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A Multicenter Study of rhFGF 18 in Patients With Knee Osteoarthritis Not Requiring Surgery

Primary Purpose

Knee Osteoarthritis

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
AS902330
Sponsored by
Merck KGaA, Darmstadt, Germany
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Knee osteoarthritis, Fibroblast growth factor 18, Sprifermin

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female >= 40 years of age; females must be postmenopausal or surgically sterile
  2. Established diagnosis of primary femoro-tibial OA of the target knee by standard American College of Rheumatology Criteria for at least six months (clinical AND radiological criteria)
  3. Radiological disease stage 2 or 3 (i.e., clear evidence of OA, but not most advanced disease) in the target knee according to the Kellgren-Lawrence grading of knee OA
  4. No major knee surgery (e.g., partial or total knee replacement, interventional arthroscopy) in the target knee planned for at least 12 months after first injection of the study drug
  5. Documented need for symptomatic PRN (as needed)-treatment for OA in the target knee with systemic non-steroidal anti-inflammatory drugs (NSAIDs) and/or other analgesics.
  6. Total WOMAC score between 24 and 72 (out of 96, corresponding to mild, moderate, or severe, but not extreme OA symptoms) for the target knee while on oral symptomatic treatment at baseline
  7. Full understanding of the requirements of the study and willingness to comply with all study visits and assessments
  8. Patients must have read and understood the informed consent form, and must have signed it prior to any study-related procedure

Exclusion Criteria:

  • any condition, including laboratory findings and findings in the medical history or in the pre-study assessments, that in the opinion of the Investigator constitutes a risk or contraindication for participation in the study or that could interfere with the study objectives, conduct or evaluation
  • clinically significant abnormal hematology (hemoglobin, leucocytes, and platelets), or blood chemistry values (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, and creatinine
  • receipt of any investigational product or any experimental therapeutic procedure within the last 12 weeks preceding screening
  • participation in FIH study 27575 or in a different cohort of this study
  • i.a. treatment of the target knee with steroids or hyaluronic acid derivatives within the 3 months before baseline
  • for MAD cohorts, any contra-indications to MRI according to MRI guidelines
  • any condition that would interfere with efficacy or safety assessments in the target knee
  • any drug or food supplement with potential disease-modifying effect (glucosamine, diacerin, chondroitin sulfate) unless given at a stable dose over at least 4 weeks prior to first injection
  • use of electrotherapy or acupuncture for OA, unless there is a stable regimen for at least 4 weeks before baseline
  • any known active infections, including suspicion of intra-articular infection and/or infections that may compromise the immune system such as HIV, Hepatitis B or Hepatitis C infection
  • history of sarcoma and/or of other active malignancy within five years, except adequately treated basal cell or squamous cell carcinoma of the skin
  • signs and symptoms suggestive of transmissible spongiform encephalopathy
  • secondary osteoarthritis: e.g., joint dysplasias, aseptic osteonecrosis, acromegaly, Paget's disease, Ehlers-Danlos syndrome, Gaucher's disease, Stickler's syndrome, joint infection, hemophilia, hemochromatosis, calcium pyrophosphate deposition disease, or neuropathic arthropathy whatever the cause

Sites / Locations

  • UMHAT "Sv. Ivan Rilski", Clinical Research Unit for Phase I
  • SKDS Research, Inc.
  • Kells Medical Research Group
  • Centre de rhumatologie St-Louis
  • Groupe de Recherche en Maldies Osseuses de Quebec
  • London Road Diagnostic Clinic
  • Albion Finch Medical Centre
  • Clinical hospital Split
  • Clinical Hospital "Sestre Milosrdnice"
  • Polyclinic for internal medicine, gynecology, radiology, physical medicine and rehabilitation
  • Kuopio University Hospital, Department of Ortopaedics
  • Oulu University Hospital, Surgical and Intensive Care Division
  • Turku University Central Hospital, Orthopedic Research Unit
  • PAREXEL International GmbH
  • NZOZ Centrum Medyczne Artur Racewicz
  • Krakowskie Centrum Medyczne NZOZ
  • REUMED Sp. z o.o.,
  • Niepubliczny Zaklad Opieki Zdrowotnej Nasz Lekarz
  • Centrum Leczenia Chorob Cywilizacyjnych
  • Centrum Medyczne OSTEOMED Sp. z o.o.
  • Clinical Hospital Center Bezanijska Kosa
  • Institute of Rheumatology Resavska 69
  • • Name: Institute of diagnostic, prevention and rechabilitation of cardiovascular and rheumatoid diseases
  • FARMOVS-PAREXEL (Pty) Ltd, University of the Free State
  • PAREXEL -George
  • PAREXEL-Port Elizabeth, Mercantile Hospital
  • Ortopediska mottagningen
  • Kirurg- och ortopedkliniken Kungälvs sjukhus, 442 83 Kungälv

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AS902330

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Change in cartilage thickness in the medial femoro-tibial compartment of the target knee joint, assessed by MRI
Nature, incidence and severity of local and systemic treatment-emergent adverse events (TEAEs)
Proportion of subjects experiencing AIRs defined as increase of pain by 30mm on a 100mm visual analogue scale (VAS) associated with a self-reported synovial fluid effusion within 3 days following i.a. injection
Laboratory assessments, including blood chemistry, hematology, urinalysis, and ECG

Secondary Outcome Measures

Change in cartilage thickness in the medial femoro-tibial compartment of the target knee joint, assessed by MRI
Change in total cartilage volume and thickness in the other compartments of the target knee joint, assessed by MRI
Change over time of structural as well as compositional parameters of the knee joint (e.g. cartilage and bone), evaluated by MRI
Change in WOMAC (Western Ontario MacMaster Osteoarthritis Questionaire) total score in the target knee from 5-point Likert scales
Change in WOMAC Function and Pain index scores in the target knee
Change in osteoarthritis (OA) pain in the target knee on a 100mm visual analogue scale (VAS)
Change in JSW in the target knee by x-ray
Presence of anti-AS902330 antibodies
Blood levels of AS902330
MRI at 3 months, score on WOMAC questionnaire at 3, 6 and 12 months.

Full Information

First Posted
December 16, 2009
Last Updated
June 24, 2014
Sponsor
Merck KGaA, Darmstadt, Germany
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1. Study Identification

Unique Protocol Identification Number
NCT01033994
Brief Title
A Multicenter Study of rhFGF 18 in Patients With Knee Osteoarthritis Not Requiring Surgery
Official Title
A Randomized, Double Blind, Placebo-controlled, Multicenter, Single and Multiple Ascending Dose Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Primary Osteoarthritis of the Knee Who Are Not Expected to Require Knee Surgery Within One Year
Study Type
Interventional

2. Study Status

Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
October 2008 (undefined)
Primary Completion Date
October 2010 (Actual)
Study Completion Date
December 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Merck KGaA, Darmstadt, Germany

4. Oversight

5. Study Description

Brief Summary
Osteoarthritis (OA) is one of the most common diseases affecting the joints, usually those that are weight bearing such as the knees. OA is considered to be a disease of the cartilage in the joints even though it involves the whole joint, including the bone and synovium (thin lining of the joints which produces synovial fluid). With time, more and more of the cartilage is destroyed by the disease with inflammation commonly occurring. AS902330 is expected to increase the production and development of specific bone cells: chondrocytes and osteoblasts (cells that produce and maintain bone and cartilage). This is expected to lead to repair and generation of the cartilage, and a narrowing of the space width between the knee joints in a selected region of the knee cartilage. The purpose of this study is to see how safe treatment with AS902330 is, and to evaluate its effect on the knee cartilage. In addition, the study will also measure the effects of AS902330 in the blood, which reflect disease activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Knee osteoarthritis, Fibroblast growth factor 18, Sprifermin

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
192 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AS902330
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Biological
Intervention Name(s)
AS902330
Other Intervention Name(s)
rhFGF 18, Recombinant human fibroblast growth factor 18, Sprifermin
Intervention Description
10, 30 or 100 µg intra-articular injection per subject in the Single Ascending Dose (SAD) cohorts and 10, 30 or 100 µg intra-articular injection per week for three weeks per subject in the Multiple Ascending Dose (MAD) cohorts.
Primary Outcome Measure Information:
Title
Change in cartilage thickness in the medial femoro-tibial compartment of the target knee joint, assessed by MRI
Time Frame
6 and 12 months after first injection
Title
Nature, incidence and severity of local and systemic treatment-emergent adverse events (TEAEs)
Time Frame
MAD Cohorts: 1 year + 1 month; SAD Cohorts: 4 Weeks
Title
Proportion of subjects experiencing AIRs defined as increase of pain by 30mm on a 100mm visual analogue scale (VAS) associated with a self-reported synovial fluid effusion within 3 days following i.a. injection
Time Frame
MAD Cohorts: Week 1, 2, 3, 13 14 and 15 (injections weeks); SAD Cohorts: Week 1
Title
Laboratory assessments, including blood chemistry, hematology, urinalysis, and ECG
Time Frame
MAD Cohorts: Week 0, 4, 13, 17, 52; SAD Cohorts: Weeks 0 & 4
Secondary Outcome Measure Information:
Title
Change in cartilage thickness in the medial femoro-tibial compartment of the target knee joint, assessed by MRI
Time Frame
52 Weeks
Title
Change in total cartilage volume and thickness in the other compartments of the target knee joint, assessed by MRI
Time Frame
52 Weeks
Title
Change over time of structural as well as compositional parameters of the knee joint (e.g. cartilage and bone), evaluated by MRI
Time Frame
52 Weeks
Title
Change in WOMAC (Western Ontario MacMaster Osteoarthritis Questionaire) total score in the target knee from 5-point Likert scales
Time Frame
52 Weeks
Title
Change in WOMAC Function and Pain index scores in the target knee
Time Frame
52 Weeks
Title
Change in osteoarthritis (OA) pain in the target knee on a 100mm visual analogue scale (VAS)
Time Frame
52 Weeks
Title
Change in JSW in the target knee by x-ray
Time Frame
52 Weeks
Title
Presence of anti-AS902330 antibodies
Time Frame
52 Weeks
Title
Blood levels of AS902330
Time Frame
52 Weeks
Title
MRI at 3 months, score on WOMAC questionnaire at 3, 6 and 12 months.
Time Frame
6 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female >= 40 years of age; females must be postmenopausal or surgically sterile Established diagnosis of primary femoro-tibial OA of the target knee by standard American College of Rheumatology Criteria for at least six months (clinical AND radiological criteria) Radiological disease stage 2 or 3 (i.e., clear evidence of OA, but not most advanced disease) in the target knee according to the Kellgren-Lawrence grading of knee OA No major knee surgery (e.g., partial or total knee replacement, interventional arthroscopy) in the target knee planned for at least 12 months after first injection of the study drug Documented need for symptomatic PRN (as needed)-treatment for OA in the target knee with systemic non-steroidal anti-inflammatory drugs (NSAIDs) and/or other analgesics. Total WOMAC score between 24 and 72 (out of 96, corresponding to mild, moderate, or severe, but not extreme OA symptoms) for the target knee while on oral symptomatic treatment at baseline Full understanding of the requirements of the study and willingness to comply with all study visits and assessments Patients must have read and understood the informed consent form, and must have signed it prior to any study-related procedure Exclusion Criteria: any condition, including laboratory findings and findings in the medical history or in the pre-study assessments, that in the opinion of the Investigator constitutes a risk or contraindication for participation in the study or that could interfere with the study objectives, conduct or evaluation clinically significant abnormal hematology (hemoglobin, leucocytes, and platelets), or blood chemistry values (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), bilirubin, and creatinine receipt of any investigational product or any experimental therapeutic procedure within the last 12 weeks preceding screening participation in FIH study 27575 or in a different cohort of this study i.a. treatment of the target knee with steroids or hyaluronic acid derivatives within the 3 months before baseline for MAD cohorts, any contra-indications to MRI according to MRI guidelines any condition that would interfere with efficacy or safety assessments in the target knee any drug or food supplement with potential disease-modifying effect (glucosamine, diacerin, chondroitin sulfate) unless given at a stable dose over at least 4 weeks prior to first injection use of electrotherapy or acupuncture for OA, unless there is a stable regimen for at least 4 weeks before baseline any known active infections, including suspicion of intra-articular infection and/or infections that may compromise the immune system such as HIV, Hepatitis B or Hepatitis C infection history of sarcoma and/or of other active malignancy within five years, except adequately treated basal cell or squamous cell carcinoma of the skin signs and symptoms suggestive of transmissible spongiform encephalopathy secondary osteoarthritis: e.g., joint dysplasias, aseptic osteonecrosis, acromegaly, Paget's disease, Ehlers-Danlos syndrome, Gaucher's disease, Stickler's syndrome, joint infection, hemophilia, hemochromatosis, calcium pyrophosphate deposition disease, or neuropathic arthropathy whatever the cause
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donatus Dreher, MD, PhD
Organizational Affiliation
Merck Serono S.A., Geneva
Official's Role
Study Director
Facility Information:
Facility Name
UMHAT "Sv. Ivan Rilski", Clinical Research Unit for Phase I
City
Sofia
ZIP/Postal Code
1612
Country
Bulgaria
Facility Name
SKDS Research, Inc.
City
Newmarket
Country
Canada
Facility Name
Kells Medical Research Group
City
Pointe Claire
Country
Canada
Facility Name
Centre de rhumatologie St-Louis
City
Quebec
Country
Canada
Facility Name
Groupe de Recherche en Maldies Osseuses de Quebec
City
Quebec
Country
Canada
Facility Name
London Road Diagnostic Clinic
City
Sarnia
Country
Canada
Facility Name
Albion Finch Medical Centre
City
Toronto
Country
Canada
Facility Name
Clinical hospital Split
City
Split
Country
Croatia
Facility Name
Clinical Hospital "Sestre Milosrdnice"
City
Zagreb
Country
Croatia
Facility Name
Polyclinic for internal medicine, gynecology, radiology, physical medicine and rehabilitation
City
Zagreb
Country
Croatia
Facility Name
Kuopio University Hospital, Department of Ortopaedics
City
Kuopio
Country
Finland
Facility Name
Oulu University Hospital, Surgical and Intensive Care Division
City
Oulu
Country
Finland
Facility Name
Turku University Central Hospital, Orthopedic Research Unit
City
Turku
Country
Finland
Facility Name
PAREXEL International GmbH
City
Berlin
ZIP/Postal Code
14050
Country
Germany
Facility Name
NZOZ Centrum Medyczne Artur Racewicz
City
Bialystok
Country
Poland
Facility Name
Krakowskie Centrum Medyczne NZOZ
City
Cracow
Country
Poland
Facility Name
REUMED Sp. z o.o.,
City
Lublin
Country
Poland
Facility Name
Niepubliczny Zaklad Opieki Zdrowotnej Nasz Lekarz
City
Torun
Country
Poland
Facility Name
Centrum Leczenia Chorob Cywilizacyjnych
City
Warsaw
Country
Poland
Facility Name
Centrum Medyczne OSTEOMED Sp. z o.o.
City
Warsaw
Country
Poland
Facility Name
Clinical Hospital Center Bezanijska Kosa
City
Beograd
Country
Serbia
Facility Name
Institute of Rheumatology Resavska 69
City
Beograd
Country
Serbia
Facility Name
• Name: Institute of diagnostic, prevention and rechabilitation of cardiovascular and rheumatoid diseases
City
Niska Banja
Country
Serbia
Facility Name
FARMOVS-PAREXEL (Pty) Ltd, University of the Free State
City
Bloemfontein
ZIP/Postal Code
9301
Country
South Africa
Facility Name
PAREXEL -George
City
George
ZIP/Postal Code
6529
Country
South Africa
Facility Name
PAREXEL-Port Elizabeth, Mercantile Hospital
City
Port Elizabeth
ZIP/Postal Code
6020
Country
South Africa
Facility Name
Ortopediska mottagningen
City
Hässleholm
Country
Sweden
Facility Name
Kirurg- och ortopedkliniken Kungälvs sjukhus, 442 83 Kungälv
City
Kungälv
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
24740822
Citation
Lohmander LS, Hellot S, Dreher D, Krantz EF, Kruger DS, Guermazi A, Eckstein F. Intraarticular sprifermin (recombinant human fibroblast growth factor 18) in knee osteoarthritis: a randomized, double-blind, placebo-controlled trial. Arthritis Rheumatol. 2014 Jul;66(7):1820-31. doi: 10.1002/art.38614.
Results Reference
result
PubMed Identifier
24798571
Citation
Onuora S. Osteoarthritis: Sprifermin shows cartilage-protective effects in knee OA. Nat Rev Rheumatol. 2014 Jun;10(6):322. doi: 10.1038/nrrheum.2014.68. Epub 2014 May 6. No abstract available.
Results Reference
result
PubMed Identifier
27393009
Citation
Roemer FW, Aydemir A, Lohmander S, Crema MD, Marra MD, Muurahainen N, Felson DT, Eckstein F, Guermazi A. Structural effects of sprifermin in knee osteoarthritis: a post-hoc analysis on cartilage and non-cartilaginous tissue alterations in a randomized controlled trial. BMC Musculoskelet Disord. 2016 Jul 9;17:267. doi: 10.1186/s12891-016-1128-2.
Results Reference
derived
PubMed Identifier
26138203
Citation
Eckstein F, Wirth W, Guermazi A, Maschek S, Aydemir A. Brief report: intraarticular sprifermin not only increases cartilage thickness, but also reduces cartilage loss: location-independent post hoc analysis using magnetic resonance imaging. Arthritis Rheumatol. 2015 Nov;67(11):2916-22. doi: 10.1002/art.39265.
Results Reference
derived

Learn more about this trial

A Multicenter Study of rhFGF 18 in Patients With Knee Osteoarthritis Not Requiring Surgery

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