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Efficacy and Safety of XT-150 in Osteoarthritis of the Knee

Primary Purpose

Osteoarthritis, Knee

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
XT-150
Placebo
Sponsored by
Xalud Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring Inflammation, Pain, Interleukin, Gene Therapy, plasmid DNA

Eligibility Criteria

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

Inclusion Criteria:

  1. Symptomatic disease due to osteoarthritis, defined as a WOMAC Pain score ≥ 8 (worst possible = 20)
  2. Focused Analgesia Selection Test will be used to determine whether patients can report pain with sufficient consistency to enter the clinical trial
  3. Males and females between 45 and 85 years of age, inclusive
  4. Kellgren-Lawrence grading of 2 or 3 within the last 6 months
  5. Stable analgesic regimen during the 4 weeks prior to enrollment
  6. In the judgment of the Investigator, acceptable general medical condition
  7. Life expectancy >6 months
  8. Male and female participants who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study
  9. Have suitable knee joint anatomy for intra-articular injection
  10. Willing and able to return for the follow-up (FU) visits
  11. Able to read and understand study instructions, and willing and able to comply with all study procedures

Exclusion Criteria:

  1. Hypersensitivity, allergy, or significant reaction to any ingredient of the study drug, including double-stranded DNA, mannose, and sucrose
  2. Previously received XT-150 injection(s)
  3. Scheduled partial or complete knee replacement within 6 months; participant agrees not to schedule a knee replacement during Stage A of the study
  4. History of knee arthroplasty on the Index Knee, i.e., selected for study injection(s)
  5. History of rheumatoid arthritis or other inflammatory disease
  6. History of immunosuppressive therapy; systemic steroids in the last 3 months
  7. Received knee injection with hyaluronic acid or stem-cells in the last 6 months
  8. Knee injection of glucocorticoid in the last 3 months
  9. Current treatment with systemic immunosuppressive (systemic corticosteroid therapy or other strong immunosuppressant)
  10. Currently receiving systemic chemotherapy or radiation therapy for malignancy
  11. Clinically significant hepatic disease as indicated by clinical laboratory results ≥3 times the upper limit of normal for any liver function test (e.g., aspartate aminotransferase, alanine aminotransferase)
  12. Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), Grade 1 white cell counts (lymphocytes <LLN - 800/mm^3; <LLN - 0.8 x 109 /L, neutrophils <LLN - 1500/mm^3; <LLN - 1.5 x 109 /L), LLN=Lower Limit Normal Range
  13. Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus
  14. Significant neuropsychiatric conditions; dementia, major depression, or altered mental state that in the opinion of the Investigator will interfere with study participation
  15. Current treatment with systemic antibiotics or antivirals (EXCEPTION: topical treatments)
  16. Current anticoagulant or anti-platelet treatment (e.g., warfarin, heparins, factor X inhibitors, clopidogrel, prasugrel, ticagrelor, or dipyridamole). Low-dose (≤ 325 mg/day) aspirin is permitted
  17. Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit
  18. Use of any investigational drug or device within 3 months before enrollment or current participation in a trial that included intervention with a drug or device; or currently participating in an investigational drug or device study
  19. Any condition that, in the opinion of the Investigator, could compromise the safety of the participant, the participant's ability to communicate with the study staff, or the quality of the data

Sites / Locations

  • eStudySite
  • Neurovations (Napa Pain Institute)
  • Source Healthcare
  • Carolinas Clinical Research Institute
  • University of Adelaide in collaboration with CMAX Clinical Research Pty Ltd
  • Alfred Health

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Placebo Comparator

Arm Label

Stage A: 0.15 mg/mL XT-150, Stage B: 0.15 mg/mL XT-150

Stage A: 0.15 mg/mL XT-150, Stage B: 0.45 mg/mL XT-150

Stage A: 0.45 mg/mL XT-150, Stage B: 0.15 mg/mL XT-150

Stage A: 0.45 mg/mL XT-150, Stage B: 0.45 mg/mL XT-150

Stage A: Placebo, Stage B: 0.15 mg/mL XT-150

Stage A: Placebo, Stage B: 0.45 mg/mL XT-150

Arm Description

Low dose active in Stage A and Stage B

Low dose active in Stage A, high dose active in Stage B

High dose active in Stage A, low dose active in Stage B

High dose active in Stage A and Stage B

Inactive comparator in Stage A, low dose active in Stage B

Inactive comparator in Stage A, high dose active in Stage B

Outcomes

Primary Outcome Measures

Stage A: Number of participants achieving 30% improvement from Baseline in Western Ontario and McMasters Arthritis Index (WOMAC) pain score
WOMAC pain score will be obtained from Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire which is a validated, commonly used instrument to assess the participant's opinion about their knee and associated problems. Each item is answered on a 5-point Likert scale. The score for pain category ranges from 0 (no pain) to 20 (maximum pain); higher score indicates worse outcomes. Baseline is defined as the Day 0 value.
Stage A: Change from Baseline in WOMAC Pain Score at Day 180
Stage A: Number of participants with adverse events (AEs) and serious adverse events (SAEs)
Stage B: Number of participants with AEs and SAEs

Secondary Outcome Measures

Stage B: Change from Baseline in WOMAC Pain Score at Day 360
Stage A and Stage B: Change from Baseline in WOMAC function score
WOMAC function score will be obtained from KOOS questionnaire which is a is a validated, commonly used instrument to assess the participant's opinion about their knee and associated problems. Each item is answered on a 5-point Likert scale. The function dimension category asks about the degree of difficulty in doing 17 activities. The score ranges from 0 (normal function) to 170 (severely limited function); higher score indicates worse outcomes. Baseline is defined as the Day 0 value.
Stage A and Stage B: Change from Baseline in Brief Pain Inventory (BPI) of Interference score
The BPI is a self-administered questionnaire for participants to rate the degree to which their pain interferes with common dimensions of feeling and function. The 7 pain interference items will be rated on 0-10 scale. Total interference score ranges from 0 (does not interfere) to 10 (completely interferes); higher score indicates worse outcomes.
Stage A and Stage B: Change from Baseline in Patients Overall Assessment (POA)
The POA is a self-administered questionnaire that records participants' responses to the question "Considering all the ways the OA in your knee affects you, how are you doing today?" on a scale of 1 to 5; 1 being very good (asymptomatic and no limitation of normal activities) to 5, very poor (very severe, intolerable symptoms and inability to carry out normal activities). Higher score indicates worse symptoms.
Stage A and B: Number of participants with presence of anti-interleukin (IL)-10 antibody

Full Information

First Posted
October 9, 2019
Last Updated
January 9, 2023
Sponsor
Xalud Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04124042
Brief Title
Efficacy and Safety of XT-150 in Osteoarthritis of the Knee
Official Title
A Double-Blind, Placebo-Controlled Assessment of the Tolerability and Efficacy of XT-150 for the Treatment of Moderate to Severe Pain Due to Osteoarthritis of the Knee
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Completed
Study Start Date
February 14, 2020 (Actual)
Primary Completion Date
April 26, 2022 (Actual)
Study Completion Date
April 26, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Xalud Therapeutics, Inc.

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 Phase 2 safety and efficacy study of XT-150 in adult participants experiencing moderate to severe pain due to osteoarthritis of the knee.
Detailed Description
In this Phase 2 study, Baseline (Day 0) confirmation of study eligibility will be completed the day before or day of study drug administration. Study drug will be administered by intra-articular (IA) injection into the joint space of the index knee (knee selected for treatment). Up to 270 participants will be randomly enrolled into 1 of 6 treatment sequences (45 participants/ group). Treatment Groups: 0.15 mg/mL XT-150 (1mL), 0.15 mg/mL XT-150 (1mL) 0.15 mg/mL XT-150 (1mL), 0.45 mg/mL XT-150 (1mL) 0.45 mg/mL XT-150 (1mL), 0.15 mg/mL XT-150 (1mL) 0.45 mg/mL XT-150 (1mL), 0.45 mg/mL XT-150 (1mL) Placebo (1mL), 0.15 mg/mL XT-150 (1mL) Placebo (1mL), 0.45 mg/mL XT-150 (1mL) The study will be conducted in 2 stages, A and B. Participants will be randomized at Day 0 to a treatment regimen, one treatment assignment for Stage A and one treatment assignment for Stage B: Stage A (Up to Day 180): Participants will receive placebo, 0.15 mg/mL XT-150 or 0.45 mg/mL XT-150 to the index knee at Day 0. Stage B (Day 180 to Day 360): Participants will have the option to receive a pre-randomized dose (XT-150 0.15 mg/mL or 0.45 mg/mL) to the index knee anytime between Day 180 and Day 330. Final assessments will be 12 months after the first IA dose.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee
Keywords
Inflammation, Pain, Interleukin, Gene Therapy, plasmid DNA

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Stage A: 0.15 mg/mL XT-150, Stage B: 0.15 mg/mL XT-150
Arm Type
Experimental
Arm Description
Low dose active in Stage A and Stage B
Arm Title
Stage A: 0.15 mg/mL XT-150, Stage B: 0.45 mg/mL XT-150
Arm Type
Experimental
Arm Description
Low dose active in Stage A, high dose active in Stage B
Arm Title
Stage A: 0.45 mg/mL XT-150, Stage B: 0.15 mg/mL XT-150
Arm Type
Experimental
Arm Description
High dose active in Stage A, low dose active in Stage B
Arm Title
Stage A: 0.45 mg/mL XT-150, Stage B: 0.45 mg/mL XT-150
Arm Type
Experimental
Arm Description
High dose active in Stage A and Stage B
Arm Title
Stage A: Placebo, Stage B: 0.15 mg/mL XT-150
Arm Type
Placebo Comparator
Arm Description
Inactive comparator in Stage A, low dose active in Stage B
Arm Title
Stage A: Placebo, Stage B: 0.45 mg/mL XT-150
Arm Type
Placebo Comparator
Arm Description
Inactive comparator in Stage A, high dose active in Stage B
Intervention Type
Biological
Intervention Name(s)
XT-150
Intervention Description
plasmid DNA
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo is a sterile phosphate-buffered saline
Primary Outcome Measure Information:
Title
Stage A: Number of participants achieving 30% improvement from Baseline in Western Ontario and McMasters Arthritis Index (WOMAC) pain score
Description
WOMAC pain score will be obtained from Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire which is a validated, commonly used instrument to assess the participant's opinion about their knee and associated problems. Each item is answered on a 5-point Likert scale. The score for pain category ranges from 0 (no pain) to 20 (maximum pain); higher score indicates worse outcomes. Baseline is defined as the Day 0 value.
Time Frame
Up to Day 180
Title
Stage A: Change from Baseline in WOMAC Pain Score at Day 180
Time Frame
At Day 180
Title
Stage A: Number of participants with adverse events (AEs) and serious adverse events (SAEs)
Time Frame
Up to Day 180
Title
Stage B: Number of participants with AEs and SAEs
Time Frame
Up to Day 360
Secondary Outcome Measure Information:
Title
Stage B: Change from Baseline in WOMAC Pain Score at Day 360
Time Frame
At Day 360
Title
Stage A and Stage B: Change from Baseline in WOMAC function score
Description
WOMAC function score will be obtained from KOOS questionnaire which is a is a validated, commonly used instrument to assess the participant's opinion about their knee and associated problems. Each item is answered on a 5-point Likert scale. The function dimension category asks about the degree of difficulty in doing 17 activities. The score ranges from 0 (normal function) to 170 (severely limited function); higher score indicates worse outcomes. Baseline is defined as the Day 0 value.
Time Frame
Up to Day 360
Title
Stage A and Stage B: Change from Baseline in Brief Pain Inventory (BPI) of Interference score
Description
The BPI is a self-administered questionnaire for participants to rate the degree to which their pain interferes with common dimensions of feeling and function. The 7 pain interference items will be rated on 0-10 scale. Total interference score ranges from 0 (does not interfere) to 10 (completely interferes); higher score indicates worse outcomes.
Time Frame
Up to Day 360
Title
Stage A and Stage B: Change from Baseline in Patients Overall Assessment (POA)
Description
The POA is a self-administered questionnaire that records participants' responses to the question "Considering all the ways the OA in your knee affects you, how are you doing today?" on a scale of 1 to 5; 1 being very good (asymptomatic and no limitation of normal activities) to 5, very poor (very severe, intolerable symptoms and inability to carry out normal activities). Higher score indicates worse symptoms.
Time Frame
Up to Day 360
Title
Stage A and B: Number of participants with presence of anti-interleukin (IL)-10 antibody
Time Frame
Up to Day 360

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Symptomatic disease due to osteoarthritis, defined as a WOMAC Pain score ≥ 8 (worst possible = 20) Focused Analgesia Selection Test will be used to determine whether patients can report pain with sufficient consistency to enter the clinical trial Males and females between 45 and 85 years of age, inclusive Kellgren-Lawrence grading of 2 or 3 within the last 6 months Stable analgesic regimen during the 4 weeks prior to enrollment In the judgment of the Investigator, acceptable general medical condition Life expectancy >6 months Male and female participants who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study Have suitable knee joint anatomy for intra-articular injection Willing and able to return for the follow-up (FU) visits Able to read and understand study instructions, and willing and able to comply with all study procedures Exclusion Criteria: Hypersensitivity, allergy, or significant reaction to any ingredient of the study drug, including double-stranded DNA, mannose, and sucrose Previously received XT-150 injection(s) Scheduled partial or complete knee replacement within 6 months; participant agrees not to schedule a knee replacement during Stage A of the study History of knee arthroplasty on the Index Knee, i.e., selected for study injection(s) History of rheumatoid arthritis or other inflammatory disease History of immunosuppressive therapy; systemic steroids in the last 3 months Received knee injection with hyaluronic acid or stem-cells in the last 6 months Knee injection of glucocorticoid in the last 3 months Current treatment with systemic immunosuppressive (systemic corticosteroid therapy or other strong immunosuppressant) Currently receiving systemic chemotherapy or radiation therapy for malignancy Clinically significant hepatic disease as indicated by clinical laboratory results ≥3 times the upper limit of normal for any liver function test (e.g., aspartate aminotransferase, alanine aminotransferase) Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), Grade 1 white cell counts (lymphocytes <LLN - 800/mm^3; <LLN - 0.8 x 109 /L, neutrophils <LLN - 1500/mm^3; <LLN - 1.5 x 109 /L), LLN=Lower Limit Normal Range Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus Significant neuropsychiatric conditions; dementia, major depression, or altered mental state that in the opinion of the Investigator will interfere with study participation Current treatment with systemic antibiotics or antivirals (EXCEPTION: topical treatments) Current anticoagulant or anti-platelet treatment (e.g., warfarin, heparins, factor X inhibitors, clopidogrel, prasugrel, ticagrelor, or dipyridamole). Low-dose (≤ 325 mg/day) aspirin is permitted Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit Use of any investigational drug or device within 3 months before enrollment or current participation in a trial that included intervention with a drug or device; or currently participating in an investigational drug or device study Any condition that, in the opinion of the Investigator, could compromise the safety of the participant, the participant's ability to communicate with the study staff, or the quality of the data
Facility Information:
Facility Name
eStudySite
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Neurovations (Napa Pain Institute)
City
Napa
State/Province
California
ZIP/Postal Code
94558
Country
United States
Facility Name
Source Healthcare
City
Santa Monica
State/Province
California
ZIP/Postal Code
90403
Country
United States
Facility Name
Carolinas Clinical Research Institute
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
University of Adelaide in collaboration with CMAX Clinical Research Pty Ltd
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5005
Country
Australia
Facility Name
Alfred Health
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Efficacy and Safety of XT-150 in Osteoarthritis of the Knee

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