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Study of Safety, Tolerability, Preliminary Efficacy of Intra-articular LNA043 Injections in Patients With Articular Cartilage Lesions and Knee Osteoarthritis.

Primary Purpose

Wounds and Injuries

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
LNA043
Placebo
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Wounds and Injuries focused on measuring Articular cartilage, partial thickness cartilage lesion, knee cartilage, regeneration, osteoarthritis, plaque-type psoriasis, metabolic syndrome, Secukinumab, lifestyle intervention, systemic inflammation, metabolism

Eligibility Criteria

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

Inclusion criteria Part A

  • Patient is ≥18 and ≤55 years old at time of screening.
  • Patient has a body mass index (BMI) <30 kg/m2 at screening, for patients with BMI >30 but ≤ 33kg/m2, eligibility will be decided by consultation with the sponsor.
  • Patient has a symptomatic, single, articular cartilage defect of one knee, grade II or IIIA according to the ICRS classification, localized to either the femoral condyles/femoral trochlea or to the patella, based on MRI or arthroscopy performed within 9 months before screening visit and confirmed by screening 3T MRI.
  • Patient has an onset of pain and impairment of function between two (2) months and two (2) years before screening.
  • Patient reports a KOOS (sports and recreational activities subscale) score of ≤ 60 at both screening and Day 1.

Inclusion criteria Part B

  • Patient is ≥18 and ≤75 years old at time of screening.
  • Patient has a body mass index (BMI) ≤ 35 kg/m2 at screening
  • Diagnosis of femorotibial osteoarthritis (OA) in the target knee by standard American College of Rheumatology (ACR) criteria at study start (clinical AND radiographic criteria)
  • Patient has a Kellgren & Lawrence (K&L) grade 2 or 3 OA of the knee with Joint Space Width (JSW) 2-4 mm evaluated with X-Ray at screening.
  • Patient must have symptomatic disease predominantly in one (the index) knee, with minimal or no symptoms in the contralateral knee. Symptomatic disease is defined as having pain in the knee more than 50% of the days during the last 3 months from screening.

Exclusion criteria Part A & B

  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing and for 15 days after stopping of investigational drug.
  • Patient has had surgical treatment of the target knee using mosaicplasty, microfracture, meniscectomy >50% (Note: prior diagnostic arthroscopy with debridement and lavage, <50% meniscectomy, lateral release, patellar realignment, medial patellofemoral ligament reconstruction are acceptable if performed at least 2 months prior to screening; anteriorcruciate ligament reconstrucion is acceptable if performed 12 months prior to screening, or less if restoration of joint function is evident, and agreed by the sponsor).
  • Patient has an unstable target knee joint or insufficiently reconstructed ligaments based on medical history and physical examination by the investigator.
  • Prohibited medication updated with reference to dosing (formerly screening).

Exclusion Criteria Part A only

  • Regular smokers (> 5 cigarettes/day). Urine cotinine levels will be measured during screening for all patients. Regular smokers will be defined as any patient who reports tobacco use of > 5 cigarettes/day and/or who has a urine cotinine ≥ 500 ng/mL.
  • Patient has radiologically apparent degenerative joint disease in the target knee as determined by Kellgren and Lawrence grade ≥2 based on X-ray evaluation performed within 9 months from screening.
  • Patient has patellofemoral dysplasia Dejour Grade B-D based on X-ray evaluation performed within 9 months from screening
  • Patient has malalignment (valgus- or varus-deformity) in the target knee ≥ 5° based on X-ray evaluation performed within 9 months from screening. In suspected cases, the mechanical axis must be established radiographically through complete leg imaging during standing and in postero-anterior (PA) projection.

Exclusion Criteria Part B only

  • Regular smokers (> 10 cigarettes/day).
  • Clinical signs of inflammation (i.e., redness) in the target knee.
  • History of knee replacement (unilateral or total) in either knee.
  • Presence of severe hip OA conditioning lower limb function according to PI's evaluation.
  • Nephrotic syndrome and/or significant proteinuria
  • History of coagulopathy or medical condition requiring anticoagulation which would preclude knee injection
  • Patient has malalignment (valgus- or varus-deformity) in the target knee ≥ 7.5° based on X-ray evaluation. In suspected cases, the mechanical axis must be established radiographically through complete leg imaging during standing and in postero-anterior (PA) projection.

Sites / Locations

  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Placebo Comparator

Arm Label

LNA043 40 mg Part B

LNA043 20 mg Part B

LNA043 20 mg Part A

Placebo Part A

Placebo Part B

Arm Description

LNA043 40 mg Part B

LNA043 20 mg Part B

LNA043 20 mg Part A

Placebo Part A

Placebo Part B

Outcomes

Primary Outcome Measures

Articular cartilage bi-layer collagen organisation evaluated with MRI and measured in milliseconds (ms) (Part A only)
To assess the efficacy of multiple i.a. injections of LNA043 in regenerating the articular cartilage tissue
Number of patients with any adverse events, serious adverse events and death (Part A and Part B)
To assess safety and local tolerability of multiple i.a. injections of LNA043
Change in cartilage volume/thickness in the index region (Part B only)
To assess the efficacy of multiple i.a. injections of LNA043 in regenerating the articular cartilage tissue

Secondary Outcome Measures

Change in volume of cartilage defect filling evaluated with MRI (Part A only)
To assess the extent of the repair cartilage tissue following multiple i.a. injections of LNA043
Maximum Observed Plasma Concentration measured in ng/mL (Part A and Part B)
To evaluate systemic and local PK of LNA043 following multiple i.a. injections of LNA043
Potential immunogenicity of LNA043 presence and characterisation of anti-LNA043 antibodies in serum (Part A and Part B)
To assess the potential immunogenicity of LNA043
Area Under the Plasma Concentration-time Curve From 0 to the Last Measurable Concentration (Part A and Part B)
To evaluate systemic and local PK of LNA043 following multiple i.a. injections of LNA043
Articular cartilage bi-layer collagen organization evaluated with T2 relaxation times (in ms) (Part B only)
To assess the extent of the repair cartilage tissue following multiple i.a. injections of LNA043

Full Information

First Posted
August 29, 2017
Last Updated
January 24, 2023
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT03275064
Brief Title
Study of Safety, Tolerability, Preliminary Efficacy of Intra-articular LNA043 Injections in Patients With Articular Cartilage Lesions and Knee Osteoarthritis.
Official Title
A Two-part, Randomized, Placebo-controlled, Patient and Investigator Blinded, Study Investigating the Safety, Tolerability and Preliminary Efficacy of Intra-articular LNA043 Injections in Regenerating the Articular Cartilage of the Knee in Patients With Articular Cartilage Lesions (Part A) and in Patients With Knee Osteoarthritis (Part B).
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
September 12, 2017 (Actual)
Primary Completion Date
September 6, 2022 (Actual)
Study Completion Date
September 6, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this two-part study is to assess the efficacy, safety and tolerability of multiple intra-articular (i.a.) injections of LNA043 in regenerating the articular surface in patients with cartilage lesions of the knee (Part A) and knee osteoarthritis (Part B).
Detailed Description
The purpose of this two-part study is to assess the efficacy, safety and tolerability of multiple intra-articular (i.a.) injections of LNA043 in regenerating the articular surface in patients with cartilage lesions of the knee (Part A) and knee osteoarthritis (Part B). In Part A, this study aims to establish Proof of Concept (PoC), namely regeneration of the articular cartilage, in order to provide information on the potential clinical utility of LNA043, with the ultimate goal of replacing current surgical procedures for cartilage repair with an injectable, less invasive regenerative therapy. In Part B, this study aims at further evaluating the cartilage anabolic activity of LNA043 in a more severe knee OA population, and at testing the potential benefit of a higher dose of LNA043 administered i.a. monthly instead of weekly.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Wounds and Injuries
Keywords
Articular cartilage, partial thickness cartilage lesion, knee cartilage, regeneration, osteoarthritis, plaque-type psoriasis, metabolic syndrome, Secukinumab, lifestyle intervention, systemic inflammation, metabolism

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LNA043 40 mg Part B
Arm Type
Experimental
Arm Description
LNA043 40 mg Part B
Arm Title
LNA043 20 mg Part B
Arm Type
Experimental
Arm Description
LNA043 20 mg Part B
Arm Title
LNA043 20 mg Part A
Arm Type
Experimental
Arm Description
LNA043 20 mg Part A
Arm Title
Placebo Part A
Arm Type
Placebo Comparator
Arm Description
Placebo Part A
Arm Title
Placebo Part B
Arm Type
Placebo Comparator
Arm Description
Placebo Part B
Intervention Type
Biological
Intervention Name(s)
LNA043
Intervention Description
LNA043 intra-articular injection
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo intra-articular injection
Primary Outcome Measure Information:
Title
Articular cartilage bi-layer collagen organisation evaluated with MRI and measured in milliseconds (ms) (Part A only)
Description
To assess the efficacy of multiple i.a. injections of LNA043 in regenerating the articular cartilage tissue
Time Frame
Up to Week 28
Title
Number of patients with any adverse events, serious adverse events and death (Part A and Part B)
Description
To assess safety and local tolerability of multiple i.a. injections of LNA043
Time Frame
Up to 52 weeks
Title
Change in cartilage volume/thickness in the index region (Part B only)
Description
To assess the efficacy of multiple i.a. injections of LNA043 in regenerating the articular cartilage tissue
Time Frame
Up to Week 52
Secondary Outcome Measure Information:
Title
Change in volume of cartilage defect filling evaluated with MRI (Part A only)
Description
To assess the extent of the repair cartilage tissue following multiple i.a. injections of LNA043
Time Frame
Week 16, Week 28
Title
Maximum Observed Plasma Concentration measured in ng/mL (Part A and Part B)
Description
To evaluate systemic and local PK of LNA043 following multiple i.a. injections of LNA043
Time Frame
Part A: 0 (pre-dose), 15 min, 60 min and 120 min post-dose Week 1, Week 2, Week 3, Week 4; Part B: Week 1, Week 4, Week 9, Week 13, Week 16, Week 28 and Week 52
Title
Potential immunogenicity of LNA043 presence and characterisation of anti-LNA043 antibodies in serum (Part A and Part B)
Description
To assess the potential immunogenicity of LNA043
Time Frame
Week 1, Week 3, Week 6, Week 16, Week 28
Title
Area Under the Plasma Concentration-time Curve From 0 to the Last Measurable Concentration (Part A and Part B)
Description
To evaluate systemic and local PK of LNA043 following multiple i.a. injections of LNA043
Time Frame
Part A: 0 (pre-dose), 15 min, 60 min and 120 min post-dose Week 1, Week 2, Week 3, Week 4; Part B: Week 1, Week 4, Week 9, Week 13, Week 16, Week 28 and Week 52
Title
Articular cartilage bi-layer collagen organization evaluated with T2 relaxation times (in ms) (Part B only)
Description
To assess the extent of the repair cartilage tissue following multiple i.a. injections of LNA043
Time Frame
Week 28, Week 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria Part A Patient is ≥18 and ≤55 years old at time of screening. Patient has a body mass index (BMI) <30 kg/m2 at screening, for patients with BMI >30 but ≤ 33kg/m2, eligibility will be decided by consultation with the sponsor. Patient has a symptomatic, single, articular cartilage defect of one knee, grade II or IIIA according to the ICRS classification, localized to either the femoral condyles/femoral trochlea or to the patella, based on MRI or arthroscopy performed within 9 months before screening visit and confirmed by screening 3T MRI. Patient has an onset of pain and impairment of function between two (2) months and two (2) years before screening. Patient reports a KOOS (sports and recreational activities subscale) score of ≤ 60 at both screening and Day 1. Inclusion criteria Part B Patient is ≥18 and ≤75 years old at time of screening. Patient has a body mass index (BMI) ≤ 35 kg/m2 at screening Diagnosis of femorotibial osteoarthritis (OA) in the target knee by standard American College of Rheumatology (ACR) criteria at study start (clinical AND radiographic criteria) Patient has a Kellgren & Lawrence (K&L) grade 2 or 3 OA of the knee with Joint Space Width (JSW) 2-4 mm evaluated with X-Ray at screening. Patient must have symptomatic disease predominantly in one (the index) knee, with minimal or no symptoms in the contralateral knee. Symptomatic disease is defined as having pain in the knee more than 50% of the days during the last 3 months from screening. Exclusion criteria Part A & B Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing and for 15 days after stopping of investigational drug. Patient has had surgical treatment of the target knee using mosaicplasty, microfracture, meniscectomy >50% (Note: prior diagnostic arthroscopy with debridement and lavage, <50% meniscectomy, lateral release, patellar realignment, medial patellofemoral ligament reconstruction are acceptable if performed at least 2 months prior to screening; anteriorcruciate ligament reconstrucion is acceptable if performed 12 months prior to screening, or less if restoration of joint function is evident, and agreed by the sponsor). Patient has an unstable target knee joint or insufficiently reconstructed ligaments based on medical history and physical examination by the investigator. Prohibited medication updated with reference to dosing (formerly screening). Exclusion Criteria Part A only Regular smokers (> 5 cigarettes/day). Urine cotinine levels will be measured during screening for all patients. Regular smokers will be defined as any patient who reports tobacco use of > 5 cigarettes/day and/or who has a urine cotinine ≥ 500 ng/mL. Patient has radiologically apparent degenerative joint disease in the target knee as determined by Kellgren and Lawrence grade ≥2 based on X-ray evaluation performed within 9 months from screening. Patient has patellofemoral dysplasia Dejour Grade B-D based on X-ray evaluation performed within 9 months from screening Patient has malalignment (valgus- or varus-deformity) in the target knee ≥ 5° based on X-ray evaluation performed within 9 months from screening. In suspected cases, the mechanical axis must be established radiographically through complete leg imaging during standing and in postero-anterior (PA) projection. Exclusion Criteria Part B only Regular smokers (> 10 cigarettes/day). Clinical signs of inflammation (i.e., redness) in the target knee. History of knee replacement (unilateral or total) in either knee. Presence of severe hip OA conditioning lower limb function according to PI's evaluation. Nephrotic syndrome and/or significant proteinuria History of coagulopathy or medical condition requiring anticoagulation which would preclude knee injection Patient has malalignment (valgus- or varus-deformity) in the target knee ≥ 7.5° based on X-ray evaluation. In suspected cases, the mechanical axis must be established radiographically through complete leg imaging during standing and in postero-anterior (PA) projection.
Facility Information:
Facility Name
Novartis Investigative Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85053
Country
United States
Facility Name
Novartis Investigative Site
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Novartis Investigative Site
City
Sacramento
State/Province
California
ZIP/Postal Code
95821
Country
United States
Facility Name
Novartis Investigative Site
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33014
Country
United States
Facility Name
Novartis Investigative Site
City
Sunrise
State/Province
Florida
ZIP/Postal Code
33351
Country
United States
Facility Name
Novartis Investigative Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33603
Country
United States
Facility Name
Novartis Investigative Site
City
Boise
State/Province
Idaho
ZIP/Postal Code
83702
Country
United States
Facility Name
Novartis Investigative Site
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Novartis Investigative Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Novartis Investigative Site
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89119
Country
United States
Facility Name
Novartis Investigative Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
Novartis Investigative Site
City
Brno
State/Province
Czech Republic
ZIP/Postal Code
66250
Country
Czechia
Facility Name
Novartis Investigative Site
City
Mlada Boleslav
State/Province
Czech Republic
ZIP/Postal Code
29301
Country
Czechia
Facility Name
Novartis Investigative Site
City
Kladno
ZIP/Postal Code
272 59
Country
Czechia
Facility Name
Novartis Investigative Site
City
Kolin
ZIP/Postal Code
280 02
Country
Czechia
Facility Name
Novartis Investigative Site
City
Pardubice
ZIP/Postal Code
53002
Country
Czechia
Facility Name
Novartis Investigative Site
City
Praha
Country
Czechia
Facility Name
Novartis Investigative Site
City
Aarhus C
ZIP/Postal Code
DK 8000
Country
Denmark
Facility Name
Novartis Investigative Site
City
Hvidovre
ZIP/Postal Code
2650
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com

Learn more about this trial

Study of Safety, Tolerability, Preliminary Efficacy of Intra-articular LNA043 Injections in Patients With Articular Cartilage Lesions and Knee Osteoarthritis.

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