Proof-of-concept Study to Assess the Efficacy, Tolerability and Safety of a Single Intraarticular Dose of GZ389988 Versus Placebo in Patients With Painful Osteoarthritis of the Knee
Primary Purpose
Osteoarthritis
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
placebo
GZ389988
acetaminophen or paracetamol
fixed combination of paracetamol + codeine
fixed combination of paracetamol + tramadol hydrochloride
Sponsored by
About this trial
This is an interventional treatment trial for Osteoarthritis
Eligibility Criteria
Inclusion criteria :
- Men or women 40 to 80 years of age.
- Diagnosis of primary knee osteoarthritis (OA), based upon the following:
- Fulfilling the American College of Rheumatology Clinical and Radiographic criteria for OA (at least knee pain and osteophytes), with
- X-ray evidence within the last 6 months for Kellgren and Lawrence classification II to IV.
- Western Ontario and McMaster Universities Arthritis Index (WOMAC) A1 Pain subscore (walking pain) over the last 48 hours ≥40 and ≤90 on VAS 0-100 in the target knee at screening with or without medication, and ≤30 on Visual Analogue Scale (VAS) 0-100 in the contralateral knee at screening with or without medication.
- WOMAC A1 pain subscore (walking pain) between 50 and 90 using the VAS 0-100, corresponding to moderate to severe pain in the target knee at baseline (from eDiary, average of at least 3 days in the time window between Day-5 and Day-1).
- Symptomatic for more than 6 months (if both symptomatic knees, at least for the most painful knee that will receive the study drug).
- Having given written informed consent prior to any procedure related to the study.
- Ambulatory with an active lifestyle and in good general health. (Assistive devices were allowed if used throughout a period of 3 months or more prior to screening, on the condition that they continue to be used throughout the study).
- A male who is sexually active must use a condom as part of a method of highly effective contraception (eg, condom + spermicide, and an additional contraceptive method used by the partner) during sexual intercourse with a women of childbearing potential for the duration of the study period up to the end-of-study visit and should not father a child in this period. Male patients also have to agree not to donate sperm for the duration of the study until the end-of-study visit.
Exclusion criteria:
- Women of childbearing potential.
- Pregnant or breastfeeding women.
- Any uncontrolled, chronic condition or laboratory finding which, in the opinion of the Investigator, could potentially put the patient at increased risk.
- Patients with clinically significant or uncontrolled hepatic, gastrointestinal, cardiovascular, respiratory, neurological (including diabetic neuropathy), psychiatric, hematological, renal, or dermatological disease, or any other medical condition, such as symptomatic peripheral vascular disease of the study leg (prior or current), clinically significant venous or lymphatic stasis present in the study leg, that might interfere with the evaluation of investigational medicinal product (IMP) according to Investigator's medical judgment.
- Chondrocalcinosis.
- Fibromyalgia.
- Moderately severe or severe depression as indicated by Patient Health Questionnaire-9 (PHQ-9) total score at screening visit.
- Severe anxiety as indicated by Generalized Anxiety Disorder (GAD-7) score at screening visit.
- History or presence of drug or alcohol abuse (alcohol consumption >40 grams per day).
- Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development, or unable to use an electronic diary daily.
- Abnormal coagulation parameters: outside the range international normalized ratio (INR) 0.85-1.15, activated partial thromboplastin time >33 seconds, platelets <140 x 10^9/L.
- Moderate to severe renal impairment.
- Underlying hepatobiliary disease and/or alanine aminotransferase (ALT) >2 x upper limit of normal (ULN).
- High sensitivity C-reactive protein (hsCRP) >2 x ULN.
- Hemoglobin <10 g/dL, white blood cell count (WBC) <3 x 10^9/L.
- Positive result on any of the following tests: hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV) antibodies, anti-human immunodeficiency virus 1 and 2 antibodies (anti-HIV1 and anti HIV2 Ab).
- Secondary OA. -Ipsilateral hip OA.-
- History of osteonecrosis and/or rapidly progressive OA (RPOA).
- Intraarticular injection within 3 months prior to inclusion.
- Unable to be maintained for at least 2 weeks prior to entry into study on paracetamol (no non-steroidal anti-inflammatory drug [NSAID] use during the 12 weeks of the study; after the end-of-study visit [Day 84 ± 7] patients may be given an NSAID if necessary to provide better control of OA symptoms).
- Any IMP within 3 months prior to the study.
- Any knee magnetic resonance imaging (MRI) contraindication.
- Patients at risk of developing a RPOA with pre-existing findings on MRI of the target knee at baseline.
- Patients with pain DETECT questionnaire (PD-Q) score >18.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Sites / Locations
- Investigational Site Number 276001
- Investigational Site Number 276002
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
GZ389988
Placebo
Arm Description
Single intraarticular injection of GZ389988 in the knee joint
Single intraarticular injection of placebo for GZ389988 in the knee joint
Outcomes
Primary Outcome Measures
Change from baseline in weekly mean score of Western Ontario and McMaster Universities Arthritis Index (WOMAC) A1 pain subscore (walking pain) collected daily in the target knee, as measured by the Visual Analogue Scale (VAS) 0-100
Secondary Outcome Measures
Change from baseline in weekly mean score of WOMAC A1 pain sub-score (walking pain) collected daily in the target knee, as measured by the VAS 0-100
Change from baseline in weekly mean score of WOMAC A1 pain sub-score collected daily in the target knee
Change from baseline in weekly mean score of WOMAC A1 pain sub-score collected daily in the target knee
Change from baseline in weekly mean score of overall knee pain collected daily in the target knee
Change from baseline in Patient Global Assessment (PGA) of disease status
Change from baseline in WOMAC index (total score for pain, stiffness, and physical function subscales), pain, stiffness and physical function sub-scores
Patient Global Impression of Change (PGIC)
Patient Global Assessment of Response to Therapy (PGART)
Rate of response to therapy according to Outcome Measures in Rheumatology committee (OMERACT) and the Osteoarthritis Research Society International (OARSI)
OMERACT and OARSI responder criteria are based on the symptomatic variables pain and function, or pain, function and patient's global assessment
WOMAC A1 responder rate based on percentage of patients with reduction in pain intensity of at least 30% and 50% at endpoint compared to baseline
Time to first WOMAC A1 response for ≥30% reduction in pain intensity
Time to first WOMAC A1 response for 50% reduction in pain intensity
Amount of rescue medication intake
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02845271
Brief Title
Proof-of-concept Study to Assess the Efficacy, Tolerability and Safety of a Single Intraarticular Dose of GZ389988 Versus Placebo in Patients With Painful Osteoarthritis of the Knee
Official Title
A Two Part Protocol Using Double Blind Placebo Control to Assess the Safety, Tolerability, and Pharmacokinetics of Single Escalating Intra-articular Doses Followed by Assessment of Efficacy, Safety, Tolerability and Pharmacokinetics of a Single Intra-articular Dose of the TrkA Inhibitor, GZ389988, in Patients With Painful Osteoarthritis of the Knee
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Completed
Study Start Date
July 21, 2016 (Actual)
Primary Completion Date
June 28, 2017 (Actual)
Study Completion Date
September 13, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genzyme, a Sanofi Company
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Primary Objective:
To assess the efficacy of a single intraarticular dose of GZ389988 compared to placebo for relief of knee pain in patients with osteoarthritis (OA) of the knee.
Secondary Objectives:
To assess the safety and tolerability of a single intraarticular dose of GZ389988 in patients with painful OA of the knee.
To assess the pharmacokinetic parameters of a single intraarticular dose of GZ389988 in patients with painful OA of the knee.
Detailed Description
Screening will be performed within 21 days of dosing. Following the single dose of study medication, the study period for each patient will be 84 ± 7 days up to the end-of-study visit.
Total duration for one patient will be up to 16 weeks (up to the end-of-study visit), not including the long-term observational safety follow-up phone call for 12 additional weeks.
The collection of primary endpoint data up to Week 4 for futility analysis is optional. Assuming a possible step-down in dose due to safety/tolerability reasons, the total expected maximum number of included patients could be increased up to a maximum of 182 patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
104 (Actual)
8. Arms, Groups, and Interventions
Arm Title
GZ389988
Arm Type
Experimental
Arm Description
Single intraarticular injection of GZ389988 in the knee joint
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Single intraarticular injection of placebo for GZ389988 in the knee joint
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
Pharmaceutical form:solvent for parenteral use
Route of administration: intraarticular
Intervention Type
Drug
Intervention Name(s)
GZ389988
Intervention Description
Pharmaceutical form:suspension for injection
Route of administration: intraarticular
Intervention Type
Drug
Intervention Name(s)
acetaminophen or paracetamol
Intervention Description
Pharmaceutical form: tablet
Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
fixed combination of paracetamol + codeine
Intervention Description
Pharmaceutical form: capsule
Route of administration: oral
Intervention Type
Drug
Intervention Name(s)
fixed combination of paracetamol + tramadol hydrochloride
Intervention Description
Pharmaceutical form: tablet
Route of administration: oral
Primary Outcome Measure Information:
Title
Change from baseline in weekly mean score of Western Ontario and McMaster Universities Arthritis Index (WOMAC) A1 pain subscore (walking pain) collected daily in the target knee, as measured by the Visual Analogue Scale (VAS) 0-100
Time Frame
Averaged over 4 weeks (up to Day 28)
Secondary Outcome Measure Information:
Title
Change from baseline in weekly mean score of WOMAC A1 pain sub-score (walking pain) collected daily in the target knee, as measured by the VAS 0-100
Time Frame
Averaged over 12 weeks (up to Day 84)
Title
Change from baseline in weekly mean score of WOMAC A1 pain sub-score collected daily in the target knee
Time Frame
Averaged over 1, 2, 3, 6, 8, and 10 weeks
Title
Change from baseline in weekly mean score of WOMAC A1 pain sub-score collected daily in the target knee
Time Frame
At 1, 2, 3, 4, 6, 8, 10, and 12 weeks
Title
Change from baseline in weekly mean score of overall knee pain collected daily in the target knee
Time Frame
At and averaged over 1, 2, 3, 4, 6, 8, 10, and 12 weeks
Title
Change from baseline in Patient Global Assessment (PGA) of disease status
Time Frame
At and averaged over 1, 2, 3, 4, 6, 8, 10, and 12 weeks
Title
Change from baseline in WOMAC index (total score for pain, stiffness, and physical function subscales), pain, stiffness and physical function sub-scores
Time Frame
Averaged over 1, 2, 3, 4, 6, 8, 10, and 12 weeks
Title
Patient Global Impression of Change (PGIC)
Time Frame
Over the last 4 weeks at Day 28 (1 to 4 weeks), Day 56 (5 to 8 weeks), and Day 84 (9 to 12 weeks)
Title
Patient Global Assessment of Response to Therapy (PGART)
Time Frame
Over the last 4 weeks at Day 28 (1 to 4 weeks), Day 56 (5 to 8 weeks), and Day 84 (9 to 12 weeks)
Title
Rate of response to therapy according to Outcome Measures in Rheumatology committee (OMERACT) and the Osteoarthritis Research Society International (OARSI)
Description
OMERACT and OARSI responder criteria are based on the symptomatic variables pain and function, or pain, function and patient's global assessment
Time Frame
By Day 28, Day 56, and Day 84
Title
WOMAC A1 responder rate based on percentage of patients with reduction in pain intensity of at least 30% and 50% at endpoint compared to baseline
Time Frame
Over 4 weeks (up to Day 28) and 12 weeks (up to Day 84) and at 1, 2, 3, 4, 6, 8, 10, and 12 weeks
Title
Time to first WOMAC A1 response for ≥30% reduction in pain intensity
Time Frame
At 1, 2, 3, 4, 6, 8, 10, 12 weeks
Title
Time to first WOMAC A1 response for 50% reduction in pain intensity
Time Frame
At 1, 2, 3, 4, 6, 8, 10, 12 weeks
Title
Amount of rescue medication intake
Time Frame
Up to Day 84
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria :
Men or women 40 to 80 years of age.
Diagnosis of primary knee osteoarthritis (OA), based upon the following:
Fulfilling the American College of Rheumatology Clinical and Radiographic criteria for OA (at least knee pain and osteophytes), with
X-ray evidence within the last 6 months for Kellgren and Lawrence classification II to IV.
Western Ontario and McMaster Universities Arthritis Index (WOMAC) A1 Pain subscore (walking pain) over the last 48 hours ≥40 and ≤90 on VAS 0-100 in the target knee at screening with or without medication, and ≤30 on Visual Analogue Scale (VAS) 0-100 in the contralateral knee at screening with or without medication.
WOMAC A1 pain subscore (walking pain) between 50 and 90 using the VAS 0-100, corresponding to moderate to severe pain in the target knee at baseline (from eDiary, average of at least 3 days in the time window between Day-5 and Day-1).
Symptomatic for more than 6 months (if both symptomatic knees, at least for the most painful knee that will receive the study drug).
Having given written informed consent prior to any procedure related to the study.
Ambulatory with an active lifestyle and in good general health. (Assistive devices were allowed if used throughout a period of 3 months or more prior to screening, on the condition that they continue to be used throughout the study).
A male who is sexually active must use a condom as part of a method of highly effective contraception (eg, condom + spermicide, and an additional contraceptive method used by the partner) during sexual intercourse with a women of childbearing potential for the duration of the study period up to the end-of-study visit and should not father a child in this period. Male patients also have to agree not to donate sperm for the duration of the study until the end-of-study visit.
Exclusion criteria:
Women of childbearing potential.
Pregnant or breastfeeding women.
Any uncontrolled, chronic condition or laboratory finding which, in the opinion of the Investigator, could potentially put the patient at increased risk.
Patients with clinically significant or uncontrolled hepatic, gastrointestinal, cardiovascular, respiratory, neurological (including diabetic neuropathy), psychiatric, hematological, renal, or dermatological disease, or any other medical condition, such as symptomatic peripheral vascular disease of the study leg (prior or current), clinically significant venous or lymphatic stasis present in the study leg, that might interfere with the evaluation of investigational medicinal product (IMP) according to Investigator's medical judgment.
Chondrocalcinosis.
Fibromyalgia.
Moderately severe or severe depression as indicated by Patient Health Questionnaire-9 (PHQ-9) total score at screening visit.
Severe anxiety as indicated by Generalized Anxiety Disorder (GAD-7) score at screening visit.
History or presence of drug or alcohol abuse (alcohol consumption >40 grams per day).
Any patient who, in the judgment of the Investigator, is likely to be noncompliant during the study, or unable to cooperate because of a language problem or poor mental development, or unable to use an electronic diary daily.
Abnormal coagulation parameters: outside the range international normalized ratio (INR) 0.85-1.15, activated partial thromboplastin time >33 seconds, platelets <140 x 10^9/L.
Moderate to severe renal impairment.
Underlying hepatobiliary disease and/or alanine aminotransferase (ALT) >2 x upper limit of normal (ULN).
High sensitivity C-reactive protein (hsCRP) >2 x ULN.
Hemoglobin <10 g/dL, white blood cell count (WBC) <3 x 10^9/L.
Positive result on any of the following tests: hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (anti-HCV) antibodies, anti-human immunodeficiency virus 1 and 2 antibodies (anti-HIV1 and anti HIV2 Ab).
Secondary OA. -Ipsilateral hip OA.-
History of osteonecrosis and/or rapidly progressive OA (RPOA).
Intraarticular injection within 3 months prior to inclusion.
Unable to be maintained for at least 2 weeks prior to entry into study on paracetamol (no non-steroidal anti-inflammatory drug [NSAID] use during the 12 weeks of the study; after the end-of-study visit [Day 84 ± 7] patients may be given an NSAID if necessary to provide better control of OA symptoms).
Any IMP within 3 months prior to the study.
Any knee magnetic resonance imaging (MRI) contraindication.
Patients at risk of developing a RPOA with pre-existing findings on MRI of the target knee at baseline.
Patients with pain DETECT questionnaire (PD-Q) score >18.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Sciences & Operations
Organizational Affiliation
Sanofi
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site Number 276001
City
Berlin
ZIP/Postal Code
14050
Country
Germany
Facility Name
Investigational Site Number 276002
City
Luebeck
ZIP/Postal Code
23538
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org
Citations:
PubMed Identifier
31351965
Citation
Krupka E, Jiang GL, Jan C. Efficacy and safety of intra-articular injection of tropomyosin receptor kinase A inhibitor in painful knee osteoarthritis: a randomized, double-blind and placebo-controlled study. Osteoarthritis Cartilage. 2019 Nov;27(11):1599-1607. doi: 10.1016/j.joca.2019.05.028. Epub 2019 Jul 25.
Results Reference
derived
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Proof-of-concept Study to Assess the Efficacy, Tolerability and Safety of a Single Intraarticular Dose of GZ389988 Versus Placebo in Patients With Painful Osteoarthritis of the Knee
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