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Safety of Use of Pandora for Patients Suffering From Gonarthrosis (PANDORA1)

Primary Purpose

Knee Osteoarthritis

Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Intra-articular single injection
Intra-articular three injections
Sponsored by
Labrha
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis

Eligibility Criteria

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

Twenty patients having a gonarthrosis asserted radiologically and justifying according to the opinion of the rheumatologist a viscosupplementation.

Inclusion Criteria:

  • Patient aged between 35 and 85 years.
  • Body mass index (BMI) < 30 kg.m^2.
  • Medial or lateral femoro-tibial knee osteoarthritis, diagnosed according to the American College of Rheumatology criteria, radiological stage 2 and 3 according to the Kellgren-Lawrence criteria modified by Felson on an X-ray, of the knee in extension, less than 12 months old.
  • Knee osteoarthritis responsible for walking pain in the target knee, assessed between 4 and 8 inclusive on an 11 points numerical scale (0 = none to 10 = extreme).
  • Ambulatory patient able to walk 50 meters without a cane, crutch or walker.
  • Patient able to read, understand, sign and date the patient information sheet.
  • Patient agreeing to follow-up study visits.
  • Patient affiliated to the health social security system.
  • Patient requiring viscosupplementation according to the investigator.

Exclusion Criteria:

  • Patient presenting knee osteoarthritis without impingement joint space narrowing of the femoro-tibial compartment (modified Kellgren stage 0-1) or with complete impingement joint space narrowing on the knee weight-bearing radiograph in extension (modified Kellgren stage 4).
  • Walking pain in the target knee, rated less than 4 or more than 8 on an 11-point numerical scale (0 = none to 10 = extreme).
  • Patient with a flare of osteoarthritis of the target or contralateral knee attested by KOFUS criteria ≥ 7.
  • Patient who received viscosupplementation or Platelet Rich Plasma (PRP) injection in the 6 months prior to inclusion.
  • Patient who received an intra-articular injection of corticosteroids in the target knee in the 2 months prior to inclusion.
  • Patients with a skin condition or a wound next to or near the injection site.
  • Patients refusing to discontinue treatment with NSAIDs or cox-2 inhibitors during the follow-up period.
  • Patient receiving treatment with level III analgesics (strong opioids).
  • Patients receiving treatment with diacerhein, avocado and soy unsaponifiables, glucosamine or chondroitin initiated less than 2 months prior to inclusion.
  • Patient with hypersensitivity to hyaluronic acid or tranexamic acid.
  • Patient with a history of seizures.
  • Patient who had arthroscopy of the target knee or major trauma to the target knee during the 3 months preceding inclusion.
  • Patient scheduled to undergo surgery, for any cause, of the target knee or other joint of the lower limbs, planned within 6 months of inclusion, likely to interfere with follow-up or evaluation of the patient in the study.
  • Patient with Fibromyalgia.
  • Patient with an active neurological or vascular musculoskeletal disorder (such as rheumatoid arthritis, lupus, psoriatic arthritis, spondyloarthritis or any other autoimmune disease, Paget's disease, gout, coxopathy, tendinopathy of the lower limb, sciatic or crural radiculalgia) that could interfere with the measurement of the effectiveness of the treatment of the knee evaluated.
  • Patient with hemostasis disorders, venous or lymphatic stenosis of the lower limbs, history of thromboembolic disease - phlebitis or pulmonary embolism - or a high risk of thromboembolism.
  • Patients with an evolving general cardiac, digestive, endocrine, haematological or broncho-pulmonary condition which, in the opinion of the investigator, would be likely to disrupt regular monitoring and/or interfere with the measurement of treatment efficacy .
  • Breastfeeding patient, pregnant or wishing to be during the 6 months of the study.
  • Patient unable to give personal consent.
  • Patient with renal insufficiency.

Sites / Locations

  • Hôpital Nord Franche-Comté, HNFC
  • Groupe Hospitalier de la Région Mulhouse Sud-Alsace, GHRMSA

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Medical Device : Happyone

Medical Device : Happysoft

Arm Description

Hyaluronic acid associated with tranexamic acid ; 4.8 ml will be injected in one time

Hyaluronic acid associated with tranexamic acid ; 2.2 ml will be injected in three times (one injection per week)

Outcomes

Primary Outcome Measures

Number of adverse event attributable to the investigational Medical Device during the week following each injection.
Adverse events will be collected at : Day 8 for Happyone arm (single injection) ; Days 8, 15 and 22 for Happysoft arm (three injections).

Secondary Outcome Measures

Number of adverse events during the month following the first injection for immediate and delayed local tolerance evaluation.
All adverse events will be collected at : Days 3, 8, 22 and 29 for Happyone arm (single injection) ; Days 3, 8, 10, 15, 17, 22 and 29 for Happysoft arm (three injections). Number of adverse events occurring beyond the week following each injection from Day 1 to D29.
Patient self-assesment of the overall tolerance of the treatment based on a 5-point scale, from "Very bad" to "Very good".
This questionnaire will be completed at : Days 3, 8, 22 and 29 for Happyone arm (single injection) ; Days 3, 8, 10, 15, 17, 22 and 29 for Happysoft arm (three injections).
Variation over time of the WOMAC score, between time of injection and end point, and the WOMAC subscores A (pain) and C (function). The WOMAC-Questionnaire is based on a 11 points scale, from 0 = None to 10 = Extreme.
This questionnaire will be completed at : Day 1, Day 8, Month 1, Month 3 and Month 6 for Happyone arm (single injection) ; Day 1, Day 8, Day 15, Month 1, Month 3 and Month 6 for Happysoft arm (three injections).
Patient self-assesment of the effectiveness of the treatment based on a 11 points numeric scale, from 0 = None to 10 = Total.
This questionnaire will be completed at Months 1, 3 and 6 for both groups.

Full Information

First Posted
June 2, 2022
Last Updated
June 20, 2023
Sponsor
Labrha
Collaborators
Statitec
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1. Study Identification

Unique Protocol Identification Number
NCT05414617
Brief Title
Safety of Use of Pandora for Patients Suffering From Gonarthrosis
Acronym
PANDORA1
Official Title
Prospective, Multicenter, Open Study Evaluating the Short-term Safety of Use of Pandora Administered in the Form of 1 Intra-articular Injection of Happyone or 3 Intra-articular Injections of Happysoft in Patients Suffering From Gonarthrosis
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
June 8, 2022 (Actual)
Primary Completion Date
January 18, 2023 (Actual)
Study Completion Date
June 14, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Labrha
Collaborators
Statitec

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The knee osteoarthritis is a frequent degenerative condition that mainly affects subjects over 60, population often weakened by numerous comorbidities and concomitant treatments, justifying the development of new therapies. The viscosupplementation is a symptomatic treatment for knee osteoarthritis ; the objective of this intra-articular injection of hyaluronic acid is to reduce knee pain and improve mobility. In practice, there are two protocols to administer viscosupplementation : in a single injection or in three injections performed weekly. The present clinical investigation has the objective to evaluate the safety of use of Pandora in a single injection or in three injections performed weekly.
Detailed Description
This clinical investigation is a multicenter, prospective, open study of a class III Medical Device. This study is designed to evaluate the safety of use of Pandora in its two forms : in a single injection or in three injections. A descriptive analysis will be carried out to characterize the demographic data, the history of the disease and its treatments, the clinical and radiological data of the patients at inclusion. The security of use of Pandora will be demonstrated by describing the proportion of patients with at least one adverse event attributable to the treatment, occurring during the week following each injection. In total, 20 participants will be enrolled across two study centers in France, 10 participants in each centers. The total duration of subjects participation is 6 months ; overall study duration including the enrollment period is expected to take approximately 9 months.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Prospective, Multi-center, Open Clinical Investigation. Two facilities are participating ; each facility will be in charge and perform a type of viscosupplementation procedure : single injection or three injections. Subjects will received one or the other viscosupplementation depending of the facility in which they will be included.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Medical Device : Happyone
Arm Type
Experimental
Arm Description
Hyaluronic acid associated with tranexamic acid ; 4.8 ml will be injected in one time
Arm Title
Medical Device : Happysoft
Arm Type
Experimental
Arm Description
Hyaluronic acid associated with tranexamic acid ; 2.2 ml will be injected in three times (one injection per week)
Intervention Type
Device
Intervention Name(s)
Intra-articular single injection
Intervention Description
Both groups will receive their first injection after a selection visit ; first injection will be planned between 7 days to 30 days after to confirm the enrollment. The injection will be performed at Day 1.
Intervention Type
Device
Intervention Name(s)
Intra-articular three injections
Intervention Description
Both groups will receive their first injection after a selection visit ; first injection will be planned between 7 days to 30 days after to confirm the enrollment. The injections will be performed at Days 1, 8 and 15.
Primary Outcome Measure Information:
Title
Number of adverse event attributable to the investigational Medical Device during the week following each injection.
Description
Adverse events will be collected at : Day 8 for Happyone arm (single injection) ; Days 8, 15 and 22 for Happysoft arm (three injections).
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Number of adverse events during the month following the first injection for immediate and delayed local tolerance evaluation.
Description
All adverse events will be collected at : Days 3, 8, 22 and 29 for Happyone arm (single injection) ; Days 3, 8, 10, 15, 17, 22 and 29 for Happysoft arm (three injections). Number of adverse events occurring beyond the week following each injection from Day 1 to D29.
Time Frame
1 month
Title
Patient self-assesment of the overall tolerance of the treatment based on a 5-point scale, from "Very bad" to "Very good".
Description
This questionnaire will be completed at : Days 3, 8, 22 and 29 for Happyone arm (single injection) ; Days 3, 8, 10, 15, 17, 22 and 29 for Happysoft arm (three injections).
Time Frame
1 month
Title
Variation over time of the WOMAC score, between time of injection and end point, and the WOMAC subscores A (pain) and C (function). The WOMAC-Questionnaire is based on a 11 points scale, from 0 = None to 10 = Extreme.
Description
This questionnaire will be completed at : Day 1, Day 8, Month 1, Month 3 and Month 6 for Happyone arm (single injection) ; Day 1, Day 8, Day 15, Month 1, Month 3 and Month 6 for Happysoft arm (three injections).
Time Frame
6 months
Title
Patient self-assesment of the effectiveness of the treatment based on a 11 points numeric scale, from 0 = None to 10 = Total.
Description
This questionnaire will be completed at Months 1, 3 and 6 for both groups.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
35 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Twenty patients having a gonarthrosis asserted radiologically and justifying according to the opinion of the rheumatologist a viscosupplementation. Inclusion Criteria: Patient aged between 35 and 85 years. Body mass index (BMI) < 30 kg.m^2. Medial or lateral femoro-tibial knee osteoarthritis, diagnosed according to the American College of Rheumatology criteria, radiological stage 2 and 3 according to the Kellgren-Lawrence criteria modified by Felson on an X-ray, of the knee in extension, less than 12 months old. Knee osteoarthritis responsible for walking pain in the target knee, assessed between 4 and 8 inclusive on an 11 points numerical scale (0 = none to 10 = extreme). Ambulatory patient able to walk 50 meters without a cane, crutch or walker. Patient able to read, understand, sign and date the patient information sheet. Patient agreeing to follow-up study visits. Patient affiliated to the health social security system. Patient requiring viscosupplementation according to the investigator. Exclusion Criteria: Patient presenting knee osteoarthritis without impingement joint space narrowing of the femoro-tibial compartment (modified Kellgren stage 0-1) or with complete impingement joint space narrowing on the knee weight-bearing radiograph in extension (modified Kellgren stage 4). Walking pain in the target knee, rated less than 4 or more than 8 on an 11-point numerical scale (0 = none to 10 = extreme). Patient with a flare of osteoarthritis of the target or contralateral knee attested by KOFUS criteria ≥ 7. Patient who received viscosupplementation or Platelet Rich Plasma (PRP) injection in the 6 months prior to inclusion. Patient who received an intra-articular injection of corticosteroids in the target knee in the 2 months prior to inclusion. Patients with a skin condition or a wound next to or near the injection site. Patients refusing to discontinue treatment with NSAIDs or cox-2 inhibitors during the follow-up period. Patient receiving treatment with level III analgesics (strong opioids). Patients receiving treatment with diacerhein, avocado and soy unsaponifiables, glucosamine or chondroitin initiated less than 2 months prior to inclusion. Patient with hypersensitivity to hyaluronic acid or tranexamic acid. Patient with a history of seizures. Patient who had arthroscopy of the target knee or major trauma to the target knee during the 3 months preceding inclusion. Patient scheduled to undergo surgery, for any cause, of the target knee or other joint of the lower limbs, planned within 6 months of inclusion, likely to interfere with follow-up or evaluation of the patient in the study. Patient with Fibromyalgia. Patient with an active neurological or vascular musculoskeletal disorder (such as rheumatoid arthritis, lupus, psoriatic arthritis, spondyloarthritis or any other autoimmune disease, Paget's disease, gout, coxopathy, tendinopathy of the lower limb, sciatic or crural radiculalgia) that could interfere with the measurement of the effectiveness of the treatment of the knee evaluated. Patient with hemostasis disorders, venous or lymphatic stenosis of the lower limbs, history of thromboembolic disease - phlebitis or pulmonary embolism - or a high risk of thromboembolism. Patients with an evolving general cardiac, digestive, endocrine, haematological or broncho-pulmonary condition which, in the opinion of the investigator, would be likely to disrupt regular monitoring and/or interfere with the measurement of treatment efficacy . Breastfeeding patient, pregnant or wishing to be during the 6 months of the study. Patient unable to give personal consent. Patient with renal insufficiency.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Charles Balblanc, MD
Organizational Affiliation
Hôpital Nord Franche-Comté, HNFC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Nord Franche-Comté, HNFC
City
Belfort
Country
France
Facility Name
Groupe Hospitalier de la Région Mulhouse Sud-Alsace, GHRMSA
City
Mulhouse
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
32931933
Citation
Sellam J, Courties A, Eymard F, Ferrero S, Latourte A, Ornetti P, Bannwarth B, Baumann L, Berenbaum F, Chevalier X, Ea HK, Fabre MC, Forestier R, Grange L, Lellouche H, Maillet J, Mainard D, Perrot S, Rannou F, Rat AC, Roux CH, Senbel E, Richette P; French Society of Rheumatology. Recommendations of the French Society of Rheumatology on pharmacological treatment of knee osteoarthritis. Joint Bone Spine. 2020 Dec;87(6):548-555. doi: 10.1016/j.jbspin.2020.09.004. Epub 2020 Sep 12.
Results Reference
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PubMed Identifier
15455338
Citation
Balazs EA. Viscosupplementation for treatment of osteoarthritis: from initial discovery to current status and results. Surg Technol Int. 2004;12:278-89.
Results Reference
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PubMed Identifier
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Citation
Concoff A, Sancheti P, Niazi F, Shaw P, Rosen J. The efficacy of multiple versus single hyaluronic acid injections: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017 Dec 21;18(1):542. doi: 10.1186/s12891-017-1897-2.
Results Reference
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PubMed Identifier
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Citation
Diracoglu D, Tuncay TB, Sahbaz T, Aksoy C. Single versus multiple dose hyaluronic acid: Comparison of the results. J Back Musculoskelet Rehabil. 2016 Nov 21;29(4):881-886. doi: 10.3233/BMR-160714.
Results Reference
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PubMed Identifier
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Citation
Bhadra AK, Altman R, Dasa V, Myrick K, Rosen J, Vad V, Vitanzo P Jr, Bruno M, Kleiner H, Just C. Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States. Cartilage. 2017 Jul;8(3):234-254. doi: 10.1177/1947603516662503. Epub 2016 Aug 10.
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Li J, Liu R, Rai S, Ze R, Tang X, Hong P. Intra-articular vs. intravenous administration: a meta-analysis of tranexamic acid in primary total knee arthroplasty. J Orthop Surg Res. 2020 Dec 2;15(1):581. doi: 10.1186/s13018-020-02119-1.
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Jules-Elysee KM, Tseng A, Sculco TP, Baaklini LR, McLawhorn AS, Pickard AJ, Qin W, Cross JR, Su EP, Fields KG, Mayman DJ. Comparison of Topical and Intravenous Tranexamic Acid for Total Knee Replacement: A Randomized Double-Blinded Controlled Study of Effects on Tranexamic Acid Levels and Thrombogenic and Inflammatory Marker Levels. J Bone Joint Surg Am. 2019 Dec 4;101(23):2120-2128. doi: 10.2106/JBJS.19.00258.
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Safety of Use of Pandora for Patients Suffering From Gonarthrosis

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