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Evaluation of LL-37 in healing of hard-to-heal venous leg ulcers : A multicentric prospective randomized placebo-controlled clinical trial

Mahlapuu, Margit ; Sidorowicz, Adam ; Mikosinski, Jacek ; Krzyżanowski, Mikołaj ; Orleanski, Jakub ; Twardowska-Saucha, Krystyna ; Nykaza, Andrzej ; Dyaczynski, Michal ; Belz-Lagoda, Beata and Dziwiszek, Grzegorz , et al. (2021) In Wound Repair and Regeneration 29(6). p.938-950
Abstract

Many patients with venous leg ulcers do not reach complete healing with compression treatment alone, which is current standard care. This clinical trial HEAL LL-37 was a phase IIb double-blind, randomized, placebo-controlled study, with the aim to evaluate the efficacy and safety of a new drug LL-37 for topical administration, in combination with compression therapy, in 148 patients suffering from hard-to-heal venous leg ulcers. The study had three arms, consisting of two groups treated with LL-37 at concentrations of 0.5 or 1.6 mg/mL, and a placebo cohort. Patients had a mean age of 67.6 years, a median ulcer duration of 20.3 months, and a mean wound size at the time of randomization of 11.6 cm2. Efficacy analysis performed... (More)

Many patients with venous leg ulcers do not reach complete healing with compression treatment alone, which is current standard care. This clinical trial HEAL LL-37 was a phase IIb double-blind, randomized, placebo-controlled study, with the aim to evaluate the efficacy and safety of a new drug LL-37 for topical administration, in combination with compression therapy, in 148 patients suffering from hard-to-heal venous leg ulcers. The study had three arms, consisting of two groups treated with LL-37 at concentrations of 0.5 or 1.6 mg/mL, and a placebo cohort. Patients had a mean age of 67.6 years, a median ulcer duration of 20.3 months, and a mean wound size at the time of randomization of 11.6 cm2. Efficacy analysis performed on the full study population did not identify any significant improvement in healing in patients treated with LL-37 as compared with the placebo. In contrast, a post hoc analysis revealed statistically significant improvement with LL-37 treatment in several interrelated healing parameters in the subgroup of patients with large target wounds (a wound area of at least 10 cm2 at randomization), which is a known negative prognostic factor for healing. The study drug was well tolerated and safe in both dose strengths. In summary, this clinical trial did not detect any significant differences in healing of venous lower leg ulcers in the entire study cohort comparing patients treated with LL-37 versus placebo. A subgroup analysis provided an interesting observation that LL-37 could offer a treatment benefit in patients with large ulcers, exigently warranting a further study adequately powered to statistically assess the treatment outcome in this patient group.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
LL-37, phase II clinical trial, venous leg ulcers, wound healing
in
Wound Repair and Regeneration
volume
29
issue
6
pages
13 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:85117858905
  • pmid:34687253
ISSN
1067-1927
DOI
10.1111/wrr.12977
language
English
LU publication?
no
additional info
Publisher Copyright: © 2021 Promore Pharma AB. Wound Repair and Regeneration published by Wiley Periodicals LLC on behalf of The Wound Healing Society.
id
a11c5d36-67c8-4a10-a8b4-af798f98b3b9
date added to LUP
2021-11-23 13:47:50
date last changed
2024-06-15 21:17:22
@article{a11c5d36-67c8-4a10-a8b4-af798f98b3b9,
  abstract     = {{<p>Many patients with venous leg ulcers do not reach complete healing with compression treatment alone, which is current standard care. This clinical trial HEAL LL-37 was a phase IIb double-blind, randomized, placebo-controlled study, with the aim to evaluate the efficacy and safety of a new drug LL-37 for topical administration, in combination with compression therapy, in 148 patients suffering from hard-to-heal venous leg ulcers. The study had three arms, consisting of two groups treated with LL-37 at concentrations of 0.5 or 1.6 mg/mL, and a placebo cohort. Patients had a mean age of 67.6 years, a median ulcer duration of 20.3 months, and a mean wound size at the time of randomization of 11.6 cm<sup>2</sup>. Efficacy analysis performed on the full study population did not identify any significant improvement in healing in patients treated with LL-37 as compared with the placebo. In contrast, a post hoc analysis revealed statistically significant improvement with LL-37 treatment in several interrelated healing parameters in the subgroup of patients with large target wounds (a wound area of at least 10 cm<sup>2</sup> at randomization), which is a known negative prognostic factor for healing. The study drug was well tolerated and safe in both dose strengths. In summary, this clinical trial did not detect any significant differences in healing of venous lower leg ulcers in the entire study cohort comparing patients treated with LL-37 versus placebo. A subgroup analysis provided an interesting observation that LL-37 could offer a treatment benefit in patients with large ulcers, exigently warranting a further study adequately powered to statistically assess the treatment outcome in this patient group.</p>}},
  author       = {{Mahlapuu, Margit and Sidorowicz, Adam and Mikosinski, Jacek and Krzyżanowski, Mikołaj and Orleanski, Jakub and Twardowska-Saucha, Krystyna and Nykaza, Andrzej and Dyaczynski, Michal and Belz-Lagoda, Beata and Dziwiszek, Grzegorz and Kujawiak, Monika and Karczewski, Marek and Sjöberg, Folke and Grzela, Tomasz and Wegrzynowski, Adam and Thunarf, Fredrik and Björk, Jakob and Ekblom, Jonas and Jawien, Arkadiusz and Apelqvist, Jan}},
  issn         = {{1067-1927}},
  keywords     = {{LL-37; phase II clinical trial; venous leg ulcers; wound healing}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{938--950}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Wound Repair and Regeneration}},
  title        = {{Evaluation of LL-37 in healing of hard-to-heal venous leg ulcers : A multicentric prospective randomized placebo-controlled clinical trial}},
  url          = {{http://dx.doi.org/10.1111/wrr.12977}},
  doi          = {{10.1111/wrr.12977}},
  volume       = {{29}},
  year         = {{2021}},
}