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Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement

Primary Purpose

Knee Osteoarthritis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
AS902330
Placebo
Sponsored by
Merck KGaA, Darmstadt, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Knee osteoarthritis, fibroblast growth factor 18

Eligibility Criteria

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

Inclusion Criteria:

  1. Established diagnosis of knee primary femoro-tibial OA by standard American College of Rheumatology Criteria (ACR) for at least six months (clinical AND radiological criteria)
  2. Postmenopausal or surgically sterile female ≥ 40 years of age Post-menopausal status will be confirmed by no menstrual periods for 12 consecutive months and no other biological or physiological cause for amenorrhea can be identified or Male ≥ 40 years of age willing to use contraception (condom with spermicide) from the first day of treatment until 2 months after the end of the treatment (3rd injection in Period 2) Even though systemic exposure of the drug is not foreseen at the doses used in this study, due to the absence of data on teratogenic potential of the drug, a very conservative approach on contraception is taken based on the spermatogenesis duration in humans.
  3. Candidate for Total Knee Replacement in the target knee, according to NIH consensus statement on Total Knee Replacement (2003)
  4. Date of planned Total Knee Replacement in the target knee ≥ 2 weeks after the anticipated last injection of study drug
  5. Subjects may be on treatment for symptomatic relief of OA, including NSAIDs (including Cox2 specific inhibitors); for NSAIDs, the dose should be stable for 4 weeks before baseline and during the study until day 4 after last injection. Paracetamol/acetaminophen (according to local standards and up to 4 grams per day) is allowed as rescue medication
  6. Willingness to stay in hospital for 24h after injection for SAD regimens and after first injection for MAD regimens (and up to 4 hours after second and third injections for MAD regimens) for safety and PK evaluation
  7. Willingness to complete a diary card to evaluate local tolerability and adverse events throughout the study
  8. Subjects must have read and understood the informed consent form and must have signed it prior to any study related procedure
  9. Subjects must fully understand the requirements of the study and be willing to comply with all study visits and assessments

Exclusion Criteria:

  1. Any condition, including laboratory findings and findings in the medical history or in the pre-study assessments, that in the opinion of the Investigator constitutes a risk or contraindication for participation in the study or that could interfere with the study objectives, conduct or evaluation
  2. Clinically significant abnormal hematology or biochemistry values (platelets, hemoglobin, leucocytes, alkaline phosphatase, AST, ALT, blood creatinine, bilirubin)
  3. Receipt of any investigational product or any experimental therapeutic procedure within the last 12 weeks preceding screening
  4. Intra-articular treatment with steroids or hyaluronic acid derivatives within the past 3 months (systemic symptomatic treatments with NSAIDs are allowed when stable for 4 weeks prior to first injection)
  5. Planned major surgery (e.g. joint replacement) within 2 weeks after last injection
  6. History of previous surgery (TKR or partial knee replacement) on the target knee
  7. Lesions at the planned injection site that would present a contra-indication to local injection of the study drug (e.g., open wounds and infections of the skin)Any drug or nutraceutical treatment with potential DMOAD effect (glucosamine, diacerin, chondroitin sulfate) unless given at a stable dose over at least 4 weeks prior to first injection
  8. Use of electrotherapy or acupuncture for OA
  9. Any known active infections, including suspicion of intra-articular infection and/or infections that may compromise the immune system such as HIV, Hepatitis B or Hepatitis C infection
  10. History of sarcoma and/or history of other active malignancy within five years, except adequately treated basal cell and squamous cell carcinoma of the skin
  11. Signs and symptoms suggestive of transmissible spongiform encephalopathy
  12. Secondary osteoarthritis: e.g. Joint dysplasias, Aseptic osteonecrosis, Acromegaly, Paget's disease, Ehlers-Danlos Syndrome, Gaucher's disease, Stickler's syndrome, Joint infection, Hemophilia, Hemochromatosis, Calcium Pyrophosphate deposition disease, or Neuropathic arthropathy whatever the cause Patients with risk factors for knee OA (e.g. obesity, meniscectomy) are not considered as having secondary OA and can be included in this study.

Sites / Locations

  • UMHAT "Sv. Ivan Rilski", Clinical Research Unit for Phase I
  • Frederiksberg Hospital
  • Gentofte Hospital
  • Nordsjællands Hospital - Hørsholm
  • Silkeborg sygehus
  • Regionshospitalet Viborg
  • Kuopio University Hospital
  • Oulu University Hospital
  • Turku University Central Hospital
  • FARMOVS-PAREXEL (Pty) Ltd, University of the Free State
  • PAREXEL-George
  • PAREXEL-Port Elizabeth, Mercantile Hospital
  • Sahlgrenska University Hospital/Östra
  • Hässleholms Sjukhus
  • Kungälv Sjukhus
  • Lund University Hospital
  • Malmö University Hospital
  • Danderyds Sjukhus
  • Cambridge University Hospitals

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

1

2

Arm Description

Outcomes

Primary Outcome Measures

Nature, incidence and severity of treatment-emergent adverse events (TEAEs)
Proportion of subjects with predefined local AEs (acute inflammatory reactions defined as increase of pain by 30 mm - on a 100 mm VAS - associated with a self-reported synovial fluid effusion within 3 days following i.a. injection)
Local tolerability in the target knee
Laboratory safety parameters (including blood chemistry, haematology, and urinalysis) and ECG

Secondary Outcome Measures

Change over time in the levels of the following biomarkers: Biomarkers of anabolic effect on knee cartilage (markers of cartilage formation/synthesis)
Change over time in the levels of the following biomarkers: Biomarkers of catabolic effect on knee cartilage (markers of cartilage degradation)
Change over time in the levels of the following biomarkers: Biomarkers of Bone Metabolism
Change in levels of cytokines related to inflammation (IL1b, IL6, IL8, TNFα and IFNα)
Blood levels of AS902330
Presence of anti-AS902330 antibodies

Full Information

First Posted
May 29, 2009
Last Updated
August 4, 2014
Sponsor
Merck KGaA, Darmstadt, Germany
Collaborators
Merck Serono S.A., Geneva
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1. Study Identification

Unique Protocol Identification Number
NCT00911469
Brief Title
Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement
Official Title
A Randomised, Double-blind, Placebo-controlled, Multicentre, Single and Multiple Ascending Dose Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Completed
Study Start Date
November 2007 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
June 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck KGaA, Darmstadt, Germany
Collaborators
Merck Serono S.A., Geneva

4. Oversight

5. Study Description

Brief Summary
Osteoarthritis (OA) is one of the most common diseases affecting the joints, usually those that are weight bearing such as the knees. OA is considered to be a disease of the cartilage in the joints even though it involves the whole joint, including the bone and synovium (thin lining of the joints which produces synovial fluid). With time, more and more of the cartilage is destroyed by the disease with inflammation commonly occurring. AS902330 is expected to increase the production and development of specific bone cells: chondrocytes and osteoblasts (cells that produce and maintain bone and cartilage). This is expected to lead to repair and regeneration of the cartilage, and a narrowing of the space width between the knee joints in a selected region of the knee.The purpose of this study is to see how safe treatment with AS902330 is, and to evaluate its effect on the knee cartilage. In addition, the study will also measure the effects of AS902330 in the blood.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Knee osteoarthritis, fibroblast growth factor 18

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Experimental
Arm Title
2
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
AS902330
Intervention Description
3, 10, 30, 100 or 300 µg intra-articular injection per subject in the Single Ascending Dose (SAD) cohorts and 10, 30, 100, 300 µg or highest tolerated dose intra-articular injection per week for three weeks per subject in the Multiple Ascending Dose (MAD) cohorts.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo or, 3, 10, 30, 100 or 300 µg intra-articular injection per subject in SAD cohorts and placebo or, 10, 30, 100, 300 µg or highest tolerated dose of AS902330 intra-articular injection per week for three weeks per subject in MAD cohorts.
Primary Outcome Measure Information:
Title
Nature, incidence and severity of treatment-emergent adverse events (TEAEs)
Time Frame
Up to 24 weeks post treatment
Title
Proportion of subjects with predefined local AEs (acute inflammatory reactions defined as increase of pain by 30 mm - on a 100 mm VAS - associated with a self-reported synovial fluid effusion within 3 days following i.a. injection)
Time Frame
Up to 24 weeks post treatment
Title
Local tolerability in the target knee
Time Frame
Up to 24 weeks post treatment
Title
Laboratory safety parameters (including blood chemistry, haematology, and urinalysis) and ECG
Time Frame
Up to 24 weeks post treatment
Secondary Outcome Measure Information:
Title
Change over time in the levels of the following biomarkers: Biomarkers of anabolic effect on knee cartilage (markers of cartilage formation/synthesis)
Time Frame
Up to 24 weeks post treatment
Title
Change over time in the levels of the following biomarkers: Biomarkers of catabolic effect on knee cartilage (markers of cartilage degradation)
Time Frame
Up to 24 weeks post treatment
Title
Change over time in the levels of the following biomarkers: Biomarkers of Bone Metabolism
Time Frame
Up to 24 weeks post treatment
Title
Change in levels of cytokines related to inflammation (IL1b, IL6, IL8, TNFα and IFNα)
Time Frame
Up to 24 weeks post treatment
Title
Blood levels of AS902330
Time Frame
Up to 24 weeks post treatment
Title
Presence of anti-AS902330 antibodies
Time Frame
Up to 24 weeks post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Established diagnosis of knee primary femoro-tibial OA by standard American College of Rheumatology Criteria (ACR) for at least six months (clinical AND radiological criteria) Postmenopausal or surgically sterile female ≥ 40 years of age Post-menopausal status will be confirmed by no menstrual periods for 12 consecutive months and no other biological or physiological cause for amenorrhea can be identified or Male ≥ 40 years of age willing to use contraception (condom with spermicide) from the first day of treatment until 2 months after the end of the treatment (3rd injection in Period 2) Even though systemic exposure of the drug is not foreseen at the doses used in this study, due to the absence of data on teratogenic potential of the drug, a very conservative approach on contraception is taken based on the spermatogenesis duration in humans. Candidate for Total Knee Replacement in the target knee, according to NIH consensus statement on Total Knee Replacement (2003) Date of planned Total Knee Replacement in the target knee ≥ 2 weeks after the anticipated last injection of study drug Subjects may be on treatment for symptomatic relief of OA, including NSAIDs (including Cox2 specific inhibitors); for NSAIDs, the dose should be stable for 4 weeks before baseline and during the study until day 4 after last injection. Paracetamol/acetaminophen (according to local standards and up to 4 grams per day) is allowed as rescue medication Willingness to stay in hospital for 24h after injection for SAD regimens and after first injection for MAD regimens (and up to 4 hours after second and third injections for MAD regimens) for safety and PK evaluation Willingness to complete a diary card to evaluate local tolerability and adverse events throughout the study Subjects must have read and understood the informed consent form and must have signed it prior to any study related procedure Subjects must fully understand the requirements of the study and be willing to comply with all study visits and assessments Exclusion Criteria: Any condition, including laboratory findings and findings in the medical history or in the pre-study assessments, that in the opinion of the Investigator constitutes a risk or contraindication for participation in the study or that could interfere with the study objectives, conduct or evaluation Clinically significant abnormal hematology or biochemistry values (platelets, hemoglobin, leucocytes, alkaline phosphatase, AST, ALT, blood creatinine, bilirubin) Receipt of any investigational product or any experimental therapeutic procedure within the last 12 weeks preceding screening Intra-articular treatment with steroids or hyaluronic acid derivatives within the past 3 months (systemic symptomatic treatments with NSAIDs are allowed when stable for 4 weeks prior to first injection) Planned major surgery (e.g. joint replacement) within 2 weeks after last injection History of previous surgery (TKR or partial knee replacement) on the target knee Lesions at the planned injection site that would present a contra-indication to local injection of the study drug (e.g., open wounds and infections of the skin)Any drug or nutraceutical treatment with potential DMOAD effect (glucosamine, diacerin, chondroitin sulfate) unless given at a stable dose over at least 4 weeks prior to first injection Use of electrotherapy or acupuncture for OA Any known active infections, including suspicion of intra-articular infection and/or infections that may compromise the immune system such as HIV, Hepatitis B or Hepatitis C infection History of sarcoma and/or history of other active malignancy within five years, except adequately treated basal cell and squamous cell carcinoma of the skin Signs and symptoms suggestive of transmissible spongiform encephalopathy Secondary osteoarthritis: e.g. Joint dysplasias, Aseptic osteonecrosis, Acromegaly, Paget's disease, Ehlers-Danlos Syndrome, Gaucher's disease, Stickler's syndrome, Joint infection, Hemophilia, Hemochromatosis, Calcium Pyrophosphate deposition disease, or Neuropathic arthropathy whatever the cause Patients with risk factors for knee OA (e.g. obesity, meniscectomy) are not considered as having secondary OA and can be included in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donatus Dreher, MD, PhD
Organizational Affiliation
Merck Serono SA - Geneva
Official's Role
Study Director
Facility Information:
Facility Name
UMHAT "Sv. Ivan Rilski", Clinical Research Unit for Phase I
City
Sofia
Country
Bulgaria
Facility Name
Frederiksberg Hospital
City
Frederiksberg
Country
Denmark
Facility Name
Gentofte Hospital
City
Hellerup
Country
Denmark
Facility Name
Nordsjællands Hospital - Hørsholm
City
Hørsholm
Country
Denmark
Facility Name
Silkeborg sygehus
City
Silkeborg
Country
Denmark
Facility Name
Regionshospitalet Viborg
City
Viborg
Country
Denmark
Facility Name
Kuopio University Hospital
City
Kuopio
Country
Finland
Facility Name
Oulu University Hospital
City
Oulu
Country
Finland
Facility Name
Turku University Central Hospital
City
Turku
Country
Finland
Facility Name
FARMOVS-PAREXEL (Pty) Ltd, University of the Free State
City
Bloemfontein
Country
South Africa
Facility Name
PAREXEL-George
City
George
Country
South Africa
Facility Name
PAREXEL-Port Elizabeth, Mercantile Hospital
City
Port Elizabeth
Country
South Africa
Facility Name
Sahlgrenska University Hospital/Östra
City
Göteborg
Country
Sweden
Facility Name
Hässleholms Sjukhus
City
Hässleholm
Country
Sweden
Facility Name
Kungälv Sjukhus
City
Kungälv
Country
Sweden
Facility Name
Lund University Hospital
City
Lund
Country
Sweden
Facility Name
Malmö University Hospital
City
Malmö
Country
Sweden
Facility Name
Danderyds Sjukhus
City
Stockholm
Country
Sweden
Facility Name
Cambridge University Hospitals
City
Cambridge
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement

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