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Efficacy and Safety Trial of PTP-001 (MOTYS) for Symptomatic Knee Osteoarthritis

Primary Purpose

Osteoarthritis, Knee

Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
PTP-001
Placebo control
Sponsored by
Bioventus LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants are eligible to be included in the study only if all of the following criteria apply:

    1. Male or female, aged 40 to 80 years
    2. Symptomatic knee OA with Kellgren-Lawrence radiographic classification of 2 or 3 (mild or moderate) as assessed by the central reading facility
    3. Target knee pain ≥ 20 and ≤ 40 out of 50 the WOMAC®NRS 3.1 pain questionnaire (sum of 5 questions) at screening and baseline
    4. Onset of symptomatic OA of the target knee was at least 6 months prior to screening
    5. Insufficient or failed response or intolerance to analgesics and/or non-steroidal anti-inflammatory drugs, as reported by the participant
    6. IF FEMALE, must meet all of the following:

      • Not breast feeding
      • Not planning to become pregnant during the study
      • If of childbearing potential, must have a negative pregnancy test result within 72 hours prior to receiving the intra-articular injection, and must commit to the use of a highly effective form of birth control (See Appendix A) for at least 12 weeks after the injection
    7. Willingness to remain on the same oral "rescue" (as needed) analgesic as the only pharmacologic treatment for knee pain during the study
    8. Willingness to abstain from taking any illicit or unauthorized medications for treatment of OA or any other concurrent condition during the study
    9. Written informed consent is obtained from the participant

Exclusion Criteria:

  • Participants are excluded from the study if any of the following criteria apply:

    1. Participant is non-ambulatory (unable to walk >50 feet without assistance)
    2. Clinically severe obesity as defined by the National Institutes of Health (body mass target ≥40 kg/m2)
    3. Contralateral knee pain equal to or exceeding the pain in the target knee (on the WOMAC® NRS3.1 pain questionnaire) at screening and/or baseline
    4. Clinically significant effusion of the target knee at either the screening or baseline visits determined by physical examination (e.g., ballotable patella or positive bulge sign). Note: Participants presenting with effusion may be enrolled in the study after undergoing knee aspiration to remove excess fluid in the target joint.
    5. Severe (excessive) malalignment of the tibial-femoral axis, assessed radiographically
    6. Presence of active infection of the target knee or systemic infection requiring treatment within the 3 months prior to screening
    7. Clinical diagnosis of inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, etc.) established by clinical history, examination, or serology
    8. Participant is receiving, has received, or plans to receive any of the following therapies

      • Prior administration of hyaluronic acid, extended release corticosteroid (e.g., Zilretta®), platelet-rich plasma (PRP), or stem cell therapies by intra-articular injection(s) of the target knee within 6 months prior to screening
      • Prior intra-articular corticosteroid within 3 months prior to screening or into any other joint within 30 days prior to screening
      • Current chronic systemic use of corticosteroids in doses exceeding 10 mg prednisolone-equivalents daily
      • Treatment with any investigational therapy (drug, device, or biologic) within 3 months prior to screening or is planned for the duration of the study
      • Treatment with immunosuppressive medication or chemotherapy within the past 5 years
    9. Chronic use of narcotics or alcohol abuse within the past 6 months prior to screening
    10. Surgery to the target knee (including arthroscopy) within 6 months prior to receiving the intra-articular injection or planned surgery to the target knee within 6 months after the injection
    11. Participant previously underwent arthroplasty of the target knee
    12. Presence of joint instability or complaints of locking, intermittent limitation in range of motion, or loose body sensation, suggestive of internal derangement of the knee (either extremity)
    13. Symptomatic OA of the non-target knee that is not responsive to paracetamol (acetaminophen) or oral nonsteroidal anti-inflammatory drugs (NSAIDs).
    14. Diagnosis of lower extremity gout or pseudo-gout in the past 6 months
    15. Osteonecrosis of either knee
    16. Significant acute (within the past 3 months) injury to the target knee
    17. History of receiving a solid organ or hematologic transplant
    18. History of malignancy, radiotherapy, or chemotherapy for malignancy within the past 5 years, except for basal or squamous cell carcinoma of the skin
    19. History of prior radiation therapy of the target knee
    20. History of autoimmune disease affecting the musculoskeletal system
    21. Known (documented) history of acquired immune deficiency syndrome or human immunodeficiency virus
    22. Any condition causing pain in or around the target knee (e.g., radiating pain, pain in another region of the ipsilateral lower extremity) that may interfere with assessment(s) of the target knee
    23. Other chronic pain anywhere in the body that requires the chronic use of analgesic medications, such as fibromyalgia, neuropathic pain, low back pain, etc.
    24. Presence of contraindications for use of 3 g/day of orally administered paracetamol/acetaminophen due to known hypersensitivity or hepatic impairment.
    25. Known presence of any concurrent medical condition (e.g., hematologic renal, hepatic, cardiac, or coagulation abnormalities) that in the investigator's judgment would interfere with the required study assessments and study participation
    26. Participant is involved in litigation (e.g., worker's compensation) for a medical condition or injury at any anatomical site

Sites / Locations

  • Emeritus Research Sydney
  • Genesis Research Services
  • Royal North Shore Hospital
  • Holdsworth House Medical Practice
  • Emeritus Research Melbourne
  • Hamilton Medical Research Group
  • McMaster University Department of Surgery St. Joseph's Healthcare Hamilton
  • Canadian Phase Onward Inc.
  • Diex Recherche Quebec Inc.
  • Diex Recherche Sherbrooke Inc.
  • Centrede Recherche Saint-Louis
  • Sanos Clinic Nordjylland
  • Sanos Clinic
  • Sanos Clinic Syddanmark

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

PTP-001 200 mg

PTP-001 100 mg

Placebo/saline

Arm Description

A single intra-articular injection in the target knee of PTP-001 200 mg.

A single intra-articular injection in the target knee of PTP-001 100 mg.

A single intra-articular injection in the target knee of 4mL of placebo control - physiological saline (0.9% sodium chloride injection, USP).

Outcomes

Primary Outcome Measures

Efficacy - Change from pretreatment baseline in the WOMAC pain subscale
To evaluate the change from pretreatment baseline in the WOMAC pain sub-score in the target knee on an 11-box numerical rating scale, with categories from 0 (none) to 10 (extreme), normalized on scales of 0-100.
Safety - Incidence of local and systemic AEs
To assess the long-term (6 months) incidence of local and systemic AEs, and consists of physical examination, laboratory values, AEs, AESI, and immunogenicity testing.

Secondary Outcome Measures

Change from pretreatment baseline in pain intensity assessed by participant self report (WOMAC Pain subscale).
WOMAC Numerical Rating Scale (NRS) 3.1 questionnaire is a health status measure questionnaire of 24 questions comprising 3 subscales (pain, stiffness and physical function). WOMAC A (measure of pain) is measured on an 11-box numerical rating scale, with categories from 0 (none) to 10 (extreme), normalized to a scale of 0-100, where higher score represents higher pain.
Change from pretreatment baseline in function assessed by participant self-report (WOMAC Function subscale).
WOMAC Numerical Rating Scale (NRS) 3.1 questionnaire is a health status measure questionnaire of 24 questions comprising 3 subscales (pain, stiffness and physical function). WOMAC C (measure of physical function) is measured on 11-point NRS ranging from 0 (none) to 10 (extreme), where higher score represents higher difficulties in physical function.
Change from pretreatment baseline in the weekly average of daily pain assessed by patient self report (NRS).
The question is an average daily (24-h) pain intensity score on a 0 to 10 NRS scale with 0 indicating 'no pain' and 10 indicating 'pain as bad as you can imagine'.
Change from pretreatment baseline in patient global assessment of OA (PGA-OA) assessed by participant self report.
Considering all the ways knee osteoarthritis affects the participants, the question is an average daily (24-h) self-reported global assessment on an 11-box numerical rating scale, with 0 indicating "very good" and 10 indicating "very poor".
Change from pretreatment baseline in participant self-reported quality of life measured by SF-36 overall score, PCS, and MCS.
The SF-36 measures 8 domains: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health, and has 2 summary scores (physical and mental). The physical health measure includes 4 scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). The assessment is performed on a scale of 0 (maximum disability)-100 (no disability) with higher scores indicating better health status.
Response to PTP-001 on the OMERACT-OARSI responder criteria.
The OMERACT-OARSI responder criteria involve changes that are deemed to be clinically relevant in the three domains: pain, function, and Patient Global Assessment. For each of these domains, ranges are defined for absolute and percent changes from baseline that correspond to "high improvement" and "moderate improvement". OMERACT-OARSI response is defined as either i) improvement in pain or physical function ≥50% and an absolute change ≥20 mm on a 100-mm visual analog scale; or (2) improvement of ≥20% and with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment (PGA).

Full Information

First Posted
October 19, 2021
Last Updated
July 18, 2022
Sponsor
Bioventus LLC
Collaborators
NBCD A/S
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1. Study Identification

Unique Protocol Identification Number
NCT05100225
Brief Title
Efficacy and Safety Trial of PTP-001 (MOTYS) for Symptomatic Knee Osteoarthritis
Official Title
A Multiple Arm, Multicenter, Prospective, Randomized, Double-Blind, Placebo-Controlled, Parallel-Arm, Phase 2 Study of Intra-Articular Administration of an Allogeneic Human Placental Tissue Particulate (PTP-001) for the Treatment of Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 30, 2021 (Actual)
Primary Completion Date
October 31, 2022 (Anticipated)
Study Completion Date
November 30, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bioventus LLC
Collaborators
NBCD A/S

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
Evaluation of safety, tolerability and efficacy of a single intra-articular (IA) injection of PTP-001, an allogeneic placental tissue particulate, in individuals with knee osteoarthritis (OA).
Detailed Description
This is a multiple arm, multicenter, prospective, randomized, double-blind, placebo-controlled, parallel-arm, phase 2 study of intra-articular administration of an allogeneic human placental tissue particulate (PTP-001) for the treatment of knee osteoarthritis. The study is planned to be conducted outside the United States. A total of approximately 210 participants are planned to be randomized to receive 1 of 2 doses of PTP-001 (100 mg or 200 mg) or saline vehicle control (placebo) injection. The purpose of the trial is to evaluate the efficacy, safety and tolerability of a single low dose and high dose of PTP-001 compared to placebo over a 26-week period.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
A Multiple Arm, Multicenter, Prospective, Randomized, Double-Blind, Placebo-Controlled, Parallel-Arm, Phase 2 Study
Masking
ParticipantInvestigator
Masking Description
This is a double-blinded trial, in which neither participant nor investigator will know the content of the investigational product. Additionally, the study staff preparing the syringe. The unblinded personnel must not be involved in any other operational aspects of the trial.
Allocation
Randomized
Enrollment
210 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PTP-001 200 mg
Arm Type
Experimental
Arm Description
A single intra-articular injection in the target knee of PTP-001 200 mg.
Arm Title
PTP-001 100 mg
Arm Type
Experimental
Arm Description
A single intra-articular injection in the target knee of PTP-001 100 mg.
Arm Title
Placebo/saline
Arm Type
Placebo Comparator
Arm Description
A single intra-articular injection in the target knee of 4mL of placebo control - physiological saline (0.9% sodium chloride injection, USP).
Intervention Type
Biological
Intervention Name(s)
PTP-001
Intervention Description
Allogeneic human placental tissue particulate (PTP-001) is administered as a single intra-articular injection to the target knee after resuspension with saline.
Intervention Type
Other
Intervention Name(s)
Placebo control
Other Intervention Name(s)
Physiological saline
Intervention Description
The placebo control, physiological saline (0.9% sodium chloride injection, USP), is administered as an intra-articular injection to the target knee.
Primary Outcome Measure Information:
Title
Efficacy - Change from pretreatment baseline in the WOMAC pain subscale
Description
To evaluate the change from pretreatment baseline in the WOMAC pain sub-score in the target knee on an 11-box numerical rating scale, with categories from 0 (none) to 10 (extreme), normalized on scales of 0-100.
Time Frame
At 6 months
Title
Safety - Incidence of local and systemic AEs
Description
To assess the long-term (6 months) incidence of local and systemic AEs, and consists of physical examination, laboratory values, AEs, AESI, and immunogenicity testing.
Time Frame
Over 6 months
Secondary Outcome Measure Information:
Title
Change from pretreatment baseline in pain intensity assessed by participant self report (WOMAC Pain subscale).
Description
WOMAC Numerical Rating Scale (NRS) 3.1 questionnaire is a health status measure questionnaire of 24 questions comprising 3 subscales (pain, stiffness and physical function). WOMAC A (measure of pain) is measured on an 11-box numerical rating scale, with categories from 0 (none) to 10 (extreme), normalized to a scale of 0-100, where higher score represents higher pain.
Time Frame
At 2 weeks, 3 months, 4 months, 5 months.
Title
Change from pretreatment baseline in function assessed by participant self-report (WOMAC Function subscale).
Description
WOMAC Numerical Rating Scale (NRS) 3.1 questionnaire is a health status measure questionnaire of 24 questions comprising 3 subscales (pain, stiffness and physical function). WOMAC C (measure of physical function) is measured on 11-point NRS ranging from 0 (none) to 10 (extreme), where higher score represents higher difficulties in physical function.
Time Frame
At 2 weeks, 3 months, 4 months, 5 months, and 6 months.
Title
Change from pretreatment baseline in the weekly average of daily pain assessed by patient self report (NRS).
Description
The question is an average daily (24-h) pain intensity score on a 0 to 10 NRS scale with 0 indicating 'no pain' and 10 indicating 'pain as bad as you can imagine'.
Time Frame
At 2 weeks, 3 months, 4 months, 5 months, and 6 months.
Title
Change from pretreatment baseline in patient global assessment of OA (PGA-OA) assessed by participant self report.
Description
Considering all the ways knee osteoarthritis affects the participants, the question is an average daily (24-h) self-reported global assessment on an 11-box numerical rating scale, with 0 indicating "very good" and 10 indicating "very poor".
Time Frame
At 2 weeks, 3 months, 4 months, 5 months, and 6 months.
Title
Change from pretreatment baseline in participant self-reported quality of life measured by SF-36 overall score, PCS, and MCS.
Description
The SF-36 measures 8 domains: physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health, and has 2 summary scores (physical and mental). The physical health measure includes 4 scales of physical functioning (10 items), role-physical (4 items), bodily pain (2 items), and general health (5 items). The mental health measure is composed of vitality (4 items), social functioning (2 items), role-emotional (3 items), and mental health (5 items). The assessment is performed on a scale of 0 (maximum disability)-100 (no disability) with higher scores indicating better health status.
Time Frame
At 3 months and 6 months.
Title
Response to PTP-001 on the OMERACT-OARSI responder criteria.
Description
The OMERACT-OARSI responder criteria involve changes that are deemed to be clinically relevant in the three domains: pain, function, and Patient Global Assessment. For each of these domains, ranges are defined for absolute and percent changes from baseline that correspond to "high improvement" and "moderate improvement". OMERACT-OARSI response is defined as either i) improvement in pain or physical function ≥50% and an absolute change ≥20 mm on a 100-mm visual analog scale; or (2) improvement of ≥20% and with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment (PGA).
Time Frame
At 2 weeks, 3 months, and 6 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants are eligible to be included in the study only if all of the following criteria apply: Male or female, aged 40 to 80 years Symptomatic knee OA with Kellgren-Lawrence radiographic classification of 2 or 3 (mild or moderate) as assessed by the central reading facility Target knee pain ≥ 20 and ≤ 40 out of 50 the WOMAC®NRS 3.1 pain questionnaire (sum of 5 questions) at screening and baseline Onset of symptomatic OA of the target knee was at least 6 months prior to screening Insufficient or failed response or intolerance to analgesics and/or non-steroidal anti-inflammatory drugs, as reported by the participant IF FEMALE, must meet all of the following: Not breast feeding Not planning to become pregnant during the study If of childbearing potential, must have a negative pregnancy test result within 72 hours prior to receiving the intra-articular injection, and must commit to the use of a highly effective form of birth control (See Appendix A) for at least 12 weeks after the injection Willingness to remain on the same oral "rescue" (as needed) analgesic as the only pharmacologic treatment for knee pain during the study Willingness to abstain from taking any illicit or unauthorized medications for treatment of OA or any other concurrent condition during the study Written informed consent is obtained from the participant Exclusion Criteria: Participants are excluded from the study if any of the following criteria apply: Participant is non-ambulatory (unable to walk >50 feet without assistance) Clinically severe obesity as defined by the National Institutes of Health (body mass target ≥40 kg/m2) Contralateral knee pain equal to or exceeding the pain in the target knee (on the WOMAC® NRS3.1 pain questionnaire) at screening and/or baseline Clinically significant effusion of the target knee at either the screening or baseline visits determined by physical examination (e.g., ballotable patella or positive bulge sign). Note: Participants presenting with effusion may be enrolled in the study after undergoing knee aspiration to remove excess fluid in the target joint. Severe (excessive) malalignment of the tibial-femoral axis, assessed radiographically Presence of active infection of the target knee or systemic infection requiring treatment within the 3 months prior to screening Clinical diagnosis of inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, systemic lupus erythematosus, etc.) established by clinical history, examination, or serology Participant is receiving, has received, or plans to receive any of the following therapies Prior administration of hyaluronic acid, extended release corticosteroid (e.g., Zilretta®), platelet-rich plasma (PRP), or stem cell therapies by intra-articular injection(s) of the target knee within 6 months prior to screening Prior intra-articular corticosteroid within 3 months prior to screening or into any other joint within 30 days prior to screening Current chronic systemic use of corticosteroids in doses exceeding 10 mg prednisolone-equivalents daily Treatment with any investigational therapy (drug, device, or biologic) within 3 months prior to screening or is planned for the duration of the study Treatment with immunosuppressive medication or chemotherapy within the past 5 years Chronic use of narcotics or alcohol abuse within the past 6 months prior to screening Surgery to the target knee (including arthroscopy) within 6 months prior to receiving the intra-articular injection or planned surgery to the target knee within 6 months after the injection Participant previously underwent arthroplasty of the target knee Presence of joint instability or complaints of locking, intermittent limitation in range of motion, or loose body sensation, suggestive of internal derangement of the knee (either extremity) Symptomatic OA of the non-target knee that is not responsive to paracetamol (acetaminophen) or oral nonsteroidal anti-inflammatory drugs (NSAIDs). Diagnosis of lower extremity gout or pseudo-gout in the past 6 months Osteonecrosis of either knee Significant acute (within the past 3 months) injury to the target knee History of receiving a solid organ or hematologic transplant History of malignancy, radiotherapy, or chemotherapy for malignancy within the past 5 years, except for basal or squamous cell carcinoma of the skin History of prior radiation therapy of the target knee History of autoimmune disease affecting the musculoskeletal system Known (documented) history of acquired immune deficiency syndrome or human immunodeficiency virus Any condition causing pain in or around the target knee (e.g., radiating pain, pain in another region of the ipsilateral lower extremity) that may interfere with assessment(s) of the target knee Other chronic pain anywhere in the body that requires the chronic use of analgesic medications, such as fibromyalgia, neuropathic pain, low back pain, etc. Presence of contraindications for use of 3 g/day of orally administered paracetamol/acetaminophen due to known hypersensitivity or hepatic impairment. Known presence of any concurrent medical condition (e.g., hematologic renal, hepatic, cardiac, or coagulation abnormalities) that in the investigator's judgment would interfere with the required study assessments and study participation Participant is involved in litigation (e.g., worker's compensation) for a medical condition or injury at any anatomical site
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Moin Khan, MD
Organizational Affiliation
McMaster University Department of Surgery St. Joseph's Healthcare Hamilton
Official's Role
Principal Investigator
Facility Information:
Facility Name
Emeritus Research Sydney
City
Botany
State/Province
New South Wales
ZIP/Postal Code
2019
Country
Australia
Facility Name
Genesis Research Services
City
Broadmeadow
State/Province
New South Wales
ZIP/Postal Code
2292
Country
Australia
Facility Name
Royal North Shore Hospital
City
Saint Leonards
State/Province
New South Wales
Country
Australia
Facility Name
Holdsworth House Medical Practice
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2010
Country
Australia
Facility Name
Emeritus Research Melbourne
City
Camberwell
State/Province
Victoria
ZIP/Postal Code
3124
Country
Australia
Facility Name
Hamilton Medical Research Group
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8M 1K7
Country
Canada
Facility Name
McMaster University Department of Surgery St. Joseph's Healthcare Hamilton
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 4A6
Country
Canada
Facility Name
Canadian Phase Onward Inc.
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M3J 0K2
Country
Canada
Facility Name
Diex Recherche Quebec Inc.
City
Québec
State/Province
Quebec
ZIP/Postal Code
G1N4V3
Country
Canada
Facility Name
Diex Recherche Sherbrooke Inc.
City
Sherbrooke
State/Province
Quebec
ZIP/Postal Code
J1L 0H8
Country
Canada
Facility Name
Centrede Recherche Saint-Louis
City
Quebec
ZIP/Postal Code
G1W 4R4
Country
Canada
Facility Name
Sanos Clinic Nordjylland
City
Gandrup
ZIP/Postal Code
9362
Country
Denmark
Facility Name
Sanos Clinic
City
Herlev
ZIP/Postal Code
2730
Country
Denmark
Facility Name
Sanos Clinic Syddanmark
City
Vejle
ZIP/Postal Code
7100
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34023528
Citation
Flannery CR, Seaman SA, Buddin KE, Nasert MA, Semler EJ, Kelley KL, Long M, Favret J, Pavesio A, Loeser RF. A novel placental tissue biologic, PTP-001, inhibits inflammatory and catabolic responses in vitro and prevents pain and cartilage degeneration in a rat model of osteoarthritis. Osteoarthritis Cartilage. 2021 Aug;29(8):1203-1212. doi: 10.1016/j.joca.2021.03.022. Epub 2021 May 20.
Results Reference
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Efficacy and Safety Trial of PTP-001 (MOTYS) for Symptomatic Knee Osteoarthritis

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