title: Defining success in clinical trials of diabetic foot wounds: the Los Angeles DFCon consensus.
abstract: Regulatory requirements for new products should be guided by clinical trials that protect the public by a thorough evaluation of safety and efficacy, while not creating unnecessary barriers to their development and ultimate approval. While healing a wound is the ultimate goal of treating an individual with a diabetic foot ulcer, achieving this goal is physiologically complex requiring the initiation and interaction of many events and therefore unlikely to be achieved by one compound. We believe that developing new, more meaningful, study outcomes or end points in wound care trials would both aid in determining the true efficacy of wound management modalities and facilitate the product development cycle. The primary guidance from the US Food and Drug Administration to industry in this field was published in 2006. This document, while helpful and largely in concert with current knowledge of wound healing, needs to be substantially improved. We therefore convened an interdisciplinary task force comprising experts in various aspects of wound care to attempt to achieve consensus in defining primary outcomes and potential secondary endpoints for various classes of wound-healing modalities.
authors.affiliation: Southern Arizona Limb Salvage Alliance, University of Arizona College of Medicine, Tucson, 85701, AZ, USA. armstrong@usa.net
authors.forename: David G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: Andrew J M
authors.initials: AJ
authors.lastname: Boulton
authors.forename: George
authors.initials: G
authors.lastname: Andros
authors.forename: Christopher
authors.initials: C
authors.lastname: Attinger
authors.forename: David
authors.initials: D
authors.lastname: Eisenbud
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Lavery
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lipsky
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Mills
authors.forename: Gary
authors.initials: G
authors.lastname: Sibbald
authors.forename: Adrianne P
authors.initials: AP
authors.lastname: Smith
authors.forename: Dane
authors.initials: D
authors.lastname: Wukich
authors.forename: David J
authors.initials: DJ
authors.lastname: Margolis
mesh_terms: D002986:Clinical Trials as Topic; D003257:Consumer Product Safety; D017719:Diabetic Foot / Q000628:therapy*; D017408:Guidelines as Topic; D006801:Humans; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration; D014945:Wound Healing / Q000502:physiology*