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An Efficacy and Safety Study of Two Doses of Intra-Articular Ampion Injection for Pain of Osteoarthritis of the Knee

Primary Purpose

Osteoarthritis of the Knee

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
4 mL injection of Ampion
10 mL Injection of Ampion
4 mL Injection of Placebo
10 mL Injection of Placebo
Sponsored by
Ampio Pharmaceuticals. Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis of the Knee focused on measuring osteoarthritis, osteoarthritis of the knee

Eligibility Criteria

40 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Able to provide written informed consent to participate in the study
  • Willing and able to comply with all study requirements and instructions of the site study staff
  • Male or female, 40 years to 85 years old (inclusive)
  • Must be ambulatory
  • Index knee must be symptomatic for greater than 6 months with a clinical diagnosis of osteoarthritis (OA) and supported by radiological evidence Kellgren Lawrence Grade II to IV) that is not older than 6 months prior to the date of screening
  • Moderate to moderately-severe OA pain in the index knee (rating of at least 1.5 on the WOMAC Index 3.1 5-point Likert Pain Subscale) assessed at screening
  • Moderate to moderately-severe OA pain in the index knee (even if chronic doses of nonsteroidal anti-inflammatory drug (NSAID), which have not changed in the 4 weeks prior to screening, have been/are being used)
  • No analgesia (including acetaminophen [paracetamol]) taken 12 hours prior to an efficacy measure
  • No known clinically significant liver abnormality e.g. cirrhosis, transplant, etc.)

Exclusion Criteria:

  • As a result of medical review and screening investigation, the Principal Investigator considers the patient unfit for the study
  • A history of allergic reactions to human albumin (reaction to non-human albumin such as egg albumin is not an exclusion criterion)
  • A history of allergic reactions to excipients in 5% human albumin (N-acetyltryptophan, sodium caprylate)
  • Presence of tense effusions
  • Inflammatory or crystal arthropathies, acute fractures, history of aseptic necrosis or joint replacement in the affected knee, as assessed locally by the Principal Investigator
  • Isolated patella femoral syndrome, also known as chondromalacia
  • Any other disease or condition interfering with the free use and evaluation of the index knee for the duration of the trial e.g. cancer, congenital defects, spine OA)
  • Major injury to the index knee within the 12 months prior to screening
  • Severe hip OA ipsilateral to the index knee
  • Any pain that could interfere with the assessment of index knee pain (e.g. pain in any other part of the lower extremities, pain radiating to the knee)
  • Any pharmacological or non-pharmacological treatment targeting OA started or changed during the 4 weeks prior to randomization or likely to be changed during the duration of the study
  • Use of the following medications:

    1. No IA injected pain medications in the study knee during the study
    2. No analgesics containing opioids. NSAIDs may be continued at levels preceding the study and acetaminophen is available as a rescue medication during the study from the provided supply
    3. No topical treatment on osteoarthritis index knee during the study
    4. No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as Aspirin and Plavix are allowed)
    5. No systemic treatments that may interfere with safety or efficacy assessments during the study
    6. No immunosuppressants
    7. No use of corticosteroids > 10 mg prednisolone equivalent per day (if ≤ 10 mg prednisolone, the dose must be stable)
  • Any human albumin treatment in the 3 months before randomization

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Placebo Comparator

    Experimental

    Placebo Comparator

    Arm Label

    Ampion 4 mL Dose

    Placebo 4 mL Dose

    Ampion 10 mL Dose

    Placebo 10 mL Dose

    Arm Description

    4 mL Injection of Ampion

    4 mL Injection of Placebo

    10 mL Injection of Ampion

    10 mL Injection of Placebo

    Outcomes

    Primary Outcome Measures

    Change in Knee Pain
    Mean Change in WOMAC A Pain (Western Ontario and McMaster Universities Arthritis Index) score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a decrease in pain with a greater negative value indicating a greater reduction in pain.

    Secondary Outcome Measures

    Change in Knee Function
    Mean change in WOMAC C function score (Western Ontario and McMaster Universities Arthritis Index) from Baseline to 12 weeks. 5-point Likert scale indicating limitation of function (0=none to 4=extreme). A greater negative value indicates a improvement in function.
    Change in Knee Stiffness.
    Mean Change in WOMAC B stiffness score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a reduction in stiffness.
    Change in Patient's Global Assessment
    Patients are asked the following question: "Considering all the ways in which your arthritis affects you, please indicate how you are doing." 5-point Likert scale (0 = very well, 1 = well, 2 = fair, 3 = poor, 4 = very poor). A negative value constitutes an improvement in patient's assessment of disease severity.

    Full Information

    First Posted
    April 22, 2013
    Last Updated
    June 29, 2022
    Sponsor
    Ampio Pharmaceuticals. Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01839331
    Brief Title
    An Efficacy and Safety Study of Two Doses of Intra-Articular Ampion Injection for Pain of Osteoarthritis of the Knee
    Official Title
    A Randomized, Placebo-Controlled, Double-Blind Study to Evaluate the Efficacy and Safety of Two Doses of Intra-Articular Injection of Ampion™ in Adults With Pain Due to Osteoarthritis of the Knee
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2022
    Overall Recruitment Status
    Completed
    Study Start Date
    March 29, 2013 (Actual)
    Primary Completion Date
    August 19, 2013 (Actual)
    Study Completion Date
    October 2013 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Ampio Pharmaceuticals. Inc.

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This study will evaluate the efficacy of two doses of Intra-Articular Injection of Ampion™ in Adults with pain due to osteoarthritis of the knee.
    Detailed Description
    A Randomized, Placebo-controlled, Double-Blind Study to Evaluate the Efficacy and Safety of two Doses of Intra-Articular Injection of Ampion™ in Adults with pain due to osteoarthritis of the knee. The primary trial objective is to evaluate whether there is greater efficacy of 10 mL Ampion™ versus 10 mL placebo than 4 mL Ampion™ versus 4 mL placebo intra-articular (IA) injection in improving knee pain, when applied to patients suffering from OA of the knee. The secondary trial objective include: the evaluation of the safety of an intra-articular injection of Ampion™ when applied to patients suffering from OA of the knee, evaluation of the efficacy of intra-articular injection of Ampion™ and placebo on stiffness and function when applied to patients suffering from OA of the knee and evaluation of responder status defined by the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) Criteria.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Osteoarthritis of the Knee
    Keywords
    osteoarthritis, osteoarthritis of the knee

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    329 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Ampion 4 mL Dose
    Arm Type
    Experimental
    Arm Description
    4 mL Injection of Ampion
    Arm Title
    Placebo 4 mL Dose
    Arm Type
    Placebo Comparator
    Arm Description
    4 mL Injection of Placebo
    Arm Title
    Ampion 10 mL Dose
    Arm Type
    Experimental
    Arm Description
    10 mL Injection of Ampion
    Arm Title
    Placebo 10 mL Dose
    Arm Type
    Placebo Comparator
    Arm Description
    10 mL Injection of Placebo
    Intervention Type
    Biological
    Intervention Name(s)
    4 mL injection of Ampion
    Intervention Description
    4 mL Injection of Ampion
    Intervention Type
    Biological
    Intervention Name(s)
    10 mL Injection of Ampion
    Intervention Description
    10 mL Injection of Ampion
    Intervention Type
    Drug
    Intervention Name(s)
    4 mL Injection of Placebo
    Other Intervention Name(s)
    Saline
    Intervention Description
    4 mL Injection of Placebo
    Intervention Type
    Drug
    Intervention Name(s)
    10 mL Injection of Placebo
    Other Intervention Name(s)
    Saline
    Intervention Description
    10 mL Injection of Placebo
    Primary Outcome Measure Information:
    Title
    Change in Knee Pain
    Description
    Mean Change in WOMAC A Pain (Western Ontario and McMaster Universities Arthritis Index) score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a decrease in pain with a greater negative value indicating a greater reduction in pain.
    Time Frame
    Scored at Baseline and 12 weeks
    Secondary Outcome Measure Information:
    Title
    Change in Knee Function
    Description
    Mean change in WOMAC C function score (Western Ontario and McMaster Universities Arthritis Index) from Baseline to 12 weeks. 5-point Likert scale indicating limitation of function (0=none to 4=extreme). A greater negative value indicates a improvement in function.
    Time Frame
    Scored at Baseline and 12 weeks.
    Title
    Change in Knee Stiffness.
    Description
    Mean Change in WOMAC B stiffness score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a reduction in stiffness.
    Time Frame
    Scored at Baseline and 12 weeks.
    Title
    Change in Patient's Global Assessment
    Description
    Patients are asked the following question: "Considering all the ways in which your arthritis affects you, please indicate how you are doing." 5-point Likert scale (0 = very well, 1 = well, 2 = fair, 3 = poor, 4 = very poor). A negative value constitutes an improvement in patient's assessment of disease severity.
    Time Frame
    Scored at Baseline and 12 weeks.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Maximum Age & Unit of Time
    85 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Able to provide written informed consent to participate in the study Willing and able to comply with all study requirements and instructions of the site study staff Male or female, 40 years to 85 years old (inclusive) Must be ambulatory Index knee must be symptomatic for greater than 6 months with a clinical diagnosis of osteoarthritis (OA) and supported by radiological evidence Kellgren Lawrence Grade II to IV) that is not older than 6 months prior to the date of screening Moderate to moderately-severe OA pain in the index knee (rating of at least 1.5 on the WOMAC Index 3.1 5-point Likert Pain Subscale) assessed at screening Moderate to moderately-severe OA pain in the index knee (even if chronic doses of nonsteroidal anti-inflammatory drug (NSAID), which have not changed in the 4 weeks prior to screening, have been/are being used) No analgesia (including acetaminophen [paracetamol]) taken 12 hours prior to an efficacy measure No known clinically significant liver abnormality e.g. cirrhosis, transplant, etc.) Exclusion Criteria: As a result of medical review and screening investigation, the Principal Investigator considers the patient unfit for the study A history of allergic reactions to human albumin (reaction to non-human albumin such as egg albumin is not an exclusion criterion) A history of allergic reactions to excipients in 5% human albumin (N-acetyltryptophan, sodium caprylate) Presence of tense effusions Inflammatory or crystal arthropathies, acute fractures, history of aseptic necrosis or joint replacement in the affected knee, as assessed locally by the Principal Investigator Isolated patella femoral syndrome, also known as chondromalacia Any other disease or condition interfering with the free use and evaluation of the index knee for the duration of the trial e.g. cancer, congenital defects, spine OA) Major injury to the index knee within the 12 months prior to screening Severe hip OA ipsilateral to the index knee Any pain that could interfere with the assessment of index knee pain (e.g. pain in any other part of the lower extremities, pain radiating to the knee) Any pharmacological or non-pharmacological treatment targeting OA started or changed during the 4 weeks prior to randomization or likely to be changed during the duration of the study Use of the following medications: No IA injected pain medications in the study knee during the study No analgesics containing opioids. NSAIDs may be continued at levels preceding the study and acetaminophen is available as a rescue medication during the study from the provided supply No topical treatment on osteoarthritis index knee during the study No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as Aspirin and Plavix are allowed) No systemic treatments that may interfere with safety or efficacy assessments during the study No immunosuppressants No use of corticosteroids > 10 mg prednisolone equivalent per day (if ≤ 10 mg prednisolone, the dose must be stable) Any human albumin treatment in the 3 months before randomization
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Howard Levy, MD
    Organizational Affiliation
    Ampio Pharmaceuticals. Inc.
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    Citations:
    PubMed Identifier
    24498399
    Citation
    Bar-Or D, Salottolo KM, Loose H, Phillips MJ, McGrath B, Wei N, Borders JL, Ervin JE, Kivitz A, Hermann M, Shlotzhauer T, Churchill M, Slappey D, Clift V. A randomized clinical trial to evaluate two doses of an intra-articular injection of LMWF-5A in adults with pain due to osteoarthritis of the knee. PLoS One. 2014 Feb 3;9(2):e87910. doi: 10.1371/journal.pone.0087910. eCollection 2014.
    Results Reference
    result

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    An Efficacy and Safety Study of Two Doses of Intra-Articular Ampion Injection for Pain of Osteoarthritis of the Knee

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