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Stem Cell Study in Osteoarthritis of the Knee and Hip Joints

Primary Purpose

Osteoarthritis

Status
Recruiting
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
Bone Marrow Aspirate, Lipoaspirate Concentrate
Sponsored by
Grigory Karmy
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis

Eligibility Criteria

18 Years - 95 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, aged 18 to 95 years old
  2. Residents of Canada
  3. Written informed consent to participate in the study
  4. Willingness and ability to comply with the study procedures and phone visit schedules and ability to follow verbal and written instruction
  5. The NRS for at least 5 daily measures will be used to calculate the average score. An average NRS pain score 4-9 (moderate to severe pain).
  6. Diagnosis of symptomatic knee or hip osteoarthritis for at least 12 weeks prior to screening based on an X-ray performed within 1 year prior to screening period.
  7. Radiographic evidence of OA of the index knee or hip (Kellgren-Lawrence Grade I to IV) within 1 year prior to screening or during the screening period.
  8. Failed conservative treatment for more than 12 weeks before the screening, meaning that pain persists for more than 12 weeks after the patient tried two or more of the following medication or intervention in that period.

    • oral analgesics, including over the counter medications and supplements,
    • physiotherapy
    • acupuncture
    • bracing
    • cortisone injections,
    • hyaluronic acid injections,
    • dextrose injections (prolotherapy)
    • platelet-rich plasma injections
  9. Women of childbearing potential must use an effective method of contraception from 14 days prior to baseline visit to 360 days after intervention. Effective birth control considered for this trial are total abstinence; consistent use of birth control pills; injectable birth control methods; intrauterine device placement; and tubal ligation or male partner with vasectomy; diaphragm with contraceptive jelly or condom with contraceptive foam.
  10. Body mass index (BMI) ≤ 50 kg/m2

Exclusion Criteria:

  1. Women who are pregnant or planning to become pregnant during the trial period.
  2. Women of childbearing potential (not surgically sterile or post-menopausal for at least one year) not using a highly effective method of contraception such as total abstinence; consistent use of birth control pills; injectable birth control methods; intrauterine device placement; and tubal ligation or male partner with vasectomy; diaphragm with contraceptive jelly or condom with contraceptive foam.
  3. History of malignancy except for the diagnosis of basal cell carcinoma > 5 years prior to the study entry
  4. Presence of retained rods or screws or insertion or joint replacement in the joint to be injected
  5. History of autoimmune diseases including lupus and rheumatoid arthritis
  6. Prior arthroscopic or open surgery of the index joint within 6 months prior to screening
  7. Planned arthroscopic or open surgery of the index joint during study period
  8. Intra-articular injections in the index joint within 3 months prior to screening for corticosteroids or dextrose injections, and within 6 months prior to screening for hyaluronic acid or platelet-rich plasma (PRP) injections
  9. Use of systemic immunosuppressives, immunomodulators or chemotherapeutic agents within 3 months prior to baseline visit
  10. Know hypersensitivity to lidocaine, epinephrine or heparin
  11. History of coagulopathy
  12. Fever (forehead temperature above 38.0 centigrade) at baseline visit
  13. Subjects with cutaneous infection at the lipoaspirate or bone marrow aspirate site and/or in the area of the injection at baseline visit
  14. Subjects with hemoglobin less than 10 g/L
  15. Subjects with platelet count less than 155x109/L
  16. Subjects participating in a study of an experimental drug or medical device within 30 days of study entry
  17. Any medical condition the qualified investigator believes makes the patient unsuitable for the study
  18. Subjects using warfarin before the screening, with an INR above 3

Sites / Locations

  • Karmy ClinicRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Knee arm randomized to Lipoaspirate Concentrate and Bone Marrow Aspirate

Hip Arm randomized to Lipoaspirate Concentrate and Bone Marrow Aspirate

Arm Description

The Subjects will be randomized to one of the treatment groups separately for the knee and hip arms of the study. Group A will receive a single intra-articular injection with lipoaspirate concentrate to the knee and Group B will receive a single intra-articular injection with bone marrow aspirate concentrate.

The subjects will be randomized to one of the treatment groups separately for the knee and hip arms of the study. Groups C will receive a single intra-articular injection with lipoaspirate concentrate to the hip and Group D will receive a single intra-articular injection with bone marrow aspirate.

Outcomes

Primary Outcome Measures

The primary endpoint is the change from the Baseline to the Day 360 in WOMAC pain subscale pain subscale

Secondary Outcome Measures

Change from Baseline to Days 90, 180 in WOMAC pain subscale
Change from Baseline to Days 90, 180, and 360 in WOMAC stiffness subscale
Change from Baseline to Days 90, 180, and 360 in WOMAC function subscale
Change from Baseline to Days 90, 180, and 360 in total WOMAC score
Change from Baseline to Days 90, 180, and 360 in Patient's Global Impression of Changes (PGIC)
Change in average weekly consumption of analgesic medications from Baseline to Day 90, 180, and 360

Full Information

First Posted
August 17, 2022
Last Updated
March 26, 2023
Sponsor
Grigory Karmy
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1. Study Identification

Unique Protocol Identification Number
NCT05507099
Brief Title
Stem Cell Study in Osteoarthritis of the Knee and Hip Joints
Official Title
A Phase 2, Randomized Study to Compare Bone Marrow Aspirate Versus Lipoaspirate Concentrate Autologous Cell Therapy for the Treatment of the Knee and Hip Osteoarthritis in Adults
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 23, 2022 (Actual)
Primary Completion Date
August 8, 2028 (Anticipated)
Study Completion Date
August 8, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Grigory Karmy

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 trial is to compare the effect of a single intra-articular injection of Lipoaspirate Concentrate vs Bone Marrow Aspirate on pain reduction and functional improvement in the treatment of the knee and hip OA.
Detailed Description
The primary objective is to compare of magnitude and duration of pain relief of intra-articular injections with Lipoaspirate Concentrate vs Bone Marrow Aspirate. The secondary objective is to compare the effect of Lipoaspirate Concentrate vs Bone Marrow Aspirate intra-articular injections on functional improvement, stiffness, global impression of change, and consumption of analgesic medication. The exploratory objective is to explore the safety and the general tolerability of a single intra-articular injection of Lipoaspirate Concentrate vs Bone Marrow Aspirate.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
400 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Knee arm randomized to Lipoaspirate Concentrate and Bone Marrow Aspirate
Arm Type
Active Comparator
Arm Description
The Subjects will be randomized to one of the treatment groups separately for the knee and hip arms of the study. Group A will receive a single intra-articular injection with lipoaspirate concentrate to the knee and Group B will receive a single intra-articular injection with bone marrow aspirate concentrate.
Arm Title
Hip Arm randomized to Lipoaspirate Concentrate and Bone Marrow Aspirate
Arm Type
Active Comparator
Arm Description
The subjects will be randomized to one of the treatment groups separately for the knee and hip arms of the study. Groups C will receive a single intra-articular injection with lipoaspirate concentrate to the hip and Group D will receive a single intra-articular injection with bone marrow aspirate.
Intervention Type
Biological
Intervention Name(s)
Bone Marrow Aspirate, Lipoaspirate Concentrate
Intervention Description
Autologous Cell Therapy.
Primary Outcome Measure Information:
Title
The primary endpoint is the change from the Baseline to the Day 360 in WOMAC pain subscale pain subscale
Time Frame
360 days
Secondary Outcome Measure Information:
Title
Change from Baseline to Days 90, 180 in WOMAC pain subscale
Time Frame
90, 180 days
Title
Change from Baseline to Days 90, 180, and 360 in WOMAC stiffness subscale
Time Frame
90, 180, 360 days
Title
Change from Baseline to Days 90, 180, and 360 in WOMAC function subscale
Time Frame
90, 180, 360 days
Title
Change from Baseline to Days 90, 180, and 360 in total WOMAC score
Time Frame
90, 180, 360 days
Title
Change from Baseline to Days 90, 180, and 360 in Patient's Global Impression of Changes (PGIC)
Time Frame
90, 180, 360 days
Title
Change in average weekly consumption of analgesic medications from Baseline to Day 90, 180, and 360
Time Frame
90, 180, 360 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
95 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, aged 18 to 95 years old Residents of Canada Written informed consent to participate in the study Willingness and ability to comply with the study procedures and phone visit schedules and ability to follow verbal and written instruction The NRS for at least 5 daily measures will be used to calculate the average score. An average NRS pain score 4-9 (moderate to severe pain). Diagnosis of symptomatic knee or hip osteoarthritis for at least 12 weeks prior to screening based on an X-ray performed within 1 year prior to screening period. Radiographic evidence of OA of the index knee or hip (Kellgren-Lawrence Grade I to IV) within 1 year prior to screening or during the screening period. Failed conservative treatment for more than 12 weeks before the screening, meaning that pain persists for more than 12 weeks after the patient tried two or more of the following medication or interventions in that period. oral analgesics, including over-the-counter medications and supplements, physiotherapy acupuncture bracing cortisone injections, hyaluronic acid injections, dextrose injections (prolotherapy) platelet-rich plasma injections Women of childbearing potential must use an effective method of contraception from 14 days prior to baseline visit to 360 days after intervention. Effective birth control considered for this trial are total abstinence; consistent use of birth control pills; injectable birth control methods; intrauterine device placement; and tubal ligation or male partner with vasectomy; diaphragm with contraceptive jelly or condom with contraceptive foam.This does not apply to male and postmenopausal women. Body mass index (BMI) ≤ 50 kg/m2 Exclusion Criteria: Women who are pregnant or planning to become pregnant during the trial period. Women of childbearing potential (not surgically sterile or post-menopausal for at least one year) not using a highly effective method of contraception such as total abstinence; consistent use of birth control pills; injectable birth control methods; intrauterine device placement; and tubal ligation or male partner with vasectomy; diaphragm with contraceptive jelly or condom with contraceptive foam. History of malignancy except for the diagnosis of basal cell carcinoma, within 5 years prior to pre-screening. Presence of retained rods or screws or insertion or joint replacement in the joint to be injected History of autoimmune diseases including lupus and rheumatoid arthritis Prior arthroscopic or open surgery of the index joint within 6 months prior to screening Planned arthroscopic or open surgery of the index joint during study period Intra-articular injections in the index joint within 3 months prior to screening for corticosteroids or dextrose injections, and within 6 months prior to screening for hyaluronic acid or platelet-rich plasma (PRP) injections Use of systemic immunosuppressives, immunomodulators or chemotherapeutic agents within 3 months prior to baseline visit Know hypersensitivity to lidocaine, epinephrine or heparin History of coagulopathy Fever (forehead temperature above 38.0 centigrade) at baseline visit Subjects with cutaneous infection at the lipoaspirate or bone marrow aspirate site and/or in the area of the injection at baseline visit Subjects with hemoglobin less than 10 g/L Subjects with platelet count less than 155x109/L Subjects participating in a study of an experimental drug or medical device within 30 days of study entry Any medical condition the qualified investigator believes makes the patient unsuitable for the study Subjects using warfarin before the screening, with an INR above 3
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Grigory Karmy, MD
Phone
905 278 5158
Email
grigmed66@gmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Maimuna F Ahmed, MBBS
Phone
905 278 5158
Email
maimuna@karmyclinic.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Grigory Karmy, MD
Organizational Affiliation
McMaster University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Karmy Clinic
City
Brampton
State/Province
Ontario
ZIP/Postal Code
L6V 1B4
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Grigory Karmy, MD
Phone
905 278 5158
Email
grigmed66@gmail.com
First Name & Middle Initial & Last Name & Degree
Melissa Butcher
Phone
905 278 5158
Email
queenstreetmedical@hotmail.com

12. IPD Sharing Statement

Learn more about this trial

Stem Cell Study in Osteoarthritis of the Knee and Hip Joints

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