NexoBrid® Clinical Efficacy

The safety and efficacy of NexoBrid were evaluated in three clinical studies.1

93% of adults treated with NexoBrid achieved ≥95% eschar removal vs 4% with gel vehicle1

≥95% Eschar Removal with NexoBrid vs Gel Vehicle

Study 1: 93% of subjects treated with NexoBrid achieved ≥95% eschar removal vs 4% with gel vehicle

NexoBrid achieved ≥95% eschar removal 2.8 days sooner than SOC* in adults1

Median Time to ≥95% Eschar Removal

Study 1: Median time to ≥95% eschar removal was 2.8 days sooner with NexoBrid vs SOC

Only 4% of adults treated with NexoBrid required follow up excision vs 72% with SOC1*

Incidence of Excision for Eschar Removal

Study 1: NexoBrid resulted in a 98.9% decrease in the probability of excision for eschar removal vs SOC

NexoBrid achieved ≥95% wound closure in 31 days vs 36 days with SOC1*||¶

Median Time to ≥95% Wound Closure
(Safety Endpoint)

Study 1: The median time to ≥95% wound closure was 31 days for NexoBrid vs 36 days for SOC

*Standard of care (SOC) included a combination of surgical and non-surgical eschar removal procedures such as: tangential, minor, avulsion, Versajet, and/or dermabrasion excision per the investigators’ discretion.

The statistical test that resulted in this p-value was Fisher’s Exact Test.

The statistical test that resulted in this p-value was Wilcoxon-Gehan Test.

§The statistical test that resulted in this p-value was Wald Chi-Square.

||Study 1 used Kaplan-Meier methods to estimate median time to ≥95% wound closure for all target wounds (TWs) on a subject. This was a noninferiority endpoint.

Subjects were not evaluated frequently enough after achieving ≥95% wound closure to adequately assess time to 100% wound closure.

Study 2 for Adult Patients number icon

Review Study 2:
NexoBrid compared to SOC in adult patients1

Review the Data 

Study 3 for Pediatric Patients number icon

Review Study 3:
NexoBrid compared to SOC in Pediatric Patients1

Review the Data 

Only 15% of DPT wounds in adults treated with NexoBrid required follow up excision vs 63% with SOC1*


NexoBrid resulted in a significant reduction of DPT wound autografts vs SOC (18% with NexoBrid vs 34% with SOC)2*

DPT Wounds Requiring Autografts

Study 2: NexoBrid resulted in an 18% reduction of DPT wound autografts vs 34% with SOC

The mean percent of DPT wound area autografted was significantly lower with NexoBrid vs SOC (8.4 ± 21.3 with NexoBrid vs 21.5 ± 34.8 with SOC)2*

DPT Wound Area Autografted

Study 2: NexoBrid resulted in a 8.4 +/–21.3 mean percent of DPT wound area autografted vs 21.5 +/–34.8% with SOC

NexoBrid achieved ≥95% wound closure in 33 days vs 24 days with SOC2*§

Median Time to ≥95% Wound Closure (Per Subject)

Study 2: NexoBrid achieved ≥95% wound closure in 33 days vs 24 days with SOC

*Standard of care (SOC) included a combination of surgical and non-surgical eschar removal procedures such as: tangential, minor, avulsion, Versajet, and/or dermabrasion excision per the investigators’ discretion.

The statistical test that resulted in this p-value was Logistic Regression Model.

Study 2 used Kaplan-Meier methods to estimate median time to ≥95% wound closure in randomized subjects.

§Subjects were not evaluated frequently enough after achieving ≥95% wound closure to adequately assess time to 100% wound closure.

||The statistical test which resulted in this p-value was the log rank test.

The statistical test that resulted in this p-value was the Analysis of Covariance (ANCOVA) Model.

Study 1 for Adult Patients number icon

Review Study 1:
NexoBrid Compared to SOC and gel vehicle in adult patients

Review the Data 

Study 3 for Pediatric Patients number icon

Review Study 3:
NexoBrid compared to SOC in Pediatric Patients1

Review the Data 

NexoBrid achieved ≥95% eschar removal 5 days sooner than SOC in pediatric patients.1*

Median Time to ≥95% Eschar Removal in Pediatrics

Study 3: Median time to ≥95% eschar removal in pediatric patients was 5 days sooner with NexoBrid vs SOC

Only 8% of pediatric patients treated with NexoBrid® required follow up excision vs 64% with SOC1

Incidence of Excision for Exchage Removal in Pediatrics

Study 3: NexoBrid resulted in an 97.5% decrease in the probability of excision for eschar removal vs SOC

NexoBrid achieved ≥95% wound closure in 32 days vs 34 days with SOC1||

*Eschar removal was considered ≥95% total debridement per treated wound.

The statistical test that resulted in this p-value was Wilcoxon-Gehan Test.

Standard of care (SOC) included a combination of surgical and non-surgical eschar removal procedures such as: tangential, minor, avulsion, Versajet, and/or dermabrasion excision per the investigators’ discretion.

§The statistical test that resulted in this p-value was Logistic Regression Model using a re-randomization test.

||The estimated median time to reach 100% wound closure on a target wound level was 44 days for the NexoBrid arm and 43 days for the SOC arm.

Study 3 used Kaplan-Meier methods to estimate median time to ≥95% wound closure in randomized subjects.

Study 1 for Adult Patients number icon

Review Study 1:
NexoBrid Compared to SOC and gel vehicle in adult patients

Review the Data 

Study 2 for Adult Patients number icon

Review Study 2:
NexoBrid compared to SOC in adult patients1

Review the Data 

Important Safety Information

Indication

NEXOBRID® (anacaulase-bcdb) is indicated for eschar removal in adults and pediatric patients with deep partial thickness (DPT) and/or full thickness (FT) thermal burns.

Limitations of Use

The safety and effectiveness of NEXOBRID have not been established for treatment of:

  • Chemical or electrical burns
  • Burns on the face, perineum, or genitalia
  • Burns on the feet of patients with diabetes mellitus or on the feet of patients with occlusive vascular disease
  • Circumferential burns
  • Burns in patients with significant cardiopulmonary disease, including inhalation injury

NEXOBRID is not recommended for:

  • Wounds contaminated with radioactive and other hazardous substances to avoid unforeseeable reactions with the product and an increased risk of spreading the noxious substance
  • Treatment of burn wounds where medical devices (e.g., implants, pacemakers, shunts) or vital structures (e.g., large vessels) could become exposed during eschar removal

Important Safety Information

Contraindications

NEXOBRID is contraindicated in patients with: known hypersensitivity to anacaulase-bcdb, bromelain, pineapples, or to any other components; known hypersensitivity to papayas or papain because of the risk of cross-sensitivity.

Important Safety Information

Indication

NEXOBRID® (anacaulase-bcdb) is indicated for eschar removal in adults and pediatric patients with deep partial thickness (DPT) and/or full thickness (FT) thermal burns.

Limitations of Use

The safety and effectiveness of NEXOBRID have not been established for treatment of:

  • Chemical or electrical burns
  • Burns on the face, perineum, or genitalia
  • Burns on the feet of patients with diabetes mellitus or on the feet of patients with occlusive vascular disease
  • Circumferential burns
  • Burns in patients with significant cardiopulmonary disease, including inhalation injury

NEXOBRID is not recommended for:

  • Wounds contaminated with radioactive and other hazardous substances to avoid unforeseeable reactions with the product and an increased risk of spreading the noxious substance
  • Treatment of burn wounds where medical devices (e.g., implants, pacemakers, shunts) or vital structures (e.g., large vessels) could become exposed during eschar removal

Important Safety Information

Contraindications

NEXOBRID is contraindicated in patients with: known hypersensitivity to anacaulase-bcdb, bromelain, pineapples, or to any other components; known hypersensitivity to papayas or papain because of the risk of cross-sensitivity.

Warnings and Precautions

Hypersensitivity Reactions

Serious hypersensitivity reactions, including anaphylaxis, have been reported with postmarketing use of anacaulase-bcdb. If a hypersensitivity reaction occurs, remove NEXOBRID (if applicable) and initiate appropriate therapy.

Healthcare personnel should take appropriate precautions to avoid exposure when preparing and handling NEXOBRID (e.g., gloves, surgical masks, other protective coverings, as needed).

Coagulopathy

Avoid use of NEXOBRID in patients with uncontrolled disorders of coagulation. Use with caution in patients on anticoagulant therapy or other drugs affecting coagulation, and in patients with low platelet counts and increased risk of bleeding from other causes. Monitor patients for possible signs of coagulation abnormalities and signs of bleeding.

Adverse Reactions

The most common adverse reactions (>5%) in adults were pruritus, pyrexia, wound complication, anemia, vomiting and insomnia. The most common adverse reactions (>5%) in pediatric patients were pruritus, pyrexia and vomiting.

Use in Special Populations
Geriatric Use

Clinical studies of NEXOBRID did not include sufficient numbers of subjects 65 years of age and older to determine whether they respond differently from younger adult subjects.

To report negative side effects contact Vericel Corporation at 888-454-BURN (888-454-2876) or FDA at 1-800-FDA-1088 (1-800-332-1088) or www.fda.gov/medwatch.

Please see Full Prescribing Information.

References: 1. NexoBrid Prescribing Information. Cambridge, MA. Vericel Corporation; 2024. 2. Data on File. BLA 761192; July 2022 and October 2023.