Investigating the treatment of fungal nail infections with a novel medical device
| ISRCTN | ISRCTN17865863 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN17865863 |
| Secondary identifying numbers | PF4-001 |
- Submission date
- 27/07/2016
- Registration date
- 08/02/2017
- Last edited
- 14/05/2021
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Infections and Infestations
Plain English summary of protocol
Background and study aims
Fungal nail infections occur as a result of the fungi that cause athlete's foot infecting the nails. They cause the nail to become discoloured, thickened and distorted. This study is investigating a new medical device for the treatment of fungal nail infections. The device produces a gas plasma (similar to the plasma in a fluorescent light bulb) that kills the fungus under the nail. The aim of this study is to find out whether the device is capable of curing a fungal nail infection.
Who can participate?
Patients aged of 18 to 80 years with fungal nail infections in both large toenails
What does the study involve?
Samples are taken from both of the participant's toenails to confirm the infection. Participants are randomly allocated to one of four treatments with the medical device on one of their large toenails on one or two occasions. The treatment may take about an hour depending on the extent of the nail infection. Both toenails are observed for the following 12 months to check whether the infection has been cured and if new nail growth occurs. Nail samples and photographs of the toenails are taken after 1, 3, 6, 9 and 12 months. The treated toenail is compared to the untreated large toenail on the participant's other foot.
What are the possible benefits and risks of participating?
Fungal nail infections do not go away spontaneously and many sufferers have tried other treatments without success. Participating in the study may result in the successful treatment of their fungal nail infection. The device has been extensively tested and has been demonstrated to be safe to use on normal tissue and nail. If the device is targeted on one area of tissue then warmth will be noticed by the patient. The generated heat could become uncomfortable in some patients in which case the patient may move their foot away from the device. The main possible risk is that the patient receives a mild burn on their skin or nail.
Where is the study run from?
Adelaide Health Centre (UK)
When is the study starting and how long is it expected to run for?
August 2016 to July 2017
Who is funding the study?
BOC / Linde (UK)
Who is the main contact?
Dr David Voegeli
Contact information
Public
Southampton General Hospital
Southampton
SO16 6YD
United Kingdom
Study information
| Study design | Randomised controlled trial |
|---|---|
| Primary study design | Interventional |
| Secondary study design | Randomised controlled trial |
| Study setting(s) | Hospital |
| Study type | Treatment |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet |
| Scientific title | A randomised pilot clinical investigation of a novel plasma device (PF4) with concurrent controls in toenail onychomycosis |
| Study acronym | CAPTOE |
| Study objectives | A gas plasma generated by a novel medical device is capable of curing a fungal nail infection. |
| Ethics approval(s) | NRES Committee London Stanmore, 19/07/2016, ref: 16/LO/0671 |
| Health condition(s) or problem(s) studied | Onychomycosis |
| Intervention | Patients are randomised to one of four different treatments with the novel device on the right or the left large toenail. The treated toenail is compared to the untreated control (the other large toenail in the same patient). The area of the nail to be treated comprises the visibly infected nail plus a margin of 5mm. The total area to be treated is divided into treatment 'spots' of 6mm x 6mm by placing a grid on the nail to determine the number of spots. The four treatment groups are: 1. Long continuous treatment on each spot followed by one short treatment under nail 2. Short treatment on each spot repeated 6 times followed by one short treatment under nail 3. Short treatment on each spot repeated 12 times followed by one short treatment under nail 3. Short treatment on each spot repeated 6 times followed by one short treatment under nail - whole process repeated 2 weeks later |
| Intervention type | Device |
| Pharmaceutical study type(s) | |
| Phase | |
| Drug / device / biological / vaccine name(s) | |
| Primary outcome measure | Measured at 1, 3, 6, 9 and 12 months after treatment: 1. Clear nail growth: measuring the distance of the visible infection from the lunula and comparing the measurement to the baseline measurement 2. Mycological cure: determined by laboratory tests (microscopy and culture of the nail samples) |
| Secondary outcome measures | Onychomycosis severity index (OSI). This is measured by the research podiatrist before treatment and at 1, 3, 6, 9 and 12 months. At each of these time points photographs of the nail are taken and an independent onychomycosis severity index will be given by an independent expert based on the photographs. |
| Overall study start date | 29/07/2016 |
| Completion date | 31/12/2018 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Lower age limit | 18 Years |
| Upper age limit | 80 Years |
| Sex | Both |
| Target number of participants | 80 |
| Key inclusion criteria | 1. Participants who can provide informed consent 2. Male or female participants 3. Aged 18-80 4. Mycologically confirmed distal subungual onychomycosis in both hallux toenails with 25 – 75% involvement of the nail area |
| Key exclusion criteria | 1. Participants < 18 years old 2. Participants > 80 years old 3. Participants currently being treated for onychomycosis or who have been treated within the past four months using topical drug therapies 4. Participants who have taken oral antifungal agents or had laser treatments in the last 12 months 5. Participants who have been involved in other drug or medical device clinical trials in the past 3 months which may affect the safety or efficacy of this study 6. Participants with ulcerations around the toe nails 7. Participants with total dystrophic onychomycosis involving the lunula/nail matrix 8. Participants with peripheral vascular disease, immune-suppression, loss of sensation in either foot, or with any other medical state which warrants definitive antifungal therapy 9. Participants with <25% or >75% onychomycosis involvement of the nail area 10. No use of nail varnish on the toe nails for at least four weeks before the first treatment and for at least four months after the last treatment 11. Participants with proximal subungual onychomycosis 12. Participants with superficial white onychomycosis 13. Participants with psoriasis, lichen planus or other medical condition which has the ability to induce nail changes 14. Participants who cannot communicate competently in English 15. Women of childbearing potential who are, or might be, pregnant at the time of the study enrolment or who plan to become pregnant within three months of the study treatment 16. Participants with a pacemaker, implantable cardiac device, deep brain stimulator, gastric stimulator or any other electrically powered implantable device |
| Date of first enrolment | 01/08/2016 |
| Date of final enrolment | 01/07/2017 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
SO16 4XE
United Kingdom
Sponsor information
Hospital/treatment centre
Western Community Hospital
William Macleod Way
Southampton
SO16 4XE
England
United Kingdom
"ROR" |
https://ror.org/04fsd0842 |
|---|
Funders
Funder type
Industry
No information available
Results and Publications
| Intention to publish date | 01/07/2019 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Not expected to be made available |
| Publication and dissemination plan | A publication is planned in a high-impact peer reviewed journal with the intent to publish by July 2019 |
| IPD sharing plan | The datasets generated during and/or analysed during the current study are not expected to be made available due to UK data protection laws. The data will be held by the Sponsor. |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| HRA research summary | 28/06/2023 | No | No |
Editorial Notes
19/10/2017: The overall trial end date was changed from 10/07/2018 to 31/12/2018.
10/04/2017: Clarified interventions field.
07/03/2017: Publication and dissemination plan and IPD sharing plan added.
