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Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain

Primary Purpose

Osteoarthritis, Knee

Status
Completed
Phase
Phase 1
Locations
Australia
Study Type
Interventional
Intervention
XT-150
Sponsored by
Xalud Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring inflammation, cytokine, anti-inflammatory, pain

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, between 18 and 90 years of age, inclusive. Women who are not of child-bearing potential in the same age range.
  2. Sufficiently severe OA of knee to require/have recommended knee replacement surgery or be unsuitable for knee replacement surgery or be unsuitable for knee replacement surgery based on co-morbidities or orthopedic considerations; be free of local or intra-articular infection.
  3. Symptomatic disease because of osteoarthritis, defined as one or more of the following Verbal Numerical Rating Scale (VNRS) scores:

    1. a worst pain of at least 7 at any time during the preceding week (based on scale of 0 to 10, with 10 representing "pain as bad as you can imagine").
    2. a worst stiffness of at least 7 at any time during the preceding week (based on a scale of 0 to 10, with 10 representing "stiffness as bad as you can imagine").
  4. Stable analgesic regimen during the 4 weeks prior to enrollment.
  5. Inadequate pain relief (mean >5 mean on Brief Pain Inventory-Severity Scale) from prior therapies lasting 3 months.
  6. In the judgment of the Investigator, acceptable general medical condition
  7. Life expectancy >6 months
  8. Male participants who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study and for 3 months after the study is completed.
  9. Have suitable knee joint anatomy for intra-articular injection
  10. Willing and able to return for the follow-up (FU) visits
  11. Able to reliably provide pain assessment
  12. Able to read and understand study instructions, and willing and able to comply with all study procedures

Exclusion Criteria:

  1. Hypersensitivity, allergy, or significant reaction to any ingredient of the study drug, including double-stranded DNA, mannose, and sucrose
  2. Scheduled knee replacement within 4 months; participant agrees not to schedule a knee replacement appointment within 4 months of study treatment
  3. History of rheumatoid arthritis of the knee
  4. High peri-operative risks which in the judgment of the investigator preclude a safe knee injection procedure (e.g., poorly controlled diabetes, cardiac inadequacy such as NYHA class > II, G4 glomerular filtration rate [eGFR < 30 mL/min by Cockcroft-Gault])
  5. Current treatment with immunosuppressive (systemic corticosteroid therapy [equivalent to >10mg/day prednisone] or other strong immunosuppressant)
  6. History of immunosuppressive therapy; high-potency systemic steroids in the last 3 months.
  7. Currently receiving systemic chemotherapy or radiation therapy for malignancy
  8. Clinically significant hepatic disease as indicated by clinical laboratory results ≥3 times the upper limit of normal for any liver function test (e.g., aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase)
  9. Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), uncontrolled coagulopathy (Grade 1, prolonged activated partial prothrombin time (aPTT) > upper limit of normal (ULN) to 1.5xULN), or bleeding diathesis, Grade 1 white cell counts (lymphocytes <LLN - 800/mm3; <LLN - 0.8 x 10e9 /L, neutrophils <LLN - 1500/mm3; <LLN - 1.5 x 10e9 /L)
  10. Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus within 4 weeks of commencing the study
  11. Significant neuropsychiatric conditions; dementia, major depression, or altered mental state that in the opinion of the Investigator will interfere with study participation
  12. Current treatment with systemic antibiotics or antivirals (EXCEPTION: topical treatments)
  13. Current treatment with anticoagulants, other than low-dose aspirin, prescribed for new onset of symptoms in 3 months before screening visit.
  14. Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit
  15. Women of child-bearing potential
  16. Use of any investigational drug or device within 1 month before enrollment or current participation in a trial that included intervention with a drug or device; or currently participating in an investigational drug or device study.
  17. Any condition that, in the opinion of the Principal Investigator, could compromise the safety of the participant, the participant's ability to communicate the study staff, or the quality of the data

Sites / Locations

  • CMAX Clinical Research Pty Ltd in collaboration with University of Adelaide

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Dose 1

Dose 2

Dose 3

Saline placebo

Arm Description

Lowest trial dose of XT-150

Second, escalating dose of XT-150

Third, escalating dose of XT-150

2 of 8 participants in each cohort will randomly be assigned to placebo

Outcomes

Primary Outcome Measures

Incidence of Treatment-Emergent Adverse Events [Safety]
Clinical Pathology, Adverse Events

Secondary Outcome Measures

Verbal Numerical Rating Scale
0 - 10 Pain assessment

Full Information

First Posted
September 11, 2017
Last Updated
July 2, 2019
Sponsor
Xalud Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03282149
Brief Title
Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain
Official Title
A Placebo-controlled, Preliminary Evaluation of Safety, Tolerability, and Efficacy of Ascending Doses of XT-150 for the Treatment of Osteoarthritic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
July 2019
Overall Recruitment Status
Completed
Study Start Date
March 21, 2018 (Actual)
Primary Completion Date
March 31, 2019 (Actual)
Study Completion Date
June 15, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xalud Therapeutics, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain - Dose escalation
Detailed Description
Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain. Subjects for whom replacement knee surgery is recommended will be enrolled in the study. A single injection of a DNA plasmid with a variant Interleukin-10 (IL-10) transgene will be injected into the synovial capsule of the knee. This is a first in human, dose-range, safety and efficacy study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee
Keywords
inflammation, cytokine, anti-inflammatory, pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Inflammation and pain due to osteoarthritis in the knee
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Unblinded pharmacy provides injection preparation for blinded administration
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dose 1
Arm Type
Experimental
Arm Description
Lowest trial dose of XT-150
Arm Title
Dose 2
Arm Type
Experimental
Arm Description
Second, escalating dose of XT-150
Arm Title
Dose 3
Arm Type
Experimental
Arm Description
Third, escalating dose of XT-150
Arm Title
Saline placebo
Arm Type
Placebo Comparator
Arm Description
2 of 8 participants in each cohort will randomly be assigned to placebo
Intervention Type
Biological
Intervention Name(s)
XT-150
Intervention Description
IL-10 transgene DNA plasmid injected into the knee synovial capsule
Primary Outcome Measure Information:
Title
Incidence of Treatment-Emergent Adverse Events [Safety]
Description
Clinical Pathology, Adverse Events
Time Frame
180 days post treatment
Secondary Outcome Measure Information:
Title
Verbal Numerical Rating Scale
Description
0 - 10 Pain assessment
Time Frame
180 days post treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, between 18 and 90 years of age, inclusive. Women who are not of child-bearing potential in the same age range. Sufficiently severe OA of knee to require/have recommended knee replacement surgery or be unsuitable for knee replacement surgery or be unsuitable for knee replacement surgery based on co-morbidities or orthopedic considerations; be free of local or intra-articular infection. Symptomatic disease because of osteoarthritis, defined as one or more of the following Verbal Numerical Rating Scale (VNRS) scores: a worst pain of at least 7 at any time during the preceding week (based on scale of 0 to 10, with 10 representing "pain as bad as you can imagine"). a worst stiffness of at least 7 at any time during the preceding week (based on a scale of 0 to 10, with 10 representing "stiffness as bad as you can imagine"). Stable analgesic regimen during the 4 weeks prior to enrollment. Inadequate pain relief (mean >5 mean on Brief Pain Inventory-Severity Scale) from prior therapies lasting 3 months. In the judgment of the Investigator, acceptable general medical condition Life expectancy >6 months Male participants who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study and for 3 months after the study is completed. Have suitable knee joint anatomy for intra-articular injection Willing and able to return for the follow-up (FU) visits Able to reliably provide pain assessment Able to read and understand study instructions, and willing and able to comply with all study procedures Exclusion Criteria: Hypersensitivity, allergy, or significant reaction to any ingredient of the study drug, including double-stranded DNA, mannose, and sucrose Scheduled knee replacement within 4 months; participant agrees not to schedule a knee replacement appointment within 4 months of study treatment History of rheumatoid arthritis of the knee High peri-operative risks which in the judgment of the investigator preclude a safe knee injection procedure (e.g., poorly controlled diabetes, cardiac inadequacy such as NYHA class > II, G4 glomerular filtration rate [eGFR < 30 mL/min by Cockcroft-Gault]) Current treatment with immunosuppressive (systemic corticosteroid therapy [equivalent to >10mg/day prednisone] or other strong immunosuppressant) History of immunosuppressive therapy; high-potency systemic steroids in the last 3 months. Currently receiving systemic chemotherapy or radiation therapy for malignancy Clinically significant hepatic disease as indicated by clinical laboratory results ≥3 times the upper limit of normal for any liver function test (e.g., aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase) Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), uncontrolled coagulopathy (Grade 1, prolonged activated partial prothrombin time (aPTT) > upper limit of normal (ULN) to 1.5xULN), or bleeding diathesis, Grade 1 white cell counts (lymphocytes <LLN - 800/mm3; <LLN - 0.8 x 10e9 /L, neutrophils <LLN - 1500/mm3; <LLN - 1.5 x 10e9 /L) Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus within 4 weeks of commencing the study Significant neuropsychiatric conditions; dementia, major depression, or altered mental state that in the opinion of the Investigator will interfere with study participation Current treatment with systemic antibiotics or antivirals (EXCEPTION: topical treatments) Current treatment with anticoagulants, other than low-dose aspirin, prescribed for new onset of symptoms in 3 months before screening visit. Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit Women of child-bearing potential Use of any investigational drug or device within 1 month before enrollment or current participation in a trial that included intervention with a drug or device; or currently participating in an investigational drug or device study. Any condition that, in the opinion of the Principal Investigator, could compromise the safety of the participant, the participant's ability to communicate the study staff, or the quality of the data
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Rickman, MD
Organizational Affiliation
University of Adelaide
Official's Role
Principal Investigator
Facility Information:
Facility Name
CMAX Clinical Research Pty Ltd in collaboration with University of Adelaide
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5005
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
All data will be de-identified in a clinical trial database

Learn more about this trial

Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain

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