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Clinical Trial of Low-dose Radiation Therapy in Patients With Knee Osteoarthritis (LoRD-KNeA Trial) (LoRD-KNeA)

Primary Purpose

Knee Osteoarthritis

Status
Not yet recruiting
Phase
Not Applicable
Locations
Korea, Republic of
Study Type
Interventional
Intervention
low-dose radiation therapy
sham radiation therapy
Sponsored by
Seoul National University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring knee, Osteoarthritis, radiation therapy, radiotherapy

Eligibility Criteria

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

Inclusion Criteria:

  • Age 60-85 years old
  • Kellgren-Lawrence grade 2-3 and diagnosed as a patient with primary knee osteoarthritis according to the ACR knee OA diagnostic criteria
  • Patients with VAS 40 or higher when walking, with or without medication at the time of screening
  • Patients who have VAS 50 or more and 90 or less when walking at the baseline
  • Among patients who were previously taking analgesic drugs at the time of screening, those with an increase in pain of 10 points or more at the baseline
  • Patients who do not want to take non-narcotic analgesics, those who have failed to control their pain due to the use of non-narcotic analgesics, or candidates for invasive treatment (intra-articular injection, arthroplasty, etc.)
  • A person who has a will to discontinue all pain medications except for rescue medications throughout screening, baseline, and clinical trials related to knee arthritis
  • A person who gives consent to use an approved contraceptive method from screening to 3 months after the end of the clinical trial
  • A person who understands the eligibility requirements for the study and has signed the consent form

Exclusion Criteria:

  • A history of knee irradiation in the past
  • Patients participating in other degenerative arthritis clinical trials
  • Kellgren-Lawrence grade 4
  • A history of malignancy within the last 5 years
  • A history of knee or hip surgery in the past
  • Patients who have received systemic steroid treatment or intra-articular steroid/hyaluronic acid injection within 2 months of screening
  • Patients with hip degenerative arthritis or other diseases of NRS 5 or higher that may affect functional score evaluation
  • Patients who are scheduled for surgical treatment of the knee joint during the clinical trial period
  • BMI > 39 kg/m2
  • Known history of analgesic or substance abuse within 2 years of screening
  • History, diagnostic signs or symptoms of any of the following clinically significant psychiatric disorders that would render the study ineligible (psychotic disorder, depression, somatic disorder)
  • History, diagnostic signs, or symptoms of any of the following clinically significant heart diseases that would render the study ineligible (surgery or stenting for ischemic heart disease and coronary artery disease within 6 months prior to screening)
  • History of other diseases that may affect the index joint, including autoimmune diseases (lupus, rheumatoid arthritis, etc.)
  • Fibromyalgia history or diagnosis
  • If the researcher judges that a person with significant trauma or other findings considered clinically important is inappropriate for participation in this study

Sites / Locations

  • Seoul National University Hospital / SMG-SNU Boramae Medical Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Sham Comparator

Experimental

Experimental

Arm Label

sham radiation therapy

low-dose radiation therapy, 30 cGy/6 fx (experimental 1)

low-dose radiation therapy, 300 cGy/6 fx (experimental 2)

Arm Description

sham radiation therapy

low-dose radiation therapy, 30 cGy/6 fx

low-dose radiation therapy, 300 cGy/6 fx

Outcomes

Primary Outcome Measures

OMERACT-OARSI response rate
OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) response rate at 4 months. The OMERACT-OARSI criteria for response are (1) improvement in pain or physical function ≥50% and an absolute change ≥20 mm; or (2) improvement of ≥20% with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment.

Secondary Outcome Measures

OMERACT-OARSI response rate
OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) response rate at 4 weeks, 8 months, and 12 months. The OMERACT-OARSI criteria for response are (1) improvement in pain or physical function ≥50% and an absolute change ≥20 mm; or (2) improvement of ≥20% with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment.
Changes in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score
Total score (min 0, max 96 points, higher scores mean a worse outcome) and WOMAC score subscale (pain: min 0 max 20, stiffness: min 0 max 8, physical function: min 0 max 68)
Changes in pain score
VAS score (min 0, max 100, higher scores mean a worse outcome)
Changes in global assessment
PGA (Patient Global Assessment) score (min 0, max 100, higher scores mean a worse outcome)
Radiological Changes Evaluated by Knee MRI
Radiological Changes Evaluated by Knee MRI
Radiological Changes Evaluated by Knee X-ray
Radiological Changes Evaluated by Knee X-ray
Changes in serum ESR (Erythrocyte sedimentation rate)
Changes in ESR (Erythrocyte sedimentation rate)
Changes in serum CRP (C-reactive protein)
Changes in CRP (C-reactive protein)
Change in the amount of analgesic rescue medication usage
Concomitant use of analgesics is prohibited until 4 months after irradiation, when the primary efficacy evaluation is scheduled. During this period, the use of a rescue drug (acetaminophen) may be permitted if the subjects need it for osteoarthritis. Monitor the amount of rescue medication prescribed to measure changes in usage during visits up to 4 months

Full Information

First Posted
September 22, 2022
Last Updated
September 27, 2022
Sponsor
Seoul National University Hospital
Collaborators
Samsung Medical Center, SMG-SNU Boramae Medical Center, Korea Hydro & Nuclear Power
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1. Study Identification

Unique Protocol Identification Number
NCT05562271
Brief Title
Clinical Trial of Low-dose Radiation Therapy in Patients With Knee Osteoarthritis (LoRD-KNeA Trial)
Acronym
LoRD-KNeA
Official Title
A Multi-center, Randomized, Single-blinded, Exploratory Clinical Trial to Evaluate Safety and Efficacy of Alleviating Symptom of Low-dose RaDiation Therapy in Patients With KNee osteoArthritis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 2022 (Anticipated)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Seoul National University Hospital
Collaborators
Samsung Medical Center, SMG-SNU Boramae Medical Center, Korea Hydro & Nuclear Power

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
Clinical verification of knee osteoarthritis pain relief and functional improvement using low-dose radiation therapy
Detailed Description
This clinical trial is a multicenter, randomized, single-blinded, exploratory clinical trial to evaluate the efficacy and safety of low-dose radiation for knee osteoarthritis patients. The experimental group is treated with low-dose irradiation 6 times for 3 weeks according to the dose determined for each group, and the control group is treated with sham irradiation. Both the experimental group and the control group visit the hospital 4 weeks after irradiation and at 4, 8, and 12 months to evaluate the efficacy and safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
knee, Osteoarthritis, radiation therapy, radiotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
114 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
sham radiation therapy
Arm Type
Sham Comparator
Arm Description
sham radiation therapy
Arm Title
low-dose radiation therapy, 30 cGy/6 fx (experimental 1)
Arm Type
Experimental
Arm Description
low-dose radiation therapy, 30 cGy/6 fx
Arm Title
low-dose radiation therapy, 300 cGy/6 fx (experimental 2)
Arm Type
Experimental
Arm Description
low-dose radiation therapy, 300 cGy/6 fx
Intervention Type
Radiation
Intervention Name(s)
low-dose radiation therapy
Intervention Description
low-dose radiation therapy to involved knee joint
Intervention Type
Radiation
Intervention Name(s)
sham radiation therapy
Intervention Description
sham radiation therapy to involved knee joint
Primary Outcome Measure Information:
Title
OMERACT-OARSI response rate
Description
OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) response rate at 4 months. The OMERACT-OARSI criteria for response are (1) improvement in pain or physical function ≥50% and an absolute change ≥20 mm; or (2) improvement of ≥20% with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment.
Time Frame
4 months
Secondary Outcome Measure Information:
Title
OMERACT-OARSI response rate
Description
OMERACT-OARSI (Outcome Measures in Rheumatology-Osteoarthritis Research Society International) response rate at 4 weeks, 8 months, and 12 months. The OMERACT-OARSI criteria for response are (1) improvement in pain or physical function ≥50% and an absolute change ≥20 mm; or (2) improvement of ≥20% with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment.
Time Frame
4 weeks, 8 months, 12 months
Title
Changes in WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) score
Description
Total score (min 0, max 96 points, higher scores mean a worse outcome) and WOMAC score subscale (pain: min 0 max 20, stiffness: min 0 max 8, physical function: min 0 max 68)
Time Frame
4 weeks, 4 months, 8 months, 12 months
Title
Changes in pain score
Description
VAS score (min 0, max 100, higher scores mean a worse outcome)
Time Frame
4 weeks, 4 months, 8 months, 12 months
Title
Changes in global assessment
Description
PGA (Patient Global Assessment) score (min 0, max 100, higher scores mean a worse outcome)
Time Frame
4 weeks, 4 months, 8 months, 12 months
Title
Radiological Changes Evaluated by Knee MRI
Description
Radiological Changes Evaluated by Knee MRI
Time Frame
4 months, 12 months
Title
Radiological Changes Evaluated by Knee X-ray
Description
Radiological Changes Evaluated by Knee X-ray
Time Frame
12 months
Title
Changes in serum ESR (Erythrocyte sedimentation rate)
Description
Changes in ESR (Erythrocyte sedimentation rate)
Time Frame
4 weeks, 4 months, 8 months, 12 months
Title
Changes in serum CRP (C-reactive protein)
Description
Changes in CRP (C-reactive protein)
Time Frame
4 weeks, 4 months, 8 months, 12 months
Title
Change in the amount of analgesic rescue medication usage
Description
Concomitant use of analgesics is prohibited until 4 months after irradiation, when the primary efficacy evaluation is scheduled. During this period, the use of a rescue drug (acetaminophen) may be permitted if the subjects need it for osteoarthritis. Monitor the amount of rescue medication prescribed to measure changes in usage during visits up to 4 months
Time Frame
4 weeks, 4 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
60 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 60-85 years old Kellgren-Lawrence grade 2-3 and diagnosed as a patient with primary knee osteoarthritis according to the ACR knee OA diagnostic criteria Patients with VAS 40 or higher when walking, with or without medication at the time of screening Patients who have VAS 50 or more and 90 or less when walking at the baseline Among patients who were previously taking analgesic drugs at the time of screening, those with an increase in pain of 10 points or more at the baseline Patients who do not want to take non-narcotic analgesics, those who have failed to control their pain due to the use of non-narcotic analgesics, or candidates for invasive treatment (intra-articular injection, arthroplasty, etc.) A person who has a will to discontinue all pain medications except for rescue medications throughout screening, baseline, and clinical trials related to knee arthritis A person who gives consent to use an approved contraceptive method from screening to 3 months after the end of the clinical trial A person who understands the eligibility requirements for the study and has signed the consent form Exclusion Criteria: A history of knee irradiation in the past Patients participating in other degenerative arthritis clinical trials Kellgren-Lawrence grade 4 A history of malignancy within the last 5 years A history of knee or hip surgery in the past Patients who have received systemic steroid treatment or intra-articular steroid/hyaluronic acid injection within 2 months of screening Patients with hip degenerative arthritis or other diseases of NRS 5 or higher that may affect functional score evaluation Patients who are scheduled for surgical treatment of the knee joint during the clinical trial period BMI > 39 kg/m2 Known history of analgesic or substance abuse within 2 years of screening History, diagnostic signs or symptoms of any of the following clinically significant psychiatric disorders that would render the study ineligible (psychotic disorder, depression, somatic disorder) History, diagnostic signs, or symptoms of any of the following clinically significant heart diseases that would render the study ineligible (surgery or stenting for ischemic heart disease and coronary artery disease within 6 months prior to screening) History of other diseases that may affect the index joint, including autoimmune diseases (lupus, rheumatoid arthritis, etc.) Fibromyalgia history or diagnosis If the researcher judges that a person with significant trauma or other findings considered clinically important is inappropriate for participation in this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Byoung Hyuck Kim, MD, PhD
Organizational Affiliation
SMG-SNU Boramae Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul National University Hospital / SMG-SNU Boramae Medical Center
City
Seoul
ZIP/Postal Code
07061
Country
Korea, Republic of
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Byoung Hyuck Kim, MD, PhD
Phone
+8228701683
Email
karlly71@snu.ac.kr

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Clinical Trial of Low-dose Radiation Therapy in Patients With Knee Osteoarthritis (LoRD-KNeA Trial)

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