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Trial to Evaluate Efficacy and Safety of Combination of Diacerein and Celecoxib Administered in Patients With Knee OA (DIA IIT_01)

Primary Purpose

Knee Osteoarthritis

Status
Unknown status
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Diacerein
Celecoxib
Sponsored by
Whan-Seok Choi
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Knee Osteoarthritis, Diacerein

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects who voluntarily consented, after listening enough explanation for this study and investigational product.
  2. Adult over 50 years of age.
  3. At least one of the knee pain VAS score is 40mm or more.
  4. Meets the ACR(American College of Rheumatology) criteria for diagnosis. (1) Confirmation of osteophytes on radiographic inspection. (2) One or more of the following three items.

    ① Age> 50 years

    ② Morning stiffness <30 minutes

    ③ Crepitus

  5. Patients who require medication for more than 12 weeks due to osteoarthritis symptoms.
  6. Those who are able to follow the requirements of this clinical trial, such as being able to trace during the clinical trial period and to read and write the VAS questionnaire.
  7. Those who weigh more than 40kg

Exclusion Criteria:

  1. Secondary knee osteoarthritis
  2. Other inflammatory Knee Osteoarthritis (e.g. gout, rheumatoid arthritis, etc.)
  3. Patients presenting with gastroesophageal reflux disease, peptic ulcer.
  4. Helicobacter infected patients who have not been treated for eradication (recruitment if negative in re-examination after treatment).
  5. Short bowel syndrome that can cause inflammatory bowel disease (ulcerative colitis, Crohn's disease) and drug absorption disorder.
  6. Intestinal obstruction syndrome
  7. Unexplained abdominal pain
  8. ALT(Alanine aminotransferase) level of liver function test exceeded 5 times of reference range
  9. Total bilirubin level exceeded 2 mg / dL
  10. Serum albumin level less than 2 g / dL
  11. Ascites
  12. Hepatic encephalopathy
  13. Hepatitis B, hepatitis C (excluding healthy carriers) or HIV positive
  14. MDRD(Modification of Diet in Renal Disease) Estimated Glomerular filtration rate less than 60 mL / m2
  15. Patients with hyperkalemia (over 5.5 meq / L)
  16. history of asthma, acute rhinitis, nasal polyps, angioedema, urticaria or allergic reactions to aspirin or other non-steroidal anti-inflammatory drugs(including COX-2 inhibitors).
  17. Malignant tumors other than basal cell or squamous cell carcinoma of the skin, CIN(Cervical Intraepitherial Neoplasia) and CIS(Carcinoma in situ) of the cervix, and intraepithelial carcinoma of other areas Within 5 years of consent date.
  18. Medical history of hypersensitivity to the components of the investigational products. (The components of test drug 1 and 2, including the Rhein-based drug)
  19. Patients with an allergic reaction to sulfonamide.
  20. Patients with galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption.
  21. Subjects who have not reached the prescribed period after receiving contraindicated medication or treatment before participation in this clinical trial.
  22. Patients receiving contraindicated medication.
  23. Alcohol and other drug abuse cases based on 6 months before screening.
  24. Pregnant women or nursing mothers who are not willing to stop breastfeeding.
  25. Female who do not fall into one or more of the following categories(In other words, only the following female can participate:)

    • (1) Menopause (non-therapy-induced amenorrhea of more than 12 months) Female
    • (2) Female infertility due to surgery (no ovaries and / or uterus)
    • (3) If you have sexual intercourse with only one male partner who has been confirmed to have no semen after fertilization.
    • (4) Female subjects who agreed to abstinence during the clinical trial period.
    • If the subject is assured of an abstinence throughout the trial period.(e.g. clergy)
    • However, intermittent abstinence (eg, contraception using ovulation period, symptothermal) or coitus interrupts is not a case of consent for abstinence.
    • (5) For women of childbearing age, the following methods or methods of contraception use the effective method of contraception to be used during the period of this clinical trial:
    • Oral contraceptive
    • The contraceptive patch
    • Intra uterine device (IUD)
    • contraceptive implant
    • contraceptive injection
    • intrauterine hormonal apparatus
    • Tubal ligation and infertility surgery
  26. If 30 days have not elapsed after the date of signing of the previous clinical trial or currently participating in other clinical trials.
  27. Patients who are scheduled for surgery during the clinical trial period or who have difficulties in completing the protocol during this clinical trial due to other reasons.
  28. In addition to the above, other diseases that the investigator judges to be inappropriate.

Sites / Locations

  • Seoul ST. Mary's HospitalRecruiting
  • Korea University Guro HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

Co-administration group

Single administration group 1

Single administration group 2

Arm Description

Co-administration of Diacerein 50mg, Celecoxib 100mg.

Single administration of Diacerein 50mg and placebo.

Single administration of Celecoxib 100mg and placebo.

Outcomes

Primary Outcome Measures

pain VAS score
Changes in pain VAS(Visual analogue scale) score before and after 12 weeks of drugs administration. (No pain score: 0, Worst pain score: 100)

Secondary Outcome Measures

pain NRS score
Changes in pain NRS(Numeric rating scale) score before and after 12 weeks of drugs administration. (No pain score: 0, Worst pain score: 10)
WOMAC index score
Changes in WOMAC(Western Ontario and mcmaster Universities Osteoarthritis Index) index score before and after 12 weeks of drugs administration (possible score range, Pain: 0-20, Stiffness: 0-8, Physical function: 0-68; Total Score range: 0-96 ('none' to 'extreme'))
GSRS index score
Changes in GSRS(Gastrointestinal symptom rating scale) index score before and after 12 weeks of drugs administration. (Score range: 0-45 ('none' to 'extreme'))

Full Information

First Posted
January 12, 2018
Last Updated
February 22, 2018
Sponsor
Whan-Seok Choi
Collaborators
Korea University Guro Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03404479
Brief Title
Trial to Evaluate Efficacy and Safety of Combination of Diacerein and Celecoxib Administered in Patients With Knee OA
Acronym
DIA IIT_01
Official Title
A Prospective, Randomized, Double-blinded, Multi-center, Trial to Evaluate Efficacy and Safety of Combination of Diacerein and Celecoxib Administered Orally in Patients With Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
February 2018
Overall Recruitment Status
Unknown status
Study Start Date
January 25, 2018 (Actual)
Primary Completion Date
January 2, 2019 (Anticipated)
Study Completion Date
January 2, 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Whan-Seok Choi
Collaborators
Korea University Guro Hospital

4. Oversight

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

5. Study Description

Brief Summary
The purpose of this study is to evaluate the pain relief effect of Co-administration of Diacerein with Celecoxib in patients with knee osteoarthritis compared with single administration of each drug.
Detailed Description
A large epidemiological study in Europe reported that over four-thirds of patients with osteoarthritis received combination therapy with two or more drugs. Approximately 1.5% of patients with osteoarthritis using three or more drugs are using COX-2(Cyclo-oxygenase-2) inhibitors and SYSADOA(Symptomatic slow acting drug), And it has been investigated that much more patients are using the two classes of drugs when the range is extended to other oral NSAIDs other than COX-2 inhibitors. Therefore, considering the characteristics of patients with osteoarthritis, such as basal disease and treatment effects on each type of drug, it is important to find the optimal combination of drugs for each patient characteristics. There is a previous study using osteoarthritis rat model as a biological basis of diacerein and celecoxib administration. Previous studies have shown that the combined use of Diacerein and Celecoxib improves osteoarthritis. The purpose of this study is to evaluate the pain relief effect of Co-administration of Diacerein with Celecoxib in patients with knee osteoarthritis compared with single administration of each drug.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Co-administration group
Arm Type
Experimental
Arm Description
Co-administration of Diacerein 50mg, Celecoxib 100mg.
Arm Title
Single administration group 1
Arm Type
Active Comparator
Arm Description
Single administration of Diacerein 50mg and placebo.
Arm Title
Single administration group 2
Arm Type
Active Comparator
Arm Description
Single administration of Celecoxib 100mg and placebo.
Intervention Type
Drug
Intervention Name(s)
Diacerein
Intervention Description
For 12 weeks, administered twice a day by oral.
Intervention Type
Drug
Intervention Name(s)
Celecoxib
Intervention Description
For 12 weeks, administered twice a day by oral.
Primary Outcome Measure Information:
Title
pain VAS score
Description
Changes in pain VAS(Visual analogue scale) score before and after 12 weeks of drugs administration. (No pain score: 0, Worst pain score: 100)
Time Frame
12 weeks after randomization
Secondary Outcome Measure Information:
Title
pain NRS score
Description
Changes in pain NRS(Numeric rating scale) score before and after 12 weeks of drugs administration. (No pain score: 0, Worst pain score: 10)
Time Frame
12 weeks after randomization
Title
WOMAC index score
Description
Changes in WOMAC(Western Ontario and mcmaster Universities Osteoarthritis Index) index score before and after 12 weeks of drugs administration (possible score range, Pain: 0-20, Stiffness: 0-8, Physical function: 0-68; Total Score range: 0-96 ('none' to 'extreme'))
Time Frame
12 weeks after randomization
Title
GSRS index score
Description
Changes in GSRS(Gastrointestinal symptom rating scale) index score before and after 12 weeks of drugs administration. (Score range: 0-45 ('none' to 'extreme'))
Time Frame
12 weeks after randomization

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects who voluntarily consented, after listening enough explanation for this study and investigational product. Adult over 50 years of age. At least one of the knee pain VAS score is 40mm or more. Meets the ACR(American College of Rheumatology) criteria for diagnosis. (1) Confirmation of osteophytes on radiographic inspection. (2) One or more of the following three items. ① Age> 50 years ② Morning stiffness <30 minutes ③ Crepitus Patients who require medication for more than 12 weeks due to osteoarthritis symptoms. Those who are able to follow the requirements of this clinical trial, such as being able to trace during the clinical trial period and to read and write the VAS questionnaire. Those who weigh more than 40kg Exclusion Criteria: Secondary knee osteoarthritis Other inflammatory Knee Osteoarthritis (e.g. gout, rheumatoid arthritis, etc.) Patients presenting with gastroesophageal reflux disease, peptic ulcer. Helicobacter infected patients who have not been treated for eradication (recruitment if negative in re-examination after treatment). Short bowel syndrome that can cause inflammatory bowel disease (ulcerative colitis, Crohn's disease) and drug absorption disorder. Intestinal obstruction syndrome Unexplained abdominal pain ALT(Alanine aminotransferase) level of liver function test exceeded 5 times of reference range Total bilirubin level exceeded 2 mg / dL Serum albumin level less than 2 g / dL Ascites Hepatic encephalopathy Hepatitis B, hepatitis C (excluding healthy carriers) or HIV positive MDRD(Modification of Diet in Renal Disease) Estimated Glomerular filtration rate less than 60 mL / m2 Patients with hyperkalemia (over 5.5 meq / L) history of asthma, acute rhinitis, nasal polyps, angioedema, urticaria or allergic reactions to aspirin or other non-steroidal anti-inflammatory drugs(including COX-2 inhibitors). Malignant tumors other than basal cell or squamous cell carcinoma of the skin, CIN(Cervical Intraepitherial Neoplasia) and CIS(Carcinoma in situ) of the cervix, and intraepithelial carcinoma of other areas Within 5 years of consent date. Medical history of hypersensitivity to the components of the investigational products. (The components of test drug 1 and 2, including the Rhein-based drug) Patients with an allergic reaction to sulfonamide. Patients with galactose intolerance, lapp lactase deficiency or glucose-galactose malabsorption. Subjects who have not reached the prescribed period after receiving contraindicated medication or treatment before participation in this clinical trial. Patients receiving contraindicated medication. Alcohol and other drug abuse cases based on 6 months before screening. Pregnant women or nursing mothers who are not willing to stop breastfeeding. Female who do not fall into one or more of the following categories(In other words, only the following female can participate:) (1) Menopause (non-therapy-induced amenorrhea of more than 12 months) Female (2) Female infertility due to surgery (no ovaries and / or uterus) (3) If you have sexual intercourse with only one male partner who has been confirmed to have no semen after fertilization. (4) Female subjects who agreed to abstinence during the clinical trial period. If the subject is assured of an abstinence throughout the trial period.(e.g. clergy) However, intermittent abstinence (eg, contraception using ovulation period, symptothermal) or coitus interrupts is not a case of consent for abstinence. (5) For women of childbearing age, the following methods or methods of contraception use the effective method of contraception to be used during the period of this clinical trial: Oral contraceptive The contraceptive patch Intra uterine device (IUD) contraceptive implant contraceptive injection intrauterine hormonal apparatus Tubal ligation and infertility surgery If 30 days have not elapsed after the date of signing of the previous clinical trial or currently participating in other clinical trials. Patients who are scheduled for surgery during the clinical trial period or who have difficulties in completing the protocol during this clinical trial due to other reasons. In addition to the above, other diseases that the investigator judges to be inappropriate.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yu-na Jo
Phone
82-70-4335-5448
Email
ynjo@symyoo.com
First Name & Middle Initial & Last Name or Official Title & Degree
Sung Woon Yang
Phone
82-31-354-0604
Email
yangsw7@naver.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Whan-Seok Choi, MD, PhD
Organizational Affiliation
Seoul St. Mary's Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Seon-Mee Kim, MD, PhD
Organizational Affiliation
Korea University Guro Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul ST. Mary's Hospital
City
Seoul
ZIP/Postal Code
06591
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Whan-Seok Choi, M.D., Ph.D.
Phone
82-2-2258-6285
Email
fmchs@catholic.ac.kr
First Name & Middle Initial & Last Name & Degree
Whan-Seok Choi, M.D., Ph.D
First Name & Middle Initial & Last Name & Degree
Chul-Min Kim, M.D., Ph.D
First Name & Middle Initial & Last Name & Degree
Ji Hyeon Ju, M.D., Ph.D
Facility Name
Korea University Guro Hospital
City
Seoul
ZIP/Postal Code
08308
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Seon-Mee Kim, MD, PhD
Phone
82-2-2626-3276
Email
ksmpdh@korea.ac.kr
First Name & Middle Initial & Last Name & Degree
Seon-Mee Kim, M.D., Ph.D.

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
25687638
Citation
Li Z, Meng D, Li G, Xu J, Tian K, Li Y. Celecoxib Combined with Diacerein Effectively Alleviates Osteoarthritis in Rats via Regulating JNK and p38MAPK Signaling Pathways. Inflammation. 2015 Aug;38(4):1563-72. doi: 10.1007/s10753-015-0131-3.
Results Reference
background
PubMed Identifier
22870441
Citation
Martel-Pelletier J, Pelletier JP. Effects of diacerein at the molecular level in the osteoarthritis disease process. Ther Adv Musculoskelet Dis. 2010 Apr;2(2):95-104. doi: 10.1177/1759720X09359104.
Results Reference
background
PubMed Identifier
25652235
Citation
Panova E, Jones G. Benefit-risk assessment of diacerein in the treatment of osteoarthritis. Drug Saf. 2015 Mar;38(3):245-52. doi: 10.1007/s40264-015-0266-z.
Results Reference
background
PubMed Identifier
9839088
Citation
Nicolas P, Tod M, Padoin C, Petitjean O. Clinical pharmacokinetics of diacerein. Clin Pharmacokinet. 1998 Nov;35(5):347-59. doi: 10.2165/00003088-199835050-00002.
Results Reference
background

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Trial to Evaluate Efficacy and Safety of Combination of Diacerein and Celecoxib Administered in Patients With Knee OA

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