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Study of Intra-articular DLX105 Applied to Patients With Severely Painful Osteoarthritis of the Knee

Primary Purpose

Osteoarthritis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
DLX105, a single-chain (scFv) antibody fragment against TNF-alpha
Placebo
Sponsored by
ESBATech AG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis focused on measuring Osteoarthritis, TNF-alpha, DLX105, scFv antibody fragment, pain, fragment, antibody fragment

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Body mass index < 30.
  • Patients with diagnosed OA of the knee (unilateral or bilateral) according to the American College of Rheumatology (ACR) Criteria for classification of idiopathic OA (clinical and radiological criteria) of the knee at Screening (for ACR criteria, see Appendix 16.1).
  • Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade II or Grade III changes, according to Kellgren-Lawrence grading system.
  • Presence of pain in the index knee (in case of bilateral OA, "index knee" is the more painful knee) defined by a level of ≥ 60 mm on a 100 mm (linear) VAS at Screening.
  • Paracetamol and NSAIDs (apart from acetyl salicylic acid ≤ 100 mg/day) must be withdrawn at least 24 hours prior to Screening .
  • Doses of "chondroprotective" agents containing glucosamine and/or chondroitin sulphate must be stable for at least 3 months prior to Screening.
  • Doses of any non-prescription medication claiming effects on signs or symptoms of OA must be stable for at least 3 months prior to Screening.
  • Use of non-pharmacological treatment modalities must be stable for at least 3 months prior to Screening.
  • Negative QuantiFERON-TB Gold test.

Exclusion Criteria:

  • Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade IV, according to Kellgren-Lawrence grading system.
  • Instability of the index knee joint of > 10° as assessed by goniometer at Screening.
  • Arthroscopic or open surgery to the index knee joint within 6 months prior to Screening.
  • Post-traumatic or any other secondary OA of the knee.
  • Isolated OA of the patello-femoral joint.
  • Co-morbidity that would confound measurement of knee pain
  • Evidence of any inflammatory arthritis.
  • History of Reiter's Syndrome, RA, psoriatic arthritis, ankylosing spondylitis, lymphoma, arthritis associated with inflammatory bowel disease, sarcoidosis, amyloidosis, or any other inflammatory disease (immune mediated inflammatory disease) that may affect the knee.
  • Local or systemic contraindication for an i.a. injection at Screening or Baseline.
  • Any i.a. injection (corticosteroids, hyaluronic acid, etc.) within the 3 months prior to Screening.
  • History of high risk exposure to Mycobacterium tuberculosis.
  • Human immunodeficiency virus (HIV), hepatitis B or hepatitis C infection.
  • Uncontrolled diabetes or cardiovascular disease (New York Heart Association criteria III + IV), including uncontrolled hypertension (> 160/100 mmHg).
  • Active infectious episodes, or history of recurrent or chronic systemic infections.
  • Malignancy within 5 years prior to Screening, except for surgically-cured non melanoma skin cancer or cervical carcinoma in situ.
  • Significant haematological disease within 1 month prior to Screening.
  • Moderately to severely impaired hepatic function, or laboratory values reflecting inadequate hepatic function

Additional criteria for the sub-population of patients undergoing MRI:

  • Contraindications to MRI.
  • Known allergy to gadolinium contrast material.
  • Presence of chronic renal failure defined by a calculated creatinine clearance (CrCl) of < 60 mL/min, using the Cockcroft-Gault estimate for GFR

Sites / Locations

  • Prof. Dr. med. Georg Schett
  • Dr. René Martz
  • Dr. Sven Ostermeier
  • Prof. Dr. Manfred Hartard
  • Rheumaklinik Kantonsspital Aarau
  • Rheumatologische Universitäts-Poliklinik, Felix-Platter Spital Basel
  • Service de rhumatologie, Centre Hospitalier Universitaire, Lausanne
  • Kantonsspital St.Gallen, Rheumatologie
  • Zentrum für Rheuma und Knochenerkrankungen
  • Universitätsspital Zürich, Rheumaklinik

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

1

2

3

Arm Description

DLX105 low dose

DLX105 high dose

Outcomes

Primary Outcome Measures

Change from Baseline (Day 0) to Day 7 in a 100mm Visual Analogue Scale (VAS) to assess the intensity of knee pain.
Safety assessment during the study period. Safety endpoints will include the nature and incidence of AEs, physical examination findings, changes in vital signs, and laboratory test results.

Secondary Outcome Measures

Change from baseline in Western Ontario and McMaster Universities Osteoarthritis (WOMAC™) scoring

Full Information

First Posted
January 8, 2009
Last Updated
September 23, 2010
Sponsor
ESBATech AG
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1. Study Identification

Unique Protocol Identification Number
NCT00819572
Brief Title
Study of Intra-articular DLX105 Applied to Patients With Severely Painful Osteoarthritis of the Knee
Official Title
A Double-blind, Randomised, Placebo-controlled Phase I/IIa Study to Investigate the Safety, Tolerability and Efficacy on Pain of Intra-articular DLX105 Applied to Patients With Severely Painful Osteoarthritis of the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
September 2010
Overall Recruitment Status
Completed
Study Start Date
December 2008 (undefined)
Primary Completion Date
September 2010 (Actual)
Study Completion Date
September 2010 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
ESBATech AG

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether an intra-articular injection of DLX105 to the knee joint of patients suffering from severly painful osteoarthritis is safe and reduces pain.
Detailed Description
Treatment options for patients suffering from osteoarthritis remain limited. TNF-alpha has been identified as a major pro-inflammatory component inducing and perpetuating peripheral hyperalgesia and cartilage degeneration in various preclinical studies. DLX105 is an antibody fragment of comparably low molecular weight, associated with an exceptional local biodistribution pattern upon intra-articular injection. In addition, due to its short systemic half life as compared to conventional monoclonal antibodies, systemic exposure to DLX105 upon intra-articular administration is low. This study is designed to determine the safety and local tolerability profile of single intra-articular injections of ESBA105 as well as to define DLX105's effect size and effect duration in reducing pain of patients suffering from severely painful osteoarthritis of the knee. The study will be conducted in two sequential parts. In a first part, 4 different doses of DLX105 will be compared in a sequential, escalating scheme against placebo treatment in a total of 24 patients. In the second part of the study, two doses of DLX105 chosen based on safety data from the first part will be compared to placebo treatment in a total of 102 patients.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis
Keywords
Osteoarthritis, TNF-alpha, DLX105, scFv antibody fragment, pain, fragment, antibody fragment

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Description
DLX105 low dose
Arm Title
2
Arm Type
Experimental
Arm Description
DLX105 high dose
Arm Title
3
Arm Type
Placebo Comparator
Intervention Type
Biological
Intervention Name(s)
DLX105, a single-chain (scFv) antibody fragment against TNF-alpha
Intervention Description
Comparison of two different doses of intra-articular DLX105
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Change from Baseline (Day 0) to Day 7 in a 100mm Visual Analogue Scale (VAS) to assess the intensity of knee pain.
Time Frame
Day 7 after intra-articular injection
Title
Safety assessment during the study period. Safety endpoints will include the nature and incidence of AEs, physical examination findings, changes in vital signs, and laboratory test results.
Time Frame
8 weeks / 12 weeks
Secondary Outcome Measure Information:
Title
Change from baseline in Western Ontario and McMaster Universities Osteoarthritis (WOMAC™) scoring
Time Frame
Day 7 after intra-articular injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Body mass index < 30. Patients with diagnosed OA of the knee (unilateral or bilateral) according to the American College of Rheumatology (ACR) Criteria for classification of idiopathic OA (clinical and radiological criteria) of the knee at Screening (for ACR criteria, see Appendix 16.1). Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade II or Grade III changes, according to Kellgren-Lawrence grading system. Presence of pain in the index knee (in case of bilateral OA, "index knee" is the more painful knee) defined by a level of ≥ 60 mm on a 100 mm (linear) VAS at Screening. Paracetamol and NSAIDs (apart from acetyl salicylic acid ≤ 100 mg/day) must be withdrawn at least 24 hours prior to Screening . Doses of "chondroprotective" agents containing glucosamine and/or chondroitin sulphate must be stable for at least 3 months prior to Screening. Doses of any non-prescription medication claiming effects on signs or symptoms of OA must be stable for at least 3 months prior to Screening. Use of non-pharmacological treatment modalities must be stable for at least 3 months prior to Screening. Negative QuantiFERON-TB Gold test. Exclusion Criteria: Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade IV, according to Kellgren-Lawrence grading system. Instability of the index knee joint of > 10° as assessed by goniometer at Screening. Arthroscopic or open surgery to the index knee joint within 6 months prior to Screening. Post-traumatic or any other secondary OA of the knee. Isolated OA of the patello-femoral joint. Co-morbidity that would confound measurement of knee pain Evidence of any inflammatory arthritis. History of Reiter's Syndrome, RA, psoriatic arthritis, ankylosing spondylitis, lymphoma, arthritis associated with inflammatory bowel disease, sarcoidosis, amyloidosis, or any other inflammatory disease (immune mediated inflammatory disease) that may affect the knee. Local or systemic contraindication for an i.a. injection at Screening or Baseline. Any i.a. injection (corticosteroids, hyaluronic acid, etc.) within the 3 months prior to Screening. History of high risk exposure to Mycobacterium tuberculosis. Human immunodeficiency virus (HIV), hepatitis B or hepatitis C infection. Uncontrolled diabetes or cardiovascular disease (New York Heart Association criteria III + IV), including uncontrolled hypertension (> 160/100 mmHg). Active infectious episodes, or history of recurrent or chronic systemic infections. Malignancy within 5 years prior to Screening, except for surgically-cured non melanoma skin cancer or cervical carcinoma in situ. Significant haematological disease within 1 month prior to Screening. Moderately to severely impaired hepatic function, or laboratory values reflecting inadequate hepatic function Additional criteria for the sub-population of patients undergoing MRI: Contraindications to MRI. Known allergy to gadolinium contrast material. Presence of chronic renal failure defined by a calculated creatinine clearance (CrCl) of < 60 mL/min, using the Cockcroft-Gault estimate for GFR
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Prof. Georg Schett, MD
Organizational Affiliation
University Hospital of Erlangen, Germany
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Prof. Hansjörg Häuselmann, MD
Organizational Affiliation
Rheumazentrum, Zurich Switzerland (Country Coordinator)
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
PD.Dr. Diego Kyburz, MD
Organizational Affiliation
University Hospital Zurich, Switzerland (Country Coordinator)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Prof. Dr. med. Georg Schett
City
Erlangen
ZIP/Postal Code
91054
Country
Germany
Facility Name
Dr. René Martz
City
Hamburg
ZIP/Postal Code
22143
Country
Germany
Facility Name
Dr. Sven Ostermeier
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
Prof. Dr. Manfred Hartard
City
Munich
ZIP/Postal Code
80809
Country
Germany
Facility Name
Rheumaklinik Kantonsspital Aarau
City
Aarau
ZIP/Postal Code
5000
Country
Switzerland
Facility Name
Rheumatologische Universitäts-Poliklinik, Felix-Platter Spital Basel
City
Basel
ZIP/Postal Code
4055
Country
Switzerland
Facility Name
Service de rhumatologie, Centre Hospitalier Universitaire, Lausanne
City
Lausanne
ZIP/Postal Code
1005
Country
Switzerland
Facility Name
Kantonsspital St.Gallen, Rheumatologie
City
St.Gallen
ZIP/Postal Code
9007
Country
Switzerland
Facility Name
Zentrum für Rheuma und Knochenerkrankungen
City
Zurich
ZIP/Postal Code
8038
Country
Switzerland
Facility Name
Universitätsspital Zürich, Rheumaklinik
City
Zürich
ZIP/Postal Code
8091
Country
Switzerland

12. IPD Sharing Statement

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Study of Intra-articular DLX105 Applied to Patients With Severely Painful Osteoarthritis of the Knee

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