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AMZ001 for the Treatment of Knee Osteoarthritis Symptoms

Primary Purpose

Osteoarthritis, Knee

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AMZ001
Placebo
Comparator
Sponsored by
Amzell
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring AMZ001

Eligibility Criteria

40 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Osteoarthritis of the knee, according the American College of Rheumatology (ACR) clinical and X-ray criteria.
  2. Pain score rated on an 11-point numerical rating scale of the target knee of ≥ 20 and ≤ 45 out of 50 in response to the WOMAC pain sub-score (5 questions), at the time of screening, after washout of any pain relief medication.
  3. Women of child-bearing potential must use at least an acceptably effective method of contraception from enrollment up to at least 3 months after the study end.
  4. Knee pain in the target knee for 14 days of the preceding month (knee pain due to osteoarthritis and not due to another condition such as bursitis, tendinitis, etc.) based on subject report.
  5. On stable pain therapy (i.e., at least 3 days per week for the previous month) with an oral or topical NSAID prescribed by physician for 30 days prior to the Screening Visit and/or prescribed over-the-counter.
  6. Except for osteoarthritis, in reasonably good health as determined by the Investigator.

Exclusion Criteria:

  1. Known or suspected hypersensitivity to diclofenac, other non-steroidal anti-inflammatory drugs or related substances including aspirin, any of the components in either of the investigation products, or any physical impediment to gel application on the target knee.
  2. Injection of corticosteroids or hyaluronic acid in the target knee within 6 months of screening or into any other joint within 30 days of screening.
  3. High dose oral/injected corticosteroid treatment of more than 14 days during the past 6 months prior to screening.
  4. Major surgery or arthroscopy of the target knee within the previous year prior to screening.
  5. Planned surgery of the target knee within the next 3 months.
  6. Presence of an additional non-osteoarthritic disease affecting either knee, such as rheumatoid arthritis, psoriasis, gout or pseudo-gout, if there is reason to believe that the disease(s) may significantly interfere with the interpretation of the clinical response to the study drug.
  7. Medical history of coronary artery bypass graft surgery.
  8. Current cancer or treatment for cancer within the past five years, with the exception of non-melanoma skin cancer, unless affecting the target knee area.
  9. Secondary osteoarthritis of the target knee, previous procedures or trauma affecting joint of the target knee.
  10. Reported incidence of any of the following diseases: known osteoarthritis of the hip(s) if pain in hip(s) exceeds that of the target knee using the WOMAC Hip Pain subscore, presence of significant back pain, or at least one migraine attack within the past 12 months before screening, as reported by the subject.
  11. Body Mass Index > 45.0 kg/m2.
  12. Generalized skin irritation, previous skin reactions upon use of topical NSAIDs, current skin irritation or redness at the planned site of gel application, or significant skin disease including psoriasis, as judged by the investigator.
  13. Known presence of a ulcer or any gastrointestinal bleeding within 6 months prior to screening.
  14. Use of moderate or higher doses of opioid medication for the treatment of pain within 6 weeks before the screening visit.
  15. Use of duloxetine, pregabalin, or gabapentin within 4 weeks before the screening visit.
  16. History of alcohol or drug abuse within the past year prior to randomization.

Sites / Locations

  • Clinical Research Consulting
  • Premier Medical Associates
  • Upstate Clinical Research Associates
  • CCR Brno, s.r.o
  • CCR Czech, a.s
  • CCR Prague s.r.o.
  • Sanos Clinic

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Placebo Comparator

Active Comparator

Arm Label

AMZ001 + Placebo

AMZ001

Placebo

Comparator

Arm Description

on the target knee

on the target knee

on the target knee

Diclofenac gel on the target knee

Outcomes

Primary Outcome Measures

WOMAC Pain Sub-score
Change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain sub-score (questions 1-5; score 0 [no pain]-50 [extreme pain]) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.

Secondary Outcome Measures

WOMAC Total Score and WOMAC Function and Stiffness
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) total score and WOMAC function (degree of difficulty experienced in performing daily activities - 17 questions score 0-170) and stiffness (the degree and timing of joint stiffness - 2 questions score 0-20). The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
WOMAC Pain Weight-bearing Score and Non-weight-bearing Score
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) pain weight-bearing score (questions 1,2, & 5; score 0-30) and non-weight-bearing score (questions 3&4; score 0-20) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
ICOAP Scores
Change from baseline in Intermittent and Constant Osteoarthritis Pain (ICOAP) scores (score 0 [no pain]- 4 [extreme pain]). ICOAP scores were normalized to a 0-100 point scale, where 0 is no pain and higher scores indicate greater pain.
Physical Function
Change in baseline in physical function assessed by the chair-stand test. The test measures the maximum number of chair stand repetitions possible in a 30-second period with out using the arms. Where 0 is no repetition completed and higher numbers corresponds to greater repetitions and physical function.
Proportion of Responders as Per OMERACT-OARSI Criteria
Outcome Measures in Rheumatology- Osteoarthritis Research Society International (OMERACT-OARSI) response involves changes that are deemed to be clinically relevant in three domains: pain, function, and PGA (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 high improvement in at least 1 of WOMAC pain and function scores OR moderate improvement in at least 2 of WOMAC pain scores, WOMAC function score or Patient Global Assessment (PGA)
Total Dose of Rescue Medication
Total dose of rescue medication calculated as the average gram use/day, based on pill counts.
Time Between Baseline and First Use of Rescue Medication
Time between baseline and first use of rescue medication.
WOMAC Pain Sub-score (Dose Comparison)
Change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain sub-score (questions 1-5; score 0 [no pain]-50 [extreme pain]) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
ICOAP Scores (Dose Comparison)
Change from baseline in Intermittent and Constant Osteoarthritis Pain (ICOAP) scores (score 0 [no pain]- 4 [extreme pain]). ICOAP scores were normalized to a 0-100 point scale, where 0 is no pain and higher scores indicate greater pain.
WOMAC Pain Weight-bearing Score and Non-weight-bearing Score (Dose Comparison)
Changes from baseline in Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain weight-bearing score (questions 1,2, & 5; score 0-30) and non-weight-bearing score (questions 3&4; score 0-20) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Physical Function (Dose Comparison)
Change in baseline assessed by the chair-stand test. The test measures the maximum number of chair stand repetitions possible in a 30-second period with out using the arms. Where 0 is no repetition completed and higher numbers corresponds to greater repetitions and physical function.
WOMAC Total Score and WOMAC Function and Stiffness (Dose Comparison)
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) total score and WOMAC function (degree of difficulty experienced in performing daily activities - 17 questions score 0-170) and stiffness (the degree and timing of joint stiffness - 2 questions score 0-20). The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Impact of Osteoarthritis on Daily Living (PGA Score)
Change from baseline in Impact of OA daily living assessed using Patient Global Assessment (PGA) score. PGA is scored on a 11-point scale from 0 (none) to 10 (extreme), where higher scores represents a higher level of disease activity or worse health.
Work Productivity
Change from baseline in work productivity and activity assessed by the Work Productivity and Active Impairment (WPAI scores 0-100% in four different categories: absenteeism, presenteeism, work productivity loss, and activity impairment). Outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity.
Change in Quality of Life: EQ5D VAS Score
The EuroQol-5 Domain (EQ-5D) is a standardized generic measure of health-related quality of life. The visual analog scale (VAS) is scored on a 0-100 scale, where 0 is "the worst health you can imagine" and 100, "the best health you can imagine".

Full Information

First Posted
September 18, 2018
Last Updated
September 14, 2020
Sponsor
Amzell
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1. Study Identification

Unique Protocol Identification Number
NCT03691844
Brief Title
AMZ001 for the Treatment of Knee Osteoarthritis Symptoms
Official Title
A Placebo-controlled, Double-blind, Randomized, Trial of AMZ001 for the Treatment of Knee Osteoarthritis Symptoms
Study Type
Interventional

2. Study Status

Record Verification Date
September 2020
Overall Recruitment Status
Completed
Study Start Date
October 4, 2018 (Actual)
Primary Completion Date
July 9, 2019 (Actual)
Study Completion Date
July 9, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amzell

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
This is a multicenter, randomized, double-blind, placebo-controlled, parallel group, 4-week trial of a formulation of AMZ001 once or twice daily versus placebo twice daily, including a single-blind treatment group with a commercial gel four times daily.
Detailed Description
This is a multicenter, randomized, double-blind, placebo-controlled, parallel group, 4-week trial of a formulation of AMZ001 once or twice daily versus placebo twice daily, including a single-blind treatment group with a commercial gel four times daily. Participants will be evaluated for osteoarthritis by X-ray images of the knees and one knee will be selected for treatment as the target knee. The study gel will be applied directly to that knee throughout the 4 weeks of the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee
Keywords
AMZ001

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Model Description
placebo-controlled, double-blind, randomized, parallel study
Masking
ParticipantInvestigator
Masking Description
3 treatment arms will be double-blind, the 4th (comparator) will be single-blind
Allocation
Randomized
Enrollment
444 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AMZ001 + Placebo
Arm Type
Experimental
Arm Description
on the target knee
Arm Title
AMZ001
Arm Type
Experimental
Arm Description
on the target knee
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
on the target knee
Arm Title
Comparator
Arm Type
Active Comparator
Arm Description
Diclofenac gel on the target knee
Intervention Type
Drug
Intervention Name(s)
AMZ001
Intervention Description
diclofenac gel
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Comparator
Other Intervention Name(s)
active comparator
Intervention Description
diclofenac gel
Primary Outcome Measure Information:
Title
WOMAC Pain Sub-score
Description
Change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain sub-score (questions 1-5; score 0 [no pain]-50 [extreme pain]) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Secondary Outcome Measure Information:
Title
WOMAC Total Score and WOMAC Function and Stiffness
Description
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) total score and WOMAC function (degree of difficulty experienced in performing daily activities - 17 questions score 0-170) and stiffness (the degree and timing of joint stiffness - 2 questions score 0-20). The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Title
WOMAC Pain Weight-bearing Score and Non-weight-bearing Score
Description
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) pain weight-bearing score (questions 1,2, & 5; score 0-30) and non-weight-bearing score (questions 3&4; score 0-20) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Title
ICOAP Scores
Description
Change from baseline in Intermittent and Constant Osteoarthritis Pain (ICOAP) scores (score 0 [no pain]- 4 [extreme pain]). ICOAP scores were normalized to a 0-100 point scale, where 0 is no pain and higher scores indicate greater pain.
Time Frame
baseline, week 4
Title
Physical Function
Description
Change in baseline in physical function assessed by the chair-stand test. The test measures the maximum number of chair stand repetitions possible in a 30-second period with out using the arms. Where 0 is no repetition completed and higher numbers corresponds to greater repetitions and physical function.
Time Frame
baseline, week 4
Title
Proportion of Responders as Per OMERACT-OARSI Criteria
Description
Outcome Measures in Rheumatology- Osteoarthritis Research Society International (OMERACT-OARSI) response involves changes that are deemed to be clinically relevant in three domains: pain, function, and PGA (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 high improvement in at least 1 of WOMAC pain and function scores OR moderate improvement in at least 2 of WOMAC pain scores, WOMAC function score or Patient Global Assessment (PGA)
Time Frame
week 4
Title
Total Dose of Rescue Medication
Description
Total dose of rescue medication calculated as the average gram use/day, based on pill counts.
Time Frame
weeks 1 through 4
Title
Time Between Baseline and First Use of Rescue Medication
Description
Time between baseline and first use of rescue medication.
Time Frame
weeks 1 through 4
Title
WOMAC Pain Sub-score (Dose Comparison)
Description
Change from baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain sub-score (questions 1-5; score 0 [no pain]-50 [extreme pain]) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Title
ICOAP Scores (Dose Comparison)
Description
Change from baseline in Intermittent and Constant Osteoarthritis Pain (ICOAP) scores (score 0 [no pain]- 4 [extreme pain]). ICOAP scores were normalized to a 0-100 point scale, where 0 is no pain and higher scores indicate greater pain.
Time Frame
baseline, week 4
Title
WOMAC Pain Weight-bearing Score and Non-weight-bearing Score (Dose Comparison)
Description
Changes from baseline in Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) pain weight-bearing score (questions 1,2, & 5; score 0-30) and non-weight-bearing score (questions 3&4; score 0-20) on target knee. The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Title
Physical Function (Dose Comparison)
Description
Change in baseline assessed by the chair-stand test. The test measures the maximum number of chair stand repetitions possible in a 30-second period with out using the arms. Where 0 is no repetition completed and higher numbers corresponds to greater repetitions and physical function.
Time Frame
baseline, week 4
Title
WOMAC Total Score and WOMAC Function and Stiffness (Dose Comparison)
Description
Change from baseline in Western Ontario McMasters Universities Osteoarthritis Index (WOMAC) total score and WOMAC function (degree of difficulty experienced in performing daily activities - 17 questions score 0-170) and stiffness (the degree and timing of joint stiffness - 2 questions score 0-20). The WOMAC scores were normalized to a 0-100 point scale for data analysis, where 0 is no pain and higher scores indicate greater pain, stiffness or difficulty in performing daily tasks.
Time Frame
baseline, week 4
Title
Impact of Osteoarthritis on Daily Living (PGA Score)
Description
Change from baseline in Impact of OA daily living assessed using Patient Global Assessment (PGA) score. PGA is scored on a 11-point scale from 0 (none) to 10 (extreme), where higher scores represents a higher level of disease activity or worse health.
Time Frame
baseline, week 4
Title
Work Productivity
Description
Change from baseline in work productivity and activity assessed by the Work Productivity and Active Impairment (WPAI scores 0-100% in four different categories: absenteeism, presenteeism, work productivity loss, and activity impairment). Outcomes are expressed as impairment percentages, with higher numbers indicating greater impairment and less productivity.
Time Frame
baseline, week 4
Title
Change in Quality of Life: EQ5D VAS Score
Description
The EuroQol-5 Domain (EQ-5D) is a standardized generic measure of health-related quality of life. The visual analog scale (VAS) is scored on a 0-100 scale, where 0 is "the worst health you can imagine" and 100, "the best health you can imagine".
Time Frame
baseline, week 4
Other Pre-specified Outcome Measures:
Title
Safety Endpoint (Adverse Events)
Description
Nature, incidence and severity of AEs.
Time Frame
weeks 1 through 4
Title
Skin Tolerability Assessment (Skin Reactions)
Description
Skin tolerability assessment, incidence of erythema at the application site. Grading scheme from 0-4 (0, normal skin, no erythema; 4, blister formation and/or necrosis).
Time Frame
week 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Osteoarthritis of the knee, according the American College of Rheumatology (ACR) clinical and X-ray criteria. Pain score rated on an 11-point numerical rating scale of the target knee of ≥ 20 and ≤ 45 out of 50 in response to the WOMAC pain sub-score (5 questions), at the time of screening, after washout of any pain relief medication. Women of child-bearing potential must use at least an acceptably effective method of contraception from enrollment up to at least 3 months after the study end. Knee pain in the target knee for 14 days of the preceding month (knee pain due to osteoarthritis and not due to another condition such as bursitis, tendinitis, etc.) based on subject report. On stable pain therapy (i.e., at least 3 days per week for the previous month) with an oral or topical NSAID prescribed by physician for 30 days prior to the Screening Visit and/or prescribed over-the-counter. Except for osteoarthritis, in reasonably good health as determined by the Investigator. Exclusion Criteria: Known or suspected hypersensitivity to diclofenac, other non-steroidal anti-inflammatory drugs or related substances including aspirin, any of the components in either of the investigation products, or any physical impediment to gel application on the target knee. Injection of corticosteroids or hyaluronic acid in the target knee within 6 months of screening or into any other joint within 30 days of screening. High dose oral/injected corticosteroid treatment of more than 14 days during the past 6 months prior to screening. Major surgery or arthroscopy of the target knee within the previous year prior to screening. Planned surgery of the target knee within the next 3 months. Presence of an additional non-osteoarthritic disease affecting either knee, such as rheumatoid arthritis, psoriasis, gout or pseudo-gout, if there is reason to believe that the disease(s) may significantly interfere with the interpretation of the clinical response to the study drug. Medical history of coronary artery bypass graft surgery. Current cancer or treatment for cancer within the past five years, with the exception of non-melanoma skin cancer, unless affecting the target knee area. Secondary osteoarthritis of the target knee, previous procedures or trauma affecting joint of the target knee. Reported incidence of any of the following diseases: known osteoarthritis of the hip(s) if pain in hip(s) exceeds that of the target knee using the WOMAC Hip Pain subscore, presence of significant back pain, or at least one migraine attack within the past 12 months before screening, as reported by the subject. Body Mass Index > 45.0 kg/m2. Generalized skin irritation, previous skin reactions upon use of topical NSAIDs, current skin irritation or redness at the planned site of gel application, or significant skin disease including psoriasis, as judged by the investigator. Known presence of a ulcer or any gastrointestinal bleeding within 6 months prior to screening. Use of moderate or higher doses of opioid medication for the treatment of pain within 6 weeks before the screening visit. Use of duloxetine, pregabalin, or gabapentin within 4 weeks before the screening visit. History of alcohol or drug abuse within the past year prior to randomization.
Facility Information:
Facility Name
Clinical Research Consulting
City
Milford
State/Province
Connecticut
ZIP/Postal Code
06460
Country
United States
Facility Name
Premier Medical Associates
City
The Villages
State/Province
Florida
ZIP/Postal Code
32162
Country
United States
Facility Name
Upstate Clinical Research Associates
City
Williamsville
State/Province
New York
ZIP/Postal Code
14221
Country
United States
Facility Name
CCR Brno, s.r.o
City
Brno
Country
Czechia
Facility Name
CCR Czech, a.s
City
Pardubice
Country
Czechia
Facility Name
CCR Prague s.r.o.
City
Praha
Country
Czechia
Facility Name
Sanos Clinic
City
Herlev
Country
Denmark

12. IPD Sharing Statement

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AMZ001 for the Treatment of Knee Osteoarthritis Symptoms

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