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AP-003-C Study to Confirm the Efficacy of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee

Primary Purpose

Osteoarthritis, Knee, Knee Osteoarthritis, Knee Arthritis

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
4 mL injection of Ampion
4 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, Knee focused on measuring osteoarthritis, osteoarthritis of the knee, OA, OAK, Kellgren Lawrence (KL)

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;
  • Must be ambulatory;
  • Study knee must have a clinical diagnosis of osteoarthritis (OA) supported by radiological evidence (Kellgren Lawrence Grade IV) which is assessed locally (x-rays within the past 6 months of screening are acceptable);
  • Moderate to moderately-severe OA pain in the study knee (rating of at least 1.5 on the WOMAC A, 5-point Likert Pain Subscale);
  • Moderate to moderately-severe OA function in the study knee (rating of at least 1.5 on the WOMAC C, 5-point Likert Function Subscale);
  • WOMAC A, 5-point Likert pain subscale <1.5 in the contralateral knee;
  • Ability to discontinue non-steroidal anti-inflammatory drug (NSAID) use at Screening visit and/or 72 hours prior to the Baseline visit and for the duration of the clinical study (low-dose aspirin (81 mg) is allowed during the study);
  • No analgesia (including acetaminophen) taken 24 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 subject 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 study knee for the duration of the trial (e.g. cancer, congenital defects, spine osteoarthritis)
  • Major injury to the study knee within the 12 months prior to screening
  • Severe hip osteoarthritis ipsilateral to the study knee
  • Any pain that could interfere with the assessment of study 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
  • Pregnancy or planning to become pregnant during the study
  • Use of the following medications:

    1. No intra-articular (IA) injected medications in the study knee during the study (or 12 weeks prior to Baseline).
    2. No analgesics containing opioids.
    3. NSAIDs are not permitted during the study; acetaminophen is available as a rescue medication during the study from the provided supply.
    4. No topical treatment on the study knee during the study
    5. No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as low-dose Aspirin (81 mg) and Plavix are allowed)
    6. No systemic treatments that may interfere with safety or efficacy assessments during the study
    7. No immunosuppressants
    8. No use of systemic or intra-articular corticosteroids
  • No human albumin treatment in the 3 months before randomization or throughout the duration of the study

Sites / Locations

  • Central Research Associates, Inc.
  • CORE Orthopaedic Medical Center
  • St. Joseph Heritage
  • Artemis Institute for Clinical Research
  • Westlake Medical Research
  • Drug Studies America
  • Healthcare Research Netword
  • Heartland Research Associates
  • Arthritis Treatment Center
  • Healthcare Network Research
  • Coastal Carolina Center at Lowcountry Orthopaedics
  • Tekton Research
  • Northwest Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AMPION™ 4 mL dose

Placebo 4 mL dose

Arm Description

4 mL injection of Ampion

4 mL injection of Placebo

Outcomes

Primary Outcome Measures

Number of Participants Classified as Responders
Using the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria of WOMAC A Pain subscore, WOMAC C Function subscore, and PGA as composite endpoints. A patient in this study will be considered a responder for the purpose of efficacy analysis if the following criteria are met: (1) demonstration of ≥ 50% improvement AND a 1.0-unit change in pain OR 1.0-unit change in function OR If the patient does not meet this criterion, then the patient must demonstrate at least 2 of the following: Improvement in pain (WOMAC A) ≥20% and a 0.5 point absolute change in pain from Baseline on the 5-point Likert scale Improvement in function (WOMAC C) ≥20% and a 0.5 point absolute change in function from Baseline on the 5-point Likert scale Improvement in patient global assessment (PGA) ≥20% and a 0.5 point absolute change in function from Baseline on the 5-point Likert scale

Secondary Outcome Measures

Full Information

First Posted
June 6, 2017
Last Updated
August 8, 2022
Sponsor
Ampio Pharmaceuticals. Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03182686
Brief Title
AP-003-C Study to Confirm the Efficacy of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee
Official Title
A Phase 3 Randomized Study to Confirm the Efficacy of an Intra-Articular Injection of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
June 19, 2017 (Actual)
Primary Completion Date
December 7, 2017 (Actual)
Study Completion Date
December 7, 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a phase 3 randomized study to confirm the efficacy of an intra-articular injection of Ampion™ in adults with pain due to severe osteoarthritis of the knee.
Detailed Description
A Randomized Study to Confirm the Efficacy of an Intra-Articular Injection of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee There will be a 7-day screening period for each subject followed by a 12-week participation period. The primary trial objective is to evaluate the clinical efficacy of Ampion using the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) (using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) 3.1 Index and Patient's Global Assessment as assessments). The secondary trial objectives are to evaluate the safety of a single intra-articular injection (4 mL) of Ampion.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee, Knee Osteoarthritis, Knee Arthritis, Knee Pain Chronic
Keywords
osteoarthritis, osteoarthritis of the knee, OA, OAK, Kellgren Lawrence (KL)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
168 (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
Intervention Type
Biological
Intervention Name(s)
4 mL injection of Ampion
Intervention Description
4 mL injection of Ampion
Intervention Type
Drug
Intervention Name(s)
4 mL Injection of Placebo
Other Intervention Name(s)
0.9% Saline
Intervention Description
4 mL Injection of Placebo
Primary Outcome Measure Information:
Title
Number of Participants Classified as Responders
Description
Using the Outcome Measures in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria of WOMAC A Pain subscore, WOMAC C Function subscore, and PGA as composite endpoints. A patient in this study will be considered a responder for the purpose of efficacy analysis if the following criteria are met: (1) demonstration of ≥ 50% improvement AND a 1.0-unit change in pain OR 1.0-unit change in function OR If the patient does not meet this criterion, then the patient must demonstrate at least 2 of the following: Improvement in pain (WOMAC A) ≥20% and a 0.5 point absolute change in pain from Baseline on the 5-point Likert scale Improvement in function (WOMAC C) ≥20% and a 0.5 point absolute change in function from Baseline on the 5-point Likert scale Improvement in patient global assessment (PGA) ≥20% and a 0.5 point absolute change in function from Baseline on the 5-point Likert scale
Time Frame
Determined from Baseline to 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; Must be ambulatory; Study knee must have a clinical diagnosis of osteoarthritis (OA) supported by radiological evidence (Kellgren Lawrence Grade IV) which is assessed locally (x-rays within the past 6 months of screening are acceptable); Moderate to moderately-severe OA pain in the study knee (rating of at least 1.5 on the WOMAC A, 5-point Likert Pain Subscale); Moderate to moderately-severe OA function in the study knee (rating of at least 1.5 on the WOMAC C, 5-point Likert Function Subscale); WOMAC A, 5-point Likert pain subscale <1.5 in the contralateral knee; Ability to discontinue non-steroidal anti-inflammatory drug (NSAID) use at Screening visit and/or 72 hours prior to the Baseline visit and for the duration of the clinical study (low-dose aspirin (81 mg) is allowed during the study); No analgesia (including acetaminophen) taken 24 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 subject 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 study knee for the duration of the trial (e.g. cancer, congenital defects, spine osteoarthritis) Major injury to the study knee within the 12 months prior to screening Severe hip osteoarthritis ipsilateral to the study knee Any pain that could interfere with the assessment of study 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 Pregnancy or planning to become pregnant during the study Use of the following medications: No intra-articular (IA) injected medications in the study knee during the study (or 12 weeks prior to Baseline). No analgesics containing opioids. NSAIDs are not permitted during the study; acetaminophen is available as a rescue medication during the study from the provided supply. No topical treatment on the study knee during the study No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as low-dose Aspirin (81 mg) and Plavix are allowed) No systemic treatments that may interfere with safety or efficacy assessments during the study No immunosuppressants No use of systemic or intra-articular corticosteroids No human albumin treatment in the 3 months before randomization or throughout the duration of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard Levy, MD
Organizational Affiliation
Ampio Pharmaceuticals. Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Central Research Associates, Inc.
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35205
Country
United States
Facility Name
CORE Orthopaedic Medical Center
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
St. Joseph Heritage
City
Fullerton
State/Province
California
ZIP/Postal Code
92835
Country
United States
Facility Name
Artemis Institute for Clinical Research
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Westlake Medical Research
City
Thousand Oaks
State/Province
California
ZIP/Postal Code
91360
Country
United States
Facility Name
Drug Studies America
City
Marietta
State/Province
Georgia
ZIP/Postal Code
30060
Country
United States
Facility Name
Healthcare Research Netword
City
Blue Island
State/Province
Illinois
ZIP/Postal Code
60406
Country
United States
Facility Name
Heartland Research Associates
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67207
Country
United States
Facility Name
Arthritis Treatment Center
City
Frederick
State/Province
Maryland
ZIP/Postal Code
21702
Country
United States
Facility Name
Healthcare Network Research
City
Hazelwood
State/Province
Missouri
ZIP/Postal Code
63042
Country
United States
Facility Name
Coastal Carolina Center at Lowcountry Orthopaedics
City
North Charleston
State/Province
South Carolina
ZIP/Postal Code
29406
Country
United States
Facility Name
Tekton Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78745
Country
United States
Facility Name
Northwest Clinical Research Center
City
Bellevue
State/Province
Washington
ZIP/Postal Code
98007
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29910837
Citation
Salottolo K, Cole B, Bar-Or D. Intra-articular injection of the anti-inflammatory compound LMWF-5A in adults with severe osteoarthritis: a double-blind prospective randomized controlled multi-center safety and efficacy trial. Patient Saf Surg. 2018 Jun 18;12:11. doi: 10.1186/s13037-018-0158-0. eCollection 2018.
Results Reference
result

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AP-003-C Study to Confirm the Efficacy of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee

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