Phase II Study of the Effects of rhPDGF-BB Injection on Lateral Epicondylitis
Primary Purpose
Lateral Epicondylitis
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
rhPDGF-BB Injection
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Lateral Epicondylitis focused on measuring elbow
Eligibility Criteria
Inclusion Criteria:
- Subject has signed the Institutional Review Board (IRB) approved Informed Consent Form specific to this study prior to enrollment
- Subject has a clinical diagnosis of lateral epicondylitis
- Subject's symptoms can be reproduced with resisted supination or wrist dorsiflexion
Subject's symptoms have persisted for at least 3 months despite conservative treatment that includes one or combinations of:
- Physical therapy
- Splinting
- Nonsteroidal antiinflammatory drug (NSAID)
- Corticosteroid injection
- Subject is independent, ambulatory, and can comply with all post-injection evaluations and visits
- Subject is 21-80 years of age and considered to be skeletally mature
Exclusion Criteria:
- Subject has undergone previous corticosteroid injection therapy to the effected elbow in less than three months prior to enrollment
- Subject has received previous Platelet Rich Plasma (PRP) injection to the affected elbow
- Subject is deemed to require a corticosteroid injection into the affected elbow during the course of the study
- Subject uses chronic medications known to affect the skeleton (e.g. glucocorticoid usage >10mg/day)
- Subject has undergone surgical intervention to the affected elbow for the treatment of lateral epicondylitis
Subject has a positive medical history of any of the following:
- medial epicondylitis
- radial tunnel syndrome
- carpal tunnel syndrome
- septic or gouty arthritis
- cervical radiculopathy
- trauma to the affected elbow within the past 6 weeks
- neuromuscular or musculoskeletal deficiency, which limits the ability to perform functional measurement (e.g. grip strength test)
- Subject currently has an acute infection at the injection site
- Subject has tested positive or been treated for a malignancy in the past or is suspected of having a malignancy or are currently undergoing radio- or chemotherapy treatment for a malignancy anywhere in the body, whether adjacent to or distant from the proposed rhPDGF-BB Injection treatment site
- Subject is physically or mentally compromised (e.g. currently being treated for a psychiatric disorder, senile dementia, Alzheimer's disease, etc.) to the extent that the Investigator judges the subject to be unable or unlikely to remain compliant
- Subject has an allergy to yeast-derived products
- Subject has received an investigational therapy or approved therapy for investigational use within 30 days of injection procedure or during the follow-up phase of this study
- Subject is a prisoner, or is known or suspected to be transient
- Subject's condition represents a worker's compensation case
- Subject is currently involved in a health-related litigation procedure
- Subject has documented evidence of a history (e.g. liver testing) of drug/alcohol abuse within the 12 months prior to screening for study entry
- Subject is pregnant, or able to become pregnant but not practicing a medically-accepted form of birth control, and/or intending to become pregnant during this study period
Sites / Locations
- Arizona Research Center
- Tucson Orthopaedic Institute
- NEA Baptist Clinic
- Coastal Orthopedics & Sports Medicine
- Foundation for Orthopaedic Research and Education
- OrthoCarolina
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Placebo Comparator
Experimental
Experimental
Experimental
Experimental
Arm Label
Placebo Control
0.45 mg rhPDGF-BB
0.75 mg rhPDGF-BB
1.5 mg rhPDGF-BB
3.0 mg rhPDGF-BB
Arm Description
Dose A - sodium acetate buffer (0 mg rhPDGF-BB)
Dose B - sodium acetate buffer + 0.45 mg rhPDGF-BB
Dose C - sodium acetate buffer + 0.75 mg rhPDGF-BB
Dose D - sodium acetate buffer + 1.5 mg rhPDGF-BB
Dose E - sodium acetate buffer + 3.0 mg rhPDGF-BB
Outcomes
Primary Outcome Measures
Elbow Pain Assessments (VAS), Treated Subjects
Subjects were asked to report current pain level at the fusion site on a 100 mm Visual Analog Scale (with 0 being no pain and 100 being worst pain imaginable).
Disabilities of the Arm, Shoulder and Hand (DASH), Treated Subjects
The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale, scored 0 (no disability) to 100.
Total Score Patient Rated Tennis Elbow Evaluation (PRTEE), All Treated Subjects
The Pain and disability measured by the Patient Rated Tennis Elbow Evaluation (PRTEE) is a 15-item questionnaire designed to measure forearm pain and disability in patients with lateral epicondylitis (also known as "tennis elbow"). The PRTEE allows patients to rate their levels of tennis elbow pain and disability from 0 to 10, and consists of 2 subscales:
PAIN subscale (0 = no pain, 10 = worst imaginable)
-Pain - 5 items
FUNCTION subscale (0 = no difficulty, 10 = unable to do)
Specific activities - 6 items
Usual activities - 4 items
In addition to the individual subscale scores, a total score can be computed on a scale of 100 (0 = no disability), where pain and functional problems are weighted equally
Grip Strength Test, All Treated Subjects
Grip strength testing will be performed to evaluate changes in the strength and sincerity of effort as a result of treatment for lateral epicondylitis. Testing will be performed to assess the pain-free grip strength (performing the test until discomfort is felt) and maximum grip strength (performing the test to the maximum of their ability). The test will be performed while the patient is standing with the elbow in full extension, as this position has been used to assess grip strength in patients with lateral epicondylitis. A Jamar Plus+ Digital Hand Dynamometer with the grip in the second position will be used because the second position has been assumed to be the most reliable and consistent position. Patients will be asked to perform three repetitions of each test (pain-free and maximum) at each study interval and the mean score will be calculated and used for analysis.
Maximum Grip Strength, Treated Subjects
A higher grip strength score indicates an improvement. A positive change from baseline indicates an improvement. Grip strength testing will be performed to evaluate changes in the strength and sincerity of effort as a result of treatment for lateral epicondylitis. Testing will be performed to assess the pain-free grip strength (performing the test until discomfort is felt) and maximum grip strength (performing the test to the maximum of their ability). The test will be performed while the patient is standing with the elbow in full extension, as this position has been used to assess grip strength in patients with lateral epicondylitis. A Jamar Plus+ Digital Hand Dynamometer with the grip in the second position will be used because the second position has been assumed to be the most reliable and consistent position. Patients will be asked to perform three repetitions of each test (pain-free and maximum) at each study interval and the mean score will be calculated and used for analysis.
Secondary Outcome Measures
Full Information
NCT ID
NCT01746420
First Posted
December 7, 2012
Last Updated
June 12, 2019
Sponsor
BioMimetic Therapeutics
1. Study Identification
Unique Protocol Identification Number
NCT01746420
Brief Title
Phase II Study of the Effects of rhPDGF-BB Injection on Lateral Epicondylitis
Official Title
A Phase II Randomized, Single Ascending Dose, Double-blinded, Placebo Controlled, Multi-center Study of the Effects of rhPDGF-BB Injection on Lateral Epicondylitis
Study Type
Interventional
2. Study Status
Record Verification Date
June 2019
Overall Recruitment Status
Completed
Study Start Date
December 12, 2012 (Actual)
Primary Completion Date
October 21, 2014 (Actual)
Study Completion Date
October 21, 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioMimetic Therapeutics
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to determine whether recombinant human platelet-derived growth factor (rhPDGF-BB) Injection is effective in the treatment of lateral epicondylitis (tennis elbow).
Detailed Description
Methodology: Randomized, single ascending dose, double-blinded, placebo controlled, multi-center study
Study Center(s): 6
Number of Subjects: 100
Diagnosis and Main Inclusion Criteria: Lateral epicondylitis; male and female subjects 21 -80 years of age
Study Drug, Dose, Regimen:
Dose A: sodium acetate buffer alone - placebo control Dose B: sodium acetate buffer + 0.45 mg rhPDGF-BB Dose C: sodium acetate buffer + 0.75 mg rhPDGF-BB Dose D: sodium acetate buffer + 1.5 mg rhPDGF-BB Dose E: sodium acetate buffer + 3.0 mg rhPDGF-BB
Duration and Route of Administration: Single administration dose by injection into the extensor carpi radialis brevis (ECRB)
Duration of Follow-up: 24 weeks (6 months) post-operative follow-up
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lateral Epicondylitis
Keywords
elbow
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
100 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Placebo Control
Arm Type
Placebo Comparator
Arm Description
Dose A - sodium acetate buffer (0 mg rhPDGF-BB)
Arm Title
0.45 mg rhPDGF-BB
Arm Type
Experimental
Arm Description
Dose B - sodium acetate buffer + 0.45 mg rhPDGF-BB
Arm Title
0.75 mg rhPDGF-BB
Arm Type
Experimental
Arm Description
Dose C - sodium acetate buffer + 0.75 mg rhPDGF-BB
Arm Title
1.5 mg rhPDGF-BB
Arm Type
Experimental
Arm Description
Dose D - sodium acetate buffer + 1.5 mg rhPDGF-BB
Arm Title
3.0 mg rhPDGF-BB
Arm Type
Experimental
Arm Description
Dose E - sodium acetate buffer + 3.0 mg rhPDGF-BB
Intervention Type
Drug
Intervention Name(s)
rhPDGF-BB Injection
Intervention Description
Comparison of placebo control (0 mg rhPDGF-BB) and different dosages (0.45, 0.75, 1.5, and 3.0 mg) of rhPDGF-BB Injection administered through a one-time injection
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
sodium acetate buffer (0 mg rhPDGF-BB)
Primary Outcome Measure Information:
Title
Elbow Pain Assessments (VAS), Treated Subjects
Description
Subjects were asked to report current pain level at the fusion site on a 100 mm Visual Analog Scale (with 0 being no pain and 100 being worst pain imaginable).
Time Frame
Baseline, 2, 4, 8, 12, and 24 weeks
Title
Disabilities of the Arm, Shoulder and Hand (DASH), Treated Subjects
Description
The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The DASH consists mainly of a 30-item disability/symptom scale, scored 0 (no disability) to 100.
Time Frame
Baseline, 4, 8, 12, and 24 weeks
Title
Total Score Patient Rated Tennis Elbow Evaluation (PRTEE), All Treated Subjects
Description
The Pain and disability measured by the Patient Rated Tennis Elbow Evaluation (PRTEE) is a 15-item questionnaire designed to measure forearm pain and disability in patients with lateral epicondylitis (also known as "tennis elbow"). The PRTEE allows patients to rate their levels of tennis elbow pain and disability from 0 to 10, and consists of 2 subscales:
PAIN subscale (0 = no pain, 10 = worst imaginable)
-Pain - 5 items
FUNCTION subscale (0 = no difficulty, 10 = unable to do)
Specific activities - 6 items
Usual activities - 4 items
In addition to the individual subscale scores, a total score can be computed on a scale of 100 (0 = no disability), where pain and functional problems are weighted equally
Time Frame
Baseline, 4, 8, 12, and 24 weeks
Title
Grip Strength Test, All Treated Subjects
Description
Grip strength testing will be performed to evaluate changes in the strength and sincerity of effort as a result of treatment for lateral epicondylitis. Testing will be performed to assess the pain-free grip strength (performing the test until discomfort is felt) and maximum grip strength (performing the test to the maximum of their ability). The test will be performed while the patient is standing with the elbow in full extension, as this position has been used to assess grip strength in patients with lateral epicondylitis. A Jamar Plus+ Digital Hand Dynamometer with the grip in the second position will be used because the second position has been assumed to be the most reliable and consistent position. Patients will be asked to perform three repetitions of each test (pain-free and maximum) at each study interval and the mean score will be calculated and used for analysis.
Time Frame
Baseline, 4, 8, 12, and 24 weeks
Title
Maximum Grip Strength, Treated Subjects
Description
A higher grip strength score indicates an improvement. A positive change from baseline indicates an improvement. Grip strength testing will be performed to evaluate changes in the strength and sincerity of effort as a result of treatment for lateral epicondylitis. Testing will be performed to assess the pain-free grip strength (performing the test until discomfort is felt) and maximum grip strength (performing the test to the maximum of their ability). The test will be performed while the patient is standing with the elbow in full extension, as this position has been used to assess grip strength in patients with lateral epicondylitis. A Jamar Plus+ Digital Hand Dynamometer with the grip in the second position will be used because the second position has been assumed to be the most reliable and consistent position. Patients will be asked to perform three repetitions of each test (pain-free and maximum) at each study interval and the mean score will be calculated and used for analysis.
Time Frame
Baseline, 4, 8, 12, and 24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject has signed the Institutional Review Board (IRB) approved Informed Consent Form specific to this study prior to enrollment
Subject has a clinical diagnosis of lateral epicondylitis
Subject's symptoms can be reproduced with resisted supination or wrist dorsiflexion
Subject's symptoms have persisted for at least 3 months despite conservative treatment that includes one or combinations of:
Physical therapy
Splinting
Nonsteroidal antiinflammatory drug (NSAID)
Corticosteroid injection
Subject is independent, ambulatory, and can comply with all post-injection evaluations and visits
Subject is 21-80 years of age and considered to be skeletally mature
Exclusion Criteria:
Subject has undergone previous corticosteroid injection therapy to the effected elbow in less than three months prior to enrollment
Subject has received previous Platelet Rich Plasma (PRP) injection to the affected elbow
Subject is deemed to require a corticosteroid injection into the affected elbow during the course of the study
Subject uses chronic medications known to affect the skeleton (e.g. glucocorticoid usage >10mg/day)
Subject has undergone surgical intervention to the affected elbow for the treatment of lateral epicondylitis
Subject has a positive medical history of any of the following:
medial epicondylitis
radial tunnel syndrome
carpal tunnel syndrome
septic or gouty arthritis
cervical radiculopathy
trauma to the affected elbow within the past 6 weeks
neuromuscular or musculoskeletal deficiency, which limits the ability to perform functional measurement (e.g. grip strength test)
Subject currently has an acute infection at the injection site
Subject has tested positive or been treated for a malignancy in the past or is suspected of having a malignancy or are currently undergoing radio- or chemotherapy treatment for a malignancy anywhere in the body, whether adjacent to or distant from the proposed rhPDGF-BB Injection treatment site
Subject is physically or mentally compromised (e.g. currently being treated for a psychiatric disorder, senile dementia, Alzheimer's disease, etc.) to the extent that the Investigator judges the subject to be unable or unlikely to remain compliant
Subject has an allergy to yeast-derived products
Subject has received an investigational therapy or approved therapy for investigational use within 30 days of injection procedure or during the follow-up phase of this study
Subject is a prisoner, or is known or suspected to be transient
Subject's condition represents a worker's compensation case
Subject is currently involved in a health-related litigation procedure
Subject has documented evidence of a history (e.g. liver testing) of drug/alcohol abuse within the 12 months prior to screening for study entry
Subject is pregnant, or able to become pregnant but not practicing a medically-accepted form of birth control, and/or intending to become pregnant during this study period
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Edward Akelman, MD
Organizational Affiliation
Brown University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Arizona Research Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85023
Country
United States
Facility Name
Tucson Orthopaedic Institute
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
NEA Baptist Clinic
City
Jonesboro
State/Province
Arkansas
ZIP/Postal Code
72401
Country
United States
Facility Name
Coastal Orthopedics & Sports Medicine
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34209
Country
United States
Facility Name
Foundation for Orthopaedic Research and Education
City
Tampa
State/Province
Florida
ZIP/Postal Code
33637
Country
United States
Facility Name
OrthoCarolina
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Phase II Study of the Effects of rhPDGF-BB Injection on Lateral Epicondylitis
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