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A Study to Evaluate the Safety and Efficacy of 2ccPA in Patients With Symptomatic Knee Osteoarthritis

Primary Purpose

Osteoarthritis, Knee

Status
Recruiting
Phase
Phase 1
Locations
Taiwan
Study Type
Interventional
Intervention
2ccPA
Placebo
Sponsored by
Orient Europharma Co., Ltd.
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: Signed written informed consent from any patient capable of giving consent. Male or female patients, 40 to 80 years of age. Documented clinical diagnosis of symptomatic OA affecting at least one knee of a minimum of 6 months prior to screening. The study knee has OA of Grade 2 to 3 severity based on the Kellgren Lawrence grading scale. A score > 6 and < 16 out of 20 on the WOMAC pain subscale for the study knee. Pain in the study knee for most of the 30 days (i.e., more than half of the days) prior to randomization. Women of childbearing potential must agree to practice a medically acceptable contraceptive regimen from screening visit until at least 1 month after the study treatment and must have a negative pregnancy test no earlier than 72 hours prior to study treatment. Male subjects must agree to practice a medically acceptable contraceptive regimen (i.e., sterilization surgery, barrier method, abstention) from screening visit until at least 1 month after the study treatment. Exclusion Criteria: Patients with known or suspected hypersensitivity to 2ccPA or any of its excipients. Use of intra-articular corticosteroids, hyaluronic acid, or other IA injection in the study knee within 3 months prior to study entry (randomization). Use of chondroitin and/or glucosamine within 4 weeks prior to study entry (randomization). Administered or requiring systemic or topical treatment of the target knee joint including immunosuppressive agents, anti-inflammatory drugs, steroids, analgesics, or opioids for knee OA within 1 week prior to randomization except for acetaminophen (oral daily dose ≤ 3000 mg or topical use at any dose). For long acting steroids (i.e., dexamethasone, betamethasone), subjects who received systemic treatment within 2 weeks before randomization will be excluded. History of post-traumatic knee arthritis, or evidence of intra-articular bleeding of the study knee. Subjects with clinical signs and symptoms of active knee infection (inflammation) or being treated for knee infection at screening. Arthroscopic or open surgery on the study knee within 6 months prior to study entry (randomization). Prior knee replacement on the study knee or planned knee replacement during the study period. Subjects with meniscus tears that required repairment surgery or known anterior cruciate ligament rupture. Subjects with known severe synovitis, synovium necrosis in the target knee joint. Subjects with known malignancy. Use of any chemotherapeutic or systemic immunosuppressant agents for inflammatory diseases within 6 months prior to study entry (randomization). Current use of anticoagulants, including warfarin, heparin, low molecular weight heparin, dabigatran, or factor Xa inhibitors (rivaroxaban, apixaban, edoxaban, and betrixaban). Subject requiring routine use of low-dose aspirin for preventing thrombosis (≤ 100 mg/day) will not be excluded. Abnormalities of laboratory parameters as described below will qualify for exclusion: hemoglobin < 8 g/dL total white blood cell count < 4000/μL serum bilirubin/ alanine aminotransferase (ALT)/ aspartate aminotransferase AST > 2 times upper limit of normal (ULN) serum creatinine > 2 times ULN Pregnancy or lactation. History of drug or alcohol dependence in the past 3 years. Having known infection with HIV-1, active hepatitis B, or active hepatitis C. Patients who are inactive carriers of HBV or HCV can be enrolled if the subjects have stable baseline condition during the screening period. Use of any investigational drug or participation in any drug study within 4 weeks prior to study entry (randomization). Subjects unwilling or unable to comply with study procedures. Any clinical condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk to participate in the study or confounds the ability to interpret data from the study as judged by the investigator.

Sites / Locations

  • Tri-Service General HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

2ccPA

placebo

Arm Description

IP name: 2-carba-cyclic phosphatidic acid (2ccPA)

Placebo

Outcomes

Primary Outcome Measures

To define maximum tolerated dose (MTD) following the intra-articular (IA) administration of a single ascending dose (SAD) 2ccPA in patients with osteoarthritis of the knee.
To evaluate the safety of 2ccPA including incidence of adverse events (AEs) and serious adverse events (SAEs).
To evaluate the efficacy of multiple doses of 2ccPA vs placebo in terms of changes in the Western Ontario and McMaster Universities Arthritis Index (WOMAC) on Day 85
The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) is a widely-used, proprietary outcome measurement tool used to evaluate the condition of subjects with Osteoarthritis (OA) of the knee and hip, including pain (5 questions), stiffness (2 questions) and physical functioning (17 questions) of the joints. Each question is scored on a scale of 0-4, which corresponds to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4).

Secondary Outcome Measures

To evaluate the efficacy of 2ccPA vs placebo in terms of changes in Western Ontario and McMaster Universities Osteoarthritis (WOMAC) on Day 15, 29, 57 and 168
WOMAC questionnaire consists of 24 items divided into 3 subscales: Pain (5 items), Stiffness (2 items), Physical Function (17 items). The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.
To evaluate the efficacy of 2ccPA vs placebo in terms of proportion of subjects with a 20% (WOMAC20), 50% (WOMAC50), and 70% (WOMAC70) improvement in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) on Days 15, 29, 57, 85 and 168
To evaluate the efficacy of 2ccPA vs placebo in terms of pain assessed by Numeric Rating Scale (NRS) on Days 15, 29, 57, 85 and 168.
NRS is an 11-point numeric scale ranges from '0' indicating "no pain" to '10' indicating "extreme pain".
To evaluate the efficacy of 2ccPA vs placebo in terms of changes in Joint Space Narrowing (JSN) measured by x-ray on Day 168
Maximum plasma concentration (Cmax) of 2ccPA
Pharmacokinetic profile of 2ccPA
Time to maximum plasma concentration (Tmax) of 2ccPA
Pharmacokinetic profile of 2ccPA
Area under plasma concentration-time curve (AUC0-infinity and AUC0-t) of 2ccPA
Pharmacokinetic profile of 2ccPA
Apparent total body clearance (CL/F) of 2ccPA
Pharmacokinetic profile of 2ccPA
Apparent volume of distribution (Vz/F) of 2ccPA
Pharmacokinetic profile of 2ccPA
Elimination half-life (t1/2) of 2ccPA
Pharmacokinetic profile of 2ccPA

Full Information

First Posted
December 29, 2022
Last Updated
June 21, 2023
Sponsor
Orient Europharma Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05807529
Brief Title
A Study to Evaluate the Safety and Efficacy of 2ccPA in Patients With Symptomatic Knee Osteoarthritis
Official Title
A Phase I-II, Dose-escalation, Double-blinded, Placebo-controlled, and Dose-finding Study to Evaluate the Safety and Efficacy of 2ccPA in Patients With Osteoarthritis of the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 3, 2022 (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
Orient Europharma Co., Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I/II study aims to evaluate the safety of single doses of 2ccPA 4,800 μg and 7,200 μg (Phase I), as well as the safety and efficacy of multiple doses of 2ccPA (Phase II) in patients with osteoarthritis (OA) of the knee.
Detailed Description
Osteoarthritis (OA) is a degenerative disease frequently associated with symptoms such as inflammation, stiffness, muscle weakness, joint swollen and joint pain. 2-carba-cyclic phosphatidic acid (2ccPA) is the derivative of natural occurring phospholipid mediator, cyclic phosphatidic acid (cPA). Previous studies suggested that 2ccPA inhibits inflammation and may relieve the pain caused by osteoarthritis. This phase I/II study aims to evaluate the safety of single doses of 2ccPA 4,800 μg and7,200 μg (Phase I), as well as the safety and efficacy of multiple doses of 2ccPA (Phase II) in patients with osteoarthritis (OA) of the knee.

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 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
136 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
2ccPA
Arm Type
Experimental
Arm Description
IP name: 2-carba-cyclic phosphatidic acid (2ccPA)
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
2ccPA
Other Intervention Name(s)
2-carba-cyclic phosphatidic acid
Intervention Description
2-carba-cyclic phosphatidic acid (2ccPA) is a first-in-class phospholipase autotaxin (ATX) inhibitor that may act as a disease-modifying drug and may relieve OA associated symptoms. Phase I: 2 dose cohorts (4800μg, 7200μg) single dose at Day 1 Phase II: 3 dose cohorts (2400μg, 4800μg, 7200μg) multiple dose at Day 1, 15, 29
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Phase I: 2 dose cohorts (4800μg, 7200μg) single dose at Day 1 Phase II: 3 dose cohorts (2400μg, 4800μg, 7200μg) multiple dose at Day 1, 15, 29
Primary Outcome Measure Information:
Title
To define maximum tolerated dose (MTD) following the intra-articular (IA) administration of a single ascending dose (SAD) 2ccPA in patients with osteoarthritis of the knee.
Time Frame
85 Days
Title
To evaluate the safety of 2ccPA including incidence of adverse events (AEs) and serious adverse events (SAEs).
Time Frame
85 Days
Title
To evaluate the efficacy of multiple doses of 2ccPA vs placebo in terms of changes in the Western Ontario and McMaster Universities Arthritis Index (WOMAC) on Day 85
Description
The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) is a widely-used, proprietary outcome measurement tool used to evaluate the condition of subjects with Osteoarthritis (OA) of the knee and hip, including pain (5 questions), stiffness (2 questions) and physical functioning (17 questions) of the joints. Each question is scored on a scale of 0-4, which corresponds to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4).
Time Frame
85 Days
Secondary Outcome Measure Information:
Title
To evaluate the efficacy of 2ccPA vs placebo in terms of changes in Western Ontario and McMaster Universities Osteoarthritis (WOMAC) on Day 15, 29, 57 and 168
Description
WOMAC questionnaire consists of 24 items divided into 3 subscales: Pain (5 items), Stiffness (2 items), Physical Function (17 items). The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.
Time Frame
85 Days
Title
To evaluate the efficacy of 2ccPA vs placebo in terms of proportion of subjects with a 20% (WOMAC20), 50% (WOMAC50), and 70% (WOMAC70) improvement in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) on Days 15, 29, 57, 85 and 168
Time Frame
168 Days
Title
To evaluate the efficacy of 2ccPA vs placebo in terms of pain assessed by Numeric Rating Scale (NRS) on Days 15, 29, 57, 85 and 168.
Description
NRS is an 11-point numeric scale ranges from '0' indicating "no pain" to '10' indicating "extreme pain".
Time Frame
168 Days
Title
To evaluate the efficacy of 2ccPA vs placebo in terms of changes in Joint Space Narrowing (JSN) measured by x-ray on Day 168
Time Frame
168 Days
Title
Maximum plasma concentration (Cmax) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days
Title
Time to maximum plasma concentration (Tmax) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days
Title
Area under plasma concentration-time curve (AUC0-infinity and AUC0-t) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days
Title
Apparent total body clearance (CL/F) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days
Title
Apparent volume of distribution (Vz/F) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days
Title
Elimination half-life (t1/2) of 2ccPA
Description
Pharmacokinetic profile of 2ccPA
Time Frame
168 Days

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: Signed written informed consent from any patient capable of giving consent. Male or female patients, 40 to 80 years of age. Documented clinical diagnosis of symptomatic OA affecting at least one knee of a minimum of 6 months prior to screening. The study knee has OA of Grade 2 to 3 severity based on the Kellgren Lawrence grading scale. A score > 6 and < 16 out of 20 on the WOMAC pain subscale for the study knee. Pain in the study knee for most of the 30 days (i.e., more than half of the days) prior to randomization. Women of childbearing potential must agree to practice a medically acceptable contraceptive regimen from screening visit until at least 1 month after the study treatment and must have a negative pregnancy test no earlier than 72 hours prior to study treatment. Male subjects must agree to practice a medically acceptable contraceptive regimen (i.e., sterilization surgery, barrier method, abstention) from screening visit until at least 1 month after the study treatment. Exclusion Criteria: Patients with known or suspected hypersensitivity to 2ccPA or any of its excipients. Use of intra-articular corticosteroids, hyaluronic acid, or other IA injection in the study knee within 3 months prior to study entry (randomization). Use of chondroitin and/or glucosamine within 4 weeks prior to study entry (randomization). Administered or requiring systemic or topical treatment of the target knee joint including immunosuppressive agents, anti-inflammatory drugs, steroids, analgesics, or opioids for knee OA within 1 week prior to randomization except for acetaminophen (oral daily dose ≤ 3000 mg or topical use at any dose). For long acting steroids (i.e., dexamethasone, betamethasone), subjects who received systemic treatment within 2 weeks before randomization will be excluded. History of post-traumatic knee arthritis, or evidence of intra-articular bleeding of the study knee. Subjects with clinical signs and symptoms of active knee infection (inflammation) or being treated for knee infection at screening. Arthroscopic or open surgery on the study knee within 6 months prior to study entry (randomization). Prior knee replacement on the study knee or planned knee replacement during the study period. Subjects with meniscus tears that required repairment surgery or known anterior cruciate ligament rupture. Subjects with known severe synovitis, synovium necrosis in the target knee joint. Subjects with known malignancy. Use of any chemotherapeutic or systemic immunosuppressant agents for inflammatory diseases within 6 months prior to study entry (randomization). Current use of anticoagulants, including warfarin, heparin, low molecular weight heparin, dabigatran, or factor Xa inhibitors (rivaroxaban, apixaban, edoxaban, and betrixaban). Subject requiring routine use of low-dose aspirin for preventing thrombosis (≤ 100 mg/day) will not be excluded. Abnormalities of laboratory parameters as described below will qualify for exclusion: hemoglobin < 8 g/dL total white blood cell count < 4000/μL serum bilirubin/ alanine aminotransferase (ALT)/ aspartate aminotransferase AST > 2 times upper limit of normal (ULN) serum creatinine > 2 times ULN Pregnancy or lactation. History of drug or alcohol dependence in the past 3 years. Having known infection with HIV-1, active hepatitis B, or active hepatitis C. Patients who are inactive carriers of HBV or HCV can be enrolled if the subjects have stable baseline condition during the screening period. Use of any investigational drug or participation in any drug study within 4 weeks prior to study entry (randomization). Subjects unwilling or unable to comply with study procedures. Any clinical condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk to participate in the study or confounds the ability to interpret data from the study as judged by the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Shirley Lin
Phone
+886-2-2755-4881
Ext
2561
Email
Shirley.Lin@mail.oep.com.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hsiang-Cheng Chen
Organizational Affiliation
Tri-Service General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tri-Service General Hospital
City
Taipei
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hsiang-Cheng Chen

12. IPD Sharing Statement

Learn more about this trial

A Study to Evaluate the Safety and Efficacy of 2ccPA in Patients With Symptomatic Knee Osteoarthritis

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