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Clinical Trial to Evaluate Efficacy and Safety of SMUP-IA-01 in Patients With Knee Osteoarthritis

Primary Purpose

Knee Osteoarthritis

Status
Recruiting
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
SMUP-IA-01(low dose)
SMUP-IA-01(mid dose)
Active Control Group Sodium chloride
Sponsored by
Medipost Co Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring human umbilical cord blood derived mesenchymal stem cells, Knee Osteoarthritis

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients who are ≥ 19 years of age on the date on which the consent form was signed
  2. Patients diagnosed with knee osteoarthritis in at least one knee according to the clinical and radiological definition criteria of American College of Rheumatology (ACR) guidline at screening visit
  3. Patients with knee OA corresponding to K&L Grade 2 or 3 on radiographic examination at screening visit
  4. Patients with less than 35 of BMI at screening visit
  5. Patients who voluntarily decide to participate and sign the consent form
  6. Patients who have persistent symptoms despite having undergone a reasonable trial of standard therapy (i.e., for a minimum of 3 months)

Exclusion Criteria:

  1. Patients with any of the following diseases.

    - infectious arthritis, autoimmune or inflammatory joint diseases, gout, recurrent pseudogout, Paget's disease, intra-articular displaced fracture, ochronosis, acromegaly, haemochromatosis, Wilson's disease, genetic disease (hyperkinesia etc.), genetic collagen disorder, etc.

  2. Patients who have ever undergone surgery or radiotherapy in the knee joint area within the 12 weeks prior to the screening visit date, or who have not been recovered from its side effect yet.
  3. Patients with SIF (Subchondral insufficiency fracture) corresponding to type II of the RPOA (rapidly progressive osteoarthritis).
  4. Patients whose physical examination results show severe degree of ligament instability.
  5. Patients who have ever been given any intraarticular drug injection (i.e., hyaluronic acid injection, etc.) in to-be-treated (index) knee within the 6 months, prior to the screening visit date.
  6. Patients who have ever been given steroids via intraarticular injection in to-be-treated (index) knee within the 12 weeks prior to the screening visit date.
  7. Patients who have ever taken medications or given therapy below within the past 2 weeks on the basis of screening visit date. However, if patients have 14 days of wash-out period, the patient is allowed to participate.

    • drugs containing the ingredient of glucosamine, chondroitin sulfate, or diacerein
    • drugs containing herbal ingredient or herbal drugs for knee OA pain relief
    • anti-inflammatory analgesics or NSAIDs (prescription/non-prescription drugs). (However, patients who take acetaminophen and have 3 days of wash-out period are allowed to participate.)
    • oral steroids
    • hospital physiotherpy or oriental medicine treatment (buhang, acupunture, moxibustion etc.)
  8. Patients who have skin disease on injection site or who are judged inappropriate for intra-articular injection on to-be-treated knee.
  9. Patients who are judged unsuitable for MRI scanning (3.0 Tesla or higher) due to an insertion of metal material (i.e., heart pacemaker, cerebral aneurysm clip, etc.) or obstructive phobia. However, patients who have an insertion of metal material that is not affected by the magnetic field is allowed to participate
  10. Patients with clinically significant past or present illness as follows;

    • heart diseases (i.e., myocardial infarction, coronary artery bypass surgery, arrhythmia and other serious heart diseases, etc.)
    • uncontrolled hypertension (not controlled down to 140/90 mmHg or below even after treatment with 3 or more antihypertensive drugs)
    • kidney disease (i.e., chronic kidney failure, glomerulonephritis, etc.)
    • liver disease (i.e., acute or chronic liver disease such as cirrhosis, fatty liver, etc.)
    • endocrine diseases (i.e., thyroiditis, diabetes insipidus, Cushing's disease, etc.)
    • other serious systemic diseases
  11. Patient with ongoing autoimmune disorder that requires treatment with an immunosuppressive medication
  12. Patients with infection that requires administration of parenteral antibiotics
  13. Patients with a history of mental illness or epilepsy
  14. Patients who have been diagnosed with cancer within the 5 years prior to the screening visit date
  15. Patients who have been given immunosuppressive drugs such as cyclosporin A or azathioprine within the 6 weeks prior to the screening visit
  16. Patients with a history of allergic reactions to hyaluronic acid injections, cryoprotectant (dimethyl sulfoxide, DMSO), or gentamicin.
  17. Patients who are pregnant or lactating, or patients who have a plan to become pregnant during the study period
  18. Male or female patients who do not agree to avoid pregnancy or the use of appropriate contraceptive methods during the study period. But women who have given infertility surgery or who have passed menopause one year or more are allowed to participate without the consent for contraception.
  19. Patients who have been given any other cell therapy products or who plan to do so during the study period.
  20. Patients who have been given any other investigational products including device within the 3 months prior to the screening visit date.
  21. Patients who are judged by the investigator as inappropriate for enrollment into the study, for any reasons other than the reasons specified above.

Sites / Locations

  • Seoul Nation University Bundang HospitalRecruiting
  • Gangnam Severance HospitalRecruiting
  • Korea University Anam HospitaRecruiting
  • Seoul National University HospitalRecruiting
  • Severance HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Study Group 1: SMUP-IA-01 (low dose)

Study Group 2:SMUP-IA-01 (mid dose)

Active Control Group

Arm Description

Investigational Product - 4.0×10^6 cells/2 mL of SMUP-IA-01 (2 ml of 1% sodium hyaluronate injection is administered before administration of SMUP-IA-01)

Investigational Product - 1.0×10^7 cells/2 mL of SMUP-IA-01 (2 ml of 1% sodium hyaluronate injection is administered before administration of SMUP-IA-01)

Investigational Product - 2 ml of 1% sodium hyaluronate (2 ml of sodium chloride injection is administered before administration of 1% sodium hyaluronate)

Outcomes

Primary Outcome Measures

Change in the WOMAC(Western Ontario and McMaster University Osteoarthritis Index) total score at post-dose 52 weeks from baseline
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).

Secondary Outcome Measures

Change amount of WOMAC total score at post-dose 24 weeks from the baseline
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).
Chage amount of WOMAC score by item (pain, stiffness, physical function) at post-dose 24 weeks and 52 weeks from the baseline
The WOMAC measures five items for pain (score range 0-20), two for stiffness (score range 0-8), and 17 for functional limitation (score range 0-68)
Chage amount of 100-mm VAS((Visual Analogue Scale) at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks from the baseline
The score ranges from "0" or no pain to "100" very severe pain
Chage amount of IKDC(International Knee Documentation Committee) at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks from the baseline
IKDC subjective knee evaluation consists of three categories: symptoms, sports activities, and functions. For each category, there are 7 questions for symptoms, 2 questions for sports activities, and 2 questions for functions, a total of 11 questions for evaluation. The scores for each category are summed up and divided into 87, which is the maximum score possible, and then is evaluated by converting it into a scale of 100 points. Higher score indicates better function and less symptoms for the knee.
Change in the WOMAS(whole-organ magnetic resonance imaging score) at post-dose 52 weeks from the baseline
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).
Change in T2 mapping at post-dose 52 weeks from the baseline
Changes on the knee structure through qualitative and quantitative evaluation of the collagen matrix of knee cartilage.
Change in K&L grade, joint space width, mechanical axis, and anatomical axis at post-dose 52 weeks from the baseline
K & L grade (0 to 4 Grade): which means that the higher the grade, the greater the joint damage and the stenosis of the joint. Joint space width(mm): Evaluation of disease progression in target knee as ascertained by change from baseline joint space width (JSW) determined using radiography. Mechanical axis(Angle): A line connecting the femoral head center point and the ankle joint center point. Anatomical axis(Angle): The middiaphyseal line of the femur and tibia
Change amount of biomarkers at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks against the baseline; serum CTX-I, Serum HA, Serum MMP-3, Urine CTX-I, Urine CTX-II.
serum C-terminal cross-linking telopetides of collagen type I(CTX-I), serum hyaluronan, serum matrix metalloproteinase-3 (MMP-3), urine C-terminal cross-linking telopetides of collagen type II (CTX -II), urine C-terminal cross-linking telopetides of collagen type I(CTX-I). Serum CTX-I, Serum HA, Serum MMP-3, Urine CTX-I, Urine CTX-II are reported in pg/ml.
Percentage of patients who took the rescue drugs and dosage at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks
Subjects will receive Patient Diary, and use of the rescue drug should be recorded on the Patient Diary.

Full Information

First Posted
December 12, 2021
Last Updated
March 13, 2023
Sponsor
Medipost Co Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05182034
Brief Title
Clinical Trial to Evaluate Efficacy and Safety of SMUP-IA-01 in Patients With Knee Osteoarthritis
Official Title
A Multi-center, Randomized, Double-Blinded, Active-Controlled, Phase II Clinical Trial to Evaluate Efficacy and Safety of SMUP-IA-01 in Patients With Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 24, 2022 (Actual)
Primary Completion Date
August 30, 2023 (Anticipated)
Study Completion Date
August 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medipost Co 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
This clinical trial is for patients who have been diagnosed with Kellgren-Lawrence (K&L) Grade 2 or 3 knee osteoarthritis on radiographic examination. Only subjects who voluntarily agree to participate by filling out the written Informed Consent document will undergo screening for subject selection (inclusion/exclusion) criteria, at which time the severity of OA in each knee will be used to determined which knee will be treated (index knee - i.e., the more severely affected knee), and enroll in this study.
Detailed Description
Patients who meet the inclusion/exclusion criteria will be randomly assigned at visit 2 to either of study group 1(low-dose), study group 2 (mid-dose) or active control group at 1:1:1 ratio. Patients will be administered with investigational product. Investigational product will be administered into the to-be-treated (index) knee one time within 7 days after randomization. All patients enrolled will be followed up a total of 6 times (1, 4, 8, 12, 24, and 52 weeks) for up to post-dose 12 months. The patients should visit the study facility according to the visit schedule, and will undergo safety evaluation (vital sign, laboratory test, etc.) and efficacy evaluation [Western Ontario and McMaster Universities osteoarthritis index (WOMAC), 100-mm visual analogue scale (VAS), International Knee Documentation Committee (IKDC) subjective knee evaluation].

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
human umbilical cord blood derived mesenchymal stem cells, Knee Osteoarthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
90 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Study Group 1: SMUP-IA-01 (low dose)
Arm Type
Experimental
Arm Description
Investigational Product - 4.0×10^6 cells/2 mL of SMUP-IA-01 (2 ml of 1% sodium hyaluronate injection is administered before administration of SMUP-IA-01)
Arm Title
Study Group 2:SMUP-IA-01 (mid dose)
Arm Type
Experimental
Arm Description
Investigational Product - 1.0×10^7 cells/2 mL of SMUP-IA-01 (2 ml of 1% sodium hyaluronate injection is administered before administration of SMUP-IA-01)
Arm Title
Active Control Group
Arm Type
Active Comparator
Arm Description
Investigational Product - 2 ml of 1% sodium hyaluronate (2 ml of sodium chloride injection is administered before administration of 1% sodium hyaluronate)
Intervention Type
Biological
Intervention Name(s)
SMUP-IA-01(low dose)
Other Intervention Name(s)
SMUP allogenic cord blood-derived mesenchymal stem cell (SMUP-Cell)
Intervention Description
A single knee administration of SMUP-IA-01(low-dose, 4.0 x 10^6 cells/2mL)
Intervention Type
Biological
Intervention Name(s)
SMUP-IA-01(mid dose)
Other Intervention Name(s)
SMUP allogenic cord blood-derived mesenchymal stem cell (SMUP-Cell)
Intervention Description
A single knee administration of SMUP-IA-01(mid-dose, 1.0 x 10^7 cells/2mL)
Intervention Type
Drug
Intervention Name(s)
Active Control Group Sodium chloride
Other Intervention Name(s)
Sodium chloride
Intervention Description
A single knee administration of Sodium chloride
Primary Outcome Measure Information:
Title
Change in the WOMAC(Western Ontario and McMaster University Osteoarthritis Index) total score at post-dose 52 weeks from baseline
Description
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).
Time Frame
Baseline, 52 week
Secondary Outcome Measure Information:
Title
Change amount of WOMAC total score at post-dose 24 weeks from the baseline
Description
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).
Time Frame
Baseline, 24 week
Title
Chage amount of WOMAC score by item (pain, stiffness, physical function) at post-dose 24 weeks and 52 weeks from the baseline
Description
The WOMAC measures five items for pain (score range 0-20), two for stiffness (score range 0-8), and 17 for functional limitation (score range 0-68)
Time Frame
Baseline, 24 week, 52 week
Title
Chage amount of 100-mm VAS((Visual Analogue Scale) at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks from the baseline
Description
The score ranges from "0" or no pain to "100" very severe pain
Time Frame
Baseline, 1 week, 4 week, 8 week, 12 week, 24 week, 52 week
Title
Chage amount of IKDC(International Knee Documentation Committee) at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks from the baseline
Description
IKDC subjective knee evaluation consists of three categories: symptoms, sports activities, and functions. For each category, there are 7 questions for symptoms, 2 questions for sports activities, and 2 questions for functions, a total of 11 questions for evaluation. The scores for each category are summed up and divided into 87, which is the maximum score possible, and then is evaluated by converting it into a scale of 100 points. Higher score indicates better function and less symptoms for the knee.
Time Frame
Baseline, 1 week, 4 week, 8 week, 12 week, 24 week, 52 week
Title
Change in the WOMAS(whole-organ magnetic resonance imaging score) at post-dose 52 weeks from the baseline
Description
Total score is between 0 point (no symptoms) ~ 96 points (higher score representing worse symptoms).
Time Frame
Baseline, 52 week
Title
Change in T2 mapping at post-dose 52 weeks from the baseline
Description
Changes on the knee structure through qualitative and quantitative evaluation of the collagen matrix of knee cartilage.
Time Frame
Baseline, 52 week
Title
Change in K&L grade, joint space width, mechanical axis, and anatomical axis at post-dose 52 weeks from the baseline
Description
K & L grade (0 to 4 Grade): which means that the higher the grade, the greater the joint damage and the stenosis of the joint. Joint space width(mm): Evaluation of disease progression in target knee as ascertained by change from baseline joint space width (JSW) determined using radiography. Mechanical axis(Angle): A line connecting the femoral head center point and the ankle joint center point. Anatomical axis(Angle): The middiaphyseal line of the femur and tibia
Time Frame
Baseline, 52 week
Title
Change amount of biomarkers at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks against the baseline; serum CTX-I, Serum HA, Serum MMP-3, Urine CTX-I, Urine CTX-II.
Description
serum C-terminal cross-linking telopetides of collagen type I(CTX-I), serum hyaluronan, serum matrix metalloproteinase-3 (MMP-3), urine C-terminal cross-linking telopetides of collagen type II (CTX -II), urine C-terminal cross-linking telopetides of collagen type I(CTX-I). Serum CTX-I, Serum HA, Serum MMP-3, Urine CTX-I, Urine CTX-II are reported in pg/ml.
Time Frame
baseline, 1 week, 4 week, 8 week, 12 week, 24 week, 52week
Title
Percentage of patients who took the rescue drugs and dosage at post-dose 1 week, 4 weeks, 8 weeks, 12 weeks, 24 weeks and 52 weeks
Description
Subjects will receive Patient Diary, and use of the rescue drug should be recorded on the Patient Diary.
Time Frame
1 week, 4 week, 8 week, 12 week, 24 week, 52week

10. Eligibility

Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients who are ≥ 19 years of age on the date on which the consent form was signed Patients diagnosed with knee osteoarthritis in at least one knee according to the clinical and radiological definition criteria of American College of Rheumatology (ACR) guidline at screening visit Patients with knee OA corresponding to K&L Grade 2 or 3 on radiographic examination at screening visit Patients with less than 35 of BMI at screening visit Patients who voluntarily decide to participate and sign the consent form Patients who have persistent symptoms despite having undergone a reasonable trial of standard therapy (i.e., for a minimum of 3 months) Exclusion Criteria: Patients with any of the following diseases. - infectious arthritis, autoimmune or inflammatory joint diseases, gout, recurrent pseudogout, Paget's disease, intra-articular displaced fracture, ochronosis, acromegaly, haemochromatosis, Wilson's disease, genetic disease (hyperkinesia etc.), genetic collagen disorder, etc. Patients who have ever undergone surgery or radiotherapy in the knee joint area within the 12 weeks prior to the screening visit date, or who have not been recovered from its side effect yet. Patients with SIF (Subchondral insufficiency fracture) corresponding to type II of the RPOA (rapidly progressive osteoarthritis). Patients whose physical examination results show severe degree of ligament instability. Patients who have ever been given any intraarticular drug injection (i.e., hyaluronic acid injection, etc.) in to-be-treated (index) knee within the 6 months, prior to the screening visit date. Patients who have ever been given steroids via intraarticular injection in to-be-treated (index) knee within the 12 weeks prior to the screening visit date. Patients who have ever taken medications or given therapy below within the past 2 weeks on the basis of screening visit date. However, if patients have 14 days of wash-out period, the patient is allowed to participate. drugs containing the ingredient of glucosamine, chondroitin sulfate, or diacerein drugs containing herbal ingredient or herbal drugs for knee OA pain relief anti-inflammatory analgesics or NSAIDs (prescription/non-prescription drugs). (However, patients who take acetaminophen and have 3 days of wash-out period are allowed to participate.) oral steroids hospital physiotherpy or oriental medicine treatment (buhang, acupunture, moxibustion etc.) Patients who have skin disease on injection site or who are judged inappropriate for intra-articular injection on to-be-treated knee. Patients who are judged unsuitable for MRI scanning (3.0 Tesla or higher) due to an insertion of metal material (i.e., heart pacemaker, cerebral aneurysm clip, etc.) or obstructive phobia. However, patients who have an insertion of metal material that is not affected by the magnetic field is allowed to participate Patients with clinically significant past or present illness as follows; heart diseases (i.e., myocardial infarction, coronary artery bypass surgery, arrhythmia and other serious heart diseases, etc.) uncontrolled hypertension (not controlled down to 140/90 mmHg or below even after treatment with 3 or more antihypertensive drugs) kidney disease (i.e., chronic kidney failure, glomerulonephritis, etc.) liver disease (i.e., acute or chronic liver disease such as cirrhosis, fatty liver, etc.) endocrine diseases (i.e., thyroiditis, diabetes insipidus, Cushing's disease, etc.) other serious systemic diseases Patient with ongoing autoimmune disorder that requires treatment with an immunosuppressive medication Patients with infection that requires administration of parenteral antibiotics Patients with a history of mental illness or epilepsy Patients who have been diagnosed with cancer within the 5 years prior to the screening visit date Patients who have been given immunosuppressive drugs such as cyclosporin A or azathioprine within the 6 weeks prior to the screening visit Patients with a history of allergic reactions to hyaluronic acid injections, cryoprotectant (dimethyl sulfoxide, DMSO), or gentamicin. Patients who are pregnant or lactating, or patients who have a plan to become pregnant during the study period Male or female patients who do not agree to avoid pregnancy or the use of appropriate contraceptive methods during the study period. But women who have given infertility surgery or who have passed menopause one year or more are allowed to participate without the consent for contraception. Patients who have been given any other cell therapy products or who plan to do so during the study period. Patients who have been given any other investigational products including device within the 3 months prior to the screening visit date. Patients who are judged by the investigator as inappropriate for enrollment into the study, for any reasons other than the reasons specified above.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Eunyoung Lee
Phone
+82234656748
Email
ley0113@medi-post.co.kr
First Name & Middle Initial & Last Name or Official Title & Degree
Seungeun Lee
Phone
+82234656748
Email
selee@medi-post.co.kr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Myungchul Lee, MD, PhD
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chonghyuk Choi, MD, PhD
Organizational Affiliation
Severance Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Chongbum Chang, MD, PhD
Organizational Affiliation
Seoul Nation University Bundang Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Seungbum Han, MD, PhD
Organizational Affiliation
Korea University Anam Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Sunghwan Kim, MD, PhD
Organizational Affiliation
Gangnam Severance Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul Nation University Bundang Hospital
City
Gyeonggi-do
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Gangnam Severance Hospital
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Korea University Anam Hospita
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Seoul National University Hospital
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting
Facility Name
Severance Hospital
City
Seoul
Country
Korea, Republic of
Individual Site Status
Recruiting

12. IPD Sharing Statement

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Clinical Trial to Evaluate Efficacy and Safety of SMUP-IA-01 in Patients With Knee Osteoarthritis

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