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Safety of NStride Autologous Protein Solution in the Treatment of Knee Osteoarthritis (PROGRESS I)

Primary Purpose

Osteoarthritis, Knee

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
APS
Sponsored by
Zimmer Biomet
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female ≥40 and ≤75 years old at time of injection..
  • A standing radiograph of the knee showing a Kellgren-Lawrence grade of 2 to 4 (within 6 months of screening).
  • Body mass index ≤40 kg/m2.
  • A Western Ontario and McMaster Universities osteoarthritis index using the Likert scale, Version 3. (WOMAC LK 3.1) pain subscale total score ≥ 10 and ≤ 19.
  • Has undergone at least two prior conservative OA therapies without satisfactory pain relief.
  • Patient has failed to get satisfactory pain relief from either HA or steroid injections or would be considered an appropriate patient to receive either HA or steroid injections

Exclusion Criteria:

  • Presence of active infection or abnormal effusion in the knee immediately preceding treatment injection.
  • Presence of symptomatic OA in the non-study knee
  • Diagnosed with rheumatoid arthritis, Reiter's syndrome, psoriatic arthritis, gout, ankylosing spondylitis, chondromalacia, arthritis secondary to other inflammatory diseases, or of metabolic origin; HIV, viral hepatitis; chondrocalcinosis, Paget's disease, villonodular synovitis, and other non-OA joint disease.
  • Disease of spine, hip or other lower extremity joints of sufficient degree to affect assessment of the index knee
  • Untreated symptomatic injury of index knee (e.g., acute traumatic injury, anterior cruciate ligament injury, meniscus injury, cartilage lesion).
  • Knee radiographs showing bone-on-bone or other gross cartilage deficits.
  • Presence of surgical hardware or other foreign body in the index knee.
  • Intra-articular steroid injections in the index knee within 3 months of screening.
  • Intra-articular HA in the index knee within 6 months of screening.
  • Other intra-articular therapy in the index knee within 6 months prior to screening.
  • Systemic steroid use within 2 weeks of screening.
  • Planned/anticipated surgery of the index knee during the study period.
  • A history of local anesthetic allergy
  • Use of systemic immunosuppressants within six weeks of treatment.
  • Currently on anticoagulant therapy
  • Any documented clinically significant condition (e.g., diabetes, malignancy), finding, or psychiatric illness at screening which could compromise patient safety or interfere with the assessment of the safety and treatment effects of the study injection.
  • Skin breakdown at the index knee where the injection is planned to take place.
  • Pregnant or nursing mothers or women who are planning on getting pregnant during the time they will be participating in the study.
  • Known drug or alcohol dependence currently or within the last year.
  • Used any investigational drug or device within 30 days prior to screening.
  • Used any investigational biologic within 60 days prior to screening

Sites / Locations

  • Orthopedic and Sports Medicine Center of Northern Indiana (OSMC)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

NStride APS

Arm Description

Subjects will receive an intra-articular injection of APS.

Outcomes

Primary Outcome Measures

Adverse Events
Adverse Events and Serious Adverse Events

Secondary Outcome Measures

Change From Baseline to 12 Months in Pain, Stiffness, and Function in Daily Living Measured With WOMAC Questionnaire
The WOMAC LK 3.1 questionnaire is a validated tool commonly used for assessing knee pain, stiffness, and function. The WOMAC LK 3.1 questionnaire has 24 items that the patient addresses about the knee: 5 items on the pain subscale, 2 on the stiffness subscale, and 17 on the physical function subscale. Each item is answered on a 5-point Likert scale, with grading from 0 (none or never) to 4 (extreme or always). A higher score indicates worse pain, stiffness, or functional limitation. The WOMAC pain subscale consists of five questions scored from 0 to 4. The pain score has a range of 0 (no pain) to 20 (maximal pain). The WOMAC stiffness subscale consists of two questions scored from 0 to 4. The stiffness score has a range of 0 (no stiffness) to 8 (maximal stiffness). The WOMAC physical function subscale consists of seventeen questions scored from 0 to 4. The physical function score has a range of 0 (no functional limitation) to 68 (maximal functional limitation).
Change From Baseline to 12 Months in Pain as Measured by the Numeric Rating Scale (NRS)
The Numeric Rating Scale (NRS) is a validated measure of knee pain. The NRS is an 11 point Likert type scale anchored by 0 "no pain" and 10 "worst possible pain". Subjects rate their average pain over the last 24 hours.
Change From Baseline to 12 Months in Pain as Measured With Knee Injury and Osteoarthritis Outcome Score (KOOS)
The KOOS questionnaire is a commonly used instrument to assess the patient's opinion about their knee and associated problems. KOOS consists of 5 subscales: Pain (9 questions), Symptoms (7 questions), Function in daily living (ADL) (17 questions), Function in sport and recreation (Sport/Rec) (5 questions) and knee related Quality of Life (QOL) (4 questions). The previous week is used as the time period for answering the questions. A higher score on the KOOS questionnaire indicates fewer problems, and 0 indicates extreme problems. Each subscale score is calculated independently. The mean score of the individual items of each subscale is calculated and divided by 4 (the highest possible score for a single answer option). Traditionally in orthopedics, 100 indicates no problems and 0 indicates extreme problems. The normalized score is transformed to meet this standard.

Full Information

First Posted
September 19, 2014
Last Updated
October 8, 2018
Sponsor
Zimmer Biomet
Collaborators
Biomet Biologics, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02262364
Brief Title
Safety of NStride Autologous Protein Solution in the Treatment of Knee Osteoarthritis (PROGRESS I)
Official Title
A Pilot Study of a Single Intra-articular Injection of Autologous Protein Solution in Patients With Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2018
Overall Recruitment Status
Completed
Study Start Date
November 2014 (undefined)
Primary Completion Date
October 2016 (Actual)
Study Completion Date
October 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zimmer Biomet
Collaborators
Biomet Biologics, LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to assess the safety of a single injection of APS.
Detailed Description
The primary objective of this study is to assess the safety of a single injection of APS in patients with painful unilateral knee osteoarthritis and who have not been able to get satisfactory pain relief with other treatments through one-month post treatment and monitor subjects for adverse events through 12 months.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
11 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NStride APS
Arm Type
Experimental
Arm Description
Subjects will receive an intra-articular injection of APS.
Intervention Type
Biological
Intervention Name(s)
APS
Intervention Description
See above
Primary Outcome Measure Information:
Title
Adverse Events
Description
Adverse Events and Serious Adverse Events
Time Frame
1 Year
Secondary Outcome Measure Information:
Title
Change From Baseline to 12 Months in Pain, Stiffness, and Function in Daily Living Measured With WOMAC Questionnaire
Description
The WOMAC LK 3.1 questionnaire is a validated tool commonly used for assessing knee pain, stiffness, and function. The WOMAC LK 3.1 questionnaire has 24 items that the patient addresses about the knee: 5 items on the pain subscale, 2 on the stiffness subscale, and 17 on the physical function subscale. Each item is answered on a 5-point Likert scale, with grading from 0 (none or never) to 4 (extreme or always). A higher score indicates worse pain, stiffness, or functional limitation. The WOMAC pain subscale consists of five questions scored from 0 to 4. The pain score has a range of 0 (no pain) to 20 (maximal pain). The WOMAC stiffness subscale consists of two questions scored from 0 to 4. The stiffness score has a range of 0 (no stiffness) to 8 (maximal stiffness). The WOMAC physical function subscale consists of seventeen questions scored from 0 to 4. The physical function score has a range of 0 (no functional limitation) to 68 (maximal functional limitation).
Time Frame
12 months
Title
Change From Baseline to 12 Months in Pain as Measured by the Numeric Rating Scale (NRS)
Description
The Numeric Rating Scale (NRS) is a validated measure of knee pain. The NRS is an 11 point Likert type scale anchored by 0 "no pain" and 10 "worst possible pain". Subjects rate their average pain over the last 24 hours.
Time Frame
12 months
Title
Change From Baseline to 12 Months in Pain as Measured With Knee Injury and Osteoarthritis Outcome Score (KOOS)
Description
The KOOS questionnaire is a commonly used instrument to assess the patient's opinion about their knee and associated problems. KOOS consists of 5 subscales: Pain (9 questions), Symptoms (7 questions), Function in daily living (ADL) (17 questions), Function in sport and recreation (Sport/Rec) (5 questions) and knee related Quality of Life (QOL) (4 questions). The previous week is used as the time period for answering the questions. A higher score on the KOOS questionnaire indicates fewer problems, and 0 indicates extreme problems. Each subscale score is calculated independently. The mean score of the individual items of each subscale is calculated and divided by 4 (the highest possible score for a single answer option). Traditionally in orthopedics, 100 indicates no problems and 0 indicates extreme problems. The normalized score is transformed to meet this standard.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female ≥40 and ≤75 years old at time of injection.. A standing radiograph of the knee showing a Kellgren-Lawrence grade of 2 to 4 (within 6 months of screening). Body mass index ≤40 kg/m2. A Western Ontario and McMaster Universities osteoarthritis index using the Likert scale, Version 3. (WOMAC LK 3.1) pain subscale total score ≥ 10 and ≤ 19. Has undergone at least two prior conservative OA therapies without satisfactory pain relief. Patient has failed to get satisfactory pain relief from either HA or steroid injections or would be considered an appropriate patient to receive either HA or steroid injections Exclusion Criteria: Presence of active infection or abnormal effusion in the knee immediately preceding treatment injection. Presence of symptomatic OA in the non-study knee Diagnosed with rheumatoid arthritis, Reiter's syndrome, psoriatic arthritis, gout, ankylosing spondylitis, chondromalacia, arthritis secondary to other inflammatory diseases, or of metabolic origin; HIV, viral hepatitis; chondrocalcinosis, Paget's disease, villonodular synovitis, and other non-OA joint disease. Disease of spine, hip or other lower extremity joints of sufficient degree to affect assessment of the index knee Untreated symptomatic injury of index knee (e.g., acute traumatic injury, anterior cruciate ligament injury, meniscus injury, cartilage lesion). Knee radiographs showing bone-on-bone or other gross cartilage deficits. Presence of surgical hardware or other foreign body in the index knee. Intra-articular steroid injections in the index knee within 3 months of screening. Intra-articular HA in the index knee within 6 months of screening. Other intra-articular therapy in the index knee within 6 months prior to screening. Systemic steroid use within 2 weeks of screening. Planned/anticipated surgery of the index knee during the study period. A history of local anesthetic allergy Use of systemic immunosuppressants within six weeks of treatment. Currently on anticoagulant therapy Any documented clinically significant condition (e.g., diabetes, malignancy), finding, or psychiatric illness at screening which could compromise patient safety or interfere with the assessment of the safety and treatment effects of the study injection. Skin breakdown at the index knee where the injection is planned to take place. Pregnant or nursing mothers or women who are planning on getting pregnant during the time they will be participating in the study. Known drug or alcohol dependence currently or within the last year. Used any investigational drug or device within 30 days prior to screening. Used any investigational biologic within 60 days prior to screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Klaassen
Organizational Affiliation
OSMC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Orthopedic and Sports Medicine Center of Northern Indiana (OSMC)
City
Elkhart
State/Province
Indiana
ZIP/Postal Code
46550
Country
United States

12. IPD Sharing Statement

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Safety of NStride Autologous Protein Solution in the Treatment of Knee Osteoarthritis (PROGRESS I)

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