MiMedx Concludes Enrollment For Phase 3 Plantar Fasciitis Trial

Media release:

MARIETTA, Ga., Sept. 17, 2020 (GLOBE NEWSWIRE) — MiMedx Group, Inc. (OTC PINK: MDXG) (“MiMedx” or “the Company”), an industry leader in advanced wound care and an emerging therapeutic biologics company, today announced the conclusion of enrollment for a Phase 3 study of plantar fasciitis, an inflammation of the fibrous tissue along the bottom of the foot that results in intense pain. This key clinical trial explores how placental science may address and treat musculoskeletal pain and function disorders. The study has met its timelines.

“Plantar fasciitis is an all-too-common, debilitating and painful foot condition that challenges both patients and clinicians. Several months to years of treatment may be required with conservative therapies before symptoms subside, and I believe plantar fasciitis represents a significant unmet patient need,” said Stuart Miller, M.D., Principal Investigator, Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, and Assistant Professor, Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. “This is a landmark study that will help us advance the science and elevate the standard of care for millions of patients; I look forward to analyzing and publishing the data regarding treatment efficacy for this musculoskeletal condition. Our progress to date is all the more gratifying given the dampening effect of the pandemic on patient enrollment. This study is designed to provide statistically significant evidence of efficacy for this biologic treatment to reduce pain and improve function.”

More than two million people are treated for plantar fasciitis inflammation in the United States annually. In 10% of patients treated with traditional measures, the condition progresses to chronic plantar fasciitis-related pain – recovery from which is lengthy and recurrence of which is very common, with an estimated $284 million annual national economic burden. The current treatment algorithm aims to maintain arch shape, modify foot loading and/or improve shock absorbency of the heel through night splints and orthotics. While they may assist in reducing pain associated with plantar fasciitis, these treatments do not address the root cause of the condition, which is thought to be both degenerative and inflammatory.

Timothy R. Wright, MiMedx Chief Executive Officer, commented, “Given the variability of efficacy, cost, and potential side effects of available plantar fasciitis treatment options, additional evidence-based alternatives are needed urgently. As a pioneer in the development of placental tissue technology, following through on clinical research is part of our mission to improve patient outcomes. Using our placental science platform to address the unmet need posed by plantar fasciitis is just one of the critical ways that we are exploring its application to improve people’s lives. We look forward to sharing the results of this trial in 2021.”

About the MiMedx Plantar Fasciitis Trial
This study is a Phase 3, prospective, double-blinded, randomized controlled trial of the micronized dehydrated Human Amnion Chorion Membrane (dHACM) injection as compared to saline placebo injection in the treatment of plantar fasciitis. The trial enrolled 276 patients between the ages of 21 and 79 years, with an investigator-confirmed diagnosis of plantar fasciitis for ≥ 1 month (30 days) and ≤ 18 months. Patients were required to have a Visual Analog Scale (VAS) Pain scale of ≥ 45 mm at randomization and be receiving conservative treatment for ≥ 1 month (30 days), including any of the following modalities: Rest, Ice, Compression, Elevation (RICE); stretching exercises; NSAIDs or orthotics. The primary endpoints are change in VAS for Pain at 90 Days and incidence of related adverse events at 180 days, serious adverse events and unanticipated events during the first 12 months post-injection. Secondary endpoints include self-reported responses to the Foot Function Index – Revised (FFI-R) at 90 days.

Custom-made foot orthoses appear to be no better than over-the-counter insoles or other treatments

Press Release:

Doctors advised to refrain from prescribing foot orthoses for patients with plantar heel pain

Foot orthoses specifically moulded to help people with plantar heel pain appear to be no more effective than cheaper over-the-counter insoles or other treatments, suggests a study published in the British Journal of Sports Medicine.

Plantar heel pain accounts for between 11% and 15% of all foot symptoms that require medical attention in adults and for 8%-10% of all running-related injuries.

The most commonly prescribed treatments for plantar pain include modified footwear, taping, stretching exercises, anti-inflammatory agents, extracorporal shock wave therapy, strengthening exercises and cortisone injections, but there is still a lack of consensus on which treatments are most effective.

Foot orthoses are often recommended in the treatment of the condition, despite a lack of evidence.

Dutch and Danish researchers led by the Erasmus Medical Center, Universitair Medisch Centrum, Rotterdam, in The Netherlands, therefore, set out to investigate the effects of different orthoses on pain, function and self-reported recovery in patients with plantar heel pain and to compare them with other conservative interventions.

They carried out an analysis of 20 existing randomised controlled trial studies on this issue that had investigated eight different types of foot orthoses. Collectively, the studies had looked at 1,756 patients with the condition.

Analysis revealed that pooled data from six studies showed no difference between prefabricated orthoses and “sham” orthoses (simple insoles bought over the counter) for pain in the short term.

In addition, no difference was found between sham orthoses and custom orthoses for pain in the short term, nor was there a difference between prefabricated orthoses and custom orthoses for pain in the short term.

Overall, for the majority of other interventions, no significant differences were found.

Most of the studies analysed had reported a significant improvement over time in patients treated with orthoses as well as patients treated with other conservative interventions – probably due to the fact that plantar heel pain tends to improve after 12 months.

However, the authors said orthosis interventions did not appear to be superior in improving pain, function or self-reported recovery when compared with other conservative interventions in patients with plantar heel pain.

They concluded: “Foot orthoses are not superior for improving pain and function compared with sham or other orthoses, or other conservative interventions in patients with PHP [plantar heel pain].

“We conclude that clinicians should be reserved in prescribing foot orthoses in all patients with PHP and take factors like patient preference and adherence into account.”