled patients and site personnel were masked to treatment allocation. Intention to treat (ITT) population and safety population were patient to primary analyses and safety analyses, respectively. Primary outcome was complete ulcer closure rate at the end of treatment. This trial is registered with ClinicalTrials.gov, number NCT02672436. Findings: Starting from March 15th, 2017 to December 26th, 2019, 141 patients were enrolled as safety population and randomized into ENERGI-F703 gel (n = 95) group or vehicle gel (n = 46) group. In ITT population, ENERGI-F703 (n = 90) and vehicle group showed ulcer closure rates of 36.7% (95% CI = 26.75% - 47.49%) and 26.2% (95% CI = 13.86% - 42.04%) with difference of 9.74 % (95 % CI = -6.74% - 26.23%) and 25% quartiles of the time to complete ulcer closure of 69 days and 84 days, respectively. There were 25 (26.3%) patients in ENERGI-F703 group and 11 (23.9%) patients in vehicle group experiencing serious adverse events and five deaths occurred during the study period, none of them related to the treatment. Interpretation: Our study suggests that ENERGI-F703 gel is a safe and well-tolerated treatment for chronic diabetic foot and leg ulcers. Further studies are needed to corroborate our findings in light of limitations. Funding: Energenesis Biomedical Co., Ltd.

Original languageEnglish
Article number101497
JournaleClinicalMedicine
Volume51
DOIs
StatePublished - 09 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
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Keywords

  • ATP
  • Adenine
  • Adenosine triphosphate
  • Diabetic foot ulcer
  • Diabetic wound healing

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