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Intra-articular Polyacrylamide Hydrogel in Knee Osteoarthritis

Primary Purpose

Osteoarthritis

Status
Unknown status
Phase
Not Applicable
Locations
Russian Federation
Study Type
Interventional
Intervention
hydrous biopolymer with silver ions "Argiform"
saline solution
Sponsored by
Research Centre BIOFORM
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis focused on measuring intra-articular, polyacrylamide hydrogel

Eligibility Criteria

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

Inclusion Criteria:

  • Verified knee osteoarthritis in accordance with the ACR (knee pain combined with one of the following signs: age above 50 years, knee crepitus or morning joint stiffness lasting for less than 30 minutes combined with radiologic signs of knee osteoarthritis);
  • Kellgren Lawrence radiological grade II-III knee osteoarthritis with the predominant involvement of the medial tibiofemoral region of the knee joint;
  • Joint space width (JSW) of the target knee joint at least 2.5 mm.

Exclusion Criteria:

  1. History of any injury or surgical intervention on the target knee joint (except for diagnostic arthroscopy made not longer than 60 days at the study entry);
  2. Severe degenerative changes in the target knee joint determined as the joint space narrowing less than 2 mm;
  3. Varus or valgus deformation of the target knee joint;
  4. Instability of the target knee joint;
  5. Active inflammation of the target knee joint (edema, hyperemia, present effusion) at the study entry;
  6. Microcrystalline arthropathies;
  7. Systemic inflammatory disease (rheumatoid arthritis, systemic lupus erythematosus, etc.);
  8. Seronegative spondyloarthritis and reactive arthritis;
  9. Inflammatory diseases of the skin and soft tissues in the proposed injection site for the test MD or placebo in the target joint;
  10. History of venous thrombosis and thromboembolia;
  11. Coagulogram abnormalities (APTT, prothrombin time, prothrombin index, fibrinogen);
  12. Inflammatory changes in the complete blood count (leukocytosis, increase of erythrocyte sedimentation rate [ESR]);
  13. Platelet count abnormality (in accordance with the reference ranges of the local laboratory;
  14. Increase of rheumatoid factor level;
  15. Increase of uric acid level > 360 μmol/l;
  16. Diabetes mellitus;
  17. Hemophilia and other hemorrhagic diatheses, as well administration of anticoagulants and disaggregants;
  18. Positive results of HIV, HBs-Ag, anti-HCV, RW tests;
  19. Intra-articular injection to the target knee joint:

    • Noltrex - within 24 months prior patient's inclusion to the study;
    • hyaluronates - within 6 months prior patient's inclusion to the study;
    • glucocorticosteroids - within 1 month prior the study inclusion;
    • non-steroidal anti-inflammatory drugs (NSAID) - within 3 weeks prior patient's inclusion to the study.
  20. Oral administration of non-steroidal anti-inflammatory drugs (NSAID) within 2 weeks prior the study inclusion;
  21. Necessity of systemic glucocorticosteroids in any dosage form;
  22. Paracetamol administration within 48 hours prior the study inclusion;
  23. Pregnancy and lactation;
  24. Hypersensitivity to components of the test MD or placebo;
  25. Severe liver disorder determined as the increase of one of the values: ALT, AST, ALP, total bilirubin, GGTP more than 3 times the upper limit of normal;
  26. Renal diseases with the glomerular filtration rate estimated per Cockraft-Gault formula less than 60 ml/min/1.73 m2 (III-V stage chronic renal disease [CRD]);
  27. Clinically manifest hip osteoarthritis;
  28. History of knee and coxofemoral endoprosthesis;
  29. Acute infectious diseases or infectious aggravations of chronic diseases (respiratory infections) within one month prior the study inclusion;
  30. Severe decompensated chronic or acute diseases and other conditions which, by the opinion of the study physician, may preclude the patient's participation in the study or affect the study results.

Sites / Locations

  • Non-budgetary healthcare facility "Railway clinical hospital n.a. Semashko N.A. at Lublino, OJSC "Russian Railways"
  • "Clinical Diagnostic Center "Ultramed", LLC
  • Private Healthcare Facilty "Clinical hospital "RZHD-Medicina" of the city Saint-Petersburg
  • State budgetary healthcare facility of Yaroslavl Region "Clinical hospital №3"

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

NOLTREX™, II-III grade OA

Placebo, II-III grade ОА

Arm Description

72 patients with II-III grade of gonarthrosis will randomised to receive PAHG

72 patients with II-III grade of gonarthrosis will randomised to receive saline solution

Outcomes

Primary Outcome Measures

Change of the total WOMAC score (WOMAC-T)
Estimated per the corresponding subscales and total arthritis index score developed by WOMAC

Secondary Outcome Measures

The total score
Change of the total score of WOMAC scale (WOMAC-T)
The pain
Change of the pain subscale score (WOMAC-A)
The rigidity and functionality
Change of rigidity (WOMAC-B) and functionality (WOMAC-C) subscale scores
Patient's assessment of the treatment efficacy
per scale from 1 - evident aggravation to 6 - significant improvement
Investigator's assessment of the treatment efficacy
per scale from 1 - evident aggravation to 6 - significant improvement
Assessment of the total number of paracetamol tablets taken
the need in paracetamol intake to relieve the knee pain during administration of intra-articular MD NOLTREX™ in comparison with placebo
Patient withdrawal rates due to safety
Proportion of patient who left the study due to: Need in paracetamol intake due to knee osteoarthritis 4 days a week and more during 2 successive weeks; The investigator makes the decision that a patient should discontinue the study in the best interests of the patient; Individual intolerability or contraindications to the test MD, placebo or paracetamol; AE/SAE which requires examination and/or treatment affecting significantly the study procedures (in particular, in particular, development of active arthritis or hemarthrosis of the target knee joint).
Patient withdrawal rates due to poor patient's treatment compliance
Proportion of patient who left the study due to: Informed consent withdrawal (patient's unwillingness to continue the study); Major deviation from the study protocol.
Intensity of pain in the target knee joint (100-mm VAS)
Assessment of pain intensity in the target knee joint per mm visual analogous scale (100-mm VAS)

Full Information

First Posted
March 26, 2019
Last Updated
July 30, 2020
Sponsor
Research Centre BIOFORM
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1. Study Identification

Unique Protocol Identification Number
NCT03897686
Brief Title
Intra-articular Polyacrylamide Hydrogel in Knee Osteoarthritis
Official Title
Multicenter Double-blind Randomized Comparative Placebo-controlled Study of Efficacy and Safety of Intra-articular Polyacrylamide Hydrogel With Silver Ions (NOLTREX™) in Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Unknown status
Study Start Date
November 29, 2019 (Actual)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Research Centre BIOFORM

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 aim of this double-blinded controlled study is to assess clinical efficacy and safety of intra-articular polyacrylamide hydrogel with ions of silver in comparison with placebo (0.9% sodium chloride solution) in Kellgren Lawrence radiological grade II-III knee osteoarthritis
Detailed Description
Polyacrylamide hydrogel (hereinafter - PAHG) is intended for a symptomatic effect leading to the decrease of joint pain intensity and improvement of functional joint characteristics. Therefore PAHG is intended for symptom-modifying therapy of joint osteoarthritis (hereinafter - OA). The aim of this study is to estimate efficacy and safety of intra-articular injections of PAHG in comparison with saline solution. Men and women above 50 years with verified knee osteoarthritis in accordance with the ACR criteria will be randomized 2 groups depends on treatment (PAHG or saline solution). Each patient will receive to the target knee joint 4.0 ml for one injection either PAHG or placebo with one-week interval between injections. Course - 2 injections. To avoid the joint overfilling with the dense, slowly resorbing material, with a good clinical result, the course of injections will be stopped. Primary and secondary efficacy endpoints, and safety parameters will be assessed on visits on Week 6, 13 and 25.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis
Keywords
intra-articular, polyacrylamide hydrogel

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
multicenter double-blind randomized comparative placebo-controlled
Masking
ParticipantInvestigator
Masking Description
A patient, study investigator and Sponsor representative (monitoring specialist) will not know to which group a patient is included. to preserve blinding of any patient and study team, an independent unblended physician is to be engaged, he/she will receive the product per randomization code and perform the procedure of intra-articular injection of the study MD and placebo.
Allocation
Randomized
Enrollment
144 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
NOLTREX™, II-III grade OA
Arm Type
Experimental
Arm Description
72 patients with II-III grade of gonarthrosis will randomised to receive PAHG
Arm Title
Placebo, II-III grade ОА
Arm Type
Placebo Comparator
Arm Description
72 patients with II-III grade of gonarthrosis will randomised to receive saline solution
Intervention Type
Device
Intervention Name(s)
hydrous biopolymer with silver ions "Argiform"
Other Intervention Name(s)
polyacrylamide hydrogel with ions of silver, Synovial fluid endoprosthesis NOLTREX™
Intervention Description
4.0 ml for one injection with one-week interval between injections. Course - 2 injections.
Intervention Type
Device
Intervention Name(s)
saline solution
Intervention Description
4.0 ml for one injection with one-week interval between injections. Course - 2 injections.
Primary Outcome Measure Information:
Title
Change of the total WOMAC score (WOMAC-T)
Description
Estimated per the corresponding subscales and total arthritis index score developed by WOMAC
Time Frame
at Week 25 in comparison with baseline at Week 1
Secondary Outcome Measure Information:
Title
The total score
Description
Change of the total score of WOMAC scale (WOMAC-T)
Time Frame
at Week 13 in comparison with baseline at Week 1
Title
The pain
Description
Change of the pain subscale score (WOMAC-A)
Time Frame
at Week 6, Week 13 and Week 25 and in comparison with baseline at Week 1
Title
The rigidity and functionality
Description
Change of rigidity (WOMAC-B) and functionality (WOMAC-C) subscale scores
Time Frame
at Week 6, Week 13 and Week 25 and in comparison with baseline at Week 1
Title
Patient's assessment of the treatment efficacy
Description
per scale from 1 - evident aggravation to 6 - significant improvement
Time Frame
Week 6, Week 13 and Week 25
Title
Investigator's assessment of the treatment efficacy
Description
per scale from 1 - evident aggravation to 6 - significant improvement
Time Frame
Week 6, Week 13 and Week 25
Title
Assessment of the total number of paracetamol tablets taken
Description
the need in paracetamol intake to relieve the knee pain during administration of intra-articular MD NOLTREX™ in comparison with placebo
Time Frame
Week 6, Week 13 and Week 25
Title
Patient withdrawal rates due to safety
Description
Proportion of patient who left the study due to: Need in paracetamol intake due to knee osteoarthritis 4 days a week and more during 2 successive weeks; The investigator makes the decision that a patient should discontinue the study in the best interests of the patient; Individual intolerability or contraindications to the test MD, placebo or paracetamol; AE/SAE which requires examination and/or treatment affecting significantly the study procedures (in particular, in particular, development of active arthritis or hemarthrosis of the target knee joint).
Time Frame
Week 25
Title
Patient withdrawal rates due to poor patient's treatment compliance
Description
Proportion of patient who left the study due to: Informed consent withdrawal (patient's unwillingness to continue the study); Major deviation from the study protocol.
Time Frame
Week 25
Title
Intensity of pain in the target knee joint (100-mm VAS)
Description
Assessment of pain intensity in the target knee joint per mm visual analogous scale (100-mm VAS)
Time Frame
Week 1, Week 2

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Verified knee osteoarthritis in accordance with the ACR (knee pain combined with one of the following signs: age above 50 years, knee crepitus or morning joint stiffness lasting for less than 30 minutes combined with radiologic signs of knee osteoarthritis); Kellgren Lawrence radiological grade II-III knee osteoarthritis with the predominant involvement of the medial tibiofemoral region of the knee joint; Joint space width (JSW) of the target knee joint at least 2.5 mm. Exclusion Criteria: History of any injury or surgical intervention on the target knee joint (except for diagnostic arthroscopy made not longer than 60 days at the study entry); Severe degenerative changes in the target knee joint determined as the joint space narrowing less than 2 mm; Varus or valgus deformation of the target knee joint; Instability of the target knee joint; Active inflammation of the target knee joint (edema, hyperemia, present effusion) at the study entry; Microcrystalline arthropathies; Systemic inflammatory disease (rheumatoid arthritis, systemic lupus erythematosus, etc.); Seronegative spondyloarthritis and reactive arthritis; Inflammatory diseases of the skin and soft tissues in the proposed injection site for the test MD or placebo in the target joint; History of venous thrombosis and thromboembolia; Coagulogram abnormalities (APTT, prothrombin time, prothrombin index, fibrinogen); Inflammatory changes in the complete blood count (leukocytosis, increase of erythrocyte sedimentation rate [ESR]); Platelet count abnormality (in accordance with the reference ranges of the local laboratory; Increase of rheumatoid factor level; Increase of uric acid level > 360 μmol/l; Diabetes mellitus; Hemophilia and other hemorrhagic diatheses, as well administration of anticoagulants and disaggregants; Positive results of HIV, HBs-Ag, anti-HCV, RW tests; Intra-articular injection to the target knee joint: Noltrex - within 24 months prior patient's inclusion to the study; hyaluronates - within 6 months prior patient's inclusion to the study; glucocorticosteroids - within 1 month prior the study inclusion; non-steroidal anti-inflammatory drugs (NSAID) - within 3 weeks prior patient's inclusion to the study. Oral administration of non-steroidal anti-inflammatory drugs (NSAID) within 2 weeks prior the study inclusion; Necessity of systemic glucocorticosteroids in any dosage form; Paracetamol administration within 48 hours prior the study inclusion; Pregnancy and lactation; Hypersensitivity to components of the test MD or placebo; Severe liver disorder determined as the increase of one of the values: ALT, AST, ALP, total bilirubin, GGTP more than 3 times the upper limit of normal; Renal diseases with the glomerular filtration rate estimated per Cockraft-Gault formula less than 60 ml/min/1.73 m2 (III-V stage chronic renal disease [CRD]); Clinically manifest hip osteoarthritis; History of knee and coxofemoral endoprosthesis; Acute infectious diseases or infectious aggravations of chronic diseases (respiratory infections) within one month prior the study inclusion; Severe decompensated chronic or acute diseases and other conditions which, by the opinion of the study physician, may preclude the patient's participation in the study or affect the study results.
Facility Information:
Facility Name
Non-budgetary healthcare facility "Railway clinical hospital n.a. Semashko N.A. at Lublino, OJSC "Russian Railways"
City
Moscow
Country
Russian Federation
Facility Name
"Clinical Diagnostic Center "Ultramed", LLC
City
Omsk
Country
Russian Federation
Facility Name
Private Healthcare Facilty "Clinical hospital "RZHD-Medicina" of the city Saint-Petersburg
City
Saint Petersburg
Country
Russian Federation
Facility Name
State budgetary healthcare facility of Yaroslavl Region "Clinical hospital №3"
City
Yaroslavl
Country
Russian Federation

12. IPD Sharing Statement

Plan to Share IPD
No

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Intra-articular Polyacrylamide Hydrogel in Knee Osteoarthritis

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