Persica 002 Phase 1b PP353 vs Placebo in the Treatment of Low Back Pain
Primary Purpose
Chronic Low-back Pain
Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
PP353
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Low-back Pain focused on measuring Back pain, Low back pain, Lower back pain, Modic
Eligibility Criteria
Inclusion Criteria:
- Aged between 18 and 70 years, inclusive.
- Chronic low back pain in the area associated with vertebral body endplate bone oedema (Modic 1) or vertebral body endplate bone oedema and fat (Modic 1 and 2) at a single lumbar level.
- Average LBP NRS score at screening and at Day 1 pre-randomisation ≥ 4 on chronic pain medication and ≥ 6 if not on chronic pain medication; it should be higher than the leg pain NRS score
- RMDQ-23 score ≥ 9 at screening and at Day 1 pre-randomisation.
- Current episode of chronic low back pain has lasted for ≥ 6 months at the time of randomisation.
- Bodyweight of ≥ 50 kg and ≤ 120 kg.
- Failure of standard of care therapies used by their treating physician
Exclusion Criteria:
Any vertebra with Modic 2 only lesions which:
- in the opinion of the investigator, after deep palpation of the vertebral spine, is contributing to the low back pain and/or
- are present within 2 vertebrae from the target lumbar disc.
- The target lumbar disc has lost more than half its original anticipated height at the centre or it is < 5mm in height over the central 15 mm portion
- A clear alternative cause for back pain
- Gross facet joint degeneration or cases where the investigator believes the primary pain generator to be the facet joints
- Interventional back procedure in the 6 months prior to screening or major surgery in the 12 weeks prior to screening
- History of alcohol abuse or drugs of abuse in the past 2 years
- Any other significant illness
- Previously been treated with antimicrobial agents for their low back pain or previously received any antimicrobial intradiscal injection.
Sites / Locations
- Gildhøj Privathospital KøbenhavnRecruiting
- CHU de Poitiers (Poitiers Hospital University)
- CGM Research TrustRecruiting
- Metge Adjunt. Servei de Medicina Física i Rehabilitació Hospital Universitari Vall d'Hebron
- Hospital Vithas Granada
- Hospital Universitario LA PAZ
- Hospital Clínico Universitario de Valencia
- Hospital Clinico Universitario
- Royal Preston HospitalRecruiting
- University Hospital Of WalesRecruiting
- University Hospital Coventry & Warwickshire
- Leeds General InfirmaryRecruiting
- Harley Street Specialist Hospital
- Oxford University Hospitals NHS Foundation TrustRecruiting
- University Hospital Southampton Nhs Foundation TrustRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
PP353
Sham injection
Arm Description
Outcomes
Primary Outcome Measures
Incidence of adverse events
Change from baseline in Low Back Pain Numerical Rating Scale (LBP NRS) score
Each question will be assessed by the subject on an 11-point scale with 0 = "no pain" and 10 = "the worst possible pain you can imagine."
The LBP NRS score throughout this protocol is defined as the average of the score of the three questions:
Low back pain intensity now
Worst low back pain intensity in the last 14 days
Average low back pain intensity over the last 14 days
Secondary Outcome Measures
Change from baseline in Low Back Pain Numerical Rating Scale (LBP NRS) score
Each question will be assessed by the subject on an 11-point scale with 0 = "no pain" and 10 = "the worst possible pain you can imagine."
The LBP NRS score throughout this protocol is defined as the average of the score of the three questions:
Low back pain intensity now
Worst low back pain intensity in the last 14 days
Average low back pain intensity over the last 14 days
Change from baseline in Roland Morris Disability Questionnaire-23 score
Clinically relevant improvement
30 percent reduction from baseline in Roland Morris Disability Questionnaire-23 score
Change from baseline in Oswestry Disability Index
Plasma pharmacokinetics - Tdur (duration above a prescribed threshold)
Plasma pharmacokinetics - tmax (the time at which Cmax was apparent)
Plasma pharmacokinetics - the area under the concentration versus time curve within a dosing interval
Plasma pharmacokinetics - Cmax (the maximum observed concentration)
Plasma pharmacokinetics - t½ (the apparent terminal half-life)
Plasma pharmacokinetics - CL/F (the systemic clearance calculated from plasma)
Full Information
NCT ID
NCT04238676
First Posted
January 16, 2020
Last Updated
September 28, 2023
Sponsor
Persica Pharmaceuticals Ltd
Collaborators
Micron Research Ltd
1. Study Identification
Unique Protocol Identification Number
NCT04238676
Brief Title
Persica 002 Phase 1b PP353 vs Placebo in the Treatment of Low Back Pain
Official Title
A Phase 1b Study Investigating the Safety, Tolerability and Efficacy of PP353 in the Treatment of Patients With Chronic Low Back Pain Associated With Vertebral Body Endplate Bone Oedema (Modic 1)
Study Type
Interventional
2. Study Status
Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 20, 2020 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Persica Pharmaceuticals Ltd
Collaborators
Micron Research Ltd
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
A Phase 1b study to investigate the efficacy of PP353 compared to placebo in the treatment of chronic low back pain associated with bone oedema.
Detailed Description
A 2-part study. In the first part the safety, tolerability and pharmacokinetics will be assessed in up to 6 participants. In the second part, the safety, tolerability and efficacy of PP353 will be assessed in up to 40 participants.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Low-back Pain
Keywords
Back pain, Low back pain, Lower back pain, Modic
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
The pharmacist and injector will not be blinded to treatment allocation
Allocation
Randomized
Enrollment
43 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
PP353
Arm Type
Experimental
Arm Title
Sham injection
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
PP353
Intervention Description
active administered by intradiscal injection
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Sham injection
Primary Outcome Measure Information:
Title
Incidence of adverse events
Time Frame
12 months
Title
Change from baseline in Low Back Pain Numerical Rating Scale (LBP NRS) score
Description
Each question will be assessed by the subject on an 11-point scale with 0 = "no pain" and 10 = "the worst possible pain you can imagine."
The LBP NRS score throughout this protocol is defined as the average of the score of the three questions:
Low back pain intensity now
Worst low back pain intensity in the last 14 days
Average low back pain intensity over the last 14 days
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Change from baseline in Low Back Pain Numerical Rating Scale (LBP NRS) score
Description
Each question will be assessed by the subject on an 11-point scale with 0 = "no pain" and 10 = "the worst possible pain you can imagine."
The LBP NRS score throughout this protocol is defined as the average of the score of the three questions:
Low back pain intensity now
Worst low back pain intensity in the last 14 days
Average low back pain intensity over the last 14 days
Time Frame
3, 6 & 9 months
Title
Change from baseline in Roland Morris Disability Questionnaire-23 score
Time Frame
3, 6, 9 & 12 months
Title
Clinically relevant improvement
Description
30 percent reduction from baseline in Roland Morris Disability Questionnaire-23 score
Time Frame
3, 6, 9 &12 months
Title
Change from baseline in Oswestry Disability Index
Time Frame
3, 6 & 12 months
Title
Plasma pharmacokinetics - Tdur (duration above a prescribed threshold)
Time Frame
11 days
Title
Plasma pharmacokinetics - tmax (the time at which Cmax was apparent)
Time Frame
11 days
Title
Plasma pharmacokinetics - the area under the concentration versus time curve within a dosing interval
Time Frame
11 days
Title
Plasma pharmacokinetics - Cmax (the maximum observed concentration)
Time Frame
11 days
Title
Plasma pharmacokinetics - t½ (the apparent terminal half-life)
Time Frame
11 days
Title
Plasma pharmacokinetics - CL/F (the systemic clearance calculated from plasma)
Time Frame
11 days
Other Pre-specified Outcome Measures:
Title
Change from baseline of average LBP intensity NRS daily score over a 7-day period
Time Frame
3, 6, 9 & 12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Aged between 18 and 70 years, inclusive.
Chronic low back pain in the area associated with vertebral body endplate bone oedema (Modic 1) or vertebral body endplate bone oedema and fat (Modic 1 and 2) at a single lumbar level.
Average LBP NRS score at screening and at Day 1 pre-randomisation ≥ 4 on chronic pain medication and ≥ 6 if not on chronic pain medication; it should be higher than the leg pain NRS score
RMDQ-23 score ≥ 9 at screening and at Day 1 pre-randomisation.
Current episode of chronic low back pain has lasted for ≥ 6 months at the time of randomisation.
Bodyweight of ≥ 50 kg and ≤ 120 kg.
Failure of standard of care therapies used by their treating physician
Exclusion Criteria:
Any vertebra with Modic 2 only lesions which:
in the opinion of the investigator, after deep palpation of the vertebral spine, is contributing to the low back pain and/or
are present within 2 vertebrae from the target lumbar disc.
The target lumbar disc has lost more than half its original anticipated height at the centre or it is < 5mm in height over the central 15 mm portion
A clear alternative cause for back pain
Gross facet joint degeneration or cases where the investigator believes the primary pain generator to be the facet joints
Interventional back procedure in the 6 months prior to screening or major surgery in the 12 weeks prior to screening
History of alcohol abuse or drugs of abuse in the past 2 years
Any other significant illness
Previously been treated with antimicrobial agents for their low back pain or previously received any antimicrobial intradiscal injection.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Operations and Project Director
Phone
+44 1227 910152
Email
info@persicapharmaceuticals.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Duncan McHale, MBBS MRCP
Organizational Affiliation
Weatherden Ltd
Official's Role
Study Chair
Facility Information:
Facility Name
Gildhøj Privathospital København
City
København
ZIP/Postal Code
2605 Brøndby
Country
Denmark
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michael R Lassen, MD
Phone
+45 40892725
Email
mrl@gildhoj.dk
Facility Name
CHU de Poitiers (Poitiers Hospital University)
City
Poitiers
ZIP/Postal Code
86000
Country
France
Individual Site Status
Withdrawn
Facility Name
CGM Research Trust
City
Christchurch
ZIP/Postal Code
8083
Country
New Zealand
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nigel Gilchrist, MB ChB FRACP
Phone
+64 3 3377821
Email
nigel.gilchrist@cdhb.health.nz
Facility Name
Metge Adjunt. Servei de Medicina Física i Rehabilitació Hospital Universitari Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035 Barcelona
Country
Spain
Individual Site Status
Withdrawn
Facility Name
Hospital Vithas Granada
City
Granada
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Universitario LA PAZ
City
Madrid
Country
Spain
Individual Site Status
Active, not recruiting
Facility Name
Hospital Clínico Universitario de Valencia
City
Valencia
ZIP/Postal Code
46010
Country
Spain
Individual Site Status
Withdrawn
Facility Name
Hospital Clinico Universitario
City
Valladolid
ZIP/Postal Code
47003
Country
Spain
Individual Site Status
Withdrawn
Facility Name
Royal Preston Hospital
City
Preston
State/Province
Lancashire
ZIP/Postal Code
PR2 9HT
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shiva Tripathi, MBBS MD FRCA
Phone
+44 1772 524185
Email
FIH@LTHTR.nhs.uk
Facility Name
University Hospital Of Wales
City
Cardiff
State/Province
Wales
ZIP/Postal Code
CF14 4XW
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sashin Ahuja, MBBS, FRCS
Email
Sashin.Ahuja@wales.nhs.uk
Facility Name
University Hospital Coventry & Warwickshire
City
Coventry
ZIP/Postal Code
CV2 2DX
Country
United Kingdom
Individual Site Status
Completed
Facility Name
Leeds General Infirmary
City
Leeds
ZIP/Postal Code
LS1 3EX
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ganesan Baranidharan, MBBS, FRCA
Phone
+44 113 3922634
Email
leedsth-tr.leedspainresearch@nhs.net
Facility Name
Harley Street Specialist Hospital
City
London
ZIP/Postal Code
W1G 8HU
Country
United Kingdom
Individual Site Status
Withdrawn
Facility Name
Oxford University Hospitals NHS Foundation Trust
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Matthew Scarborough, MD
Email
matthew.scarborough@ouh.nhs.uk
Facility Name
University Hospital Southampton Nhs Foundation Trust
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Cathy Price, MD FFPMRCA
Email
c.m.price@soton.ac.uk
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Persica 002 Phase 1b PP353 vs Placebo in the Treatment of Low Back Pain
We'll reach out to this number within 24 hrs