APIC-CF Therapy for Mild to Moderate Osteoarthritis of the Knee
Primary Purpose
Pain, Osteoarthritis
Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
APIC-CF, 4 cc
APIC-CF, 2 cc
Placebo Comparator: Saline
Sponsored by
About this trial
This is an interventional treatment trial for Pain focused on measuring Osteoarthritis, Protease Inhibitors, Alpha-2-macroglobulin, Autologous treatment, APIC-CF, Pain due to Mild to Moderate osteoarthritis (OA) of the knee
Eligibility Criteria
Inclusion Criteria:
- The patient provides signed written informed consent
- The patient is willing and able to complete effectiveness and safety questionnaires and is able to read and understand study instructions in English.
- Patient is a male or female aged between 21 - 70 years of age at the time of informed consent.
- Patient is ambulatory (assistive devices allowed if used 4 weeks or more prior to Screening).
- Patient has symptomatic OA in the target knee
- Patient has a radiographic confirmation of OA at the target knee prior to screening with a grade II or III score on the K-L grading scale (Kellgren, 1957)using radiographs performed within 24 weeks of Screening
- The patient has knee pain as demonstrated by a score of ≤3 on the KOOS pain subscale
- The patient has venous access sufficient for APIC-CF production
Exclusion Criteria:
The patient has any of the following:
- Grade 4 score on the K-L grading scale for the target knee
- Grade 3 score on the K-L grading scale and exhibits at least one Grade 4 characteristic (large osteophytes, marked narrowing of joint space, severe sclerosis, or definite deformity of bone contour).
- Acute fracture of the lower limb.
- Medical history of severe bone disease (e.g., osteoporosis, osteonecrosis, joint deformity, instability, or septic arthritis).
- The patient is categorized as grossly obese, defined as body mass index (BMI) greater than 35 kg/m2
- Hemoglobin values <11 g/dL
- Pregnant or breastfeeding women
- Has clinically apparent tense effusion of the target knee.
- Has had chondrocyte transplantation or reconstruction of ligaments in the target knee.
- Has received an intra-articular injection(s) into any joint (e.g., corticosteroids or chondroprotective agents) within 60 days prior to Screening. Subjects receiving a corticosteroid injection during the study will be withdrawn from the study.
- Has had surgery to the target knee within 12 months or arthroscopy of the target knee within 90 days prior to Screening.
- Has an inflammatory disease of either knee other than OA (e.g., rheumatoid arthri septic arthritis).
- Has another disease that can affect the health of the knee (e.g., chronic hemochromatosis; sickle cell anemia; arthropathies of systemic diseases such as chondrocalcinosis, gout, pseudogout, psoriasis, hemophilia, and infectious diseases of the joints).
- Has significant joint infection in the target knee or inflammatory or skin disorder in the injection area of the target knee.
- Septic arthritis in any joints within 1 year prior to screening;
- Has fibromyalgia, anserine bursitis, lumbar radiculopathy, neurogenic or vascular claudication, vascular insufficiency of lower limbs, or peripheral neuropathy severe enough to interfere with the study evaluations.
- Patella femoral instability
- Patients with a history of cartilage allograft, autograft or microfracture in the study knee
- Patients with a history of any type of blood coagulation or bleeding disorder, currently taking warfarin or other parental anticoagulant therapy or history of DVT/PE during <1 year of Screening.
- Has a systemic or other disease or significant liver function test result from screening that, in the opinion of the investigator, would interfere with study evaluation or have an impact on the balance of benefits and risks of study treatment.
Diseases that may interfere:
- type 1 diabetes
- immunodeficiency syndrome
- significant cardiovascular, renal, or liver disease
- severe anemia
- severe thrombocytopenia
- severe infectious disease with or without fever.
- any significant chronic skin disorders, active skin or soft tissue infection that could interfere with the evaluation of the injection site.
- mal-alignment/deformity of the leg
- active asthma that may require periodic treatment with steroids during the study period
- active malignancy receiving treatment, or prior history of any malignancy, with the exception of basal cell carcinoma of the skin treated more than 1 year ago
- Patients with psychiatric or neurological disorders including cognitive impairment or inability to provide informed consent
- Incarcerated or confined patients
- Medical-legal, personal injury, ongoing litigation or worker's compensation claim
- History of drug abuse
- Use of investigational drug, device, or biologic within 12 weeks of screening
- Any condition that, in the opinion of the investigator, might interfere with the evaluation of the study objectives.
Sites / Locations
- IRC ClinicalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Placebo Comparator
Arm Label
APIC-CF 4cc,
APIC-CF, 2cc
Saline
Arm Description
APIC-CF 4cc, once at first day
APIC-CF, 2cc, one at first day
Outcomes
Primary Outcome Measures
Reduction in pain after 8 weeks
Statistically significant reduction in pain after 8 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Reduction in pain while walking at 8 weeks
Statistically significant reduction in pain while walking after 8 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Secondary Outcome Measures
Reduction in pain after 2 weeks
Statistically significant reduction in pain after 2 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score.
Reduction in pain while walking at 2 weeks
Statistically significant reduction in pain while walking after 2 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Reduction in pain at 24 weeks
Statistically significant reduction in pain after 24 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Reduction in pain while walking after 24 weeks
Statistically significant reduction in pain while walking after 24 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02210468
Brief Title
APIC-CF Therapy for Mild to Moderate Osteoarthritis of the Knee
Official Title
A Phase I/II, Multicenter, Double-Blind, Placebo-controlled Safety and Efficacy Study to Evaluate APIC-CF Therapy for Mild to Moderate Primary Osteoarthritis of the Knee
Study Type
Interventional
2. Study Status
Record Verification Date
August 2015
Overall Recruitment Status
Unknown status
Study Start Date
May 2015 (undefined)
Primary Completion Date
July 2016 (Anticipated)
Study Completion Date
December 2016 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cytonics Corporation
4. Oversight
5. Study Description
Brief Summary
The mechanism of Osteoarthritis (OA) is complex, however the investigators know that cartilage breakdown follows changes in certain cells in the cartilage called chondrocytes, leading to proteases that break down cartilage. There is a protein in the human blood called alpha-2-macroglobulin that can trap these proteases and prevent the breakdown of cartilage. Cytonics developed a device that use the patient's own blood to remove all cells and concentrate alpha-2-macroglobulin to be injected in the painful knee due to osteoarthritis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Osteoarthritis
Keywords
Osteoarthritis, Protease Inhibitors, Alpha-2-macroglobulin, Autologous treatment, APIC-CF, Pain due to Mild to Moderate osteoarthritis (OA) of the knee
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
300 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
APIC-CF 4cc,
Arm Type
Experimental
Arm Description
APIC-CF 4cc, once at first day
Arm Title
APIC-CF, 2cc
Arm Type
Experimental
Arm Description
APIC-CF, 2cc, one at first day
Arm Title
Saline
Arm Type
Placebo Comparator
Intervention Type
Device
Intervention Name(s)
APIC-CF, 4 cc
Intervention Type
Device
Intervention Name(s)
APIC-CF, 2 cc
Intervention Type
Other
Intervention Name(s)
Placebo Comparator: Saline
Intervention Description
Placebo Comparator: Saline
Primary Outcome Measure Information:
Title
Reduction in pain after 8 weeks
Description
Statistically significant reduction in pain after 8 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Time Frame
8 weeks
Title
Reduction in pain while walking at 8 weeks
Description
Statistically significant reduction in pain while walking after 8 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Reduction in pain after 2 weeks
Description
Statistically significant reduction in pain after 2 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score.
Time Frame
2 weeks
Title
Reduction in pain while walking at 2 weeks
Description
Statistically significant reduction in pain while walking after 2 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Time Frame
2 weeks
Title
Reduction in pain at 24 weeks
Description
Statistically significant reduction in pain after 24 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Time Frame
24 weeks
Title
Reduction in pain while walking after 24 weeks
Description
Statistically significant reduction in pain while walking after 24 weeks from initial treatment of APIC-CF compared to control as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) total score
Time Frame
24 week
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The patient provides signed written informed consent
The patient is willing and able to complete effectiveness and safety questionnaires and is able to read and understand study instructions in English.
Patient is a male or female aged between 21 - 70 years of age at the time of informed consent.
Patient is ambulatory (assistive devices allowed if used 4 weeks or more prior to Screening).
Patient has symptomatic OA in the target knee
Patient has a radiographic confirmation of OA at the target knee prior to screening with a grade II or III score on the K-L grading scale (Kellgren, 1957)using radiographs performed within 24 weeks of Screening
The patient has knee pain as demonstrated by a score of ≤3 on the KOOS pain subscale
The patient has venous access sufficient for APIC-CF production
Exclusion Criteria:
The patient has any of the following:
Grade 4 score on the K-L grading scale for the target knee
Grade 3 score on the K-L grading scale and exhibits at least one Grade 4 characteristic (large osteophytes, marked narrowing of joint space, severe sclerosis, or definite deformity of bone contour).
Acute fracture of the lower limb.
Medical history of severe bone disease (e.g., osteoporosis, osteonecrosis, joint deformity, instability, or septic arthritis).
The patient is categorized as grossly obese, defined as body mass index (BMI) greater than 35 kg/m2
Hemoglobin values <11 g/dL
Pregnant or breastfeeding women
Has clinically apparent tense effusion of the target knee.
Has had chondrocyte transplantation or reconstruction of ligaments in the target knee.
Has received an intra-articular injection(s) into any joint (e.g., corticosteroids or chondroprotective agents) within 60 days prior to Screening. Subjects receiving a corticosteroid injection during the study will be withdrawn from the study.
Has had surgery to the target knee within 12 months or arthroscopy of the target knee within 90 days prior to Screening.
Has an inflammatory disease of either knee other than OA (e.g., rheumatoid arthri septic arthritis).
Has another disease that can affect the health of the knee (e.g., chronic hemochromatosis; sickle cell anemia; arthropathies of systemic diseases such as chondrocalcinosis, gout, pseudogout, psoriasis, hemophilia, and infectious diseases of the joints).
Has significant joint infection in the target knee or inflammatory or skin disorder in the injection area of the target knee.
Septic arthritis in any joints within 1 year prior to screening;
Has fibromyalgia, anserine bursitis, lumbar radiculopathy, neurogenic or vascular claudication, vascular insufficiency of lower limbs, or peripheral neuropathy severe enough to interfere with the study evaluations.
Patella femoral instability
Patients with a history of cartilage allograft, autograft or microfracture in the study knee
Patients with a history of any type of blood coagulation or bleeding disorder, currently taking warfarin or other parental anticoagulant therapy or history of DVT/PE during <1 year of Screening.
Has a systemic or other disease or significant liver function test result from screening that, in the opinion of the investigator, would interfere with study evaluation or have an impact on the balance of benefits and risks of study treatment.
Diseases that may interfere:
type 1 diabetes
immunodeficiency syndrome
significant cardiovascular, renal, or liver disease
severe anemia
severe thrombocytopenia
severe infectious disease with or without fever.
any significant chronic skin disorders, active skin or soft tissue infection that could interfere with the evaluation of the injection site.
mal-alignment/deformity of the leg
active asthma that may require periodic treatment with steroids during the study period
active malignancy receiving treatment, or prior history of any malignancy, with the exception of basal cell carcinoma of the skin treated more than 1 year ago
Patients with psychiatric or neurological disorders including cognitive impairment or inability to provide informed consent
Incarcerated or confined patients
Medical-legal, personal injury, ongoing litigation or worker's compensation claim
History of drug abuse
Use of investigational drug, device, or biologic within 12 weeks of screening
Any condition that, in the opinion of the investigator, might interfere with the evaluation of the study objectives.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gaetano Scuderi, MD
Phone
561-575-4451
Ext
1
Email
scuderimd@aol.com
Facility Information:
Facility Name
IRC Clinical
City
Townsend
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kendra Barton, RN, BSN
Phone
443-275-1599
Email
kendra.barton@ircclinical.com
12. IPD Sharing Statement
Learn more about this trial
APIC-CF Therapy for Mild to Moderate Osteoarthritis of the Knee
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