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Efficacy and Safety of MT-5547 in Patients With Osteoarthritis Accompanied by Moderate to Severe Pain

Primary Purpose

Osteoarthritis, Knee / Osteoarthritis, Hip

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
MT-5547
MT-5547-matching placebo
Sponsored by
Mitsubishi Tanabe Pharma Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee / Osteoarthritis, Hip

Eligibility Criteria

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

Inclusion Criteria:

Additional screening criteria check may apply for qualification:

  • Male and female Japanese patients, 40 years to 85 years at the time written informed consent is obtained.
  • Patients who have been diagnosed with osteoarthritis (OA) of the knee or hip based on the American College of Rheumatology (ACR) criteria.
  • Patients with an evaluated joint (knee or hip) with a K-L (Kellgren-Lawrence) score of ≥2 based on the X-ray test performed.
  • Moderate to severe pain in the evaluated joint, defined as a WOMAC pain score of ≥4 (mean of the 5 items), on the WOMAC assessments.
  • Patients who satisfy both 1) and 2) below.

    1. Inadequate OA pain relief from at least 1 oral NSAID.
    2. Intolerance to or inadequate OA pain relief from at least 1 opioid (including combination drugs), or unwillingness to take opioid therapy.
  • Patients who agree to not change their current lifestyle (daily living activities and exercise) throughout the study.
  • Patients who are able to complete post-operative follow-up for any joint replacement surgery that is performed during the study.
  • Body mass index at screening ≤39.
  • Patient who are able to understand and answer endpoint questions used in the study.

Exclusion Criteria:

Additional screening criteria check may apply for qualification:

  • Presence of symptoms of carpal tunnel syndrome within 6 months before screening.
  • Patients who cannot undergo MRI.
  • Trauma to the index joint within 3 months prior to screening.
  • Presence or history of inflammatory joint diseases other than OA, Paget's disease of the spine, pelvis or femur, multiple sclerosis, fibromyalgia, vertebral tumors or infections, or renal osteodystrophy.
  • Presence or history, confirmed by imaging, of arthropathy, neuropathic joint arthropathy, hip dislocation, knee dislocation, extensive subchondral cyst, marked bone destruction or bone loss, or pathologic fractures.
  • Autonomic neuropathy diagnosed in the assessment of autonomic nerve symptoms performed at screening, or baseline.
  • Presence or history of orthostatic hypotension at the orthostatic hypotension assessments performed at screening, prerandomization, or baseline.
  • Presence or history of autonomic neuropathy, diabetic neuropathy, or other peripheral neuropathy such as reflex sympathetic dystrophy at screening.
  • Presence or history of chronic familial dysautonomia.
  • Intolerance to naproxen.
  • Systemic (excluding topical, intranasal, ophthalmic, and inhaled formulations) corticosteroids within 4 weeks prior to screening.
  • Intra-articular corticosteroids in the evaluated joint within 12 weeks prior to screening, or in any other joint within 4 weeks prior to screening.
  • Received an intra-articular injection of hyaluronic acid in any joint within the period specified for each medicine prior to screening.
  • Resting heart rate of <50 bpm or >100 bpm at screening, or baseline.
  • Presence or history of 2nd or 3rd degree heart block, 1st degree heart block with abnormal QRS, or bifascicular block by ECG assessment at screening.
  • Non-compliance with the Numerical rating scale (NRS) recording (average pain on walking in the evaluated joint over 1 day) during the pre-treatment observation period.
  • Women who are pregnant, breast-feeding, or may be pregnant.
  • Use of an anti-Nerve growth factor (anti-NGF) antibody in the past, or apparent hypersensitivity or intolerance to anti-NGF antibodies.

Sites / Locations

  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site
  • Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

MT-5547 dosing regimen 1

MT-5547 dosing regimen 2

MT-5547-matching placebo

Arm Description

MT-5547 Subcutaneous (SC) dosing regimen 1. Naproxen-matching placebo oral after Week 16.

MT-5547 SC dosing regimen 2. Naproxen-matching placebo oral after Week 16.

MT-5547-matching placebo SC dosing. Naproxen oral after Week 16.

Outcomes

Primary Outcome Measures

WOMAC Pain Score (Change From Baseline at Week 16)
The WOMAC is a scale that is used to assess the activities of daily living in osteoarthritis, the WOMAC pain subscale score was defined as the average of 5 items (during walking, using stairs, in bed, sitting or lying, and standing). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no pain) to 10 (worst pain imaginable), where higher scores indicated worse pain.

Secondary Outcome Measures

WOMAC Physical Function Score (Change From Baseline at Week 16)
The WOMAC physical function subscale score was defined as the average of 17 items(the level of difficulty of activities of daily living: stair use, rising from sitting, standing, bending, walking, getting in and out of a car, shopping, putting on and taking off socks, rising from bed, lying in bed, getting in and out of the bath, sitting, getting on and off the toilet, heavy household duties, light household duties). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no difficulty) to 10(extremely difficult), where higher scores indicated worse function limitation.
WOMAC Pain Score (Change From Baseline at Each Assessment Time Point)
The WOMAC is a scale that is used to assess the activities of daily living in osteoarthritis, the WOMAC pain subscale score was defined as the average of 5 items (during walking, using stairs, in bed, sitting or lying, and standing). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no pain) to 10 (worst pain imaginable), where higher scores indicated worse pain.
WOMAC Physical Function Score (Change From Baseline at Each Assessment Time Point)
The WOMAC physical function subscale score was defined as the average of 17 items(the level of difficulty of activities of daily living: stair use, rising from sitting, standing, bending, walking, getting in and out of a car, shopping, putting on and taking off socks, rising from bed, lying in bed, getting in and out of the bath, sitting, getting on and off the toilet, heavy household duties, light household duties). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no difficulty) to 10(extremely difficult), where higher scores indicated worse function limitation.
WOMAC Stiffness Score (Change From Baseline at Each Assessment Time Point)
The WOMAC stiffness subscale score was defined as the average of 2 items(after first waking and later in the day). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no stiffness) to 10(extremely stiffness), where higher scores indicated worse stiffness.
WOMAC Total Score (Change From Baseline at Each Assessment Time Point)
The WOMAC total subscale score was defined as the average of 24 items(5 pain subscale items, 17 physical functioning subscale items, and 2 stiffness subscale items). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no stiffness) to 10(extremely stiffness), where smaller values being better.
Patient Global Assessment (PGA) (Change From Baseline at Each Assessment Time Point)
Patient Global Assessment(PGA) was a measure whereby the participant assessed global improvement in OA using the 5-level scale(1=very well; 2=well; 3=fair; 4=poor; and 5=very poor).
Number of Participants With Adverse Events and Adverse Drug Reactions
Number of Participants With a Joint Replacement Procedure is Scheduled
All the Joint Replacement surgeries that were performed within 20 weeks from the day after the end date of the treatment period were reported and tabulated in this study in order to assess the outcome of joint damage regardless of the presence or absence of related adjudicated arthropathy. The subjects who were going to undergo JR surgery were to be withdrawn from study treatment.

Full Information

First Posted
August 7, 2017
Last Updated
April 23, 2023
Sponsor
Mitsubishi Tanabe Pharma Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT03245008
Brief Title
Efficacy and Safety of MT-5547 in Patients With Osteoarthritis Accompanied by Moderate to Severe Pain
Official Title
A Phase 2/3 (Placebo-Controlled, Double-Blind, Comparative) Study on MT-5547 in Patients With Osteoarthritis Accompanied by Moderate to Severe Pain
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
September 8, 2017 (Actual)
Primary Completion Date
December 14, 2019 (Actual)
Study Completion Date
March 9, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mitsubishi Tanabe Pharma Corporation

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
The objective of this study is to verify the superiority of 16 weeks of MT-5547 treatment to placebo, as evidenced by the WOMAC pain score (the efficacy outcome measure), in patients with osteoarthritis of the knee or hip. Additional objectives of the study are to investigate the efficacy, safety, and pharmacokinetics of MT-5547 in long-term use.
Detailed Description
The blind will be maintained, including for the study sponsor, until the key code is opened after the data have been fixed for all subjects in Week 24. In addition, in order to eliminate any bias that could affect the study assessments, to the extent possible, the blind will be maintained with respect to the study site and the subject even after the opening of the study sponsor key code.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
626 (Actual)

8. Arms, Groups, and Interventions

Arm Title
MT-5547 dosing regimen 1
Arm Type
Experimental
Arm Description
MT-5547 Subcutaneous (SC) dosing regimen 1. Naproxen-matching placebo oral after Week 16.
Arm Title
MT-5547 dosing regimen 2
Arm Type
Experimental
Arm Description
MT-5547 SC dosing regimen 2. Naproxen-matching placebo oral after Week 16.
Arm Title
MT-5547-matching placebo
Arm Type
Placebo Comparator
Arm Description
MT-5547-matching placebo SC dosing. Naproxen oral after Week 16.
Intervention Type
Drug
Intervention Name(s)
MT-5547
Other Intervention Name(s)
Fasinumab
Intervention Description
Solution for injection in pre-filled syringe
Intervention Type
Drug
Intervention Name(s)
MT-5547-matching placebo
Intervention Description
Solution for injection in pre-filled syringe
Primary Outcome Measure Information:
Title
WOMAC Pain Score (Change From Baseline at Week 16)
Description
The WOMAC is a scale that is used to assess the activities of daily living in osteoarthritis, the WOMAC pain subscale score was defined as the average of 5 items (during walking, using stairs, in bed, sitting or lying, and standing). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no pain) to 10 (worst pain imaginable), where higher scores indicated worse pain.
Time Frame
Baseline to Week 16
Secondary Outcome Measure Information:
Title
WOMAC Physical Function Score (Change From Baseline at Week 16)
Description
The WOMAC physical function subscale score was defined as the average of 17 items(the level of difficulty of activities of daily living: stair use, rising from sitting, standing, bending, walking, getting in and out of a car, shopping, putting on and taking off socks, rising from bed, lying in bed, getting in and out of the bath, sitting, getting on and off the toilet, heavy household duties, light household duties). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no difficulty) to 10(extremely difficult), where higher scores indicated worse function limitation.
Time Frame
Baseline to Week 16
Title
WOMAC Pain Score (Change From Baseline at Each Assessment Time Point)
Description
The WOMAC is a scale that is used to assess the activities of daily living in osteoarthritis, the WOMAC pain subscale score was defined as the average of 5 items (during walking, using stairs, in bed, sitting or lying, and standing). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no pain) to 10 (worst pain imaginable), where higher scores indicated worse pain.
Time Frame
Baseline to Week 68
Title
WOMAC Physical Function Score (Change From Baseline at Each Assessment Time Point)
Description
The WOMAC physical function subscale score was defined as the average of 17 items(the level of difficulty of activities of daily living: stair use, rising from sitting, standing, bending, walking, getting in and out of a car, shopping, putting on and taking off socks, rising from bed, lying in bed, getting in and out of the bath, sitting, getting on and off the toilet, heavy household duties, light household duties). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no difficulty) to 10(extremely difficult), where higher scores indicated worse function limitation.
Time Frame
Baseline to Week 68
Title
WOMAC Stiffness Score (Change From Baseline at Each Assessment Time Point)
Description
The WOMAC stiffness subscale score was defined as the average of 2 items(after first waking and later in the day). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no stiffness) to 10(extremely stiffness), where higher scores indicated worse stiffness.
Time Frame
Baseline to Week 68
Title
WOMAC Total Score (Change From Baseline at Each Assessment Time Point)
Description
The WOMAC total subscale score was defined as the average of 24 items(5 pain subscale items, 17 physical functioning subscale items, and 2 stiffness subscale items). The participants assessed the past 48 hours on an 11-point numeric rating scale, from 0 (no stiffness) to 10(extremely stiffness), where smaller values being better.
Time Frame
Baseline to Week 68
Title
Patient Global Assessment (PGA) (Change From Baseline at Each Assessment Time Point)
Description
Patient Global Assessment(PGA) was a measure whereby the participant assessed global improvement in OA using the 5-level scale(1=very well; 2=well; 3=fair; 4=poor; and 5=very poor).
Time Frame
Baseline to Week 68
Title
Number of Participants With Adverse Events and Adverse Drug Reactions
Time Frame
Baseline to Week 68 (Treatment period=48 weeks, Post-treatment Observation Period=20weeks)
Title
Number of Participants With a Joint Replacement Procedure is Scheduled
Description
All the Joint Replacement surgeries that were performed within 20 weeks from the day after the end date of the treatment period were reported and tabulated in this study in order to assess the outcome of joint damage regardless of the presence or absence of related adjudicated arthropathy. The subjects who were going to undergo JR surgery were to be withdrawn from study treatment.
Time Frame
Baseline to Week 68

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: Additional screening criteria check may apply for qualification: Male and female Japanese patients, 40 years to 85 years at the time written informed consent is obtained. Patients who have been diagnosed with osteoarthritis (OA) of the knee or hip based on the American College of Rheumatology (ACR) criteria. Patients with an evaluated joint (knee or hip) with a K-L (Kellgren-Lawrence) score of ≥2 based on the X-ray test performed. Moderate to severe pain in the evaluated joint, defined as a WOMAC pain score of ≥4 (mean of the 5 items), on the WOMAC assessments. Patients who satisfy both 1) and 2) below. Inadequate OA pain relief from at least 1 oral NSAID. Intolerance to or inadequate OA pain relief from at least 1 opioid (including combination drugs), or unwillingness to take opioid therapy. Patients who agree to not change their current lifestyle (daily living activities and exercise) throughout the study. Patients who are able to complete post-operative follow-up for any joint replacement surgery that is performed during the study. Body mass index at screening ≤39. Patient who are able to understand and answer endpoint questions used in the study. Exclusion Criteria: Additional screening criteria check may apply for qualification: Presence of symptoms of carpal tunnel syndrome within 6 months before screening. Patients who cannot undergo MRI. Trauma to the index joint within 3 months prior to screening. Presence or history of inflammatory joint diseases other than OA, Paget's disease of the spine, pelvis or femur, multiple sclerosis, fibromyalgia, vertebral tumors or infections, or renal osteodystrophy. Presence or history, confirmed by imaging, of arthropathy, neuropathic joint arthropathy, hip dislocation, knee dislocation, extensive subchondral cyst, marked bone destruction or bone loss, or pathologic fractures. Autonomic neuropathy diagnosed in the assessment of autonomic nerve symptoms performed at screening, or baseline. Presence or history of orthostatic hypotension at the orthostatic hypotension assessments performed at screening, prerandomization, or baseline. Presence or history of autonomic neuropathy, diabetic neuropathy, or other peripheral neuropathy such as reflex sympathetic dystrophy at screening. Presence or history of chronic familial dysautonomia. Intolerance to naproxen. Systemic (excluding topical, intranasal, ophthalmic, and inhaled formulations) corticosteroids within 4 weeks prior to screening. Intra-articular corticosteroids in the evaluated joint within 12 weeks prior to screening, or in any other joint within 4 weeks prior to screening. Received an intra-articular injection of hyaluronic acid in any joint within the period specified for each medicine prior to screening. Resting heart rate of <50 bpm or >100 bpm at screening, or baseline. Presence or history of 2nd or 3rd degree heart block, 1st degree heart block with abnormal QRS, or bifascicular block by ECG assessment at screening. Non-compliance with the Numerical rating scale (NRS) recording (average pain on walking in the evaluated joint over 1 day) during the pre-treatment observation period. Women who are pregnant, breast-feeding, or may be pregnant. Use of an anti-Nerve growth factor (anti-NGF) antibody in the past, or apparent hypersensitivity or intolerance to anti-NGF antibodies.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
General Manager
Organizational Affiliation
Mitsubishi Tanabe Pharma Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Investigational Site
City
Aichi
Country
Japan
Facility Name
Investigational Site
City
Aomori
Country
Japan
Facility Name
Investigational Site
City
Chiba
Country
Japan
Facility Name
Investigational Site
City
Ehime
Country
Japan
Facility Name
Investigational Site
City
Fukui
Country
Japan
Facility Name
Investigational Site
City
Fukuoka
Country
Japan
Facility Name
Investigational Site
City
Fukushima
Country
Japan
Facility Name
Investigational Site
City
Gunma
Country
Japan
Facility Name
Investigational Site
City
Hiroshima
Country
Japan
Facility Name
Investigational Site
City
Hokkaido
Country
Japan
Facility Name
Investigational Site
City
Hyogo
Country
Japan
Facility Name
Investigational Site
City
Ibaraki
Country
Japan
Facility Name
Investigational Site
City
Kagoshima
Country
Japan
Facility Name
Investigational Site
City
Kanagawa
Country
Japan
Facility Name
Investigational Site
City
Kumamoto
Country
Japan
Facility Name
Investigational Site
City
Kyoto
Country
Japan
Facility Name
Investigational Site
City
Mie
Country
Japan
Facility Name
Investigational Site
City
Miyagi
Country
Japan
Facility Name
Investigational Site
City
Miyazaki
Country
Japan
Facility Name
Investigational Site
City
Oita
Country
Japan
Facility Name
Investigational Site
City
Osaka
Country
Japan
Facility Name
Investigational Site
City
Saitama
Country
Japan
Facility Name
Investigational Site
City
Shiga
Country
Japan
Facility Name
Investigational Site
City
Shizuoka
Country
Japan
Facility Name
Investigational Site
City
Tokyo
Country
Japan
Facility Name
Investigational Site
City
Yamagata
Country
Japan
Facility Name
Investigational Site
City
Yamaguchi
Country
Japan

12. IPD Sharing Statement

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Efficacy and Safety of MT-5547 in Patients With Osteoarthritis Accompanied by Moderate to Severe Pain

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